Bacteriuria in elderly women

ABSTRACT

Thirty-five ambulatory elderly women with a mean age of 64.6 +/- 4.2 years were examined for pyuria and bacteriuria and were questioned about urinary symptoms [dysuria, incontinence, frequency, urgency, suprapubic pain, flank pain and fever]. Attempts of localization of the site of urinary tract infection [UTI] were done for those with bacteriuria by detecting antibody coated bacteria in urinary specimens [using the direct immunofluorescent technique] and by estimating urinary N acetyl beta-D-glucosaminidase [NAG] urinary excretion [in units/g creatinine] as indicators of upper UTI. Bacteriuria was found in 22.8% of the elderly women in the present study of whom 62.5% were asymptomatic. No association was found between symptoms [dysuria, loin pain, incontinence] and bacteriuria. Absence of pyuria was a good predictor of absence of bacteriuria. Upper urinary tract infection represented 50% of cases with bacteriuria and all cases with upper UTI were asymptomatic. NAG urinary excretion is too sensitive to renal damage to be used to localize the site of UTI