Prospective Study on the Appearance of Antibody-Coated Bacteria in Patients with an Indwelling Urinary Catheter

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Abstract
Elderly patients without urinary tract infection were given prophylactic medication with nitrofurantoin (NF) or methenamine hippurate (MH) because of need for an indwelling urinary catheter. Within 2 weeks of catheter use, all 31 controls without medication had significant bacteriuria; in the MH group (29 patients) 77% and in the NF group (26 patients) 58% were infected. Within 6 weeks virtually all the patients had bacteriuria. Antibody-coated bacteria (ACB) in the urine sediment were found in the minority of patients when bacteriuria first appeared; at 1 week, 50% of controls had ACB, whereas in the NF group this level of positivity was reached after 3 weeks. However, by 5 weeks approximately 70% > of patients in all groups had ACB. The mean time until ACB test positivity after the appearance of bacteriuria was 1.7 weeks in the controls and 2.2 weeks in the MH group; in the NF group it was significantly longer (4.6 weeks). Prophylactic treatment of patients with an indwelling urinary catheter delayed the appearance of bacteriuria and ACB; however, their appearance could not be prevented even by NF.