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PubMed2002

Urine separating sewage systems--environmental effects and resource usage.

Effects of urine separation on the environment and resource usage were estimated using the simulation package ORWARE. Measurements on the urine-separating system in the housing district Palsternackan in Stockholm and on the fertilising effect of the urine were used in the simulations. The tenants were at home 65% of the time and separated 65% of the urine. Under these conditions, urine separation decreased the waterborne emissions of nitrogen and phosphorus by 55% and 33% respectively. Compared to the conventional system, urine separation increased the flow from the wastewater system to agriculture of plant-available nitrogen by a factor of 28, phosphorus by a factor of 1.35 and potassium by a factor of 23. Urine is a well-balanced complete fertiliser with very low concentrations of heavy metals. Urine separation conserved energy as long as the urine was transported distances shorter than 221 km to the field with a truck and trailer. If all the urine had been separated and transported only 1 km, the energy saving would have been 36%. In this and in previous studies, urine separation proved to be an improvement over the conventional system as regards environmental effects and resource usage.

Conservation of Natural Resources↗
PubMed2005

Characterization of the solubility of a poorly soluble hydroxylated metabolite in human urine and its implications for potential renal toxicity.

The solubility, in human urine, of the major hydroxylated metabolite (M1) of an experimental cognition enhancer was characterized through a series of in vitro experiments in an effort to estimate the probability of crystalluria occurring following oral administration of the parent compound. The aim of these experiments was to determine if a safety margin existed between clinically observed urine concentrations and the solubility of M1. The mean urine concentrations of M1 in young and elderly subjects following oral administration of the parent compound at the highest doses tested, were 4865 +/- 2368 ng/mL and 2764 +/- 791 ng/mL, respectively. In vitro solubility experiments with M1 were conducted in drug-free human urine (37 degrees C) from four male and four female healthy subjects under conditions of high and low urine osmolality. Mean concentrations (n = 16) of M1 in human urine to which solid M1 was added, were 3656 +/- 621 ng/mL, 4678 +/- 1169 ng/mL and 5378 +/- 2474 ng/mL after stirring for 24, 48 and 72 h, respectively, indicating that the ex vivo mean solubility of M1 in human urine is no greater then approximately 5 microg/mL. Addition of solid M1 to urine from human subjects dosed with the parent compound resulted in mean urine M1 concentrations 23.5% greater than those observed in vivo. The results from both experiments indicated a significant overlap between urine concentrations of M1 in vivo following the highest oral administration of the parent drug and M1 solubility measured in vitro, suggesting a high potential for in vivo saturation of urine with M1 with subsequent precipitation, crystalluria, and nephrotoxicity. Consequently, the results of these studies have placed restrictions on the dose that could be administered during clinical development of this compound.

Animals↗
PubMed2006

Results of an Aboriginal community-based renal disease management program incorporating point of care testing for urine albumin:creatinine ratio.

INTRODUCTION: There has been a significant increase in the burden of renal disease among Aboriginal Australians over the past 15 years. Urine albumin:creatinine ratio (ACR) is a well-established marker of microalbuminuria and can be conveniently performed on the DCA 2000 point-of-care testing (POCT) analyser (Bayer Australia; Melbourne, VIC, Australia) with an on-site result available in 7 min. The application of the urine ACR POCT for renal disease risk assessment was pioneered by our group in the Umoona Kidney Project. This article describes the results of the management arm of the Umoona Kidney Project, which used point-of-care urine ACR testing for the first time within a management framework to monitor albuminuria in patients at highest risk of renal disease. The article also examines the analytical quality of POCT results and overall community acceptance of the Umoona Kidney Project. METHODS: Adults clinically assessed by Flinders Medical Centre renal specialists as being at greatest risk for renal disease were offered the ACE inhibitor (ACEI) perindopril on a voluntary basis. Selected renal markers, including POCT urine ACR (conducted on-site by Umoona's Aboriginal health worker team), plasma electrolytes, urea, creatinine, calculated glomerular filtration rate and blood pressure were measured six monthly. Regular quality control testing was undertaken to monitor the analytical performance of the POCT analyser. A culturally appropriate questionnaire was designed and implemented to assess community satisfaction with the project. RESULTS: In all, 231 patient management consultations were conducted over a two year period, with over 70% of patients having four or more (up to a maximum of eight) consultations; 35 patients (mean age 49.2 [+/-2.3] years, 54% males) participated voluntarily in the management arm. All were overtly hypertensive, hypertensive with other risk factors or had diabetes. The renal status of these patients was followed for a mean of 63 +/- 4.5 weeks. In total, 111 POCT urine ACR tests were performed for patient management (mean 3.2 tests per patient). There was no significant difference in POCT urine ACR in the study period with a median (and inter-quartile range) of 5.7 mg/mmol (1.2-15.2) pre-ACEI and 4.3 mg/mmol (1.3-16.7) post-ACEI treatment (p = 0.50, Wilcoxon signed ranks test). The calculated glomerular filtration rate altered from 110 to 118 mL/min (p = 0.019, paired t-test). There was no change in the group plasma potassium, urea and creatinine. Collectively these results indicate a stabilisation in renal function among the management group. Blood pressure (both lying and standing) fell significantly in the study period. The imprecision for urine ACR quality control POCT conducted during the management program was within nationally and internationally accepted precision goals for urine albumin, creatinine and ACR. Fifty community members completed the satisfaction questionnaire. Three-quarters of respondents felt there were no cultural barriers in providing a urine sample for urine ACR POCT. CONCLUSIONS: The management arm of the Umoona Kidney Project was effective in stabilising the renal function and improving the blood pressure of community members identified to be at greatest risk of kidney disease. POCT urine ACR testing can be utilised, not only for community risk assessment, but also for patient management. The Umoona Kidney Project was well accepted by the health service and community members.

