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PubMed2004

Evaluation of modified Wright-staining of urine sediment as a method for accurate detection of bacteriuria in dogs.

OBJECTIVE: To compare the findings of light microscopic evaluation of routine unstained wet-mounted preparations and air-dried, modified Wright-stained preparations of urine sediment with results of quantitative aerobic bacteriologic culture of urine. DESIGN: Masked prospective study. SAMPLE POPULATION: 459 urine samples collected by cystocentesis from 441 dogs. PROCEDURE: Urinalyses and quantitative bacteriologic cultures of urine were performed. Unstained wet-mounted preparations and air-dried, modified Wright-stained urine sediment preparations were examined by light microscopy for the presence of bacteria. RESULTS: Compared with results of quantitative bacteriologic culture, routine unstained preparations and modified Wright-stained preparations had sensitivities of 82.4% and 93.2%, specificities of 76.4% and 99.0%, positive predictive values of 40.1% and 94.5%, negative predictive values of 95.8% and 98.7%, and test efficiencies of 77.3% and 98.0%, respectively. Compared with 74 samples that yielded growth on bacteriologic culture, the routine unstained method had concordance and misclassification rates of 39.2% and 60.8%, respectively, whereas the Wright-stained method had concordance and misclassification rates of 78.4% and 21.6%, respectively. Significant associations between each of occult blood in urine, pyuria, female sex, and lower urine specific gravity with bacteriuria detected by Wright-stained sediment examination and quantitative bacteriologic culture of urine were identified. CONCLUSIONS AND CLINICAL RELEVANCE: Examination of modified Wright-stained preparations of urine sediment appeared to be a rapid, cost effective method that significantly improved the sensitivity, specificity, positive predictive value, and test efficiency of light microscopic detection of bacteriuria, compared with that of the routine unstained method.

Animals↗
PubMed1986

Catheter-associated bacteriuria. A controlled trial with the Bardex Urinary Drainage System.

In a randomized trial, the Bardex Urinary Drainage System was tested against a routine system consisting of a silicone-coated 16F Latex Foley catheter and exchangeable 1 500 ml collecting bags. The Bardex system consists of an all-silicone balloon catheter preconnected and sealed to the drainage tube with tape. The tube is united with a 2,000 ml collecting bag via a vented drip chamber. It has an extremely hydrophilic coating (BN-74) resembling the natural glycosaminoglycans lining the urothelium. This coating is intended to minimize urethral irritation and bacterial migration and also to cause slow release of water-soluble antiseptics applied to the surface. In the present study, isobetadine 10% was applied prior to the insertion and reapplied daily after pulling gently on the catheter. Forty female patients aged 31 to 85 years completed the study. In the Bardex group of patients, bacteriuria developed in none by the third day of catheterization and in 5% by the fourth day. In the Foley group, the bacteriuria rate was significantly higher, with 35% on the third day (p less than 0.01) and 45% on the fourth day (p less than 0.02). No difference between the two drainage systems was found concerning incontinence beside the catheter, urethral pain or burning, meatal reddishness or urethral discharge. No conclusion regarding the advantages or disadvantages of the BN-74 coating and the isobetadine application can be drawn from the present study.

Adolescent↗
PubMed1989

Urinary tract infections and asymptomatic bacteriuria after vaginal plastic surgery. A comparison of suprapubic and transurethral catheters.

In a prospective randomized study comprising 90 women undergoing vaginal plastic surgery, suprapubic and transurethral catheter drainage of the bladder were compared regarding urinary tract infection and asymptomatic bacteriuria. No statistically significant differences were found. The mean duration of catheterization was 4.9 days for suprapubic vs 3.3 days for transurethral catheter patients. Postoperative urinary tract infection was diagnosed in 23.7% of patients with suprapubic and in 27.5% of patients with transurethral catheters. Asymptomatic bacteriuria at catheter removal was found in 21.0% of suprapubic and in 12.5% of transurethral catheter patients. More mechanical complications were seen with SPCs than with TUCs. It is concluded that the two methods involve similar risks of infectious complications but that SPCs have a higher rate of mechanical complications.

Bacteriuria↗
PubMed1989

Evaluation of a bioluminescence assay for the detection of bacteriuria.

Bacteriuria defined with urine culture as the reference method was compared with bacterial adenosine triphosphate (ATP) measurements of cystoscopical urine samples from 216 men. Discrepant samples were studied by reculturing and microscopy of the sediment. Results show a good correlation (sensitivity 1.0 and specificity 0.95) between bacteriuria greater than or equal to 10(4) cfu/ml and bacterial ATP greater than 10 nmol/l measured by bioluminescence. Samples with macroscopic hematuria may influence the ATP value and give false positive results.

