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PubMed1999

Evaluation of the leukocyte esterase and nitrite urine dipstick screening tests for detection of bacteriuria in women with suspected uncomplicated urinary tract infections.

A positive dipstick urinalysis (i.e., leukocyte esterase test and/or nitrite test) did not reliably detect significant bacteriuria in 479 ambulatory women with suspected uncomplicated urinary tract infection; 18.9% of the urine samples that demonstrated significant bacteriuria would have been rejected by the laboratory based on a negative urinalysis screen.

Adolescent↗
PubMed2001

Diagnosis of bacteriuria by detection of volatile organic compounds in urine using an automated headspace analyzer with multiple conducting polymer sensors.

The Osmetech Microbial Analyzer (OMA) is an automated headspace analyzer fitted with a novel detector system consisting of an array of polymer sensors, each of which responds to different volatile organic compounds. The system can be used for screening clinical urine specimens for significant bacteriuria by sampling urine headspace and subjecting the output of the multiple-detector response to principal component analysis. The OMA readily distinguished artificially infected urine samples from sterile controls. The OMA was then used to analyze 534 unselected clinical urine specimens, of which 21.5% had significant bacteriuria (containing >10(5) CFU of bacteria/ml). The sensitivity and specificity of the OMA compared with conventional culture were 83.5 and 87.6%, respectively. The OMA is a promising automated system for the rapid routine screening of urine specimens, and further clinical trials are in progress.

Bacteria↗
PubMed1975

Asymptomatic bacteriuria in schoolchildren in Newcastle upon Tyne.

A screening survey for asymptomatic bacteriuria (ASB) in 13464 schoolgirls aged 4 to 18 years in Newcastle upon Tyne showed an overall prevalence of 1.9%. In girls 4 to 6 years it was 1.4%, in girls aged 7 to 11 years it was 2.5%, in girls aged 12 to 18 years it was 1.6%, a statistically significant rise and fall. Renal scarring was found in 39 (15%) of 254 girls with ASB. Neither the prevalence nor the severity of renal scarring increased with age. There was no association between ASB and social class. Of the 254 girls with ASB, 24% had no symptoms. Infections with klebsiella were more frequently associated with renal scarring than infections with Esch. coli. The prevalence of ASB in 1595 boys aged 5 to 18 was low, 0.2%. Ureteric reflux was present in 15% of girls without renal scarring and in 46% of those with renal scarring (P less than 0.001). Renal scarring also showed a significant association with duplication, hydroureter, or single saccules in the bladder. The greater the severity of scarring the more frequently was reflux present. This study gave no evidence that asymptomatic bacteriuria leads to progressive renal damage during childhood. It therefore does not support the recommendation for prescriptive screening of schoolchildren, but emphasizes the need for prospective studies of the natural history of ASB.

Adolescent↗
PubMed1969

Asymptomatic significant bacteriuria in the non-pregnant woman. II. Response to treatment and follow-up.

Short courses of nitrofurantoin and ampicillin produced an immediate cure in 80% of adult non-pregnant bacteriuric women. Of the subjects so treated, 55% remained cured at the end of one year. Over the same follow-up period 36% of untreated bacteriuric women developed a spontaneous remission of bacteriuria. Treatment failed to prevent the development of symptomatic infection, and the reinfections which followed successful treatment were more commonly associated with the development of symptoms than the persistent or relapsing infections in untreated or unsuccessfully treated subjects.It is concluded that a search for bacteriuria in non-pregnant women is unlikely to be of value as a preventive measure, since in many instances it fails to detect urinary tract infection at an early stage and since treatment by methods suitable for large-scale use is ineffective.

Adult↗
PubMed1971

Long-term control of bacteriuria with trimethoprim-sulphonamide.

Long-term antibacterial therapy with the drug combination trimethoprim-sulphonamide has been used for the treatment of 52 patients with persistent or recurrent bacteriuria. Hypersensitivity or gastrointestinal intolerance was observed in six. Bacteriuria was controlled in 36 out of 38 patients with organisms sensitive to trimethoprim-sulphonamide, 28 having received treatment for periods ranging from 6 to 49 months. Treatment was in some cases curative and in others suppressive or prophylactic. The importance of supportive measures is re-emphasized.

