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PubMed1990

Fosfomycin trometamol versus pipemidic acid in the treatment of bacteriuria in pregnancy.

The Italian multihospital study of bacteriuria in pregnancy randomized 153 pregnant bacteriuric patients to receive fosfomycin trometamol (FT) as a single dose of 3 g and 138 such patients to receive conventional therapy with pipemidic acid (PA), 400 mg b.i.d. for seven days. The two groups were well matched for age, parity, pregnancy course, symptoms and past history of cystitis. Infecting organisms were eradicated in 147 (96%) of FT and 129 (94%) of PA patients. Similar recurrence rates occurred. Minimal side effects (mostly nausea and dyspepsia) occurred (9%) FT; 15% PA). Single-dose FT appeared equivalent to conventional treatment with PA.

Adult↗
PubMed1996

Persistent bacteriuria caused by uropathogenic Escherichia coli.

The predominant strain of Escherichia coli, the most frequently associated causative agent of urinary tract infections (UTI), in the rectal flora of patients with UTI has been reported to match the strain associated with the etiologic agent of UTI. Since acquisition of UTI may depend on the immediate surrounding flora of the patient, the chromosomal DNAs of strains of E. coli isolated from 3 patients suffering from recurrent cystitis and asymptomatic bacteriuria were examined by multiple polymerase chain reaction using 6 sets of primers for all the known urovirulence factors and by pulsed-filed gel electrophoresis. Genetically identical or similar strains were continuously isolated from these patients and each strain carried the identical urovirulence factors. The findings strongly supported the previous notion that the acquisition of UTI is dependent upon the occurrence of the strain carrying the urovirulence factors in patients or in the environment.

Adult↗
PubMed1975

A ten-year survey of bacteriuria in the Osaka university hospital.

10 consecutive years of observation of the laboratory data of quantitative urinary bacterial culture in the Central Clinical Laboratory of Osaka University Hospital was made. The marked rise of Pseudomonas and other Enterobacteriaceae was clearly demonstrated. The difference in bacterial species in bacteriuria between inpatients and outpatients strongly suggests that the origin of infection was quite different. The disappearance of Staph. aureus as a causative agent was also demonstrated.

Bacteriuria↗
PubMed1975

Cephalexin in the management of bacteriuria.

This report evaluates the effectiveness of cephalexin in the treatment of bacteriuria in 93 children. Cephalexin therapy eradicated sensitive organisms in 97 per cent of the cases regardless of recurrence, structural abnormality, or status of renal function. Nevertheless, recurrences with a new, resistant organism occurred significantly in certain patients, expecially those with major anatomic abnormalities, during a six-week follow-up period. The incidence of drug reactions was low.

Adolescent↗
PubMed1990

Comparison of urine dipstick, microscopy, and culture for the detection of bacteriuria in children.

The authors compared dipstick tests for leukocyte esterase and nitrite and microscopic examination of urinary sediment with urine culture to assess whether the former tests could reliably rule out bacteriuria in specimens from children. The authors studied urine specimens from 1010 infants and children younger than age 18. Compared with culture at greater than or equal to 10(5) colony forming units (cfu)/ml, the sensitivities of leukocyte esterase, nitrite, and microscopic examination of white blood cells (greater than or equal to 5 wbc/hpf) or bacteria (in at least moderate numbers) were 76 percent, 29 percent, 82 percent, and 80 percent, respectively. The specificities of the same tests were 81 percent, 99 percent, 81 percent, and 83 percent, respectively. Compared with culture at greater than or equal to 10(4) cfu/ml, the sensitivities of the tests were 64 percent, 21 percent, 64 percent, and 59 percent; the specificities were 82 percent, 99 percent, 81 percent, and 83 percent, respectively. The negative predictive values of leukocyte esterase and microscopic examinations of urinary sediment for white blood cells and bacteria were all 95 percent (greater than or equal to 10(4) cfu/ml) or 98 percent (greater than or equal to 10(5) cfu/ml). The authors conclude that the leukocyte esterase test is as accurate as sediment microscopy in identifying urine specimens from infants and children harboring less than 10(4) or less than 10(5) cfu/ml.

