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PubMed2005

Asymptomatic bacteriuria in men with orthotopic ileal neobladders: possible relationship to nocturnal enuresis.

OBJECTIVE: To assess prospectively the incidence with time of asymptomatic bacteriuria in patients with orthotopic ileal neobladders, and the possible effect on neobladder function. PATIENTS AND METHODS: In all, 47 patients (mean age 52.7 years, sd 8.7, range 31-68) with uncomplicated orthotopic ileal neobladders were prospectively evaluated. With no antibiotic manipulation, consecutive urine cultures were assessed monthly. Continence was assessed by direct information from the patients at each follow-up visit. RESULTS: Overall, 797 samples were cultured from the 47 patients (mean 17.6, sd 7.1). There was a steady decrease in the incidence of positive cultures, from 74.5%, to 35.6% and 6.7% at 1, 6 and 18 months, respectively. While there was persistently sterile urine in only eight patients (17%), 32 had occasional and seven had persistent bacteriuria. Escherichia coli was the commonest organism (76.6%) followed by Klebsiella pneumonia (15.7%); 54% of E. coli and 38% of K. pneumonia infections were sensitive to nitrofurantoin. Diurnal continence was achieved in 98% of the patients at 6 months after surgery. There was a gradual decrease in the frequency of nocturnal enuresis (NE) with time, from 87%, to 42%, 28% and 27% at 1, 6, 12 and 18 months, respectively. There was a significant correlation between the presence of bacteriuria and NE during the first 6 months, but it was not sustained after that. The age of the patients was also related significantly to the incidence of NE; at 6 months, only one of 18 men aged < or = 50 years had NE, while 19 of 29 aged > 50 years had (P < 0.001). At 1 year all patients aged < or = 50 years were nocturnally continent, while half of those aged > 50 years had NE (P = 0.001). CONCLUSIONS: Ileal neobladders are associated with a high incidence of asymptomatic bacteriuria during the first year after surgery. There was spontaneous clearance of bacteriuria with time, with no antimicrobial manipulation. Soon after surgery there was a significant association between bacteriuria and NE. The effect of antimicrobials on patients with NE should be evaluated.

Adult↗
PubMed1982

Bacteriuria in patients undergoing prostatectomy.

A review of the literature revealed that the reported incidence of bacteriuria arising before and after prostatectomy varied considerably, that there had been little investigation of the organisms isolated, and that the value of chemoprophylaxis at the time of prostatectomy was unproven. Using standard criteria and technical procedures, 248 patients undergoing prostatectomy were studied over a two-and-a-half-year period. Preoperative bacteriuria occurred in 28% of patients. The incidence was significantly increased in patients catheterised before operation (44%) compared with those who had not been catheterised (18%). The incidence of bacteriuria was directly related to the duration of catheter drainage. Postoperatively, 40% of patients with sterile urine at the time of prostatectomy developed bacteriuria. There was an increased prevalence of Enterococcus and coagulase-negative Staphylococcus isolates from postprostatectomy bacteriuria compared with preprostatectomy bacteriuria. Based on this information, suggestions can be made regarding the choice of a suitable chemoprophylactic agent and the optimum timing and duration of its administration.

Anti-Bacterial Agents↗
PubMed1996

Urinary symptoms, sexual intercourse and significant bacteriuria in male patients attending STD clinics.

OBJECTIVE: To assess the relationship between sexual behaviour, urinary symptoms, urinalysis and bacteriuria in men attending STD clinics. DESIGN: A prospective study recording sexual behaviour, urinary symptoms and collecting mid-stream urine specimens. SETTING: Two West Midlands STD clinics, UK. SUBJECTS: 1086 new male patients. RESULTS: 704 patients had had sexual intercourse (SI) within 14 days of testing, 424 had urinary symptoms and 122 had pyuria. All 13 patients with positive culture had SI < 14 days before testing, urinary symptoms and pyuria. No association was found between sexual orientation, type of SI, number of sexual partners, condom usage and bacteriuria. CONCLUSION: Bacteriuria does not behave as an STD but SI may be a factor in acquiring bacteriuria. Dysuria with or without urethral discharge is the most predictive symptom of bacteriuria. Pyuria has a high sensitivity for predicting bacteriuria among males.

Adolescent↗
PubMed1998

[Asymptomatic bacteriuria in women diagnosed with systemic lupus erythematosus (SLE)].

