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PubMed1991

Escherichia coli bacteriuria and contraceptive method.

We evaluated the effects of contraceptive method on the occurrence of bacteriuria and vaginal colonization with Escherichia coli in 104 women who were evaluated prior to having sexual intercourse, the morning after intercourse, and 24 hours later. After intercourse, the prevalence of E coli bacteriuria increased slightly in oral contraceptive users but dramatically in both foam and condom users and diaphragm-spermicide users. Twenty-four hours later, the prevalence of bacteriuria remained significantly elevated only in the latter two groups. Similarly, vaginal colonization with E coli was more dramatic and persistent in users of diaphragm-spermicide and foam and condoms. Vaginal colonization with Candida species, enterococci, and staphylococci also increased significantly in diaphragm-spermicide users after intercourse. We conclude that use of the diaphragm with spermicidal jelly or use of a spermicidal foam with a condom markedly alters normal vaginal flora and strongly predisposes users to the development of vaginal colonization and bacteriuria with E coli.

Adult↗
PubMed1990

Screening for asymptomatic bacteriuria, hematuria and proteinuria. The U.S. Preventive Services Task Force.

RECOMMENDATION: Periodic testing for asymptomatic bacteriuria is recommended for persons with diabetes and for pregnant women, and it may also be clinically prudent in preschool children. In general, dipsticks combining the leukocyte esterase and nitrite tests should be used to detect asymptomatic bacteriuria. However, urine culture is a more accurate screening test than is dipstick urinalysis, and it is recommended for detecting asymptomatic bacteriuria during pregnancy. Dipstick urinalysis for asymptomatic bacteriuria, hematuria and proteinuria may also be clinically prudent in persons over age 60.

Bacteriuria↗
PubMedDate not supplied

[The pertinence of microscopic analysis of the urine as a diagnostic test for asymptomatic bacteriuria in pregnancy].

The genito-urinary tract is the most frequent site of infection during pregnancy. Asymptomatic bacteriuria is found in 2 to 12% of the obstetrical population. The importance of its detection is underlined by the fact that 20 to 40% of untreated cases will present acute pyelonephritis. Our study's first aim was determining the incidence of asymptomatic bacteriuria in our population. Our results show an incidence of 3.9%. Second, routine mandatory prenatal laboratory examinations include urinalysis and urine culture. Considering the fact that we already do a routine culture, we questioned the pertinence of the microscopic part of urinalysis for screening asymptomatic bacteriuria. Our study has shown that no amount of erythrocytes, leucocytes, bacteria, pus or combination thereof has sufficient sensitivity and/or specificity to be used for screening. We thus conclude that in our context of budget restrictions, the microscopic analysis of urine should be abandoned as a routine test. The biochemical part of urinalysis could be done easily with dipsticks at a lower cost. Urine culture remains the gold standard for detection of asymptomatic bacteriuria.

Adult↗
PubMed1989

[Pathogenic characteristics of Escherichia coli strains in cases of asymptomatic bacteriuria and symptomatic urinary tract infections].

The aim of this study was to examine if E. coli isolated from asymptomatic bacteriuria differed in pathogenic features from strains isolated from symptomatic infections of urinary tract. In this study 130 strains of E. coli isolated from women having asymptomatic bacteriuria and 112 strains isolated from patients with symptoms of urinary tract infection were examined. It was shown that E. coli isolated from patients with symptomatic urinary tract infection showed the more frequently ability to cause mannose-resistant haemagglutination of human erythrocytes, resistance to bactericidal activity of serum and haemolytic properties than those isolated from asymptomatic bacteriuria. These strains showed also the higher ability to adhere to Vero cells in tissue culture. Among E. coli strains isolated from persons with asymptomatic bacteriuria the pathogenic features were most frequently found in strains from healthy women and the most rarely in isolated from diabetic women.

Adolescent↗
PubMed1989

Screening for asymptomatic bacteriuria in pregnancy. A decision and cost analysis.

