Bacteriology and clinical outcomes of urine mixed bacterial growth in pregnancy
Introduction and hypothesis The objective was to analyse the risk of significant bacteriuria in repeat urine cultures from pregnant women, following initial mixed bacterial results. Methods This retrospective study examined maternal characteristics and clinical features of women who repeated urine c...
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| Veröffentlicht in: | International Urogynecology Journal 2024-02, Vol.35 (2), p.347-353 |
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| creator | Sgayer, Inshirah Shamalov, Gabriel Assi, Silas Glikman, Daniel Lowenstein, Lior Frank Wolf, Maya |
| description | Introduction and hypothesis
The objective was to analyse the risk of significant bacteriuria in repeat urine cultures from pregnant women, following initial mixed bacterial results.
Methods
This retrospective study examined maternal characteristics and clinical features of women who repeated urine cultures due to previous mixed cultures results.
Results
Of 262 women included, 80 (30.5%) had negative cultures and 125 (47.7%) had mixed bacterial growth in their repeat cultures. Positive results (≥10
4
CFU/ml of a urinary pathogen) were obtained for 57 women (21.8% [95% CI 17.1–27.0]). For 37 (14.1%), the repeat specimen grew 10
4
–10
5
CFU/ml of microorganisms; whereas for 20 women (7.6% [95% CI 4.9–11.3]), it grew ≥10
5
CFU/ml. Among women with positive (>10
4
CFU/ml) compared with those with negative or mixed growth, rates of urinary symptoms were higher (38.6% vs 23.4%,
p
=0.028), abnormal dipstick results (49.1% vs 21.0%,
p |
| doi_str_mv | 10.1007/s00192-023-05672-5 |
| format | Article |
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The objective was to analyse the risk of significant bacteriuria in repeat urine cultures from pregnant women, following initial mixed bacterial results.
Methods
This retrospective study examined maternal characteristics and clinical features of women who repeated urine cultures due to previous mixed cultures results.
Results
Of 262 women included, 80 (30.5%) had negative cultures and 125 (47.7%) had mixed bacterial growth in their repeat cultures. Positive results (≥10
4
CFU/ml of a urinary pathogen) were obtained for 57 women (21.8% [95% CI 17.1–27.0]). For 37 (14.1%), the repeat specimen grew 10
4
–10
5
CFU/ml of microorganisms; whereas for 20 women (7.6% [95% CI 4.9–11.3]), it grew ≥10
5
CFU/ml. Among women with positive (>10
4
CFU/ml) compared with those with negative or mixed growth, rates of urinary symptoms were higher (38.6% vs 23.4%,
p
=0.028), abnormal dipstick results (49.1% vs 21.0%,
p
<0.001) and hydronephrosis, as demonstrated by renal ultrasound (12.3% vs 2.0,
p
=0.003). In a multivariate logistic regression analysis, hydronephrosis was associated with the occurrence of a positive repeat culture (aOR = 10.65, 95% CI 2.07–54.90). The sensitivity and specificity for predicting a repeat urine culture with ≥10
5
CFU/ml were 12.9% and 94.3% respectively, for urinary symptoms; and 19.7% and 97.4% respectively, for abnormal dipstick results.
