Title

Epidemiologic and diagnostic aspects of bacteriuria: a longitudinal study in older women.

UMMS Affiliation

Meyers Primary Care Institute; Department of Medicine, Division of Geriatric Medicine

Date

6-1-1995

Document Type

Article

Medical Subject Headings

Aged; Aged, 80 and over; Bacteria; Bacteriuria; Boston; Carboxylic Ester Hydrolases; Cohort Studies; Colony Count, Microbial; Cross-Sectional Studies; Escherichia coli Infections; Female; Follow-Up Studies; Humans; Longitudinal Studies; Middle Aged; Predictive Value of Tests; Prevalence; Prospective Studies; Pyuria; Reagent Strips; Urinary Tract Infections

Disciplines

Health Services Research | Medicine and Health Sciences

Abstract

OBJECTIVE: To examine month-by-month variability of bacteriuria in a cohort of older women and to evaluate the performance of rapid diagnostic tests commonly used to indicate the presence of significant bacteriuria. DESIGN: Prospective, observational study. SETTING: Community housing sites and a long-term care institution. PARTICIPANTS: Sixty-one women, mean age 77.6, took part in the study. MEASUREMENTS: Midstream clean-catch urine samples and medical information on subjects were collected at baseline, and then monthly for 6 months. RESULTS: Bacteriuria alone (> or = 10(5) organisms per mL) occurred in 17% of all urine samples (28% of patients), bacteriuria with pyuria in 15% (26% of patients), and bacteriuria with symptoms in 3% (10% of patients). Spontaneous clearance of bacteriuria with pyuria was common (P = .30), as were new occurrences (P = .12) over 6 months of follow-up. For the outcome of bacteriuria with symptoms, sensitivity of urinary diagnostic tests such as bacteria and pyuria on microscopic analysis, and leukocyte esterase on dipstick testing, ranged from 79 to 93%. Negative predictive values of these tests approached 100%. CONCLUSIONS: Bacteriuria was a very common event, occurring in almost one-fifth of all urine samples and one-third of all subjects during 6 months of follow-up. Month-by-month follow-up indicates that the natural history of bacteriuria is marked by frequent spontaneous alternation between positive and negative events. The high negative predictive value of many simple diagnostic tests commonly used for urinary tract disease suggests that they can quickly and cost-effectively rule out bacteriuria in the older female patient.

Rights and Permissions

Citation: J Am Geriatr Soc. 1995 Jun;43(6):618-22.

Related Resources

Link to article in PubMed

PubMed ID

7775718