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PubMed1992

Bacteriuria in patients with glomerular diseases.

In a comparative study of significant bacteriuria in an African population, 1.7% of 697 healthy subjects (10 females and 2 males) were found to have positive urine cultures. Of these, 5 subjects grew E. coli, 4 Klebsiella strains, 2 Staphylococcus aureus and 1 Serratia marcescens. Among 116 patients with glomerular disease, 15.5% (7 males and 11 females) yielded positive cultures. E. coli, Staph. aureus and Proteus species were commonly isolated organisms. There was a nine fold increase in prevalence of bacteriuria in patients with glomerular disease and in females, this correlated with the amount of protein lost per 24 hours. It is postulated that the presence of protein in urine per se favours bacterial growth and because of the high prevalence of bacteriuria in patients with glomerular disease, it is recommended that all such patients should be screened and treated appropriately.

Adult↗
PubMed1992

Catheter-associated bacteriuria.

Catheter-associated bacteriuria is the most common nosocomial infection in both acute and long-term care facilities. Complications include fever, bacteremia, acute pyelonephritis, urinary stones, chronic renal inflammation, and death. Catheter-associated bacteriuria can be postponed by maintaining the closed nature of the catheter system. Postponement may become prevention of bacteriuria if the catheter is removed as soon as possible.

Aged↗
PubMed1992

[Demonstration of bacteriuria in elderly hospitalized patients. Comparison between leukocyte and nitrite strips and culture].

The purpose of this study was to assess the accuracy of test strips for urinary nitrite and leucocytes for detection of bacteriuria in elderly patients. The material consisted of 213 urine samples from 85 women and 26 men (median age 79 years, range 60-93 years) within the first two days in hospital. The results of the test strip reactions were read in the department and in the laboratory. The strip test results and symptoms of UTI were compared with culture results. 27% of the samples showed significant bacteriuria on culture (> or = 10(5) colonies/ml urine). 21% of the 102 patients who had submitted two urine samples within the first two days had significant bacteriuria in both samples. Less than half of these patients had symptoms of UTI. The false negative rate of test strips (defined as the number of proven laboratory UTIs not demonstrated by the test strips, expressed as a percentage of the total number of proven UTIs) was 29% in the department and in the laboratory it was 13%. 15% of the test strips at the laboratory failed to detect significant E. coli infections which were predominant. In conclusion, we found that it is advisable to perform urine culture if symptoms of urinary tract infections are present.

Aged↗
PubMed1992

Outcome of pregnancy in an Oxford-Cardiff cohort of women with previous bacteriuria.

To investigate the influence of asymptomatic bacteriuria in childhood on subsequent pregnancy, we reviewed the outcome of 139 pregnancies in 88 women who were first identified during a programme of screening schoolgirls for asymptomatic bacteriuria carried out between 1970-1972. Data were analysed for the following groups: 50 pregnancies in 28 women with known renal scars (group 1); 16 pregnancies in 14 women with normal kidneys and reflux (group 2); 73 pregnancies in 46 women with normal urinary tracts (group 3); 139 healthy controls. Women in group 1 had a 3.3-fold increased relative risk of hypertension (p < 0.01) and a 7.6-fold increased risk of pre-eclampsia (p < 0.05) compared to controls, and a higher rate of obstetric interventions, including emergency caesarean section. Women in groups 2 and 3 appeared to carry a slightly increased risk of hypertension during the last trimester (RR = 1.8) but there were no significant differences in this or the incidence of pre-eclampsia or mode of delivery. Bacteriuria was more prevalent in all index groups compared to controls (37 per cent vs. 8 per cent, p < 0.01) and included four cases of acute pyelonephritis in in the study group. Fetal outcome was satisfactory in all cases. These results suggest that women with renal scars are at risk of hypertension and pre-eclampsia during pregnancy but that modern obstetric care minimizes these risks.

Adult↗
PubMedDate not supplied

[The role of asymptomatic bacteriuria in epidemiologic study of the urinary tract infection].

