Hancock, Viktoria; Nielsen, E.M.; Klemm, Per
Urinary tract infections (UTIs) affect millions of people each year. Escherichia coli is the most common organism associated with asymptomatic bacteriuria (ABU) in humans. Persons affected by ABU may carry a particular E. coli strain for extended periods of time without any symptoms. In contrast to...... uropathogenic E. coli (UPEC) that cause symptomatic UTI, very little is known about the mechanisms by which these strains colonize the urinary tract. Here, we have investigated the growth characteristics in human urine as well as adhesin repertoire of nine ABU strains; the ability of ABU strains to compete...
Hancock, Viktoria; Nielsen, E.M.; Klemm, Per
Urinary tract infections (UTIs) affect millions of people each year. Escherichia coli is the most common organism associated with asymptomatic bacteriuria (ABU) in humans. Persons affected by ABU may carry a particular E. coli strain for extended periods of time without any symptoms. In contrast to...... uropathogenic E. coli (UPEC) that cause symptomatic UTI, very little is known about the mechanisms by which these strains colonize the urinary tract. Here, we have investigated the growth characteristics in human urine as well as adhesin repertoire of nine ABU strains; the ability of ABU strains to compete...... against the UPEC strain CFT073 was also studied. The different ABU strains displayed a wide variety of the measured characteristics. Half of the ABU strains displayed functional type 1 fimbriae while only one expressed functional P fimbriae. A good correlation between the growth rate of a particular...
Screening for asymptomatic bacteriuria is a standard of obstetrical care and is included in most antenatal guidelines. There is good evidence that treatment of asymptomatic bacteriuria will decrease the incidence of pyelonephritis. All pregnant women should be screened for asymptomatic bacteriuria, and there are no new data that would indicate otherwise. Antibiotic treatment of asymptomatic bacteriuria is associated with a decrease in the incidence of preterm delivery or low birth weight, but the methodological quality of the studies means any conclusion about the strength of this association needs to be drawn cautiously. A better understanding of the mechanism by which treatment of asymptomatic bacteriuria could prevent preterm delivery is needed. While several rapid screening tests have been evaluated, none perform adequately to replace urine culture for detecting asymptomatic bacteriuria. Until there are data from well-designed trials that establish the optimal duration of therapy for asymptomatic bacteriuria, standard treatment courses are recommended. PMID:17347050
Lavigne, Jean-Philippe; Boutet-Dubois, Adeline; Laouini, Dorsaf; Combescure, Christophe; Bouziges, Nicole; Marès, Pierre; Sotto, Albert
We compared the virulence properties of a collection of asymptomatic bacteriuria (ABU) Escherichia coli strains to urinary tract infection (UTI) strains isolated from pregnant women in a university hospital over 1 year. The in vitro and in vivo studies suggest that ABU strains presented a virulence behavior similar to that of strains isolated from cases of cystitis. PMID:21918033
Lavigne, Jean-Philippe; Boutet-Dubois, Adeline; Laouini, Dorsaf; Combescure, Christophe; Bouziges, Nicole; Marès, Pierre; Sotto, Albert
We compared the virulence properties of a collection of asymptomatic bacteriuria (ABU) Escherichia coli strains to urinary tract infection (UTI) strains isolated from pregnant women in a university hospital over 1 year. The in vitro and in vivo studies suggest that ABU strains presented a virulence behavior similar to that of strains isolated from cases of cystitis.
Nicolle, Lindsay E
Asymptomatic bacteriuria is very common. In healthy women, asymptomatic bacteriuria increases with age, from asymptomatic bacteriuria, irrespective of age or gender. The prevalence is very high in residents of long-term-care facilities, from 25% to 50% of women and 15% to 40% of men. Escherichia coli is the most frequent organism isolated, but a wide variety of other organisms may occur. Bacteriuria may be transient or persist for a prolonged period. Pregnant women with asymptomatic bacteriuria identified in early pregnancy and who are untreated have a risk of pyelonephritis later in pregnancy of 20% to 30%. Bacteremia is frequent in bacteriuric subjects following mucosal trauma with bleeding, with 5% to 10% of patients developing severe sepsis or septic shock. These two groups with clear evidence of negative outcomes should be screened for bacteriuria and appropriately treated. Asymptomatic bacteriuria in other populations is benign and screening and treatment are not indicated. Antimicrobial treatment has no benefits but is associated with negative outcomes including reinfection with antimicrobial resistant organisms and a short-term increased frequency of symptomatic infection post-treatment. The observation of increased symptomatic infection post-treatment, however, has led to active investigation of bacterial interference as a strategy to prevent symptomatic episodes in selected high risk patients. PMID:26542046
Paul Erhunmwunse Imade
Full Text Available Background: Asymptomatic bacteriuria is the significant presence of bacteria in the urine of an individual without symptoms. In pregnancy, the apparent reduction in immunity of pregnant women tends to encourage the growth of pathogens. Aim: This study was carried out to determine the prevalence of asymptomatic bacteriuria in pregnant women attending a primary health centre in Benin City, Nigeria. Materials and Methods: A total of 1,228 pregnant women were recruited for this study. All subjects were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine sample was collected from each patient into sterile universal container. The urine samples were examined microscopically and by cultural method. Identification of isolates was by standard microbiological technique. Result: A total of 556 (45.3% were positive for significant bacteriuria. There was a significant difference in the prevalence of asymptomatic bacteriuria with respect to age (P < 0.0001. Trimester did not show any significant difference (P = 0.2006 in the prevalence of asymptomatic bacteriuria. Escherichia coli was the most predominant organism followed closely by Staphylococcus aureus. Ciprofloxacin, Ceftriaxone and Augmentin were found to be the most effective antibiotics against the urinary isolates. Conclusion: Asymptomatic bacteriuria is not uncommon among antenatal patients in the population studied. Routine urine cultural test should be carried out on all antenatal patients in order to identify any unsuspecting infection. This measure will go a long way in reducing maternal and obstetric complications associated with pregnancy.
