The ageing of the population—especially in developed countries—has brought on many societal challenges and has significantly contributed to the burden on healthcare infrastructures worldwide. Elderly persons (aged ≥ 65 years) are at higher risk for developing UTIs, due to a range of intrinsic and extrinsic risk factors, and they often delay seeking treatment. A retrospective observational study was performed regarding the epidemiology and resistance of UTIs in elderly patients. Identification of the isolates was carried out using VITEK 2 ID/AST and MALDI-TOF mass spectrometry. Antibiotic resistance in these isolates was assessed based on EUCAST guidelines, and were grouped into the WHO AWaRe (Access, Watch, Reserve) classification of antimicrobials. During the 10-year study period, n = 4214 (421.4 ± 118.7/year) and n = 4952 (495.2 ± 274.6) laboratory-confirmed UTIs were recorded in inpatients and outpatients, respectively. The causative agents showed differentiation among outpatients and inpatients: Escherichia coli (48.14% vs. 25.65%; p = 0.001), Enterococcus spp. (20.15% vs. 21.52%; p > 0.05), Klebsiella spp. (16.28% vs. 16.26%; p > 0.05), Pseudomonas spp. (4.40%vs. 13.36%; p = 0.001); Proteus-Providencia-Morganella group (4.56% vs. 10.96%; p = 0.001); Candida spp. (0.53% vs. 5.98%; p = 0.001); Citrobacter-Enterobacter-Serratia group (1.90% vs. 2.71%; p < 0.05). Significantly higher resistance rates were observed in inpatient isolates for many Access and Watch antibiotics compared to isolates of outpatient origin; in addition, resistance rates were higher in these uropathogens compared to the previously recorded rates in the region. More care should be taken for the diagnosis and treatment of UTIs affecting elderly patients, as they represent a particularly vulnerable patient population.

中文翻译：

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老年患者尿路感染：基于 WHO 获取、观察、保留 (AWaRe) 分类的流行病学和抗生素耐药性的 10 年研究


人口老龄化（特别是在发达国家）带来了许多社会挑战，并极大地加重了全球医疗保健基础设施的负担。由于一系列内在和外在的危险因素，老年人（年龄≥65岁）患尿路感染的风险较高，而且他们往往会延迟寻求治疗。对老年患者尿路感染的流行病学和耐药性进行了回顾性观察研究。使用 VITEK 2 ID/AST 和 MALDI-TOF 质谱法对分离株进行鉴定。这些分离株的抗生素耐药性根据 EUCAST 指南进行评估，并按 WHO AWaRe（获取、观察、保留）抗菌药物分类进行分组。在为期 10 年的研究期间，住院患者和门诊患者分别记录了n = 4214 (421.4 ± 118.7/年) 和n = 4952 (495.2 ± 274.6) 实验室确诊的 UTI。门诊患者和住院患者的病原体存在差异：大肠杆菌（48.14% vs. 25.65%； p = 0.001）、肠球菌。 （20.15% vs. 21.52%； p > 0.05），克雷伯菌属。 （16.28% vs. 16.26%； p > 0.05），假单胞菌属。 （4.40% 与 13.36%； p = 0.001）； Proteus-Providencia-Morganella组（4.56% vs. 10.96%； p = 0.001）；念珠菌属（0.53% 与 5.98%； p = 0.001）；柠檬酸杆菌-肠杆菌-沙雷氏菌组（1.90% vs. 2.71%； p < 0.05）。 与门诊来源的分离株相比，住院分离株对许多 Access 和 Watch 抗生素的耐药率显着较高；此外，与该地区先前记录的耐药率相比，这些尿路病原体的耐药率更高。应更加谨慎地诊断和治疗影响老年患者的尿路感染，因为他们是特别脆弱的患者群体。