Adolescent↗
PubMed1982

Long-term, low-dose treatment with pivmecillinam alone and in combination with pivampicillin in patients prone to recurrent bacteriuria.

The results of three separate studies aimed at evaluating the efficacy of long-term, low-dose treatment with pivmecillinam alone, and in combination with pivampicillin, in patients prone to recurrent bacteriuria, are presented. Overall, pivmecillinam and pivmecillinam/pivampicillin appeared to be equally effective, both clinically and bacteriologically, in a group of elderly subjects treated for 6 months. Pivmecillinam was also used successfully for up to 1 year in 10 out of 12 children in whom prophylactic therapy was indicated. The various regimens employed were without any significant toxic effects and were well tolerated.

Aged↗
PubMed2005

Asymptomatic bacteriuria in elderly patients: significance and implications for treatment.

Asymptomatic bacteriuria (ASB) is frequent in elderly patients and even more prevalent in residents of long-term care facilities. Furthermore, because more and more people are reaching advanced age and the need for care increases with age, ASB is becoming increasingly important. There are several definitions for ASB, all of which require positive urine cultures and place little or no importance on accompanying pyuria. Most ASB is associated with complicating factors, as might be found in complicated urinary tract infections (UTIs). Thus, the bacterial spectrum associated with ASB is comparable to that seen in complicated UTIs. A variety of complicating factors are more frequently found in elderly patients with ASB, such as hormonal factors (e.g. estrogen decrease), certain anatomical factors (e.g. prostate obstruction), metabolic factors (e.g. diabetes mellitus), functional alteration of the urinary bladder, immunological changes and a high rate of indwelling-catheter use. Screening for ASB in elderly people is limited to those undergoing invasive urological procedures and surgical procedures with implant material. In other situations, examination of the urine is not recommended if signs or symptoms in the urinary tract are absent. Treatment of ASB is recommended only before urological procedures. Pyuria accompanying ASB is not an indication for antimicrobial treatment. If antimicrobial treatment is considered, concomitant factors that occur frequently in elderly people, such as renal insufficiency, must be taken into account. Although ASB is apparently a benign condition, prevention in elderly people is important. The degree of pathogenicity of bacteria causing ASB has not yet been satisfactorily elucidated. Therefore, until the implications of the bacteria involved in ASB are fully understood, implementing the same hygienic precautions as are used in individuals with symptomatic UTIs should at least be undertaken.

Aged↗
PubMed1987

The long-term prognosis of bacteriuria in pregnancy. A 16 to 17 year follow-up study.

An investigation made in 1966-67 of 2,122 pregnant women revealed 182 (8.6%) with significant asymptomatic bacteriuria, of whom 127 could be located in 1983. In 182 non-bacteriuric controls from the same investigation 105 could be located. Eight bacteriuric and 1 non-bacteriuric patient had died, all from causes of death unrelated to urinary tract infections. Data were collected by questionnaires, together with a urine specimen from approximately 73% of the survivors. No differences could be found between the initial bacteriuric and non-bacteriuric group concerning the number and complications of later pregnancies, urinary tract infections requiring hospitalization, or recognized arterial hypertension. In 1983, more of the initially bacteriuric women had experienced urinary tract infections not demanding hospitalization and more were bacteriuric (greater than or equal to 10(5) col/ml), compared with the controls: 36.5% and 28.8%, respectively. These high rates probably indicate some contamination due to self-sampling. B. anitratum was a new bacteria emerging, compared with the original study.

Bacteriuria↗
PubMed1978

Persistent bacteriuria in the rat after reflux challenge with Pseudomonas aeruginosa.

An experiment based upon reflux of culture suspensions of Pseudomonas aeruginosa into the rat kidney was set up to examine possible factors of importance in the development of ascending renal infection. We monitored the persistence of challenge bacteria in the rat urinary tract by quantitative culture of urine collected by spontaneous micturition, despite heavy contamination with commensal microflora. In most animals challenged, pseudomonads gave rise to bacteriuria of only limited duration. During bacterial persistence in urine, colony counts fluctuated widely from day to day.

