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At least 127 records · Page 7Linked to original sources
PubMed1980

Causes of the acute urethral syndrome in women.

To determine the cause of the acute urethral syndrome, we studied 59 women with dysuria and frequent urination without "significant bacteriuria" (defined as greater than or equal to 10(5) organisms per milliliter), 35 women with typical cystitis and 66 women with no symptoms of urinary-tract infection. Although none of the 59 women with urethral syndrome had greater than 3.4 x 10(4) bacteria per milliliter in either of two successive midstream urine specimens, samples of bladder urine obtained by suprapubic aspiration or catheterization from 24 women contained coliforms, and samples from three contained Staphylococcus saprophyticus; all but one of these 27 women also had pyuria. Of the 32 women with sterile bladder urine, 10 of 16 with pyuria and one of 16 without pyuria were infected with Chlamydia trachomatis (P = 0.002). Chlamydial infection was found in 11 of 42 women with urethral syndrome and pyuria, in three of 66 without symptoms, and in one of 35 with cystitis (P less than 0.01 when the group with urethral syndrome is compared with either of the other groups). Thus, 42 of 59 women with urethral syndrome had abnormal pyuria and 37 of these 42 were infected with coliforms, S. saprophyticus, or C. trachomatis, whereas few women without pyuria had demonstrable infection. Bacteriuria of greater than or equal to 10(5) per milliliter may be an insensitive diagnostic criterion when applied to symptomatic lower-urinary-tract infection.

Acute Disease↗
PubMed1989

The prevalence of bacteriuria among high risk neonates in Nigeria.

Among the 446 high risk neonates studied for significant bacteriuria and pyuria in the neonatal wards of the Obafemi Awolowo University teaching hospital Complex, Ile-Ife, 7.6% and 5.8% were positive for significant bacteriuria and pyuria respectively, while none of the 81 infants in the control group were positive. Males and females were similarly affected and there was no seasonal variation in the prevalence of pyuria or bacteriuria. It is noteworthy that 25 (96%) of the 26 pyuria neonates also had bacteriuria emphazising the significance of pyuria as a possible screening method for urinary tract infections in neonates. The clinical problems in the neonates studied included prematurity, low birthweight, neonatal jaundice, fever, CNS symptoms, ophthalmia neonatorum, prolonged rupture of the membranes (PROM), respiratory distress, septic cord/skin, diarrhoea, vomiting and feeding problems. Only prematurity and low birthweight were significantly associated with bacteriuria in the neonates studied. The organisms encountered in this study were Escherichia coli (58.4%), Klebsiella species (35.3%) and Proteus species (5.9%). Of the bacterial isolates, 67% were sensitive to Ampicillin and 97% to Gentamycin. The combination of these antibiotics was effective in all cases in the present study. The study has highlighted the need for routine urine culture in our high risk neonates.

Bacteriuria↗
PubMed1990

Home-voided urine specimens in women. Diagnostic agreement with clean-catch midstream specimens.

One hundred and fifty women who brought a home-voided urine sample to a general practitioner were asked at the same consultation to provide another sample under controlled conditions. Seventy-three women had lower urinary tract symptoms and 77 were asymptomatic. The two samples were analysed for pyuria (greater than or equal to 5 leucocytes/HPF) and bacteriuria (greater than or equal to 10(4) v. greater than or equal to 10(5) cfu/ml). The agreement when diagnosing pyuria and bacteriuria was estimated by Kappa (K). The home-voided sample was taken with adequate sampling technique by only 12% of women. Moreover, its bladder incubation time was twice that of the surgery sample (5.4 h v. 2.4 h). There was, however, no difference in the distribution of pyuria or bacteriuria between the paired samples. Agreement, which was high for the diagnosis of pyuria (K = 0.80), was significantly lower for the diagnosis of bacteriuria (K = 0.52, P less than 0.01). A home-voided sample seems sufficient in the diagnosis of the dysuria-pyuria syndrome in women.

Adolescent↗
PubMed1991

Laboratory in the diagnosis and management of urinary tract infections.

