Repeated Urinary Tract Infections In Elderly

How Is A Uti Diagnosed

To find out whether you have a UTI, your doctor or nurse will test a clean sample of your urine. This means you will first wipe your genital area with a special wipe. Then you will collect your urine in midstream in a cup. Your doctor or nurse may then test your urine for bacteria to see whether you have a UTI, which can take a few days.

If you have had a UTI before, your doctor may order more tests to rule out other problems. These tests may include:

• A cystogram. This is a special type of x-ray of your urinary tract. These x-rays can show any problems, including swelling or kidney stones.
• A cystoscopic exam. The cystoscope is a small tube the doctor puts into the urethra to see inside of the urethra and bladder for any problems.

Why Older Women Are At Risk For Recurrent Utis

Urinary tract infections are a common medical condition that can affect any person of any age. They develop when bacteria infect the bladder or other parts of the urinary tract.

Although anyone can get UTIs, they are more likely to occur in women. In fact, women are more than 30 times more likely than men to get a UTI, according to the US Department of Health and Human Services Office on Womens Health. Overall, more than 50% of women will develop a UTI at some point in their lives.

Among women, UTIs are more prevalent among older women than younger women. Whats more, older women are at risk for recurrent UTIs, which are those that occur over and over.

Why do recurrent UTIs strike older women? And if youre an older woman, what can you do to protect yourself from UTIs?

The experienced care providers at Associates in Womens Health in Cincinnati would like to answer your questions about recurrent UTIs. Here, we share a few facts about why UTIs sometimes plague older women.

What Are The Symptoms Of Urinary Tract Infection

Classic symptoms of UTI include:

The symptoms of UTI in older adults related to changes in mood, cognition, and behavior are well-documented, but they often mimic symptoms of other conditions like dementia or stroke. This coupled with the fact that the elderly may not be able to tell you when they are experiencing classic symptoms of UTI make it important for their loved ones and caregivers to take prompt action when an abrupt change in mood or behavior is observed. Medical professionals can test for UTI and can determine whether or not a bacterial or fungal infection is present in the urinary tract, or if the changes are the result of some other condition. Tests for UTI are usually performed through urinalysis.

The good news is that if UTI is diagnosed early enough, treatments are usually easy and effective. Depending on the source of infection, antibiotics or antifungal medications are used with great success against UTI. Drinking plenty of fluids while taking the medication will also help flush the infection out of the urinary tract. It is important to take the antibiotic or antifungal medication exactly as it is prescribed, even after UTI symptoms go away. Taking all of the medication will help kill all of the infections. Centric Healthcares trained and caring professionals can help ensure that their clients take all medications as prescribed and drink appropriate amounts of fluids.

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Prostatitis Epididymitis Urethritis And Orchitis

In contrast to UTI, prostatitis affects men of all ages and, from 1990-1994, accounted for almost 2 million office visits per year in the United States. Prostatitis syndromes account for 25% of male office visits for genitourinary complaints, 8% of visits to urologists, and 1% of visits to primary care physicians. Of these men, 5% have bacterial prostatitis, 64% have nonbacterial prostatitis, and 31% have prostatodynia. Digital examination of the prostate in the setting of probable or possible UTI should be avoided to prevent the risk of inciting bacteremia.

Epididymitis has a bimodal distribution, corresponding to different age groups and pathogens. Most cases in men younger than 35 years are due to sexually transmitted pathogens. Older patients are more likely to have obstructive prostatism or a history of instrumentation or catheterization.

Gonococcal urethritis is more common in ethnic minorities, lower socioeconomic groups, and persons living in urban centers. The risk to a male having intercourse with an infected female is 17%. Some of these associations may be limited by confounding. The peak age for urethritis is 20-24 years.

Mumps orchitis occurs in 18% of postpubertal boys infected with the mumps virus.

John L Brusch, MD, FACP Corresponding Faculty Member, Harvard Medical SchoolJohn L Brusch, MD, FACP is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of AmericaDisclosure: Nothing to disclose.

Diagnosing A Urinary Tract Infection In Older Adults

Vague, uncommon symptoms such as confusion make UTIs challenging to diagnose in many older adults. Once your doctor suspects a UTI, its easily confirmed with a simple urinalysis.

Your doctor may perform a urine culture to determine the type of bacteria causing the infection and the best antibiotic to treat it.

There are home UTI tests that check urine for nitrates and leukocytes. Both are often present in UTIs. Because bacteria are often in the urine of older adults to some degree, these tests arent always accurate. Call your doctor if you take a home test and get a positive result.

Antibiotics are the treatment of choice for UTIs in older adults and younger people. Your doctor may prescribe amoxicillin and nitrofurantoin .

More severe infections may require a broad-spectrum antibiotic such as ciprofloxacin and levofloxacin .

You should start antibiotics as soon as possible and take them for the entire duration of treatment as prescribed by your doctor. Stopping treatment early, even if symptoms resolve, increases the risks of recurrence and antibiotic resistance.

Antibiotic overuse also increases your risk for antibiotic resistance. For this reason, your doctor will likely prescribe the shortest treatment course possible. Treatment typically lasts no more than 7 days, and your infection should clear up in a few days.

