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Asymptomatic bacteriuria in older adults: the most fragile women are prone to long-term colonization.

ABSTRACT: BACKGROUND:The 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. METHODS:Residents 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. RESULTS:ABU occurred in approximately 40% of the participants and was mostly caused by Escherichia coli. Long-term ABU (> 3 months) 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. CONCLUSIONS:Institutionalized 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.

SUBMITTER: Biggel M

PROVIDER: S-EPMC6588879 | biostudies-other | 2019 Jun

REPOSITORIES: biostudies-other

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Asymptomatic bacteriuria in older adults: the most fragile women are prone to long-term colonization.

Biggel Michael M Heytens Stefan S Latour Katrien K Bruyndonckx Robin R Goossens Herman H Moons Pieter P

BMC geriatrics 20190621 1

<h4>Background</h4>The 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.<h4>Methods</h4>Residents in a long-term c ...[more]

PMID: 31226945

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Dataset Information

Asymptomatic bacteriuria in older adults: the most fragile women are prone to long-term colonization.

Publications

Asymptomatic bacteriuria in older adults: the most fragile women are prone to long-term colonization.

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