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PubMed1979

Bacteria causing symptomatic urinary tract infection or asymptomatic bacteriuria.

One thousand bacterial isolates from consecutive suprapublic aspirations of urine in two groups of patients with symptomatic urinary tract infection and two groups with asymptomatic bacteriuria were studied. Staphylococci accounted for 13 and 27% of the isolates from symptomatic patients but for only 3 and 4% of strains from asymptomatic bacteriuria. Conversely, 18 and 30% of Escherichia coli isolates from asymptomatic bacteriuria were auto-agglutinable when tested with antisera to the common urinary O-serogroups, whereas such strains accounted for only 5 and 7% of the E. coli from symptomatic patients. The high prevalence of auto-agglutinable E. coli in asymptomatic bacteriuria was accompanied by a reduction in the frequency of the common uninary O-serogroups rather than other smooth strains.

Adolescent↗
PubMed1990

Urinary IgG and IgA antibodies in elderly individuals with bacteriuria.

We studied the urinary IgG and IgA antibody in elderly subjects without bacteriuria, with asymptomatic bacteriuria and symptomatic urinary infection. Elderly individuals with asymptomatic bacteriuria had significantly elevated antibody levels relative to controls. When followed up to 12 months with persistent bacteriuria, antibody levels tended to persist but were variable. In elderly women with elevated urinary antibody titers, site of infection tended to be localized to the kidney, but antibody levels within the control range occurred as frequently as elevated antibody levels for renal infection. Subjects with invasive urinary infection had significantly elevated antibody levels at onset of symptoms, with levels increased or decreased when repeated 2-4 weeks later. Further studies to clarify the clinical significance of these observations are necessary.

Aged↗
PubMed2001

The prevalence of bacteriuria in older institutionalized patients.

We set out to determine the prevalence of bacteriuria in elderly patients institutionalised in 10 homes in Northumberland. Single mid-stream urine (MSU) specimens were collected from 161 asymptomatic patients aged 64-101 years. Thirty-four (21%) samples had > 100 white blood cells (WBC/microliter) on microscopy as well as a significant bacteriuria of > 10(8) bacteria/l, being suggestive of a true urinary tract infection. A total of 115(71%) samples had < 100 WBC. Seventy-five (46%) samples could be described as 'contaminated' or 'infection unlikely' but of these only 31 (19.2% of all samples) were reported as 'contaminated' by the laboratory. This study confirms previous work in America to indicate the high level of bacteriuria in institutionalised elderly patients as well as the very high number (46%) who may show bacteriuria but no rise in the number of WBC suggesting contamination only. Nurses and GPs must be very cautious in interpreting MSU results from such patients.

Aged↗
PubMed1987

Ureteral dilatation in children with febrile urinary tract infection or bacteriuria.

Little information is available on the relationship between urinary infection in children and infants, with or without vesicoureteral reflux, and dilatation of the urinary tract. The purpose of this study was to determine the effects of infection and reflux on the diameter of the ureter at excretory urography in children with acute, febrile urinary tract infections and in infants with bacteriuria found at screening. Standardized measurements of ureteral diameter were obtained for 79 children (2 months to 6 years old) with urinary tract infections and for 45 infants with bacteriuria. Patients with urinary tract obstruction or malformations were excluded. Seventy-one children with febrile urinary tract infection had ureteral visualization that allowed measurements. Ureteral diameter in this group was significantly wider than in a reference group, and 42 children (59%) had ureteral diameters that were more than 2 standard deviations above the normal mean. Ureteral diameter at excretory urography increased with increasing grades of reflux, but dilatation occurred also in the absence of reflux. Twenty-two of the 45 infants in the group with bacteriuria had sufficient ureteral visualization for measurements. The ureters in this group were wider than in the reference group, and eight infants had ureteral diameters that were more than 2 standard deviations above the normal mean. We conclude that ureteral dilatation is a common effect of acute urinary tract infection and bacteriuria in children.

Bacteriuria↗
PubMedDate not supplied

Bacteriuria and autonomic nerve function in diabetic women.

