Der Urologe

, Volume 55, Issue 4, pp 494–498 | Cite as

Harnwegsinfektionen im Alter

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Zusammenfassung

Harnwegsinfektion (HWI) und asymptomatische Bakteriurie sind ein verbreitetes Krankheitsbild im Alter. Im Gegensatz zu jüngeren Erwachsenen ist die Unterscheidung zwischen HWI und asymptomatischer Bakteriurie im Alter, speziell bei Patienten im Altenheim, häufig, aufgrund begleitender Faktoren, wie z. B. überaktive Harnblase, Prostatavergrößerung, Blasendauerkatheter etc., schwerer. Fehlende Standards in der Definition und Therapie im Alter sowie eingeschränkte Anamneseerhebung führen häufig zu einer Übertherapie einer vermuteten Harnwegsinfektion. Als Folge steigt der Antibiotikaselektionsdruck und multiresistente Bakterienstämme können entstehen. Anderseits kann eine insuffiziente Therapie zu einer erheblichen Steigerung der Morbidität oder zur Entwicklung hochakuter Krankheitsverläufe führen. In diesem Artikel wollen wir einen Überblick zu Definition, Prävalenz, Management sowie Prävention von HWI bei älteren Patienten geben.

Schlüsselwörter

Harnwegsinfektion Asymptomatische Bakteriurie Ältere Patienten Antibiotikatherapie Diagnostik 

Urinary tract infections in the elderly

Abstract

Urinary tract infections (UTIs) and asymptomatic bacteriuria are frequent in elderly patients. Distinguishing UTI from asymptomatic bacteriuria in older adults, particularly those living in long-term care facilities, might be a challenge for physicians due to the presence of confounding factors, such as an overactive bladder, prostate enlargement, and an indwelling bladder catheter. The absence of standards in the definition and treatment of UTI in the elderly frequently leads to overtreatment. Consequently, antibiotic selection pressure increases and as a result multidrug-resistant organisms might arise. On the other hand, insufficient treatment can result in prolonged and complicated courses of infections or increased morbidity. This review covers the definition, prevalence, diagnosis and management of UTI in older adults.

Keywords

Urinary tract infection Asymptomatic bacteriuria Elderly Antibiotic treatment Diagnostic 
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Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

N. Mirsaidov und F.M.E. Wagenlehner geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführte Studien an Menschen oder Tieren.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Klinik für Urologie, Kinderurologie und AndrologieUniversitätsklinikum Gießen und Marburg GmbHGießenDeutschland

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