Its important to drink plenty of water during treatment to help flush out the remaining bacteria.

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How To Prevent Urinary Tract Infections In The Elderly

With a proper understanding of UTI, its potential causes, and risk factors there are some simple things that all of us can do to help prevent infections in our urinary tracts. Some of the most practical preventive behaviors are:

In addition to the suggestions listed above, here are some preventive behaviors specifically for avoiding UTI in seniors:

The prevention of UTI in older adults boils down to two words: better care. Remember, as people age, they sometimes lose the ability to care for themselves in ways that we all take for granted when we are younger. This makes it essential for loved ones and professional caregivers to be vigilant, look for unmet care needs, and respectfully provide that care when necessary.

What Are The Symptoms Of Utis In The Elderly

Like anyone with a UTI, older adults may experience typical physical symptoms. Yet they may not notice a mild infection right away. This is because chronic urinary problems common in seniors, such as urinary incontinence or frequency, may have similar symptoms to a UTI, masking an infection.

Common symptoms of a UTI include:

• Burning, painful sensation with urination
• Frequent, intense urge to urinate even when theres little urine to pass
• A feeling that the bladder is not completely emptied
• Blood in the urine

• Inability to perform common daily tasks, such as getting dressed or feeding themselves

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How To Prevent Utis In Seniors

Older adults can help prevent UTIs by drinking plenty of fluids to flush the bacteria from their systems, Forciea says. She recommends older adults drink four to six 8-ounce glasses of water a day. Forciea further notes that drinking cranberry juice or taking cranberry tablets also can make urine less inviting for bacteria.

Use these strategies to help prevent UTIs in elderly women:

• Urinating promptly after the urge arises
• Wiping front to back

Why More Women Get Urinary Tract Infections

Urinary tract infections are most common in women because of the natural design of their urinary tract. Females have shorter urethra and bacteria need to travel much less of a distance to reach the urinary tract.

Women are also more likely to develop urinary tract infections if they use diaphragms and spermicides for birth control. As women head toward the transition to menopause, underlying hormone changes can lead to changes in the urinary tract making them more susceptible to infections in their urinary tract.

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Acute And Chronic Prostatitis

In the 1800s, prostatitis was thought to be secondary to excessive alcohol consumption or physical or sexual activity. It was often associated with gonorrhea and could be fatal or lead to abscess formation. By the 1920s, most cases were attributed to microorganisms, and antibiotics combined with prostate massage were standard therapy after World War II. Although the role of bacteria was questioned in the 1950s, it was reemphasized in 1968 when Meares and Stamey described their “4-glass test.”

Acute prostatitis is caused by an acute infection of the entire prostate gland, resulting in fever and localized pain. Microscopically, neutrophilic infiltrates, diffuse edema, and microabscesses may be seen, which may coalesce into larger collections.

Chronic prostatitis may be caused by inflammatory or noninflammatory diseases. This condition may arise via dysfunctional voiding, intraprostatic reflux, chronic exposure to microorganisms, autoimmune mechanisms, irritative urinary metabolites, and as a variant of neuropathic pain. Chronic bacterial prostatitis often produces few or no symptoms related to the prostate, but it is probably the most common cause of relapsing UTI in men.

Chronic prostatitis has been subdivided by the National Institutes of Health into the following categories:

Signs You May Have A Urinary Tract Infection

A urinary tract infection is a common condition that can cause discomfort or pain. This type of infection develops when bacteria enter any part of your urinary tract, such as your bladder, kidneys, ureters, and urethra.

Infections are most common in the lower tract and often result from sexual activity, poor personal hygiene, or blockages in the urinary tract.

You can have a urinary tract infection without any symptoms. As the condition worsens, you may experience noticeable side effects, including:

• Burning while urinating

Women especially may notice they have pain in the pelvic area as the infection worsens.

Because the symptoms of a urinary tract infection can be similar to other underlying health conditions, its important that you schedule a diagnostic evaluation at Primary Care & Walk-In Medical Clinic as soon as possible. They offer in-office urine testing to confirm the infection quickly.

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Risk Factors For Urinary Tract Infection In Older Adults

Certain factors may increase the risk of UTIs in older people.

Conditions common in older adults may lead to urinary retention or neurogenic bladder. This increases the risk of UTIs. These conditions include Alzheimers disease, Parkinsons disease, and diabetes.

They often require people to wear incontinence briefs. If the briefs arent changed regularly, an infection may occur.

Several other things put older adults at risk for developing a UTI:

• a history of UTIs

How Centric Healthcare Can Help

It has been well-established by medical researchers that older adults have a greater risk of getting UTI than the rest of the population. At the same time, demographers are projecting that the population of our state and our country continues to age dramatically. Therefore, the impact of UTI on our health will continue to grow.

Listed below are some of the services offered by Centric Healthcare that can help you and your loved one prevent and manage UTI.

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Senior Uti Do You Know The Symptoms

Urinary tract infections, or UTIs, are the most common bacterial infection in older adults,affecting women more often than men.

