Antimicrobial Treatment in Diabetic Women with Asymptomatic Bacteriuria

2002 ◽  
Vol 347 (20) ◽  
pp. 1576-1583 ◽  
Author(s):  
Godfrey K.M. Harding ◽  
George G. Zhanel ◽  
Lindsay E. Nicolle ◽  
Mary Cheang
Keyword(s):  
Asymptomatic Bacteriuria ◽  
Antimicrobial Treatment

Urine Cultures among Hospitalized Veterans: Casting Too Broad a Net?

2014 ◽  
Vol 35 (5) ◽  
pp. 574-576 ◽  
Author(s):  
Dimitri M. Drekonja ◽  
Christina Gnadt ◽  
Michael A. Kuskowski ◽  
James R. Johnson
Keyword(s):  
Asymptomatic Bacteriuria ◽  
Clinical Manifestations ◽  
Antimicrobial Treatment ◽  
Antimicrobial Use ◽  
High Count ◽  
Asymptomatic Patients

Since detection of asymptomatic bacteriuria among inpatients often leads to inappropriate antimicrobial treatment, we studied why urine cultures were ordered and correlates of treatment. Most cultures were obtained from patients without urinary complaints and a minority from asymptomatic patients. High-count bacteriuria, not clinical manifestations, appeared to trigger most antimicrobial use.

scholarly journals Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by the Infectious Diseases Society of Americaa

2019 ◽  
Vol 68 (10) ◽  
pp. 1611-1615 ◽  
Author(s):  
Lindsay E Nicolle ◽  
Kalpana Gupta ◽  
Suzanne F Bradley ◽  
Richard Colgan ◽  
Gregory P DeMuri ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Clinical Symptoms ◽  
Asymptomatic Bacteriuria ◽  
Antimicrobial Treatment ◽  
Common Finding ◽  
Solid Organ ◽  
Current Guideline ◽  
Indwelling Catheters ◽  
Healthy Women ◽  
Cord Injury

Abstract Asymptomatic bacteriuria (ASB) is a common finding in many populations, including healthy women and persons with underlying urologic abnormalities. The 2005 guideline from the Infectious Diseases Society of America recommended that ASB should be screened for and treated only in pregnant women or in an individual prior to undergoing invasive urologic procedures. Treatment was not recommended for healthy women; older women or men; or persons with diabetes, indwelling catheters, or spinal cord injury. The guideline did not address children and some adult populations, including patients with neutropenia, solid organ transplants, and nonurologic surgery. In the years since the publication of the guideline, further information relevant to ASB has become available. In addition, antimicrobial treatment of ASB has been recognized as an important contributor to inappropriate antimicrobial use, which promotes emergence of antimicrobial resistance. The current guideline updates the recommendations of the 2005 guideline, includes new recommendations for populations not previously addressed, and, where relevant, addresses the interpretation of nonlocalizing clinical symptoms in populations with a high prevalence of ASB.

scholarly journals 1484. Prevalence of Pyuria With and Without Bacteriuria in Healthy Pre-Menopausal Women

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S541-S541
Author(s):  
Ann E Stapleton ◽  
Pacita Roberts ◽  
Thomas M Hooton
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Asymptomatic Bacteriuria ◽  
Premenopausal Women ◽  
Antimicrobial Treatment ◽  
Medical Attention ◽  
Healthy Women ◽  
Day Range ◽  
History Of

Abstract Background Pyuria has long been considered key to diagnosis of urinary tract infection in women, but there is a paucity of data on its prevalence and association with asymptomatic bacteriuria (ASB) in healthy women, even though pyuria and ASB often trigger inappropriate antimicrobial treatment. Methods We enrolled 104 healthy premenopausal women with a history of recurrent urinary tract infection (UTI) in an observational study and performed daily assessments of bacteriuria, pyuria (leukocyte esterase strips) and UTI symptoms over a 3-month period. These data enabled an evaluation of the prevalence of pyuria and ASB and associations between them. Results The mean age of participants was 22 and 74% were white. Pyuria occurred frequently in this cohort of women, with 72 (77%) of 94 evaluable subjects having pyuria on at least one day with no symptomatic UTI diagnosed. The median percent of days with pyuria reported was 7% (range, 0–100%). Asymptomatic bacteriuria (ASB, urine culture with colony count ≥105 CFU/mL of uropathogen on days with no symptomatic UTI diagnosed) occurred in 45 (45%) women on 159 (2.5%) of 6,283 days. ASB was most commonly caused by E. coli, which was present in 1.4% of days with median duration one day (range, 1–10). The positive predictive value of pyuria in detecting ASB was 4%. Five women had 11 transient episodes of pyuria, significant bacteriuria, and UTI symptoms (“preclinical UTI”) but did not seek medical attention. Conclusion In this population of healthy women at high risk for UTI and ASB, asymptomatic pyuria was a frequent occurrence and ASB rarely lasted more than 2 days. Pyuria, whether associated with bacteriuria or not, was generally not accompanied by urinary symptoms and did not appear to be clinically meaningful. Young women with recurrent UTI are often advised by their providers to test their urine with dipsticks for pyuria or bacteriuria, and be treated if either are positive, regardless of absence of UTI symptoms. Such practices, which contribute to antimicrobial resistance, are not supported by our data. Disclosures All authors: No reported disclosures.

