Authors: L E Nicolle G G Zhanel G K M Harding
Publish Date: 2005/12/31
Volume: 24, Issue: 1, Pages: 61-65
Abstract
Background Asymptomatic bacteriuria is common in diabetic women Treatment of asymptomatic bacteriuria is not beneficial but the natural history of the microbiology of asymptomatic bacteriuria has not been well described Objective To describe the microbiological outcomes of bacteriuria in diabetic women with untreated asymptomatic bacteriuria Methods Study subjects were initially identified through ambulatory endocrinology clinics They were enrolled if they had two positive urine cultures ≥108 cfu/l with the same organism within 2 weeks and no symptoms referable to urinary tract infection Women initially received a 2week course of placebo with followup cultures obtained at the end of treatment and 4 weeks posttreatment Subsequently the prevalence of bacteriuria was determined with urine cultures obtained every 3 months to a maximum of 36 months Outcomes at yearly intervals were designated as one of persistent bacteriuria spontaneous resolution resolution with antibiotics for symptomatic urinary infection or resolution with antibiotics given for other indications Women with and without persistent or frequent bacteriuria were compared to identify variables associated with bacteriuria Results The prevalence of bacteriuria in the study cohort declined to about 50 by 9 months and subsequently remained stable throughout 3 years followup Almost 20 of subjects remained bacteriuric with the original infecting organism throughout the period of observation With evaluation at 12month intervals approximately onequarter of subjects had each of the four potential outcomes of resolution following antibiotic therapy for symptomatic urinary infection following antibiotic therapy for other indications spontaneous resolution without antibiotics and persistent bacteriuria with the same organism Women infected with gramnegative organisms were more likely to have persistent bacteriuria Many women with resolution of initial bacteriuria with or without antibiotics became bacteriuric again during followup Conclusions Women with asymptomatic bacteriuria and diabetes tend to have persistent or recurrent asymptomatic bacteriuria Bacteriuria is benign and seldom permanently eradicable
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