The main cause of UTIs , at any age, is usually bacteria. Escherichia coli is the primary cause , but other organisms can also cause a UTI . In older adults who use catheters or live in a nursing home or other full-time care facility, bacteria such as Enterococci and Staphylococci are more common causes .
UTIs can cause sudden confusion (also known as delirium) in older people and people with dementia. If the person has a sudden and unexplained change in their behaviour, such as increased confusion, agitation, or withdrawal, this may be because of a UTI .
In institutionalized older adults, catheter- ization, incontinence , antimicrobial exposure, and functional status are most strongly related to risk of recurrent UTIs. 22 Among older men, risk factors for UTIs include dementia, incontinence of bladder and bowel, and use of condom or in- dwelling catheters.
As Armellino noted, catheters used in nursing home care can be a prime source of the infections. UTIs often occur “when bacteria enters the urinary tract through the urethra and move up the tract to infect the bladder or kidneys,” she explained.
By drinking more water, the urge to urinate will become more frequent. Urinating more often prevents infecting bacteria that cause UTIs from building up. Get moving: Elderly people who are sedentary have a higher risk for UTIs . Walking more frequently, even in small increments, helps in preventing UTIs in the elderly .
When left untreated , UTIs can cause serious problems in the elderly , including permanent kidney damage and sepsis, a generalized and potentially life-threatening infection.
UTIs can cause a significant and distressing change in someone’s behaviour that is commonly referred to as ‘ acute confusional state ‘ or ‘ delirium ‘. Delirium is a change in someone’s mental state and usually develops over one or two days .
People shouldn’t die from a UTI , but if sepsis begins to take over and develops to severe sepsis and then to septic shock, this is exactly what can happen. More than half the cases of urosepsis among older adults are caused by a UTI .
If the infection moves upstream to the kidneys, additional symptoms are likely, such as fatigue , weakness or feeling faint , and difficulty walking or thinking clearly. Other symptoms could include a fever of 101 F or greater, shaking and chills, upper back and side pain, and nausea or vomiting.
Urinary tract infections are caused by bacterium that invade the urinary epithelium cells causing irritation and inflammation of these cells. The infection can start in the urethra and can progress its way up to the bladder, ureters, or kidney.
Trimethoprim/sulfamethoxazole , nitrofurantoin , and fosfomycin are the most preferred antibiotics for treating a UTI.
Infections that increase the risk of febrile seizures include gastroenteritis, tonsillitis, a urinary tract infection and other common infections. Far less common but very serious are infections of the central nervous system that affect the brain and the spinal cord, including encephalitis and meningitis.
Risk factors for UTIs Poor hygiene and wiping ‘back to front’ (rather than front to back) after going to the toilet can enable bacteria from the bowel and vagina to enter the urethral opening to the bladder more easily.
The most frequent pathogens associated with CA-UTI in hospitals reporting to National Healthcare Safety Network (NHSN) between 2009-2010 were Escherichia coli (26.8%) and Pseudomonas aeruginosa(11.3%), followed by Klebsiella (11.2%), Candida albicans(8.9%), Enterococcus faecalis(7.2%%), Proteusspp.
Several practices, often implemented in bundles, appear to reduce UTI or CAUTI in nursing home residents such as improving hand hygiene, reducing and improving catheter use, managing incontinence without catheters, and enhanced barrier precautions.