老年患者与有症状的尿路感染：德国三级保健医院的细菌分布及耐药率分析。
Geriatric Patients and Symptomatic Urinary Tract Infections: Analysis of Bacterial Range and Resistance Rates at a 3rd Level of Care Hospital in Germany.
机构信息
Department of Urology Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany.
Urologie im Gesundheitsforum, Regensburg, Germany.
出版信息
Urol Int. 2022;106(3):298-303. doi: 10.1159/000516677. Epub 2021 Jun 25.
BACKGROUND
Increasing life expectancy and demographic change result in a rising number of geriatric patients, but knowledge about geriatric treatment options and adapted diagnostic pathways is low. Simultaneously, urinary tract infections (UTIs) are common in older people and often difficult to treat.
METHODS
Patients with a UTI at a urological outpatient department between January 01, 2016, and December 31, 2017, were retrospectively identified in the data system. One thousand one hundred fifteen patients with "N30" and "N39" diagnosis were included in this study, 965 of which were under the age of 75 (group 1) and 150 of which 75 years or older (group 2).
RESULTS
Of 150 patients in group 2, 41.6% had nitrite-positive urine (vs. 20.9% in group 1, p < 0.05 in χ2 testing). Patients in group 2 often had indwelling devices (30.3 vs. 6.0%, p < 0.05) and presented a sterile urine culture in only 20.7% (vs. 40.1% in group 1). Regarding calculated antibiotic therapy, there were significant differences concerning prescription of ciprofloxacin (34.9 vs. 25%, p < 0.05) and fosfomycin (12.7 vs. 40.7%, p < 0.05).
CONCLUSION
UTI in geriatric patients should be treated differently than in younger patients because antibiotic resistance is high. The group with indwelling devices is complex. Individual strategies for geriatric patients should be considered.
背景
预期寿命的延长和人口结构的变化导致老年患者人数不断增加，但对老年治疗选择和适应的诊断途径的了解却很低。同时，尿路感染（UTI）在老年人中很常见，而且往往难以治疗。
方法
在 2016 年 1 月 1 日至 2017 年 12 月 31 日期间，在泌尿科门诊对患有 UTI 的患者进行了回顾性识别。在该数据系统中，共纳入了 1115 名患有“N30”和“N39”诊断的患者，其中 965 名年龄小于 75 岁（第 1 组），150 名年龄为 75 岁或以上（第 2 组）。
结果
在第 2 组的 150 名患者中，有 41.6%的尿液亚硝酸盐阳性（第 1 组为 20.9%，卡方检验，p < 0.05）。第 2 组的患者经常有留置装置（30.3%比 6.0%，p < 0.05），并且仅 20.7%的尿液培养无菌（第 1 组为 40.1%）。在计算的抗生素治疗方面，环丙沙星的处方（34.9%比 25%，p < 0.05）和磷霉素（12.7%比 40.7%，p < 0.05）存在显著差异。
结论
老年患者的 UTI 治疗应与年轻患者不同，因为抗生素耐药性很高。有留置装置的患者群体很复杂。应考虑针对老年患者的个体化策略。
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