Incidence Of Asymptomatic Bacteriuria Research Articles

Clinico-microbiological Profile and Outcomes of Asymptomatic Bacteriuria in Pregnancy.

Asymptomatic bacteriuria (ASB) during pregnancy can lead to symptomatic urinary tract infection (UTI), with increased fetal and maternal morbidity and mortality. We evaluated the incidence, clinical and microbiological profile, and outcome of ASB in pregnant women attending our antenatal clinic. This prospective study was conducted on 3769 pregnant women in a routine antenatal clinic at a tertiary care center. Participants were divided into two groups, ASB and non-bacteriuria. Data were collected in a standard proforma and analyzed using the software Statistical Package for the Social Sciences (SPSS) v. 20. The incidence of ASB was 3.29% (124/3769). Majority of the women were in the age group of 21-30 years (78.76%, n = 89). Escherichia coli (61.06%) was the most common organism isolated. Maternal anemia (30.08% and 2.93% in the ASB and non-bacteriuria groups, respectively), low birth weight (LBW; 42.5% and 27.98% in the ASB and non-bacteriuria groups, respectively), intrauterine death (4.4% and 1.4% in the ASB and non-bacteriuria groups, respectively), and preterm delivery (37.2% and 22.31% in the ASB and non-bacteriuria groups, respectively) were were associated with ASB (P = 0.001). ASB was associated with maternal anemia, preterm delivery, intrauterine death, and LBW. Early detection and treatment of ASB may result in favorable maternal outcome.

Incidence and risk factors of asymptomatic bacteriuria in patients with type 2 diabetes mellitus: a meta-analysis

BackgroundThe prevalence of type 2 diabetes mellitus (T2DM) is increasing each year and has become one of the most prominent health concerns worldwide. Patients with T2DM are prone to infectious diseases, and urinary tract infections are also widespread. Despite a comprehensive understanding of urinary tract infection (UTI), there is a lack of research regarding primary prevention strategies for asymptomatic bacteriuria (ASB).ObjectiveTo clarify the incidence and risk factors of asymptomatic urinary tract infection in patients with T2DM by meta-analysis to provide evidence for preventing UTI. Help patients, their families, and caregivers to identify the risk factors of patients in time and intervene to reduce the incidence of ASB in patients with T2DM. Fill in the gaps in existing research.Study designMeta-analyses were conducted in line with PRISMA guidelines.MethodsEleven databases were systematically searched for articles about ASB in T2DM, and the retrieval time was selected from the establishment of the database to February 5, 2023. Literature screening, quality evaluation, and meta-analysis were independently performed by two researchers according to the inclusion and exclusion criteria, and a meta-analysis was performed using Stata 17.0.ResultsFourteen articles were included, including cohort and case–control studies. A meta-analysis of 4044 patients with T2DM was included. The incidence of ASB in patients with T2DM was 23.7%(95% CI (0.183, 0.291); P < 0.001). After controlling for confounding variables, the following risk factors were associated with ASB in patients with T2DM: age (WMD = 3.18, 95% CI (1.91, 4.45), I2 = 75.5%, P < 0.001), female sex (OR = 1.07, 95% CI(1.02, 1.12), I2 = 79.3%, P = 0.002), duration of type 2 diabetes (WMD = 2.54, 95% CI (1.53, 5.43), I2 = 80.7%, P < 0.001), HbA1c (WMD = 0.63, 95% CI (0.43, 0.84), I2 = 62.6,%. P < 0.001), hypertension (OR = 1.59, 95% CI (1.24, 2.04), I2 = 0%, <0.001), hyperlipidemia (OR = 1.66, 95% CI (1.27, 2.18), I2 = 0%, P < 0.001), Neuropathy (OR = 1.81, 95% CI (1.38, 2.37), I2 = 0%, P < 0.001), proteinuria (OR = 3.00, 95% CI (1.82, 4.95), I2 = 62.7%, P < 0.001).ConclusionThe overall prevalence of ASB in T2DM is 23.7%. Age, female sex, course of T2DM, HbA1C, hypertension, hyperlipidemia, neuropathy, and proteinuria were identified as related risk factors for ASB in T2DM. These findings can provide a robust theoretical basis for preventing and managing ASB in T2DM.

