Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Bacteriuria”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 361 records · Page 20Linked to original sources
PubMed1973

Rapid detection of gram-negative bacteriuria by use of the Limulus endotoxin assay.

The Limulus in vitro endotoxin assay was evaluated as a possible method for the prompt detection of significant gram-negative bacteriuria in children. This assay is capable of detecting endotoxin associated with intact cell walls of viable gram-negative bacteria as well as free endotoxin. Quantitative results are obtained following a 1-h incubation of Limulus lysate and 10-fold dilutions of otherwise untreated urine. A standard curve of Limulus activity and viable cell counts of Escherichia coli and Klebsiella pneumoniae in urine demonstrated that a positive Limulus reaction at a dilution of 1:100 or 1:1,000 indicated a colony count of at least 100,000 bacteria/ml. A positive Limulus reaction only from undiluted urine or at a dilution of 1:10 indicated less than 100,000 cells/ml. These experimental observations were confirmed by comparing the Limulus test with quantitative plate counts on 209 urine specimens from a mixed pediatric population. These results indicate that the Limulus assay is a simple, accurate method for rapid presumptive detection of gram-negative bacteriuria in patients where an immediate diagnosis is needed. This test would also seem promising for screening large patient populations for bacteriuria or for monitoring the effectiveness of treatment of urinary tract infections.

Adolescent↗
PubMed1991

Persistence of Escherichia coli bacteriuria is not determined by bacterial adherence.

The role of bacterial adherence in the persistence of bacteria in the human urinary tract was analyzed. Women with chronic symptomatic urinary tract infections were subjected to deliberate colonization with nonvirulent Escherichia coli, after eradication of their current infections. E. coli organisms were instilled into the bladder through a catheter. The strain used for colonization, E. coli 83972, was isolated from a patient with stable bacteriuria. It lacked expressed adherence factors and did not belong to the uropathogenic O:K:H serotypes. Strain 83972 was transformed with the pap and pil DNA sequences encoding Gal alpha 1-4Gal beta- and mannose-specific (type 1) adhesins. Patients were colonized with a mixture of the wild-type and the transformed strains. E. coli 83972 caused stable bacteriuria for greater than 30 days in 7 of 12 individuals. In contrast, the Gal alpha 1-4 Gal beta-recognizing or mannose-binding transformants were eliminated within 48 h. The consistent superiority of the wild-type strain in establishing stable bacteriuria when compared with the adhesive transformants did not appear to be due to differences in growth rates or to plasmid segregation. Rather, the transformants expressing the adhesin determinants were selectively eliminated by the host. This suggested that the acquisition of adherence factors is not sufficient to increase the fitness of E. coli for survival in the urinary tract of humans.

Adult↗
PubMed1993

Urethral obstruction of 6 hours or less causes bacteriuria, bacteremia, and pyelonephritis in mice challenged with "nonuropathogenic" Escherichia coli.

Urethral obstruction may be caused by prostatic hypertrophy, urethral stricture, or encrustation of a urethral-catheter lumen. Bacteriuria often complicates these obstructions. The sequelae include fever, acute pyelonephritis, chronic renal inflammation, and death. We hypothesized that even brief obstruction of the urinary tract containing a nonvirulent bacterium would result in these complications. Mice challenged transurethrally with Escherichia coli FN414, which is rapidly eliminated from normal mice without causing bacteriuria, bacteremia, or renal pathology, were subjected to reversible urethral obstruction by coating the urethral meatus with collodion for 1, 3, or 6 h. The majority of mice obstructed for 1 h demonstrated parenchymal renal inflammation 48 h later. At the end of 3 h of obstruction, 9 of 10 mice were bacteremic; some bacteremias were present at 48 h after removal of the obstruction. At that time, more severe renal inflammation was seen in these mice. As little as 6 h of obstruction resulted not only in the acute changes described above but also in chronic renal inflammation and fibrosis in the majority of animals sacrificed 3 and 6 weeks later. Additional studies demonstrated that urethral obstruction enhanced the uropathogenicity of another nonpathogenic E. coli strain (K-12 strain HB101) and caused more severe renal lesions in mice challenged with E. coli CFT073, isolated from a patient with symptoms of pyelonephritis. These findings demonstrate that brief urethral obstruction may (i) induce organisms which are cleared rapidly from the normal urinary tract to cause bacteriuria, bacteremia, and pyelonephritis and (ii) intensify the renal lesions caused by a uropathogen.