Conclusions
Mixed bacterial growth might represent a true urinary tract infection in a considerable proportion of women who are symptomatic and have an abnormal dipstick urinalysis.</description><identifier>ISSN: 0937-3462</identifier><identifier>EISSN: 1433-3023</identifier><identifier>DOI: 10.1007/s00192-023-05672-5</identifier><identifier>PMID: 37938399</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Bacteriology ; Bacteriuria ; Female ; Gynecology ; Humans ; Hydronephrosis ; Medicine ; Medicine & Public Health ; Original Article ; Pregnancy ; Retrospective Studies ; Urine ; Urology</subject><ispartof>International Urogynecology Journal, 2024-02, Vol.35 (2), p.347-353</ispartof><rights>The International Urogynecological Association 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The International Urogynecological Association.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-e96a018b9334fbe9e64fb9d034c33dc40ef60298f57cc32c7d8eeadbf9d0b4a73</cites><orcidid>0000-0002-2060-3234</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00192-023-05672-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00192-023-05672-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37938399$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sgayer, Inshirah</creatorcontrib><creatorcontrib>Shamalov, Gabriel</creatorcontrib><creatorcontrib>Assi, Silas</creatorcontrib><creatorcontrib>Glikman, Daniel</creatorcontrib><creatorcontrib>Lowenstein, Lior</creatorcontrib><creatorcontrib>Frank Wolf, Maya</creatorcontrib><title>Bacteriology and clinical outcomes of urine mixed bacterial growth in pregnancy</title><title>International Urogynecology Journal</title><addtitle>Int Urogynecol J</addtitle><addtitle>Int Urogynecol J</addtitle><description>Introduction and hypothesis
The objective was to analyse the risk of significant bacteriuria in repeat urine cultures from pregnant women, following initial mixed bacterial results.
Methods
This retrospective study examined maternal characteristics and clinical features of women who repeated urine cultures due to previous mixed cultures results.
Results
Of 262 women included, 80 (30.5%) had negative cultures and 125 (47.7%) had mixed bacterial growth in their repeat cultures. Positive results (≥10
4
CFU/ml of a urinary pathogen) were obtained for 57 women (21.8% [95% CI 17.1–27.0]). For 37 (14.1%), the repeat specimen grew 10
4
–10
5
CFU/ml of microorganisms; whereas for 20 women (7.6% [95% CI 4.9–11.3]), it grew ≥10
5
CFU/ml. Among women with positive (>10
4
CFU/ml) compared with those with negative or mixed growth, rates of urinary symptoms were higher (38.6% vs 23.4%,
p
=0.028), abnormal dipstick results (49.1% vs 21.0%,
p
<0.001) and hydronephrosis, as demonstrated by renal ultrasound (12.3% vs 2.0,
p
=0.003). In a multivariate logistic regression analysis, hydronephrosis was associated with the occurrence of a positive repeat culture (aOR = 10.65, 95% CI 2.07–54.90). The sensitivity and specificity for predicting a repeat urine culture with ≥10
5
CFU/ml were 12.9% and 94.3% respectively, for urinary symptoms; and 19.7% and 97.4% respectively, for abnormal dipstick results.
Conclusions
Mixed bacterial growth might represent a true urinary tract infection in a considerable proportion of women who are symptomatic and have an abnormal dipstick urinalysis.</description><subject>Bacteriology</subject><subject>Bacteriuria</subject><subject>Female</subject><subject>Gynecology</subject><subject>Humans</subject><subject>Hydronephrosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Pregnancy</subject><subject>Retrospective Studies</subject><subject>Urine</subject><subject>Urology</subject><issn>0937-3462</issn><issn>1433-3023</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE2P0zAQhi0EoqXwB_awssSFS2DiceL4yK6WD6lSL3C2HGdSskrsYidi--8xpIC0B04j2c_7zuhh7KqEtyWAepcASi0KEFhAVStRVE_YtpSIBea3p2wLGlWBshYb9iKlewCQUMFztkGlsUGtt-xwY91McQhjOJ659R134-AHZ0celtmFiRIPPV_i4IlPwwN1vF0TmTjG8GP-xgfPT5GO3np3fsme9XZM9Ooyd-zrh7svt5-K_eHj59v3-8KhqOeCdG2hbFqNKPuWNNV56A5QOsTOSaC-BqGbvlIuJ5zqGiLbtX1mWmkV7tibtfcUw_eF0mymITkaR-spLMmIplFSSa0wo68fofdhiT5fZ0Te30ghtM6UWCkXQ0qRenOKw2Tj2ZRgfuk2q26T1Zrfuk2VQ9eX6qWdqPsb-eM3A7gCKX_5I8V_u_9T-xPHhIs8</recordid><startdate>20240201</startdate><enddate>20240201</enddate><creator>Sgayer, Inshirah</creator><creator>Shamalov, Gabriel</creator><creator>Assi, Silas</creator><creator>Glikman, Daniel</creator><creator>Lowenstein, Lior</creator><creator>Frank