The aims of our research were: estimation of asymptomatic bacteriuria (a.b.) incidence in population of women with systemic lupus erythematodes (SLE), evaluation its clinical significance and examination of bacterial colonisation of nostrils and pharynx in SLE patients with a.b. 85 women aged 24-77 (mean 49.3) with mean SLE duration 7.8 (range 1-32) years were examined. All of them fulfilled ARA criteria for the classification of SLE. Among group of patients with a.b. were counted women who had significant bacteriuria > or = 10(4) in ml urine in two cultures. Asymptomatic bacteriuria was found in 14 cases of 85 women with SLE (16.5%). In two following urine cultures bacteria from family Enterobacteriaceae were dominated: the same types of bacteria were in 85.7%--bacteriuria persistens, in others 14.3% were observed change of bacteria--bacteriuria transistens. In 9 from 14 patients with (64.3%) a.b. very massive growth of Staphylococcus aureus in culture from vestibulae of the nose swab was, in other cultures very massive growth of physiological flora was seen. All patients with a.b. were in clinical remission of SLE and they had no clinical symptoms of infection in urinary tract in 5 months of observation. However clinical significance of asymptomatic bacteriuria and pathogenic bacteria colonisation of nostrils as a precedence to symptomatic infections needs further investigations.

Adult↗
PubMedDate not supplied

Bacteriuria in the elderly population in a developing country.

Among 1470 elderly hospitalized and nonhospitalized people, 566 cases of bacteriuria were identified. There were 663 men (41.5% with bacteriuria) and 807 women (36.0% with bacteriuria). The overall prevalence of bacteriuria was 38.5%. More than 90% of the isolates were gram-negative organisms with Proteus species being the predominant pathogen among men, with 68.1% seen among inpatients. Escherichia coli was the main pathogen in women, with 62.0% recovered from inpatients. Catheterization was seen most commonly among non-hospitalized males with outflow obstruction. Catheter care in this population is often performed at home by these men who either refuse prostate surgery, are not fit for surgery, or are awaiting surgery. Polymicrobic bacteriuria was identified more frequently (approximately 60%) among the catheterized group. Of the 440 gram-negative bacilli recovered as single organisms, 352 (80.0%) were resistant to ampicillin, cephalothin, and tetracycline, whereas 229 (52.0%) were resistant to co-trimoxazole. The most effective antibiotics (in increasing order of sensitivity; 80% - 100%) were augmentin, nalidixic acid, cefuroxime, gentomicin, and ciprofloxacin. No mortality due to bacteremia complicated by bacteriuria was observed during the study period.

Aged↗
PubMed2003

Significant asymptomatic bacteriuria among Nigerian type 2 diabetics.

Significant asymptomatic bacteriuria is a risk factor for symptomatic urinary infection and septicemia among predisposed individuals such as diabetics. We investigated the pattern of asymptomatic bacteriuria among our type 2 diabetics with a view to documenting the prevalence, type of organisms responsible and the antibiotic susceptibility pattern. One hundred and twenty-four type 2 Nigerian diabetics (55 males and 69 females) submitted midstream urine specimens for culture. Thirty-three patients had significant bacteriuria (9 males and 24 females), showing the frequency of occurrence of asymptomatic bacteriuria to be 26.6%. The most common organism isolated was Klebsiella pneumonia at 42.4%. Gram-negative bacilli made up about 23 (69.7%) of the isolates. Isolates were poorly sensitive to the readily available antibiotics (ampicillin, tetracycline and cotrimoxazole), but a large number of the organisms isolated were sensitive to nitrofurantoin, gentamicin, ciprofloxacin and ofloxacin. Sensitivity to erythromycin, nalidixic acid and cefuroxime was moderate. Asymptomatic bacteriuria is, thus, more prevalent among the Nigerian diabetic population than in the non-diabetics. A changing pattern of disease is observed with Klebsiella sp. now accounting for the majority of asymptomatic bacteriuria among diabetics. The organisms are not sensitive to the commonly available antibacterial agents.

Anti-Bacterial Agents↗
PubMed2005

High prevalence of bacteriuria in pregnancy and its screening methods in north India.

The study aims at finding out the prevalence of bacteruria in pregnancy in an urban setting and ascertaining methods to screen them in primary care clinics. A total of 1 61 pregnant ladies visiting a primary care clinic were screened for bacteriuria based on the symptomatology. Urine culture was done to know the prevalence of bacteriuria. Sensitivities and specificities were calculated for each symptom and risk assessment. A score card was developed based on combination of positive risk assessment and constellation of symptoms. Prevalence of symptomatic and asymptomatic bacteriuria was found to be 19.87% and 4.34% respectively. Prevalence of bacteriuria was significantly high among those who had intercourse more frequently and those with less water intake. Those with a score of more than or equal to 4, as per score card were 60% more likely to suffer from bacteriuria. When combined with microscopic examination for leucocytes on positively screened, the positive predictive value was found to be 89%. It is concluded that prevalence of symptomatic bacteriuria is common among pregnant women. Syndromic management of cases on the basis of score card is helpful in resource constraint areas. This may be combined with microscopic examination of urine to entail rational use of antibiotics.