Asymptomatic bacteriuria as a major criterion of urinary tract infection (UTI) was revealed in 597 (25.6%) of 2.330 rural inhabitants under study. In adults that value (25.3%) appeared to be lower to some extent as compared with children (at age 1 to 14)--27.2% (P>0.5). At the same time asymptomatic bacteriuria occurred reliably more frequent in females as compared with males, 50.3% and 14.7% correspondingly (P<0.001). Use of the asymtomatic bacteriuria sign in epidemiological studies allows to reveal early stages of UTI and carry out prophylactics of the disease timely.

Adult↗
PubMed2006

Asymptomatic bacteriuria in adults.

A common dilemma in clinical medicine is whether to treat asymptomatic patients who present with bacteria in their urine. There are few scenarios in which antibiotic treatment of asymptomatic bacteruria has been shown to improve patient outcomes. Because of increasing antimicrobial resistance, it is important not to treat patients with asymptomatic bacteriuria unless there is evidence of potential benefit. Women who are pregnant should be screened for asymptomatic bacteriuria in the first trimester and treated, if positive. Treating asymptomatic bacteriuria in patients with diabetes, older persons, patients with or without indwelling catheters, or patients with spinal cord injuries has not been found to improve outcomes.

Adult↗
PubMed1991

Asymptomatic bacteriuria in school children in a rural area, Egypt.

Forty hundred and fifty urine samples collected from school children in a rural area were screened for the presence of significant bacteriuria. The incidence of asymptomatic bacteriuria was found to be 7% with Predominance in females (11%) than in males (3.6%). From the total bacterial isolates E. coli were isolated in 18% of cases, Co-agulase positive staphylococci in 30%, co-agulase negative staphylococci in 15%, streptococcus pyogenes in 6%, Klebsiella species in 9% and enterococci in 21% of cases. There was no difference between the incidence of asymptomatic bacteriuria (ABU) in younger children than in older ones. We recommended a routine screening for ABU among school children for the early diagnosis and management of such cases.

Bacteriuria↗
PubMed1991

Intrapartum bacteriuria and postpartum endometritis.

Ten gravidas with bacteriuria in the immediate antepartum period subsequently delivered vaginally and did not receive antibiotic therapy. Four of these women developed postpartum endometritis and in three of them, the same Enterobacteriaceae recovered from the urine was present in the endometrial cultures. Of the 1233 study subjects whose screening urine cultures were negative and who delivered vaginally, 27 (2.2%) developed endometritis. Intrapartum bacteriuria was significantly associated with postpartum endometritis in women delivering vaginally (P less than .001). Monitoring for asymptomatic bacteriuria and eradicating it in pregnancy should diminish the occurrence of endometritis and possible endomyometritis in the postpartum period.

Bacteriuria↗
PubMed1990

The evaluation of urine pH in screening for asymptomatic bacteriuria in pregnancy.

The purpose of this prospective investigation was to determine whether an alteration in urine pH, either by itself or in combination with other rapid screening tests, could be used to identify asymptomatic bacteriuria in pregnant women. Clean catch urine specimen was used to evaluate 510 asymptomatic obstetric patients. Urine specimens were tested for pH, leukocyte esterase activity, and the presence of nitrites. The pH, leukocyte esterase activity, and nitrite reaction were evaluated singly and in combination to determine if these variables could be used to predict significant bacteriuria. Twenty-four (4.8%) patients had positive cultures for E. coli. The mean pH of the infected population was not significantly different from that of the uninfected population. The performance parameters of pH, singly and in combination with the leukocyte esteras and nitrite status, were poor. We concluded that the identification of urine pH is not of value in detecting asymptomatic bacteriuria.

Bacteriuria↗
PubMed1990

[Bacteriuria screening in gynecologic practice: what is the value of mid-stream urine?].

