Urogenit Tract Infect.  2020 Dec;15(3):71-78. 10.14777/uti.2020.15.3.71.

Clinical Characteristics and Antimicrobial Susceptibility of Elderly Women with Acute Pyelonephritis

• Yun JK
• Kim WB
• Lee SW
• Lee KW
• Kim JM
• Kim YH

• KMID: 2510471
• DOI: http://doi.org/10.14777/uti.2020.15.3.71

Abstract

Purpose
Acute pyelonephritis in older patients can lead to a poorer treatment response and prognosis. The objective of this study was to classify older female patients with acute pyelonephritis according to age and compare their clinical characteristics and antibiotic susceptibility.
Materials and Methods
In this retrospective study, 360 patients aged 65 years or older and hospitalized for acute pyelonephritis in a single tertiary medical facility from 2012 to 2016 were selected as research subjects. The patients were divided into three groups according to their age. Their clinical symptoms, blood tests and urinalysis, underlying diseases, causative organisms for urinary tract infections (UTIs), and antibiotic susceptibility were compared.
Results
One hundred and seventy-six patients aged 69.9±2.7 years, 142 patients aged 79.4±3.1 years, and 42 patients aged 87.3±3.1 years were assigned into the young-old, old-old, and oldest-old groups, respectively. The duration of hospitalization and fever due to acute pyelonephritis increased with age. On the other hand, the maximum body temperature was similar among the three groups.In blood tests, erythrocyte sedimentation rate and C-reactive protein increased with age. Among the underlying diseases, the incidence of diabetes and chronic renal disease was similar among the three groups, while cerebrovascular diseases, heart failure, and urinary stones were associated with aging. Older patients were more likely to have UTIs over the past year. Older groups showed a more significant decrease in sensitivity to carbapenems, amikacin, and ciprofloxacin.
Conclusions
Choosing appropriate antibiotics, considering the patientʼs age, is important when treating acute pyelonephritis.

Keyword

Pyelonephritis; Aged; Uropathogen; Susceptibility