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PubMed2004

Clinical importance of significant asimptomatic bacteriuria in newborns and infants during early postnatal period.

The aim of the study was to detect newborns at risk for developing renal impairment, and to point out the importance of significant asimptomatic bacteriuria in perinatal period and early infancy. Severe urinary tract anomalies are very often accompanied only by asimptomatic bacteriuria in perinatal period. Three urinalysis ware done after delivery. 212 newborns with significant asimptomatic bacteriuria underwent ultrasound examination, and were followed up to three months. Those with normal findings and with passing bacteriuria in the first 2 months were excluded. Group of 52 newborns underwent radioisotope examination. Frequency of urinary tract anomalies in newborns was 34.6%. Increased risk for renal impairment had children with urinary tract anomalies in close family, urinary tract infection or bacteriuria, EPH gestosis and prepartal symptoms of febrile infection in mother, children with IUGR, strangulated umbilical cord, prolonged jaundice and attacks of peripheral cyanosis in perinatal period.

Bacteria↗

PubMed1994

Clinical risk factors for methicillin-resistant Staphylococcus aureus bacteriuria in a skilled-care nursing home.

OBJECTIVE: To establish the risk factors for methicillin-resistant Staphylococcus aureus (MRSA) bacteriuria in a nursing home population. DESIGN, SETTING, AND SUBJECTS: A case-control study was conducted in a 360-bed skilled-care nursing facility in the northeastern United States that was experiencing an outbreak of MRSA. Fifteen residents were identified as having had MRSA isolated from their urine over an 18-month period and were compared with 40 controls who were randomly selected from all nursing facility residents. RESULTS: In bivariate analysis, MRSA bacteriuria was associated with the presence of an indwelling urinary catheter (odds ratio [OR], 36; 95% confidence interval [CI], 7.0 to 184.2), antibiotic use in the prior 6 months (OR, 2.9; 95% CI, 1.5 to 5.5), and impaired physical function (OR, 5.8; 95% CI, 1.3 to 26.6). Urinary catheter use and antibiotic use remained significantly associated with MRSA bacteriuria even when controlling for impaired physical function. CONCLUSIONS: Methicillin-resistant S aureus is being isolated with increasing frequency in nursing homes, and MRSA bacteriuria may prove to be an important reservoir for the spread of organisms in long-term-care settings. Conservative use of indwelling urinary catheters and of broad-spectrum antibiotics should be investigated as potential control measures to reduce the spread of MRSA in nursing homes.

Bacteriuria↗

PubMed1975

Detection of bacteriuria in pediatric outpatients. A new culture device.

Urine samples from 1,003 pediatric patients were examined for bacteriuria with a culture-nitrite strip test, along with microscopic assessment of pyruia and conventional chemical analysis. The latter two methods proved of little value in reliably detecting or excluding substantial bacteriuria. An overall prevalence of 5.2% was shown. Using Microstix Reagent Strips, 92 urine samples with substantial colony counts were detected. Subculture from the strips disclosed that 52 of these involved single pathogens, interpreted as true bacteriuria. When Microstix growth results were compared with the calibrated loop method on 108 randomly selected specimens, the strip gave only two false negatives and one false positive. Bacteriuria screening should be done in high-risk groups and in asymptomatic children as part of the health evaluation. The index of suspicion should be higher in girls, and reliable interpretation of culture results requires attention to proper specimen collection.

Adolescent↗

PubMed1994

Reduction of bacteriuria and pyuria after ingestion of cranberry juice.

OBJECTIVE: To determine the effect of regular intake of cranberry juice beverage on bacteriuria and pyuria in elderly women. DESIGN: Randomized, double-blind, placebo-controlled trial. SUBJECTS: Volunteer sample of 153 elderly women (mean age, 78.5 years). INTERVENTION: Subjects were randomly assigned to consume 300 mL per day of a commercially available standard cranberry beverage or a specially prepared synthetic placebo drink that was indistinguishable in taste, appearance, and vitamin C content but lacked cranberry content. OUTCOME MEASURES: A baseline urine sample and six clean-voided study urine samples were collected at approximately 1-month intervals and tested quantitatively for bacteriuria and the presence of white blood cells. RESULTS: Subjects randomized to the cranberry beverage had odds of bacteriuria (defined as organisms numbering > or = 10(5)/mL) with pyuria that were only 42% of the odds in the control group (P = .004). Their odds of remaining bacteriuric-pyuric, given that they were bacteriuric-pyuric in the previous month, were only 27% of the odds in the control group (P = .006). CONCLUSIONS: These findings suggest that use of a cranberry beverage reduces the frequency of bacteriuria with pyuria in older women. Prevalent beliefs about the effects of cranberry juice on the urinary tract may have microbiologic justification.

