The topic we leaned this week is “Urinary Tract Infections in the Elderly Population”, which is a review artical. The auther choosed the literature from MEDLINE (1966–April 2011), Cochrane Library, BIOSIS (1993–April 2011), and EMBASE (1970–April 2011). Search terms included urinary tract infections, asymptomatic bacteriuria, acute uncomplicated cystitis, acute uncomplicated pyelonephritis, antibiotic resistance, catheter associated urinary tract infections, recurrent urinary tract infections, and elderly.
This review covered the management of asymptomatic bacteriuria, acute uncomplicated cystitis, acute uncomplicated pyelonephritis, antibiotic resistance, catheter-associated bacteriuria/symptomatic UTIs, and antibiotic prophylaxis for recurrent infections in elderly men and women. The author detailed analysis these diseases, included definition, clinical diagnosis, uropathogen, signs and symptoms, treatment. The people who residing in LTCFs have higher infection morbidity than the community residents. We also recognized that a urine culture ( clean-catch urine culture/ clean-catch midstream urine) and sensitivity obtained in elderly population was important. It was used to guide clinical work and adjust the therapy for these patients.
The management of UTIs in the elderly population presented various problems for the clinician. We need to improve the guidelines for diagnosis and management of UTIs in these population. Better techniques to evaluate and prevent catheter-associated bacteriuria and UTIs await improved diagnostic modalities and catheter technologies. For the antibiotic treatment, we should base on local antibiotic resistance patterns, and seek alternative methods for prophylaxis of recurrent infections that minimize the risk of developing or propagating antibiotic resistance.
(Zhanwang Yuan)