Albuminuria↗
PubMed1990

[The activity of gamma glutamyltransferase in the urine of sheep].

The activity of gamma glutamyltransferase (GGT) was measured in sheep urine using a method developed for the routine assay of serum. Despite variation in urine pH and specific gravity, this method gave reproducible results. Serial dilutions of urine samples to which bovine GGT extract was added, showed a linear relationship for GGT values between 48 U l-1 and 373 U l-1. When a saline solution of GGT was added to urine and serum to compare the behaviour of GGT in the two fluid mediums, no difference could be demonstrated. The presence of non-specific enzyme inhibitors for GGT in sheep urine could not be established, eliminating the need for urine dialysis before the assessment of GGT activity. GGT activity remained the same in urine samples that were stored at 4, 25 and -20 degrees C for 12 and 24 hours. Serial urine samples from 16 sheep were collected for 24 hours and the activity of GGT and the creatinine concentration were measured. Although there was significant variation in the measured GGT and creatinine values, the ratio of GGT:creatinine remained constant. The mean urine GGT:creatinine ratio was found to be 29.1 with a standard deviation of 7.0. A population reference value for urine GGT: urine creatinine ratio in clinically normal sheep was calculated to be 43.1.

Animals↗
PubMed1985

Evaluation of a technique for measurement of gamma-glutamyltranspeptidase in equine urine.

gamma-Glutamyltranspeptidase (GGT) activity in equine urine was measured, using an assay developed for use with serum and was found to be reproducible. The GGT activity was measured in samples prepared by serial dilution of exogenous GGT with equine urine, and the activity was determined to be linear between 21 IU/L and 407 IU/L. The behavior of exogenously added GGT was compared in equine serum and urine. The enzyme behaved similarly in both fluids. The GGT activity was measured in serum and urine samples after storage at -20, 4, and 25 C for 24 and/or 72 hours. Enzyme activity decreased after storage at all temperatures and times, but the decrease was greatest and most variable at -20 C. The urine GGT: urine creatinine ratio was calculated on serial urine samples collected over 24 hours. Although the urine GGT activity and creatinine concentration had significant variation, the ratio remained constant. The urine GGT: urine creatinine ratio was calculated from random urine samples collected from 27 clinically healthy adult horses and was found to be 10.52 +/- 4.78 (mean +/- SD).

Animals↗
PubMed1994

Diurnal electrolyte excretion pattern affects estimates of electrolyte status based on 24-hour, half-day, and overnight urine.

This study set out to examine the diurnal pattern of electrolyte excretion in urine, and to investigate whether urine collected from after dinner until next morning (half-day evening urine) might to be an alternative to 24-h urine more valid than overnight urine for ranking a person's electrolyte status. In a cross-sectional study of 40 young adults, two consecutive 24-h urine samples were collected, followed one month later by two further consecutive 24-h samples. Mean excretion rates of sodium and chloride steadily increased during the daytime. Electrolyte/creatinine ratios also increased, but all excretion rates decreased after sleep. The potassium excretion rate increased rapidly in the morning but declined steadily after 10 a.m.. Estimates of 24-h electrolyte content calculated from half-day amounts were approximately 80-92% of the actual 24-h urinary electrolyte values. Estimates obtained using overnight urine amounts approximated 60% of the actual 24-h values. Correlation coefficients between actual 24-h urinary electrolytes and estimates based on half-day urine were better than correlates between actual 24-h amounts and estimates obtained using timed overnight urine. These results suggest that half-day evening urine may be a useful alternative to 24-h urine for assessing electrolyte in-take.