Adenosine Triphosphate↗
PubMed1989

Uricult and Sensicult dipslides for diagnosis of bacteriuria and prediction of drug resistance in primary health care.

Uricult dipslide as an indicator of bacteriuria yielded acceptable results in primary health care (PHC), and readings by local staffs were similar to those by laboratory technicians. Sensicult dipslide detected somewhat fewer bacteriurias and predicted bacterial drug sensitivity better than resistance (predictive values 93% and 50%, respectively). The mean risk of bacterial drug resistance against seven common urinary tract infection (UTI) antibiotics in PHC was 17%. The use of Sensicult for targeting UTI therapy resulted in an average risk of 7% for prescribing drugs to which the organism was resistant. The corresponding risk with Uricult for classification of UTI bacteria by Gram grouping, lactose and catalase reactions, and local guidelines for therapy of different bacterial groups, was also 7%. The latter method is simple, offers qualitative, and thus prognostic information, but can be further improved.

Bacteriuria↗
PubMed1990

The diagnosis of bacteriuria during pregnancy.

Three diagnostic tests, Nitur, Urobact, and Uricult, were evaluated in the detection of bacteriuria in 865 pregnant women. As reference method agar culture was performed. Heavy growth (greater than 10(5) CFU/ml) of urinary tract bacteria was considered a true positive result and demonstrated in 58 (6.7%) of the women, 14 of whom had gram-negative rods. The sensitivity of the nitrite test was extremely low (0.13). The test gave negative results in eight of 17 specimens yielding heavy growth of Escherichia coli or Proteus mirabilis. Although the Urobact test was highly sensitive as regards gram-negative infection, it had an unacceptably low (0.27) predictive value in positive tests. The sensitivity of the Uricult test was low (0.35) in this study. The predictive value (0.50) of a positive test result may be acceptable, since just over half of the false positive results were explainable by moderate growth of urinary tract pathogens (10(4)-10(5) CFU/ml). It is argued that semi-quantitative urine culture may be preferable to the rapid diagnostic methods studied for the screening of bacteriuria in pregnant women.

Agar↗
PubMed1982

The bacteriuria in long-stay geriatric inpatients with an indwelling catheter.

Long-stay geriatric inpatients with an indwelling urinary catheter are harassed by foul-smelling urine, urine leakage, and frequent catheter blockages. It is reasonable to assume that catheter-induced bacteriuria plays an essential role in the catheter problems of these patients. An attempt to reduce the catheter-induced bacteriuria was made by the introduction of a latex catheter coated with a layer of copper metal. The antibacterial properties of the copper-coated catheters studied were, however, insufficient, probably due to too small amount of copper on the catheter. The copper layer was dissolved from the catheter in a few days. The effective time of copper treatment thus became too short.

Aged↗
PubMed2004

Bacteriuria in spinal cord injured patients with neurogenic bladder dysfunction.

The occurrence of bacteriuria in spinal cord injured patients with neurogenic bladder dysfunction who used clean intermittent catheterisation to empty their bladders was studied in order to examine cut-off concentration breakpoints for significant bacteriuria in this group of patients using procedures of the European Urinanalysis Guideline. 344 samples were cultured, yielding 285 isolates. Coagulase-negative staphylococci (27%), Enterococci (25%), Klebsiella spp (19%), and Escherichia coli (12%) were the most common findings. Bacteria grew at concentrations of 10(5)-10(8) cfu/L, but only a few at 10(4) cfu/L. It is concluded that low bacterial concentrations in the urine (10(5) cfu/L) of patients with neurogenic bladder dysfunction who are on intermittent catheterisation might be as significant for bladder contamination with bacteria as a high bacterial concentration and can possibly be responsible for bladder infections.

Bacteriuria↗
PubMed1975

Effect of consecutive antibacterial therapy on bacteriuria in hospitalized geriatric patients.

The effects of treatment with a consecutive series of different antibacterial drugs, most of them commonly used in urinary tract infections, were studied in 36 hospitalized geriatric patients with bacteriuria. Most of the patients had advanced handicaps and all had urinary incontinence. Urinary acidifying drugs, penicillin V, sulfonamide, nitrofurantoin, nalidixic acid, and trimethoprim/sulfamethoxazole were used as antibacterial agents. The general conclusion was that even the administration of a series of potent antibacterial drugs only rather seldom eliminates bacteriuria in such patients, and that the original bacteria in most cases are replaced by strains highly resistant to antibacterial drugs. The treatment had obvious influence on the clinical state only in one patient.

