Turkish Journal of Geriatrics 2016 , Vol 19, Issue 3
Tayfur DEMİRAY1, Kerem YILMAZ2, Özlem AYDEMİR1, Mehmet KÖROĞLU2, Ahmet ÖZBEK2, Fikret HALİS3, Mustafa ALTINDİŞ2
1Sakarya University Trainig and Research Hospital, Department of Medical Microbiology, SAKARYA
2Sakarya University, Faculty of Medicine, Department of Medical Microbiology, SAKARYA
3Sakarya University, Faculty of Medicine, Department of Urology, SAKARYA
Introduction: Elderly men with benign prostatic hyperplasia have a higher risk of urinary tract infections. With advanced age, an increased prostate gland results in altered bladder emptying and increased urine retention and rates of urinary tract infections. Here, we aimed to determine the uropathogens and their antimicrobial susceptibility isolated from elderly men with benign prostatic hyperplasia to create baseline data for active surveillance and empiric antimicrobial regimens.

Materials and Method: Urine cultures from 506 elderly men with benign prostatic hyperplasia were retrospectively evaluated. Distribution of the bacteria causing urinary tract infections and their antimicrobial susceptibility test results were examined using automated identification and antimicrobial susceptibility testing system.

Results: No growth was reported in 69.8% (n=353) of the whole cultures. Contamination constituted 13.6% (n=69) of the reports. Urinary tract infection was reported in 16.6% (n=84) of the samples. Gram-negative bacteria (79.8%) were the major cause of urinary tract infection among elder men with benign prostatic hyperplasia; Escherichia coli (53.4%) was the most common cause. Among the elderly men, contamination rates in the >85 years group was significantly higher (p<0.005). The most susceptible antimicrobials were determined as carbapenems for the Gram-negative bacteria and glycopeptides for the Gram-positive bacteria, which are the last resort and parenteral only antibiotics.

Conclusion: Gram-negative bacteria, predominantly Escherichia coli, are the major causes of urinary tract infections in elderly men with benign prostatic hyperplasia. High resistance to frequently used drugs such as first generation cephalosporins and quinolones is an alerting situation. Also, contamination rates increase with advancing age; thus, urine sampling from these patients should be revised. Antimicrobial treatment should depend on local antimicrobial susceptibility testing results. Keywords : Aged; Urinary Tract Infection; Prostatic Hyperplasia; Drug Resistance, Microbial; Escherichia coli