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Urinary Tract Infections in Long-Term Care Facilities

Published online by Cambridge University Press:  21 June 2016

L.E. Nicolle
L.E. Nicolle*
Affiliation:
Departments of Internal Medicine and Medical Microbiology, University of Manitoba, Winnipeg
*
Health Sciences Centre, MS673-820 Sherbrook Street, Winnipeg, Manitoba, Canada R3A 1R9
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Extract

Urinary tract infection, or bacteriuria, is common in residents of long-term care facilities (LTCFs). The prevalence of bacteriuria in noncatheterized residents of LTCFs has been reported to be 15% to 50% in studies performed in several different countries (Table). As with most other age groups, the prevalence is greater for women than men. The female to male ratio is, however, lower than in younger populations.

The incidence of bacteriuria is also extremely high. In one group of severely functionally disabled elderly men, 45 new infections/100 patient years were observed, with 10% of nonbacteriuric residents becoming bacteriuric in each three-month period. An institutionalized population in Greece had initial prevalences of bacteriuria of 19% for men and 27% for women, with an additional 11% and 23% of the non-bacteriuric population, respectively, developing a positive urine culture at 6 or 12 months from admission.4 A nursing home population of elderly women in Philadelphia, with an initial prevalence of bacteriuria of 25%, had an additional 8% of the initially nonbacteriuric subjects identified with a positive urine culture each six-month period of follow-up.

Type
Topics in Long-Term Care
Information
Infection Control & Hospital Epidemiology , Volume 14 , Issue 4 , April 1993 , pp. 220 - 225
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1993