Wolf, Maya</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2060-3234</orcidid></search><sort><creationdate>20240201</creationdate><title>Bacteriology and clinical outcomes of urine mixed bacterial growth in pregnancy</title><author>Sgayer, Inshirah ; Shamalov, Gabriel ; Assi, Silas ; Glikman, Daniel ; Lowenstein, Lior ; Frank Wolf, Maya</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-e96a018b9334fbe9e64fb9d034c33dc40ef60298f57cc32c7d8eeadbf9d0b4a73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Bacteriology</topic><topic>Bacteriuria</topic><topic>Female</topic><topic>Gynecology</topic><topic>Humans</topic><topic>Hydronephrosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Pregnancy</topic><topic>Retrospective Studies</topic><topic>Urine</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sgayer, Inshirah</creatorcontrib><creatorcontrib>Shamalov, Gabriel</creatorcontrib><creatorcontrib>Assi, Silas</creatorcontrib><creatorcontrib>Glikman, Daniel</creatorcontrib><creatorcontrib>Lowenstein, Lior</creatorcontrib><creatorcontrib>Frank Wolf, Maya</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>International Urogynecology Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sgayer, Inshirah</au><au>Shamalov, Gabriel</au><au>Assi, Silas</au><au>Glikman, Daniel</au><au>Lowenstein, Lior</au><au>Frank Wolf, Maya</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bacteriology and clinical outcomes of urine mixed bacterial growth in pregnancy</atitle><jtitle>International Urogynecology Journal</jtitle><stitle>Int Urogynecol J</stitle><addtitle>Int Urogynecol J</addtitle><date>2024-02-01</date><risdate>2024</risdate><volume>35</volume><issue>2</issue><spage>347</spage><epage>353</epage><pages>347-353</pages><issn>0937-3462</issn><eissn>1433-3023</eissn><abstract>Introduction and hypothesis
The objective was to analyse the risk of significant bacteriuria in repeat urine cultures from pregnant women, following initial mixed bacterial results.
Methods
This retrospective study examined maternal characteristics and clinical features of women who repeated urine cultures due to previous mixed cultures results.
Results
Of 262 women included, 80 (30.5%) had negative cultures and 125 (47.7%) had mixed bacterial growth in their repeat cultures. Positive results (≥10
4
CFU/ml of a urinary pathogen) were obtained for 57 women (21.8% [95% CI 17.1–27.0]). For 37 (14.1%), the repeat specimen grew 10
4
–10
5
CFU/ml of microorganisms; whereas for 20 women (7.6% [95% CI 4.9–11.3]), it grew ≥10
5
CFU/ml. Among women with positive (>10
4
CFU/ml) compared with those with negative or mixed growth, rates of urinary symptoms were higher (38.6% vs 23.4%,
p
=0.028), abnormal dipstick results (49.1% vs 21.0%,
p
<0.001) and hydronephrosis, as demonstrated by renal ultrasound (12.3% vs 2.0,
p
=0.003). In a multivariate logistic regression analysis, hydronephrosis was associated with the occurrence of a positive repeat culture (aOR = 10.65, 95% CI 2.07–54.90). The sensitivity and specificity for predicting a repeat urine culture with ≥10
5
CFU/ml were 12.9% and 94.3% respectively, for urinary symptoms; and 19.7% and 97.4% respectively, for abnormal dipstick results.
Conclusions
Mixed bacterial growth might represent a true urinary tract infection in a considerable proportion of women who are symptomatic and have an abnormal dipstick urinalysis.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>37938399</pmid><doi>10.1007/s00192-023-05672-5</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-2060-3234</orcidid></addata></record> |
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| subjects | Bacteriology Bacteriuria Female Gynecology Humans Hydronephrosis Medicine Medicine & Public Health Original Article Pregnancy Retrospective Studies Urine Urology |
| title | Bacteriology and clinical outcomes of urine mixed bacterial growth in pregnancy |
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