Urinary tract infection

Urinary tract infection treatments and risk reduction and physical therapy enterococci-leading-causes-of-nosocomial-bacteremia-surgical-wound-infection-and-urinary-tract-infection-692x544

My elderly family member is getting urinary tract infections- how can I help them?

July 29, 2016

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Jon Keller physical therapist

Above is a picture of E Coli under a microcope.  This bacteria  is a major cause of urinary tract infections.  When women especially and men don’t wipe ourselves well after a bowel movement this bacteria migrates into the urinary tract area and makes us sick- it can actually kill us.

I used to work at a nursing home for about 5 years in Northern Virginia- there were about 250 beds that were filled at a time with patients.  About 1/3 of the patients that came in out of the many years I worked there came in from a urinary tract infection, dehydration, and kidney dysfunction due to not having enough water.  They simply did not drink enough water (soda pop and coffee are not good sources of hydration really).

The annual incidence of UTIs in the elderly is around 10 per cent and it may be as high as 30 per cent for people living in nursing homes and other institutions.1 1. Porush JG, Faubert PF, eds. Renal disease in the aged. Boston, MA: Little Brown, 1991; 241-58.

The mortality rate in bacteraemic elderly patients with UTI is as high as 33 percent !!!Tal S, Guller V, Levi S, et al. Profile and prognosis of febrile elderly patients with bacteraemic urinary tract infection. J Infect 2005; 50(4): 296-305.

Typical symptoms

• Fever • Dysuria • Loin pain • Frequency Atypical symptoms • Altered mental state • New-onset incontinence • Nausea and vomiting • Urinary retention

A wider variety of organisms are responsible for infections in the elderly than in younger patients. Escherichia coli is still the most common, causing 70 per cent of infections in uncatheterised patients. In patients with catheters or living in institutions, however, it is found in only 40 per cent of cases. In these patients, other Gram-negative organisms such as Klebsiella, Proteus and Pseudomonas become more important, and some Gram-positive organisms such as enterococci and staphylococci are also more prevalent.

 Trends in Urology, Gynaecology & Sexual HealthVolume 12, Issue 4, Version of Record online: 20 AUG 2007

Possible causes

1. Not enough water intake- it is more difficult with the elderly to recognize dehydration – make sure the urine is not cloudy – this is a red flag, and that it does not have a foul odor- red flag, that it does not have deposits – red flag- the urine color should be more on the clear side for sure in healthy urine

2. Wearing a diaper that has urine in it for more than a few minutes- it can cause a UTI and also cause a chemical burn

3. Wiping the perianal area front to back!!!!

4. Using wet wipes that are flushable- how are we still using toilet paper in the year 2016!!!!??? If you think you are cleaning your bottom area from feces well… you are not almost certainly with toilet paper alone. Showering every 2 days is critical as well to wash and rinse away E. Coli from the feces

5. In dwelling cathetars can be a huge cause

Helps

There are over the counter tests at pharmacy stores that test for UTI’s they may not be as accurate as the Dr office and a possible culture but it is very helpful

Treatments

Antibiotics the Dr will help prescribe for you- make sure to take the full amount or you will create super bugs that are resistant to regular antibiotics

Drink more water

Don’t allow a wet diaper on a patient/family member for more than a few minutes

Try the over the counter UTI test if you suspect a problem- if you are still worried call your Dr asap- it can be a life threatening situation!!!

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