The Importance of the Host Nutritional and Immune Status on the Prognosis of Urinary Tract Infection in the Elderly

Abstract

This study was performed to evaluate the role of the nutritional and immune status on the prognosis of urinary tract infections (UTI) in the elderly. 192 patients among the 790 inpatients were diagnosed as UTI. Age-related increase in the prevalence of UTI was accompanied with poor prognosis in the patients with hypoalbuminemia (<2.6 g/dl) and lymphocytopenia (<700/mm3). To study the immunologic basis for susceptibility to UTI in the aged further, we compared the T-cell functions between outpatients without serious disease and inpatients with chronic UTI. The absolute numbers of lymphocyte, OKT3 (pan T-cell marker), OKT4 (Helper/Inducer marker) and Interleukin (IL)-2 as well as serum albumin concentration were decreased in the patients with UTI. A prospective study was done to confirm that these nutritional and immunological changes become risk factors in the prognosis of UTI with long-term and low-dose chemotherapy. In the patients continued with bacteriuria (Non-responders, n=6), serum albumin concentration and IL-2 production were significantly lower than the patients who became free from bacteriuria (Responders, n=7). These results suggest that poor nutrition-related immune dysfunction contributes to the vulnerbility of elderly patients to UTI and becomes risks for he prognosis of UTI. © 1993, The Japan Geriatrics Society. All rights reserved.