Asymptomatic Bacteriuria in Women With Autoimmune Rheumatic Disease: Prevalence, Risk Factors, and Clinical Significance

• Published in: Clinical infectious diseases Vol. 60; no. 6; pp. 868 - 874
• Main Authors: Georgiadou, Sarah P., Gamaletsou, Maria N., Mpanaka, Ioanna, Vlachou, Aggeliki, Goules, Andreas V., Ziogas, Dimitrios C., Syriou, Vassiliki, Tektonidou, Maria G., Kaltsas, Gregory, Manoussakis, Menelaos N., Sipsas, Nikolaos V.
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 15.03.2015
• Subjects: Adult; Aged; ARTICLES AND COMMENTARIES; Asymptomatic Infections - epidemiology; Autoimmune diseases; Autoimmune Diseases - complications; Bacteriuria - complications; Bacteriuria - epidemiology; Bacteriuria - microbiology; Case-Control Studies; Demographics; E coli; Escherichia coli; Escherichia coli - isolation & purification; Female; Follow-Up Studies; Humans; Immunocompromised Host; Immunosuppressive Agents - therapeutic use; Middle Aged; Pregnancy; Pregnancy in Diabetics; Prevalence; Prospective Studies; Rheumatic diseases; Rheumatic Diseases - complications; Risk Factors; Urinary Tract Infections - complications; Urinary Tract Infections - microbiology; Womens health; immunocompromised patients; autoimmune rheumatic disease; asymptomatic bacteriuria
• ISSN: 1058-4838; 1537-6591; 1537-6591
• DOI: 10.1093/cid/ciu938

Background. Data regarding the prevalence and clinical significance of asymptomatic bacteriuria (AB) in women with autoimmune rheumatic disease (ARD) are scarce. Methods. In this prospective, case-control study, consecutive female outpatients with ARD were screened for AB. For each patient, demographics, type, duration, and treatment of underlying ARD, and risk factors for urinary tract infection (UTI), were recorded. Age-matched women with endocrine disease, without any autoimmune disease, not receiving immunosuppressive agents were used as controls. Subjects were followed up for 1 year for the development of symptomatic UTI. Results. Two hundred sixty patients with ARD (mean age, 52.4 [standard deviation {SD}, 14.6] years) and 238 controls (mean age, 51.2 [SD, 16.5] years) were enrolled. The majority of patients with ARD (93.5%; 95% confidence interval [CI], 89.7%–95.9%) were receiving immunosuppressive agents. AB was detected in 24 patients with ARD (9.2%; 95% CI, 6.2%–13.4%) and in 22 controls (9.2%; 95% CI, 5.5%–12.9%) (P = 1.000). The most prevalent pathogen was Escherichia coli (16/24 [66%]). Independent predictors for AB among patients were diabetes (odds ratio [OR], 6.6; P= .008) and a longer ARD duration (>84 months; OR, 4.3; P = .018). During the 1-year follow-up, 9 patients with baseline AB remained persistently bacteriuric, whereas 11 were intermittently bacteriuric. Symptomatic UTI developed in 4 of 24 patients (16.7%; 95% CI, 6.1%–36.5%) with baseline AB vs 29 of 236 (12.3%; 95% CI, 8.6%–17.1%) without AB (P= .522). Conclusions. In our study, the prevalence of AB among women with ARD was not higher than that of controls, and AB was not associated with higher risk for symptomatic UTI. Risk factors for AB were longer duration of ARD and diabetes.