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Bacteriuria is associated with urge urinary incontinence in older women
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Center for Clinical Research Dalarna. (Family medicine and clinical epidemiology)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Center for Clinical Research Dalarna. (Family Medicine and Clinical Epidemiology)
2008 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 26, no 1, 35-39 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To investigate the association between bacteriuria and frequency and type of urinary incontinence in elderly people living in the community. Bacteriuria and urinary incontinence are common conditions and often coexisting in this population; the authors have previously reported the prevalence of bacteriuria to be 22.4% in women and 9.4% in men. DESIGN: Cross-sectional study. SETTING: The catchment area of a primary healthcare centre in a Swedish middle-sized town. SUBJECTS: Residents, except for those in nursing homes, aged 80 and over. Participation rate: 80.3% (431/537). MAIN OUTCOME MEASURES: Urinary cultures and questionnaire data on urinary incontinence. RESULTS: In women the OR for having bacteriuria increased with increasing frequency of urinary incontinence; the OR was 2.83 (95% CI 1.35-5.94) for women who were incontinent daily as compared with continent women. Reporting urge urinary incontinence increased the risk of having bacteriuria: 3.36 (95% CI 1.49-7.58) in comparison with continent women while there was no significant association between stress urinary incontinence and bacteriuria. The prevalence of bacteriuria among men was too low to make any meaningful calculations about the association between bacteriuria and frequency and type of incontinence. CONCLUSION: Bacteriuria is associated with more frequent leakage and predominantly with urge urinary incontinence. The causes of this association and their clinical implications remain unclear. There might be some individuals who would benefit from antibiotic treatment, but further studies are warranted.

Place, publisher, year, edition, pages
2008. Vol. 26, no 1, 35-39 p.
Keyword [en]
Bacteriuria, elderly, family practice, stress urinary incontinence, urge urinary incontinence
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-97548DOI: 10.1080/02813430701878250ISI: 000253514300008OAI: oai:DiVA.org:uu-97548DiVA: diva2:172538
Available from: 2008-10-02 Created: 2008-10-02 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Asymptomatic Bacteriuria in the Elderly
Open this publication in new window or tab >>Asymptomatic Bacteriuria in the Elderly
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to explore the features of asymptomatic bacteriuria (ASB) in elderly people living in the community, and to seek diagnostic tools to discriminate between ASB and symptomatic urinary tract infection (UTI).

All men and women aged 80 and over living in an urban district of Falun, Sweden, were invited to participate. Urine samples were obtained together with information on symptoms and on health indicators. The same cohort was surveyed again after 6 and 18 months. Urinary cytokines were analysed in 16 patients with UTI, in 24 subjects with ASB and in 20 negative controls.

ASB occurred at baseline in 19.0% of women and 9.4% of men, and was found at least once in 36.9% of women and in 20.2% of men. ASB in women was associated with reduced mobility and urge urinary incontinence. Of those with ASB at baseline, 60% still had bacteriuria at 6 and 18 months, but among those with repeated findings of ASB with E. coli, only 40% had the same bacterial strain after 18 months. In women, the risk of developing a UTI within 24 months was higher among those with ASB at baseline than in those without. Urinary levels of cytokines (CXCL1, CXCL8 and IL-6) and leukocyte esterase were higher in patients with UTI than in patients with ASB.

There is convincing evidence that ASB is harmless and should not be treated with antibiotics. However, such treatment is still often given, thereby unnecessarily contributing to the increased number of bacteria resistant to common antibiotics. This study confirms the high prevalence of ASB in elderly people living in the community. In order not to be misled by a urinary test showing bacteria, it is important to restrict urinary testing for bacteria to patients where there is a suspicion of UTI. In elderly patients with diffuse symptoms or in patients who are unable to communicate their symptoms, further diagnostic help could possibly be obtained by evaluating the urinary levels of leukocyte esterase and/or IL-6.

Place, publisher, year, edition, pages
Uppsala: Universitetsbiblioteket, 2008. 69 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 377
Keyword
family practice, aged 80 and over, E. coli, bacteriuria, urinary tract infections, urinary incontinence, leukocyte esterase, cytokines
National Category
Family Medicine
Identifiers
urn:nbn:se:uu:diva-9288 (URN)978-91-554-7285-6 (ISBN)
Public defence
2008-10-25, Föreläsningssalen, Falu lasarett, Falun, 13:15 (English)
Opponent
Supervisors
Available from: 2008-10-02 Created: 2008-10-02 Last updated: 2011-05-13Bibliographically approved

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