Paul Erhunmwunse Imade
Full Text Available Background: Asymptomatic bacteriuria is the significant presence of bacteria in the urine of an individual without symptoms. In pregnancy, the apparent reduction in immunity of pregnant women tends to encourage the growth of pathogens. Aim : This study was carried out to determine the prevalence of asymptomatic bacteriuria in pregnant women attending a primary health centre in Benin City, Nigeria. Materials and Methods: A total of 1,228 pregnant women were recruited for this study. All subjects were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine sample was collected from each patient into sterile universal container. The urine samples were examined microscopically and by cultural method. Identification of isolates was by standard microbiological technique. Result: A total of 556 (45.3% were positive for significant bacteriuria. There was a significant difference in the prevalence of asymptomatic bacteriuria with respect to age (P < 0.0001. Trimester did not show any significant difference (P = 0.2006 in the prevalence of asymptomatic bacteriuria. Escherichia coli was the most predominant organism followed closely by Staphylococcus aureus. Ciprofloxacin, Ceftriaxone and Augmentin were found to be the most effective antibiotics against the urinary isolates. Conclusion : Asymptomatic bacteriuria is not uncommon among antenatal patients in the population studied. Routine urine cultural test should be carried out on all antenatal patients in order to identify any unsuspecting infection. This measure will go a long way in reducing maternal and obstetric complications associated with pregnancy.
Sugandha Srivastava; Jyotsna Agarwal; Bharti Mishra; Richa Srivastava
Purpose: Escherichia coli isolated from asymptomatic bacteriuria (ABU) correlated genotypically and phenotypically with cystitis isolates may help in distinguishing urovirulence determinants from 'fitness factors', latter necessary only for survival of E. coli in urinary tract; for gaining insight into the pathogenesis of urinary tract infection. Materials and Methods: In this cross-sectional study, we compared genotypic (phylogroups and 15 putative virulence genes), and phenotypic profiles o...
Ferriéres, L.; Hancock, Viktoria; Klemm, Per
Many bacterial infections are associated with biofilm formation. In the urinary tract bacterial biofilms develop on both living surfaces and artificial implants, producing chronic and often intractable infections. Escherichia coli is the most common organism associated with urinary tract infections....... In contrast to uropathogenic E coli (UPEC), which cause symptomatic urinary tract infection, asymptomatic bacteriuria (ABU) strains are associated with essentially symptom-free infections. Here the biofilm-forming capacity on abiotic surfaces of selected E coli ABU strains and UPEC strains in human...... biofilm formation. The results support the notion of bacterial prophylaxis employing selected ABU strains to eliminate UPEC strains and other pathogens in patients prone to recalcitrant infections....
Klemm, Per; Hancock, Viktoria; Ulett, G.C.;
Escherichia coli 83972 is a clinical asymptomatia bacteriuric isolate that is able to colonize the human urinary bladder without inducing an immune response. Here we demonstrate that one of the mechanisms by which this strain has become attenuated is through the mutation of its genes encoding type...
Hancock, Viktoria; Seshasayee, Aswin S.; Ussery, David;
be found in CFT073, and genes on six of the seven pathogenicity islands were expressed in 83972. Despite the very different patient symptom profiles, the two strains seem to be very similar. Genes expressed in CFT073 but not in 83972 were identified and can be considered as virulence factor......Escherichia coli strains are the major cause of urinary tract infections in humans. Such strains can be divided into virulent, UPEC strains causing symptomatic infections, and asymptomatic, commensal-like strains causing asymptomatic bacteriuria, ABU. The best-characterized ABU strain is strain...... factors for the human urinary tract could be identified. Also, presence/absence data of the gene expression was used as an adaptive genomics tool to model the gene pool of 83972 using primarily UPEC strain CFT073 as a scaffold. In our analysis, 96% of the transcripts filtered present in strain 83972 can...