Age Factors↗
PubMed1985

Asymptomatic bacteriuria during pregnancy with special reference to group B streptococci.

The relationship between significant bacteriuria (SB), i.e. 2 subsequent voided urine specimens with greater than or equal to 10(5) colony forming units (CFU)/ml, and the occurrence of bacteria in the urinary bladder detected by bladder punction, was investigated in asymptomatic pregnant women. From 30 (70%) of the 43 women with SB studied, bacteria were isolated from the urinary bladder. The same bacteria were found in the bladders of all 21 women with Escherichia coli, the one with Klebsiella pneumoniae, and the one with Staphylococcus saprophyticus in midstream urine. Six of 10 patients with group B streptococci (GBS), 1 of 4 patients with Streptococcus faecalis, and none of 5 patients with Staphylococcus epidermidis in voided specimens had bacteria in the aspirated urine. Serotype III was isolated from 8/10 patients with SB caused by GBS. One child born to a woman with GBS SB but no bacteria in the urinary bladder, got early onset septicaemia. The poor predictive value of SB with GBS, S. faecalis and S. epidermidis necessitates the increased use of bladder puncture for diagnosis of true asymptomatic bacteriuria (AB), i.e. AB with bacteria in the urinary bladder. SB with GBS even without bacteria in the urinary bladder, may constitute a threat to the baby's health.

Adolescent↗
PubMed1978

Bacteriuria in urinary schistosomiasis in Egypt a prevalence survey.

An epidemiologic survey to assess the prevalence of bacteriuria in urinary schistosomiasis was carried out in a region endemic for urinary schistosomiasis in Egypt. Twenty of 390 (5.1%) school boys aged 5--16 years were bacteriuric. This prevalence rate is more than 10 times greater than that found in comparable surveys in areas non-endemic for urinary schistosomiasis. In this endemic population bacteriuria was found in 6.5% of active egg excreters and 2.3% of non-egg excreters.

Adolescent↗
PubMed1987

The association of bacteriuria with resident characteristics and survival in elderly institutionalized men.

Ninety-one elderly male residents of a skilled nursing facility were classified as nonbacteriuric (41%), intermittently bacteriuric (34%), or continuously bacteriuric (25%) on the basis of urine cultures obtained over a 3-year period. Bacteriuric and nonbacteriuric residents were similar in age, number of diagnoses and medications, and mobility. However, bacteriuric residents were more frequently confused or demented, whether continuously bacteriuric (78%) or intermittently bacteriuric (62%) compared with nonbacteriuric residents (42%) (p less than 0.04). In addition, bacteriuria was significantly associated with incontinence of bladder (96% of continuous, 66% of intermittent, and 25% of nonbacteriuric; p less than 0.001) and bowel (52%, 39%, and 5.5%, respectively; p less than 0.002). At 6 years of follow-up there were no differences in survival among the three groups. Urinary tract infection caused or contributed to only two (2.9%) deaths. Thus, in this population, bacteriuria was associated with higher functional disability but not with increased mortality.

Aged↗
PubMed1980

Nosocomial bacteriuria: a prospective study of case clustering and antimicrobial resistance.

To investigate the role of cross-infection in nonepidemic nosocomial bacteriuria in a large, university-affiliated hospital, we identified in adult patients admitted over an 11-week period all cases caused by organisms of the same genus, species, and antimicrobial susceptibility and clustered by date of onset and hospital ward. Further laboratory studies were conducted to verify clustering. Among the 3452 patients studied, 194 cases of nosocomial bacteriuria were identified; 49 appeared clustered by epidemiologic evidence. Additional laboratory tests verified clustering in 30 cases (15.5%). We found that 90% of clustered and 76% of nonclustered cases had had previous urinary catheterization; Pseudomonas aeruginosa, Serratia marcescens, and Citrobacter freundii often caused clustered infection while Escherichia coli predominated in nonclustered cases; and resistance to gentamicin, sulfathiazole, and carbenicillin was significantly greater for pathogens from clustered cases than for nonclustered ones. This increased resistance emphasizes the need to prevent cross-infection, even in the absence of epidemics.

Anti-Bacterial Agents↗
PubMed1998

Asymptomatic bacteriuria in pregnancy: epidemiological, clinical and microbiological approach.

