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From 1973 to 1978 in 2.6% out of 244 female students and in none out of 160 male students a significant persisting bacteriuria was proved. By the slight rate of falsely positive findings could be demonstrated that the midstream technique gives evident results when persons able to cooperate are sufficiently instructed.
Mid stream specimens of urine that showed pyuria or bacteriuria on direct microscopy and no bacterial growth on initial routine culture were collected from 346 patients. These specimens were cultured for the presence of fastidious organisms using two different test systems. One system used non selective media and the other used selective media. Any fastidious organism isolated was identified by standard methods. Lactobacilli were the only fastidious organisms isolated in significant numbers. Using comparable test systems, equivalent numbers of Lactobacilli were isolated from both test and control group and because of the difficulty in specimen collection, these are to be considered as possible contaminants.
Of 500 asymptomatic adolescent girls who were screened for bacteriuria by three methods-dipslide (Uricult), dipstrip (Microstix-3 reagent strips), and home nitrite test (Microstix-Nitrite reagent strips)-eight cases (1.6%) were detected: 6/8 by dipslide and dipstrip; 5/8 by nitrite testing. The false-positive-rate (greater than 10(4) colonies/ml) of the dipslide test was 6.4%, and the dipstrip test, 2.8%. A history of vaginal discharge was not associated with "contaminated" specimens. False-positive nitrite tests were reported by 0.6% of the patients who returned the postcards. Overall, 70.4% of the patients returned the postcards for the home nitrite test. The patients were divided by method of payment (Medicaid vs non-Medicaid) in order to provide an approximation of socioeconomic status; non-Medicaid patients were significantly more likely to return postcards than Medicaid patients (75.8% vs 63.7%). Of the group reporting previous urinary tract infection, 79% of both Medicaid and non-Medicaid patients returned postcards, suggesting that a prior experience with the diagnosis increased compliance with a home test.
Home urine culture in dipslide was performed in 297 preschool girls. Results correlated well with those of cultures at the medical office, specially if midstream urine was used. This method proved to be an inexpensive, reliable (100% sensitivity) technique for detecting significant bacteriuria in preschool girls. False-positive tests occurred in 22 cases.
Eight hundred eighty five samples of urine sent for culture were examined at the same time with BDD Ortho. In a smaller amount (348) of these samples a microscopic examination of urine sediment was also carried out. Results obtained allow the authors to state that BDD is a good instrument for the screening of bacteriurias.
During different periods in 1976 and 1977 the bacteria of hospitalized patients were selected at random in significant bacteriuria. The species determination was carried out exactly and the susceptibility to beta-lactam-and aminoglycoside antibiotics was investigated using the quantitative tube dilution test. The bacterial spectrum of 941 isolated strains is shown in Table I. E. coli was found in 50% only. The spectrum of bacteria is different in the various hospitals, caused by regional phenomenons of nosocomial infections (Table II). The sex distribution (Table III) shows that mostly E. coli and Strept. faecalis are isolated from women, and Klebsiella sp. from men. The difference is significant. May be there exists a sex specificity for some bacteria. The sensitivity tests include the antibiotics Ampicillin, Carbenicillin, Ticarcillin, Mezlocillin, Azlocillin, Cefalotin, Cefamandole, Cefazolin, Gentamicin, Tobramycin and Amikazin (Table IV). Different sensitivity patterns could be established because of the exact species determination.
The results from the uroculture with those from Griess and Csokonay are compared in 1030 subjects and those from the TTC test in 767. Significant bacteriuria was found in only 73.33% of the cases with positive results from Griess tests, 46.51% from the Csokonay test and in 64.91% from the TTC test. Griess test appeared to be most suitable the conduction of wide epidemiological investigations as a screening method.
Results of a comparative study for the detection of significant bacteriuria (greater than 10(5)/ml) under routine conditions in 300 urine samples were reported. The urine specimens were obtained from patients of different clinical departments of our university hospital. Only midstream urines were investigated. The results from ATP determination with bioluminescence, quantitative determination of colony forming units and a semiquantitative method with standard loop were compared. The obtained data with different methods show a good correlation. Only four cases (1.3 per cent) were classified false negative and 10 urines (3.3 per cent) false positive with the bioluminescence method. In contrast to the conventional methods the results from bioluminescence assay can be obtained within 30 min.
A streep test has been employed for bacteriuria involving identification of nitrites in the urine and results are compared with those obtained with classical bacteriological techniques. Parallel performance of the nitrite test and urine culture showed that the latter cannot be replaced as far as diagnosis goes but it also proved the usefulness of the nitrite test for mass screening purposes.
Particle size distribution analysis (PSDA) was evaluated as a rapid screening method for detecting significant bacteriuria by linking a C1000 Channelyzer to a Coulter Counter. Colony counts and PSDA screening results were compared for 800 urine specimens. The PSDA method proved to be 92% specific, but only 64% sensitive, for detecting at least 10(5) colony forming units (CFU)/ml. By performing serial dilution colony counts on 109 culture-positive specimens (greater than or equal to 10(5) CFU/ml), it was determined that the low level of sensitivity (64%) was due to culture-positive specimens that had between 10(5) and less than 10(7) CFU/ml. The sensitivity of the PSDA method increased to 90% and 100% when culture-positive specimens had 10(7) or more and 10(8) or more CFU/ml, respectively. The low level of sensitivity demonstrated in this investigation makes the introduction of this method into clinical usage unacceptable at this time.