The laboratory is essential in the diagnosis and management of UTIs. The presence of pyuria and bacteriuria, the two most important indicators of UTIs, are most accurately determined by standard techniques. In quantitating pyuria, the finding of greater than or equal to 10 leukocytes/mm3 of urine by either hemocytometry or direct microscopy correlates highly with symptomatic, culture-proven UTIs. The determination of bacteriuria by direct microscopy is inaccurate, particularly at lower levels of bacteriuria; thus, quantitative urine cultures remain the most accurate measure of bacteriuria. Significant bacteriuria, previously defined as greater than or equal to 10(5) CFU/ml of urine, has been redefined with the observation that as few as 10(2) CFU/ml can be associated with significant pyuria and symptoms suggestive of cystitis. The need for routine and posttreatment urine cultures in nonpregnant women with acute dysuria remains controversial, but current data suggest that they are usually unnecessary. Rapid diagnostic tests for detection of pyuria and bacteriuria are designed to increase efficiency and decrease cost in the diagnosis of UTI. Unfortunately, none of these techniques can quantitate pyuria or bacteriuria as accurately as the standard methods, but the level of accuracy offered by the standard methods is not always necessary in the care of patients with uncomplicated UTIs. These tests are particularly well suited for screening asymptomatic high-risk populations. Noninvasive localization techniques continue to be explored as possible alternatives to invasive localization procedures, but they remain largely research tools that are not readily available to the practicing clinician. Understanding the applicability and appropriate use of newer technologies in the evaluation of patients with UTIs and how these technologies complement the standard diagnostic techniques will lead to better, more efficient, and less costly patient care.

Bacterial Infections↗
PubMed1969

Staining of urinary leucocytes as an aid to the diagnosis of inflammation in the urinary tract.

Five hundred specimens of urine have been examined for pyuria and bacteriuria, the leucocytes being stained by the Sternheimer-Malbin method. Most urines contained either less than 1 or more than 10 leucocytes per cmm; a few specimens contained 1 to 10 cells per cmm, whatever their viable bacterial count. The presence of leucocytes in urine was usually related to the bacterial count, pyuria being commonest in urines showing ;significant bacteriuria'. However, urinary tract instrumentation caused pyuria in the absence of infection. Leucocytes with nuclei staining blue by the Sternheimer-Malbin technique were considered to be indicative of active inflammation, but the incidence of such cells appeared to be a reflection of the total leucocyte count of the specimen rather than of its viable bacterial count. In the majority of cases the diagnosis of infection can be made on the basis of the bacterial count and the degree of pyuria. The staining technique appears to have a limited use, restricted to the interpretation of cases in which the results of culture and conventional leucocyte counts are ambiguous.

Bacteriuria↗
PubMed1991

[Study of the long-term administration of ofloxacin to the patients following transurethral resection of the prostate].

The present study was undertaken to evaluate the clinical efficacy of long-term administration of ofloxacin (OFLX) to the patients following transurethral resection of the prostate. The patients were randomly divided into two groups: A and B. All the patients were administered flomoxef (FMOX) intravenously for 3 days following transurethral resection of the prostate (TUR-P). In group A, 100 mg of OFLX twice daily was thereafter administered for 4 to 15 weeks to 22 patients until they showed an improvement in pyuria. In group B, which served as a control, neither OFLX nor any other antibiotics were administered to 26 patients until they showed an improvement in pyuria. No patients complained of urination trouble due to infection. At the same time, cultures of bacillus in the urine were also examined 4 days, 7 days and 2 weeks after TUR-P with these two groups. The mean days necessary for the improvement of pyuria were 64.9 +/- 20.5 in group A, 66.3 +/- 18.4 in group B. At 2 weeks after TUR-P, bacillus in the urine were negative in 19/22 patients in group A, and 14/26 in group B. Chi-square test showed significance for these two groups. Accordingly, OFLX was useful for bacillus in the urine, but OFLX was not so useful for shortening the continuance of pyuria of post TUR-P. No patients complained of nausea or any other complications during the study.

Aged↗
PubMed1991

[A study on the treatment duration of an antibacterial agent in complicated urinary tract infections. Utility and recurrence after 14-day treatment by fleroxacin].