Animals↗
PubMed1981

Rapid detection of Gram-negative bacteriuria by Limulus amoebocyte lysate assay.

The Limulus amoebocyte lysate (LAL) test was evaluated for rapid detection of gram-negative bacteriuria in an adult patient population. Time to gelation of a standard LAL preparation was used as a measure of significant (greater than 10(5) bacteria per ml) gram-negative bacteriuria, and the results of 190 LAL assays were compared with quantitative urine cultures. Initially, 33 of 36 urine specimens containing greater than 10(5) gram-negative bacteria per ml were detected by LAL assay. The three false-negative LAL tests were the result of urine pH levels below the pH minimum for LAL gelation; neutralization of these urine specimens resulted in positive LAL assays and 100% correlation with culture results. All 36 bacteriuric urine specimens were LAL positive within 15 min, with the majority of assays (86.1%) being positive after only 10 min of incubation at 37 degrees C. These data compared favorably with gelation times of 15 min when 1 X 10(5) to 2 X 10(5) gram-negative bacteria per ml were added to sterile urine. Two urine samples obtained from male patients with culture-proven gonococcal urethritis yielded positive LAL assays. The LAL assay was shown to correctly differentiate 96.2% of urine specimens as containing less than 10(5) or greater than 10(5) gram-negative bacteria per ml. The results of this study have shown that the LAL test can be used as a rapid, simple, and reliable screening procedure for the diagnosis of clinically significant gram-negative bacteriuria.

Adult↗
PubMed1982

Bacteriuria caused by Acinetobacter calcoaceticus biovars in a normal population and in general practice.

A total of 14 strains of Acinetobacter calcoaceticus biovar anitratus and 93 strains of A. calcoaceticus biovar lwoffi from a total of 97 patients participating in studies of significant bacteriuria were cultured. These studies involved an interview survey of asymptomatic significant bacteriuria and a multiple-center investigation of urinary tract infection diagnosed in general practice. Antibiotic susceptibilities of the strains as determined by a disk diffusion technique were generally in agreement with the results in the available literature, although we found high activity exhibited by ampicillin, cephalosporin, chloramphenicol, erythromycin, and streptomycin. The following resistance patterns were seen. (i) The strains from the interview survey were more often resistant to ampicillin, oxacillin, and tetracycline than were strains from the general practice study. (ii) More biovar anitratus strains than biovar lwoffi strains were resistant to chloramphenicol, erythromycin, and mecillinam. (iii) More biovar anitratus strains than biovar lwoffi strains were resistant to carbenicillin in the interview survey. The literature relevant to the incidence and significance of A. calcoaceticus biovars in urinary cultures, as well as predisposing factors, was reviewed. The incidence of these organisms in significant bacteriuria seems to be increasing. We concluded that A. calcoaceticus biovars can cause urinary tract infection in abnormal hosts as well as in basically healthy individuals.

Acinetobacter↗
PubMed1983

Rapid method for identification and susceptibility testing of Escherichia coli bacteriuria.

