Diuresis bacteriuria in physically dependent elderly women.

Among 34 women aged 74-96 years, residents of a Home for the Aged, with reduced mobility and repeatedly negative urine cultures, 16 (47%) responded to a rapid hydration and 20 mg frusemide administered intravenously with a transient bacterial excretion usually trailing the diuresis. Antibody-coated bacteria were detected in 11 of the 13 Gram-negative isolates tested. Women with urine turning positive had significantly lower glomerular filtration rates and more advanced renal tubular defects than the steadily nonbacteriuric subjects of the same age. Progress to renal insufficiency was somewhat faster and all-causes mortality at 1 year was higher in subjects with urine turning positive. Diuresis bacteriuria originating from the upper urinary tract along with frank bacteriuria may be detected in up to 70% of women in their mid-80s and represents a likely source of the most common infection in man's last period of life.