scholarly journals Symptomatic urinary tract infection or asymptomatic bacteriuria? Improving care for the elderly

2019 ◽  
Vol 25 (7) ◽  
pp. 779-781 ◽  
Author(s):  
L. Nicolle
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Asymptomatic Bacteriuria ◽  
The Elderly ◽  
Symptomatic Urinary Tract Infection ◽  
Care For The Elderly

scholarly journals Análise da Revisão Cochrane: Antibióticos Destinados ao Tratamento da Bacteriúria Assintomática. Cochrane Database Syst Rev. 2015;4:CD009534.

2018 ◽  
Vol 31 (2) ◽  
pp. 76
Author(s):  
Miguel Bigotte Vieira ◽  
Mariana Alves ◽  
João Costa ◽  
António Vaz-Carneiro
Keyword(s):  
Systematic Review ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Adverse Events ◽  
Kidney Function ◽  
Antibiotic Treatment ◽  
Asymptomatic Bacteriuria ◽  
Controlled Trials ◽  
Symptomatic Urinary Tract Infection

Asymptomatic bacteriuria is frequently detected in women aged up to 60 years, patients with diabetes and elderly patients. The benefit of antibiotic treatment for this condition is controversial. The objective of this Cochrane systematic review was to assess the effectiveness and safety of antibiotic treatment for asymptomatic bacteriuria in adults. A systematic review of the literature up to 24 February 2015 was performed using the Cochrane Renal Group’s Specialised Register. Randomised controlled trials (RCTs) and quasirandomised controlled trials comparing antibiotics to placebo or no treatment for asymptomatic bacteriuria in adults were included. The outcomes of interest were the development of symptomatic urinary tract infection, complications, death, adverse events, development of antibiotic resistance, bacteriological cure, and decline in kidney function. Nine studies (1614 participants) were included in this review. The incidence of symptomatic urinary tract infection, complications or death was similar between groups. Antibiotic use was significantly associated with bacteriological cure and an increase in minor adverse events. No decline in kidney function was observed with any one of the treatments. According to the results of the studies included in this revision, authors have concluded that there is no clinical benefit in treating asymptomatic bacteriuria in adults.

scholarly journals Maternofetal outcome in early versus late detected asymptomatic bacteriuria of pregnancy

2017 ◽  
Vol 7 (1) ◽  
pp. 80
Author(s):  
Indira Guntoory ◽  
Poornima Penmetsa ◽  
Sarath B. Rayapu ◽  
Nambaru R. Nambaru
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Pregnant Women ◽  
Asymptomatic Bacteriuria ◽  
P Value ◽  
Negative Group ◽  
Symptomatic Urinary Tract Infection ◽  
Foetal Outcome ◽  
In Pregnancy

Background: Urinary tract infection in pregnancy is a problem of global significance. Untreated asymptomatic bacteriuria in pregnancy is known to be associated with maternal and foetal outcome in the form of symptomatic urinary tract infection (UTI), acute pyelonephritis, anaemia, pregnancy induced hypertension (PIH), preterm labour (PTL), low birth weight (LBW), intrauterine growth restriction (IUGR) and prematurity. This study is aimed to compare the maternal and foetal outcome of pregnant women with bacteriuria with that of women without bacteriuria and also to see if screening later in pregnancy at 28-37 weeks of gestation is as effective as screening at less than 20 weeks of pregnancy in terms of maternofoetal outcome.Methods: 165 pregnant women attending the antenatal clinic at MIMS, Nellimerla, Vizianagaram district, Andhra Pradesh, India were screened for asymptomatic bacteriuria by urine culture and sensitivity. They were grouped into asymptomatic bacteriuria negative and culture positive groups. Culture positives were further grouped as early detected and late detected group based on the gestational age at sampling. They were followed up till delivery. The maternofoetal outcome was compared between different groups by computing Odd’s ratio and P value of less than 0.05 was taken as significant.Results: There was no statistically significant increase in adverse maternofoetal outcome between early detected and bacteriuria negative group. The women of late detected group had greater odds of developing symptomatic UTI, PIH, PTL, LBW, IUGR and neonatal intensive care unit admissions when compared to early detected and bacteriuria negative group which was statistically significant.Conclusions: Screening for asymptomatic bacteriuria early in pregnancy at less than 20 weeks is more effective in reducing the adverse maternofoetal outcome.

scholarly journals Positive Urine Cultures: A Major Cause of Inappropriate Antimicrobial Use in Hospitals?