Profile, Risk Factors, and Outcomes of Asymptomatic Bacteriuria in Kidney Transplant Recipients with Normal Pretransplant Genitourinary Tract: A Single-Center Experience.

There is a paucity of studies on asymptomatic bacteriuria (ASB) among kidney transplant recipients (KTR) in developing countries. This study assessed the clinical profile, risk factors, outcomes, and impact of treatment of ASB in KTRs with a normal genitourinary tract. Consecutive KTRs from 2009 to 2018 with no clinical or radiological evidence of obstructive uropathy were included. Urinary tract infection (UTI) after ASB was defined as occurrence of cystitis, pyelonephritis, or urosepsis, with ASB being the first bacteriuric episode. Seven hundred ten out of 794 patients with median follow up of 47 months were included. The mean age was 35.5 ± 12 years. Eighty-one patients (11.4%) developed ASB at a median of 25 days (IQR 10, 134.5). Fifty-three percent and 4.9% of ASB episodes were extended-spectrum beta-lactamase (ESBL) positive and carbapenem-resistant organisms, respectively. Eighteen patients (32.1%) with early ASB (<3 months) and 5 (20%) with late ASB developed UTI on follow-up. Fifty-five percent of early and 16% of late ASB episodes were treated, with no significant difference observed in the risk of development of UTI when compared to untreated ASB episodes. The incidence of ASB as first bacteriuric episode in our cohort was 11.4%, with there being significant antimicrobial resistance. Female gender, pretransplant UTI, and delayed graft function were independently associated with development of ASB. Treatment of ASB episodes either early or late did not decrease the risk of development of UTI.

ASYMPTOMATIC BACTERIURIA IN REPRODUCTIVE AGE GROUP FEMALES.

Background: Asymptomatic bacteriuria is one of the important causative factors for premature or low-birth infants, postpartum urinary tract infections and higher fetal mortality rates in pregnant women Methods: Thirty-two asymptomatic females from the antenatal clinic, twenty-five females admitted to the post-natal ward and ten nonpregnant females were randomly selected. Clean-catch midstream urine sample was collected and processed for culture and sensitivity as per standard guidelines.Results: Overall incidence of asymptomatic bacteriuria was 11.9%. The incidence of asymptomatic bacteriuria in pregnant females was 3.1% whereas the incidence in post-natal females was 40%. None of the non-pregnant females had asymptomatic bacteriuria. Conclusion: Screening of antenatal and post-partum females is required to avoid adverse outcomes.

Associated Risk Factors for Asymptomatic Bacteriuria in Pregnant Women Visited Antenatal Clinic in Lahore, Pakistan

Background: Asymptomatic bacteriuria is the occurrence of bacteria in the urine sample without any clinical symptoms. The odds of asymptomatic bacteriuria increase due to the hormonal growth during pregnancy. Methodology: The data was collected from a sample of size 167 pregnant women using self-structured questionnaire. The questionnaire was based on two sections. The questionnaire was tested using Cronbach alpha. The data was collected using convenient sampling. The frequency distribution of the risk factors was given. The binary logistic regression analysis was performed to access the major risk factors that enhance the odds for asymptomatic bacteriuria in pregnant women. Results: The past history of UTI was seen as a significant risk factor. The overall incidence of asymptomatic bacteriuria was found in 22 pregnant women and among these, approximately 9% had past history of UTI. About 44.9% of the pregnant women showed a past history of UTI. Conclusion: Most of the pregnant women fall in the age group 26-32 years. The significant factor is age group for asymptomatic bacteriuria. Advancement in age enhance the odds for the asymptomatic bacteriuria. History of UTI is found as a significant risk factor. Keywords: Asymptomatic bacteriuria, pregnancy, infections,

Urinary tract infections in patients with multiple sclerosis and different methods of bladder evacuation

