Urinary tract infection: a cohort of older people with urinary incontinence

To evaluate epidemiological aspects of urinary tract infection in older patients with urinary incontinence living in long-term care institutions in Belo Horizonte. Method: Concurrent cohort held from April 1^st to October 1^st, 2015. The study was conducted in two long-term care institutions in the city of Belo Horizonte, Minas Gerais, with 84 incontinent older people.

Results:

Cumulative incidence of urinary tract infection was 19% (95% CI: 7.83-23.19) and the incidence density was 3.6 cases/100 people-month of follow-up period. The variables Bacteriuria and Institution presented statistical association with the occurrence of urinary tract infection.

Conclusion:

It is observed that the incidence of urinary tract infection in the study was smaller than in other similar international and national studies, however this is an important world health problem for the older population, with impact on mortality of these individuals.

Descriptors:
Urinary Infections; Urinary Incontinence; Older people; Nursing; Long-term Care Institution for the Older Population

Variable	n	%	Mean (SD^‡ ‡ Standard Deviation. )
Age			77.1 (8.6)
60-69	20	23.8
70-79.	34	40.5
80-89	22	26.2
90 or older	8	9.5
Gender
Male	44	52.4
Female	40	47.6
Institution
1	40	47.6
2	44	52.4
Functionality
Total Dependence	41	48.8
Severe Dependence	27	32.1
Moderate dependence	11	13.1
Very Light Dependence	5	6.0
Time of stay in the institution (years)			5.5 (5.2)
Less than 3	28	33.3
3-10	44	52.4
More than 10	12	14.3
Bacteriuria
No	48	57.1
Yes	36	42.9
Constipation
No	76	90.5
Yes	8	9.5
Fecal Incontinence
No	19	22.6
Yes	65	77.4
Use of diapers
No	18	20.2
Yes	66	79.8
Underlying diseases
Escherichia Coli	19	52.8
Klebisiella ssp	3	8.3
Enterococcus Faecalis	1	2.8
Enterobacter ssp	9	25.0
Morganela Morgani	1	2.8
Staphylococcus ssp	2	5.5
Pseudomona ssp	1	2.8
Systemic Arterial Hypertension	53	63.1
Previous cerebrovascular accident	38	45.2
Dementia	38	45.4
Diabetes Mellitus	21	25
Chronic Kidney Disease	2	2.3
Parkinson's disease	1	1.2
Benign prostate hyperplasia	1	1.2

Variable	Categories	n	%	Mean (SD^‡ ‡ Standard Deviation. )
Average number of diaper changes in 24 hours	≤3	18	26.2	3.8 (0.6)
Average number of diaper changes in 24 hours	4 or more	48	73.8
Average volume of urinary incontinence in 24 hours	<720mL	36	53.8	728.1 (323)
Average volume of urinary incontinence in 24 hours	≥720mL	30	46.2

Variables	UTI^‡ ‡ Urinary Tract Infection;		Total	pvalue	95% CI^* * Confidence Interval. of the p value
Variables	No	Yes	Total	pvalue	95% CI^* * Confidence Interval. of the p value
Institution				0.044	0.019; 0.413
Institution 1	36	4	40
Institution 2	32	12	44
Bacteriuria				0.004	0.130; 0.496
No	44	4	48
Yes	24	12	36
Dementia	34	12	46	0.071	-0.411; 0.08
No	34	12	46
Yes	34	4	38

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[1] CORRESPONDING AUTHOR: Flavia Falci Ercole. Email: flavia.ercole@gmail.com