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Lower Urinary Tract Infections in the Elderly

  • Geriatric Bladder Dysfunction (GM Ghoniem, Section Editor)
  • Published:
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Abstract

Urinary tract infections are among the most common infections seen in both the ambulatory inpatient and nursing facility settings. Due to unique characteristics of the geriatric population, including physiology, comorbidities, and social history, incidences of these infections increase with age requiring special attention. Here, we provide an overview of the etiology, diagnosis, treatment, and prevention of urinary tract infections with focus on the geriatric patient.

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References

Papers of particular interest, published recently, have been highlighted as: •Of importance •• Of major importance

  1. Christensen KL, Holman RC, Steiner CA, Sejvar JJ, Stoll BJ, Schonberger LB. Clinical infectious disease. Infect Dis hosp US. 2009;49(7):1025–35.

    Article  Google Scholar 

  2. Centers for Disease Control. Urinary tract infections. Available online at: http://www.cdc.gov/ncidod/dbmd/diseaseinfo/urinarytractinfections_t.htm

  3. Litwin MS, Saigal CS, Beerbohm EM. The burden of urologic diseases in America. J Urol. 2005;173:1065–6.

    Article  PubMed  Google Scholar 

  4. Foxman B. Urinary tract infection syndromes: occurrence, recurrence, bacteriology, risk factors, and disease burden. Infect Dis Clin N Am. 2014;28(1):1–13. Provides recent review of epidemiolgic factors.

  5. Tal S, Guller V, Levi S, et al. Profile and prognosis of febrile elderly patients with bacteraemic urinary tract infection. J Infect. 2005;50(4):296–305.

    Article  PubMed  Google Scholar 

  6. Perrotta C, Aznar M, Mejia R, Albert X, Ng CW. Oestrogens for preventing recurrent urinary tract infection in postmenopausal women. Cochrane Database Syst Rev. 2008;16;(2)

  7. Raz R, Gennesin Y, Wasser J. Recurrent urinary tract infections in postmenopausal women. Clin Infect Dis. 2000;30:152–6.

    Article  CAS  PubMed  Google Scholar 

  8. Caljouw MA, den Elzen WP, Cools HJ, et al. Predictive factors of urinary tract infections among the oldest old in the general population. A population-based prospective follow-up study. BMC Med. 2011;9:57.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Nicolle LE. Urinary tract pathogens in complicated infection and in elderly individuals. J Infect Dis. 2001;183(1):S5–8.

    Article  PubMed  Google Scholar 

  10. Das R et al. Antimicrobial susceptibility of bacteria isolated from urine samples obtained from nursing home residents. Infect Control Hosp Epidemiol. 2009;30(11):1116–9.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Dairiki Shortliffe L, McCue J. Urinary tract infection at the age of extremes: pediatrics and geriatrics. Am J Med. 2002;113(1):55–65.

    Article  Google Scholar 

  12. Routh JC et al. Increasing prevalence and associated risk factors for methicillin resistant Staphylococcus aureus bacteriuria. J Urol. 2009;181(4):1694–8.

    Article  PubMed  Google Scholar 

  13. Mody L, Juthani-Mehta M. Urinary tract infections in older women: a clinical review. JAMA. 2014;311(8):844–54. Provides recent insight into UTIs in older women.

  14. Nicolle LE. Asymptomatic bacteriuria. Curr Opin Infect Dis. 2014;27(1):90–6. Addresses important clinical issue that is often overlooked in the treament of patients of all ages.

  15. Nicolle LE et al. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis. 2005;40(5):643–54. Provides concise guidelines that aid clinicians in reducing antibiotic overuse.

    Article  PubMed  Google Scholar 

  16. Juthani-Mehta M. Urinary tract infections in elderly persons, in online curricula: geriatric nephrology. 2009.

  17. Kaye D et al. Asymptomatic bacteriuria in the elderly. Trans Am Clin Climatol Assoc. 1989;100:155–62.

    PubMed Central  CAS  PubMed  Google Scholar 

  18. Zalmanovici Trestioreanu A, Lador A, Sauerbrun-Cutler MT, Leibovici L. Antibiotics for asymptomatic bacteriuria. Cochrane Database Syst Rev. 2015;8:4. Recent publication.

