Nordenstam G, Sundh V, Lincoln K, Svanborg A, Edén C S
Department of Clinical Immunology, University of Göteborg, Sweden.
Am J Epidemiol. 1989 Dec;130(6):1176-86. doi: 10.1093/oxfordjournals.aje.a115446.
Screening for bacteriuria was performed between 1984 and 1988 in persons aged 72-79 years representative of the general population in Göteborg, Sweden. The frequency of bacteriuria (greater than or equal to 10(5)/ml) at a single screening was 6% and 16% at age 72 years and 6% and 14% at age 79 years for the screened men (n = 235 and 259) and women (n = 259 and 297), respectively. By repeated screening after one month and 30 months of those previously negative at age 72 years, an additional 4% and 3% of men and 3% and 7% of women with bacteriuria were detected. Bacteriuric persons were excluded from further screening and controlled by frequent cultures during several years, with careful monitoring of clinical interventions. The persistence of untreated bacteriuria was analyzed in relation to bacterial species and number in the untreated subgroup of bacteriuric individuals. Nine of 10 Escherichia coli (E. coli) with less than 10(6)/ml and 22/22 non-E. coli strains disappeared spontaneously. In contrast, 20/26 (77%, p less than 0.01) with greater than or equal to 10(6) E. coli/ml persisted. Of 17 persons with bacteriuria persisting at least 12 months, 16 were women and 16 had E. coli. Of 201 E. coli cultures obtained from this group, 94% had greater than or equal to 10(6)/ml, and 99% had greater than or equal to 5 x 10(5)/ml. The results indicate that screening for high counts (greater than 10(6)/ml) of E. coli most effectively detects persisting bacteriuria in the general elderly population.
1984年至1988年期间，在瑞典哥德堡具有一般人群代表性的72至79岁人群中进行了菌尿筛查。在单次筛查中，接受筛查的男性（n = 235和259）和女性（n = 259和297）中，72岁时菌尿（≥10⁵/ml）的发生率分别为6%和16%，79岁时分别为6%和14%。对72岁时之前检测为阴性的人群在1个月和30个月后进行重复筛查，又分别检测出4%的男性和3%的男性、3%的女性和7%的女性患有菌尿。菌尿患者被排除在进一步筛查之外，并在数年中通过频繁培养进行监测，同时仔细监测临床干预情况。对未治疗的菌尿患者亚组中细菌种类和数量与未治疗菌尿持续存在情况进行了分析。每毫升低于10⁶个的10株大肠杆菌（E. coli）中有9株以及22株非大肠杆菌菌株自发消失。相比之下，每毫升≥10⁶个大肠杆菌的菌株中有20/26（77%，p<0.01）持续存在。在17例菌尿持续至少12个月的患者中，16例为女性，且16例感染的是大肠杆菌。从该组患者中获得的201份大肠杆菌培养物中，94%每毫升≥10⁶个，99%每毫升≥5×10⁵个。结果表明，对大肠杆菌高计数（>10⁶/ml）进行筛查能最有效地检测出一般老年人群中持续存在的菌尿。
