DESCRIPTIVE CHARACTERISTICS, ETIOLOGICAL AGENTS, AND RISK FACTORS FOR MORTALITY OF URINARY TRACT INFECTIONS IN OLDER ADULTS

Abstract

OBJECTIVE: Urinary tract infections are common in older adults and associated with significant morbidity and mortality. This study aimed to characterize the clinical features, bacterial etiologies, antimicrobial resistance patterns, and risk factors for mortality in elderly patients hospitalized with urinary tract infection. MATERIAL AND METHODS: Data were retrospectively analyzed from 118 patients aged ≥65 years hospitalized with a diagnosis of urinary tract infection between January 2018 and December 2022. Urinary tract infections were defined according to Centers for Disease Control and Prevention criteria. Isolated microorganisms in urine cultures and antimicrobial resistance rates were determined. Risk factors associated with mortality were evaluated by logistic regression analysis. RESULTS: 50.8% of patients were female; the mean age was 72.5±7.0 years. The most common symptoms were dysuria (65.3%), anorexia (65.3%), and flank pain (57.6%). Forty-nine patients (41.5%) had nosocomial urinary tract infections. All cause in hospital mortality was observed in 48 patients (40.6%), and 22 patients (18.6%) had in-hospital mortality directly related to urinary tract infection. Urosepsis (OR: 13.518, 95% CI: 1.711-106.793, p=0.014), kidney stones (OR: 7.529, 95% CI: 1.596-35.525, p=0.011) and urinary tract infections caused by multidrug-resistant organisms (OR: 18. 612, 95% CI: 1.564-4.283, p<0.001) were independent risk factors for mortality, and appropriate treatment (OR: 0.090, 95% CI: -3.736--1.085, p<0.001) was an independent protective factor for mortality. CONCLUSIONS: Urinary tract infections in elderly adults present with a wide range of symptoms and are predominantly caused by drug-resistant Escherichia coli. Urosepsis and kidney stones are critical determinants of mortality, emphasizing the need for rapid and appropriate management strategies. Understanding the etiology, clinical features, and mortality risk factors of urinary tract infections in elderly adults is crucial for optimizing infection management in this vulnerable population.