In this study, fleroxacin (FLRX), a new quinolone derivative, was orally given at 300 mg once daily for 14 days to 102 patients with non-catheterized complicated urinary tract infections in order to determine the optimal treatment duration. We investigated its efficacy at day 5-7 and day 14, according to the criteria proposed by the Japanese UTI Committee, and also to the recurrence rate after the withdrawal. The results were as follows: 1. Overall clinical efficacy rates were 86% at day 5-7 and 84% at day 14. Both incidence of bacterial replacement in bacteriuria and normalization in pyuria were increased at day 14 as compared with those at day 5-7. 2. Bacteriological eradication rates were 91% at day 5-7 and 89% at day 14. 3. Clinical efficacy rates from physicians' evaluation were 86% at day 5-7 and 88% at day 14. 4. Incidence of side effects was 9.1%, and most of the cases were gastrointestinal symptoms which appeared within 4 days. Slight and transitory changes in laboratory findings were noted in 2.3% of evaluable cases. 5. With the occurrence of pyuria and bacteriuria as markers, the "no recurrence" rates were 63% at 1 week, 54% at 2 weeks, 61% at 3 weeks, 81% at 4-6 weeks after the withdrawal, and the "recurrence" rates were 4%, 4%, 6% and 5%, respectively. Remaining cases were judged as "reserved assessment". Generally, aggravation of bacteriuria was found but the aggravation of pyuria was observed in only few cases. 6. According to breakdown of cases with bacteriuria only, cure rate was 67% and recurrence rate was 33%. Re-infections were observed much more frequently than relapse based on the identification of infecting organisms. These results suggest that sufficient bacteriological eradication and clinical efficacy could be obtained by 14-day treatment of FLRX in non-catheterized complicated urinary tract infections. The efficacy of the treatment became evident around day 7. In approximately 30% of the cases in which eradication of the initial causative organisms was observed at day 14 reappearance of bacteriuria (greater than or equal to 10(3) CFU/ml) occurred after withdrawal of the antibiotic, but cases with pyuria were few, and the incidence of true recurrence was generally low. Onset of side effect after 5-day was not seen, hence FLRX seemed to be a safe agent.

Administration, Oral↗
PubMed1988

Postoperative prophylaxis with norfloxacin in patients requiring bladder catheters.

The effect of once daily doses of 200 mg oral norfloxacin on the occurrence of catheter-associated bacteriuria (greater than 1000 CFU/ml) and pyuria was studied in 105 post-operative gynaecologic patients. Norfloxacin was given from the second day after surgery until catheter removal. Bacteriuria developed in 32 of 51 (63%) control patients compared to 8 of 54 (15%) patients receiving norfloxacin (p less than 0.001). Pyuria was present in 22 of 51 (43%) control subjects versus only 3 of 54 (5%) patients treated with norfloxacin (p less than 0.001). Bacteria isolated from control patients comprised species of Enterobacteriaceae (40%), Staphylococcus (35%), and Streptococcus (17%); seven isolates were resistant to multiple antibiotics reflecting their nosocomial origin. In contrast, strains isolated from norfloxacin-treated patients comprised non-fermenting gram-negative rods (79%, usually Alcaligenes or Acinetobacter spp.) and faecal streptococci (12%). It is concluded that once daily doses of 200 mg oral norfloxacin are effective in reducing the rate of catheter-associated bacteriuria and pyuria following reconstructive gynaecologic surgery.

Adult↗
PubMed1985

Urinary tract infections in male spinal cord injured patients. Part two: Diagnostic value of symptoms and of quantitative urinalysis.

Seventy paired samples of urine, obtained by collection of a clean voided specimen and by suprapubic aspiration (SPA) of the bladder, were obtained from 43 male SCI patients who were free of indwelling catheters. The relationship of the presence or absence of symptoms and the degree of pyuria (determined quantitatively using a haemocytometer) to the presence or absence of bacteriuria (SPA specimen) was determined. Symptoms were poorly predictive of bacteriuria with concordance seen only 40% of the time. Most bacteriuric episodes (37/51-72.5%) were asymptomatic. The quantity of WBC in voided urine accurately reflected that in SPA urine (r = 0.825), indicating that urodynamics in SCI patients who received sphincterotomies are different than in normal persons. Pyuria (greater than or equal to 10(4) WBC per cc urine) was an excellent predictor of UTI--37 of 38 (97.4%) had UTI. However, 40.6% of samples with WBC less than 10(4) were also culture positive. Overall, consideration of the presence or absence of pyuria in relation to the presence of bacteriuria provided a sensitivity of 74.0%, specificity of 95.9%, and predictive value of a positive test of 97.4%. The predictive value of a negative test (WBC less than 10(4), however, was only 59.4%. There was poor correlation between absolute bacterial and WBC count. The point of cutoff for bacterial count correlating with 10(4) WBC count was not statistically significant in these patients; this is possibly due to repeated bacterial contamination from anterior urethra. While symptom status was often misleading, the presence of greater than 10(4) WBC per cc of urine was highly predictive of the presence of bacteriuria in male SCI patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1991

[Vesicourethral dysfunction of diabetic patients].