Screening women for asymptomatic bacteriuria on the first prenatal visit is a standard of obstetric care. Treating women with positive results decreases the risk of pyelonephritis and possible prematurity. This study uses decision and cost analysis to compare the utility of screening for asymptomatic bacteriuria with not screening. Data are based on published reports and average charges for services. Costs are based on 1988 charges, projected for the expected results of outpatient screening, possible suppressive therapy, and risks of pyelonephritis. Screening is based on the combined sensitivities and specificities of the MacConkey and CLED (cysteine-lactose-electrolyte-deficient agar) panels of the dip-slide culture. Under the baseline assumptions, the risk of pyelonephritis is estimated to be 2 cases per 100 screened women vs 3.5 cases per 100 unscreened women. The anticipated cost of screening 100 women is $9,939, compared with $12,824 for not screening 100 women. Screening is cost saving unless the cost of screening is above $26, the length of hospitalization for pyelonephritis is fewer than 2.2 days, the risk of asymptomatic bacteriuria falls below 2%, the risk of pyelonephritis with asymptomatic bacteriuria falls below 13%, or the efficacy of treatment in preventing pyelonephritis falls below 38%.

Bacteriuria↗
PubMed1986

Asymptomatic bacteriuria in Nigerian diabetics.

One hundred and ninety diabetic patients and an equal number of non-diabetic patients, age- and sex-matched, were screened for occurrence of asymptomatic bacteriuria. Of the diabetics 6.3% were found to have covert bacteriuria as were 5.3% of the control group. Asymptomatic bacteriuria was found to occur more commonly in females than males and in the patients who were over 40 years old. The incidence of bacteriuria was not found to be related to the degree of control in the diabetic patients. The most common organism cultured was E. coli.

Adult↗
PubMedDate not supplied

[Recurrent bacteriuria in children].

Fifty-four children admitted to the Children's Hospital of Cordoba City with recurrent bacteriuria were followed for 12 to 97 months. Most of them were females and Escherichia coli was the most frequent microorganism isolated in recurrent attacks of bacteriuria. Ninety percent of the patients showed urological abnormalities. Vesicoureteral reflux was the most frequent. Residual urine was considered the main cause of recurrent bacteriuria. After antibioticotherapy and surgical treatment, over one half of the patients persisted with relapses. Recurrent bacteriuria appeared more frequently in male infants with severe urologic abnormalities. Finally, three groups of patients in relation to uropathy and functional renal impairment are described and a different prognosis for each one is proposed. For this reason, each patient must have a complete urologic examination done at the onset and a carefull follow-up, carried out.

Bacteriuria↗
PubMed1985

Detection of latent bacteriuria in patients with chronic pyelonephritis.

Diagnostic possibilities of selective examination of renal urine particularly collected under medicamentous polyuria conditioned by the administration of Lazix were studied in latent bacteriuria. By means of separate collection of renal urine against the background of polyuria it was possible additionally to detect bacteriuria in 1/3 of the patients, to record increase in the intensity of the index in almost half of the patients with renal bacteriuria and, in 1/4 of them to detect, in renal urine, the aetiological agent absent from bladder urine. The latter circumstance not only has a diagnostic significance but also plays a certain role in the selection of medicamentous therapy in chronic pyelonephritis. In addition to traditional bacteriological methods, filtration through membrane filters was used to isolate and identify microflora in the urine. By means of this method it is possible to detect extremely low bacteriuria which cannot be established by any other method.

Bacteria↗
PubMed1979

Asymptomatic bacteriuria in adolescent girls: I. Epidemiology.

Because the incidence of bacteriuria in asymptomatic school girls is low (1% to 2%), we examined possible risk factors in adolescents, such as previous history of urinary tract infection (UTI) and sexual intercourse (previous and recent). Eight (1.6%) of 500 adolescent girls were detected with asymptomatic bacteriuria (ABU). Of 47 patients reporting a previous UTI, four (9%) were bacteriuric. Two other patients detected with bacteriuria had a history of enuresis; thus 6/8 adolescents with ABU had a history that suggests a need to screen for infection. A history of sexual activity was not helpful in case detection. Of the 500 girls, 133 had a routine pelvic examination at the time of the visit. The procedure was not associated with bacteriuria, as measured by a home nitrite test each day for three days following the clinic visit.

Adolescent↗
PubMed1984

Screening for bacteriuria in healthy Japanese school children.

