Asymptomatic Bacteriuria in Older Adults

Abstract

Asymptomatic bacteriuria is a common finding in older populations. The prevalence increases with age in both men and women and is the highest in the most functionally impaired. Subjects with chronic indwelling catheters are always bacteriuric. Current management issues include the continuing need to refine clinical features identifying symptomatic infection and developing effective strategies to minimize inappropriate antimicrobial use for the treatment of asymptomatic bacteriuria. These are particularly relevant for residents of long-term care facilities where this is a high prevalence of bacteriuria. Recent reports continue to describe substantial antimicrobial treatment of asymptomatic bacteriuria in older populations in both acute and long-term care facilities. Comprehensive antimicrobial stewardship programs are effective in decreasing inappropriate use, including innovative strategies such as non-reporting of urine culture results. However, the durability of such programs remains uncertain.