Turnover of bacteriuria in old age.

Among 352 residents of a home for the elderly, who were fully mobile and devoid of most predisposing factors for bacteriuria, 19% of men and 27% of women had two positive cultures within two months. Positive conversion at one year among men and women negative at entry was 11% and 23% respectively, negative conversion of bacteriurics 22% and 27%. Subjects bacteriuric at entry but sterile at six months had a 77% (men) and 44% (women) reinfection rate at 12 months. The data indicate firstly that a significant proneness to infection does exist in old age, coupled with a lesser trend toward spontaneous cure; the latter is equal to that of younger ages. Thus, prevalence rises steadily in old age. Secondly a previous history of bacteriuria in a subject with currently sterile urine increases his chances of reinfection or recurrence two to seven times compared to those of subjects without past infection.

Bacteriuria and survival in old age.

We studied the effect of asymptomatic bacteriuria on survival in 342 healthy residents of a home for the aged. At entry into the study 76 subjects (22 per cent) had bacteriuria on two consecutive urine cultures. There were no differences in age distribution, blood pressure, hematocrit, smoking habits, cholesterol, or myocardial changes between bacteriuric and nonbacteriuric subjects. Median survival was 53 and 75 months in nonbacteriuric men and women 70 to 79 years old, and 45 months in all nonbacteriuric subjects over 79; median survival of bacteriuric men and women aged 70 to 79 was 33 and 34 months, and that of those older was 31 and 29.5 months; the shorter survival of bacteriuric subjects was significant (P less than 0.003). These differences in mortality among subjects living under identical conditions and with equal prevalence of risk factors indicate that bacteriuria in old age is associated with a reduction in survival of 30 to 50 per cent.