Anti-Infective Agents, Urinary↗
PubMed1976

Co-trimoxazole in prevention of bacteriuria after prostatectomy.

In a prospective, double-blind trial prophylactic cotrimoxazole produced a highly significant reduction in the incidence of bacteriuria after prostatectomy. Only two out of 38 patients who received the drug developed bacteriuria compared with 19 out of 36 patients on placebo. Klebsiella-Enterobacter spp and coagulase-negative staphylococci were responsible for most infections. Although co-trimoxazole prophylaxis is obviously effective, widespread use might increase the incidence of bacterial resistance.

Aged↗
PubMed1988

Screening for bacteriuria with Clinitec-200.

A method of testing for bacteriuria with multiple reagent strips for blood, nitrite, and leucocyte esterase was evaluated. Of 669 urine specimens tested, 267 were negative on the reagent strips and so would ordinarily be discarded, creating a reduction in the workload of culturing urine specimens of 40%. Thirteen of these were false negative results, however, which represented 10% of all the samples with definite bacteriuria. Additional time was required for the screening test which reduced potential savings in manpower. Overall, we found costs to be slightly increased. In our laboratory this screening test was not economic and would produce an unacceptable rate of false negative results.

Bacteriuria↗
PubMed1993

Evaluation of Questor urine screening system for bacteriuria and pyuria.

AIMS: To evaluate the Questor automated bacteriuria and pyuria screening system; to compare its performance with that of a reference method; and to assess its usefulness in a routine clinical laboratory. METHODS: The Questor urine screening system was compared with a comprehensive regimen to detect urinary tract infection, using pour-plate viable counts to determine the numbers of bacteria present in urine samples, a wide range of other cultural methods, microscopic findings and clinical information. RESULTS: The optimal performance in detecting significant growths was a sensitivity of 93%, a specificity of 74%, a positive predictive value of 43% and a negative predictive value of 98%. The list price per test is 0.17 pounds and the capital cost of the system is 39,950 pounds. Questor can test 50 samples an hour and can be operated by one member of the laboratory staff, who is not required to make interpretative judgments--for example, a medical laboratory assistant. CONCLUSIONS: The sensitivity and specificity of the Questor was better than that obtained from other screening systems using the same protocol. The system was easy to use and is a useful addition to the methods available for screening for bacteriuria.

Bacteriuria↗
PubMed1979

Long-term effects of bacteriuria on the urinary tract in schoolgirls.

In order to examine the effects of bacteriuria on renal growth and scarring, 208 schoolgirls aged 5 to 12 years, in whom bacteriuria was detected during a screening program, were followed for 4 years. Of these, 110 were treated. Excretory urography and micturating cystography were performed at the start and end of the study period. Remission of ureteric reflux was equally common in both treated and untreated children. Renal scarring progressed in 12, and diminution in renal growth without scarring occurred in 9 others; treatment did not affect either of these events. A significant association existed between reflux and scarring. No new scars developed in previously unscarred kidneys. Difficulties in assessing normal renal growth and progression of scarring are discussed.

Adolescent↗
PubMedDate not supplied

Transurethral prostatectomy in patients with preoperative bacteriuria: double-blind study with oral fleroxacin and cefalexin.

We compared oral fleroxacin and cefalexin in the prevention of postoperative infectious complications after transurethral prostatectomy (TURP) in patients with preoperative bacteriuria. 95 patients underwent TURP due to benign prostatic hyperplasia with preoperative bacteriuria. The therapy consisted of 7 days of oral fleroxacin 400 mg once a day or cefalexin 500 mg three times daily. After 2 weeks, 62% of the urine samples were sterile in the fleroxacin groups but only 37% in the cefalexin group (p = 0.047). Patients in the cefalexin group had also statistically significantly more symptoms of urinary tract infections. After 6 weeks, the bacterial eradication rate was 53% in the fleroxacin group and 37% in the cefalexin group. There were no septicemias. TURP can be performed with reasonable safety with this oral antibiotic therapy.

Administration, Oral↗
PubMed1979

Bacteriuria diagnosis and antibiotic susceptibility testing in a group practice by dipslide techniques.