2009 ◽  
Vol 20 (4) ◽  
pp. 107-111 ◽  
Author(s):  
Samuel A Silver ◽  
Laura Baillie ◽  
Andrew E Simor
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Medical Records ◽  
Urine Culture ◽  
Asymptomatic Bacteriuria ◽  
Antimicrobial Use ◽  
Symptomatic Urinary Tract Infection ◽  
Positive Urine ◽  
Urine Specimens

INTRODUCTION: Urine specimens are among the most common samples submitted for culture to microbiology laboratories. The objectives of the present study were to describe the indications for obtaining urine cultures in a cohort of hospitalized patients, and to determine the appropriateness of antimicrobial therapy in response to urine culture results.METHODS: The study was performed at a teaching hospital with an adjoining long-term care facility from June 1 to July 31, 2006. The medical records of nonpregnant adult patients with and without bacteriuria were reviewed. A symptomatic urinary tract infection was defined as the presence of bacteriuria in a patient with fever or urinary symptoms; asymptomatic bacteriuria was defined as bacteriuria without urinary symptoms and no infection evident at another site.RESULTS: Medical records of 335 eligible patients (64% male; mean age 68 years) were reviewed, including all 137 with bacteriuria, and 198 with negative urine cultures. In total, 51% of the urine specimens were obtained from an indwelling urinary catheter, and 28% were voided urine samples. Confusion (57%) and fever (36%) were the most common indications noted for obtaining the urine cultures. Only 34 patients (25% of those with positive urine cultures) met the criteria for a symptomatic urinary tract infection; 67 (49%) had asymptomatic bacteriuria and 36 (26%) had infection at a nonurinary site. Of those with asymptomatic bacteriuria, 64% received antimicrobial therapy for a total of 347 days. Confused patients with asymptomatic bacteriuria were more likely to be treated than were bacteriuric patients without altered mental status (OR 1.8, 95% CI 1.2 to 4.1; P=0.03).CONCLUSIONS: Urine cultures are frequently obtained from hospitalizedpatients,evenintheabsenceofurinarysymptoms.Asymptomatic bacteriuria is often treated in these patients, and accounts for a substantial burden of inappropriate antimicrobial use in hospitals. Effective strategies to improve urine culture ordering and antimicrobial utilization in hospitals need to be implemented.

scholarly journals Diagnosis, Prevention, and Treatment of Catheter-Associated Urinary Tract Infection in Adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America

2010 ◽  
Vol 50 (5) ◽  
pp. 625-663 ◽  
Author(s):  
Thomas M. Hooton ◽  
Suzanne F. Bradley ◽  
Diana D. Cardenas ◽  
Richard Colgan ◽  
Suzanne E. Geerlings ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Infectious Diseases ◽  
Management Strategies ◽  
Asymptomatic Bacteriuria ◽  
Direct Patient Care ◽  
Term Care ◽  
Medical Specialties ◽  
Symptomatic Urinary Tract Infection

Abstract Guidelines for the diagnosis, prevention, and management of persons with catheter-associated urinary tract infection (CA-UTI), both symptomatic and asymptomatic, were prepared by an Expert Panel of the Infectious Diseases Society of America. The evidence-based guidelines encompass diagnostic criteria, strategies to reduce the risk of CA-UTIs, strategies that have not been found to reduce the incidence of urinary infections, and management strategies for patients with catheter-associated asymptomatic bacteriuria or symptomatic urinary tract infection. These guidelines are intended for use by physicians in all medical specialties who perform direct patient care, with an emphasis on the care of patients in hospitals and long-term care facilities.

