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PubMed1987

An evaluation of two rapid bacteriuria screening procedures.

Two commercially available rapid bacteriuria screening procedures were evaluated for routine screening for 10(4) or more colony forming units per milliliter of pathogenic bacteria in two female patient populations. In 694 obstetric patients with 56 cases of significant bacteriuria, the sensitivity, specificity, positive predictive, and negative predictive values, respectively, were as follows: for Chemstrip LN, 69.6, 83.4, 26.9, and 96.9%; and for Bac-T-Screen, 96.4, 56.0, 16.1, and 99.4%. In 143 nonpregnant females with 32 cases of significant bacteriuria, these values were: for Chemstrip LN, 71.9, 75.7, 46.0, and 90.3%; and for Bac-T-Screen, 84.4, 65.8, 41.5, and 93.6%. These results indicate that the LN strip did not have acceptable sensitivity in either patient group. The Bac-T-Screen had better sensitivity, particularly for obstetric patients; however, a high false-positive rate and high cost per test may restrict its use in those clinical settings where culture is available and cost-effective.

Bacteria↗

PubMed1984

Hydrogen peroxide: potential for prophylaxis against bacteriuria.

The effect of dilute solutions of hydrogen peroxide, povidone-iodine, and acetic acid on a chronic Staphylococcus epidermidis bacteriuria was studied to determine whether direct bladder instillation of the antimicrobial solutions would reduce or eliminate the bacterial count. In vivo instillation of volumes ranging from 50 to 400ml and retained for 30 seconds to 48 hours was evaluated. The effect of the antimicrobial solution on bacterial survival in urine was also measured in vitro through quantitative analysis of the mixture at various times over 24 hours. Instillation of the antimicrobial solutions into the bladder had no measurable effect on the established bacteriuria. Symptoms of discomfort related to such a manipulation were least evident with hydrogen peroxide. In vitro, hydrogen peroxide had an antimicrobial effect as reflected by the reduction of the number of surviving organisms. Despite inefficacy in a case of already established bacteriuria, hydrogen peroxide appears worthy of study as a prophylactic agent against a variety of organisms because it exhibits in vitro efficacy and minimal in vivo symptoms.

Acetates↗

PubMed1982

Cephalexin for susceptible bacteriuria in afebrile, long-term catheterized patients.

Patients with long-term indwelling urethral catheters are subject to acute and long-term complications of bacteriuria. To evaluate the common practice of short-course antibiotic therapy in such patients, we performed a randomized controlled trial of ten-day courses of cephalexin monohydrate repeated whenever a susceptible bacteriuria was present. We observed 17 cephalexin group patients for 545 patient-weeks (160 cephalexin courses) and 18 control group patients for 477 patient-weeks. Throughout the study, the groups were comparable in regard to incidence and prevalence of bacteriuria, number of bacterial strains per weekly urine specimen, incidence of febrile days, and incidence of obstructed catheters. In the cephalexin group, the frequency of fever during periods when antibiotics were being used was similar to that during periods when antibiotics were not being used. More cephalexin-resistant bacteria were isolated from cephalexin group patients. Routine treatment with cephalexin of asymptomatic long-term catheterized patients, even for susceptible organisms, does not seem to be warranted.

Adult↗

PubMedDate not supplied

[The frequency of bacteriuria in pregnancy].

The authors present the results of a bacteriological urine analysis of 1774 pregnant women controlled in the Gynecological Dispensary Pesćenica in Zagreb. In 2824 examined urine specimens sterile urinocultures were found in 67.6% and bacteriuria in 32.4%. Significant findings of bacteriuria were recorded in 10.5% and insignificant ones in 21.9% of the specimens. The most common bacteria were E. coli (45.24%), then Staphylococcus albus epidermidis (17.4%), Staphylococcus pyogenes aureus (14.64%), Proteus mirabilis (9.39%), and Enterococcus (5.24%). Urine specimens were taken by the dip slide method. A rather high percentage of significant asymptomatic bacteriurias (10.5%) suggests the early detection and therapy in urinary infections as the best prevention of pyelonephritis gravidarum and gestosis. A routine bacteriological urine analysis in pregnant women should be one of the factors included in prenatal care.

