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Background This study compared the bacterial spectrum and antibiotic susceptibility of uropathogens in older and younger patients with urinary stones to provide appropriate antibiotic management. Methods We retrospectively reviewed urinary tract infection patients with urolithiasis, presented to Xiangya Hospital from March 2014 to April 2021. Patients were divided into older and younger groups according to 60 years of age. The bacterial spectrum and drug sensitivity of uropathogens were compared. Results A total of 542 strains of uropathogens (177 in older and 365 in younger groups) were isolated from 507 patients.  E. coli  (41.8% vs 43.6%) remains the most common pathogen, followed by  E. faecalis  (6.2% vs 9.6%) in older and younger groups, respectively. Particularly,  K. pneumoniae  was significantly more frequent in older (9.6%) than in younger group (4.7%,  P  &lt; .05).  E. faecium  was substantially more prevalent in older group (6.2%) than in younger group (2.7%,  P  &lt; .05). The proportion of males increased in older patients (47.3%) than in younger patients (34.9%,  P  = 0.007). In both groups, major Gram-negative bacteria ( E. coli  and  K. pneumoniae ) revealed a high sensitivity over 70% to piperacillin/tazobactam, imipenem and amikacin, whereas the resistance level was high to penicillin, tetracycline and vancomycin. Major Gram-positive ( E. faecalis  and  E. faecium ) isolates demonstrated high sensitivity of over 50% to gentamicin and vancomycin in both groups. Furthermore, uropathogens isolated from younger urolithiasis patients were more susceptible to antimicrobials than those isolated from older patients. Conclusions The male increased in the older urolithiasis patients with UTI and uropathogens microbial spectrum in older urolithiasis patients are different from younger. High susceptibility and age should be utilized in empirical antibiotic selection to avoid increased multidrug-resistant bacteria.

Comparative study of the bacterial distribution and antimicrobial susceptibility of uropathogens in older and younger patients with urinary stones