Asymptomatic bacteriuria and urinary tract infection in geriatric inpatients after indwelling urinary catheter removal: a descriptive two-centre study

Abstract

Summary: Background: Patients with indwelling urinary catheters (IUC) are common in geriatric care. Catheterization increases the risk of asymptomatic bacteriuria (ASB) and urinary tract infection (UTI). The prevalence of ASB after IUC-removal is only sparsely studied. This study aimed to compare the occurrence of ASB and UTI in geriatric patients with and without a history of catheterization and to explore factors associated with ASB. Methods: Patients were included at two geriatric rehabilitation wards in Stockholm, Sweden. Data were collected about history of catheterization, antibiotic treatment, and diabetes mellitus. Urine samples were analysed. Occurrence of UTI during inpatient care was identified by patient records. Results: In total 196 asymptomatic patients were included in the analysis. Asymptomatic bacteriuria was significantly more common in patients with a history of catheterization (38/104, 36.5%) compared to those without IUC during the past four weeks (19/92, 20.6%, P=0.018). Enterococci were more commonly found in patients with a history of catheterization. Of 124 patients possible to follow up, five UTI-cases were found during hospital stay. All cases had had ASB and 4/5 had had an IUC on admission.Catheterization was significantly associated with ASB after adjustment for confounders (OR 2.79, CI 1.31–5.91, P=0.008). Conclusions: Catheterization is associated with ASB, this persists after IUC-removal. The results indicate that colonisation by Enterococcus species linked to catheterization may persist for at least four weeks after IUC-removal. Trial registration: The study is registered at clinicaltrials.gov with the identification number NCT05039203 (09/09/2021).

Keywords

• Asymptomatic bacteriuria
• Indwelling urethral catheter
• Geriatric post-void residual urine volume