Urinary tract infections (UTIs) are one of the most common reasons for hospital visits worldwide and are associated with significant economic burden.1-3 In the United States alone, an estimated 2.8 billion USD was spent on healthcare costs associated with UTIs in 2011.2 Another estimate from 2007 which included missed work hours draws this number at approximately 3.5 billion USD.3 These numbers continue to grow as disease incidence increases, with a 52% surge between 1998–2011.2
Rising antimicrobial resistance has resulted in limited effective treatment options for UTIs, making antimicrobial stewardship all the more important.2 Risk factors and clinical presentation of UTI vary in different age categories, with differing trends in causative pathogens and/or antimicrobial susceptibility.4 Such age-dependent differences will warrant treatment selection according to age categories, and will be an important step forward in making more informed selection of empirical antimicrobial therapy.4
Researchers from Peking University First Hospital, Beijing, China investigated UTI causative agents and antimicrobial resistance patterns across age groups in a total of 13,308 UTI patients.4 Data was collected retrospectively, and included all positive urine culture results from non-repetitive UTI patients recorded in their hospital from January 2009 to December 2020.4 Aetiological profiles were sorted based on age category (newborn, ≤28 days; paediatric, 29 days to ≤14 years; adult, >14 to ≤65 years; geriatric, >65 years) and antimicrobial resistance rates for top five causative pathogens were analysed.4
Key findings from their research were4:
Aetiological data and resistance profiles in UTI as highlighted in this study could provide the empirical evidence needed to select more appropriate treatments and provide timely intervention for different age sub-populations.1,4 Especially among paediatric and geriatric patients where patterns vary, it is important to consider different antimicrobial therapies before beginning treatment.4 The findings of this study could inform future UTI treatment guidelines to consider the aetiological and antimicrobial resistance patterns in different sub-populations.
*Newborns and paediatric cases were not included in this analysis due to low sample size when stratified according to ward type.