A total of 1299 urine samples from kidney-transplant patients were tested for bacteriuria using the electrochemical rapid procedure. For germ counts of more than 10(5)/ml the registration rate was 97.6% after incubation for 1 hour and 100% after 2 h, providing the patients were not under the influence of antibiotics at the time of examination. Bacteria inhibitors in the urine delayed the reaction so that an incubation period of 2-3 hours was necessary. The electrochemical rapid procedure proved to be unsuitable in cases where small quantities of germs are expected to be discharged.
The aim of this study is to check the clinical relevance of a new cultural method for the detection of urinary tract infection especially in urine samples containing residue of antimicrobial agents. The new procedure concerns a urine collecting and cultivating cup (UCCC Biotest Serum Institute), containing a recovery agar (RA5) with incorporated chemotherapeutica antagonists. The efficiency of the UCCC is compared with the familiar dip slide coated with cystein lactose electrolyte deficient (CLED) agar and MacConkey agar. A collective of 305 children is considered in this study. The investigation was carried out before starting, three to five days after starting and three to five days after stopping the chemotherapy. The highest correlation between the microbial count in urine samples and the whole clinical diagnosis was achieved with RA5. The lowest correlation was attained with MacConkey agar. With CLED agar a good correlation was determined before starting therapy, a modest correlation during therapy and very good correlation after stopping therapy. Regarding relapses and reinfections the detection quote of relevant bacteriuria during therapy amounted to 90% as RA5 was used, 62% with CLED agar and 34,5% with MacConkey. RA5 proved very useful for follow-up purposes, especially during treatment with antimicrobial agents and may be considered as a susceptibility testing in vivo.
Data from serial follow-up evaluations of 103 patients with traumatic or atraumatic myelopathy were recorded to determine rates significant bacteriuria in groups using different antimicrobial suppressive regimens or no pharmacologic agents. Rates of urinary tract infection were compared in patient taking methenamine salts with urinary acidifiers, co-trimoxazole, or no drug. At all follow-up period rates of infection were consistently lower in the groups taking methenamine and co-trimoxazole than in the group not taking a drug, the group taking co-trimoxazole having the lowest rates. These results suggest that the long-term use of antimicrobial suppressants can help reduce rates of urinary tract infection in bladder-retrained patients and in patients emptying by intermittent self-catheterization.
In an 8-year period, 16 cases of parturitional septicemia due to the Enterobacteriaceae in the immediate postpartum period were identified that were not due to pyelonephritis. Fourteen of the 16 patients had more than 100,000 colonies per milliliter of urine of the same member of the Enterobacteriaceae as was present in the blood. Twelve of the 16 patients had concomitant endometrial cultures. In 11 patients the same isolate was recovered from urine and endometrium as had been recovered from the intravascular compartment. The data suggest an etiologic relationship between asymptomatic bacteriuria and septicemia due to the Enterobacteriaceae in which the maternal implantation site affords the principal portal of infection.
The incidence of significant asymptomatic bacteriuria was found in 8,14 per cent of 614 nonselected pregnant women's. The method of taking the "clean" middle stream urine is well accepted and valid one, but in some cases it is useful to do the suprapubic puncture of urinary bladder in order to avoid the contamination of urine. It is discussed about the incidence, aetiology, pathogenesis and prevention of urinary infection in pregnancy.
A screening method for the rapid detection of bacteriuria through a combination of filtration and staining has been evaluated. 307 urine samples have been tested with both the regular colony enumeration on culture media and the rapid method. Taking 10(5) CFU/ml as a cut-off, the agreement was reached for 279 (90.9%) samples, 65 (21.2%) of which positive and 214 (69.7%) negative. Only 4 (1.3%) false negative and 24 (7.8%) false positive were obtained; false positive (whose real significance is further discussed) anyhow can be corrected after cultural confirmation. If the cut-off is lowered to 10(4) CFU/ml the frequency of agreements is slightly less (88.6%). From the operational side, the method is unsensitive to the antimicrobial content of the urines, and appears easy to apply and quite rapid: a sample needs not longer than 2 minutes to be processed.
In the period from 1974 to 1976 3465 deliveries were performed in the "Landesfrauenklinik". During pregnancies there were started 10,7% urological and nephrological complications with the asymptomatic bacteriuria were predominating at a rate of 6,1%. --Considering the high rate of chronic complications in all types of urinary tract infections, long-term dispensary care should be postulated.
After description of the highly effective, cheap and independent of consumption material rapid electrochemical method for the proof of significant bacteriurias the author enters some detail problems which seem worth to be taken into consideration when using this test method. The result is a sensitivity of the method of 92.3% and a specificity of 96.2%. The experimental conditions may still be simplified for screening examinations.