In 55 healthy women corresponding urine proofs were taken by suprapubic punction and by mid stream technique from the same content of the urinary bladder. For detection or exclusion of bacteriuria both collection-methods are of equal value. In 96% of the cases the microbiological results were corresponding. The leucocyte-count is of no value to detect indirectly a bacteriuria as well in punction- and in mid stream urine. A pathologic count is just as little pathognomonic for infection as a normal count excludes a bacteriuria. Therefore the counting of leucocytes should be given up to the favour of a better microbiological observation in gynecological outpatient departments.

Adult↗
PubMed1989

[The prevention of urinary infection during pregnancy in patients with asymptomatic bacteriuria].

A prospective study was carried out in which quantitative clean-voided urine cultures, were obtained at the first clinic visit from 986 consecutive pregnant women, followed to delivery to assess the maternal and pediatric finding associated with maternal asymptomatic bacteriuria. Patients to be evaluated were divided in two groups: Treatment group (TG) with 42/46 patients that were treated with nitrofurantoin 100 mg a day during 10 days, and control group (CG) with 45/46 patients that were not treated. Patients who failed were given a second course of nitrofurantoin. The patients who remained infected were given further treatment (cephalexin). Primary treatment was successful in 85%, 10% more with the second course and 5% were failure treatment. There was a highly significant difference in the incidence of symptomatic bacteriuria (pyelonephritis), premature deliver, prematurity and other perinatal events in patients with persistent infection. Eradication of asymptomatic bacteriuria reduced the risk of pre-term deliveries and lower infant birth weights for gestational age.

Acute Disease↗
PubMed1989

[Bacteriuria in primary biliary cirrhosis].

The high incidence of significant bacteriuria observed in 30 patients diagnosed of primary biliary cirrhosis in our department is studied. Although a significant increase in general infections has not been described in this type of liver disease, of probable autoimmune nature, the high incidence of bacteriuria in these patients has been previously reported. Possible predisposing factors are evaluated; we observed that there was a significant increase in the frequency of bacteriuria with age, but there was no relationship between the incidence of infection and the histologic stage of the disease.

Adult↗
PubMed1989

Incidence and importance of bacteriuria in postoperative, short-term urinary catheterization.

The frequency and importance of bacteriuria in patients requiring short-term postoperative catheterization (24 to 48 hours) is unknown. From a prospective, controlled study of 100 patients requiring catheterization postoperatively, the authors determined that there was a definite risk (6%) of bacteriuria; however, a symptomatic urinary tract infection developed in only 1% of the patients. There was no advantage to using either a latex or silicone catheter. It appears that the risk of symptomatic bacteriuria in this group of patients is very low when a closed urinary drainage system is used under strict, sterile conditions of catheter insertion and with meticulous ongoing catheter care.

Bacteriuria↗
PubMed1977

Short-term versus continuous antimicrobial therapy for asymptomatic bacteriuria in pregnancy.

Asymptomatic bacteriuria was identified in 300 pregnant women prior to the 28th week of gestation. In one group of 200 women short-term treatment with either nitrofurantoin or sulfamethizole was given for 14 days, and in another group of 100 women continuous therapy with one of these drugs was given for the remainder of gestation. Weekly urine cultures were obtained from all the women. Of the women treated with short-term therapy, 65% were abacteriuric for the remainder of pregnancy following one course of therapy, 24% became abacteriuric but subsequently relapsed, 2% had reinfection after becoming abacteriuric, and 9% demonstrated no response. Following treatment with a second course of short-term therapy, another 19% of these women were cured for the remainder of their pregnancy, and 3.5% responded to a third course. In the continuous therapy group, 88% of the women became abacteriuric for the remainder of the gestation, 3% demonstrated relapse, 2% developed reinfection, and 7% had no response to the first drug given. These data demonstrate that short-term administration of antimicrobials, when combined with surveillance for recurrent bacteriuria, is effective for the management of the pregnant woman with asymptomatic bacteriuria.

Bacteriuria↗
PubMed1987

The natural history of bacteriuria in childhood.