Clean Vesical Intermittent Catheterization: Lubrication of Vesical Catheter through Lidocaine or Gentamicine?

2012 ◽  
Vol 79 (1) ◽  
pp. 49-53 ◽  
Author(s):  
Raimondo Fausto Liotta ◽  
Maria Lucia Tarantino
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urine Analysis ◽  
Asymptomatic Bacteriuria ◽  
Intermittent Catheterization ◽  
Clean Intermittent Catheterization ◽  
Symptomatic Urinary Tract Infection ◽  
Significant Bacteriuria ◽  
Group B

Introduction The patients who undergo intermittent catheterization are at high risk of urinary tract infection. A prophylaxis method for this infection can be represented by the lubrication of urethral catheters with 0.1% gentamycin cream. This study compared the lubrication of urethral catheters with 0.1% gentamycin cream and 2% lidocaine jelly in relation to the quantitative results of the urine culture and incidence of symptomatic urinary tract infection and asymptomatic bacteriuria. Material and Methods Sixteen patients, divided in groups A and B, were studied. Patients in Group A were directed to lubricate the urethral catheter with 0.1% gentamicin cream, whereas in Group B with 2% lidocaine jelly. Urine cultures and urine analysis were carried out every three weeks, for four months, for a total of 5 samples. The presence or absence of bacteria or fungi, the number of colonies and the isolated types, and the leukocyturia were evaluated. Results No significant differences in the presence of significant bacteriuria, symptomatic urinary tract infection and asymptomatic bacteriuria were found between the two groups. Escherichia coli was the most common isolated bacterium in both groups. Conclusions The results of this study, in line with previous works, showed that the lubrication of urethral catheters with 0.1% gentamicin cream is not an effective alternative to reduce significant bacteriuria and prevent urinary infection in patients who undergo clean intermittent catheterization.

scholarly journals Asymptomatic Bacteriuria and Pyuria in Premenopausal Women

2020 ◽  
Author(s):  
Thomas M Hooton ◽  
Pacita L Roberts ◽  
Ann E Stapleton
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
High Risk ◽  
Tract Infection ◽  
Recurrent Urinary Tract Infection ◽  
Asymptomatic Bacteriuria ◽  
Premenopausal Women ◽  
Antimicrobial Treatment ◽  
Symptomatic Urinary Tract Infection ◽  
Healthy Women

Abstract Background Asymptomatic bacteriuria and pyuria in healthy women often trigger inappropriate antimicrobial treatment, but there is a paucity of data on their prevalence and persistence. Methods To evaluate the prevalence and persistence of asymptomatic bacteriuria and pyuria in women at high risk of recurrent urinary tract infection, we conducted an observational cohort study in 104 healthy premenopausal women with a history of recurrent urinary tract infection with daily assessments of bacteriuria, pyuria, and urinary symptoms over a 3-month period. Results The mean age of participants was 22 years, and 74% were white. Asymptomatic bacteriuria events (urine cultures with colony count ≥105 CFU/mL of a uropathogen on days with no symptomatic urinary tract infection diagnosed) occurred in 45 (45%) women on 159 (2.5%) of 6283 days. Asymptomatic bacteriuria events were most commonly caused by Escherichia coli, which was present on 1.4% of days, with a median duration of 1 day (range, 1–10). Pyuria occurred in 70 (78%) of 90 evaluable participants on at least 1 day and 25% of all days on which no symptomatic urinary tract infection was diagnosed. The positive predictive value of pyuria for E. coli asymptomatic bacteriuria was 4%. Conclusions In this population of healthy women at high risk of recurrent urinary tract infection, asymptomatic bacteriuria is uncommon and, when present, rarely lasts more than 2 days. Pyuria, on the other hand, is common but infrequently associated with bacteriuria or symptoms. These data strongly support recommendations not to screen for or treat asymptomatic bacteriuria or pyuria in healthy, nonpregnant women.

Sign in / Sign up

Export Citation Format

Share Document