Bacteriuria was screened among 28,202 healthy school children, 14,575 boys and 13,627 girls by dipstick and dipslide methods and also by pour plate culture method. Prevalence of bacteriuria was 0.06% in boys and 0.54% in girls after third screening. A high rate of false negative results with dipstick test and a high rate of false positive results with dipslide culture method using Microstix-3 were observed. About 60% of screened children continued to have bacteriuria persistently for 9 months after third screening followed by monthly urine culture. Anomalies of urinary tract were detected in 9 of 26 children with persistent bacteriuria.

Adolescent↗
PubMed1981

Screening of asymptomatic bacteriuria in a disadvantaged school population.

In the Pose-Robbins School Health Project, 314 seventh grade students were screened for asymptomatic bacteriuria. A multiple dipstrip detection method was used for nitrite, glucose, and protein. Where one or more of the dipstrip tests was positive, urine cultures were performed on clean voided specimens. A child whose urine culture showed a colony count of greater than 100,000 colonies/ml was defined as having asymptomatic bacteriuria. Of the female students, 5.4 percent were found to have asymptomatic bacteriuria. None of the male students had asymptomatic bacteriuria. The percentage of schoolgirls in this age group who demonstrated infection was higher than previously reported. The school population screened in this study was from a poverty area disadvantaged according to most demographic parameters.

Adolescent↗
PubMed1994

Asymptomatic bacteriuria in pregnancy: maternal and fetal complications.

From an analysis of the data reported in the literature it is clear that pregnancy is a predisposing factor for urinary tract infection and that pregnant women with this pathology are exposed to dangerous risks which may influence maternal wellbeing and fetal prognosis. Authors do not concur on the specific risks to the mother and fetus, one reason being that the statistics reported to date reveal discrepancies relating to the presence of disorders prior to pregnancy and the environmental, working and socio-hygienic conditions of the populations studied. The apparently paradoxical finding of a higher incidence of perinatal problems in pregnant women with asymptomatic bacteriuria compared to manifest forms can be attributed to the fact that the latter are treated with adequate therapies whereas asymptomatic bacteriuria, which is difficult to diagnose, may persist throughout pregnancy. This underlines the importance of early diagnosis using a protocol which entails the execution of serial urine tests and urine cultures and adequate treatment of all cases of asymptomatic bacteriuria in order to reduce the incidence of urinary tract infections and materno-fetal complications. Non-treated asymptomatic bacteriuria in fact represents a considerable risk factor since it may lead to the onset of acute pyelonephritis in approximately 5% of pregnant women and may increase the risk of fetal mortality.

Bacteriuria↗
PubMed1978

Sequelae of covert bacteriuria in schoolgirls. A four-year follow-up study.

A trial involving 208 girls aged 5-12 who had bacteriuria on screening was carried out to determine the effects of covert bacteriuria on renal growth and scarring. 98 were observed for 4 years without treatment and 110 were treated. 77% of the treated girls, but only 26% of the untreated controls, were free of infection for at least half of the 4-year follow-up. However, treatment had no effect on the emergence of symptoms, clearance of vesico-ureteric reflux (V.U.R.), kidney growth, or the progression of kidney scars. New kidney scars did not develop in previously unscarred kidneys. 12 (6%) of the 208 girls had progression of re-existing kidney scars; this high-risk group was characterised by kidney scarring on the initial X-ray, a high prevalence of v.u.r., and persistent or recurrent bacteriuria. Screening for covert bacteriuria cannot therefore be recommended in schoolgirls since kidney damage associated with infection arises before the age of 5.

Anthropometry↗
PubMed1995

Interpretation of the bacteriologic outcome of antibiotic treatment for uncomplicated cystitis: impact of the definition of significant bacteriuria in a comparison of ritipenem acoxil with norfloxacin. Swedish Urinary Tract Infection Study Group.

