Bardsley Alison
Coventry University, West Midlands, England.
Nurs Older People. 2017 Feb 28;29(2):32-38. doi: 10.7748/nop.2017.e884.
Urinary tract infections (UTIs) are common in older people, with the prevalence increasing with age in both sexes. UTI is a frequent reason for emergency admission to hospital. There are many conditions that contribute to older people being more at risk of UTI and the main preventive strategy is to avoid the use of indwelling urethral catheters. Where an indwelling catheter is inserted its continued use should be regularly reviewed and the catheter removed, especially if the reason for insertion is incontinence and the person becomes additionally incontinent of faeces. Diagnosis of UTI can be complex because older people do not always exhibit the signs and symptoms commonly associated with UTI. Diagnosis can be further complicated by a person's inability to provide a comprehensive history and by difficulties obtaining an uncontaminated, 'clean catch' urine specimen. Antibiotic therapy should not be used routinely for people with asymptomatic bacteriuria and, where antibiotics are required, healthcare professionals should follow local prescribing guidelines.
尿路感染（UTIs）在老年人中很常见，男女患病率均随年龄增长而增加。UTI是老年人紧急住院的常见原因。有许多因素导致老年人更容易患UTI，主要的预防策略是避免使用留置导尿管。如果插入了留置导尿管，应定期评估是否继续使用，并拔除导尿管，特别是在插入导尿管的原因是尿失禁且患者出现额外的大便失禁时。UTI的诊断可能很复杂，因为老年人并不总是表现出与UTI相关的常见体征和症状。患者无法提供完整病史以及难以获取未受污染的“清洁中段”尿液样本会使诊断更加复杂。对于无症状菌尿症患者，不应常规使用抗生素治疗，如需使用抗生素，医护人员应遵循当地的处方指南。
