{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T02:05:39Z","timestamp":1791252339442,"version":"4.1.0"},"reference-count":36,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Introduction: Urinary tract infections (UTIs) remain a significant public health issue worldwide, particularly affecting the geriatric population with increased morbidity and mortality. Aging-related immune changes, comorbidities, and urogenital abnormalities contribute to the higher incidence and complexity of UTIs in elderly patients. Antimicrobial resistance, especially extended-spectrum beta-lactamase (ESBL) production and carbapenem resistance, poses a major challenge in managing UTIs in this group. Methods: This retrospective, multicenter study included 776 patients aged 65 and older, hospitalized with a diagnosis of urinary tract infection between January 2019 and August 2024. Clinical, laboratory, and microbiological data were collected and analyzed. Urine samples were obtained under sterile conditions and pathogens identified using conventional and automated systems. Antibiotic susceptibility testing was performed according to CLSI standards. Logistic regression analyses were conducted to identify factors associated with ESBL production, carbapenem resistance, and mortality. Results: Among the patients, the median age was 78.9 years, with 45.5% female. ESBL production was detected in 56.8% of E. coli isolates and carbapenem resistance in 1.2%. Klebsiella species exhibited higher carbapenem resistance (37.8%). Independent predictors of ESBL production included the presence of urogenital cancer and antibiotic use within the past three months. Carbapenem resistance was associated with recent hospitalization, absence of kidney stones, and infection with non-E. coli pathogens. Mortality was independently associated with intensive care admission at presentation, altered mental status, Gram-positive infections, and comorbidities such as chronic obstructive pulmonary disease and urinary incontinence. Discussion: Our findings suggest that urinary pathogens and resistance patterns in elderly patients are similar to those in younger adults reported in the literature, highlighting the need for age-specific awareness in empiric therapy. The identification of risk factors for multidrug-resistant organisms emphasizes the importance of targeted antibiotic stewardship, especially in high-risk geriatric populations. Multicenter data contribute to regional understanding of resistance trends, aiding clinicians in optimizing management strategies for elderly patients with UTIs. Conclusions: This study highlights that E. coli and Klebsiella species are the primary causes of UTIs in the elderly, with resistance patterns similar to those seen in younger adults. The findings also contribute important data on risk factors for ESBL production and carbapenem resistance, supported by a robust patient sample.<\/jats:p>","DOI":"10.3390\/antibiotics14070719","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T11:25:17Z","timestamp":1752751517000},"page":"719","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Extended-Spectrum Beta-Lactamase Production and Carbapenem Resistance in Elderly Urinary Tract Infection Patients: A Multicenter Retrospective Study from Turkey"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9032-4046","authenticated-orcid":false,"given":"\u00c7i\u011fdem","family":"Y\u0131ld\u0131r\u0131m","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Ni\u011fde Training and Research Hospital, Ni\u011fde 51200, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sema","family":"Sar\u0131","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Ni\u011fde Training and Research Hospital, Ni\u011fde 51200, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ay\u015fe Merve","family":"Parmaks\u0131zo\u011flu Ayd\u0131n","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Ege University Medical School, \u0130zmir 35100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aysin","family":"Kilin\u00e7 Toker","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Kayseri State Hospital, Kayseri 38039, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ay\u015fe","family":"Turun\u00e7 \u00d6zdemir","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Kayseri State Hospital, Kayseri 38039, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esra","family":"Erdem K\u0131vrak","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Manisa Celal Bayar University Medical School, Manisa 45030, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinan","family":"Mermer","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Izmir Economy University Medical School, \u0130zmir 35100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5120-4877","authenticated-orcid":false,"given":"Hasip","family":"Kahraman","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Eski\u015fehir Osmangazi University Medical School, Eski\u015fehir 26040, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9664-3531","authenticated-orcid":false,"given":"Or\u00e7un","family":"Soysal","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Ni\u011fde Training and Research Hospital, Ni\u011fde 51200, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3060-377X","authenticated-orcid":false,"given":"Hasan \u00c7a\u011fr\u0131","family":"Y\u0131ld\u0131r\u0131m","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ege University Medical School, \u0130zmir 35100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4689-720X","authenticated-orcid":false,"given":"Meltem Isikgoz","family":"Tasbakan","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Ege University Medical School, \u0130zmir 35100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1016\/j.idc.2017.07.002","article-title":"Urinary tract infection and asymptomatic bacteriuria in older adults","volume":"31","author":"Trautner","year":"2017","journal-title":"Infect. 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