Bacteria↗

PubMed1980

[Frequency of asymptomatic significant bacteriuria in bile duct and colon inflammations].

When investigating the asymptomatic significant bacteriuria in cholepathias and disease of the colon was stated that the asymptomatic significant bacteriuria is a frequent concomitant appearance of acute cholecystitis, of chronic cholangitis and ulcerous colitis. The asymptomatic significant bacteriuria does not mean pyelonephritis; but is a sign for the fact that the kidneys are in a condition endangered by pyelonephritis (potential pyelonephritis), that's why an aimed antibacterial treatment and subsequently bacteriological controls of the urine prove necessary.

Acute Disease↗

PubMed1994

Asymptomatic bacteriuria in pregnancy: a diagnostic and therapeutic approach.

Pregnancy is a predisposing factor for urinary tract infection and pregnant women suffering from this pathology are exposed to dangerous risks which may condition maternal wellbeing and fetal prognosis. The apparently paradoxal finding of a higher incidence of perinatal problems in pregnant women with asymptomatic bacteriuria compared to those with manifest infections may be explained by the fact that the latter are adequately treated, whereas asymptomatic bacteriuria, which is difficult to diagnose, may continue in a subtle form for the entire duration of pregnancy. This emphasises the importance of the early diagnosis of infection using a protocol based on urine tests and urine culture and the adequate treatment of all cases of asymptomatic bacteriuria in order to reduce the incidence of maternal and fetal complications (acute pyelonephritis, increased fetal morbidity and mortality). The choice of the antibiotic to be used must be made on the basis of the urine culture test, the stage of gestation, maternal clinical data and the characteristics of the antibiotic itself (pharmacokinetics, maternal and fetal toxicity). With regard to the treatment protocol, the "single-dose" protocol is currently preferred. After negative urine culture tests, all patients must carry out a complete urine test each month with hormonal and echographic monitoring of the fetoplacental unit.

Bacteriuria↗

PubMed1994

[The peripartum disease complex of the sow in industrial swine breeds. 1. Peripartum course of bacteriuria of sows with vaginal-vulvar discharge in a modern swine breeding facility].

In an industrial pig production unit ten sows were selected at random. All the sows had puerperal disease in their anamnesis and all of them revealed at the time of selection--during their late pregnancy--Urinary Tract Infection (UT)I and vaginal-vulvar discharge (VD). Mid-stream early morning urine samples were collected during four days ante partum and during four days post partum. The samples were semiquantitatively examined for E. coli and gram positive cocci. Three sows showed ante partum non significant bacteriuria which turned into significant bacteriuria post partum. The majority of the reminding sows revealed a significant bacteriuria during the whole period of examination.

Animals↗

PubMed1993

Asymptomatic bacteriuria in a multiracial workforce.

Prevalence of asymptomatic bacteriuria was determined in the first morning urine specimens from 5669 people who participated in a health screening survey of a local workforce. Higher age-standardized prevalences were observed in Maori women (18.0%), compared with Pacific Island women (9.8%) and European women (8.7%). Similarly, higher prevalences were observed in Maori men (3.2%), compared with Pacific Island men (0.7%) and European men (1.3%). After controlling for age and gender, the relative risk for asymptomatic bacteriuria in Maori people was estimated to be 2.22 times that for non-Maori people (associated 95% CI: 1.54-3.18). Significant associations of bacteriuria included a past history of myocardial infarction, a past history of kidney disease, absence of tertiary education, and impaired glucose tolerance. The most common pathogens, isolated from a subsample of 1660 participants, were Escherichia coli, 27 cases (50.9%), and Streptococcal sp, 14 cases (26.4%).

Adult↗

PubMed1976

Bacteriuria and kidney damage.

Chronic pyelonephritis is a disease of childhood that is carried on into adult life. Children under the age of 4 in whom UTI, vesicoureteric reflux and pyelotubular backflow coexist appear to be particularly at risk of developing kidney damage. Attempts to prevent kidney damage in adults by detection and treatment of covert UTI are doomed to failure because persistent bacteriuria in the adult is a consequence of underlying abnormality of the urinary tract rather than its cause. Our main hope for the prevention of kidney damage associated with bacteriuria and reflux is to detect and treat these conditions at the earliest possible age. The controlled trials of the value of treatment of bacteriuria and vesicoureteric reflux in childhood that are in progress in various centers in the United Kingdom should be allowed to continue and medical opinion as to the value of such treatments should not be allowed to crystallize before the results of these trials are known.

