Urine culture doubtful in determining etiology of diffuse symptoms among elderly individuals: a cross-sectional study of 32 nursing homes

BMC Family Practice

Research Article

Peter Ulleryd¹  Ronny K Gunnarsson²  Pär-Daniel Sundvall³ 

[1] Department of Communicable Disease Control and Prevention, Region Västra Götaland, Institute of Biomedicine, The Sahlgrenska Academy, Kaserntorget 11 B, 411 18, Göteborg, Sweden;Research and development unit, Primary Health Care in Southern Älvsborg County, Sven Eriksonsplatsen 4, 503 38, Borås, Sweden;Department of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Box 454, 405 30, Göteborg, Sweden;Sandared Primary Health Care Centre, Strandvägen 11, 518 32, Sandared, Sweden;Research and development unit, Primary Health Care in Southern Älvsborg County, Sven Eriksonsplatsen 4, 503 38, Borås, Sweden;Department of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Box 454, 405 30, Göteborg, Sweden;

关键词: Urinary Tract Infections;    Homes for the Aged;    Nursing Homes;    Bacteriuria;    Predictive Value of Tests;   

DOI  :  10.1186/1471-2296-12-36

 received in 2010-10-20, accepted in 2011-05-19,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThe high prevalence of bacteriuria in elderly individuals makes it difficult to know if a new symptom is related to bacteria in the urine. There are different views concerning this relationship and bacteriuria often leads to antibiotic treatments. The aim of this study was to investigate the relationship between bacteria in the urine and new or increased restlessness, fatigue, confusion, aggressiveness, not being herself/himself, dysuria, urgency and fever in individuals at nursing homes for elderly when statistically considering the high prevalence of asymptomatic bacteriuria in this population.MethodsIn this cross-sectional study symptoms were registered and voided urine specimens were collected for urinary cultures from 651 elderly individuals. Logistic regressions were performed to evaluate the statistical correlation between bacteriuria and presence of a symptom at group level. To estimate the clinical relevance of statistical correlations at group level positive and negative etiological predictive values (EPV) were calculated.ResultsLogistic regression indicated some correlations at group level. Aside from Escherichia coli in the urine and not being herself/himself existing at least one month, but less than three months, EPV indicated no clinically useful correlation between any symptoms in this study and findings of bacteriuria.ConclusionsUrinary cultures provide little or no useful information when evaluating diffuse symptoms among elderly residents of nursing homes. Either common urinary tract pathogens are irrelevant, or urine culture is an inappropriate test.

【 授权许可】

CC BY   
© Sundvall et al; licensee BioMed Central Ltd. 2011