In group practice, screening for bacteriuria and antibacterial susceptibility testing of bacteria in urine specimens were performed by dipslide methods (Uricult and Sensicult, Orion Diagnostica) and the results were evaluated with respect to conventional cultivation of urine specimens and standardized susceptibility testing by the disc diffusion method at a bacteriological laboratory. Bacteriuria diagnosis by screening by the Uricult method seemed to be satisfactorily performed except for some streptococcal strains. In the case of direct susceptibility testing by the Sensicult dipslide method, however, the results obtained by personnel at the surgeries and by trained bacteriologists displayed unacceptable disparities, despite the fact that a continuously running training programme was established.

Anti-Bacterial Agents↗
PubMed1991

Kinetics and comparative efficacy of ofloxacin versus co-trimoxazole in the asymptomatic bacteriuria of elderly subjects.

In a prospective randomized study ofloxacin (400 mg orally once daily) versus co-trimoxazole (320/1,600 mg orally once daily) were given for 3 weeks in 30 and 22 elderly semimobile patients respectively, suffering from asymptomatic bacteriuria. From the obtained results it was evident that: (a) ofloxacin was superior to co-trimoxazole regarding eradication of bacteriuria (p less than 0.05) particularly in patients with a positive antibody-coated bacteria test; (b) a high rate of superinfections and reinfections with strains resistant to co-trimoxazole was observed in both groups indicative of hidden underlying conditions predisposing to urinary tract infections and (c) ofloxacin did not accumulate in serum during prolonged therapy but the half-life ranged between 8.3 and 10.2 h.

Aged↗
PubMed1977

Detrusor hyperreflexia and bacteriuria.

In a retrospective study of 579 patients with cystometrically proven detrusor hyperreflexia bacteriuria was correlated to the commonly accepted etiologies, and to the duration and amplitude of the uninhibited bladder contractions. Blood flow in the bladder wall may be reduced by increased intravesical pressure due to detrusor hyperreflexia, and it has been suggested that a resulting weakening of antibacterial defense mechanisms is responsible for the majority of urinary tract infections in these patients. We have not been able to confirm this hypothesis. We found no statistically significant difference between the incidence of bacteriuria in patients with low amplitude and short duration of the bladder contractions and in patients with high amplitude and long duration of the uninhibited bladder contractions.

Bacteriuria↗
PubMed1987

Single-dose treatment of bacteriuria in pregnancy.

Comparison of the results of single-dose treatment of urinary tract infection in women is confused by differences between published series in the duration of follow-up and in the diagnosis of infection. Pregnancy allows prolonged follow-up in a motivated population, but increases the possibility of false positive diagnosis of infection from midstream urines due to increased vulvovaginal contamination. Suprapubic aspiration (SPA) is safe in pregnancy and accurately confirms the presence or absence of bacteria in the bladder urine. Bacteriuria was diagnosed by SPA in 86 pregnant women. Thirty-seven of these were treated with a single dose of 3 g cephalexin and 49 with 3 days of cephalexin 1 g or of a combined preparation of pivmecillinam-pivampicillin. Both single-dose and 3-day treatments prevented further bacteriuria in 65% of the patients for the remainder of their pregnancies. This is similar to the results achieved with 10-day treatment. If extended trials confirm that single-dose treatment is as effective as conventional treatment with the same drug, then single-dose treatment has the advantages in pregnancy of minimal medication, good patient compliance and lack of side-effects.

Amdinocillin↗
PubMed1984

Ultrasonographic renal parenchymal volume related to kidney function and renal parenchymal area in children with recurrent urinary tract infections and asymptomatic bacteriuria.

A comparison of the relationship that might exist between ultrasonographically calculated renal parenchymal volume and renal parenchymal area assessed from urography and also between renal parenchymal volume and kidney function was conducted in a series of 26 children with recurrent urinary tract infection or asymptomatic bacteriuria. Glomerular filtration rate (GFR) was determined by the clearance of inulin, renal parenchymal area was measured from urography and renal parenchymal volume was calculated from sequential longitudinal scans of the kidney using an automated water-delay ultrasonographic equipment (Octoson). High correlation was found between 1) renal parenchymal volume and GFR, 2) renal parenchymal volume and renal parenchymal area and 3) renal parenchymal area and GFR. Octoson ultrasonographic determination of renal parenchymal volume is a reliable method to evaluate glomerular filtration rate and renal parenchymal area in children with recurrent urinary tract infections and asymptomatic bacteriuria.