Introduction and objectivesTo evaluate the incidence and course of urinary tract infections (UTI) in patients with multiple sclerosis (MS) and their relationship to the method of bladder evacuation. Materials and MethodsPatients with neurogenic bladder dysfunction due to MS (n=111) were enrolled in the study. During one-year follow-up, clinical examination with urine culture was performed every 4 months or whenever symptoms occurred. The control group included patients with symptomatic UTI, without neurological or autoimmune disease. Incidence of symptomatic and asymptomatic bacteriuria, the effect of urine drainage on UTI incidence, and the effect of antibiotics were statistically evaluated. Results54 MS patients completed the protocol. The mean incidence of symptomatic and asymptomatic bacteriuria in the MS group was 12.5% and 29.6%, respectively. A decreasing trend in the incidence of symptomatic, and an increasing trend in the incidence of asymptomatic bacteriuria was observed. Eradication of UTI in symptomatic MS patients was significantly lower than in controls (37.75% vs. 92.93%, P<0.05). Causative agents significantly differed in both groups (P=0.0005). The hypothesis that the incidence of UTIs in MS patients is independent of the method of bladder evacuation was not rejected (P>0.99 at visit 0, 1 and 3, P=0.078 at visit 2). ConclusionsThere is a significant difference between the causative agents of UTI in both groups. Eradication of bacteriuria in symptomatic MS patients is difficult when compared to the normal population. We have insufficient evidence to confirm the relationship between the incidence of UTI and the method of bladder evacuation.

Infecciones del tracto urinario en pacientes con esclerosis múltiple y los diferentes sistemas de vaciado vesical

Introduction and objectivesTo evaluate the incidence and course of urinary tract infections (UTI) in patients with multiple sclerosis (MS) and their relationship to the method of bladder evacuation. Materials and methodsPatients with neurogenic bladder dysfunction due to MS (n=111) were enrolled in the study. During one-year follow-up, clinical examination with urine culture was performed every 4 months or whenever symptoms occurred. The control group included patients with symptomatic UTI, without neurological or autoimmune disease. Incidence of symptomatic and asymptomatic bacteriuria, the effect of urine drainage on UTI incidence, and the effect of antibiotics were statistically evaluated. ResultsFifty-four MS patients completed the protocol. The mean incidence of symptomatic and asymptomatic bacteriuria in the MS group was 12.5% and 29.6%, respectively. A decreasing trend in the incidence of symptomatic, and an increasing trend in the incidence of asymptomatic bacteriuria was observed. Eradication of UTI in symptomatic MS patients was significantly lower than in controls (37.75% vs. 92.93%, P<.05). Causative agents significantly differed in both groups (P=.0005). The hypothesis that the incidence of UTIs in MS patients is independent of the method of bladder evacuation was not rejected (P>.99 at visit 0, 1 and 3, P=.078 at visit 2). ConclusionsThere is a significant difference between the causative agents of UTI in both groups. Eradication of bacteriuria in symptomatic MS patients is difficult when compared to the normal population. We have insufficient evidence to confirm the relationship between the incidence of UTI and the method of bladder evacuation.

Asymptomatic Bacteriuria (ASB) in Pregnancy: Prevalence and Fetal Risk

Objective: To evaluate the prevalence of Asymptomatic Bacteriuria (ASB) and its association with fetal outcome at tertiary care Hospital. Material and Methods: This was a descriptive cross-sectional study was conducted at the Obstetrics and Gynaecology department of Liaquat University of Medical and Health Sciences for six months from February 2021 to August 2021. Total 2838 pregnant women in third trimester (more than 28 weeks of gestion) whose urine sample were taken, aged 18 to 41 years of either parity or booking status were included. Following the clinical examination, the investigator gave each mother a labeled sterile container and instructed them about how to obtain midstream urine, after that the urine samples were obtained and were sent to the Hospital diagnostic laboratory for the urine culture. A positive culture of each case was considered Asymptomatic Bacteriuria (ASB). All the data were gathered using the self-made study proforma. SPSS version 26 was used to analyze the data. Results: Total 2838 women were assessed regarding Asymptomatic Bacteriuria (ASB), and the overall incidence of Asymptomatic Bacteriuria (ASB) was (5.32%). Mean age of the women was 27.70+4.83 years and the average gestational age was 37.11+2.91 weeks. Most of the females were primiparous 90(59.6%). Majority of the cases 93(61.6%) were un-booked. As per fetal complications 31(20.5%) new born were low birth weight babies, PROM was 22(14.6%) and preterm deliveries were 28(18.5%). Fetal complications were statistically significant according to maternal age and gestational age (p-&lt;0.05), while they were statistically insignificant according to parity and booking status (p-.0.05). Conclusion: Asymptomatic Bacteriuria (ASB) was observed to be 5.32%. Asymptomatic Bacteriuria (ASB) observed to be the causative factor for adverse fetal outcome. Urine culture should be done during the antenatal care to improve the fetal outcome by early diagnosis and management. Keywords: Asymptomatic Bacteriuria (ASB), incidence, fetal complications

