Bacteriuria in the elderly population in a developing country

Among 1470 elderly hospitalized and nonhospitalized people, 566 cases of bacteriuria were identified. There were 663 men (41.5% with bacteriuria) and 807 women (36.0% with bacteriuria). The overall prevalence of bacteriuria was 38.5%. More than 90% of the isolates were gram-negative organisms with Proteus species being the predominant pathogen among men, with 68.1% seen among inpatients. Escherichia coli was the main pathogen in women, with 62.0% recovered from inpatients. Catheterization was seen most commonly among non-hospitalized males with outflow obstruction. Catheter care in this population is often performed at home by these men who either refuse prostate surgery, are not fit for surgery, or are awaiting surgery. Polymicrobic bacteriuria was identified more frequently (approximately 60%) among the catheterized group. Of the 440 gram-negative bacilli recovered as single organisms, 352 (80.0%) were resistant to ampicillin, cephalothin, and tetracycline, whereas 229 (52.0%) were resistant to co-trimoxazole. The most effective antibiotics (in increasing order of sensitivity; 80% - 100%) were augmentin, nalidixic acid, cefuroxime, gentomicin, and ciprofloxacin. No mortality due to bacteremia complicated by bacteriuria was observed during the study period.