Urinary tract infections older adults at Mohammed VI University Hospital of Oujda: case series

Abstract

Background: Due to its incidence, clinical polymorphism and severity, urinary tract infection is an important problem in elderly. The objectives of the authors’ work were to establish the bacteriological profile of urinary tract infection and/or colonization in the elderly and then to study drug resistance of bacterial strains isolated. Materials and methods: This is a 36 months retrospective study from 22 March 2016 to 11 May 2019. The study included urinary specimens of persons aged 65 years or over, hospitalized or consulting at the authors’ hospital. Urines were processed according to the recommendations of the medical microbiology reference system and European Committee on Antimicrobial Susceptibility Testing. Results: The authors collected 6552 requests for cytobacteriological examination of urine. Most of the specimens was collected in the middle stream (n=5503; 84%). Cultures were sterile in 49.77% of cases. Positive in 50.22% of cases. Among positive samples we had 53.41% polymorphic cultures, 32.75% urinary tract infection, and 13.82% urinary tract colonization. Gender distribution showed a sex ratio at 0.62. Gram-negative bacilli, with Escherichia coli as the main species, dominated the isolated bacteria. Resistance rates of E. coli strains that we isolated were 70% for amoxicillin, 36.31% for amoxicillin-clavulanate and 25% for ciprofloxacin. A high resistance rate was seen for third generation cephalosporins. Least resistance recorded to nitrofurantoin. Conclusion: ITU in the elderly is diverse and significantly different from that of younger patients, through its high contamination rate, difficulty in acquiring clinical information, high rate of asymptomatic bacteriuria, and high proportion of multidrug resistant bacteria.

Educational interventions to prevent urinary infections in institutionalized elderly people. Quasi-experimental Study

“… 14 On the other hand, nursing activities cause work overload and are not restricted, in most cases, exclusively to the ILPI, as most professionals have an employment bond with other healthcare spaces. 10 , 12 - 14 Among the aspects related to the knowledge of signs, symptoms and treatment (Blocks of Questions A, B and C), all participants were unaware that in UTI, the absence of fever in the elderly may occur due to a senescent change in their thermoregulation, leading to a lowest basal temperature in the elderly; 2 , 16 therefore, this is not an absolute sign of UTI, and other changes must be observed for an accurate diagnosis. 7 - 9 …”

“… 1 However, institutionalization increases the propensity for developing infections, such as urinary infections, one of the most prevalent in this population group, ranging from 12 to 30%. 2 The risk factors are varied and can be linked to the condition of senescence itself as there is a decrease in the body’s defense mechanisms, as well as to the fact that they live in a community space that favors the transmission between residents, in addition to factors such as the unnecessary use of antibiotics, the frequent use of diuretics, incontinence, the use of diapers and dehydration. 3 Recognizing these factors and promoting actions that reduce urinary infection rates are aspects that must permeate the practices of the nursing and caregiving teams, as these are the professionals who are constantly accompanying the elderly.…”