The clinical utility of intrapartum screening urinalysis for the prevention of postpartum pyelonephritis

ObjectivesUrinary tract infection (UTI) is the most common bacterial infection to complicate pregnancy. Medical authorities recommend screening for asymptomatic bacteriuria (ASB) in pregnancy; albeit there is no consensus on ideal timing and frequency for testing. Due to the persistent physiologic changes of pregnancy postpartum, a recent trend to perform urinalysis upon presentation for delivery has been adopted at our institution and various satellite hospitals to putatively minimize cases of postpartum pyelonephritis. The aim of this study is to examine whether routine testing with urinalysis and screening for ASB following suspicious urinalysis with treatment can decrease the incidence of postpartum pyelonephritis, and to determine whether certain urinalysis parameters are more predictive of a positive urine culture. Study designA retrospective chart review study of all term deliveries was conducted over two years at the American University of Beirut Medical Center, a university teaching hospital. A total of 2359 deliveries of women with no increased susceptibility to UTIs were reviewed. None had urinary symptoms upon presentation. Urinary parameters including time of urinalysis and urine culture collection with respect to time of delivery, corresponding results and mode of urine collection were correlated to intrapartum course, incidence of ASB and of postpartum pyelonephritis. ResultsThe incidence of ASB among women presenting for delivery was 4.83 %, with Escherichia coli as the most commonly detected pathogen. The presence of nitrite on urinalysis was significantly associated with a positive urine culture (p-value<0.001). Women with history of antenatal ASB or UTI were more likely to have ASB intrapartum with an odds ratio of 3.14 (95 % CI 1.71–5.75, p-value <0.001). Intrapartum urinalysis with subsequent diagnosis and treatment of ASB did not significantly affect the incidence of postpartum pyelonephritis (p-value 0.280). Similarly, intrapartum urinalysis in the setting of positive history of antenatal ASB or UTI did not increase the incidence of postpartum pyelonephritis compared to women with no such history (p-value 0.659). ConclusionsUrinalysis screening intrapartum does not decrease the incidence of postpartum pyelonephritis. Universal urinalysis screening intrapartum is not warranted and should be reserved for women reporting urinary symptoms and/or women at high risk of UTI.

Asymptomatic Bacteriuria (ABU) in Elderly: Prevalence, Virulence, Phylogeny, Antibiotic Resistance and Complement C3 in Urine.