Animals↗
PubMed1981

The association of bacteriuria and reduced serum pyridoxal concentrations in patients with diabetes mellitus.

Of 1017 patients admitted to the Royal Perth Hospital Diabetic Survey 142 were found to have significant bacteriuria. In these bacteriuric patients serum pyridoxal concentrations were significantly reduced (P = less than 0.001) when compared with 142 diabetic patients matched for age (+/- 5 years) and sex but without infection of the urinary tract. Measurements were repeated up to 6 mth after antibacterial treatment and serum pyridoxal concentrations were still low. Pyridoxal has a role in immunological competence, and it is possible that the increased incidence of urinary tract infection in patients with diabetes reflects impaired immunological competence due to pyridoxal deficiency.

Bacteria↗
PubMed1989

Norfloxacin versus trimethoprim-sulfamethoxazole. A study in patients with known bacteriuria undergoing transurethral resection of the prostate.

Three hundred and forty-three patients with suspected bacteriuria undergoing transurethral resection of the prostate (TUR-P) were randomized to treatment with either trimethoprim-sulfamethoxazole (TMP-SMX) or norfloxacin (NF) for 5 1/2 days beginning the evening prior to operation. It was possible to analyse 165 patients for efficacy. Elimination of bacteria on days 10 to 20 was achieved in 78.1% and 78.3% in the TMP-SMX and NF group, respectively. The accumulated elimination rates for the follow up period (days 10-42) were 68.5% for the TMP-SMX group and 76.2% for the NF group. The differences were not statistically significant. No patient had any clinical signs of upper urinary tract infection or septicemia. Three hundred and twelve patients were analysed for safety. Twenty-six patients reported 32 adverse drug events (ADEs). Four reactions in the TMP-SMX group were considered severe while in the NF group all the ADEs were of mild or moderate intensity. In this study NF seems to be at least as effective and safe as TMP-SMX.

Aged↗
PubMed1987

Evaluation of a new commercial kit (UROBACT) for detection of bacteriuria.

A new commercially available method (UROBACT, AB Dermaci, Sweden) for detection of bacteriuria was compared to a conventional semiquantitative bacteriological method. The kit consisted of two tubes, which were inoculated with urine in two different dilutions. Positive tests were recorded as a colour change from red to yellow in both tubes, and the test was considered negative if one or both tubes remained red. When studying 556 urine samples, the test detected 153 of 163 samples with greater than or equal to 10(5) colony forming units (CFU) of bacteria per ml, i.e. the sensitivity was 93.9%. Among the samples containing less than 10(5) CFU/ml, 347 of 357 were recorded as negative, giving a specificity of 97.2%. Although relatively few urine samples containing Staphylococcus saprophyticus and Pseudomonas pyoceanea were tested the results indicated that the method was less reliable for these species. However, compared to dip-slides, which also give poor results with S. saprophyticus, the new test has several advantages, including a more simple interpretation, i.e. a distinct colour change.

Bacteriological Techniques↗
PubMed1979

Comparison of pivmecillinam and cephradine in bacteriuria in pregnancy and in acute urinary tract infection.

48 non-pregnant domiciliary patients referred by general practitioners and 50 pregnant women were treated for bacteriuria with either 500 mg cephradine or 400 mg pivmecillinam every 6 h for 7 days. In the pregnant women, cure rates were over 90% after 2 weeks for both compounds, and after 6 weeks were 86% for cephradine and 78% for pivmecillinam. Cure rates in the non-pregnant were 83% for cephradine and 95% for pivmecillinam at 6 weeks. Seven patients (3 given cephradine, 4 given pivmecillinam) stopped treatment due to side-effects. Overall, side-effects (many of which were trivial) were more common in patients treated with cephradine (51%) than in those receiving pivmecillinam (33%). It is concluded that both drugs are highly effective in these two common types of urinary infection.

