RESUMO
Urinary tract infections [UTI] in elderly are frequent and polymorphic clinical symptoms. This is a public health problem both in support and cost they generate. To study the epidemiological, clinical, paraclinical and therapeutic aspects of UTI in the elderly. We conducted a retrospective study of 50 cases of UTI in the elderly collected in the Internal Medicine Department at Habib Thameur Hospital between January 2002 and December 2006 [Group I]. We compared this group to another group of patients aged below 60 years also explored for UTI in the same service and during the same period [Group II]. They were 37 women and 13 men in group I and 41 women and 9 men in the group II. In group I, the average age was 74.10 +/- 6.7 years, in group II 43.58 +/- 11.26 years. In group I, 35 patients [70%] showed no evidence of suspicion of a UTI on admission. 15 patients [30%] were admitted for suspected UTI. In group II, 36 patients [72%] showed no evidence of suspicion of a UTI on admission. 14 patients [28%] were admitted for suspected UTI. Urological abnormalities underlying the UTI, detected by ultrasound, were more frequent in Group I [40%] than in Group II [12%]. Second-line antibiotics, due to the likely resistance of the microorganism, had to be prescribed in 16% cases in Group I vs. 4% of cases in Group II. The evolution under antibiotic treatment was marked by the occurrence of 3 deaths and transition to renal failure in 4 cases for Group I. In Group II, the outcome was favorable in all cases. Urinary tract infection is a significant factor in morbidity and mortality in the elderly. Female is much more concerned than male. Clinical manifestations of UTI are often crude and misleading in a pathological and poly polymedicated patient. The preventive arm accounts for most of the management of urinary tract infection in the elderly