This report describes a rapid method for the identification and susceptibility testing of Escherichia coli bacteriuria by use of the Autobac urine screen (AUS), a 5-h indole test, and the AutoMicrobic system E. coli Susceptibility Card (AMS-ECSC). All specimens that were AUS negative at 3 and 5 h were reported as negative. All specimens that were AUS positive at 3 or 5 h were removed from the refrigerator and streaked to a MacConkey-blood agar biplate with a 0.001-ml calibrated loop and incubated at 35 degrees C. The standard method for identification and susceptibility testing consisted of inoculating isolated colonies into the AutoMicrobic system Enterobacteriaceae-Plus Biochemical Card and the AutoMicrobic system General Susceptibility Card. Of 915 specimens, 212 (23.2%) were AUS positive at 3 h, of which 112 (52.8%) were indole positive when tryptophan broth was tested at 5 h. The sensitivity and specificity of this screening method for E. coli bacteriuria were 78.8 and 72.2%, respectively. If contaminated cultures were excluded, specificity was 94.4%. When the indole test was positive, 10 microliters of growth from tryptophan broth was used as inoculum for the AMS-ECSC. AMS-ECSC results were final at 12 h. The sensitivity and specificity of the AMS-ECSC for identification of E. coli were 90.4 and 55.0%, respectively. If contaminated cultures were excluded, specificity was 100%. AMS-ECSC susceptibility results demonstrated an overall agreement of 94.3% with the standard method, with 0.5% very major, 3.4% major, and 1.8% minor discrepancies. The biplate was examined after overnight incubation, and when colonies compatible in morphology with E. coli were present in significant numbers, AMS-ECSC results were reported. When discrepancies were found between biplate and AMS-ECSC results, the biplate was processed in the conventional manner. A rapid method for identifying and performing susceptibility tests for approximately 70% of the specimens with E. coli bacteriuria is described.

Anti-Bacterial Agents↗
PubMed1983

Evaluation of the Bacteriuria Detection Device.

The ability of the Bacteriuria Detection Device (BDD) (Marion Laboratories, Kansas City, Mo.) to detect significant bacteriuria was evaluated. Quantitative plating and BDD results were compared for 513 clinical specimens, 188 of which were voided. Eighty-seven specimens (17%) could not be tested because of clogging or excessive pigmentation. Specimens were considered positive if they contained more than 10(4) bacteria per ml. Thirteen specimens gave false-negative BDD results; 10 of these contained gram-positive cocci. The sensitivity of the BDD test was calculated to be 89%; the specificity, 65%. The predictive value of a negative test was 94%; that of a positive test was 49%. The efficiency of the BDD test was 71.6%. The BDD has the potential for providing rapid detection of bacteriuria, but requires further improvement before it can reliably be substituted for urine culture.

Bacteriuria↗
PubMed1984

Bacteriuria screening by direct bioluminescence assay of ATP.

A direct bioluminescence assay for bacteriuria screening is described and compared with the MS-2 system (Abbott Laboratories, Irvine, Tex.) and the chemical strip, Gram smear, and calibrated-loop methods. A total of 973 specimens were tested. Unlike previously described bioluminescence methods, this test measures total ATP in urine without pretreatment of samples to remove somatic ATP. The result was compared with an ATP standard (20 ng/ml). A low result (less than 3% of standard) was interpreted as negative and a high result (greater than 10% of standard) as positive. Samples with intermediate results (38% of total) were incubated at 35 degrees C in thioglycolate broth (1:10). A 2% increase in ATP concentration was interpreted as positive. The sensitivity of this method for detecting greater than 10(5) pathogens per ml was 92.3% and was comparable to those of the MS-2 system (92.7%) and the Gram smear method (90.5%). The chemical strip method was less sensitive (84.0%). The direct bioluminescence method was more sensitive than were the MS-2 system and the Gram smear method for detecting low-level bacteriuria (less than 10(3) to 10(5) organisms per ml), primarily because of associated pyuria. Thioglycolate broth provided a suitable medium for ATP production, and 5% CO2 decreased bacterial ATP synthesis during log-phase growth. The direct bioluminescence assay is rapid, simple, cost-effective, and reliable for bacteriuria screening.

Adenosine Triphosphate↗
PubMed1985

Bioluminescence screening for bacteriuria.