Adult↗
PubMed1999

Urine release in freely moving catheterised lobsters (Homarus americanus) with reference to feeding and social activities.

Previous studies suggest that urine-borne pheromones play an important role in lobster agonistic and sexual behaviour. This paper investigates the pattern of urine release in catheterised, but otherwise freely moving, adult lobsters with respect to feeding, social and non-social activities. Lobsters on average released 4.1 ml (1 % of body mass) of urine over a 12 h period; this more than doubled to 10.6 ml over the 12 h period after feeding. Hourly monitoring revealed that most urine was released in the first hour after feeding (2.84 ml). With the exception of the first hours after feeding, urine release was intermittent, with pauses lasting up to 17 h. The probability of urine release per hour in unfed lobsters was 0.34 (median); this value increased during agonistic interactions elicited by the introduction of a conspecific (median 0. 63) and during activity initiated by non-social disturbance (median 0.56). Mean urine volume during output hours in unfed lobsters amounted to 1.09 ml h-1. This volume was significantly increased by the presence of a conspecific (1.88 ml h-1) and decreased during activity initiated by non-social disturbances (0.56 ml h-1). No sex-specific differences in urine release were found. The data demonstrate that lobsters control their urine release in a manner dependent on behavioural context. This supports recent findings suggesting the use of urine for chemical signalling in agonistic interactions.

Animals↗
PubMed2001

[An automated electronic anesthesia record and automated urine output measurement].

We can now collect many parameters (NIBP, HR, ABP, SpO2, EtCO2, CCO, etc) from an anesthesia monitor in an automated electronic anesthesia record system. The function of automated urine output measurement has been added to an automated electronic anesthesia record system. A digital weight meter connected with a personal computer by RS-232 C is used to measure the weight of urine. We convert the weight to the volume hypothesizing that the density of urine is 1 g.ml-1. Physiologic parameters are recorded every 10 seconds from an anesthesia monitor and we can set the period of automated urine output measurement we like. We must enter the initial and final urine output but the intraoperative urine output is collected automatically to an automated electronic anesthesia record and visualized in urine bar graph. The total volume of urine is calculated. Computerized urine output measurement can record data more frequently, for example, every 10 minute. At the end of the operation, intraoperative data are sent to a host computer and the anesthesia record is printed. Combining the automated urine output measurement with an automated electronic anesthesia record system is useful in anesthesia practice of a long operation.

Anesthesia↗
PubMed1999

Use of spun urine to enhance detection of Trichomonas vaginalis in adolescent women.

BACKGROUND: Diagnosis of Trichomonas vaginalis infection is traditionally performed by microscopic examination of vaginal fluid. Although this technique is relatively insensitive compared with culture, it is widely used because of its lower cost and immediate results. OBJECTIVE: To assess the utility of microscopic examination of spun urine as a means of increasing the sensitivity of microscopic diagnosis of T. vaginalis. DESIGN AND SETTING: Retrospective observational study performed in a hospital-based adolescent clinic. SUBJECTS: Female patients enrolled between July 1995 and August 1996 into a larger study evaluating diagnosis of vaginal infections (N = 686). To be included, subjects had to have a positive culture for T. vaginalis (n = 97); those who did not have a spun urine examination were excluded (n = 22). MAIN OUTCOME MEASURE: Microscopic examination of vaginal fluid and spun urine for presence of motile trichomonads. Using a positive Trichomonas culture as the reference standard, the sensitivity of vaginal fluid alone was compared with vaginal fluid plus spun urine. The McNemar test for paired samples was used to test the statistical significance of the difference in sensitivities. RESULTS: Ninety-seven subjects had culture results positive for Trichomonas. Of these, 75 (77%) had a spun urine examination performed. Subjects were aged 13 to 22 years and all were African American. Seventy-three percent of the infections were detected by vaginal fluid specimen, 64% by spun urine, and 85% by either vaginal specimen or spun urine. The difference in sensitivity between vaginal specimen alone and vaginal specimen plus spun urine was 12% (95% confidence interval, 3%-21%; P<.005). Nine patients who would not have been diagnosed by examination of vaginal fluid alone were diagnosed with the addition of spun urine examination. CONCLUSION: Microscopic examination of a spun urine specimen performed in conjunction with microscopic examination of a vaginal fluid specimen improves the detection rate of T. vaginalis.

