Epidemiological and clinical aspects of urinary tract infection in community-dwelling elderly women

Background: Urinary tract infections (UTIs) in elderly patients can be a complex problem in terms of approach to diagnosis, treatment, and prevention, because the patients often present nonspecific symptoms. The epidemiological and clinical characteristics of UTI in elderly women were studied, in or...

Full description

Bibliographic Details
Main Authors: Luiz Paulo José Marques, Juliana Timóteo Flores, Onofre de Oliveira Barros Junior, Giovana Breda Rodrigues, Carla de Medeiros Mourão, Rosa Maria Portella Moreira
Format: Article
Language:English
Published: Elsevier 2012-09-01
Series:Brazilian Journal of Infectious Diseases
Online Access:http://www.sciencedirect.com/science/article/pii/S1413867012001298
_version_ 1818398999660462080
author Luiz Paulo José Marques
Juliana Timóteo Flores
Onofre de Oliveira Barros Junior
Giovana Breda Rodrigues
Carla de Medeiros Mourão
Rosa Maria Portella Moreira
author_facet Luiz Paulo José Marques
Juliana Timóteo Flores
Onofre de Oliveira Barros Junior
Giovana Breda Rodrigues
Carla de Medeiros Mourão
Rosa Maria Portella Moreira
author_sort Luiz Paulo José Marques
collection DOAJ
description Background: Urinary tract infections (UTIs) in elderly patients can be a complex problem in terms of approach to diagnosis, treatment, and prevention, because the patients often present nonspecific symptoms. The epidemiological and clinical characteristics of UTI in elderly women were studied, in order to make early diagnosis and prevent serious clinical complications secondary to UTI. Methods: This was a prospective population-based study, with elderly women, during their first medical office visit. Medical records were obtained by clinical history and physical examination in order to detect signs and symptoms of UTI and the presence of co-morbidities. Clean-catch midstream urine specimens for urinary dipstick test, sediment, and culture were collected; cervical samples for conventional Pap smears were also collected. Results: UTI was found in 16.55% of elderly women. The most frequent urinary symptom was foul smelling urine, in 60.6%. E. coli was responsible for 98 (76.56%) cases of significant bacteriuria; 34 (34.69%) were resistant to trimethoprim-sulfamethoxazole, and 21 (21.42%) to fluoroquinolones. Asymptomatic bacteriuria (AB) was not treated. The presence of predisposing factors demonstrated that the history of previous UTI (p < 0.001), vaginitis (p < 0.001), and diabetes (p = 0.042) increased the risk for UTI. Conclusion: This study confirmed the high prevalence of UTI among elderly women and its unusual clinical presentation. Diabetes, history of previous UTI, and vaginitis were shown to be predisposing factors for UTI; it is not necessary to treat AB in elderly women, even among diabetics. Keywords: Elderly women, Urinary tract infection, Asymptomatic bacteriuria, Risk factors, Therapy
first_indexed 2024-12-14T07:13:42Z
format Article
id doaj.art-af99df005639480587650a1717c1ab71
institution Directory Open Access Journal
issn 1413-8670
language English
last_indexed 2024-12-14T07:13:42Z
publishDate 2012-09-01
publisher Elsevier
record_format Article
series Brazilian Journal of Infectious Diseases
spelling doaj.art-af99df005639480587650a1717c1ab712022-12-21T23:11:45ZengElsevierBrazilian Journal of Infectious Diseases1413-86702012-09-01165436441Epidemiological and clinical aspects of urinary tract infection in community-dwelling elderly womenLuiz Paulo José Marques0Juliana Timóteo Flores1Onofre de Oliveira Barros Junior2Giovana Breda Rodrigues3Carla de Medeiros Mourão4Rosa Maria Portella Moreira5Corresponding author at: Universidade Federal do Rio de Janeiro, Department of Medicine, Rua Santa Sofia, 134/201, 20540-090 – Rio de Janeiro, Brazil.; Hospital Universitário Gaffrèe e Guinle, Department of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BrazilHospital Universitário Gaffrèe e Guinle, Department