To the Editor: Marcantonio (Oct. 12 issue)1 lists urinary tract infection as a contributing factor to delirium in older patients and recommends evaluating and treating such patients for urinary tract infection. However, underlying cognitive and functional deficits predispose elderly patients to both delirium and asymptomatic bacteriuria, creating an association even without causation.2 The attribution of delirium to coincidentally discovered (and probably causally unrelated) bacteriuria leads to considerable use of antibiotic agents, with uncertain benefit and possible harms. This clinical scenario represents a contentious evidence-free zone. Infectious disease specialists regard this entity as asymptomatic bacteriuria, for which high-quality evidence supports nontreatment.2,3 . . .

中文翻译：

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住院老年人的妄

致编者：Marcantonio（10月12日发行）1将尿路感染列为老年患者ir妄的成因，并建议评估和治疗此类患者的尿路感染。然而，潜在的认知和功能缺陷使老年患者容易患上ir妄和无症状菌尿，甚至在没有因果关系的情况下也会产生关联。2ir妄归因于偶然发现的（可能是因果无关的）菌尿，导致大量使用抗生素，但获益不确定以及可能的危害。这种临床情况代表了一个有争议的无证据区。传染病专家将此实体视为无症状菌尿，对此高质量的证据支持不治疗。2,3。。。