Adolescent↗
PubMed2000

Urine from chronic hepatitis B virus carriers: implications for infectivity.

Horizontal transmission of hepatitis B virus (HBV) without apparent sexual or parenteral exposure is common in hyperendemic areas. In most cases, the route of transmission is unknown. To investigate urine as a potential source of infection, serum and urine from 56 chronic hepatitis B surface antigen (HBsAg) carriers were examined for the presence of HBV DNA using the polymerase chain reaction (PCR). Thirty-four of the patients were anti-hepatitis B e antigen (anti-HBe) positive and 22 were hepatitis B e antigen (HBeAg) positive. HBV DNA was detected in serum from 46 patients (82%) and in urine from 28 patients (50%). Most HBeAg-positive patients had HBV DNA detectable in urine (91%), whereas urine samples from anti-HBe-positive patients were found to contain HBV DNA to a lesser extent (24%). When comparing HBV DNA from serum and urine by an end-point titration PCR, a titration difference averaging 10(3) was found between serum and urine. A significant female predominance was also noted among the positive urine samples (P < 0.05), which was not correlated to the presence of haematuria. Detection of HBV DNA may indicate active viral replication, and thereby infectivity. Because a high proportion of chronic HBV carriers were found to have HBV DNA in urine, it is suggested that irrespective of HBeAg/anti-HBe status, urine should be regarded as a potential route of transmission and therefore be investigated further as a means of horizontal and nosocomial transmission of HBV.

Adult↗
PubMedDate not supplied

Chorioamnionitis does not affect fetal urine production in patients with premature rupture of membranes.

The objective of this study was to evaluate fetal urine production rate in patients with premature rupture of membranes in the presence or absence of chorioamnionitis and to determine its clinical usefulness. Fetal urine production was evaluated in 30 women between 24 and 39 weeks' gestational age with ruptured membranes. Fetal bladder measurements were determined every 3-5 min for 30-90 min. Chorioamnionitis was defined by both clinical criteria and histological examination of the placenta. The last determination of fetal urine production rate prior to delivery was compared in patients with and without histologic and/or clinical chorioamnionitis. Fetal urine production rate was corrected for gestational age using birth weight prior to analysis. A total of 96 assessments of fetal urine production were performed (range 1-16 per patient). Twelve subjects (40%) had no evidence of chorioamnionitis (group 1), 10 (33%) had histologic chorioamnionitis alone (group 2), and eight (27%) had both clinical and histologic chorioamnionitis (group 3). The mean (+/- SD) urine production rates in these groups were 9.43 +/- 3.15 ml/kg/hr, 10.65 +/- 3.43 ml/kg/hr, and 9.97 +/- 2.81 ml/kg/hr, respectively. The difference in fetal urine production rate between the three groups was not statistically significant. A power analysis revealed that individual group sizes were adequate to document a 50% increase in fetal urine production rate with a type II error of < 10%. There were no documented cases of fetal infection based on neonatal cultures. The presence of histologic or clinical chorioamnionitis does not significantly affect fetal urine production in patients with premature rupture of membranes. The prospective assessment of fetal urine production rate does not appear to be clinically useful as an early indicator of chorioamnionitis.

Chorioamnionitis↗
PubMed1987

Stability and inactivation of mutagenic drugs and their metabolites in the urine of patients administered antineoplastic therapy.

