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Microbiological outcomes in women with diabetes and untreated asymptomatic bacteriuria.

Abstract：

BACKGROUND:Asymptomatic bacteriuria is common in diabetic women. Treatment of asymptomatic bacteriuria is not beneficial, but the natural history of the microbiology of asymptomatic bacteriuria has not been well described. OBJECTIVE:To describe the microbiological outcomes of bacteriuria in diabetic women with untreated asymptomatic bacteriuria. METHODS:Study subjects were initially identified through ambulatory endocrinology clinics. They were enrolled if they had two positive urine cultures > or = 10(8) cfu/l with the same organism within 2 weeks and no symptoms referable to urinary tract infection. Women initially received a 2-week course of placebo with follow-up cultures obtained at the end of treatment and 4 weeks post-treatment. Subsequently, the prevalence of bacteriuria was determined with urine cultures obtained every 3 months to a maximum of 36 months. Outcomes at yearly intervals were designated as one of: persistent bacteriuria; spontaneous resolution; resolution with antibiotics for symptomatic urinary infection; or resolution with antibiotics given for other indications. Women with and without persistent or frequent bacteriuria were compared to identify variables associated with bacteriuria. RESULTS:The prevalence of bacteriuria in the study cohort declined to about 50% by 9 months, and subsequently remained stable throughout 3 years follow-up. Almost 20% of subjects remained bacteriuric with the original infecting organism throughout the period of observation. With evaluation at 12-month intervals, approximately one-quarter of subjects had each of the four potential outcomes of: resolution following antibiotic therapy for symptomatic urinary infection, following antibiotic therapy for other indications, spontaneous resolution without antibiotics, and persistent bacteriuria with the same organism. Women infected with gram-negative organisms were more likely to have persistent bacteriuria. Many women with resolution of initial bacteriuria, with or without antibiotics, became bacteriuric again during follow-up. CONCLUSIONS:Women with asymptomatic bacteriuria and diabetes tend to have persistent or recurrent asymptomatic bacteriuria. Bacteriuria is benign, and seldom permanently eradicable.

journal_name

World J Urol

journal_title

World journal of urology

authors

Nicolle LE,Zhanel GG,Harding GK

doi

10.1007/s00345-005-0042-2

keywords:

subject

Has Abstract

pub_date

2006-02-01 00:00:00

pages

61-5

issue

eissn

0724-4983

issn

1433-8726

journal_volume

pub_type

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Microbiological outcomes in women with diabetes and untreated asymptomatic bacteriuria.