Urinary tract infections in women over 65: is age a marker for complications?
Scientists from the United States have conducted a study to determine whether there are differences in the spectrum of pathogens and the sensitivity of Escherichia coli to antibiotics in elderly patients with pathway infections urinary tract (UTI), as well as identifying patient management tactics for this purpose. age group compared to younger patients.
The study was performed as a secondary analysis of patient data excluded from the previous retrospective study, which was conducted in women with uncomplicated UTI.
Of the patients examined with urinary tract infections, 26% were women over 65 years of age with an uncomplicated infection and 21% with a complicated urinary tract infection. E. coli was the main pathogen of uncomplicated urinary tract infections in women over 65 years of age (81% of cases); in complex urinary tract infections, Escherichia coli was isolated in more than half of the cases (54%). E. coli sensitivity to trimethoprim / sulfamethoxazole was the same in both groups and amounted to 86%. Doctors prescribed trimethoprim / sulfamethoxazole significantly less frequently in older patients with complex urinary tract infections than in young patients with uncomplicated urinary tract infections (p = 0.017). In addition, physicians were less likely to prescribe trimethoprim / sulfamethoxazole to elderly women and to all patients with complicated urinary tract infections (p = 0.011). Rarely, after isolation of the microorganisms, correction of antibacterial therapy has been necessary (in particular, replacement of antibiotics).
Thus, the structure of UTI pathogens and the frequency of excretion E. coli does not depend on the age of the patient, but on the complication or not of the infection. Complicated urinary tract infections are not a risk factor for E. coli hypersensitivity to trimethoprim / sulfamethoxazole, but other pathogens are more often excreted in complex urinary tract infections. The appointment of trimethoprim / sulfamethoxazole without first isolating the pathogen and determining its sensitivity to antibiotics is recommended in patients of an older age group. Nevertheless, to determine the most optimal approaches to the treatment of this category of UTI patients, according to the authors, prospective studies are necessary in the future.