Significant bacteriuria (viable count greater than or equal to 10(5)/ml) was found on single testing in 10% of 400 consecutive diabetic women aged 15-65 yr routinely attending a diabetic clinic. Twenty patients with and 21 without significant bacteriuria were then randomly selected for measurement of cardiovascular autonomic reflexes, bladder ultrasound, and mictiography. There were no significant differences between these two groups in age, duration and type of diabetes, glycosylated hemoglobin, blood urea, and creatinine. Abnormalities of cardiovascular autonomic function were more common in the bacteriuric group (P less than .01). Although the bacteriuric group voided a smaller volume of urine, none had evidence of increased residual bladder volume of urine on ultrasound. Diabetic women with cardiovascular autonomic neuropathy appear to be at increased risk of developing bacteriuria. However, age is probably the most important factor influencing the prevalence of bacteriuria in diabetic and in nondiabetic women.

Adolescent↗
PubMedDate not supplied

Asymptomatic bacteriuria and hemoglobin A1.

We measured hemoglobin A1 (HbA1) and performed clean-catch urine cultures in 752 patients (411 men and 341 women) with non-insulin-dependent diabetes mellitus (NIDDM) attending an outpatient diabetes clinic. Prevalence of bacteriuria was significantly greater in diabetic women than in controls (9.1 vs. 5.0%, P less than .001) but not in diabetic men. Risk of bacteriuria was not related to level of HbA1 at the time of urine culture. However, mean duration of diabetes mellitus was significantly greater in diabetic women with bacteriuria than in those without infection (9.9 +/- 1.5 vs. 5.4 +/- 0.4 yr, P less than .025), and the prevalence of bacteriuria was significantly greater in patients with complications of long-standing diabetes mellitus than in those without complications (P less than .005).

Bacteriuria↗
PubMed1991

Bacteriuria in patients treated with clean intermittent catheterization.

Bacteriuria has been studied in 407 patients treated with clean intermittent catheterization (CIC) during 1 year. Significant bacteriuria was found in 50.6% of 1413 analyzed urine samples. Escherichia coli was the dominating species (54.8%). The relative distribution of species was different in males and females, but there were no differences between the CIC patients and a reference group of outpatients. On the other hand, a higher frequency of resistance among enterobacteria was found in samples from CIC patients compared to the reference group. The majority of CIC patients with bacteriuria had no symptoms, and bacteriuria per se does not seem to be an indication for treatment in most of these patients.

Adolescent↗
PubMedDate not supplied

Asymptomatic bacteriuria among outpatients with diabetes mellitus in an urban black population.

OBJECTIVE: To determine the prevalence of asymptomatic bacteriuria (ASB) in individuals afflicted by Diabetes mellitus; the antibiotic susceptibility of the microbial isolates and the association of host factors with ASB. DESIGN: This was a prospective cross sectional study. SETTING: Attendants of outpatient polyclinics at three main tertiary hospitals; namely, Harare, Chitungwiza and Parirenyatwa Hospitals. SUBJECTS: 176 participants. MAIN OUTCOME MEASURES: Patients attending the polyclinics between 6.30 am and 9.30 am from Monday to Friday were randomly selected. Demographic data was obtained at enrollment using a standardized questionnaire. Fasting venous blood was withdrawn from the participants for glucose analysis. Clean-catch midstream urine samples from all men and women were cultured and the causal organisms were isolated and identified by standard microbiological methods. Antibiotic susceptibility testing was performed using a disc diffusion method. Potential host factors included age, type of diabetes, duration of diabetes, glucosuria and leukocyturia. RESULTS: The prevalence of ASB was 32% in the diabetics and 11% in nondiabetic participants. The commonest bacterial organism isolated in participants afflicted by Diabetes mellitus was Escherichia coli (26%) followed by Staphylococcus aureus (21%), Streptococcus group B (14%), Streptococcus group D and non-lactose fermenting coliforms (7% respectively). Other isolates were Micrococcus and Pseudomonas (5% respectively), Klebsiella and Proteus (2% respectively). Gentamicin, nitrofurantoin, ampicillin and nicene were the most effective antimicrobials in the majority of isolates. Certain isolates exhibited some bacterial resistance to conventional antibiotics. Of the host factors, an association was found between bacteriuria and glucosuria (p < 0.001) and between leukocyturia and bacteriuria (p = 0.005). CONCLUSION: The prevalence of ASB is increased in diabetes and the rather high blood glucose levels exhibited by these individuals may further complicate this condition. As some bacterial species exhibited resistance to some common antimicrobials, these results raise questions regarding future clinical reliability of some conventional antimicrobials when considering therapy for asymptomatic bacteriuria.