A rapid screening test (45 min) for bacteriuria was evaluated in 1,000 clinical urine specimens. The test procedure is based upon firefly luciferase analysis of bacterial ATP and uses the Lumac kit and Lumac M2010 Biocounter (3M Co., St. Paul, Minn.). The procedure allows for removal and destruction of nonbacterial ATP and subsequent analysis of bacterial ATP by firefly luciferase with a single photon counter. Results, expressed in relative light units, were compared with actual CFU by the calibrated loop technique. Sensitivities and specificities were calculated separately for clean-catch midstream specimens and for urines obtained by catheterization. The sensitivity for 719 clean-catch specimens with a Lumac cutoff of greater than or equal to 500 relative light units, representing greater than or equal to 10(5) CFU/ml, was 93%. The sensitivity for 281 catheterized specimens with a Lumac cutoff of greater than or equal to 200 relative light units, representing greater than or equal to 10(4) CFU/ml, was 95%. There were 19 false-negative results in the 1,000 specimens tested; more than 50% of these were contaminated cultures and were not considered significant in determining bacteriuria. In conclusion, the Lumac bioluminescence assay is a reliable, rapid bacteriuria screening technique with the potential of reducing the laboratory cost and for reducing the turnaround time in processing negative urine cultures.

Bacteriological Techniques↗
PubMed1985

Comparison of the automicrobic system, acridine orange-stained smears, and gram-stained smears in detecting bacteriuria.

We compared the accuracy of the Gram-stained smear, the acridine orange-stained smear, and the AutoMicrobic system (AMS; Vitek Systems, Inc., Hazelwood, Mo.) in screening for bacteriuria, as detected by conventional cultures. For 1,024 clinical specimens, results with the acridine orange-stained smear and the Gram-stained smear were very similar. When read for the presence of one or more microorganisms or leukocytes per 20 oil immersion fields, both smears were highly sensitive (92.1 and 93.3%, respectively) and moderately specific (70.0 and 61.7%, respectively). Sensitivity was greater for specimens yielding greater than or equal to 10(5) CFU/ml (96.1 and 98.9%, respectively) than for those with 10(3) to 10(4) CFU/ml (81.4 and 78.0%, respectively). Preliminary classification based upon the tinctorial and morphological characteristics of the Gram-stained smear was compatible with culture results in nearly all cases. The accuracy of the Gram-stained smears was not influenced by special cleaning of the microscopic slides, or the level of expertise of the microscopist. For 715 specimens, the sensitivity of the AMS in detecting bacteriuria (91.5%) was very similar to that of the stained smears (92.1 and 95.7%, respectively), but the specificity was significantly higher (83.2% versus 42.6 and 70.0%). Detection of microorganisms by the AMS took an average of 6.3 +/- 3.0 h. These data suggest that the Gram-stained smear is easily interpreted, very sensitive, acceptably specific, and still the optimal rapid method for screening for bacteriuria in most clinical microbiology laboratories.

Acridine Orange↗
PubMed2000

Detection of significant bacteriuria by automated urinalysis using flow cytometry.

A new flow cytometry-based automated urine analyzer, the UF-50, was evaluated for its ability to screen urine samples for significant bacteriuria. One hundred eighty-six urine specimens from patients attending an outpatient clinic of a university-based hospital were examined. The results obtained with the UF-50 were compared with those obtained by conventional quantitative urine culture. The UF-50 detected significant bacteriuria with a sensitivity of 83.1%, a specificity of 76.4%, a positive predictive value of 62.0%, a negative predictive value of 90.7%, and an accuracy of 78.5%. These results are comparable to those obtained by previously reported screening procedures. Besides detecting significant bacteriuria, the UF-50 can also perform routine urinalysis, including measurement of concentrations of red blood cells, white blood cells, epithelial cells, and casts, within 70 s. This capability renders this new flow cytometry-based urine analyzer superior to previously reported rapid screening methods.

