Asymptomatic Bacteriuria and Pyuria in Premenopausal Women.

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Asymptomatic Bacteriuria and Pyuria in Premenopausal Women.

Clin Infect Dis. 2020 Mar 16;:

Authors: Hooton TM, Roberts PL, Stapleton AE

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 for recurrent urinary tract infection, we conducted an observational cohort study of 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 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 E. coli, which was present on 1.4% of days with median duration one day (range, 1-10). Pyuria occurred in 70 (78%) of 90 evaluable subjects on at least one 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 for recurrent urinary tract infection, asymptomatic bacteriuria is uncommon and when present rarely lasts more than two 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, non-pregnant women.

PMID: 32179902 [PubMed - as supplied by publisher]