Aged↗

PubMed1993

Labial fusion and asymptomatic bacteriuria.

Thirty-three female children with labial fusion were screened for bacteriuria which was defined as the growth of a single micro-organism with < or = 100,000 colony-forming units/ml (> or = 100 x 10(6) colonies/l) in a properly collected urine specimen. Six girls were found to have bacteriuria. In contrast, none of the 33 girls in a control group had bacteriuria. We recommend that a urine culture be performed in girls with labial fusion and that all girls with bacteriuria should be checked for labial fusion.

Bacteriuria↗

PubMed1978

Bacteriuria in the puerperium: an evaluation of methods for collecting urine specimens.

Five hundred and eighteen puerperal patients were screened for bacteriuria by examination of clean-catch, midstream urine specimens using the dip-slide cultivation technique. Bladder urine from 105 patients showing 10(4) or more bacteria per milliliter of midstrean urine was obtained by suprapubic bladder aspiration and cultivated, along with two consecutive midstream specimens. The bacteriologic results in these specimen categories are compared. Of 23 patients showing growth in the midstream samples compatible with a true bacteriuria, 18 had sterile puncture urine specimens. Consecutive contaminated midstream specimens from the same patient usually yielded growth of the same bacterial species. It is concluded that a diagnosis of bacteriuria in the puerperium cannot be based upon cultural results of midstream specimens alone. In several of the bladder urine specimens, microogranisms being nonpathogenic in the urinary tract and residing normally in the vaginal flora were found, probably due to the traumatic effect of partus. In Oslo the frequency of bacteriuria among women post partum is estimated at a maximum of 1 per cent.

Bacteriuria↗

PubMed1989

Asymptomatic bacteriuria in normal and high-risk pregnancy.

A routine urine culture was performed in 1130 normal pregnant women and in 211 high-risk pregnancies (136 diabetics and 75 women with a previous urinary tract infection). Asymptomatic bacteriuria was found in 5.9% of the normal pregnancies, 12.5% among the diabetics and in 18.5% of the previous urinary tract infection patients. The higher incidence of a clinical urinary tract infection among patients with asymptomatic bacteriuria was found statistically significant (p less than 0.001) in all three groups. A high correlation was found between a negative urine culture in early pregnancy and the absence of development of cystitis and pyelonephritis in later pregnancy. The incidence of asymptomatic bacteriuria in normal pregnant women who developed cystitis later in pregnancy was 33.3% and in those developing pyelonephritis, 66%. In the two high-risk pregnancy groups, the incidence of asymptomatic bacteriuria among those developing clinical infection was even higher, 58.3 and 85.7%, respectively, among the diabetics, and 60 and 66.6% respectively, among the previous urinary tract infection patients.

Bacteriuria↗

PubMed1994

Risk factors for bacteriuria in men.

OBJECTIVE: To identify risk factors for bacteriuria in a selected group of institutionalized men. METHODS: A total of 99 men, mean age seventy-one years, range forty-eight to one hundred four years, living in a nursing home were evaluated for diagnoses of benign prostatic hyperplasia (BPH) and diabetes mellitus (DM), symptoms of bladder outlet obstruction, and postvoid residual urine volume (PVR). At the time of evaluation urine cultures were performed for all subjects. Urinalyses had been performed in all men within the two years prior to initiation of the study. Residents unable to give informed consent, with a history of cancer of the prostate or bladder, previous urethral or prostate surgery, or inability to void in the standing position were excluded. RESULTS: Prior to or during the study 30 residents had bacteriuria, which was not correlated with age, PVR, previous diagnoses of BPH or DM, or with obstructive or irritative urinary symptoms consistent with bladder outlet obstruction. CONCLUSIONS: Competent, institutionalized residents with higher functional levels meeting the inclusion criteria were not at a high risk of bacteriuria. The concept that increased PVR per se predisposes to bacteriuria cannot be substantiated.

