Evaluation of urinary tract infection in the elderly patients: a multicenter prospective study

AIM: The study aimed to ascertain the indications for urine culture in inpatients over 65, the prevalence of asymptomatic bacteriuria and urinary tract infection (UTI), and the compliance of antimicrobial treatments with national/international guidelines and their suitability for geriatric age. BACK...

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Main Authors: Cigdem Erol, Aysel Pehlivanli, Salih Riza Ozan Yildiz, Leman Elif Dogangonul Doygun, Seyma Arslan, Nermin Karakurt, Sidre Erganis, Ezgi Gulten, Duygu Ocal, Hasan Selcuk Ozger, Hacer Dogan Varan, Daryoush Majidi, Huseyin Doruk, Ozlem Kurt Azap, Nurefşan Tuba Kurt
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Journal of Global Antimicrobial Resistance
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2213716524003497
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author Cigdem Erol
Aysel Pehlivanli
Salih Riza Ozan Yildiz
Leman Elif Dogangonul Doygun
Seyma Arslan
Nermin Karakurt
Sidre Erganis
Ezgi Gulten
Duygu Ocal
Hasan Selcuk Ozger
Hacer Dogan Varan
Daryoush Majidi
Huseyin Doruk
Ozlem Kurt Azap
Nurefşan Tuba Kurt
author_facet Cigdem Erol
Aysel Pehlivanli
Salih Riza Ozan Yildiz
Leman Elif Dogangonul Doygun
Seyma Arslan
Nermin Karakurt
Sidre Erganis
Ezgi Gulten
Duygu Ocal
Hasan Selcuk Ozger
Hacer Dogan Varan
Daryoush Majidi
Huseyin Doruk
Ozlem Kurt Azap
Nurefşan Tuba Kurt
author_sort Cigdem Erol
collection DOAJ
description AIM: The study aimed to ascertain the indications for urine culture in inpatients over 65, the prevalence of asymptomatic bacteriuria and urinary tract infection (UTI), and the compliance of antimicrobial treatments with national/international guidelines and their suitability for geriatric age. BACKGROUND: UTIs are the most common bacterial infection in the elderly population and cause morbidity and mortality. METHODS: A multicenter, prospective observational study was conducted, including elderly patients who were sent urine cultures. Demographic profiles, clinical and laboratory features, antimicrobial susceptibility patterns, and outcomes were documented and analysed. RESULTS: A total of 550 urine cultures taken from 3 university hospitals were included and 382 patients (71.0%) with infectious diseases (ID) consultation were evaluated. The most common reasons to perform urine culture are the presence of symptoms (22.0%), elevation of C-reactive protein (19.3%), and the search for focus on infection (15.8%). The microorganism growth rate in urine cultures evaluated by ID specialists was 41.4% (158/382). The gram-negative bacteria isolation rate was 68.6%, while the gram-positive and candida growth rates were 17.3% and 14.1%, respectively. E. coli and K. pneumoniae were the most frequent bacteria (43.7% and 21.5%). The prevalence of asymptomatic bacteriuria was 11.4%, and 27.8% of these patients were prescribed antibiotics. A total of 136 of 158 patients (86.1%) with growth in urine culture died, and the mortality rate was higher than patients without bacteriuria (p <0.001). CONCLUSIONS: Mortality rate is very high in elderly patients with UTIs. There is an urgent need for antimicrobial stewardship programs in this group.
