Urinary tract infections in the elderly. The effect of reducing the age criteria in a geriatric service

Introduction: Urinary tract infections (UTIs) are one of the most common community-acquired infections in older adults. Methodology: This was a retrospective and descriptive study carried out in a Mexican Geriatric Service from January 2013 to December 2015. Demographic characteristics of patients were recorded including age, gender, cause of disease, urine culture, microorganism identifi cation and antibiogram. The objective of this study was to describe the situational status of microbial antibiotic resistance in the elderly after reduction of the age criteria to be treated in a geriatric service. Results: One hundred and eighty-two geriatric patients (74 males mean age 81.5±13.5 years and 108 females mean age 81.5±11.5 years) with positive urine culture for one or more microbial identifi cation and antibiograms were included in the analysis. The most common isolations were positive for Escherichia coli BLEE, Escherichia coli, Candida albicans, Enterococcus faecalis, Pseudomonas aeruginosa, Proteus vulgaris and Klebsiella pneumoniae. After widening of the age range to enter the geriatric service (in 2015), there was a reduction in total cases of Escherichia coli BLEE and an increase for Escherichia coli. Conclusion: In our study, a growing increase of E. coli BLEE was recorded, however, at the same time, it was possible to confi rm that the majority of cases of this bacterium showed resistance to β-lactams, cephalosporins of different generations, quinolones and sulfas, demonstrating that it is becoming a public health problem

INFEKCIJE MOKRAĆNOG SUSTAVA KOD STARIJIH OSOBA. UČINAK SMANJENJA KRITERIJA DOBI U GERIJATRIJSKOJ SLUŽBI

Introduction: Urinary tract infections (UTIs) are one of the most common community-acquired infections in older adults. Methodology: This was a retrospective and descriptive study carried out in a Mexican Geriatric Service from January 2013 to December 2015. Demographic characteristics of patients were recorded including age, gender, cause of disease, urine culture, microorganism identifi cation and antibiogram. The objective of this study was to describe the situational status of microbial antibiotic resistance in the elderly after reduction of the age criteria to be treated in a geriatric service. Results: One hundred and eighty-two geriatric patients (74 males mean age 81.5±13.5 years and 108 females mean age 81.5±11.5 years) with positive urine culture for one or more microbial identifi cation and antibiograms were included in the analysis. The most common isolations were positive for Escherichia coli BLEE, Escherichia coli, Candida albicans, Enterococcus faecalis, Pseudomonas aeruginosa, Proteus vulgaris and Klebsiella pneumoniae. After widening of the age range to enter the geriatric service (in 2015), there was a reduction in total cases of Escherichia coli BLEE and an increase for Escherichia coli. Conclusion: In our study, a growing increase of E. coli BLEE was recorded, however, at the same time, it was possible to confi rm that the majority of cases of this bacterium showed resistance to β-lactams, cephalosporins of different generations, quinolones and sulfas, demonstrating that it is becoming a public health problem.Uvod: Infekcije mokraćnog sustava (IMS) su jedna od najčešćih infekcija stečenih u zajednici kod starijih odraslih osoba. Metodologija: Ovo je retrospektivna i opisna studija provedena u meksičkoj gerijatrijskoj službi od siječnja 2013. do prosinca 2015. godine. Zabilježene su demografske karakteristike pacijenata, uključujući dob, spol, uzrok bolesti, kulturu urina, identifi kaciju mikroorganizama i antibiogram. Cilj ove studije bio je opisati situacijski status mikrobiološke rezistencije antibiotika kod starijih osoba nakon smanjenja dobnih kriterija za liječenje u gerijatrijskoj službi. Rezultati: U analizu su bila uključena 182 gerijatrijska pacijenta (74 muškarca prosječne dobi 81,5±13,5 godina i 108 žena prosječne dobi 81,5±11,5 godina) s pozitivnom kulturom urina za jednu ili više bakterijskih identifi kacija i antibiogramima. Najzastupljenije izolacije bile su pozitivne za Escherichia coli BLEE, Escherichia coli, Candida albicans, Enterococcus faecalis, Pseudomonas aeruginosa, Proteus vulgaris i Klebsiella pneumoniae. Nakon širenja dobnog raspona za ulazak u gerijatrijsku službu (2015. godine) došlo je do smanjenja ukupnih slučajeva Escherichia coli BLEE i povećanja za Escherichia coli. Zaključak: U našem je istraživanju pronađeno sve veće povećanje E. coli BLEE. Istodobno je bilo moguće potvrditi da je u većini slučajeva ova bakterija pokazala otpornost na b-laktame, cefalosporine različitih generacija, kinolonske antibiotike i sulfa lijekove pokazujući da postaje problem javnog zdravstva