Evaluation of urinary tract infections and causative agents in geriatric patients

Objective: Urinary tract infections are the second most common disease in elderly patients and the most common disease related to bacteria. Due to the immune senescence, comorbid diseases and various physiological changes, susceptibility to such infections may develop with age. It is important to know the common pathogens and resistance profile in this patient population for empirical treatment selection. We aimed to evaluate patient characteristics, causative microorganisms and their resistance in elderly patients hospitalized in our clinic due to urinary tract infection. Methods: Patients who were older than 65 years and hospitalized in Ankara City Hospital Infectious Diseases and Clinical Microbiology clinic with a diagnosis of urinary tract infection between March 2019 and March 2020 were retrospectively evaluated. Hospitalization information, patient files and all medical records on the hospital information processing system in terms of demographic characteristics, culture results and resistance status of the pathogens were screened. YOLU ENFEKSİYONLARI Results: A total of 118 patients were included in the study and the mean age of the patients was 74.65 ± 7.4. hypertension (41.5%), diabetes (30.0%) and dementia (18.6%) were the most common comorbid diseases. Urinary procedure history (11.0%) was the most common complicating factor in the patients. Majority (86.0%) of the causative agents were Gram-negative bacteria. Escherichia coli ( E. coli ) (59.0%) and Klebsiella pneumoniae ( K. pneumoniae ) (17.0%) were the most commonly isolated pathogens, respectively. While extended spectrum beta-lactamase (ESBL) was observed as 56.0% in E. coli and 40.0% in K. pneumoniae , carbapenem resistance was observed at a rate of 20.0% in K. pneumoniae strains. Patients with and without mortality were compared in terms of the presence of resistance (ESBL / carbapenem resistance) and distribution of the infectious agents, and there was no statistically significant difference between the two groups (p=0.573 and p=0.161, respectively). Conclusion: Urinary tract infections are the most common cause of bacteremia in the elderly population and often require hospitalization. Aging is one of the major risk factors for the development of urinary tract infections due to reasons such as urinary incontinence, urinary retention, hospitalizations requiring urinary catheterization, staying in a nursing home and immune aging. It can cause significant morbidity and mortality. In our study, resistance rates were high in the isolated specimens. This should be take into consideration during choosing empiric treatment. Each center should periodically monitor infectious agents and their resistance profiles which observed in their specific patient populations and should develop their own solution strategies to reduce antimicrobial resistance and provide effective treatment to