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spelling doaj-art-4e6ecfecae4949a9b8a9f88fed5809572025-08-20T01:57:48ZengElsevierJournal of Global Antimicrobial Resistance2213-71652024-12-01395410.1016/j.jgar.2024.10.172Evaluation of urinary tract infection in the elderly patients: a multicenter prospective studyCigdem Erol0Aysel Pehlivanli1Salih Riza Ozan Yildiz2Leman Elif Dogangonul Doygun3Seyma Arslan4Nermin Karakurt5Sidre Erganis6Ezgi Gulten7Duygu Ocal8Hasan Selcuk Ozger9Hacer Dogan Varan10Daryoush Majidi11Huseyin Doruk12Ozlem Kurt Azap13Nurefşan Tuba Kurt14Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Baskent University, Ankara, TurkeyDepartment of Pharmacology, Faculty of Pharmacy, Baskent University, Ankara, Turkey, Clinical Pharmacy and Drug Information Center, Baskent University Ankara Hospital, Ankara, TurkeyDepartment of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Baskent University, Ankara, TurkeyDepartment of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ankara University, Ankara, TurkeyDepartment of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Gazi University, Ankara, TurkeyDivision of Geriatric Medicine, Department of Internal Medical Sciences, Faculty of Medicine, Gazi University, Ankara, TurkeyDepartment of Medical Microbiology, Faculty of Medicine, Gazi University, Ankara, TurkeyDepartment of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ankara University, Ankara, TurkeyDepartment of Medical Microbiology, Faculty of Medicine, Ankara University, Ankara, TurkeyDepartment of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Gazi University, Ankara, TurkeyDivision of Geriatric Medicine, Department of Internal Medical Sciences, Faculty of Medicine, Gazi University, Ankara, TurkeyDivision of Geriatric Medicine, Department of Internal Medical Sciences, Faculty of Medicine, Baskent University, Ankara, TurkeyDivision of Geriatric Medicine, Department of Internal Medical Sciences, Faculty of Medicine, Baskent University, Ankara, TurkeyDepartment of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Baskent University, Ankara, TurkeyDepartment of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Baskent University, Ankara, TurkeyAIM: The study aimed to ascertain the indications for urine culture in inpatients over 65, the prevalence of asymptomatic bacteriuria and urinary tract infection (UTI), and the compliance of antimicrobial treatments with national/international guidelines and their suitability for geriatric age. BACKGROUND: UTIs are the most common bacterial infection in the elderly population and cause morbidity and mortality. METHODS: A multicenter, prospective observational study was conducted, including elderly patients who were sent urine cultures. Demographic profiles, clinical and laboratory features, antimicrobial susceptibility patterns, and outcomes were documented and analysed. RESULTS: A total of 550 urine cultures taken from 3 university hospitals were included and 382 patients (71.0%) with infectious diseases (ID) consultation were evaluated. The most common reasons to perform urine culture are the presence of symptoms (22.0%), elevation of C-reactive protein (19.3%), and the search for focus on infection (15.8%). The microorganism growth rate in urine cultures evaluated by ID specialists was 41.4% (158/382). The gram-negative bacteria isolation rate was 68.6%, while the gram-positive and candida growth rates were 17.3% and 14.1%, respectively. E. coli and K. pneumoniae were the most frequent bacteria (43.7% and 21.5%). The prevalence of asymptomatic bacteriuria was 11.4%, and 27.8% of these patients were prescribed antibiotics. A total of 136 of 158 patients (86.1%) with growth in urine culture died, and the mortality rate was higher than patients without bacteriuria (p <0.001). CONCLUSIONS: Mortality rate is very high in elderly patients with UTIs. There is an urgent need for antimicrobial stewardship programs in this group.http://www.sciencedirect.com/science/article/pii/S2213716524003497urinary tract infectionelderly patientsasymptomatic bacteriuria
spellingShingle Cigdem Erol
Aysel Pehlivanli
Salih Riza Ozan Yildiz
Leman Elif Dogangonul Doygun
Seyma Arslan
Nermin Karakurt
Sidre Erganis
Ezgi Gulten
Duygu Ocal
Hasan Selcuk Ozger
Hacer Dogan Varan
Daryoush Majidi
Huseyin Doruk
Ozlem Kurt Azap
Nurefşan Tuba Kurt
Evaluation of urinary tract infection in the elderly patients: a multicenter prospective study
Journal of Global Antimicrobial Resistance
urinary tract infection
elderly patients
asymptomatic bacteriuria
title Evaluation of urinary tract infection in the elderly patients: a multicenter prospective study
title_full Evaluation of urinary tract infection in the elderly patients: a multicenter prospective study
title_fullStr Evaluation of urinary tract infection in the elderly patients: a multicenter prospective study
title_full_unstemmed Evaluation of urinary tract infection in the elderly patients: a multicenter prospective study
title_short Evaluation of urinary tract infection in the elderly patients: a multicenter prospective study
title_sort evaluation of urinary tract infection in the elderly patients a multicenter prospective study
topic urinary tract infection
elderly patients
asymptomatic bacteriuria
url http://www.sciencedirect.com/science/article/pii/S2213716524003497
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