Bacteria↗
PubMed1979

Reliability of a single urine culture in establishing diagnosis of asymptomatic bacteriuria in adult males.

Fifty-nine asymptomatic men without catheters of ileal-loop bladders, who were attending a urology clinic and were incidentally discovered to have 100,000 or more Enterobacteriaceae per ml ("significant bacteriuria") in a clean voided urine sample, were prospectively evaluated. To identify these 59 patients, 5,876 urine samples, collected exclusively from men, had been subjected to quantitation and identification. A repeat urine culture performed on these patients invariably confirmed the results of the initial culture. The reproducibility of a single urine culture containing significant bacteriuria occurred independently of the tissue source of infection, as determined by the antibody-coated-bacteria immunofluorescence test. We conclude that a single urine culture obtained from a cooperative man can establish the diagnosis of asymptomatic bacteriuria.

Adult↗
PubMed1991

Covert bacteriuria: long term follow up.

In a longitudinal prospective study 58 schoolgirls with covert bacteriuria were followed up for an average of 11.2 years (range 8.8 to 13.5 years). Intravenous urography was carried out at the start of the study (aged 4 to 11 years) and after completion of the follow up period (aged 14.8 to 22.3 years). After random allocation 27 of these girls received intermittent treatment for covert bacteriuria for the first four years and the control group received no treatment. The effect of covert bacteriuria, treatment, vesicoureteric reflux, and reflux nephropathy at presentation on the final renal length, progression of scarring, and development of new scars was analysed. No new scars were found in girls with bilaterally normal kidneys. In girls with reflux nephropathy, three kidneys showed progression of existing scars and two kidneys developed new scars. It was shown that final renal length was not influenced by vesicoureteric reflux or treatment, but reduced renal length at final assessment was associated with the presence of kidney scarring at initial assessment.

Bacteriuria↗
PubMed1975

Screening methods for covert bacteriuria in schoolgirls.

Screening tests for bacteriuria based on two different principles were evaluated in1582 schoolgirls aged 5-11 years, and in 26 girls aged 3-16 years attending hospitalwith symptomatic urinary tract infection. Tests for hypoglucosuria, performed by a semi-automated fluorometric method and with Uriglox strips on early-morning urine samples voided after overnight fasting, gave unacceptably high false-negative rates (16.7% and 20.8% respectively). Oxoid and Uricult dipslides were immersed in fresh midstreamspecimens of urine obtained at school and read overnight incubation at 37 degrees C. Both gave comparable results, with low false-positive rates and no false-negative responses. The higher cost of screening by dipslides was halved by using the "dipstream" technique, which also gave no false-negative results. Its false-positive rate of 13.5% could be reduced to 1.8% by disregarding colony counts of 10-8 non-faecal organisms and over per litre, which appear unimportant in schoolchildren. Bacteriuria was found in 2.3% of the schoolgirls; 39% of them had symptons, compared with 7.2% of the healthy girls, and 25% showed vesicoureteric reflux, which in 17% was associated with renalscarring. Since the natural history of covert bacteriuria and its relationship withreflux and scarring remain undetermined further research is required. The dipstreamtechnique offers a simple, reliable, and comparatively cheap screening method which could also be applied in general practice.

Adolescent↗
PubMed1982

Glomerular filtration rate in schoolgirls with covert bacteriuria.

Clearance of technetium-99m-labelled diethylenetriaminepenta-acetic acid was used to measure total and individual kidney glomerular filtration rates in 48 girls with covert bacteriuria. The mean (+/- SD) of the total rates of 18 girls with scarred kidneys (99 +/- 24 ml/min/1.73 m2) was significantly (0.005 greater than p greater than 0.002) lower than that in 30 girls with unscarred kidneys (119 +/- 18 ml/min/1.73 m2). This reduction in glomerular filtration was related to the loss of kidney substance associated with scarring rather than to vesicoureteric reflux. The glomerular filtration rate was unrelated to the duration of bacteriuria. These findings suggest that in girls aged 4 and over neither vesicoureteric reflux nor covert bacteriuria contributes to the progression of kidney damage.

