Urinary Tract Infection in Elderly: Clinical Profile and Outcome.

OBJECTIVE

Urinary tract infection (UTI) being the most common bacterial infection with considerable morbidity and mortality especially in hospitalized geriatric patients, this study was designed to assess clinical profile, predisposing factors, uropathogen profile causing UTI and to identify associated factors responsible for mortality.

METHODS

:Prospective observational study was undertaken among elderly patients aged ≥ 60 years in a tertiary care hospital. 95 indoor patients from medicine wards having symptoms of UTI and urine culture showing significant growth were included in the study. Demographic profile, clinical features, predisposing factors, laboratory features, urine culture reports, antimicrobial susceptibility patterns and outcome were noted and analysed.

RESULTS

Of the 95 patients studied, 55.78% were males. 50.52% patients were in age group of 61 to 70 year. Frequency of micturition was the major symptom. Diabetes mellitus was the most common predisposing factor associated with UTI seen in (46.31%) patients. Gram negative organism accounted for 88(92.63%) of bacterial isolates, with Escherichia coli seen in 47.36% of cases. Non-E.coli gram negative organisms such as Pseudomonas, Klebsiella showed lower sensitivity to Levofloxacin, Piperacillin + Tazobactam, Amikacin and Ceftazidime. Mortality rate was 17.89%. Significantly higher mortality was seen in patients with diabetes mellitus (p< 0.0001), complicated UTI (p<0.001), dementia (p<0.0001), serum creatinine >1.4 mg/dl ((p<0.0001) and increasing number of predisposing factors. Fatality was not associated with use of urethral catheters and increased leucocyte count.

CONCLUSION

Diabetes mellitus, dementia increases risk of mortality in elderly UTI patients. As gram negative isolates shows drug resistance, prompt diagnosis and the right choice of antimicrobials can play a key role in reducing mortality in elderly UTI patients.