Ageing and Health, Division of Medical Sciences, Ninewells Hospital and Medical School.
Clin Interv Aging. 2011;6:173-80. doi: 10.2147/CIA.S13423. Epub 2011 Jun 22.
Urinary tract infections (UTI) occur frequently in older people. Unfortunately, UTI is commonly overdiagnosed and overtreated on the basis of nonspecific clinical signs and symptoms. The diagnosis of a UTI in the older patient requires the presence of new urinary symptoms, with or without systemic symptoms. Urinalysis is commonly used to diagnose infection in this population, however, the evidence for its use is limited. There is overwhelming evidence that asymptomatic bacteriuria should not be treated. Catheter associated urinary tract infection accounts for a significant amount of hospital-associated infection. Indwelling urinary catheters should be avoided where possible and alternatives sought. The use of narrow spectrum antimicrobial agents for urinary tract infection is advocated. Local guidelines are now widely used to reflect local resistance patterns and available agents. Guidelines need to be updated to reflect changes in antimicrobial prescribing and a move from broad to narrow spectrum antimicrobials.
尿路感染（UTI）在老年人中很常见。不幸的是，基于非特异性的临床症状和体征，UTI 常常被过度诊断和过度治疗。老年患者 UTI 的诊断需要存在新的尿路症状，无论是否伴有全身症状。尿液分析常用于该人群的感染诊断，但该方法的应用证据有限。大量证据表明无症状菌尿不应治疗。与导尿管相关的尿路感染占医院相关感染的很大一部分。应尽可能避免留置导尿管，并寻找替代方法。提倡使用窄谱抗菌药物治疗尿路感染。现在广泛使用本地指南来反映本地耐药模式和可用药物。指南需要更新以反映抗菌药物处方的变化，并从广谱抗菌药物转向窄谱抗菌药物。
