Urinary tract infection (UTI) accounts for 15.5% of hospitalizations by infectious disease in over age of 65, second only to pneumonia, and they are responsible for 6.2% of infectious disease related deaths. UTI and asymptomatic bacteriuria (ASB) are very common in elderly. Distinguishing symptomatic urinary tract infection from asymptomatic bacteriuria is often difficult especially in old people living in long-term care facilities due to lack of specific symptoms. As the population is getting older, UTIs and ASB in elderly adults represent a significant health care burden. However, there is no exact data on morbidity of UTIs in elderly persons in Korea. This article reviews the prevalence of ASB and the incidence of symptomatic UTIs.

The study aimed to evaluate the usability of sterile bag collection (SBC) urinalysis and urine culture for diagnosing urinary tract infections (UTI). Urine culture is key for diagnosing UTI, and transurethral catheterization (TUC) or suprapubic aspiration is recommended for non-toilet-trained children. Although urine testing using SBC is non-invasive and easy, UTI can be diagnosed only if other criteria including clinical symptoms and positive urinalysis results are met. This study included 228 infants who were hospitalized for unexplained fever from October 2015 to June 2016. TUC culture, SBC urinalysis, and urine culture were performed for all patients. UTI was diagnosed when the TUC culture results met the criterion of ≥104 colony-forming units (CFU)/mL. When UTI diagnosis was made based on SBC urine colony counts ≥105 CFU/mL, the false-positive and false-negative rates were 6.3% and 70.0%, respectively. When the criterion was set as ≥104 CFU/mL, they were 23.7% and 30.0%, respectively. When both the criteria of ≥105 CFU/mL and positive urinalysis results were met, the false-positive rate was 2.4%, and the false-negative rate was 80%. Our results suggest that diagnosing UTI using SBC urinalysis and urine culture is not useful in infants with unexplained fever.

A 72-year-old woman with diabetic chronic kidney disease visited the authors’ hospital with fever, dysuria, and left flank pain. She did not complain of typical angina upon her admission, however, given the presence of a new-onset left-bundle branch block, elevated cardiac enzymes, and documented E. coli septicemia, coronary angiography and percutaneous coro-nary interventions were performed for the mid-left anterior descending artery and the mid-to distal-right coronary artery. We should keep in mind that urosepsis in patients with diabetic chronic kidney disease, who are at high risk of cardiovascular disease, can be associated with painless acute myocardial Infarction.