Urinary tract infection in older adults in long-term care facilities

Ajayi, Tokunbo; Radhakrishnan, Ramya

doi:10.1503/cmaj.150708

Cited by 7 publications

(6 citation statements)

References 7 publications

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“…Age wise the study population was between the age of 8 and 85 Elderly individuals appear to be more susceptible to T2D. The maximum number of T2D patients was found within age group 41-60 years 17 (65.4%), T2DM patients age mean (54.4±10.1) , which in line with a local study by Mansour et al (2020), that reported the mean age of type II diabetics being (51.4±3 years).The results seem to disagree with a study by Ajayi and Radhakrishnan (2016) in, the most common age group inflected with UTI is above 60 years of age rather than meddle aged population which the current study presents. While the maximum number of T1D patients was found within age group ≤20years 10 (50%).And, the age mean and standard deviation of T1DM (26.3±8.9 years), that in line with previous study by Goldberg et al (2020) which concluded that the T1DM prevalence at a younger age (21.2±3 years).…”

Section: Figure (1)contrasting

confidence: 54%

Bacteriuria with Unusual Uropathogens in Diabetics in Thi-Qar Province

Beden¹,

Mousa²

2022

jsci

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This study was designed to investigate the causative agents of recurrent urinary tract infection in diabetic patients in Thi-Qar Province . The study included 87 Iraqi participants of whom 46 diabetics and 41 non diabetics healthy control . Urine samples were collected from each participant and cultured on blood and MacConkey agars ,followed by macro and microscopic identification and biochemical tests. API 20E and Vitek 2 compact systems were used as a confirmatory tests . The findings showed ,of the total 87 participants 60(69%) gave a positive growth for urine culture. The results also showed thatT2DM patients were more susceptible to UTI with positive urine growth of 23/26 (88%) compared to T1DM patients who showed 14/20 (70%), and the majority of cases were female. Escherichia coli is the most common isolates accounting for the majority of cases 29 (48%), followed by Klebsiellapneumoniae9(15%) and Acinetobacter radioresistens 8(13.3%).It can be concluded that diabetic patients are more susceptible to UTI, especially T2DM. According to the present results, the immune disturbance due to diabetic patients is taking tall on T2DM patients even with asymptomatic bacteriuria.

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Section: Figure (1)contrasting

confidence: 54%

Bacteriuria with Unusual Uropathogens in Diabetics in Thi-Qar Province

Beden¹,

Mousa²

2022

jsci

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“…Another reason is the contamination rate in our study, which concerns one out of two positive samples (53.41%; n =1758), which constitutes a considerable diagnostic loss. Finally, clinical evaluation is often limited by the difficulty of obtaining a reliable history from patients who are often unable to communicate their symptoms adequately 12 , 20 – 23 . Differentiating urinary tract infection and asymptomatic bacteriuria can be a challenge in older adults.…”

Section: Discussionmentioning

confidence: 99%

“…Differentiating urinary tract infection and asymptomatic bacteriuria can be a challenge in older adults. Diagnosis of UTI must be based on a thorough clinical evaluation, presence of new genitourinary signs and symptoms, and the exclusion of other possible diagnoses 12 , 20 – 23 .…”

Section: Discussionmentioning

confidence: 99%

Urinary tract infections older adults at Mohammed VI University Hospital of Oujda: case series

Saddari

Benhamza

Dalli

et al. 2023

Annals of Medicine &Amp; Surgery

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Background: Due to its incidence, clinical polymorphism and severity, urinary tract infection is an important problem in elderly. The objectives of the authors’ work were to establish the bacteriological profile of urinary tract infection and/or colonization in the elderly and then to study drug resistance of bacterial strains isolated. Materials and methods: This is a 36 months retrospective study from 22 March 2016 to 11 May 2019. The study included urinary specimens of persons aged 65 years or over, hospitalized or consulting at the authors’ hospital. Urines were processed according to the recommendations of the medical microbiology reference system and European Committee on Antimicrobial Susceptibility Testing. Results: The authors collected 6552 requests for cytobacteriological examination of urine. Most of the specimens was collected in the middle stream (n=5503; 84%). Cultures were sterile in 49.77% of cases. Positive in 50.22% of cases. Among positive samples we had 53.41% polymorphic cultures, 32.75% urinary tract infection, and 13.82% urinary tract colonization. Gender distribution showed a sex ratio at 0.62. Gram-negative bacilli, with Escherichia coli as the main species, dominated the isolated bacteria. Resistance rates of E. coli strains that we isolated were 70% for amoxicillin, 36.31% for amoxicillin-clavulanate and 25% for ciprofloxacin. A high resistance rate was seen for third generation cephalosporins. Least resistance recorded to nitrofurantoin. Conclusion: ITU in the elderly is diverse and significantly different from that of younger patients, through its high contamination rate, difficulty in acquiring clinical information, high rate of asymptomatic bacteriuria, and high proportion of multidrug resistant bacteria.

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“…The most common indication is for a UTI (17,18). Overdiagnosis and treatment of UTI in long-term care is well recognized, with at least half of antibiotic prescriptions for this indication considered unnecessary (19).…”

Section: Urinary Tract Infection In Long-term Care Homesmentioning

confidence: 99%

Prescriber-led practice changes that can bolster antimicrobial stewardship in community health care settings

Leis¹,

Born²,

Ostrow³

et al. 2020

CCDR

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Stabilizing the emerging resistance of antibiotics depends on our ability to practise appropriate antimicrobial stewardship (AMS). Over 90% of antibiotics dispensed for human use are prescribed in community health care settings rather than in hospitals, with the main prescribers being family physicians, dentists, pharmacists and nurse practitioners working across a broad range of private offices, family health teams, urgent care clinics, emergency departments and long-term care homes. To improve the reach of AMS in community health care settings, the Public Health Agency of Canada partnered with Choosing Wisely Canada in 2017 to develop a focused campaign titled Using Antibiotics Wisely. This campaign is led by the prescribers of antibiotics themselves, who work in community health care settings and are better equipped to identify the specific changes that would support more appropriate use of antibiotics. This article describes these practice changes, the strengths and challenges of Using Antibiotics Wisely and future opportunities to further advance AMS across community health care settings.

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Urinary tract infection in older adults in long-term care facilities

Cited by 7 publications

References 7 publications

Bacteriuria with Unusual Uropathogens in Diabetics in Thi-Qar Province

Bacteriuria with Unusual Uropathogens in Diabetics in Thi-Qar Province

Urinary tract infections older adults at Mohammed VI University Hospital of Oujda: case series

Prescriber-led practice changes that can bolster antimicrobial stewardship in community health care settings

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