Urine samples from patients administered mutagenic antineoplastic drugs are mutagenic in the Ames assay, and hence may pose a genotoxic hazard to hospital personnel or family members caring for the patient. The urine samples in the present study were tested for mutagenicity in several strains of Salmonella typhimurium that were uvr negative (TA98, TA100) or positive (TA102, UTH8413, UTH8414), and were analyzed for the presence of drugs and their metabolites using high-pressure liquid chromatography (HPLC). Urine samples from cancer patients were kept at room temperature and their mutagenicity as well as the chemical stability of the drugs was tested for a period of 14 days. It was observed that, in general, the urine remained mutagenic for the 14-day period while the parent compound degraded within the first seven days. An exception was cisplatin, which was chemically stable as platinum, but the urine decreased in mutagenicity with time. This decrease was probably the result of ligand exchange with the platinum. Inactivation methods were developed to reduce the genotoxic hazard posed by the mutagenic compounds in the urine. Cisplatin was inactivated by complexing with sodium diethyldithiocarbamate (DDTC). Oxidation of urine containing mitomycin C and doxorubicin (sodium thiosulfate must be added to urine containing doxorubicin) with 5.25% sodium hypochlorite solution (bleach) results in mutagenic inactivation. Urine containing cyclophosphamide and its metabolites was oxidized with alkaline potassium permaganate and the active degradation products trapped with sodium thiosulfate. Both chemical and mutagenic assays are necessary to determine the reduction of risk. Methods of inactivation of mutagenic urine developed in this study are both effective and practical for the reduction of exposure to genotoxic hazards.

Antineoplastic Agents↗
PubMed1993

The immunomodulatory effects of urine from patients with superficial bladder cancer receiving intravesical evans BCG therapy.

Bladder cancer cells were stimulated with urine obtained from patients with superficial bladder cancer who had received treatment using intravesical bacillus Calmette-Guérin (BCG). The urine from the first 12 h following each of six BCG instillations was collected and examined for its biological effect. We evaluated effects that had previously been attributed to cytokines detected in the urine of such patients. The modulation of MHC class II antigen and intercellular adhesion molecule-1 (ICAM-1) expression were studied. Using neutralizing polyclonal antibodies to interferon gamma and tumour factor alpha the relative contribution of these molecules to the effects investigated were determined. When cells were stimulated for up to 48 h with first-instillation urine, little effect was seen in any of the parameters investigated. Urine from the sixth instillation, however, proved to be a potent immunomodulatory agent, inducing MHC class II molecule and ICAM-1 expression. Urine from instillations two to five mediated increasing immunomodulatory effects. When sixth-instillation urine samples were treated with neutralizing antibodies to interferon gamma prior to their addition to the bladder cancer cells, a marked and significant decrease in their potency was observed. Only in urine from one patient did any immunomodulatory capability remain after antibody treatment. Neutralizing antibodies to tumour necrosis factor alpha, however, failed to reduce the ability of any patient's urine to induce ICAM-1 expression. When both antibodies were used simultaneously no further decrease in potency was observed. These studies demonstrate for the first time the potential immunomodulatory and cytotoxic effects of urine produced by patients receiving intravesical BCG. Furthermore, in all samples tested, the major immunomodulatory component was shown to be interferon gamma. Although tumour necrosis factor alpha is produced as a result of BCG therapy, this cytokine did not appear to contribute to the parameters investigated, namely the induction of HLA class II antigens, and cell-surface ICAM-1.

BCG Vaccine↗
PubMed2000

Membranes and their constituents as promoters of calcium oxalate crystal formation in human urine.

We have proposed that membranes of cellular degradation products are a suitable substrate for the nucleation of calcium oxalate (CaOx) crystals in human urine. Human urine is generally metastable with respect to CaOx. To demonstrate that cellular membranes present in the urine promote nucleation of CaOx we removed these substrates by filtration or centrifugation and induced crystallization by adding sodium oxalate, before and after filtration or centrifugation. In a separate experiment, membrane vesicles isolated from rat renal tubular brush border were added into the filtered or centrifuged urine before crystal induction. Crystals were counted using a particle counter. Urine, the pellet, and retentate were analyzed for the presence of membranes, lipids, and proteins. Lipids were further separated into different classes, identified, and quantified. Both filtration and centrifugation removed lipids, proteins, and membrane vesicles, causing a reduction in lipid and protein contents of the urine. More crystals formed in whole than in filtered or centrifuged urine. The number of crystals significantly increased when filtered urine was supplemented with various urinary components such as the retentate and phospholipids, which are removed during filtration. We also determined the urinary metastable limit with respect to CaOx. Filtration and centrifugation were associated with increased metastable limit which was reduced by the addition of membrane vesicles. These results support our hypothesis that urine normally contains promoters of CaOx crystal formation and that membranes and their constituents are the most likely substrate for crystal nucleation in the urine.

Animals↗
PubMed1993

Overnight urine growth hormone, cortisol and adenosine 3' 5' cyclic monophosphate excretion in children with chronic asthma treated with inhaled beclomethasone dipropionate.