Adolescent↗
PubMed1996

Typing of proteus from patients with bacteriuria.

Forty-five strains of Proteus mirabilis isolated from hospital in-patients, out-patients and community patients with significant bacteriuria, were investigated to determine whether a predominant type was present using the Dienes test. Antimicrobial susceptibility patterns of the 45 strains of Proteus mirabilis were also determined. There were 38 different Dienes types which shows that there is no predominant type of Proteus amongst the isolates examined in this study. This suggests that there is no predominant type of Proteus mirabilis in the community and hospital acquired bacteriuria. The antimicrobial susceptibility pattern of an isolate was not a useful marker for typing because susceptibility patterns between different Dienes types were so similar.

Adolescent↗
PubMed2006

Asymptomatic bacteriuria in sickle cell disease: a cross-sectional study.

BACKGROUND: It is known that there is significant morbidity associated with urinary tract infection and with renal dysfunction in sickle cell disease (SCD). However, it is not known if there are potential adverse outcomes associated with asymptomatic bacteriuria (ASB) infections in sickle cell disease if left untreated. This study was undertaken to determine the prevalence of ASB, in a cohort of patients with SCD. METHODS: This is a cross-sectional study of patients in the Jamaican Sickle Cell Cohort. Aseptically collected mid-stream urine (MSU) samples were obtained from 266 patients for urinalysis, culture and sensitivity analysis. Proteinuria was measured by urine dipsticks. Individuals with abnormal urine culture results had repeat urine culture. Serum creatinine was measured and steady state haematology and uric acid concentrations were obtained from clinical records. This was completed at a primary care health clinic dedicated to sickle cell diseases in Kingston, Jamaica. There were 133 males and 133 females in the sample studied. The mean age (mean +/- sd) of participants was 26.6 +/- 2.5 years. The main outcome measures were the culture of > or = 10(5) colony forming units of a urinary tract pathogen per milliliter of urine from a MSU specimen on a single occasion (probable ASB) or on consecutive occasions (confirmed ASB). RESULTS: Of the 266 urines collected, 234 were sterile and 29 had significant bacteriuria yielding a prevalence of probable ASB of 10.9% (29/266). Fourteen patients had confirmed ASB (prevalence 5.3%) of which 13 had pyuria. Controlling for genotype, females were 14.7 times more likely to have confirmed ASB compared to males (95% CI 1.8 to 121.0). The number of recorded visits for symptomatic UTI was increased by a factor of 2.5 (95% CI 1.4 to 4.5, p < 0.005) but serum creatinine, uric acid and haematology values were not different in patients with confirmed ASB compared with those with sterile urine. There was no association with history of gram negative sepsis. CONCLUSION: ASB is a significant problem in individuals with SCD and may be the source of pathogens in UTI. However, further research is needed to determine the clinical significance of ASB in SCD.

Adult↗
PubMed2004

Management of asymptomatic bacteriuria in patients with diabetes mellitus.

OBJECTIVE: To review the literature regarding the management of asymptomatic bacteriuria (ASB) in patients with diabetes mellitus. DATA SOURCES: A MEDLINE (1967-June 2003) and bibliographic search of the English-language literature was conducted using the search terms diabetes mellitus, asymptomatic, bacteriuria, and urinary tract infection. DATA SYNTHESIS: ASB occurs in diabetic women more commonly than in non-diabetics and is associated with an increased risk of symptomatic urinary tract infection (UTI) among patients with type 2 diabetes. Symptomatic UTIs tend to follow a more complicated course in diabetics. Despite these independent observations, antimicrobial therapy has not been shown to reduce symptomatic UTIs, pyelonephritis, or hospitalization for UTI. CONCLUSIONS: Available evidence does not support antimicrobial treatment of ASB among patients with diabetes mellitus.

Anti-Infective Agents, Urinary↗