of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BrazilHospital Universitário Gaffrèe e Guinle, Department of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BrazilHospital Universitário Gaffrèe e Guinle, Department of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BrazilHospital Universitário Gaffrèe e Guinle, Department of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BrazilHospital Universitário Gaffrèe e Guinle, Department of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BrazilBackground: Urinary tract infections (UTIs) in elderly patients can be a complex problem in terms of approach to diagnosis, treatment, and prevention, because the patients often present nonspecific symptoms. The epidemiological and clinical characteristics of UTI in elderly women were studied, in order to make early diagnosis and prevent serious clinical complications secondary to UTI. Methods: This was a prospective population-based study, with elderly women, during their first medical office visit. Medical records were obtained by clinical history and physical examination in order to detect signs and symptoms of UTI and the presence of co-morbidities. Clean-catch midstream urine specimens for urinary dipstick test, sediment, and culture were collected; cervical samples for conventional Pap smears were also collected. Results: UTI was found in 16.55% of elderly women. The most frequent urinary symptom was foul smelling urine, in 60.6%. E. coli was responsible for 98 (76.56%) cases of significant bacteriuria; 34 (34.69%) were resistant to trimethoprim-sulfamethoxazole, and 21 (21.42%) to fluoroquinolones. Asymptomatic bacteriuria (AB) was not treated. The presence of predisposing factors demonstrated that the history of previous UTI (p < 0.001), vaginitis (p < 0.001), and diabetes (p = 0.042) increased the risk for UTI. Conclusion: This study confirmed the high prevalence of UTI among elderly women and its unusual clinical presentation. Diabetes, history of previous UTI, and vaginitis were shown to be predisposing factors for UTI; it is not necessary to treat AB in elderly women, even among diabetics. Keywords: Elderly women, Urinary tract infection, Asymptomatic bacteriuria, Risk factors, Therapyhttp://www.sciencedirect.com/science/article/pii/S1413867012001298
spellingShingle Luiz Paulo José Marques
Juliana Timóteo Flores
Onofre de Oliveira Barros Junior
Giovana Breda Rodrigues
Carla de Medeiros Mourão
Rosa Maria Portella Moreira
Epidemiological and clinical aspects of urinary tract infection in community-dwelling elderly women
Brazilian Journal of Infectious Diseases
title Epidemiological and clinical aspects of urinary tract infection in community-dwelling elderly women
title_full Epidemiological and clinical aspects of urinary tract infection in community-dwelling elderly women
title_fullStr Epidemiological and clinical aspects of urinary tract infection in community-dwelling elderly women
title_full_unstemmed Epidemiological and clinical aspects of urinary tract infection in community-dwelling elderly women
title_short Epidemiological and clinical aspects of urinary tract infection in community-dwelling elderly women
title_sort epidemiological and clinical aspects of urinary tract infection in community dwelling elderly women
url http://www.sciencedirect.com/science/article/pii/S1413867012001298
work_keys_str_mv AT luizpaulojosemarques epidemiologicalandclinicalaspectsofurinarytractinfectionincommunitydwellingelderlywomen
AT julianatimoteoflores epidemiologicalandclinicalaspectsofurinarytractinfectionincommunitydwellingelderlywomen
AT onofredeoliveirabarrosjunior epidemiologicalandclinicalaspectsofurinarytractinfectionincommunitydwellingelderlywomen
AT giovanabredarodrigues epidemiologicalandclinicalaspectsofurinarytractinfectionincommunitydwellingelderlywomen
AT carlademedeirosmourao epidemiologicalandclinicalaspectsofurinarytractinfectionincommunitydwellingelderlywomen
AT rosamariaportellamoreira epidemiologicalandclinicalaspectsofurinarytractinfectionincommunitydwellingelderlywomen