Profiling urinary tract infections bacteria among elderly population in a Nigerian Teaching Hospital

Abstract

There have been conflicting reports about prevalence of Urinary Tract Infections (UTIs) causing bacteria in elderly in recent times. This study aims to evaluate the prevalence and resistance pattern of UTIs causing bacteria in elderly Nigerian patients. A prospective cross-sectional study was carried out among elderly patients attending the general and medical outpatients’ clinics of Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. Patients aged 60 years and above with at least two signs of UTIs were purposefully selected for the study. Clean catch mid-stream urine specimens from 100 eligible patients were examined for significant bacteriuria. Identification and antibiotics susceptibility patterns of the isolates were determined using standard techniques. Data were analysed using descriptive statistics such as frequency and percentage. Association between variables was determined using Chi-squared test. P values<0.05 were considered significant. One hundred elderly outpatients were evaluated. Majority of the study participants were males (68, 68.0%) and (64, 64.0%) were married. More than half of the participants (59, 59.0%) had no significant bacteriuria. Among the participants with significant bacteriuria (41, 41.0%), males (29/41, 70.7%, p=0.001) were more than the females (12, 29.3%). Klebsiella pneumoniae (19/41, 46.3%) was the most isolated organism in the participants’ urine specimens, (35/41, 85.4%) of the isolates were resistant to nitrofurantoin. Klebsiella pneumoniae was the most isolated UTIs-causing bacteria among the elderly evaluated. Physicians need to be aware of trends in profiles of UTIs-causing bacteria for effective diagnosis of the disease in elderly.Journal of Medical and Biomedical Sciences (2017) 6(3), 15 - 22

An Appraisal of Bacteriological Profile and Antibiogram Patterns among Elderly with Urinary–Tract-Infection: A Retrospective Study

“…The variations in the structure and microbiota between male and female genitourinary systems may play a role in the preponderance of positive culture among females [22,23]. However, in another study done in other part of Nigeria, majority of the study participants were males [10]. In addition, it was discovered in this study that elderly people between the ages of 60 and 70 had higher rates of UTI, which supports the findings of another study in Southern Nigeria [11].…”

“…Among the uropathogens analyzed from the retrospective study, Staphylococcus aureus was the most common microorganism isolated from the urine culture of the elderly. This finding was not in keeping with finding from other studies were E. coli and Klebsiella species were attributed as the most common organism causing UTI among the elderly [10,11,18,22,24]. However, other studies done found Staphylococcus aureus to be majorly responsible for the UTI [15][16][17].…”

“…There was also significant resistance to routinely used antibiotics such as Augmentin, Ceftriaxone Cefuroxime, Amoxicillin, and others. This high prevalence of resistance to routinely used antibiotics has sparked widespread concern, echoing findings from earlier studies, and there is a palpable fear that resistance may spread [10,11,18,25].…”

“…The clinical presentation of older individuals with UTI is typically unusual, with an increased risk of multiple drug load, drug-drug interaction and comorbidities [10][11][12][13][14][15][16][17][18][19][20][21][22]. As a result, identifying the pathogenic agent and its effective antibiotic sensitivity to the UTI in question plays a critical role in effective early management among the elderly around the world [12,18,22].…”

“…Globally, it has been estimated that the prevalence of UTI among the elderly in noninstitutionalized care was 10.9% for men and 14% in women [9]. However, in Nigeria the prevalence of UTI in the elderly have been reported to within the range of 11% -53% [10][11][12]. The occurrence of UTI have been reported more among the elderly females because of their short urethra and other associated factors, however, some other studies have reported more UTI infection elderly male [9,12].…”