Background: The incidence of asymptomatic bacteriuria (ABU) increases with age and is most common for persons 80 years of age and above and in elderly living in nursing homes. The distinction between ABU and urinary tract infection (UTI) is often difficult, especially in individuals, who are unable to communicate their symptoms, and there is a lack of objective methods to distinguish between the two entities. This can lead to overuse of antibiotics, which results in the selection and dissemination of antibiotic resistant isolates. Materials and methods: From voided midstream urine samples of 211 participants ≥60 years old from nursing homes, an activity center and a general practitioners clinic, we collected 19 ABU, 16 UTI and 22 control urine samples and compared them with respect to levels of complement component C3 in urine as determined by an ELISA assay relative to creatinine levels in the same urine samples, as measured by a creatinine assay. Further, we studied all Escherichia coli isolates for selected virulence genes by multiplex PCR, and by whole-genome sequencing (WGS) for genotypes and phylogenetic clustering. Antibiotic susceptibility was determined by microtiter broth dilution. Results: We identified a prevalence of ABU of 18.9% in nursing home residents, whereas ABU was only found in 4% of elderly living in the community (p < 0.001). E. coli from ABU patients were significantly more antibiotic resistant than E. coli from UTIs (p = 0.01). Prevalence of classical virulence genes, detected by multiplex PCR, was similar in E. coli isolates from ABU and UTI patients. Whole-genome sequencing of the E. coli isolates showed no specific clustering of ABU isolates compared to UTI isolates. Three isolates from three different individuals from one of the nursing homes showed signs of transmission. We demonstrated a significantly increased level of C3/creatinine ratio in ABU and UTI samples compared to healthy controls; however, there was no significant difference between the ABU and UTI group with respect to C3 level, or virulence factor genes. Conclusion: ABU was significantly more prevalent in the elderly residing in nursing homes than in the elderly living at home. Antibiotic resistance was more prevalent in E. coli from nursing homes than in UTI isolates, but there was no difference in prevalence of virulence associated genes between the two groups and no phylogenetic clustering, as determined by WGS relative to the two types of E. coli bacteriuria. The similar complement C3 response in ABU and UTI patients may indicate that ABU should be reconsidered as an infection albeit without symptoms.

Efeitos da limpeza periuretral na incidência de bacteriúria após cateterização urinária: ensaio clínico randomizado

Objetivo: Comparar o efeito da limpeza periuretral com o uso de sabão comum e antissépticos na incidência de bacteriúria assintomática em pacientes adultos submetidos ao cateterismo urinário de demora. Métodos: Trata-se de ensaio clínico randomizado realizado entre os meses de dezembro de 2017 a janeiro de 2019, com 28 pacientes internados em um hospital de grande porte submetidos ao cateterismo urinário de demora. Os participantes foram alocados aleatoriamente nos grupos: sabão (n=11) e grupo antisséptico (n=17). Uroculturas foram coletadas no momento da inserção do cateter e 24h após. Resultados: A incidência global de bacteriúria assintomática foi de 7,14%, no grupo sabão foi de 9,1% e no grupo antissépticos foi de 5,9%. A regressão logística mostrou que não houve diferença estatisticamente significativa na incidência de bacteriúria assintomática quando realizada a limpeza com sabão ou antissépticos (clorexidina ou povidona-iodo). Conclusão: Não houve diferenças estatisticamente significativas quando se utilizou sabão comum ou antisséptico para a limpeza periuretral anterior à inserção do cateter urinário ao comparar as incidências de BA.

Systematic review and meta-analysis of asymptomatic bacteriuria after renal transplantation: incidence, risk of complications, and treatment outcomes.

Routine treatment for asymptomatic bacteriuria (ASB) after renal transplantation (RT) represents nowadays a controversial topic, being unknown its impact on the overall prognosis of the transplanted patient. Studies published during 1970-2019 that evaluated the benefit of treating ASB after RT regarding the risk of renal complications were included. The primary outcome was to assess whether the treatment is associated with a lower risk of symptomatic urinary tract infection (UTI) or an improved renal function at the end of the follow-up period. The secondary outcome was the risk of acute graft rejection (AGR). A meta-analysis with a random-effect model was performed. Heterogeneity was assessed with the I2 measure. Fifteen studies were included. The incidence of ASB in the first month and the first year after RT was 22% and 30%, respectively. ASB was not correlated to AGR (OR 1.18; 95% CI, 0.78-1.79). Eight studies compared the outcomes of ASB treatment, finding no benefit of treating regarding the risk of symptomatic UTI (OR 1.08; 95% CI, 0.63-1.84; I2 =35%) or the change in renal function (mean difference in serum creatinine concentration-0.03mg/dL,95% CI-0.15-0.10; I2 =53%). Asymptomatic bacteriuria represents a frequent finding after RT, highlighting the need for appropriate management of this condition. Considering that its treatment did not decrease the risk of the studied complications, antibiotic therapy should start to be questioned, as it has been related to higher rates of antimicrobial resistance and high economic costs.