Evaluation of an Antimicrobial Stewardship Approach to Minimize Overuse of Antibiotics in Patients with Asymptomatic Bacteriuria

2014 ◽  
Vol 35 (2) ◽  
pp. 193-195 ◽  
Author(s):  
Denise Kelley ◽  
Patrick Aaronson ◽  
Elaine Poon ◽  
Yvette S. McCarter ◽  
Ben Bato ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Medical Center ◽  
Academic Medical Center ◽  
Asymptomatic Bacteriuria ◽  
Antimicrobial Treatment ◽  
Antimicrobial Use ◽  
Educational Initiative ◽  
Educational Initiatives ◽  
Academic Medical ◽  
Inappropriate Treatment

An antimicrobial stewardship educational initiative provided to physicians and pharmacists was evaluated at an academic medical center to minimize inappropriate treatment of asymptomatic bacteriuria (ASB). A significant decrease in empirical antimicrobial use for ASB was observed after education. Multifaceted educational initiatives can reduce inappropriate antimicrobial treatment of ASB.

scholarly journals A short course of antimicrobial therapy for asymptomatic bacteriuria is safe and effective before urologic procedures

2021 ◽  
Vol 15 (05) ◽  
pp. 742-746
Author(s):  
Murat Kutlu ◽  
Merve Arslan ◽  
Yusuf Ozlulerden ◽  
Kevser Ozdemir ◽  
Selda Sayin-Kutlu ◽  
...  
Keyword(s):  
Single Dose ◽  
Antimicrobial Therapy ◽  
Urinary Catheter ◽  
Asymptomatic Bacteriuria ◽  
Antimicrobial Treatment ◽  
Sensitivity Testing ◽  
Post Procedure ◽  
Short Course ◽  
Urological Procedures ◽  
The Mean

Introduction: In the presence of asymptomatic bacteriuria (ASB) before the urological procedure, the duration of antimicrobial treatment is controversial. This study aims to evaluate whether a short course of antimicrobial therapy is safe and effective in cases with ASB before urological procedures. Methodology: We retrospectively reviewed adult patients who had ASB before undergoing several urological procedures between 2011 and 2019. The patients received a single dose of an appropriate parenteral antibiotic, determined by antimicrobial sensitivity testing, 30 to 60 minutes before the urological procedure. If a urinary catheter was placed post-procedure, a second dose was given. Results: A total of 293 patients who had ASB before undergoing several urological procedures were included in the study. The total number of procedures was 328. Female/male ratio was 92 (31.4%)/201 (68.6%). The mean age was 63.7 ± 14.9 years. The most common isolated microorganisms were Escherichia coli (155 [47%]), Klebsiella pneumoniae (38 [11.6%]), and Pseudomonas aeruginosa (28 [8.5%]). The most common antimicrobial used was ertapenem. A second dose antimicrobial was given for 290 procedures due to a urinary catheter after a urological procedure. The mean hospitalization time was 3.97 ± 3.42 days. None of the patients developed infectious complications. Conclusions: This study has demonstrated that a single dose of parenteral antimicrobial drug administered 30-60 minutes before the urologic procedures and a second dose in the presence of a post-procedure catheter, was adequate to prevent post-procedure septicemia and urinary tract infection.

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.

scholarly journals Is short course of antimicrobial therapy for asymptomatic bacteriuria before urologic surgical procedures sufficient?

2011 ◽  
Vol 6 (02) ◽  
pp. 143-147 ◽  
Author(s):  
Selda Sayin Kutlu ◽  
Zafer Aybek ◽  
Koray Tekin ◽  
Demet Okke ◽  
Serife Akalin ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Antimicrobial Therapy ◽  
Asymptomatic Bacteriuria ◽  
Antimicrobial Treatment ◽  
Sensitivity Testing ◽  
Urologic Surgical Procedures ◽  
Short Course ◽  
Group A ◽  
Urological Procedures ◽  
Group B

Introduction: Duration of treatment of asymptomatic bacteriuria for patients undergoing urologic surgical procedures is undetermined. We compared the efficacy of long- versus short-course antimicrobial treatment in patients with asymptomatic bacteriuria undergoing urologic surgical procedures. Methodology: Patients were divided into two groups according to duration of antimicrobial treatment. Group A patients received a single dose of an appropriate antibiotic, determined by antimicrobial sensitivity testing, 30 to 60 minutes before the surgical procedure. If a urinary catheter was placed postoperatively, a second dose was given following the recommended dose interval. Group B patients received antimicrobial treatment prior to surgery at least until patient urine became sterile. All patients were monitored for signs and symptoms of septicemia following surgical procedures. Results: None of the patients enrolled in the study developed infectious complications such as sepsis or upper urinary tract infection. In group A, 31 patients were treated with antimicrobials before 39 urological procedures. In group B, the mean treatment time for 28 patients before 30 urological procedures was 8.03 ± 3.86 days. There were also significant differences in length of stay and the cost of antimicrobial therapy between the groups (P < 0.0001). Isolation of an increased number of resistant microorganisms was associated with long course therapy in group B. Conclusions: Short course therapy protocol may be a practical, simple approach for antibiotic use; it decreases hospital stays, eliminates delayed procedure times, lowers the economic cost of antimicrobials and lessens the chance of superinfection with and spread of antimicrobial resistant microorganisms.

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