Table 2. Distribution of Patient-Level Variables and Treatment of Asymptomatic Bacteriuria.
| Variable | No. (%) | Odds Ratio (95% CI) | P Valuea | |
|---|---|---|---|---|
| Antibiotics (n = 2259) | No Antibiotics (n = 474) | |||
| Baseline characteristics | ||||
| Age, median (IQR), y | 78 (67-87) | 74 (62-83) | 1.02 (1.01-1.02) | <.001 |
| Women | 1774 (78.6) | 364 (76.8) | 1.09 (0.84-1.42) | .51 |
| White race | 1813 (80.5) | 397 (84.1) | 0.99 (0.73-1.34) | .95 |
| Charlson Comorbidity Index score | ||||
| 0 | 258 (11.4) | 54 (11.4) | 1 [Reference] | .009 |
| 1-2 | 656 (29.0) | 150 (31.7) | 0.88 (0.63-1.24) | |
| 3-4 | 720 (31.9) | 113 (23.8) | 1.35 (0.98-1.88) | |
| ≥5 | 625 (27.7) | 157 (33.1) | 0.87 (0.62-1.22) | |
| Diabetes | 876 (38.8) | 200 (42.2) | 0.84 (0.69-1.02) | .07 |
| Moderate to severe chronic kidney disease | 934 (41.4) | 204 (43.0) | 1.00 (0.80-1.26) | .98 |
| History of cancer | 477 (21.1) | 105 (22.2) | 1.00 (0.80-1.25) | .99 |
| Spinal cord injury | 36 (1.6) | 6 (1.3) | 1.66 (0.69-3.99) | .26 |
| Dementia | 506 (22.4) | 54 (11.4) | 2.10 (1.53-2.89) | <.001 |
| Immunosuppressionb | 73 (3.2) | 22 (4.6) | 0.79 (0.49-1.29) | .35 |
| IV chemotherapy in preceding 30 d | 19 (0.8) | 10 (2.1) | 0.46 (0.23-0.92) | .03 |
| Hemodialysis | 38 (1.7) | 12 (2.5) | 0.60 (0.32-1.12) | .11 |
| Transfer from post–acute care facilityc | 96 (4.3) | 11 (2.3) | 2.02 (0.78-5.20) | .15 |
| Nonambulatory | 355 (15.7) | 44 (9.3) | 1.65 (1.22-2.23) | .001 |
| Hospitalization in past 90 d | 662 (29.3) | 144 (30.4) | 0.91 (0.69-1.21) | .52 |
| Antibiotics in past 90 d | 492 (21.8) | 99 (20.9) | 1.00 (0.76-1.32) | .99 |
| Indwelling catheter | 331 (14.7) | 44 (9.3) | 1.45 (1.10-1.91) | .009 |
| Any catheterd | 369 (16.3) | 48 (10.1) | 1.57 (1.18-2.08) | .002 |
| Signs and symptoms | ||||
| Abdominal pain | 383 (17.0) | 100 (21.1) | 0.81 (0.60-1.08) | .15 |
| Incontinence | 534 (23.6) | 59 (12.4) | 2.31 (1.68-3.19) | <.001 |
| Functional decline | 165 (7.3) | 23 (4.9) | 1.42 (0.94-2.16) | .09 |
| Acutely altered mental status | 425 (18.8) | 45 (9.5) | 1.96 (1.28-3.00) | .002 |
| Fatigue, malaise, or lethargy | 659 (29.2) | 128 (27.0) | 1.12 (0.83-1.51) | .47 |
| Nausea or vomiting | 481 (21.3) | 123 (25.9) | 0.82 (0.64-1.05) | .11 |
| Change in color, sediment, or malodorous urine | 254 (11.2) | 42 (8.9) | 1.63 (1.04-2.57) | .03 |
| Urinary retention or postvoid residual >200 mL | 207 (9.2) | 27 (5.7) | 1.75 (1.19-2.57) | .004 |
| Heart rate >90 beats/min | 1276 (56.5) | 254 (53.6) | 1.20 (0.94-1.54) | .13 |
| Respiratory rate ≥22 breaths/min | 767 (34.0) | 169 (35.7) | 0.98 (0.73-1.33) | .92 |
| Systolic blood pressure <90 mm Hg | 286 (12.7) | 60 (12.7) | 1.09 (0.74-1.59) | .67 |
| Severity of illness | ||||
| qSOFA (≥2 vs <2)e | 273 (12.1) | 55 (11.6) | 1.12 (0.69-1.82) | .64 |
| ≥2 SIRS criteriaf | 760 (33.6) | 149 (31.4) | 1.28 (0.95-1.71) | .10 |
| Laboratory results | ||||
| Leukocytosisg | 816 (36.1) | 151 (31.9) | 1.26 (0.99-1.60) | .06 |
| Positive urinalysish | 2104 (93.1) | 382 (80.6) | 3.36 (2.44-4.62) | <.001 |
| Urine culture with ≥100 000 CFU | 1903 (84.2) | 308 (65.0) | 2.85 (2.26-3.60) | <.001 |
| Pseudomonas aeruginosa | 90 (4.0) | 14 (3.0) | 1.24 (0.69-2.25) | .47 |
| Escherichia coli | 1192 (52.8) | 180 (38.0) | 1.67 (1.35-2.07) | <.001 |
| Resistant E colii | 81 (3.6) | 8 (1.7) | 1.47 (0.90-2.37) | .12 |
Abbreviations: CFU, colony-forming unit; IQR, interquartile range; IV, intravenous; SIRS, systemic inflammatory response syndrome; qSOFA, quick sequential organ failure assessment; TNF, tumor necrosis factor.
P < .05 was considered significant.
Defined in a footnote to Table 1.
Includes transfer from subacute rehabilitation center, skilled nursing home, acute rehabilitation center, assisted living, or other hospital. Also includes whether patient had been admitted or resided in a nursing home, subacute rehabilitation center, or extended care facility in the past 30 days.
Includes Foley catheter, intermittent straight catheterization, and suprapubic catheter present on day of or 1 day before urine culture collection.
Systolic blood pressure of 100 mm Hg or lower = 1, respiratory rate of 22 or more breaths/min = 1; and Glasgow Coma Scale score less than 15 = 1.
Temperature less than 36 °C or greater than 38 °C, heart rate more than 90 beats/min, respiratory rate more than 20 breaths/min, and peripheral white blood cell count less than 4000/μL or greater than 12 000/μL (to convert to ×109 per liter, multiply by 0.001).
Defined as a peripheral white blood cell count greater than 10 000/μL.
Defined as presence of leukocyte esterase or nitrite, or more than 5 white blood cells per high-power field.
Resistant to ceftriaxone or labeled as extended-spectrum β-lactamase E coli in culture result.