Asymptomatic Bacteriuria and Urinary Tract Infection in Older Adults

2007 ◽  
Vol 23 (3) ◽  
pp. 585-594 ◽  
Author(s):  
Manisha Juthani-Mehta
2017 ◽  
Vol 31 (4) ◽  
pp. 673-688 ◽  
Author(s):  
Nicolas W. Cortes-Penfield ◽  
Barbara W. Trautner ◽  
Robin L.P. Jump

Author(s):  
Bradley J Langford ◽  
Kevin A Brown ◽  
Christina Diong ◽  
Alex Marchand-Austin ◽  
Kwaku Adomako ◽  
...  

Abstract Background The role of antibiotics in preventing urinary tract infection (UTI) in older adults is unknown. We sought to quantify the benefits and risks of antibiotic prophylaxis among older adults. Methods We conducted a matched cohort study comparing older adults (≥66 years) receiving antibiotic prophylaxis, defined as antibiotic treatment for ≥30 days starting within 30 days of a positive culture, with patients with positive urine cultures who received antibiotic treatment but did not receive prophylaxis. We matched each prophylaxis recipient to 10 nonrecipients based on organism, number of positive cultures, and propensity score. Outcomes included (1) emergency department (ED) visit or hospitalization for UTI, sepsis, or bloodstream infection within 1 year; (2) acquisition of antibiotic resistance in urinary tract pathogens; and (3) antibiotic-related complications. Results Overall, 4.7% (151/3190) of UTI prophylaxis patients and 3.6% (n = 1092/30 542) of controls required an ED visit or hospitalization for UTI, sepsis, or bloodstream infection (hazard ratio [HR], 1.33; 95% confidence interval [CI], 1.12–1.57). Acquisition of antibiotic resistance to any urinary antibiotic (HR, 1.31; 95% CI, 1.18–1.44) and to the specific prophylaxis agent (HR, 2.01; 95% CI, 1.80–2.24) was higher in patients receiving prophylaxis. While the overall risk of antibiotic-related complications was similar between groups (HR, 1.08; 95% CI, .94–1.22), the risk of Clostridioides  difficile and general medication adverse events was higher in prophylaxis recipients (HR [95% CI], 1.56 [1.05–2.23] and 1.62 [1.11–2.29], respectively). Conclusions Among older adults with UTI, the harms of long-term antibiotic prophylaxis may outweigh their benefits.


Author(s):  
Justin Choi ◽  
Kerry Meltzer ◽  
Anna Cornelius-Schecter ◽  
Assem Jabri ◽  
Matthew Simon ◽  
...  

2016 ◽  
Vol 37 (12) ◽  
pp. 1499-1501 ◽  
Author(s):  
Curtis D. Collins ◽  
Jared J. Kabara ◽  
Sarah M. Michienzi ◽  
Anurag N. Malani

Implementation of an antimicrobial stewardship program bundle for urinary tract infections among 92 patients led to a higher rate of discontinuation of therapy for asymptomatic bacteriuria (52.4% vs 12.5%; P =.004), more appropriate durations of therapy (88.7% vs 63.6%; P =.001), and significantly higher overall bundle compliance (75% vs 38.2%; P < .001).Infect Control Hosp Epidemiol 2016;1499–1501


2019 ◽  
Vol 25 (3) ◽  
pp. 222-227 ◽  
Author(s):  
Catherine S. Forster ◽  
Hans Pohl

Bacteriuria, a non-specific term that refers to the presence of bacteria in the urine, is common in people with neuropathic bladders. However, accurately determining when bacteriuria represents a urinary tract infection (UTI) as opposed to asymptomatic bacteriuria is difficult. There is currently no widely accepted definition of what constitutes a UTI in people with neuropathic bladders. As a result, there is significant variation in care, which likely leads to unnecessary use of antibiotics for bacteriuria. To improve the clinical management of people with neuropathic bladders, it is important to be able to accurately diagnose and treat UTIs. In this article, we review the difficulties associated with accurately diagnosing UTIs and then review proposed definitions. Finally, we discuss the emerging literature of the urinary microbiome and how this may assist in accurately diagnosing UTIs in people with neuropathic bladders.


2018 ◽  
pp. 217-220
Author(s):  
Glenn Patriquin

This case illustrates one of the most common healthcare-associated infections (HAI) in a patient who is admitted to hospital. Catheter-associated urinary tract infections (CAUTI) can be prevented by eliminating unnecessary urinary catheter use. Furthermore, non-specific symptoms are frequently erroneously attributed to a presumed urinary tract infection (UTI) upon isolating bacteria from a urine sample. Except for a few specific circumstances, asymptomatic bacteriuria should not be treated with antibiotics. Without symptoms consistent with UTI, growth of bacteria from urine does not constitute an infection. Culturing urine without UTI symptoms can lead to misuse of antibiotics, which can increase adverse events and drive antimicrobial resistance. This case reviews common causes of UTIs and criteria for diagnosis.


2015 ◽  
Vol 3 (1) ◽  
pp. 34-37
Author(s):  
Una Jessica Sarker ◽  
Md Sakil Munna ◽  
Saurab Kishore Munshi

With the previous knowledge on the production of ?-lactamase by the bacterial pathogens causing urinary tract infection, present study further investigated the presence of symptomatic and asymptomatic bacteriuria in female patients admitted into the Delta Medical College with suspected urinary tract infections (UTIs). The manifestation of uropathogens and their responses against locally available antibiotics (amoxicillin, 10 ?g; cephradin, 30 ?g; ciprofloxacin, 5 ?g; cotrimoxazole, 23.8 ?g; gentamicin, 10 ?g; nalidixic acid, 30 ?g) were inquired by means of conventional cultural techniques and double-disc diffusion methods, respectively. Among 110 urine samples collected from the patients with suspected UTI, 34 were found to be culture positive. Symptomatic (64.7%) and asymptomatic (36.3%) bacteriuria were noticed inside the puss cell of the UTI positive cases. Escherichia coli (73.5%) was the dominant bacteria while Klebsiella spp. (26.5%) was also exultant. Around 96% uropathogens were found to be sensitive against imipenem, and 75% against amikacin. E. coli was found to be sensitive against all of the antibiotics used, whereas Klebsiella spp. was found to be 100% resistant against nalidixic acid and cotrimoxazole. DOI: http://dx.doi.org/10.3329/sjm.v3i1.22751 Stamford Journal of Microbiology, Vol.3(1) 2013: 34-37


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