CLINICALLY INAPPARENT (ASYMPTOMATIC) BACTERIURIA IN AMBULATORY ELDERLY MEN - EPIDEMIOLOGIC, CLINICAL, AND MICROBIOLOGICAL FINDINGS

In a prospective longitudinal study, ambulatory elderly men were followed from 1 to 4.5 years to gain insight into the prevalence rates, clinical characteristics, and patterns of clinically inapparent (asymptomatic) bacteriuria (CIB). The prevalence of CIB was 12% (29/238) and increases with age. Unlike the gram‐negative organisms that cause overt urinary tract infection in this age group, gram‐positive organisms dominated the CIB group. Both the CIB and abacteriuric patients have multiple chronic medical conditions and are indistinguishable on that basis. Twenty‐nine elderly men with bacteriuria and 105 abacteriuric subjects were followed with serial urine cultures. During the study period the bacteriuric subjects exhibited spontaneous temporary or permanent resolution (76%, 22/29), intermittency (21%, 6/29), and probable bacterial persistence (38%, 11/29). No consistent pattern of bacteriuria was evident. Therefore, antimicrobial therapy is not warranted in the treatment of asymptomatic or clinically inapparent bacteriuria in ambulatory elderly men. © 1990 The American Geriatrics Society