  19. Juthani-Mehta M et al. Clinical features to identify urinary tract infection in nursing home residents. J Am Geriatr Soc. 2009;57(6):963–70.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Boscia J et al. Pyuria and asymptomatic bacteriuria in elderly ambulatory women. Ann Intern Med. 1989;110:404–5.

    Article  CAS  PubMed  Google Scholar 

  21. Ouslander J et al. Pyuria among chronically incontinent but otherwise asymptomatic nursing home residents. J Am Geriatr Soc. 1996;44:420–3.

    Article  CAS  PubMed  Google Scholar 

  22. Kunin C. Urinary tract infections in females. Clin Infect Dis. 1994;18:1–12.

    Article  CAS  PubMed  Google Scholar 

  23. Deville W et al. The urine dipstick test useful to rule out infections. BMC Urol. 2004;4:4.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Nicolle LE. Urinary tract infection in geriatric and institutionalized patients. Curr Opin Urol. 2002;12(1):51–5.

    Article  PubMed  Google Scholar 

  25. Gupta K, Hooton TM, Naber KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Disease Society of America and the European Society for Microbiology and Infectious Disease. Clin Infect Dis. 2011;52:e103–20.

    Article  PubMed  Google Scholar 

  26. American Geriatrics Society, American Geriatrics Society 2012 Beers Criteria Update Expert Panel. American Geriatrics Society Updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2012;60:616–31.

    Article  Google Scholar 

  27. Bains A, Buna D, Hoag NA. A retrospective review assessing the efficacy and safety of nitrofurantoin in renal impairment. Can Pharm J. 2009;142:248–52.

    Article  Google Scholar 

  28. Williams EM, Triller DM. Recurrent acute nitrofurantoin-induced pulmonary toxicity. Pharmacotherapy. 2006;26:713–8.

    Article  PubMed  Google Scholar 

  29. Spring PJ, Sharpe DM, Hayes MW. Nitrofurantoin and peripheral neuropathy: a forgotten problem? Med J Aust. 2001;174:153–4.

    CAS  PubMed  Google Scholar 

  30. Adverse Drug Reactions Advisory Committee. Hepatic toxicity with nitrofurantoin. Aust Adverse Drug Reac Bull. 2008;27:11.

    Google Scholar 

  31. Gu Q, Dillon CF, Burt VL. Prescription drug use continues to increase: U.S. prescription drug data for 2007–2008. CDC. National Center for Health Statistics Data Brief No. 42, September 2010. Available at:http://www.cdc.gov.ezproxy.cul.columbia.edu/nchs/data/databriefs/db42.pdf

  32. Mody L, Crnich C. Effects of excessive antibiotic use in nursing homes. JAMA Intern Med. Epub June 2015. Recent publication.

  33. Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis. 2005;40(5):643–54.

    Article  PubMed  Google Scholar 

  34. Jepson RG, Williams G, Craig JC. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev. 2012;17:10. Comprehensive review.

  35. Norwood DA, Parke CK, Rappa LR. A comprehensive review of potential warfarin-fruit interactions. J Pharm Pract. 2014 Aug 11. Recent publication.

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Conflict of Interest

Marissa C. Velez, Elisabeth M. Sebesta, and Kimberly L. Cooper declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Correspondence to Kimberly L. Cooper.

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This article is part of the Topical Collection on Geriatric Bladder Dysfunction

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Velez, M.C., Sebesta, E.M. & Cooper, K.L. Lower Urinary Tract Infections in the Elderly. Curr Bladder Dysfunct Rep 10, 370–375 (2015). https://doi.org/10.1007/s11884-015-0329-0

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  • DOI: https://doi.org/10.1007/s11884-015-0329-0

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