The Clinical Significance of Asymptomatic Bacteriuria in the Nonpregnant Woman

• Published in: The Journal of infectious diseases Vol. 120; no. 1; pp. 17 - 26
• Main Authors: Asscher, A. W., Sussman, M., Waters, W. E., Evans, Joy A. S., Campbell, H., Evans, K. T., Williams, J. Edmund
• Format: Journal Article
• Language: English
• Published: United States The University of Chicago Press 01.07.1969; University of Chicago Press
• Subjects: Adult; Aged; Ampicillin - therapeutic use; Analgesics; Analgesics - adverse effects; Bacteriuria; Bacteriuria - drug therapy; Blood Pressure; Blood Urea Nitrogen; Contraceptives, Oral - adverse effects; Female; Follow-Up Studies; Hematuria - epidemiology; Humans; Infections; Mass Screening; Middle Aged; Nitrofurantoin - therapeutic use; Placebos; Pregnancy; Radiology; Reinfection; Serotyping; Symptoms; Urinary tract infections; Urinary Tract Infections - prevention & control; Urination Disorders - epidemiology; Urine; Urogenital Abnormalities; Urography
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/120.1.17

The clinical, laboratory, and radiological findings have been compared in 107 nonpregnant bacteriuric women and 88 matched controls. A previous history of urinary tract infection was more commonly obtained from bacteriuric than from control subjects. Oral contraceptives were taken nearly twice as frequently by the bacteriuric women as by the controls. There was no difference in the consumption of analgesics by the 2 groups. Diastolic blood pressure and serum urea were significantly higher in the bacteriuric group, and acquired renal abnormalities were demonstrated in 18% of the bacteriuric women as compared with 4 % of the controls. A controlled treatment trial showed that short courses of nitrofurantoin and ampicillin cured bacteriuria in 80% of cases, but after a 1-year follow-up only 55% remained cured. A high spontaneous cure rate was observed among untreated bacteriuric subjects. Treatment failed to prevent the development of symptoms, and the reinfections which followed successful treatment were more commonly associated with the development of symptoms than were the persistent or relapsing infections in the untreated or unsuccessfully treated subjects. It is concluded that screening for bacteriuria in a nonpregnant female population is unlikely to be of value as a preventive measure, since in many instances it fails to detect urinary tract infection at an early and reversible stage of its natural history and since treatment by methods suitable for large-scale use is ineffective.