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

Surveillance de la santé et des maladies  
[1]
Téléchargement 1.35 Mo [1]

Public Access

Published

Peer reviewed scientific article

Anglais

DOI : https://doi.org/10.1186/s12877-019-1181-4 [2]

Auteurs

Biggel, Michael [3]; Heytens, Stefan [4]; Katrien Latour [5]; Bruyndonckx, Robin [6]; Goossens, Herman [7]; Moons, Pieter [8]

Mots-clés

  1. Asymptomatic bacteriuria [9]
  2. older adults [10]
  3. urinary tract infection [11]

Résumé:

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…
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Résumé

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.

Associated health topics:

Collection de souches [12]

Source URL: https://www.sciensano.be/fr/biblio/asymptomatic-bacteriuria-older-adults-most-fragile-women-are-prone-long-term-colonization

Liens
[1] https://www.sciensano.be/sites/default/files/biggel_et_al-2019-bmc_geriatrics.pdf
[2] https://doi.org/10.1186/s12877-019-1181-4
[3] https://www.sciensano.be/fr/biblio?f%5Bauthor%5D=87829&f%5Bsearch%5D=Biggel%2C%20Michael
[4] https://www.sciensano.be/fr/biblio?f%5Bauthor%5D=87830&f%5Bsearch%5D=Heytens%2C%20Stefan
[5] https://www.sciensano.be/fr/people/katrien-latour/biblio
[6] https://www.sciensano.be/fr/biblio?f%5Bauthor%5D=43476&f%5Bsearch%5D=Bruyndonckx%2C%20Robin
[7] https://www.sciensano.be/fr/biblio?f%5Bauthor%5D=43326&f%5Bsearch%5D=Goossens%2C%20Herman
[8] https://www.sciensano.be/fr/biblio?f%5Bauthor%5D=87832&f%5Bsearch%5D=Moons%2C%20Pieter
[9] https://www.sciensano.be/fr/biblio?f%5Bkeyword%5D=36116&f%5Bsearch%5D=Asymptomatic%20bacteriuria
[10] https://www.sciensano.be/fr/biblio?f%5Bkeyword%5D=25635&f%5Bsearch%5D=older%20adults
[11] https://www.sciensano.be/fr/biblio?f%5Bkeyword%5D=1746&f%5Bsearch%5D=urinary%20tract%20infection
[12] https://www.sciensano.be/fr/sujets-sante/collection-de-souches