The efficacy and safety of a 5-day course of treatment with the new oral penem agent ritipenem acoxil (500 mg three times daily) or with norfloxacin (200 mg twice daily) were assessed in a double-blind study of women with uncomplicated cystitis. The effects of the definition of bacteriuria used on the interpretation of treatment outcome were also analyzed. Of 281 women randomized to one of the two treatment arms, 84% were evaluable in terms of the bacteriologic efficacy of therapy; 99% of the evaluable patients returned for the first follow-up examination and 92% for the second. Five to 9 days after the completion of therapy, persistent bacteriuria was documented in more women given ritipenem acoxil than norfloxacin (95% confidence interval, 0.14; 0.38). The two groups did not differ markedly with regard to bacteriologic or clinical outcome 3 to 4 weeks after treatment. Subanalyses of bacteriologic outcome showed that failure rates varied between 6% and 67% for ritipenem acoxil and between 1% and 43% for norfloxacin, depending on how significant posttherapy bacteriuria was defined; systematic studies are are clearly needed on how best to define significant posttherapy bacteriuria. Ritipenem acoxil caused significantly more adverse reactions (especially diarrhea or loose stools) than norfloxacin (P < .005).

Adolescent↗
PubMed1994

Screening for bacteriuria in Malaysian school children.

Urinary tract infection is the most common of bacterial infections. Screening children for asymptomatic bacteriuria to prevent pyelonephritis and renal scarring is widely recommended. In Malaysia no such attempt has been made to establish the prevalence of asymptomatic bacteriuria. Bacteriuria was screened among 44,816 healthy school children from three different districts in Kelantan. There were 23,132 boys and 21,684 girls. The prevalence of bacteriuria was 0.12% after second screening. Higher prevalence was seen in other reports.

Bacteriuria↗
PubMed1994

[Asymptomatic bacteriuria and pyuria during pregnancy].

BACKGROUND: The presence of pyuria and the role of mixed culture in the diagnosis of asymptomatic bacteriuria in pregnant women have been evaluated METHODS: One hundred and sixty four pregnant women without any symptomatology have been studied using two cultures of mid-stream urine samples and pyuria quantification. In addition culture of bladder urine has been carried out in 17 of these patients (12 with pure cultures and 5 with mixed cultures). RESULTS: 110 samples were culture negative without pyuria; 7 were pure cultures with pyuria; 19 pure culture without pyuria and the remaining 28 patients yielded mixed culture with or without pyuria in the first culture. Twenty of these 28 mixed cultures were negative in the second culture. A estimated frequency of asymptomatic bacteriuria in pregnancy was 16% and pyuria was only found in 27% of pregnant women with asymptomatic bacteriuria. CONCLUSION: The pyuria is not a useful marker for the diagnosis of asymptomatic bacteriuria in pregnancy.

Bacteria↗
PubMed1975

Qualitative assessment of midstream urine cultures in the detection of bacteriuria.

3550 women attending cervical smear and family planning clinics have been screened for bacteriria. Suprapubic aspiration of urine was carried out in 131 patients from whom two consecutive midstream urine specimens contained either a pure growth of Gram positive cocci or a growth in which Gram negative bacilli predominated. 95 patients were found to have bacteriuria; in 93 the urine was infected with a Gram negative organism. Of 53 patients with a count of more than 10-5 Gram negative organisms per milliliter on two consecutive midstream urine samples, 48 (91%) had bacteriuria. However, 45 (48%) of the 93 patients with bacteriuria did not have two consecutive counts greater than 10-5 organisms per milliliter , and 10 (11%) had counts of less than 10-4 organisms per milliliter in at least one of the two midstream urine samples. It is concluded that midstream urine counts of less than 10-5 organisms per milliliter in which Gram negative bacilli predominate may be indicative of bacteriuria and should be confirmed by suprapubic aspiration.

Bacteriuria↗
PubMed1994

Bacteriuria and pregnancy outcome: a prospective hospital-based study in Pakistani women.

The prevalence of bacteriuria in Pakistani women and its association with complications of pregnancy was studied. Out of 1579 women, 77 had bacteriuria (4.8%). There was no association of age, gravidity, parity, haemoglobin, pre-eclampsia, mode of delivery, gestational age at delivery, preterm delivery and low birth-weight with presence of bacteriuria. With detection and treatment the pregnancy outcome of women with bacteriuria in pregnancy was the same as that of those without.

Adult↗