Age Factors↗

PubMed1984

Bacteriuria in pregnancy and growth and development of the infants.

In the framework of a community-oriented programme in a western neighbourhood in Jerusalem, screening for bacteriuria during pregnancy was introduced. Between the years 1972 and 1979, 30 cases were identified, an incidence of 1.7%. All women diagnosed as having bacteriuria received antibiotic treatment according to sensitivity of the organism. This report presents the pregnancy outcome as measured by physical growth and development of the offspring. Cases of bacteriuria were compared with individually matched nonbacteriuric controls. No statistically significant differences were found in mean birth weight, mean weight and length at 1, 3, 6, 9 and 12 months, and development quotient at 2 years. No low birth weight infants were found among the cases. The fact that no differences were found between cases and controls, the feasibility, validity, acceptability and low cost of the screening test, and the health benefits of the programme justify introduction of routine screening and treatment of bacteriuria in the preventive health services.

Adult↗

PubMedDate not supplied

Association of sexual activity and bacteriuria in women with non-insulin-dependent diabetes mellitus.

A group of 215 patients with non-insulin-dependent diabetes mellitus (NIDDM) (147 women and 68 men) were selected by home interview, and accepted to undergo clinical examination including urine culture, in order to determine the frequency of bacteriuria and its possible associations with clinical and laboratory findings. Bacteriuria was found in 17.7% of women and 1.5% of men. Univariate and multivariate analysis performed for the group of women revealed sexual intercourse and pyuria as the only factors associated with the frequency of bacteriuria. It was concluded that asymptomatic bacteriuria may be associated with sexual activity in women with NIDDM.

Analysis of Variance↗

PubMed2005

Predicting bacteriuria in urogynecology patients.

OBJECTIVE: This study was undertaken to determine whether reagent strip testing can predict bacteriuria in urogynecology patients. STUDY DESIGN: All women undergoing urodynamic evaluations from June 1997 to October 2001 were identified by using a computerized database. Urine culture results were compared with reagent strip testing. Significant bacteriuria was defined as greater than 10(5) colony-forming units per milliliter. RESULTS: Bacteriuria prevalence was 8.6% (n = 51). Sensitivity and specificity of nitrites were 0.51, (95% CI, 0.31-0.66) and 0.991, (95% CI, 0.974-0.998), respectively. Blood had a lower sensitivity (0.35, 95% CI, 0.20-0.54) and specificity (0.80, 95% CI, 0.75-0.84). Leukocyte esterase was similar to blood with a sensitivity of 0.28 (95% CI, 0.14-0.45) and specificity of 0.83 (95% CI, 0.78-0.87). No combination of tests offered improved sensitivity or specificity over nitrites alone. CONCLUSION: Nitrite dipstick testing has excellent specificity for bacteriuria in urogynecologic patients. These results support the treatment of women with positive nitrites who are preparing to undergo urodynamics without obtaining culture.

Adult↗

PubMed2006

[Screening for bacteriuria in diabetic patients. Is it possible to stop systematic urine cytobacteriological testing?].

OBJECTIVES AND METHOD: The discordance between test by urine dipstick (nitrites and leucocyte-esterase) and analysis in laboratory, with urinary culture on the same sample was studied in diabetic patients, from October 2000 to May 2002, to eventually stop systematic laboratory test. The dipstick result (Clinitek 20 Bayer) was classified as "possibility of bacteriuria" if one of the two tests was positive. Bacteriuria was considered significant if the laboratory test result gave, at least 10(5) bacteria per mL, (one strain), and at least 10(4) leucocytes. The out point was the dipstick negative predictive value (NPV). RESULTS: The study included 683 patients. The dipstick result was "possibility of bacteriuria" in 153 cases (22.4%). Thirty-nine bacteriuria (5.7%) were reported, including 2 dipstick false negatives. The NPV was 99.6% [IC 95% : 99.1-100]. CONCLUSION: The systematic laboratory tests were stopped.