Adult↗
PubMed1994

[A cooperative study on the incidence of bacteriuria in patients with benign prostatic hypertrophy].

The incidence of bacteriuria in patients with benign prostatic hypertrophy was studied at 8 National Hospitals. Among 1,542 patients, urinary infection was the reason of visit in 63 patients (4.1%). After open and transurethral prostatectomy, one-third of patients developed bacteriuria (30 of 59 subcapsular enucleations, and 252 of 776 transurethral resections). When a catheter is placed without prophylactic antimicrobial, all patients developed bacteriuria within 10 days, and within 30 days even if they received antimicrobials. The incidence of bacteriuria increased with age.

Aged↗
PubMed1993

A reassessment of the importance of "low-count" bacteriuria in young women with acute urinary symptoms.

OBJECTIVE: To determine whether a statistical association exists between "low-count" bacteriuria (> 10(2) to 10(4) colony-forming units/mL) and acute urinary symptoms in young women. DESIGN: Prospective, case-control study. SETTING: Gynecology clinic at a student health center. PATIENTS: Women with or without urinary or vaginal symptoms. MEASUREMENTS: History of urinary infections and sexual activity. Quantitative determination of bacteriuria and pyuria and bacterial species; urine leukocyte esterase test; specific gravity; creatinine levels; vaginal leukocytes; and in-vitro culture of urine. RESULTS: The frequency of recent sexual activity, pregnancies, and contraceptive practices was not statistically different between women with acute urinary symptoms and asymptomatic controls. Escherichia coli and Staphylococcus saprophyticus were the only microorganisms statistically associated with urinary symptoms and pyuria (P < 0.001). Low counts of these organisms were found in 10.2% of asymptomatic women. As the bacterial count increased, the association between these organisms and symptoms increased, and a step-wise increase occurred in the frequency and magnitude of pyuria, but the specific gravity and urine creatinine levels remained unchanged. Escherichia coli, even at low counts, grew well in the patients' own urine. Pyuria (> 20 leukocytes/mm3) was present in 19.6% of asymptomatic women and was associated with vaginal leukorrhea. CONCLUSIONS: "Low-count" bacteriuria was statistically more frequent among young women with urinary symptoms than among asymptomatic controls. The low counts could not be explained by dilution of the urine or failure of the bacteria to grow well in the patients' urine. These findings suggest that the infection was not established in the bladder urine and that "low-count" bacteriuria might be an early phase of urinary tract infection.

Acute Disease↗
PubMed1994

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

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 analysis, infection was not related to mortality (relative risk, 1.1; P > 0.2), whereas age at entry and self-rated health (score 1 [excellent] to 4 [bad or poor]) were strong predictors. In the clinical trial, mortality in 166 treated residents (13.8 per 100,000 resident-days) was comparable to that of 192 untreated residents (15.1 per 100,000 resident-days); the relative rate was 0.92 (95% CI, 0.57 to 1.47). The cure rates among treated and untreated residents were 82.9% and 15.6%, respectively. CONCLUSION: Urinary tract infection was not an independent risk factor for mortality, and its treatment did not lower the mortality rate. Screening and treatment of asymptomatic bacteriuria in ambulatory elderly women to decrease mortality do not appear warranted.

Aged↗
PubMed2006

Frequency and risk factors of asymptomatic bacteriuria during pregnancy.

