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Urinary Tract Infections (UTIs) in Seniors

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Urinary tract infections are common at any age and particularly in females. However, with advancing age and the host of conditions that tend to arise more frequently in seniors, urinary tract infections are frequently seen in the elderly. The urinary tract includes the kidney, ureter, urinary bladder and urethra.  The infection of the lower part of the urinary tract, the bladder and urethra, are more common whereas infection of the kidney, although less common, is very serious and potentially life threatening.

UTI Symptoms

The symptoms of  urinary tract infections may vary depending on the sex, age and the site of infection. Specific symptoms may arise with specific organisms. Symptoms of urinary tract infection could include :

  • Fever.
  • Chills.
  • Nausea and vomiting.
  • Strong urge to urinate or urinary urgency.
  • Burning sensation on urination.
  • Frequent urination in small amounts.
  • Cloudy appearance of urine.
  • Blood-tinged urine or presence of blood in urine.
  • Pelvic pain in women or rectal pain in men.
  • Pelvic pressure.
  • Lower abdominal discomfort.
  • Offensive smelling urine.
  • Upper back and flank pain if there is kidney involvement.

Untreated UTIs can lead to complications such as :

  • Scarring and narrowing (strictures) of the urinary tract.
  • Bladder stones.
  • Kidney damage that could be permanent.

Causes of Urinary Tract Infections

UTIs are an infectious disease caused mainly by bacteria which enter the urinary tract via the urethral opening and spread to the upper parts of the urinary tract. This is known as an ascending infection. In rare cases, fungi may be responsible. The body’s immune system is unable to combat the infection either due to large inoculation (many bacteria) or other kidney and urinary tract problems that increase the risk of an infection.

The most common manifestation is cystitis – infection of the bladder is called cystitis. Overall urinary tract infections are more common in women due to the shorter urethra and closer proximity to the anus. The most common bacteria responsible for UTIs is Escherichia coli (E.coli) usually originating from the rectum. Sometimes sexually transmitted diseases may also cause an infection, usually affecting the urethra (urethritis) and possibly even the bladder (cystitis).

Risk factors

  • Females are at a higher risk.
  • Sexually active individuals are also at a higher risk.
  • Postmenopausal woman due to low production of estrogen.
  • People with urinary tract abnormalities or blockage.
  • Immunocompromised individuals.
  • Patients with a urinary catheter.
  • Men with prostate problems.
  • Bedridden patients.

Treatment of UTIs

Urine sample analysis and culture confirms the infection and helps to identify the causative organism. This is useful for identifying the most appropriate antibiotic to be used for the treatment of the urinary infection. Commonly used antibiotics for UTIs includes :

  • Sulfamethoxazole-trimethoprim
  • Amoxicillin
  • Nitrofurantoin
  • Ampicillin
  • Ciprofloxacin
  • Levofloxacin

The duration of antibiotic use is usually 7 days but can vary depending on the severity of the infection. Analgesic medications are prescribed for pain and burning sensation. Antipyretics can be prescribed for fevers. Postmenopausal woman may require vaginal estrogen therapy to reduce the chance of recurrent infections if it is occurring. Severe infections may need hospitalization and administration of IV antibiotics.

References :

http://www.mayoclinic.com/health/urinary-tract-infection/DS00286

http://www.emedicinehealth.com/urinary_tract_infections/article_em.htm


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