Adolescent↗

PubMed2006

[Microbial description of bacteriuria in long-term care facilities: a prospective study in the French Teaching Hospital of Strasbourg].

OBJECTIVE: The authors had for aim to assess, the incidence of symptomatic bacteriuria and the level of antibiotic resistance in bacteria identified in long-term care facilities (LTC). DESIGN: Symptomatic bacteriuria cases were prospectively collected, during 9 months in the two LTC of the Strasbourg French Teaching Hospital (196 beds). RESULTS: One hundred and eleven bacteriuria cases were included. They concerned 67 of the 274 residents (cumulative incidence: 2.07/1,000 patients-day). A gram-negative bacillus was identified in 85% of the symptomatic bacteriuria cases, and Escherichia coli in 40%. Sixty percent of the identified bacterial strain was resistant to amoxicillin (Amx-R) and 42% to the clavulanic acid combination (AmC-R). Third generation cephalosporins (3GC) were effective in 90% of Urinary tract infections (UTIs) and fluoroquinolones in 65% (Fq). Four bacterias with broad beta-lactamase spectrum were identified (0.04%) including 3 Enterobacter aerogenes. No yeast infection was diagnosed. E. coli strains were 65% Amx-R and 50% AmC-R. Concerning the Fq-R strains (15%), 50% were cotrimoxazole resistant (Stx-R) and 70% Amx-R; 3GC remained effective (82%). CONCLUSION: In LTC, multi-drug resistance bacteria are rare and 3GCs seem to be the best first line treatment. Nevertheless, Fq-R is increasing (15 vs 8%), and attention must be paid to the antibiotic therapy used.

Aged↗

PubMed1998

Nitrofurantoin prophylaxis for bacteriuria and urinary tract infection in children with neurogenic bladder on intermittent catheterization.

OBJECTIVE: To determine the effect of nitrofurantoin prophylaxis on rates of bacteriuria and symptomatic urinary tract infection in children with chronic neurogenic bladder receiving clean intermittent catheterization. DESIGN: Double-blind, placebo-controlled, crossover trial of 15 children receiving nitrofurantoin or placebo for 11 months (5 months receiving one drug, then 1 month of washout followed by 5 months of the alternate drug). Weekly home visits were made. During each visit a sample of bladder urine was obtained by intermittent catheterization, signs and symptoms of urinary tract infection were recorded, and all medications were recorded as well as a capsule count of the study drug. RESULTS: During nitrofurantoin the frequency of bacteriuria remained high. Cultures of 74% (203 of 274) of the 274 samples on placebo were positive for a pathogen (> or = 10(4) colony-forming units per milliliter) compared with 65% (165 of 252) of the 252 samples on nitrofurantoin. The bacterial species responsible for bacteriuria, however, were altered; Escherichia coli, the most common pathogen isolated during placebo, was replaced by resistant Klebsiella spp. and Pseudomonas spp. during nitrofurantoin. The carriage of these resistant organisms tripled during nitrofurantoin. Symptomatic infection dropped in half on nitrofurantoin, but this decline was due solely to infections caused by E. coli. Despite an increased frequency of resistant organisms on nitrofurantoin prophylaxis, an increase in urinary tract infections caused by these resistant organisms did not occur. CONCLUSION: Routine use of nitrofurantoin prophylaxis in an attempt to eradicate bacteriuria in patients with chronic neurogenic bladder is not effective.

Adolescent↗

PubMed1999

Effect of cranberry juice on bacteriuria in children with neurogenic bladder receiving intermittent catheterization.

