A Cross-Sectional Assessment of Urinary Tract Infections Among Geriatric Patients: Prevalence, Medication Regimen Complexity, and Factors Associated With Treatment Outcomes

Overview

Journal Front Public Health

Specialty Public Health

Date 2021 Nov 4

PMID 34733812

Citations 7

Authors

Ali Akhtar

Mohamed Azmi Ahmad Hassali

Hadzliana Zainal

Irfhan Ali

Amer Hayat Khan

Affiliations

Soon will be listed here.

Abstract

Urinary tract infections (UTIs) are the second most prevalent infection among the elderly population. Hence, the current study aimed to evaluate the prevalence of UTIs among older adults, medication regimen complexity, and the factors associated with the treatment outcomes of elderly patients infected with UTIs. A retrospective cross-sectional study was conducted at the Department of Urology, Hospital Pulau Pinang, Malaysia. The patients ≥65 years of age were included in the present study with a confirmed diagnosis of UTIs from 2014 to 2018 (5 years). A total of 460 patients met the inclusion criteria and were included in the present study. Cystitis (37.6%) was the most prevalent UTI among the study population followed by asymptomatic bacteriuria (ASB) (31.9%), pyelonephritis (13.9%), urosepsis (10.2%), and prostatitis (6.4%). Unasyn (ampicillin and sulbactam) was used to treat the UTIs followed by Bactrim (trimethoprim/sulfamethoxazole), and ciprofloxacin. The factors associated with the treatment outcomes of UTIs were gender (odd ratio [] = 1.628; = 0.018), polypharmacy ( = 0.647; = 0.033), and presence of other comorbidities ( = 2.004; = 0.002) among the study population. Cystitis is the most common UTI observed in older adults. Gender, the burden of polypharmacy, and the presence of comorbidities are the factors that directly affect the treatment outcomes of UTIs among the study population.

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References

Eriksson I, Gustafson Y, Fagerstrom L, Olofsson B . Prevalence and factors associated with urinary tract infections (UTIs) in very old women. Arch Gerontol Geriatr. 2009; 50(2):132-5. DOI: 10.1016/j.archger.2009.02.013. View

Sewify M, Nair S, Warsame S, Murad M, Alhubail A, Behbehani K . Prevalence of Urinary Tract Infection and Antimicrobial Susceptibility among Diabetic Patients with Controlled and Uncontrolled Glycemia in Kuwait. J Diabetes Res. 2016; 2016:6573215. PMC: 4710901. DOI: 10.1155/2016/6573215. View

Nace D, Drinka P, Crnich C . Clinical uncertainties in the approach to long term care residents with possible urinary tract infection. J Am Med Dir Assoc. 2014; 15(2):133-9. DOI: 10.1016/j.jamda.2013.11.009. View

Hooton T, Scholes D, Hughes J, Winter C, Roberts P, Stapleton A . A prospective study of risk factors for symptomatic urinary tract infection in young women. N Engl J Med. 1996; 335(7):468-74. DOI: 10.1056/NEJM199608153350703. View

Muller L, Gorter K, Hak E, Goudzwaard W, Schellevis F, Hoepelman A . Increased risk of common infections in patients with type 1 and type 2 diabetes mellitus. Clin Infect Dis. 2005; 41(3):281-8. DOI: 10.1086/431587. View

Harrington R, Hooton T . Urinary tract infection risk factors and gender. J Gend Specif Med. 2001; 3(8):27-34. View

Gharbi M, Drysdale J, Lishman H, Goudie R, Molokhia M, Johnson A . Antibiotic management of urinary tract infection in elderly patients in primary care and its association with bloodstream infections and all cause mortality: population based cohort study. BMJ. 2019; 364:l525. PMC: 6391656. DOI: 10.1136/bmj.l525. View

Drekonja D, Rector T, Cutting A, Johnson J . Urinary tract infection in male veterans: treatment patterns and outcomes. JAMA Intern Med. 2012; 173(1):62-8. DOI: 10.1001/2013.jamainternmed.829. View

Casanova J . Incontinence after use of enalapril. J Urol. 1990; 143(6):1237-8. DOI: 10.1016/s0022-5347(17)40240-0. View

10.

Ruben F, Dearwater S, NORDEN C, Kuller L, Gartner K, Shalley A . Clinical infections in the noninstitutionalized geriatric age group: methods utilized and incidence of infections. The Pittsburgh Good Health Study. Am J Epidemiol. 1995; 141(2):145-57. DOI: 10.1093/oxfordjournals.aje.a117402. View

11.

Schneidinger C, Umek W, Bohmdorfer B . The Problem of Polypharmacy in Female Patients with Overactive Bladders - Cross-Sectional Study in a Specialist Outpatient Department. Geburtshilfe Frauenheilkd. 2017; 76(12):1318-1324. PMC: 5193149. DOI: 10.1055/s-0042-114221. View

12.

Ekundayo O, Markland A, Lefante C, Sui X, Goode P, Allman R . Association of diuretic use and overactive bladder syndrome in older adults: a propensity score analysis. Arch Gerontol Geriatr. 2008; 49(1):64-8. PMC: 2720316. DOI: 10.1016/j.archger.2008.05.002. View

13.

Nitzan O, Elias M, Chazan B, Saliba W . Urinary tract infections in patients with type 2 diabetes mellitus: review of prevalence, diagnosis, and management. Diabetes Metab Syndr Obes. 2015; 8:129-36. PMC: 4346284. DOI: 10.2147/DMSO.S51792. View

14.

Rahn D, Carberry C, Sanses T, Mamik M, Ward R, Meriwether K . Vaginal estrogen for genitourinary syndrome of menopause: a systematic review. Obstet Gynecol. 2014; 124(6):1147-1156. PMC: 4855283. DOI: 10.1097/AOG.0000000000000526. View

15.

Geerlings S, Meiland R, van Lith E, Brouwer E, Gaastra W, Hoepelman A . Adherence of type 1-fimbriated Escherichia coli to uroepithelial cells: more in diabetic women than in control subjects. Diabetes Care. 2002; 25(8):1405-9. DOI: 10.2337/diacare.25.8.1405. View

16.

George J, Phun Y, Bailey M, Kong D, Stewart K . Development and validation of the medication regimen complexity index. Ann Pharmacother. 2004; 38(9):1369-76. DOI: 10.1345/aph.1D479. View

17.

Marcum Z, Amuan M, Hanlon J, Aspinall S, Handler S, Ruby C . Prevalence of unplanned hospitalizations caused by adverse drug reactions in older veterans. J Am Geriatr Soc. 2011; 60(1):34-41. PMC: 3258324. DOI: 10.1111/j.1532-5415.2011.03772.x. View

18.

Foxman B, Barlow R, DArcy H, Gillespie B, Sobel J . Urinary tract infection: self-reported incidence and associated costs. Ann Epidemiol. 2000; 10(8):509-15. DOI: 10.1016/s1047-2797(00)00072-7. View

19.

Jackson S, Boyko E, Scholes D, Abraham L, Gupta K, Fihn S . Predictors of urinary tract infection after menopause: a prospective study. Am J Med. 2005; 117(12):903-11. DOI: 10.1016/j.amjmed.2004.07.045. View

20.

Rowe T, Juthani-Mehta M . Urinary tract infection in older adults. Aging health. 2014; 9(5). PMC: 3878051. DOI: 10.2217/ahe.13.38. View