Asymptomatic urinary tract infection is a risk factor for fetal and maternal morbidity including development of pyelonephritis, premature labor and impaired intra-uterine development. In this study, 326 pregnant and 100 non-pregnant control women were screened for significant asymptomatic bacteriuria from April 8 to July 25, 1997 to gain insight into the prevalence rate, clinical characteristics of the disease and microbiological assessments of the causative agents. All the subjects were clinically identified to have no signs and symptoms of urinary tract infection (UTI). The age ranges of the study and control groups were between 15-40 years for both groups with mean of 25.1 and 25.3 years, respectively. Bacteriological screening of mid-stream urine (MSU) revealed that 24/326 (7%) and 3/100 (3%) were positive for asymptomatic bacteriuria in the study group and controls, respectively (P < 0.05). Further biochemical species identification showed that Escherichia coli was found in 11/24 (46%) followed by coagulase-negative staphylococci (CNS) in 8/24 (33%) and Citrobacter freundii in 2/24 (8%). Others found in smaller number included Staphylococcus aureus, Enterobacter cloacae and Proteus rettgeri in 1/24 (4%) each. Antimicrobial susceptibility test revealed that 10/11 (91%) of the E. coli isolates were resistant to ampicillin and amoxicillin and 10/11 (91%) of them sensitive to nitrofurantoin.

Adolescent↗
PubMedDate not supplied

[Asymptomatic bacteriuria in pregnancy].

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. Asymptomatic bacteriuria is the common bacterial infection requiring medical treatment in pregnancy. Diagnosis and treatment of asymptomatic bacteriuria is important as approximately 20-40% of these women, if untreated during pregnancy, will develop a symptomatic urinary tract infection.

Bacteriuria↗
PubMed1975

Asymptomatic bacteriuria, bacteremia, and other infections due to NSU corynebacteria.

By means of the new medium, nonspecific urethritis (NSU) chocolate agar, NSU corymebacteria were isolated from patients with asymptomatic bacteriuria, bacteremia, cervicitis, conjuctivitis, and pericarditis, and also with bone marrow, wound, and cul-de-sac infections. The NSU corynebacteria were considered the etiologic agents. On the basis of biochemical reactions, antibiotic sensitivity, and complement fixation tests some isolates were the same microorganisms. Both patients with conjunctivitis were infected with the same NSU corynebacteria. A second isolate was cultured from patients with osteomyelitis and cervicitis, while a third was recovered from an infected leg wound and from a patient with pericarditis. Seven of the isolates, when injected into rabbits hypersensitive to four NSU corynebacteria isolated from the inflamed epididymis of patients with epididymitis, elicited delayed hypersensitivity reactions, which indicated that they also were related antigenically. It is suggested that nonspecific urethritis and eididymitis may represent an infection with NSU corynebacteria, or may be an extension of bacteriuria due to these microorganisms, with a delayed hypersensitivity reaction as a possible additional complication. Colony counts on NSU chocolate agar of the bacteria in urines from male and female patients were higher than those obtained on conventional agar media. NSU chocolate agar is superior to other agar media for the isolation of pathogenic and saprophytic bacteria not only from the urogenital tract but also from other foci of infection. It is easily prepared from commercial blood agar plates and its use should be considered when a selective medium is not required.

Adult↗
PubMed2001

Covert bacteriuria in nephrotic syndrome.

Prevalence of covert bacteriuria in patients of nephrotic syndrome admitted for kidney biopsy was studied in 205 patients. Age ranged from 10 years to 65 years. 148 patients were male and 57 were female. Prevalence of covert bacteriuria was found in 38 patients (18.53%). In bacteriuric patients 30 were male, 8 were female. Escherichia coli was the commonest organism grown in bacteriuric patients (30 or 78.9%). Serum albumin was low and 24-hour urinary protein excretion was high in bacteriuric patients in comparison to abacteriuric patients. In bacteriuric patients membranous nephropathy was the commonest histopathological finding present in 15 patients (39.47%).

Adolescent↗
PubMed2002

Reagent strip testing is not sensitive for the screening of asymptomatic bacteriuria in pregnant women.

The objective of the study was to assess the diagnostic performance of the reagent strip in screening for asymptomatic bacteriuria in pregnant women using urine culture as a gold standard. This study comprised 204 asymptomatic pregnant women who attended their first antenatal care at Srinagarind Hospital, Khon Kaen University from April 1, 1999 to June 30, 1999. Women with symptoms of urinary tract infection, antibiotic treatment within the previous 7 days, pregnancy-induced hypertension, bleeding per vagina and history of urinary tract diseases were excluded. Urine specimens were collected by clean catched midstream urine technique for urinalysis, reagent strip test and urine culture. Diagnostic performance of reagent strip in terms of sensitivity, specificity, positive and negative predictive value was analyzed. Urine reagent strip test had a sensitivity of 13.9 per cent, a specificity of 95.6 per cent, a positive predictive value of 46.1 per cent, a negative predictive value of 80.6 per cent in detecting asymptomatic bacteriuria in pregnant women.

Adult↗