UTIs can typically be treated effectively with antibiotics once diagnosed.Unfortunately, not all UTIs are treated quickly, and some arent even identified, particularly in seniors.

What is a UTI?

A UTI is an infection in the urinary tract. The urinary tract includes the kidneys, bladder, ureters and the urethra which carries urine out of the body. They are most commonly caused by bacteria but can also be a fungal infection.

A lower UTI is a common infection, affecting the lower part of the urinary tract, the urethra and urinary bladder. Infection of the urethra is urethritis while a bladder infection is cystitis. An upper UTI affects the kidneys.

What causes a UTI?

A typical bacterial UTI is caused by bacteria, often fecal bacteria, entering the urethra through the urethral opening where urine is released from the body. Usually, the body can fight off these bacteria and prevent infection. However, if the immune system is too weak, the bacteria multiply, causing infection.

Fungal UTIs usually stem from fungus in the bloodstream. Fungal UTIs are relatively uncommon, impacting mainly those with illnesses that compromised their immune system.

What are the symptoms of a UTI?

When typical, healthy adults get a UTI, the symptoms are usually easy to identify, and the infection is simple to diagnose:

If left untreated, a person may experience:

Tips For Preventing Utis In The Elderly

The following lifestyle and personal hygiene changes can significantly reduce a seniors risk of developing a urinary tract infection.

• Drink plenty of fluids.
• Drink cranberry juice or use cranberry tablets, but NOT if the elder has a personal or family history of kidney stones.
• Avoid or limit caffeine and alcohol, which irritate the bladder.
• After toileting, always wipe from front to back .
• If incontinence is not an issue, wear breathable cotton underwear and change them at least once a day.
• Change soiled incontinence briefs promptly and frequently.
• Keep the genital area clean and dry.
• Set reminders/timers for seniors who are memory impaired to try to use the bathroom instead of an adult brief.

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Urinary Tract Infections And Dementia Urinary Tract Infections And Dementia

Urinary tract infections are a type of infection common among older people. If a person with a memory impairment or dementia has a UTI, this can cause sudden and severe confusion known as delirium.

Urinary tract infections and dementiaUrinary tract infections and dementia .

Are Utis The Same In Older Women As Younger Women

Although women can get UTIs at any age, they can affect older women differently. UTI symptoms can be different or more severe in older women. Sometimes older women can have a UTI and be asymptomatic.

In addition to the general symptoms listed above, older women should be aware of these additional symptoms:

• Delirium or hallucination
• Agitation and restlessness
• Social withdrawal

Older women are also more likely to have an underlying medical condition thats triggering their recurrent UTIs or causing UTI-like symptoms. For example, pelvic organ prolapse can cause symptoms that are very similar to UTIs, such as a frequent urge to urinate or pain and pressure in the lower abdomen.

Since these conditions cant be treated with the antibiotics often prescribed for UTIs, its important to have a comprehensive medical exam. At Alpenglow Gynecology, we rule out underlying causes or conditions that may be causing your UTI symptoms.

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Treatment Considerations In Older Adults

Dr N: She told me that her incontinence had definitely gotten worse in the last couple of weeks. I had noticed that another physician had sent a urine culture that had grown more than 105 CFU/mL of E coli that was sensitive to all antibiotics. Assuming that this was asymptomatic bacteriuria, it was not treated with antibiotics. A repeat urine culture again showed more than 105 CFU/mL of E coli, again it was pan sensitive. Given her symptoms, I treated her with a 7-day course of an antibiotic. However the antibiotics didnt really make a difference.

Studies have shown that treatment of asymptomatic bacteriuria does eradicate bacteriuria.41 However, reinfection rates , adverse antimicrobial drug effects, and isolation of increasingly resistant organisms occur more commonly in the therapy vs nontherapy groups. No differences in genitourinary morbidity or mortality were observed between the 2 groups.42

Treating Utis In The Elderly

If you think your loved one might have a urinary tract infection, see a doctor right away to avoid further complications. An urgent care clinic is a viable alternative if you cannot get an appointment with their primary care physician soon enough. Urinalysis and/or a urine culture are typically required to diagnose a UTI, determine what kind of bacteria are present in the urine and select the most appropriate antibiotic for treatment. If caught early on, a course of antibiotics typically clears the infection in no time.

Keep in mind that older individuals are also prone to a related condition called asymptomatic bacteriuria, which is characterized by the presence of bacteria in the urine but the absence of any signs or symptoms of a urinary tract infection. The estimated incidence of asymptomatic bacteriuria is 15 percent or greater in women and men between 65 and 80 years of age and continues to climb after age 80 to as high as 40 to 50 percent of long-term care residents.

Research shows that most patients with asymptomatic bacteriuria do not develop symptomatic UTIs, therefore antibiotic treatment is not beneficial. In fact, antibiotic use can result in adverse side effects, such as Clostridium difficileinfection, and contribute to the development of resistant bacteria. A seniors physician will consider their symptoms and test results to differentiate between a UTI and asymptomatic bacteriuria and determine whether treatment is necessary.

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