Necessity of Laboratory Screening for Bacteriuria in ElderlyPopulation

Background and Aim : Bacteriuria is common in functionally impaired elderly patients.Asymptomatic bacteriuria (ASB) is the presence of bacteria in the properly collected urine of apatient with no signs or symptoms of urinary tract infection (UTI). Bacteriuria is common in theelderly, especially among institutionalized or hospitalized patients. Risk factors include impairedimmune system, diabetes mellitus, structural urinary tract abnormalities and indwelling catheters.Its incidence increases with age and is usually caused by ascending of normal flora of the gut.Differentiating between ASB and UTI in this population is challenging. Identifying subpopulationswith low or high risks for asymptomatic bacteriuria could help to guide the decision to initiate orwithhold antibiotic therapy.Methods : This review article aims to discuss the benefits and harms of screening for and treatmentof ASB in elderly patients. PubMed and the Infectious Disease Society of America (IDSA)guideline were the sources of search in this article.Results : Most patients with ASB, specifically older patients, will have no adverse consequencesfrom asymptomatic bacteriuria. Treatment in these patients does not decrease the incidence of ASBor improve survival, but it will increase the adverse effects from antibiotics and the developmentof antibiotic-resistant bacteria.Conclusion : In the absence of symptoms or signs of infection, routine screening and subsequentantimicrobial therapy is not recommended. It is not appropriate to routinely order a urinalysis andurine culture and sensitivity test on every patient admitted to the hospital unless there is a clinicalreason to suspect a symptomatic or an occult urinary tract infection.

کلیدواژه ها:

elderly ، asymptomatic bacteriuria ، screening ، UTI