OBJECTIVE: To determine the frequency and risk factors of asymptomatic bacteriuria during pregnancy. DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Satellite Town and Behari Colony, Bahawalpur from October 2001 to March 2002. PATIENTS AND METHODS: There were 3000 houses in Satellite Town and Behari Colony, Bahawalpur. Taking 40% of total, 1200 houses were selected by systemic random sampling. Pregnant residents of these houses were included in the study. Data collected was coded, computed and analyzed on SPSS version 10. Frequencies were runned and chi-square test was used as test of significance. RESULTS: Five hundred and eighty women, fulfilling the inclusion criteria, were interviewed and tested for bacteriuria. Out of them, 4% were below 20 years, 4.6% were between 20-30 years and 5.4% women aged above 30 years (p=0.103). Regarding parity 3.18 % of primigravidae and 6.04 % multigravida had bacteriuria (p=0.0039). Regarding socioeconomic status, 6.45% from lower class and 2.5% from middle and upper middle class were the sufferer (p=0.0039). Prevalence was 6.64% among uneducated and 3.06% among educated women (p=0.0039). As for past history, 35.7% of women had an episode previously (p=0.001). No association was found with anaemia. CONCLUSION: Asymptomatic bacteriuria is a common infection during pregnancy, having strong association with multiparity, lower socioeconomic status and illiteracy.

Adolescent↗
PubMed2000

Bacteremia and bacteriuria after transrectal ultrasound guided prostate biopsy.

PURPOSE: We determined the incidence and predisposing factors of bacteremia and bacteriuria after prostate biopsy with specific emphasis on the value of a pre-biopsy enema. MATERIALS AND METHODS: We randomized 50 men undergoing ultrasound and biopsy to rule out prostate cancer to receive a preoperative (25) or no (25) enema. Preoperatively urine was obtained for culture, and questionnaires regarding urological history and voiding symptoms were completed. The initial prostate biopsy, biopsy needle, and postoperative urine and blood specimens were cultured. The following day a symptom questionnaire was completed. RESULTS: Bacterial growth in post-procedure cultures did not correlate with the number of biopsies, prostate specific antigen, obstructive voiding symptoms, prostate volume, cancer or post-biopsy hematuria. Bacteriuria was noted in 44% of the cases and bacteremia was present in 16% of the patients, of whom 87.5% did not receive an enema (p = 0.0003). Only 1 patient had chills and fever greater than 37.5C, requiring additional antibiotics. On the followup questionnaire 12% of patients described dysuria, including 84% with bacteriuria after biopsy. CONCLUSIONS: Bacteremia and bacteriuria after multiple biopsies are common but usually asymptomatic. Bacteria is apparently introduced into the urine and/or blood from the rectum via the biopsy needle, which may be minimized by a pre-biopsy enema. Dysuria or a history of urinary tract infection did not predict problems after biopsy.

Aged↗
PubMed1975

The relationship of urinary symptoms to significant bacteriuria.

Selected samples of healthy people (804 males, 796 non-pregnant females and 400 pregnant women) were questioned about present and previous urinary symptoms. Mid-stream specimens of urine were cultured quantitatively. Symptoms in the males occurred more frequently in the presence of ;significant bacteriuria', but the numbers were too small to allow statistical analysis. Among the non-pregnant females frequency or burning micturition was found more frequently in those who had significant bacteriuria than in those whose urinary bacterial counts were low; for nocturia this difference was statistically significant (p <0.001).Of the pregnant women, comparison of those who had significant bacteriuria with those whose urine was normal showed that diurnal and nocturnal frequency, and loin pain, occurred more frequently in those with significant bacteriuria (for each of these symptoms p <0.0.1).These results suggest that the recent onset of nocturia is the most reliable symptom of urinary tract infection. There remain, however, many people with urinary symptoms and with low urinary bacterial counts in whom other causes for the symptoms should be sought.

Age Factors↗
PubMed1975

[Bacteriuria--findings in diabetics].

The frequency of bacteriuria in 2.058 unselected diabetics obtained with the help of microscopic slides was 9.67%. Here women (n=1,325) with 13.5% have an essentially higher share of constant bacteriuria (number of germs more than 10(5)/ml) than men (n=733) with 2.4%. In very old men older than 75 years a clear increase to 14.6% could be proved. A relation between duration of diabetes and frequency of bacteriuria could not be ascertained. On the other hand there existed a dependence on the form of therapy of diabetes. A constant bacteriuria was present in dietetically led diabetics at 7.3%, in those persons treated with oral antidiabetics at 10.2%, in diabetics treated with insulin at 13.8%. The slide culture is clearly superior to the hitherto still used bacteriological and biochemical methods and is recommended particularly for screening tests.

Administration, Oral↗
PubMed2002

Laboratory aspects of asymptomatic bacteriuria in pregnancy.