Adult↗

PubMed1977

Bacteriuria in Black diabetics.

Urine of 198 diabetics and 147 non-diabetics was examined for bacteriuria by means of the Uricult dip slide method. Prevalence of bacteriuria in diabetics (18,7%) was significantly higher than in the control group (7,6%). This increased prevalence in diabetics was due primarily to an exceedingly high prevalence in diabetic women (27%). There was no relation between bacteriuria and age, duration of diabetes, treatment for diabetes, quality of control of diabetes, symptoms of urinary tract infection or hypertension.

Adult↗

PubMed1977

Association of bacteriuria and rheumatoid factors in a population sample.

To obtain further information on the possible association of bacteriuria and RFs on the population level, an epidemiological study was carried out among middle-aged women in a rural area. Fifty-five of ther 1223 women aged 40-64 years had bacteriuria and 31 were under treatment for urinary tract infection. The latex test was twice as often positive among the bacteriuria women as among the persons under treatment and the age-matched controls. The association was noted in the same way in persons with symptoms and signs suggestive of RA and in those with no evidence of this disease.

Adult↗

PubMed1996

Evaluation of dipstrips, direct gram stain and pyuria as screening tests for the detection of bacteriuria.

Two hundred and fifty cases of clinically suspected urinary tract infection were analysed for the detection of bacteriuria. Parameters studied included direct Gram staining, pyuria on microscopic examination of uncentrifuged urine and dip strip method for the detection of blood, protein, nitrite and leucocyte esterase. Significant bacteriuria (colony count 10(5) per ml) was found in 112 cases with a positivity ranging from 65 to 83% for the presence of blood, protein, nitrite and leucocyte esterase. Highest positive predictive values were obtained with the presence of nitrite and leucocyte esterase (98%), blood, protein and nitrite (94%) as well as with blood, protein, nitrite and leucocyte esterase (98%). Both pyuria and direct Gram staining were positive in 85% cases. The combined presence of both these parameters gave 100% positive predictive value. Gram staining combined with pyuria was more effective and economical as compared to the dipstrips for the detection of bacteriuria.

Bacteriological Techniques↗

PubMedDate not supplied

The clinical course of untreated asymptomatic bacteriuria in diabetic patients--14-year follow-up.

The present study aimed at accessing the natural history of untreated asymptomatic bacteriuria in diabetic patients observed for 14 years. Two groups of diabetic patients were examined. Group I comprised 53 patients with significant bacteriuria, without clinical symptoms of urinary tract infection. Group II consisted of 54 patients with sterile urine. All patients were clinically and bacteriologically examined every 3-6 months for 14 years. The results obtained in this study have proved that clinical symptoms of acute pyelonephritis occur with similar frequency in both groups (group I-6, group II-5 cases). No deterioration of kidney function was found. Arterial hypertension did not differ significantly in both groups at the beginning and end of the follow-up. The usefulness of antibacterial treatment of asymptomatic bacteriuria in diabetic patients is not adequately documented.

Adult↗

PubMed1995

Asymptomatic bacteriuria in older adults: when is it necessary to screen and treat?

The incidence of asymptomatic bacteriuria increases with age, and thus it is a common finding in older adults, especially the very old and the institutionalized. Bacteriuria in most older adults, while common, is often transient. The clinical significance is generally minor and the treatment yields very little benefit, is expensive, and may cause substantial drug toxicity. Guidelines to help determine which patients may benefit from treatment are included. Primary care providers for older adults in ambulatory, home, hospital, or institutional settings, should recognize asymptomatic bacteriuria and know when and when not to treat. This management decision will become an increasingly important aspect of gerontological health care.

Aged↗

PubMed1977

Bacteriuria in patients with spinal cord lesions: its relationship to urinary drainage appliances.