The highest figure for first-time UTI is found in infants below one year of age. These early infections are often pyelonephritic in character, but they are easily overlooked because symptoms are unspecific, high fever and failure to thrive being the most important. It has been shown that delay in start of treatment increases the risk of the child developing pyelonephritic scarring. There is reason to believe that undetected and therefore untreated attacks of pyelonephritis may be associated with renal scarring revealed later in life. This type of renal damage is associated with development of hypertension in about 10 per cent of children and it accounts for around 20 per cent of the children entered into dialysis and transplant programs. Prevention of such long-term problems would be of great value and pyelonephritic scarring is a potentially preventable disease. The majority of infants and young children with UTI are probably managed at the primary care level. It is therefore essential that general practitioners are well informed about the epidemiology of UTI in infancy and childhood and that adequate diagnostic facilities are provided. For example, suprapubic aspiration to obtain uncontaminated urine is a technique that may well be used in an outpatient setting, and dipslide cultures are accurate and inexpensive. In addition to young age, vesicoureteric reflux and repeated attacks of pyelonephritis are risk factors associated with development of renal scarring. Therefore, diagnostic imaging to detect children with anomalies within the urinary tract are especially important in the very young. Furthermore, long-term supervision should be provided and the parents advised to consult the doctor when there is suspicion of a new infection to avoid delay in treatment. There is no reason to perform general screening for bacteriuria in healthy infants. Although bacteriuria may be found in 1 to 2 per cent, asymptomatic children have a very high rate of spontaneous clearing of the bacteriuria and they seem to constitute a low-risk group. Instead, frequent culturing of urine from febrile infants would be much more important.

Anti-Bacterial Agents↗
PubMed1979

[Frequency of bacteriuria in the aged (author's transl)].

1125 inhabitants of 2 homes for aged people were tested for bacteriuria by dip slides. Increasing of age did not lead to higher frequency of bacteriuria, neither in women (n = 869), nor in men (n = 256). The persons were divided in the 4 decades of being 61--70, 71--80, 81--90, and 91--99 years old. The corresponding rates of bacteriuria (greater than or equal to 10(5) germs/ml) were 14.0, 15.0, 12.4, and 9.1%, respectively. The rate of reproducibility was 75.4%, indicating still smaller values in reality. The discrepancies to the much higher values reported in the literature may depend on the people tested: "normal persons" instead of hospital patients or patients' specimens having been sent to a microbiological laboratory.

Age Factors↗
PubMed1978

The incidence of significant bacteriuria in the dog.

Counts of the number of bacteria in canine urine samples have a bimodal distribution similar to that found in man. Therefore it is reasonable to accept the same criterion of significant bacteriuria in the dog as in man, namely a count of 10(5) or more organisms/ml. of urine. The incidence of significant bacteriuria in the total canine population was 1.4%. It was higher in bitches compared with male dogs, and higher in older animals. The larger proportion of Boxers affected was attributed to their greater age compared with the mean of the sample population. The most frequently observed clinical signs in case of significant bacteriuria were haematuria, incontinence and frequent urination, and only 4.1% of such cases were asymptomatic.

Age Factors↗
PubMed1978

Evaluation of an office method of detecting bacteriuria.

Although catheter-associated UTI continues to be the leading cause of nosocomial infection, epidemiological investigation of catheter use in many hospitals may be precluded by the reluctance of the laboratory to process the large number of urine cultures. We have evaluated the use by Nurse Epidemiologists of Bacturcult tubes for such purposes. The urine of 111 catheterized patients was cultured daily using both the Bacturcult and streak plate method until significant bacteriuria developed (greater than 10(5) colonies/ml). Bacturcult proved as accurate as the conventional technique in detecting bacteriuria. In contrast to previous studies, the daily incidence of infection rose with increasing duration of catheterization. Concomitant antibiotic usage reduced the risk of infection but selected out multi-drug resistant organisms. Older age and procedural errors also increased the risk of infection. The study took 150 hours to complete and cost about $250. It is concluded that Bacturcult is an accurate, simple and relatively inexpensive method of detecting bacteriuria and could be useful for investigating the epidemiology of catheter-associated infections in community hospitals.

Adult↗