Adolescent↗
PubMed2005

Evaluation and importance of asymptomatic bacteriuria in pregnancy.

OBJECTIVES: This study was undertaken to determine the incidence of asymptomatic bacteriuria (ASB) during pregnancy and its prevalance in the three trimesters. SUBJECTS AND METHODS: One hundred and ten pregnant women in their first trimester attending the antenatal outpatient clinic with no urinary tract complaints were included in the study. After perineal cleaning, urine samples were obtained from all patients for culture and microscopic evaluation. Approximately 1 ml urine was sampled using the mid-stream catch technique. Patients with bacterial counts over 100,000 with the mid-stream catch technique were considered to have asymptomatic bacteriuria. Patients fulfilling the criteria for bacteriuria were treated with either penicillin or cephalosporine for one week, depending on the in-vitro sensitivity test results. RESULTS: ASB rate in the study group was 8.1%. E. coli was isolated as the pathogenic organism in 77.77% of the cases with ASB. ASB was found to be more frequent in patients over age 25 and the average age of pregnant women with ASB was 29.89 +/- 5.80 (p < 0.05). Average duration of gestation in the group with ASB was 28.11 +/- 2.26 weeks. ASB rate in the group age 35 and over was 22.22% (p < 0.05). ASB was diagnosed in nine patients; one of these patients was in the first trimester, two were in the second trimester, and six in the third trimester. Clustering in the third trimester was found to be statistically significant (p < 0.05). CONCLUSION: ASB distribution in the first, second, and third trimesters was 0.9%, 1.83%, and 5.6%, respectively. There was a significant relationship between advanced maternal age and incidence of ASB. Women with no bacteriuria in their initial examination in the first trimester developed bacteriuria in the later trimesters. We, therefore, suggest that it would be prudent to screen pregnant women for bacteriuria in the second and third trimesters.

Adolescent↗
PubMed1990

[Asymptomatic bacteriuria in patients with diabetes mellitus].

The prevalence of asymptomatic bacteriuria and the relation of bacteriuria to pyuria, glycosuria and HbA1c in patients with diabetes mellitus were investigated. The study population included 110 diabetic patients and 100 healthy persons (control group). The ratio of bacteriuria was found as 25.5% (31.3% in women, 17.4% in men) in the diabetic group and as 9% (16% in women, 0% in men) in the control group. The prevalence of asymptomatic bacteriuria was significantly higher in the diabetic patients than in the control group (p less than 0.05). There was a significant relation between bacteriuria, pyuria and HbA1c levels (p less than 0.05). But, there wasn't any important correlation between bacteriuria and glycosuria.

Bacteriuria↗
PubMed1977

Significant bacteriuria among the mentally retarded. Identification and antibiotic sensitivity of isolates.

A study was carried out to determine the prevalence of significant bacteriuria in a mentally retarded population. With 100,000 or more bacteria per ml. of urine used as a criterion for significant bacteriuria, 24 of 665 persons studied were considered to have significant bacteriuria for an overall prevalence rate of 3.6%. Seventeen of the 24 positive urine cultures were either from clean catch or catheter specimens. All patients undergoing catheterization were found to have significant bacteriuria. The individual prevalence rates of significant bacteriuria for males and females were 1.7 and 5.6 respectively. In females, an increasing prevalence of bacteriuria was found primarily in the 55-64 age group. The predominant bacteria isolated from bacteriuric patients were gram-negative bacilli, Escherichia coli, being isolated in 50% of all positive cultures. Antiobiotic sensitivity patterns of the isolates indicated a high degree of in vitro resistance to both ampicillin and cephalothin.

Adolescent↗
PubMed1987

Therapy vs no therapy for bacteriuria in elderly ambulatory nonhospitalized women.