In order to evaluate vesicourethral dysfunction in diabetic patients, urodynamic studies, IVP and urinalysis were performed on 173 diabetic patients (male 78, female 95) and 17 nondiabetic control cases. In addition to the classical findings as increased volume at the first desire to void and decreased maximum vesical pressure, diabetic patients showed varieties of vesicourethral dysfunctions such as overactive bladder (14.5%), low compliance bladder (11.0%) and loss of detrusor-external sphincter coordination (31.7%). Vesicourethral function of diabetics was classified in following 5 types by analysing the volume at first desire to void, volume at maximum desire to void, maximum vesical pressure, residual urine volume and bladder compliance. 1. Type 1, normal vesical function, 13 cases. 2. Type 2, vesical dysfunction with minimal residual urine, 49 cases. 3. Type 3, vesical dysfunction with residual urine, 66 cases. 4. Type 4, low compliance bladder, 20 cases. 5. Type 5, overactive bladder, 25 cases. Pyuria was observed in 59.8%, hydronephrosis was found in 10.9% and ectasia of lower ureter was found in 17.8% of diabetic patients. The highest incidence of pyuria and abnormality of the upper urinary tract were noted in Type 4 and followed by Type 3 and by Type 2 in decreasing order. Extent of pyuria and ectasis of the upper urinary tract showed statistically significant correlation with residual urine volume and detrusor-external sphincter coordination. When vesicourethral function was compensated by abdominal strain, the volume of residual urine is not elevated, but when the mechanism of compensation is lost or in the absence of detrusor-external sphincter coordination results in gradual accumulation of residual urine. In cases with long standing chronic urinary tract infection may results in fibrosis of the bladder wall with low compliance bladder. Fibrotic obstruction of uretero-vesical junction can cause hydroureteronephrosis and followed by renal function impairment. As vesical damage become irreversible at this end stage, proper management during early stage is crucial for management of diabetic patients. Cholinergic agent were effective to reduce residual urine volume in Type 3. alpha-blocking agent were effective to reduce residual urine volume in Type 3 and some cases of Type 4. In cases in which medication therapy failed to reduce residual urine, the clean intermittent catheterization was successful in control of urinary tract infection and upper urinary tract ectasis. Transurethral resection of the prostate and the bladder neck is indicated in the male patients with a large amount of residual urine in Type 3 and 4.

Aged↗
PubMed1992

Does residual urine predispose to urinary tract infection?

The relationship between the presence of post-micturition residual urine and urinary tract infection is unclear. We have performed a retrospective analysis of 342 studies on bladder emptying and compared the incidence of bacterial infection and pyuria in patients with residual urinary volumes of more or less than 100 ml. In patients with a residual volume > 100 ml 49/219 studies showed evidence of pyuria and 28/198 studies of patients whose residual urine was less than 100 ml showed evidence of infection. In cases where the residuals were > 100 ml 33/123 had evidence of pyuria and 19/109 infection. There was no significant increase in the rate of infection in patients with large residual urinary volumes, suggesting that there is no definite correlation between post-micturition residues and urinary tract infection.

Adult↗
PubMed1977

[Alport syndrom (author's transl)].

A deaf-and-dumb patient died at the age of ten of failure of the kidneys. An uncle of the boy died at the age of 42, an aunt at the age of 16 years, both of atrophic kidneys. The mother of the proband is suffering from hard hearing on one side and recurrent episodes of pyuria. Repeated examinations in two aunts revealed slight pyuria resp. erythruria. Contrary to most reports affected members of the family showed pyuria rather than haematuria. A special inheritance could not be proved.

Child↗
PubMed1985

Laboratory diagnosis of urinary tract infection in ambulatory women.

We evaluated the accuracy and work load of six different approaches to identifying urinary tract infections in a general microbiology laboratory. Midstream urine (MSU) specimens from 387 ambulatory women were examined for pyuria and were cultured using a dual-plating technique that detects both low (10(2) to 10(4) organisms per milliliter) and high (greater than or equal to 10(5) organisms per milliliter) colony counts. Seventy-four urinary tract infections (defined as greater than or equal to 10(5) organisms per milliliter of MSU or greater than or equal to 10(2) aerobic gram-negative bacilli per milliliter of MSU in symptomatic patients) were identified. Twenty-four (32%) of the infections were characterized by low colony counts and would not have been identified using a 10(5) or greater colony-forming units/mL criterion for infection. Using the presence of pyuria to direct microbiological processing of urine specimens was the most accurate and efficient method of identifying urinary tract infections among voided specimens from ambulatory women, particularly if rapid screening methods for pyuria can be used.

Adolescent↗