Valoración de las infecciones del tracto urinario en ancianos institucionalizados. Propuesta de mejora en el abordaje clínico

• Noelia Domínguez Manzano ^[2] ; Adelaida Gómez Calvo ^[3] ; Orestes Octavio Rodríguez Aguado ^[2] ; Ana Sainz Otero ^[1] ; Carolina Lagares Franco ^[1]
  1. [1] Universidad de Cádiz

     Universidad de Cádiz

     Cádiz, España

     
  2. [2] Empresa Pública de Emergencias Sanitarias EPES 061 (Cádiz, España)
  3. [3] Residencia San Juan de Dios de Cádiz (Cádiz, España)

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• Localización: Evidentia: Revista de enfermería basada en la evidencia, ISSN-e 1697-638X, Vol. 16, Nº. 16, 2019
• Idioma: español
• Títulos paralelos:
  • Assessment of urinary tract infections in institutionalized elderly. Proposal for improvement in clinical approach
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• Resumen
  • español

    Objetivo: analizar las ITU en una Residencia y diseñar una estrategia de manejo y prevención. Metodología: estudio descriptivo, retrospectivo y longitudinal de ancianos institucionalizados en una Residencia de Cádiz entre el 1/abril/2015 al 31/marzo/2016. Seleccionamos aquellos que padecieron al menos un episodio de ITU. No presentamos criterios de exclusión. Resultados: contamos con 119 residentes, (media de 88/mes), presentaron infección 44 (75% mujeres). Edad entre 71 y 102 años, moda y mediana de 84. Tasa de incidencia global 49%/año. Sondaje vesical un 15,90% e incontinencia urinaria 86,36%. El 79.1% fueron episodios agudos, 20.9% crónicos y el 68.08% recidivaron. Manifestaciones clínicas: fiebre, astenia, dolor, hiperglucemia y hematuria. Escherichia coli. como germen más habitual. Conclusión: constatamos alta prevalencia de ITU mejorable con estrategia de gestión multidisciplinar, evitando sobrediagnóstico y sobretratamiento y prevención primaria con probióticos.

  • English

    Objective: the main objective is to analyse UTIs in a long-term care facility in Cadiz, and to design a management and prevention strategy. Methods: descriptive, retrospective and longitudinal study in an elderly population institutionalized in a long-term care facility in Cadiz. The study period covers between the 1st of April 2016 and the 31st of March 2016. Those who experienced at least one UTI episode during the established period were selected. Exclusion criteria are not presented. Results: there are 119 institutionalized residents, with an average of 88 per month. 44 patients presented an infection, of which 75% were females and 25% were males. The age range varies between 71 and 102 years old. The median and mode was 84 years old. The overall incidence rate was 49% in one year. 15.90% of individuals had an indwelling caterer and 86.36% had urinary incontinence. 79.1% are acute events, 20.9% are chronic and 68.08% produce relapse. The symptoms manifested were mainly fever, asthenia, pain, stinging, hyperglycemia, sediment alterations and hematuria. The most involved germ was Escherichia coli. Conclusions: A high prevalence of UTI is observed in our residents. We propose a multidisciplinary management strategy, therapeutic approach and to avoid overdiagnosis and overtreatment. We recommend to establish primary prevention with basic hygiene measures, daily management of the elderly and use of probiotics.