This prospective randomized study was undertaken to determine the efficacy of antimicrobial therapy compared with no therapy for bacteriuria in elderly ambulatory nonhospitalized women. Sixty-one women (mean age, 85.8 years) with bacteriuria were in the no therapy control group and 63 women (mean age, 85.8 years) with bacteriuria were in the therapy group; none had symptoms of urinary tract infection. One short course of antimicrobial therapy achieved a cure rate of 68.3% (43 of 63 women cured) two weeks after treatment. During the six-month follow-up period, ten (16.4%) of 61 women in the no therapy group and five (7.9%) of 63 women in the therapy group developed symptomatic urinary tract infection. At the time of six-month follow-up, 19 (34.5%) of 55 women in the no therapy group and 35 (63.6%) of 55 women in the therapy group did not have bacteriuria. We conclude that for asymptomatic bacteriuria in elderly ambulatory nonhospitalized women, short-course antimicrobial therapy is effective at two-week follow-up and that antimicrobial therapy can eliminate bacteriuria in most of these women for at least a six-month period.

Aged↗
PubMed1984

The significance of asymptomatic bacteriuria in patients undergoing hip/knee arthroplasty.

The urinary tract has received a great deal of attention as a possible source of infection following arthroplasty. The incidence and significance of asymptomatic bacteriuria in patients admitted for arthroplasty is obscure. The occurrence of bacteriuria was therefore analyzed retrospectively in 299 patients admitted for hip/knee arthroplasty to determine its incidence and relation to the age of the patient and the result of the operation. There was a high incidence of bacteriuria in patients 65 years of age or older and an abnormally high incidence of asymptomatic bacteriuria in younger patients of both sexes who were to undergo hip/knee arthroplasty. However, there was no correlation between bacteriuria and surgical infection in these patients. Bacteriuria is common in patients admitted to the hospital for arthroplasty and should not be considered a cause for postponement of surgical treatment in the absence of other signs of cystitis or pyelonephritis.

Age Factors↗
PubMed1981

A four-year follow-up of schoolgirls with untreated covert bacteriuria: bacteriological aspects.

In 75 schoolgirls aged 5-11 with untreated covert coliform bacteriuria who were followed up to 4 years, infection cleared in 16 (21%), cleared and recurred in 37 (50%) and persisted in 22 (29%). Clearance of bacteriuria was significantly (P less than .05) more frequent in girls with normal radiological findings than in those with abnormal findings. In 31 (59%) of the 53 girls in whom bacteriuria cleared spontaneously, the urine became sterile within the first year after the discovery of the bacteriuria. Spontaneous clearance of bacteriuria was preceded by an increase of the sensitivity of the urinary pathogens to the cidal effect of human serum. Seven (10%) of the 75 untreated bacteriuric girls had shown progression of kidney damage (progression of scarring in 4 and failure of kidney growth in 3). In all of these 7 girls vesico-ureteric reflux (VUR) was present and bacteriuria was persistent, but in 6 of them from one to three changes in the serotype of Esch. coli or bacterial species were noted during follow-up. These observations suggest that changes in bacterial flora may be a risk factor in the progression of kidney damage in girls with urinary tract infection and VUR.

Bacteriuria↗
PubMed1980

Bacteriuria in a population sample of women. Prevalence, characteristics, results of treatment, and prognosis.

The prevalence of bacteriuria was studied in a population sample of women aged 38-60. Significant (greater than or equal to 100 000 bacteria/ml of the same species in two consecutive specimens) or "probable" bacteriuria (greater than or equal to 100 000 in the first and 20 000-90 000 bacteria/ml of the same organism in the second specimen) were found in 5% of the women, increasing from 3.5% in women aged 38 to 8.6% in women aged 60. Escherichia coli predominated (90% of those with significant bacteriuria), and 91% of the Escherichia coli strains were sensitive to sulphonamides. About half of the women who were non-bacteriuric after short-term treatment had one or more recurrent urinary tract infections during a two-year follow-up period. Serum creatinine and urine concentrating capacity did not differentiate women with significant or "probable" bacteriuria from the others. Pathological radiological changes were found in 17% of bacteriuric women who were submitted to i.v. pyelography. When re-examined six years after the first study, 23% of initially bacteriuric and 5% of initially non-bacteriuric women had bacteriuria. Patients with renal lesions have been followed for ten years, but none of them has developed progressive renal impairment. Three women with chronic pyelonephritis and acute pyelonephritic attacks in the past were discovered when screening the concentrating capacity in this population sample, but they were non-bacteriuric when screening for bacteriuria. A study of this kind must be conducted over many years before valid conclusions can be drawn.

Adult↗
PubMed1993

[Bacteriuria in patients with primary biliary cirrhosis].

