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Diuresis bacteriuria in physically dependent elderly women.

A S Dontas, I Paraskaki, G Petrikkos

    Age and Ageing
    |July 1, 1987
    PubMed
    Summary

    Elderly women with reduced mobility may develop transient bacterial excretion after rapid hydration and intravenous frusemide. This condition, linked to kidney function decline, increases infection risk in older adults.

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    Area of Science:

    • Gerontology
    • Nephrology
    • Infectious Diseases

    Background:

    • Elderly individuals, particularly those in aged care facilities, often experience reduced mobility and are susceptible to urinary tract issues.
    • Repeatedly negative urine cultures do not always exclude the possibility of future bacteriuria in this population.

    Purpose of the Study:

    • To investigate the incidence and characteristics of transient bacterial excretion in elderly women following a hydration and diuretic challenge.
    • To explore the relationship between this transient bacteriuria, renal function, and clinical outcomes.

    Main Methods:

    • A cohort of 34 women (aged 74-96) residing in an aged care facility underwent rapid hydration and intravenous frusemide administration.
    • Urine cultures were monitored, and antibody-coated bacteria were tested in positive isolates.
    • Glomerular filtration rates and renal tubular function were assessed.

    Main Results:

    • 47% of women exhibited transient bacterial excretion following the intervention, often coinciding with diuresis.
    • Antibody-coated bacteria were found in most Gram-negative isolates.
    • Women with transient bacteriuria showed poorer renal function (lower GFR, advanced tubular defects) compared to controls.
    • These women experienced faster progression to renal insufficiency and higher 1-year mortality.

    Conclusions:

    • Transient bacterial excretion, potentially originating from the upper urinary tract, can be triggered by hydration and diuresis in elderly women.
    • This phenomenon is associated with impaired renal function and poorer clinical outcomes.
    • Diuresis-induced bacteriuria may be a significant, often overlooked, source of common infections in the elderly.

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