Overnight urine samples were obtained from 34 asthmatic children, 24 of whom were receiving inhaled beclomethasone dipropionate (BDP), and 30 controls. The urine volume of the children receiving inhaled steroids was significantly greater than that of the other asthmatic children and of the controls (P < 0.05). Urine growth hormone was within the normal range for all of the subjects and there was no demonstrable relationship between urine growth hormone and height or height standard deviation score. Urine steroid output was significantly reduced in the BDP receiving group when the results were expressed in U l-1 but there was no difference between the groups when the results were expressed per specimen. Urine adenosine 3' 5' cyclic monophosphate (cAMP) results were similar for all groups. We conclude that use of BDP increases overnight urine volume but, in our study, does not appear to influence the output of urine cortisol. Urine free cortisol measurements may not be a very sensitive tool for the detection of small changes in endogenous steroid production. The use of BDP does not adversely affect the output of urine growth hormone.

Administration, Inhalation↗
PubMed1986

The inhibitory effect of human urine on urease-induced crystallization in vitro.

To study whether human urine contains inhibitors against urease-induced crystallization, Jackbean urease and human urine, in amounts small enough (0.5 to 10 per cent) not to influence the ion concentration, buffering capacity or pH, were added to synthetic urine. The ammonia production and alkalinization that followed were independent of the amounts of human urine added. The addition of human urine gave a dose-related decrease in the amount of calcium phosphate and struvite precipitated on glass rods immersed in the synthetic urine, however. Addition of only 0.5 per cent human urine gave a reproducible decrease and when 10 per cent human urine was added to the synthetic urine the precipitation of calcium phosphate was reduced by 50 per cent and that of struvite by 75 per cent. The results thus indicate that human urine contains components with the ability to reduce the urease-induced crystallization.

Adult↗
PubMed1982

Opsonic effect of normal and infected human urine on phagocytosis of Escherichia coli and yeasts by neutrophils.

The opsonic effect of urine from normal adults and patients with acute cystitis on phagocytosis of yeast and E. coli by purified human neutrophils was investigated. Urine with an osmotic pressure between 200 and 500 mOsm./kg. was the most effective as an opsonic buffer in either phagocytosis of yeast or E. coli by PMN. However, those with an osmotic pressure greater than 500 mOsm./kg. or less than 200 mOsm./kg. were rather suppressive to phagocytosis by PMN. Patient's urine exhibited a more potent opsonic effect on phagocytosis of either bacteria when compared with that of normal urine with a similar osmotic pressure. Heat inactivation gave no effect on the potent opsonic activity of patient's urine, suggesting that complement may not be working in these phagocytosis systems or that the test urine may originally contain no complement. However, immunoelectrophoretic survey of test urine and addition of serum proteins into the urine suggest the possibility that certain serum derived urine proteins other than complement may play an opsonic role in phagocytosis by PMN in the patient's urine, although the factors have not been determined.

Complement System Proteins↗
PubMed1980

Observations on the growth of urethral and vaginal bacteria in sterile urine.

Voided, midstream urine specimens from 127 patients and volunteers with sterile bladder urine were incubated for 24 hours to measure the presence or absence of inhibitory activity in urine to small numbers (100 or less bacteria per milliliter) of contaminating Enterobacteriaceae (Escherichia coli, Proteus, Klebsiella), enterococci and several species of the normal perineal flora. Virtually no inhibitory activity was found for Enterobacteriaceae, enterococci or Staphylococcus epidermidis when measured by substantial growth at 24 hours. Of the 32 patients with 100 or less Enterobacteriaceae per milliliter urine before incubation, 30 urine specimens had growth of 10(5) bacteria per milliliter or more of the same organism; 9 of 30 specimens began growth at less than 10 Enterobacteriaceae per milliliter urine. The 39 urine specimens containing 10(4) or more enterococci or Staphylococcus epidermidis after 24 hours of incubation began with original inocula of 100 bacteria per milliliter or less; 28 of 39 began growth at less than 10 bacteria per milliliter. Growth rates of pure strains inoculated into sterile, filtered urine (strains derived from from the same individual as the urine in which they were inoculated) showed significant differences in bacterial growth at 4 to 6 hours after incuation; Escherichia coli and enterococci generated 10 to 100 times more colonies than strains from the normal perineal flora (lactobacilli, corynebacteria and so forth). We conclude that normal urine is non-inhibitory to small inocula of Enterobacteriacea and enterococci but that it is not as conducive to growth for some of the indigent, resident flora, perhaps explaining the relative infrequency of urinary infections owing to normal, perineal bacteria.

Enterobacteriaceae↗