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Title
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Asymptomatic bacteriuria in older adults: the most fragile women are prone to long-term colonization
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Author
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Abstract
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| BackgroundThe diagnosis of urinary tract infections (UTIs) in institutionalized older adults is often based on vague symptoms and a positive culture. The high prevalence of asymptomatic bacteriuria (ABU), which cannot be easily discriminated from an acute infection in this population, is frequently neglected, leading to a vast over-prescription of antibiotics. This study aimed to identify subpopulations predisposed to transient or long-term ABU.MethodsResidents in a long-term care facility were screened for ABU. Mid-stream urine samples were collected during two sampling rounds, separated by 10 weeks, each consisting of an initial and a confirmative follow-up sample.ResultsABU occurred in approximately 40% of the participants and was mostly caused by Escherichia coli. Long-term ABU (>3months) was found in 30% of the subjects. The frailest women with urinary incontinence and dementia had drastically increased rates of ABU and especially long-term ABU. ABU was best predicted by a scale describing the functional independence of older adults.ConclusionsInstitutionalized women with incontinence have ABU prevalence rates of about 80% and are often persistent carriers. Such prevalence rates should be considered in clinical decision making as they devalue the meaning of a positive urine culture as a criterion to diagnose UTIs. Diagnostic strategies are urgently needed to avoid antibiotic overuse and to identify patients at risk to develop upper UTI. |
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Language
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English
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Source (journal)
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BMC geriatrics. - London
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Publication
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London
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2019
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ISSN
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1471-2318
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DOI
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10.1186/S12877-019-1181-4
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Volume/pages
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19
(2019)
, 11 p.
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Article Reference
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170
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ISI
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000472501100001
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Pubmed ID
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31226945
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Medium
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E-only publicatie
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Full text (Publisher's DOI)
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Full text (open access)
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