Bacteriuria in Nursing Home Residents in the Netherlands: Point Prevalence and Associated Factors

To provide insight into the point prevalence of bacteriuria in frail older adults residing in Dutch nursing homes (NHs), to describe identified bacteria, and to investigate possible associations between resident characteristics and asymptomatic bacteriuria (ASB).

Cross-sectional study.

NH residents residing in long-term care wards in 22 Dutch NHs between February 2024 and July 2024.

Urine samples were collected from NH residents (either through spontaneous voiding, extracted from urine-saturated incontinence material, or from an indwelling urinary catheter) and cultured. Resident characteristics and clinical data, including urinary tract infection (UTI)-related signs and symptoms, were collected via NH staff and from electronic health records. Primary outcome is bacteriuria (>10⁵ colony-forming units per milliliter) point prevalence, and secondary outcomes are types of identified bacteria. Resident characteristics associated with ASB were explored using logistic mixed-model analysis.

Urine samples from 570 residents were analyzed (56.8% spontaneously voided; 27.7% extracted from incontinence material; 15.4% from an indwelling urinary catheter). Bacteriuria was found in 54.2% of the samples (women: 58.8%; men: 45.0%); only one resident had UTI-related signs and symptoms. Bacteriuria prevalence was 40.4% in spontaneously voided urine samples, 67.7% in samples extracted from incontinence material, and 80.7% in samples collected from an indwelling urinary catheter. The most commonly identified bacteria were Escherichia coli (39.9%). Female gender was positively associated with ASB [odds ratio (OR) 2.50, 95% CI 1.41-4.44], whereas dementia was inversely associated (OR 0.55, 95% CI 0.34-0.89).

The ASB rates identified in our study are comparable to previous findings. More research is needed to provide insight into the identified association between dementia and ASB.