UNJ June 2004

Urinary tract infections (UTIs) are the most common type of nosocomial infection found in long-term care facilities (LTCFs) (Warren, Palumbo, Fitterman, & Speedie, 1991). Yet, there is much to be understood about UTIs in the elderly (generally considered to be those over 64 years old). Just as children are medically not small adults, the elderly are not necessarily older adults. They are unique in many ways. Urinary tract infection requiring antibiotic treatment is defined in the general population as the presence of significant amounts of a single microorganism in the urine (Winsinger, 1996). In the elderly, researchers have found that significant bacteriuria, even with accompanying pyuria, is not sufficient as an indicator for a UTI or antibiotic therapy (Nicolle, 2000). Further, symptoms of a UTI in the general population are not always applicable Urinary tract infections (UTIs) are common in the elderly, yet there is much disagreement in the literature regarding many aspects of this condition.To assist the nurse in developing optimum care strategies, UTI criteria in the elderly are discussed. Using the most recent knowledge to guide clinical assessment and intervention skills, the longterm care facility nurse and nurses who care for the elderly can influence positive outcomes in this challenging population.