Asymptomatic bacteriuria in institutionalized elders in Israel

Area of Science:

• Gerontology
• Infectious Diseases
• Urology

Background:

• Asymptomatic bacteriuria (ASB) is the presence of bacteria in urine without associated symptoms.
• Prevalence of ASB is notably high in long-term care facility (LTCF) residents, particularly the elderly.
• Understanding the clinical outcomes of ASB in LTCF populations is crucial for patient management.

Purpose of the Study:

• To determine the prevalence of asymptomatic bacteriuria (ASB) in residents of a large long-term care facility.
• To describe and compare clinical outcomes, including mortality, in bacteriuric versus non-bacteriuric residents over a one-year period.

Main Methods:

• Prospective observational study involving 196 residents from a 800-inhabitant long-term care center.
• Urine cultures were obtained, with repeat cultures for those initially positive for >or= 10(5) cfu/ml.
• Residents were followed for one year, recording clinical events, antibiotic use, and mortality. Demographic data and comorbidities were collected.

Main Results:

• Asymptomatic bacteriuria (ASB) was detected in 43.3% (85/196) of screened residents.
• ASB patients exhibited significantly higher rates of being bed-ridden, dementia, and urinary/bowel incontinence.
• Mortality rate was substantially higher in bacteriuric residents (25.9%) compared to non-bacteriuric residents (7.1%) over 12 months.

Conclusions:

• Asymptomatic bacteriuria (ASB) in this LTCF population is associated with increased functional impairment.
• A significant increase in 12-month mortality was observed in residents with ASB.
• The elevated mortality in ASB patients was not solely attributable to urinary tract infections.