Risk of infection in patients undergoing urologic surgery based on the presence of asymptomatic bacteriuria: A prospective study

Treatment of asymptomatic bacteriuria (ASB) is recommended in pregnant women and prior to urologic procedures with anticipated mucosal disruption. However, there is still insufficient evidence of the usefulness of treating ASB prior to urologic procedures. Therefore, the aim of this study was to ascertain the risk of infections in patients undergoing urologic surgery based on the presence of ASB. We conducted a cohort study among patients undergoing urologic surgery at a single center located in Medellín, Colombia. All patients were screened for ASB prior to their procedures. Patients were evaluated for the development of any postoperative infectious complications for up to 30 days after the procedure. A total of 149 patients were included in this cohort. Incidence of ASB was 14.8%. Thirteen patients (8.72%) developed infectious complications: 3 (13.64%) with ASB and 10 (7.87%) without ABS. Factors associated with postoperative infectious complications included urologic cancers (hazard ratio [HR], 5.26; 95% confidence intervals [CI], 1.24-22.37), urologic interventions in the preceding 3 months (HR, 3.72; 95% CI, 1.02-13.51), and use of antibiotics 3 months prior to surgery (HR, 3.83; 95% CI, 1.01-15.49). Presence of ASB was not associated with postsurgical infectious complications (HR, 1.02; 95% CI, 0.26-3.96). There was no association between ASB and postoperative infectious complications. There were other factors associated with infectious complications, such as urologic cancer, previous history of urologic manipulation, and antibiotic use.

Impact of asymptomatic bacteriuria incidence and management post-kidney transplantation.

Urinary tract infections (UTIs) are the most commonly occurring infectious complication following kidney transplantation. Questions remain regarding whether asymptomatic bacteriuria (ASB) should be treated. The aim was to evaluate the incidence and management of ASB in kidney transplant recipients at a large academic medical center. All subjects receiving an isolated kidney transplant between September 2012 and October 2016, and with at least one ASB episode were included. Demographics, symptomatology, and urine culture data were collected on subjects with bacteriuria in the first year post-transplant. Cultures were classified by symptoms, ASB treatment trends were analyzed, and ASB-to-UTI progression was compared between ASB treatment and non-treatment. A total of 527 subjects were transplanted with 64 developing at least one ASB episode. The incidence of ASB was 12.1% and treated 74.6% of the time. Neither lack of ASB treatment (P=0.463) nor ASB within the first month post-transplant (P=0.303) were associated with ASB-to-UTI progression. Despite high ASB treatment rate, this was not found to be protective against ASB-to-UTI progression. ASB within the first month post-transplant also did not correlate with increased progression risk. These results suggest minimization of ASB treatment in kidney transplant recipients remains an important antimicrobial stewardship target.

Advances and Challenges in the Diagnosis and Treatment of Urinary Tract Infections: the Need for Diagnostic Stewardship.

Urinary tract infections (UTIs), including catheter-associated UTIs, are among the most common bacterial infections in both inpatient and outpatient settings. Diagnosis of true UTI remains a clinical challenge, and excessive antimicrobial treatment of asymptomatic bacteriuria (ASB) or contaminated urine cultures is common. Challenges with the appropriate diagnosis of UTIs include the lack of specific signs and symptoms, no definitive diagnostic criteria, high incidence of ASB, contamination of samples, and frequent lack of indications for ordering urine cultures. Promising interventions include education and feedback, indication requirements when ordering cultures, and use of reflex culture policies that limit urine cultures. Antimicrobial and diagnostic stewardship interventions can work synergistically to decrease ordering of urine cultures without clear indication and prevent excessive antimicrobial administration in patients without clearly defined UTI.

