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188 The role of asymptomatic bacteriuria in young women with recurrent urinary tract infections: To treat or not to treat
188 - The role of asymptomatic bacteriuria in young women with recurrent urinary tract i...
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e188 The role of asymptomatic bacteriuria in young women with recurrent urinary tract infections: To treat or not to treat 1
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3
2
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Cai T. , Mazzoli S. , Mondaini N. , Meacci F. , Nesi G. , Luciani 1
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1
1
L.G. , D'Elia C. , Tiscione T. , Malossini G. , Bartoletti R. 1 2
3
Santa Chiara Regional Hospital, Dept. of Urology, Trento, Italy, Santa Maria Annunziata Hospital, Dept. of Sexually Transmitted
Disease, Florence, Italy,
3
Department of Urology, Dept. of Urology,
4
Florence, Italy, University of Florence, Dept. of Pathological Anatomy, Dept of Critical Care Medicine and Surgery, Florence, Italy INTRODUCTION & OBJECTIVES: Asymptomatic bacteriuria (AB) is common in young women, but little is known about its role in urinary tract infections (UTI). The aim of this study was to evaluate the impact of AB treatment in recurrence rate among young women affected by recurrent UTI. MATERIAL & METHODS: All consecutive asymptomatic young women with demonstrated bacteriuria attending a single Sexually Transmitted Disease Centre from January 2005 and December 2009, were prospectively enrolled. All patients were split into two groups: Group A – not treated, Group B – treated. Microbiological and clinical evaluations were performed at 3, 6 and 12 months. Quality of life was also measured. RESULTS: 673 women were analyzed. 312 were assigned to Group A while 361 to Group B. At the baseline, the two most commonly isolated pathogens were Escherichia coli (Group A 38.4%; Group B 39.3%) and Enterococcus faecalis (Group A 32.7%; Group B 33.2%). At the first follow-up visit, there was no difference between the two Groups, while after 6 months, 23 (7.6%) in Group A and 98 (29.7%) in Group B showed recurrence with a statistically significant difference (df=1; Chi square=48.26; p<0.001). At the last follow-up, 41 (13.1%) in Group A and 169 (46.8%) in Group B showed recurrence (df=1; Chi
file://F:\RamShankar\April\04-05-12\Cip\Sour\188.html
4/6/2012
188 - The role of asymptomatic bacteriuria in young women with recurrent urinary tract i... Page 2 of 2
e188a square=169.1; p<0.001) (Figure 1). 1 patient in Group A and 2 patients in Group B were found to be affected by pyelonephritis.
CONCLUSIONS: In conclusion, this study shows that asymptomatic bacteriuria should not be treated when found in young women affected by recurrent urinary tract infections, hypothesizing its protective role in preventing symptomatic recurrence, particularly when Enterococcus faecalis has been isolated.
file://F:\RamShankar\April\04-05-12\Cip\Sour\188.html
4/6/2012
Page 1 of 2
e188 The role of asymptomatic bacteriuria in young women with recurrent urinary tract infections: To treat or not to treat 1
2
3
2
4
Cai T. , Mazzoli S. , Mondaini N. , Meacci F. , Nesi G. , Luciani 1
1
1
1
L.G. , D'Elia C. , Tiscione T. , Malossini G. , Bartoletti R. 1 2
3
Santa Chiara Regional Hospital, Dept. of Urology, Trento, Italy, Santa Maria Annunziata Hospital, Dept. of Sexually Transmitted
Disease, Florence, Italy,
3
Department of Urology, Dept. of Urology,
4
Florence, Italy, University of Florence, Dept. of Pathological Anatomy, Dept of Critical Care Medicine and Surgery, Florence, Italy INTRODUCTION & OBJECTIVES: Asymptomatic bacteriuria (AB) is common in young women, but little is known about its role in urinary tract infections (UTI). The aim of this study was to evaluate the impact of AB treatment in recurrence rate among young women affected by recurrent UTI. MATERIAL & METHODS: All consecutive asymptomatic young women with demonstrated bacteriuria attending a single Sexually Transmitted Disease Centre from January 2005 and December 2009, were prospectively enrolled. All patients were split into two groups: Group A – not treated, Group B – treated. Microbiological and clinical evaluations were performed at 3, 6 and 12 months. Quality of life was also measured. RESULTS: 673 women were analyzed. 312 were assigned to Group A while 361 to Group B. At the baseline, the two most commonly isolated pathogens were Escherichia coli (Group A 38.4%; Group B 39.3%) and Enterococcus faecalis (Group A 32.7%; Group B 33.2%). At the first follow-up visit, there was no difference between the two Groups, while after 6 months, 23 (7.6%) in Group A and 98 (29.7%) in Group B showed recurrence with a statistically significant difference (df=1; Chi square=48.26; p<0.001). At the last follow-up, 41 (13.1%) in Group A and 169 (46.8%) in Group B showed recurrence (df=1; Chi
file://F:\RamShankar\April\04-05-12\Cip\Sour\188.html
4/6/2012
188 - The role of asymptomatic bacteriuria in young women with recurrent urinary tract i... Page 2 of 2
e188a square=169.1; p<0.001) (Figure 1). 1 patient in Group A and 2 patients in Group B were found to be affected by pyelonephritis.
CONCLUSIONS: In conclusion, this study shows that asymptomatic bacteriuria should not be treated when found in young women affected by recurrent urinary tract infections, hypothesizing its protective role in preventing symptomatic recurrence, particularly when Enterococcus faecalis has been isolated.
file://F:\RamShankar\April\04-05-12\Cip\Sour\188.html
4/6/2012