Urine cultures from spinal cord injuried patients demonstrate a high incidence of bacteriuria, with patterns of bacteriuria varying with the mode of drainage. The highest incidence of positive cultures occurs in patients with indwelling or suprapubic catheters, and the lowest in patients who are appliance-free. The organisms occurring most frequently differ from those of the general hospital population as reported by Needham, Smith and Matsen. There is an increase in the incidence of Pseudomonas, Proteus and Serratia and a decrease in the occurrence of E coli and Klebsiella. Sixty-four percent of the organisms occurred in concentrations of 100,000 col/ml or greater, and 65% of all positive cultures contained multiple species of organisms. Cultures taken from urinary collecting appliances and hands demonstrate possible sources of bacteriuria and the need for careful training and education of patients and their attendants and constant monitoring of urinary tract appliance care.

Bacteriuria↗

PubMed1998

[Recurrent significant bacteriuria and progression of IgA nephropathy].

Tubulointerstitial changes seems to be of decisive importance among factors influencing the prognosis of IgA nephropathy. In consequence of decreased protection ability of mucous membranes, in some cases masked urinary tract infections may stand in the background of the tubulointerstitial changes. In this study the connection between urinary tract infections, significant bacteriurias and the progression of IgA nephropathy was retrospectively investigated. The data and the progress of the disease of 19 IgA nephropathy patients with significant bacteriuria (microbiologically identified) were compared to 19 IgA nephropathy patients of similar age, sex and the time of follow-up without bacteriuria. During the follow-up (on the average 8.5 years), the renal function (values of serum creatinine) decreased significantly (p < 0.05) in both groups, but there was no significant difference between the two groups. Neither at start, nor at the end of the follow-up no significant difference was found in the two groups in the prevalence of proteinuria, haematuria, hypertension and between the values of serum parameters. On the basis of these data we assume, that with the help of frequent medical check up and adequate antibiotic treatment the unfavourable effects of urinary tract infections (chronic tubulointerstitial changes) can probably be fended off.

Adult↗

PubMed1999

The value of leucocyte stix results in predicting bacteriuria and urinary tract infection after gynaecological surgery.

This prospective study was carried out on 454 women to determine the value of a leucocyte dipstick test in predicting significant bacteriuria and symptomatic postoperative urinary tract infection after routine gynaecological surgery. Urine was cultured and tested for leucocytes with a dipstick test (Nephur test, Boehringer) at catheter removal and 2 days later. Among the 454 patients, 16.3% developed urinary tract infection and 53.3% had significant bacteriuria at least once. Among 898 urine specimens, taken from asymptomatic patients, 41.6% were stix-positive and 58.4% stix-negative. The predictive value of a positive stix result was 59.6% for a positive culture and 27.5% for urinary tract infection. It is concluded that, the predictive value of a positive stix for postoperative significant bacteriuria or urinary tract infection is too low to be of practical use. However, the predictive value of a negative test was high, and few patients developed symptomatic urinary tract infection when the leucostix was negative.

Journal Article↗

PubMed2006

Enumeration of bacterial cell numbers and detection of significant bacteriuria by use of a new flow cytometry-based device.

A new, automated flow cytometry-based urine bacterium analyzer (UBA) was developed. We assessed the UBA for linearity of measurement, reproducibility of results, carryover rate, and correlation of measured results with those determined by urine culture. We also evaluated its ability to screen urine samples for significant bacteriuria. The UBA showed excellent linearity and a minor carryover rate. Results from the UBA were highly reproducible, and in between-run precision assays, the coefficients of variation for the UBA results were smaller than those for the urine culture results. Two hundred seventy-three urine specimens from patients attending the outpatient clinics of two university-based hospitals were examined. The results for the UBA were compared with those for urine culture. The UBA detected significant bacteriuria with a sensitivity of 96.6%, a specificity of 79.9%, a positive predictive value of 57.0%, a negative predictive value of 98.8%, a false-positive rate of 15.8%, a false-negative rate of 0.7%, and an accuracy of 83.5%. These results were comparable to or better than those obtained with previously reported screening procedures. The UBA can perform accurate enumeration of bacterial cells automatically in 90 seconds and can be used for the screening of significant bacteriuria.

Bacteria↗