Adolescent↗
PubMed1998

Evaluation of reagent strips in detecting asymptomatic bacteriuria in early pregnancy: prospective case series.

OBJECTIVE: To evaluate the performance of reagent test strips in screening pregnant women for asymptomatic bacteriuria at their first visit to an antenatal clinic. DESIGN: Prospective case series. SETTING: Antenatal clinic of a large inner city maternity hospital. SUBJECTS: All women attending for their first antenatal clinic. Patients taking antibiotics for any reason and those with urinary tract symptoms were excluded. INTERVENTION: A midstream urine specimen was divided; half was sent for microscopy and formal bacteriological culture and the other half was tested with a commercial reagent strip test for the presence of blood, protein, nitrite, and leucocyte esterase. MAIN OUTCOME MEASURES: Sensitivity, specificity, and positive and negative predictive values of the reagent strips in diagnosing asymptomatic bacteriuria (defined as 10(5) colony forming units/ml urine). RESULTS: Sensitivity was low, with a maximum of 33% when all four tests were used in combination. Specificity was high, with typical values of 99% or more. Positive predictive value reached a maximum of 69% and negative predictive value was typically 95% or more. CONCLUSION: Urine reagent strips are not sufficiently sensitive to be of use in the screening for asymptomatic bacteriuria and therefore many patients would be missed. In view of the potentially serious sequelae of this condition in pregnant women we recommend that formal bacteriological investigation remain the investigation of choice in this group of patients.

Bacteriuria↗
PubMed1995

Natural history of bacteriuria in women with primary biliary cirrhosis and the effect of antimicrobial therapy in symptomatic and asymptomatic groups.

Primary biliary cirrhosis (PBC) patients have an increased incidence of recurrent urinary tract infection compared with patients with other chronic liver diseases. The course of significant asymptomatic and symptomatic bacteriuria in women with PBC was evaluated: consecutive patients were screened for bacteriuria at their outpatient appointments. Bacteriuric patients who were asymptomatic (n = 21) were randomised to receive antimicrobial therapy (n = 11), or no therapy (n = 10). Bacteriuric patients who were symptomatic (n = 13) were treated. All were followed up by weekly dipslide examination of urine. The course of bacteriuria in the 13 symptomatic and 11 asymptomatic treated patients was similar in terms of the medium interval between successive infective episodes (three and four weeks respectively), the number of relapses (six and seven) and reinfections (14 and 18). Most untreated asymptomatic patients became abacteriuric spontaneously but became reinfected with a different organism during the study period. A separate group of 24 PBC patients with no previous bacteriologically proved urinary tract infection was followed weekly in a similar fashion: seven (29%) became bacteriuric for two to four weeks during a three month period. This study suggests that treatment of recurrent bacteriuric episodes in PBC patients does not alter the natural history of their infection. The long term implication of periodically infected urine in these patients is currently unknown.

Adult↗
PubMed1968

Detection of bacteriuria in women attending local authority antenatal clinics using the dip-inoculum transport medium spoon method.

Four hundred and seventy-eight pregnant women attending local authority clinics in Portsmouth were screened for bacteriuria using the dip-inoculum transport medium (DITM) spoon method. The detection of asymptomatic bacteriuria in 5% of the patients with a very low proportion of equivocal results (0.83%) suggests that this is an efficient method; and large numbers of urine specimens could be sampled with relatively little work for the laboratory. A cystine-MacConkey medium was devised for incorporation in the spoons. General practitioners treated the women with bacteriuria, and remained responsible for home delivery and postpartum examinations. The possibility of successful cooperation between non-hospital clinics, a bacteriological laboratory, and general practitioners is demonstrated.

Bacteriological Techniques↗