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. 2018;9(5):659-667.
doi: 10.1007/s41999-018-0099-2. Epub 2018 Aug 29.

Urinary tract infections in a geriatric sub-acute ward-health correlates and atypical presentations

Zyta B Wojszel  1   2 , Małgorzata Toczyńska-Silkiewicz  3
Affiliations

Urinary tract infections in a geriatric sub-acute ward-health correlates and atypical presentations

Zyta B Wojszel et al. Eur Geriatr Med. 2018.

Abstract

Purpose: Bacterial urinary tract infections (UTIs) are the most frequently occurring infectious diseases in the geriatric population. The aim of the study was to determine the prevalence and clinical features of UTIs in geriatric in-patients and their association with health and functional ability characteristics.

Methods: A prospective cross-sectional cohort study was conducted among patients hospitalized on the geriatric ward. Patients were interviewed, examined, and had their hospital records analyzed. An uncontaminated midstream urine sample was collected and cultured in all of the cases suspected for UTI. Relative risks for UTI were counted and multivariable logistic regression model was built.

Results: 246 patients were included, 179 (72.8%) women, 210 (85.4%) 75 + -year-olds. Bacterial UTIs occurred in 18.3% of the patients. The main etiological agent was Escherichia coli (73.3%). The most significant predictors of UTI were recurrent UTI and urinary catheter. The typical clinical UTI symptoms occurred in less than half of the cases (only in 11.1% of cases fever was observed). More often, than in patients without UTIs, they reported symptoms such as delirium (28.9% vs. 18%), tachycardia (11.1% vs. 1.5%) or hypotension (20% vs. 12.1%).

Conclusions: Bacterial UTIs affect about 1/5 of hospitalized geriatric patients. The clinical picture of these infections very often is atypical and it indicates a need for diagnostic vigilance.

Keywords: Bacterial urinary tract infections; Clinical picture; Correlates; Hospitalization; Older people.

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Conflict of interest statement

The authors declare that there is no conflict of interest regarding the publication of this article.The study was approved by the Ethics Committee at Medical University in Bialystok. All procedures performed in studies involving human participants were in accordance with the ethical standards of the Medical University in Bialystok research committee and with the Helsinki Declaration and its later amendments.Informed consent was obtained from all individual participants included in the study.

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