Incidence of Asymptomatic Bacteriuria among Pregnant Women Attending Federal Medical Center, Katsina

Asymptomatic bacteriuria is common among pregnant women and it is frequently associated with adverse pregnancy outcomes leading to maternal and fetal morbidity and mortality. The burden of asymptomatic bacteria in pregnancy has not been previously evaluated in this environment. Therefore, the study aimed to determine the prevalence of asymptomatic bacteriuria and its clinical correlate among pregnant women attending Federal Medical Center, Katsina. The study was a prospective study conducted among 126 antenatal attendees from 19th September – 4th November 2017. Urine microscopy and culture technique were conducted for each participant. The prevalence of asymptomatic bacteriuria among pregnant women was 19.8% and only gestational age and tribe had significant association with asymptomatic bacteriuria (p = 0.02) respectively however age (p = 0.66), educational status (p = 0.19) and settlement (p = 0.91) showed no significant association. Staphylococcus aureus was the most prevalent organism (40%), followed by coagulase negative Staphylococcus (32%) while Eschericia coli was least prevalent organism (4%). Asymptomatic bacteriuria is not uncommon among pregnant women in this environment; as such urine culture should be routinely carried out as part of antenatal care package for early detection and prevention of possible complications of urinary tract infections in pregnancy.

1529. Suprapubic Catheter Placement Improves Antimicrobial Stewardship in a Veterans Affairs Long-term Care Facility

BackgroundIt is unknown if suprapubic catheters (SCs) offer benefit over indwelling urethral catheters (IUCs) in incidence of asymptomatic bacteriuria and catheter-associated infection (CAUTI), or subsequent antibiotic exposure.MethodsWe conducted a retrospective cohort study of unique patients with SCs placed at VA Pittsburgh Healthcare System from February 2015 to March 2018, who had a prior IUC (≥30 days for each). Demographic, laboratory, microbiologic, and antibiotic use data were compared over the same number of days between IUC and SC periods. IDSA Guidelines were used to define CAUTI and asymptomatic bacteriuria.ResultsEighteen patients with SC were included. SCs were in place for a median of 213 days (range: 49–1,085). The indications for catheterization were urinary retention (n = 12), neurogenic bladder (n = 5), and decubitus healing (n = 1). The most common underlying conditions were benign prostatic hyperplasia (n = 9), multiple sclerosis (n = 2), and Parkinson’s disease (n = 2). The median number of urine cultures collected per 100 IUC and 100 SC days were 2.28 (range: 0–4.08) and 0.35 (range: 0–5.85), respectively (P = 0.02). Forty-four percent (8/18) and 39% (7/18) received at least one antibiotic course for asymptomatic bacteriuria during IUC and SC periods. A total of 170 days of antibiotic therapy were given for asymptomatic bacteriuria per 4,881 IUC days vs. 107 days for asymptomatic bacteriuria per 4,881 SC days (P = 0.0001). The median rate of CAUTI was 0.25 per 100 IUC days vs. 0.08 per 100 SC days (P = 0.15). The most common pathogens causing CAUTIs were Pseudomonas aeruginosa (n = 5), Candida albicans (n = 2), Klebsiella pneumoniae (n = 1) and Enterococcus faecalis (n = 1). A total of 163 days of antibiotic therapy were given for CAUTI per 4,881 IUC days vs. 38 days of antibiotic therapy for CAUTI per 4,881 SC days (P < 0.0001).ConclusionSCs were associated with significantly less overall antibiotic exposure than IUCs, both as treatment of CAUTIs and as inappropriate agents against asymptomatic bacteriuria. CAUTI rates were similar among patients with SCs and IUCs, although cultures were performed more often in those with IUCs. Reducing the treatment of asymptomatic bacteriuria remains a leading stewardship challenge.Disclosures All authors: No reported disclosures.

