Dataset Information

Urinary microbiota of women with recurrent urinary tract infection: collection and culture methods.

ABSTRACT:

Introduction and hypothesis

Many clinicians utilize standard culture of voided urine to guide treatment for women with recurrent urinary tract infections (RUTI). However, despite antibiotic treatment, symptoms may persist and events frequently recur. The cyclic nature and ineffective treatment of RUTI suggest that underlying uropathogens pass undetected because of the preferential growth of Escherichia coli. Expanded quantitative urine culture (EQUC) detects more clinically relevant microbes. The objective of this study was to assess how urine collection and culture methods influence microbial detection in RUTI patients.

Methods

This cross-sectional study enrolled symptomatic adult women with an established RUTI diagnosis. Participants contributed both midstream voided and catheterized urine specimens for culture via both standard urine culture (SUC) and EQUC. Presence and abundance of microbiota were compared between culture and collection methods.

Results

Forty-three symptomatic women participants (mean age 67 years) contributed specimens. Compared to SUC, EQUC detected more unique bacterial species and consistently detected more uropathogens from catheterized and voided urine specimens. For both collection methods, the most commonly detected uropathogens by EQUC were E. coli (catheterized: n = 8, voided: n = 12) and E. faecalis (catheterized: n = 7, voided: n = 17). Compared to catheterized urine samples assessed by EQUC, SUC often missed uropathogens, and culture of voided urines by either method yielded high false-positive rates.

Conclusions

In women with symptomatic RUTI, SUC and assessment of voided urines have clinically relevant limitations in uropathogen detection. These results suggest that, in this population, catheterized specimens analyzed via EQUC provide clinically relevant information for appropriate diagnosis.

SUBMITTER: Hochstedler BR

PROVIDER: S-EPMC8514570 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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Publications

Urinary microbiota of women with recurrent urinary tract infection: collection and culture methods.

Hochstedler Baylie R BR Burnett Lindsey L Price Travis K TK Jung Carrie C Wolfe Alan J AJ Brubaker Linda L

International urogynecology journal 20210414 3

<h4>Introduction and hypothesis</h4>Many clinicians utilize standard culture of voided urine to guide treatment for women with recurrent urinary tract infections (RUTI). However, despite antibiotic treatment, symptoms may persist and events frequently recur. The cyclic nature and ineffective treatment of RUTI suggest that underlying uropathogens pass undetected because of the preferential growth of Escherichia coli. Expanded quantitative urine culture (EQUC) detects more clinically relevant micr ...[more]

PMID: 33852041

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Project description:BackgroundMidstream urine specimen cultures play an important role in assisting clinicians to choose antibiotics to remove urinary tract pathogens. At present, there are many culture methods for obtaining midstream urine specimens. In this article, different urine culture methods were compared to improve the detection rate of pathogenic bacteria in patients with urinary tract infections (UTIs).MethodsUrina sanguinis specimens were collected from 90 outpatients and inpatients who had UTI symptoms, had been clinically diagnosed with UTI between February and March 2021, and had been tested within 2 h using the conventional 1-µL culture method, the modified 100-µL culture method, and the centrifugal urine sediment culture method. After incubation at 35 °C with 5% carbon dioxide (CO2) for 48 h, the detection rates of pathogenic bacteria in UTIs were compared among the three methods.ResultsA total of 75 strains of pathogenic bacteria were detected in the 90 specimens. The positive detection rates of pathogenic microorganisms were 23.33%, 73.33%, and 75.56% for the conventional 1-µL culture method, the modified 100-µL culture method, and the centrifugal urine sediment culture method, respectively. Among the patients who used antibiotics before the collection of the urine specimens, the positive detection rates of pathogenic microorganism were 16.00%, 66.00% and 66.00% for the conventional 1-µL culture method, the modified 100-µL culture method, and the centrifugal urine sediment culture method, respectively. In the specimens grown aseptically using the conventional 1-µL culture method, a similar average number of colonies was found using the modified 100-µL culture method and the centrifugal urine sediment culture method. Among the specimens with bacterial growth in the conventional 1-µL culture method, the average colony numbers of the three methods were similar.ConclusionsThe modified 100-µL culture method and the centrifugal urine sediment culture method greatly improved the positive detection rates of pathogenic bacteria in patients with UTIs.

Project description:BackgroundUrinary tract infections (UTIs) in pregnant women contribute about 25% of all infections and are among the most frequent clinical bacterial infections. Pregnancy changes in women that include anatomical, physiological and hormonal make them susceptible to develop UTI. Left untreated, UTI in pregnancy is associated with grave complications to the mother and fetus. These complications can be decreased by prompt and proper diagnosis and appropriate treatment that also reduces the emergency of drug resistance. Antimicrobial resistance is a major health problem in the treatment of UTI. We determined the prevalence, bacteriology and antimicrobial susceptibility of symptomatic urinary tract infection among pregnant women at Mbarara Regional Referral Hospital.MethodsWe conducted a cross-sectional study from November 2019 to February 2020 involving 400 pregnant women with symptomatic UTI. Patient information was obtained using a structured questionnaire. We collected clean-catch midstream urine specimens for culture and performed antimicrobial susceptibility testing following Clinical and Laboratory Standards Institute standards. Data was entered into RED-cap Version 8.2 software and then exported to Stata Version 14.1 for analysis.ResultsThe proportion of culture-positive UTI was 140/400 (35%). Gram-negative bacteria were more prevalent (73%): Klebsiella pneumoniae 52(37.41%), Escherichia coli 40(28.78%), Pseudomonas aeruginosa and Proteus mirabilis 7(5.04% each), Citrobacter freundii 1(1%). Staphylococcus aureus 33(23.57%) was the only gram-positive isolate. All the isolates were resistant to ampicillin, amoxicillin, amoxicillin/clavulanic acid and ceftazidime/clavulanic acid (95.7, 95.0, 72.9 and 50.7% respectively). Prevalence of extended-spectrum beta-lactamases producing Enterobacteriaceae was 29.0% while that of methicillin-resistant Staphylococcus aureus was 33.3%. All cultures demonstrated resistance to more than one drug. Majority of the bacterial isolates were sensitive to ciprofloxacin, ceftriaxone, nitrofurantoin, cefotaxime and gentamicin at 82.9, 81.4, 79.3, 78.6, 66.4 and 65.7% respectively.ConclusionsKlebsiella pneumoniae was the most prevalent isolate followed by E. coli. These two organisms were highly resistant to the commonly used antibiotics. Our study recorded a higher prevalence of culture-positive UTI in pregnancy than all the studies in Uganda. Empirical treatment of UTI should be minimized as sensitivity varies for each organism, for each drug and over time.

Dataset Information

Urinary microbiota of women with recurrent urinary tract infection: collection and culture methods.

Introduction and hypothesis

Methods

Results

Conclusions

Publications

Urinary microbiota of women with recurrent urinary tract infection: collection and culture methods.

Similar Datasets

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