Journal of the Chinese Medical Association
Volume 69, Issue 5 , Pages 213-217, May 2006

Asymptomatic Bacteriuria Among the Institutionalized Elderly

  • Yi-Ting Lin

      Affiliations

    • Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Liang-Kung Chen

      Affiliations

    • Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Ming-Hsien Lin

      Affiliations

    • Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Shinn-Jang Hwang

      Affiliations

    • Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Prof. Shinn-Jang Hwang, Department of Family Medicine, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.

Received 9 September 2005; accepted 28 March 2006.

Article Outline

Background

Urinary tract infections (UTI) are the most common type of infection among residents of long-term care facilities (LTCFs). The presence of asymptomatic bacteriuria among LTCF residents brings challenges to onsite health professionals. The aim of this study was to explore the prevalence and related factors of aymptomatic bacteriuria among the institutionalized elderly in Taiwan.

Methods

In 2002, residents of 2 private LTCFs participated in this study. History taking, anthropometric measurements, and urine and blood samplings were performed by experienced research staff. Urine bacterial culture was performed by a standard procedure; subjects with symptoms indicating UTI were excluded. Repeated urine bacterial culture was performed 1 week after screening tests. Bacteriuria was defined as 1 or more organisms isolated from 2 consecutive urine specimens (≥ 105 CFU [colony-forming units]/mL). Asymptomatic bacteriuria was defined as identical microorganisms isolated from 2 urine culture specimens taken at 1-week intervals from a subject who was free of UTI symptoms. The presence of asymptomatic bacteriuria and its related factors, such as age, sex, nutritional status, and long-term placement of urinary catheter, were evaluated.

Results

A total of 64 institutionalized Chinese elderly (mean age, 76.2 ± 9.1 years; male:female, 48:16) were collected. The prevalence of asymptomatic bacteriuria was 57.8% (37/64), and was not associated with age, sex, functional status, long-term foley catheter, or previous UTI history. The most commonly isolated organisms were Escherichia coli (29.7%), Klebsiella pneumoniae (21.6%), Providentia stuartii (16.2%), and Pseudomonas aeruginosa (13.5%). Moreover, 21.6% of them showed multiple organisms. Nutritional status (body mass index, serum levels of albumin, total cholesterol, total lymphocyte count, and hemoglobin) was similar between subjects with or without bacteriuria (p >0.05).

Conclusion

Asymptomatic bacteriuria is common among Chinese residents in LTCFs. Escherichia coli was the most commonly cultured bacterium. Presence of asymptomatic bacteriuria was not associated with age, sex, functional status, catheter indwelling, previous history of UTI, or nutritional status of residents in LTCFs.

Key Words:  asymptomatic bacteriuria , institutionalized elderly , nutritional status , urinary catheterization , urinary tract infection

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PII: S1726-4901(09)70221-7

doi:10.1016/S1726-4901(09)70221-7

Journal of the Chinese Medical Association
Volume 69, Issue 5 , Pages 213-217, May 2006

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