Prevalence of Asymptomatic Bacteriuria in Patients with Preterm Labor

Background: asymptomatic bacteriuria (ASB) during pregnancy is the primary cause of acute pyelonephritis, preterm labor, low birth weight fetus, etc., if left untreated. Adequate and early treatment reduces the prevalence of these obstetric complications. Objectives: this study aimed to determine the prevalence of ASB during pregnancy and determine the association between asymptomatic bacteriuria and spontaneous preterm birth. Patients Methods: this was a case control study of 120 preterm pregnancies and 40 term pregnancies among those attending El-Galaa Teaching Hospital, Obstetric Emergency Unit to evaluate the incidence of ASB and determine the association between asymptomatic bacteriuria and spontaneous preterm birth from March 2016 to March2017.Urine analysis and culture with antibiotic sensitivity were performed . Results: out of the 160 patients studied, ASB was observed in 7 patients (6 cases in preterm group (5%) and 1 case in full term group (2.5%) with no significant difference between the two groups (p-value˃ 0.05), the incidence of ASB in preterm labor was quite lower 5%. E. coli was the most common pathogen (55.14%) followed by proteus 28.57 followed by klebsiella (14.28%). Conclusion: all pregnant women should be screened by urine culture to detect asymptomatic bacteriuria at their first visit to prevent overt urinary tract infections (UTI) and other complications in both mother and fetus.

Prevalence of Asymptomatic Bacteriuria in Patients with Preterm Labor

Background: asymptomatic bacteriuria (ASB) during pregnancy is the primary cause of acute pyelonephritis, preterm labor, low birth weight fetus, etc., if left untreated. Adequate and early treatment reduces the prevalence of these obstetric complications. Objectives: this study aimed to determine the prevalence of ASB during pregnancy and determine the association between asymptomatic bacteriuria and spontaneous preterm birth. Patients Methods: this was a case control study of 120 preterm pregnancies and 40 term pregnancies among those attending El-Galaa Teaching Hospital, Obstetric Emergency Unit to evaluate the incidence of ASB and determine the association between asymptomatic bacteriuria and spontaneous preterm birth from March 2016 to March2017.Urine analysis and culture with antibiotic sensitivity were performed . Results: out of the 160 patients studied, ASB was observed in 7 patients (6 cases in preterm group (5%) and 1 case in full term group (2.5%) with no significant difference between the two groups (p-value˃ 0.05), the incidence of ASB in preterm labor was quite lower 5%. E. coli was the most common pathogen (55.14%) followed by proteus 28.57 followed by klebsiella (14.28%). Conclusion: all pregnant women should be screened by urine culture to detect asymptomatic bacteriuria at their first visit to prevent overt urinary tract infections (UTI) and other complications in both mother and fetus.

THE ASSOCIATION BETWEEN ASYMPTOMATIC BACTERIURIA AND GLYCEMIC CONTROL IN TYPE 2 DIABETES MELLITUS

The incidence of infection often occurs in patients with Diabetes Mellitus (DM) due to hyperglycemia that causes dysfunction of chemotaxis, phagocytic activity, malfunction of neutrophils and glycosuria. It is followed by other complications that lead to the malfunction of the bladder. Highly urinary glucose level is an exellent medium for pathogenic microorganisms growth. Asymptomatic Bacteriuria (ASB) is a risk factor for symptomatic urinary tract infection spontaneously or due to urinary catheters. This study aimed to analyze the association between the incidence of ASB of type 2 DM and glycemic control. The study was conducted during June-August 2016 with a cross-sectional method. Subjects were type 2 DM patients with age ≤60 years, who were treated in the Endocrinology Out-Patient Clinic of the Adam Malik Hospital. HbA1c was measured by Indiko automatic analyzer. Its association with urine culture results was analyzed. A total of 50 samples were enrolled, consisting of 25 females, and 25 males, with 19 having an exellent glycemic control (HbA1c &lt;7%) and 31 with poor glycemic control (HbA1c ≥7%). Thirteen positive ASB were found, 5 with good glycemic control and 8 with poor glycemic control. Statistical analysis revealed a nonsignificant association between glycemic control and culture results (p = 1.000). Somers'd did not show a significant association between glycemic control and the incidence of ASB (p=0.968, d=-0.005). However, significant differences in culture results between gender, in which the ASB were found in samples of four females and two males (p=0.004). Somers'd revealed a significant association between culture results and gender (p=0.001; d=-0.360). Most of the bacteria found were Gram-negative. There was no significant association between glycemic control with an incidence of ASB. However, gender had significant differences in the incidence of ASB, which occurred more frequently in DM females than males. Urinalysis should be performed in patients with type 2 DM with ASB. However, further study was needed to analyze the relationship between glycemic control with the incidence of ASB and other factors that might affect the incidence of ASB.