Urinary Tract Infections in Long-Term Care Facilities

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Abstract
Urinary tract infection, or bacteriuria, is common in residents of long-term care facilities (LTCFs). The prevalence of bacteriuria in noncatheterized residents of LTCFs has been reported to be 15% to 50% in studies performed in several different countries (Table). As with most other age groups, the prevalence is greater for women than men. The female to male ratio is, however, lower than in younger populations.The incidence of bacteriuria is also extremely high. In one group of severely functionally disabled elderly men, 45 new infections/100 patient years were observed, with 10% of nonbacteriuric residents becoming bacteriuric in each three-month period. An institutionalized population in Greece had initial prevalences of bacteriuria of 19% for men and 27% for women, with an additional 11% and 23% of the non-bacteriuric population, respectively, developing a positive urine culture at 6 or 12 months from admission.4 A nursing home population of elderly women in Philadelphia, with an initial prevalence of bacteriuria of 25%, had an additional 8% of the initially nonbacteriuric subjects identified with a positive urine culture each six-month period of follow-up.