Does asymptomatic bacteriuria predict mortality and does antimicrobial treatment reduce mortality in elderly ambulatory women?

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Does asymptomatic bacteriuria predict mortality and does antimicrobial treatment reduce mortality in elderly ambulatory women?

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OBJECTIVE: To determine whether asymptomatic bacteriuria in elderly ambulatory women is a marker of increased mortality and, if so, whether it is because of an association with other determinants of mortality or because asymptomatic bacteriuria is itself an independent cause, the removal of which might improve longevity. DESIGN: A cohort study and a controlled clinical trial of the effect of antimicrobial treatment. SETTING: A geriatric center and 21 continuing care retirement communities. PARTICIPANTS: Women without urinary tract catheters. MEASUREMENTS: Urine cultures every 6 months (the same organism at 10(5) colony-forming units or more per mL on two midstream urine specimens defined asymptomatic bacteriuria), comorbidity, and mortality. RESULTS: In the observational study, infected residents (n = 318) were older, and sicker, and had higher mortality (18.7 per 100,000 resident-days) than uninfected residents (n = 1173; 10.1 per 100,000 resident-days). However, in a multivariate Cox

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