BACKGROUND: Controversies exist about the association between significant bacteriuria and primary biliary cirrhosis. There is evidence suggesting that infections by Gram negative bacteria may be implicated in the pathogenesis of this liver disease. AIM: To compare the incidence of bacteriuria in patients with primary biliary cirrhosis and those with autoimmune chronic hepatitis. PATIENTS AND METHODS: Twenty women with primary biliary cirrhosis and twenty three female patients with autoimmune chronic hepatitis were prospectively studied by routine bacteriological cultures of midstream urine specimens. Samples were obtained at three months intervals or when patients complained of symptoms suggesting urinary tract infection. Significant bacteriuria was defined as the growth of > 10(5) organisms/ml in pure culture. RESULTS: During 8 +/- 1 months of follow up. 60 urine samples from patients with primary biliary cirrhosis and 73 from autoimmune hepatitis cases were tested. Twenty one samples of patients with primary biliary cirrhosis (35%) were positive for significant bacteriuria compared with 7 from women with autoimmune hepatitis (9%); p < 0.01. In the follow up, ten patients with primary biliary cirrhosis (50%) and six with autoimmune hepatitis (26%) developed at least one episode of significant bacteriuria. CONCLUSION: These results suggest that female patients with primary biliary cirrhosis are in higher risk of significant bacteriuria than women with autoimmune hepatitis. Prospective studies evaluating the effects of long-term antibiotic therapy on cholestasis parameters in primary biliary cirrhosis are deserved.

Adult↗
PubMed1993

Asymptomatic bacteriuria in pregnancy.

Asymptomatic bacteriuria occurs in 4 to 7 percent of pregnancies and is associated with the development of acute pyelonephritis, preterm labor and low-birth-weight infants. Treatment of bacteriuria prevents up to 80 percent of cases of pyelonephritis and reduces the risk of preterm delivery. All women should be screened for bacteriuria by a urine culture at the first prenatal visit. Women with bacteriuria should be treated with appropriate antibiotics and should be monitored throughout pregnancy to identify recurrences. Women with persistent bacteriuria require antibiotic suppression until delivery and urologic evaluation following delivery. Urologic evaluation during pregnancy is indicated if bacteriuria persists despite antibiotic therapy.

Bacteriuria↗
PubMed1983

Effect of D-mannose and D-glucose on Escherichia coli bacteriuria in rats.

The effect of D-mannose and D-glucose on bacteriuria due to Escherichia coli with mannose-sensitive adhesins was investigated in adult male Sprague-Dawley rats undergoing diuresis. Inocula of 10(5), 10(7), or 10(8) bacteria in 0.1 ml of normal saline or 2.5% or 10% D-mannose or D-glucose were injected intravesically and urine was cultured 1, 3, 5, 7 and 9 days later. The levels of bacteriuria on days 1 and 5 were significantly lower in rats inoculated with 10(5) E coli and 10% D-mannose than in controls (p less than 0.05 and 0.01 respectively) and the percentages of rats with less than 100 bacteria/ml were higher on days 1 and 3 (p = 0.05 and 0.02 respectively). Bacteriuria was significantly lower in rats inoculated with 10(7) bacteria and 10% D-mannose than in controls on days 5 and 7 (p less than 0.01 for each day) and the percentage of rats with less than 100 bacteria/ml was higher on day 7 (p = 0.01). D-glucose reduced bacteriuria significantly only with a concentration of 10% after instillation of 10(5) E. coli (p less than 0.05, day 1). The results indicate that D-mannose and D-glucose can significantly reduce bacteriuria within 1 day and that their efficacy is dependent upon the concentration of both saccharide and bacteria.

Adhesiveness↗
PubMed1997

Bacteriuria in pregnancy: a comparison of Bangladeshi and Caucasian women.

During a 5-year period all urine culture results from pregnant Caucasian and Bangladeshi women booked for confinement at the Royal London Hospital, London, UK, were reviewed to determine race-specific rates of bacteriuria. The results showed that the overall prevalence of bacteriuria in the Caucasian group was 6.3% compared to 2.0% for the Bangladeshi women. Caucasian women were found to be at significantly greater risk across all pregnancy outcome and history categories, with the greatest risk observed in grand multiparous women (RR: 4.7, 95% CI: 2.8-8.3). Pregnancies that resulted in preterm delivery showed a strong association of bacteriuria in Caucasian women which was not seen in the Bangladeshi women (RR: 4.4, 95% CI: 2.0-8.7). The data suggest that Caucasian women have a significantly higher prevalence of bacteriuria in pregnancy than their Bangladeshi neighbors. Differences in hygiene practices and clothing may explain the observed differences in the bacteriuria rates.

Adult↗