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References

1. Walkey, FA, Judge, TG, Thompson, J, Sarkasi, NBS. Incidence of urinary infection in the elderly. Scott Med J. 1967;12:411–414.Google Scholar
2. Gladstone, JL, Friedman, SA. Bacteriuria in the aged: a study of its prevalence and predisposing lesions in a chronically ill population. Urol. 1971;106:745–749.Google Scholar
3. Bentzen, A, Vejlsgaard, R. Asymptomatic bacteriuria in elderly subjects. Dun Med Bull. 1980;27:101–106.Google Scholar
4. Kasviki-Charvati, R Drolette-Kefakis, B, Papanayiotou, PC, Dontas, AS. Turnover of bacteriuria in old age. Age Ageing. 1982;11:169–174.CrossRefGoogle ScholarPubMed
5. Nicolle, LE, Bjornson, J, Harding, GKM, MacDonell, JA. Bacteriuria in elderly institutionalized men. N Engl J Med. 1983;309:1420–1425.Google Scholar
6. Nicolle, LE, Mayhew, WJ, Bryan, L. Prospective randomized comparison of therapy and no therapy for asymptomatic bacteriuria in institutionalized elderly women. Am J Med. 1987;83:27–33.Google Scholar
7. Abrutyn, E, Massey, J, Levison, M, Boscia, J, Pitsakis, P, Kaye, D. Epidemiology of asymptomatic bacteriuria in elderly women. Am Geriatr Soc. 1991;39:388–393.Google Scholar
8. Boscia, JA, Kobasa, WD, Knight, RA, Abrutyn, E, Levison, ME, Kaye, D. Epidemiology of bacteriuria in an elderly ambulatory population. Am J Med. 1986;80:208–214.Google Scholar
9. Warren, JW. Catheter-associated bacteriuria. Clin Geriatr Med. 1992;8:805–819.Google Scholar
10. Carty, M, Brocklehurst, JC, Carty, J. Bacteriuria and its correlates in old age. Gerontology. 1981;27:72–75.CrossRefGoogle ScholarPubMed
11. Nicolle, LE, Henderson, E, Bjomson, J, Mclntyre, M, Harding, GKM, MacDonell, JA. The association of bacteriuria with resident characteristics and survival in elderly institutionalized men. Ann Intern Med. 1987;106:682–686.Google Scholar
12. Boscia, JA, Kaye, D. Asymptomatic bacteriuria in the elderly. Infect Dis Clin North Am. 1987;1:893–905.CrossRefGoogle ScholarPubMed
13. Zhanel, G, Harding, GKM, Nicolle, LE. Asymptomatic bacteriuria in diabetics. Rev Infect Dis. 1991;13:150–154.Google Scholar
14. Hirsh, DD, Fainstein, V, Musher, DM. Do condom catheter collecting systems cause urinary tract infections? JAMA. 1979;242:340–341.CrossRefGoogle Scholar
15. Brandbertr, A. Mellstrom, D. Samsioe, G. Low dose oral estriol treatmentin elderly women with urogenital infections. Acta Obstet Gynecol Scand 1987; (suppl) S140:33–38.Google Scholar
16. Sobel, JD, Kaye, D. The role of bacterial adherence in urinary tract infection in elderly adults. J Gerontol, 1987;42:29–32.CrossRefGoogle ScholarPubMed
17. Nicolle, LE, Harding, GKM, Kennedy, J, Mclntyre, M, Aoki, F, Murray, D. Urine specimen collection with external devices for diagnosis of bacteriuria in elderly incontinent men. J Clin Microbiol. 1988;26:1115–1119.Google Scholar
18. Nicolle, LE, Muir, P, Harding, GKM, Norris, M. Localization of site of urinary infection in elderly institutionalized women with asymptomatic bacteriuria. J Infect Dis. 1988;157:65–70.CrossRefGoogle ScholarPubMed
19. Boscia, JA, Abrutyn, E, Levison, ME, Pitsakis, PG, Kaye, D. Pyuria and asymptomatic bacteriuria in elderly ambulatory women. Ann Intern Med. 1989;100:404–405.CrossRefGoogle Scholar
20. Rodgers, K, Nicolle, LE, Mclntyre, M, Harding, GKM, Hoban, D, Murray, D. Pyuria in institutionalized elderly subjects. Can J Infect Dis. 1991;2:142–146.Google Scholar
21. Ouslander, JG, Greengold, BA, Silverblatt, FJ. An accurate method to obtain urine for culture in men with external catheters. Arch Intern Med. 1987; 147–286.Google ScholarPubMed
22. McGeer, A, Campbell, B, Eckert, DG, et al. Definitions for surveillance of infections in residents of long-term care facilities. Am J Infect Control 1991;19:1–7.Google Scholar
23. Nicolle, LE, Norris, M, Finlayson, M. Hemagglutination characteristics of Escherichia coli isolates from elderly women with asymptomatic bacteriuria. In: Kass, EH, Svanburg Eden, C. Host-Ffzrasite Interactions in Urinary Tract Infections. Chicago, IL: University of Chicago Press; 1989.Google Scholar
24. Boscia, JA, Kobasa, WD, Abrutyn, E, Levison, ME, Kaplan, AM, Kaye, D. Lack of association between bacteriuria and symptoms in the elderly. Am J Med. 1986;81:929–982.Google Scholar
25. Berman, P, Hogan, DB, Fox, RA. The atypical presentation of infection in old age. Age Ageing. 1987;16:201–207.Google Scholar
26. Nicolle, LE, Orr, R Duckworth, H, et al. Gross hematuria in residents of long-term care facilities. Am J Med. In press.Google Scholar
27. Nicolle, LE, Mclntyre, M, Zacharias, H, MacDonell, JA. Twelvemonth surveillance of infections in institutionalized elderly men. J Am Geriatr Soc. 1984;32:513–519.CrossRefGoogle ScholarPubMed
28. Muder, RR, Brennen, C, Wagener, MM, Goetz, AM. Bacteriutia in a long-term care facility: a five-year prospective study of 163 consecutive episodes. Clin Infect Dis. 1992;14:647–654.CrossRefGoogle Scholar
29. Senay, H, Getz, MB. Epidemiology of bacteremic urinary tract infections in chronically hospitalized elderly men. J Urol. 1991;145:1201–1204.Google Scholar
30. Johnson, JR, Stamm, WE. Diagnosis and treatment of acute urinary tract infections. Infect Dis Clin North Am 1987;1:773–792.Google Scholar
31. Seeberg, S, Brandberg, A, Bergstrom, G, Nordquist, P, The effect on bacteriuria of removal of indwelling catheters and treatment with cotrimoxazole. JHosp Infect. 1982;3:159–164.Google ScholarPubMed
32. Wingard, E, Shlaes, JH, Mottimer, EA, Shlaes, DM. Colonization and cross-colonization of nursing home patients with tri-methoprim-resistant gram-negative bacilli. Clin Infect Dis. 1993;16:75–81.CrossRefGoogle ScholarPubMed
33. Shlaes, DM, Lehman, M-H, Curri-McCumber, CA, Kim, CH, Floyd, R. Prevalence of colonization with antibiotic resistant gram-negative bacilli in a nursing home care unit: the importance of cross-colonization as documented by plasmid analysis. Infect Control. 1986;7:538–545.Google Scholar
34. Zimmer, JG, Bentley, DW, Valenti, WM, Watson, NM. Systemic antibiotic use in nursing homes: a quality assessment. J Am Geriatr Soc. 1986;34:703–710.Google Scholar
35. Warren, JW, Palumbo, FB, Fitterman, L, Speedie, SM. Incidence and characteristics of antibiotic use in aged nursing home patients. J Am Geriatr Soc. 1991;39:963–972.Google Scholar
36. Gaynes, RR Weinstein, R, Chamberlin, W. Antibiotic resistant flora in nursing home patients admitted to the hospital. Arch Intern Med. 1985;145:1804–1807.Google Scholar
37. Fierer, J, Ekstrom, M. An outbreak of Providencia stuartii urinary tract infections: patients with condom catheters are a reservoir of the bacteria. JAMA. 1981;245:1553–1555.Google Scholar