A total of 1,661 pregnant women aged between 13 and 45 years were screened for bacteriuria by urine culture. Of the 1,661 culture results, 615 (37%) yielded no growth; 728 (43.8%) yielded no significant growth (presence of <10(5) organisms/ml urine of one or more types of bacteria); 286 (17.2%) yielded mixed growth (presence of >10(5) organisms/ml urine of more than one type of bacteria) and only 32 (1.9%) showed significant growth (presence of >10(5) organisms/ml urine of a single bacterium). Urine microscopy was also conducted. Two hundred and twenty-four (13.5%) specimens had >10 white blood cells/ml urine, of which 66 had >100 white blood cells; 13 were from the significant growth group. Three hundred and seventy-four (22.5%) specimens showed the presence of bacteria, 42 (2.5%) had red blood cells, 370 (22.3%) had epithelial cells, 58 (3.5%) had crystals, and 14 (0.8%) had yeasts. The most common bacterium isolated was Escherichia coli (12; 40%); the others included group B Streptococcus (5; 15%), Klebsiella spp (5; 15%), Diphtheroids (2), and Candida albicans (2). Fifty-two percent of tested strains were sensitive to ampicillin; 24 of 28 strains (85.7%) were sensitive to ciprofloxacin; all 7 strains tested were sensitive to nitrofurantoin and all 20 strains tested were sensitive to cotrimoxazole; 14/20 (70%) and 16/17 (94.1%) were sensitive to cephalexin and cefuroxime respectively. This study shows that asymptomatic bacteriuria does occur in pregnant women, albeit at a very low rate in an urban setting like Cheras. Urine microscopy is not specific and only serves as a guide to bacteriuria. The commonest causative organisms are those from the gastrointestinal tract and vagina. The antibiogram showed that cefuroxime and cephalexin are likely to be effective in treating bacteriuria: ampicillin must be reserved for Gram-negative organisms. For Gram-positive organisms, of which Group B Streptococcus is important, ampicillin is still effective in vitro. Nitrofurantion and cotrimoxazole have excellent activity in vitro and should be considered for therapy. 17.2% of the urine culture yielded mixed growth: likely to indicate that contamination of urine specimens still happens despite the strict instructions given to patients about the collection of a midstream urine specimen. Proper collection, appropriate transport, and the early processing of urine specimens remain essential.

Adolescent↗
PubMed1992

Asymptomatic significant bacteriuria among pregnant and non-pregnant women in Sagam, Nigeria.

In a study carried out among 510 pregnant and 304 non-pregnant women at Ogun State University Teaching Hospital, Sagamu, 122 (23.9 pc) of the pregnant women and 37 (2.2 pc) of the non-pregnant women had significant bacteriuria. The rate amongst the pregnant women was significantly higher than in non-pregnant women (P < 0.001). There was a correlation between pyuria and significant bacteriuria in 45 (8.8 pc) of the pregnant women and in 11 (3.6 pc) of the non-pregnant women. Significant bacteriuria was closely associated with nulliparae. Most of the pregnant women with significant bacteriuria belonged to the low socio-economic group. Unlike in previous studies in this country, the most prevalent organism in this study was the Staphylococcus aureus.

Adolescent↗
PubMed2004

Bacteriuria in patients with gallbladder and biliary tract diseases.

Urinary tract infections (UTI) are important hospital acquired entities, resulting in bacteriuria indicated by the presence of significant numbers of bacteria in the urine. This study examined the prevalence of bacteriuria in our patients with gallbladder diseases. Three hundred and forty eight patients with various gallbladder (GB) diseases were enrolled in our study. Routine bacteriological cultures of midstream urine specimens were done. Significant bacteriuria was defined as the growth of 105 or more organisms in pure culture per milliliter of urine. Forty four (12.6%) of the patients (18 symptomatic; 26 asymptomatic) showed bacteriuria. Escherichia coli was the predominant isolate followed by Klebsiella pneumoniae, Enterobacter, Pseudomonas aeruginosa, Enterococci and several others. Thus UTI is also a frequent concomitant of gall bladder diseases and is a sign of the fact that kidneys are in a condition endangered by pyelonephritis.

Adolescent↗