Adult↗
PubMed1983

Effect of a three-day course of nalidixic acid in the frequency-dysuria syndrome with significant bacteriuria in women.

The effect of a 3-day course of nalidixic acid was studied in 82 women, presenting with the dysuria-frequency syndrome and significant bacteriuria, mostly Escherichia coli sensitive to nalidixic acid. 62/76 patients (82%) that could be evaluated about 1 week after initiation of therapy were subjectively cured. Negative urinary cultures were found in 64/76 patients (84%). Two patients (2.4%) developed resistance to nalidixic acid. Bacteriological cure rate was 76% of 71 patients that could be controlled 1 month after the initiation of therapy. Nalidixic acid in the used granulate preparation initiated only mild side-effects.

Adolescent↗
PubMed2006

Three-year follow-up of an outbreak of Serratia marcescens bacteriuria in a neurosurgical intensive care unit.

We report on the investigations and interventions conducted to contain an extended outbreak of Serratia marcescens bacteriuria that lasted for years in a neurosurgical intensive care unit (NSICU). A case-control study was performed to identify the risk factors for S. marcescens acquisition in urine. In case patients, urine sampling for tests and central venous catheterization were performed more frequently before the isolation of S. marcescens. Case patients were more frequently prescribed third-generation cephalosporins. Adherence to hand antisepsis was encouraged through in-service educational meetings and infection control measures, especially concerning the manipulation of indwelling urinary catheters, were intensified. The outbreak persisted despite the reinforcement of infection control measures. However, no patient has newly acquired the organism in the NSICU since December 2004. Multiple factors, including inadequate infection control practices and inappropriate antimicrobial usage, possibly contributed to the persistence of this S. marcescens outbreak. Healthcare workers should consistently follow infection control policies to ensure quality care.

Bacteriuria↗
PubMedDate not supplied

Nosocomial significant bacteriuria: prevalence and pattern of bacterial pathogens among children hospitalised for non-infective urinary tract disorders.

This study was undertaken to determine the prevalence of nosocomial significant bacteriuria (NSB) and pattern of bacterial pathogens among children hospitalised for non-infective urinary rtract disorders (NUTDs) namely, acute glomerulonephritis, nephrotic syndrome, renal failure and congenital urinary tract anormalies in our nephrology unit. Serial midstream or suprapubic puncture urine specimens were collected into sterile plastic universal bottles from the patients for microscopy, culture and sensitivity, using the standard laboratory methods. Seventeen of the 96 patients admitted for NUTDs were excluded from the study based on the set exclusion criteria; only 19 out of the 79 patients studied were found to have NSB giving a prevalence rate of 24.05%. The isolated pathogens included Klebsiella spp. (47.37%). Staphylococcus aureus (31.58%). Escherichia coli (10.53%), Pseudomonas spp. (5.26%) and Citobacter spp. (5.26%). While 78.95% and 69.23% of the isolates were sensitive to gentamicin and cefuroxime respectively, 57.9% were sensitive to ceftazidime and nitrofurantoin. Less than 50% of the isolates were sensitive to each of the other antibiotics tested. Five of the patients died giving a case fatality rate of 26.3%. In this study, NSB is evidently a very common health problem and a significant risk factor for mortality in patients with NUTDs. Weekly urine culture is recommended in any hospitalised child with NUTD in order to diagnose and manage NSB early before clinical deterioration sets in.

Adolescent↗
PubMed1976

[Bacteriuria detection by dip-slide test (author's transl)].

A new dip-inoculum method markated as Microstix for detecting bacteriuria was studied to evaluate its usefulness as a screening procedure. This test was found to be reliable when compared with the standard pour plate method. However, antimicrobial agents often present in the urine samples rendered this procedure unsuitable for indiscriminate application in large hospital laboratories. This technique might conceivably be employed in mass screening programs where urine specimens are less likely contamined by antimicrobial drugs.

Bacteriuria↗