OBJECTIVE: To determine the effect of cranberry prophylaxis on rates of bacteriuria and symptomatic urinary tract infection in children with neurogenic bladder receiving clean intermittent catheterization. DESIGN: Double-blind, placebo-controlled, crossover study of 15 children receiving cranberry concentrate or placebo concentrate for 6 months (3 months receiving one concentrate, followed by 3 months of the other). Weekly home visits were made. During each visit, a sample of bladder urine was obtained by intermittent catheterization. Signs and symptoms of urinary tract infection and all medications were recorded, and juice containers were counted. RESULTS: During consumption of cranberry concentrate, the frequency of bacteriuria remained high. Cultures of 75% (114 of 151) of the 151 samples obtained during consumption of placebo were positive for a pathogen (>/=10(4) colony-forming units/mL) compared with 75% (120 of 160) of the 160 samples obtained during consumption of cranberry concentrate. Escherichia coli remained the most common pathogen during placebo and cranberry periods. Three symptomatic infections each occurred during the placebo and cranberry periods. No significant difference was observed in the acidification of urine in the placebo group versus the cranberry group (median, 5.5 and 6.0, respectively). CONCLUSION: The frequency of bacteriuria in patients with neurogenic bladder receiving intermittent catheterization is 70%; cranberry concentrate had no effect on bacteriuria in this population.

Adolescent↗

PubMed1994

The incidence of urinary tract infection in patients without bacteriuria who underwent extracorporeal shock wave lithotripsy.

The incidence and severity of urinary tract infections in 145 patients with renal calculi undergoing extracorporeal shock wave lithotripsy (ESWL*) who were catheterized for a short period without evidence of bacteriuria and/or infected stones evaluated. The patients were followed clinically and bacteriologically 1 and 14 days after the procedure. Bacteriuria was observed in 7 of the 145 patients (4.8%): in 5 patients 24 hours after ESWL and in 2 patients 2 weeks later. Of these patients 2 were symptomatic but only 1 had fever. No patient was hospitalized. We found no correlation between bacteriuria and the number or size of the stones. We conclude that the incidence of bacteriuria in catheterized patients who underwent ESWL without urinary tract infection is low and the use of antibiotics in these patients is probably not indicated.

Adult↗

PubMed1983

Evaluation of daily meatal care with poly-antibiotic ointment in prevention of urinary catheter-associated bacteriuria.

Meatal care with a poly-antibiotic ointment twice daily was evaluated in a prospective, randomized, controlled study of patients with temporary indwelling urethral catheters. Bacteriuria was acquired in 14 of 214 patients treated (6.5 per cent), compared to 16 of 214 patients not given treatment (7.5 per cent). The rate of bacteriuria was slightly lower in the treated than in the untreated group by each of 4 different statistical methods. In a subset of female patients at high risk a significant reduction in the rate of bacteriuria in treated patients was found by 1 method of analysis. These results contrast to previous studies in our hospital in which meatal care, using either nonantiseptic soap and water or an iodophor solution and ointment, was found to predispose to bacteriuria in high risk female patients. The benefit, if any, of meatal care with poly-antibiotic ointment appears to be small.

Administration, Topical↗

PubMed1982

Immunologic response of the prostate to bacteriuria and bacterial prostatitis. I. Immunoglobulin concentrations in prostatic fluid.

We investigated the impact of bacteriuria and bacterial prostatitis on the immunoglobulin content of prostatic fluid. Using an indirect solid-phase radioimmunoassay, we assayed samples of expressed prostatic secretion (EPS) from 20 men with no histories of bacteriuria and from 13 men with histories of culture proven bacteriuria for IgG, IgA and IgM concentrations. Five of the bacteriuric men had culture proven bacterial prostatitis. The concentrations of each immunoglobulin varied widely and were unrelated to age, race, history of urologic instrumentation, presence of benign prostatic hyperplasia, leukocyte content of EPS or EPS aerobic bacterial culture results. The mean concentration of IgG for samples from the bacteriuric patients, 44.3 mg/ml., was similar to that of the uninfected patients, 58.4 mg./dl. (p less than 0.5). The mean concentrations of IgA and IgM for samples from the bacteriuric patients, 89.2 and 1.44 mg./dl., respectively, were greater than those of the uninfected patients, 25.2 and 0.95 mg./dl., respectively. These differences, however, did not achieve statistical significance, p less than 0.025 and p less than 0.3, respectively. However, the mean ratio of IgA:IgG for samples from the bacteriuric patients, 1.67, was significantly greater than that of the uninfected patients, 0.34 (p less than 0.005). The fraction of IgA in the form of secretory IgA was greater than 60 per cent for samples obtained from both the uninfected and bacteriuric patients. These data suggest that bacteriuria is associated with increased secretion of IgA in the prostatic fluid.

Adult↗