title: Localization of urinary tract infection in elderly, institutionalized women with asymptomatic bacteriuria.
abstract: We determined the site of urinary tract infection in 51 elderly, institutionalized women (mean age, 80.5 years) with asymptomatic bacteriuria by using the Fairley bladder washout technique. Thirty-four (67%) infections were localized in the kidney and 17 (33%) in the bladder. Women with renal infection were older than those with bladder infection (81.9 vs. 77.6 years of age; P = .04). The antibody-coated bacteria test had a sensitivity of 58%, specificity of 71%, positive predictive value of 82%, and negative predictive value of 43% for upper-urinary-tract infection. A quantitative urinary leukocyte count of greater than or equal to 20 leukocytes/mm3 had a positive predictive value of 80% and a negative predictive value of 88% for upper-urinary-tract infection. This study suggests that the majority of elderly, institutionalized women with asymptomatic bacteriuria have upper-urinary-tract infection. Both the antibody-coated bacteria test and the quantitative urinary leukocyte count may be useful as noninvasive tests for localization of urinary tract infection in this population.
authors.affiliation: Department of Medicine, University of Calgary, Alberta, Canada.
authors.forename: L E
authors.initials: LE
authors.lastname: Nicolle
authors.forename: P
authors.initials: P
authors.lastname: Muir
authors.forename: G K
authors.initials: GK
authors.lastname: Harding
authors.forename: M
authors.initials: M
authors.lastname: Norris
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001437:Bacteriuria / Q000175:diagnosis*; D003556:Cystitis / Q000175:diagnosis; D005260:Female; D006801:Humans; D007326:Institutionalization; D007674:Kidney Diseases / Q000175:diagnosis; D007958:Leukocyte Count; D014552:Urinary Tract Infections / Q000175:diagnosis*