Hancock, Viktoria; Ulett, G.C.; Schembri, M.A.;
Escherichia coli is the most common organism associated with asymptomatic bacteriuria (ABU). In contrast to uropathogenic E. coli (UPEC), which causes symptomatic urinary tract infections (UTI), very little is known about the mechanisms by which these strains colonize the human urinary tract. The...... prototype ABU E. coli strain 83972 was originally isolated from a girl who had carried it asymptomatically for 3 years. Deliberate colonization of UTI-susceptible individuals with E. coli 83972 has been used successfully as an alternative approach for the treatment of patients who are refractory to...... conventional therapy. Colonization with strain 83972 appears to prevent infection with UPEC strains in such patients despite the fact that this strain is unable to express the primary adhesins involved in UTI, viz. P and type 1 fimbriae. Here we investigated the growth characteristics of E. coli 83972 in human...
Sarı O et al.
Full Text Available Most of the complications caused by asymptomatic bacteriuria (ABU in pregnancy can be avoided by early treatment. In our study, we aimed to determine the urinary infection prevalence and the pathogen agent identification in the pregnant women observing in our clinic. 240 asymptomatic pregnant women having no antibiotic treatment history during last 1 week and were enrolled to the study. Urine specimens were collected from 12th and 16th week pregnant women, and were examined by light microscope and cultured at the mediums. Demographic data belonging to the patients (age, birth number, abortion number were recorded. Mean age was assigned as 24, 49±2, 74 (20-31 years. 104 patients (43,3% were primipara, 94 patients (39.2% had previous pregnancy and 42 patients (17,5% were multipara. 19,2% of the patients (n=46 had an abortion history. Mean value of leucocyte levels among pregnant women was assigned as 10045 / mm3 (6750-15200. Although positive urine culture ratio was 12,5% (n=30 at first visit, it was 10% (n=30 in the 12th week. Urine culture in 16th week was determined as negative in all pregnant women. When agent pathogen was analyzed from urine culture, the most common isolated microorganism that causes asymptomatic bacteriuria (ABU was Escherichia coli with ratio of 83%(n=200. Asymptomatic bacteriuria (ABU is common in pregnancy and can cause serious maternal and fetal complications if it’s not treated on time and properly. Therefore; all pregnant women should be screened at first antenatal visit for asymptomatic bacteriuria (ABU as a routine program and medical treatment should be required at the positive cases.
Watts, Rebecca E; Hancock, Viktoria; Ong, Cheryl-lynn Y;
Urinary tract infections (UTIs) are among the most common infectious diseases of humans, with Escherichia coli being responsible for >80% of all cases. Asymptomatic bacteriuria (ABU) occurs when bacteria colonize the urinary tract without causing clinical symptoms and can affect both catheterized...... patients (catheter-associated ABU [CA-ABU]) and noncatheterized patients. Here, we compared the virulence properties of a collection of ABU and CA-ABU nosocomial E. coli isolates in terms of antibiotic resistance, phylogenetic grouping, specific UTI-associated virulence genes, hemagglutination...... previously described for the prototype ABU E. coli strain, 83972. This is the first global gene expression analysis of E. coli CA-ABU strains. Overall, our data suggest that nosocomial ABU and CA-ABU E. coli isolates possess similar virulence profiles....
Hancock, Viktoria; Klemm, Per
Urinary tract infection (UTI) is an important health problem worldwide, with many millions of cases each year, and Escherichia coli is the most common organism causing UTI in humans. Also, E. coli is responsible for most infections in patients with chronic indwelling bladder catheter. The two...... strains 83972 and VR50. Significant differences in expression levels were seen between the biofilm expression profiles of the two strains with the corresponding planktonic expression profiles in morpholinepropanesulfonic acid minimal laboratory medium and human urine; 417 and 355 genes were up- and down...... asymptomatic bacteriuria (ABU) E. coli strains 83972 and VR50 are significantly better biofilm formers in their natural growth medium, human urine, than the two uropathogenic E. coli isolates CFT073 and 536. We used DNA microarrays to monitor the expression profile during biofilm growth in urine of the two ABU...
Introduction: The aim of this study was to evaluate the frequency of bacteriuria in pregnant women referred to the medical centers of Tabriz, Iran, for prenatal care. Materials and Methods: A total of 1100 healthy pregnant women who were referred to 50 medical centers in Tabriz for a regular prenatal care were evaluated for bacteriuria. Results: The frequency of asymptomatic bacteriuria was 6.1%. Maternal age was lower in the women with a positive urine culture (P = .02). Asymptomatic bact...
Nicolle, Lindsay E
Asymptomatic bacteriuria, also called asymptomatic urinary infection, is a common finding in healthy women, and in women and men with abnormalities of the genitourinary tract. The characterization and introduction of the quantitative urine culture in the 1950s first allowed the reliable recognition of asymptomatic bacteriuria. The observations that a substantial proportion of patients with chronic pyelonephritis at autopsy had no history of symptomatic urinary infection, and the high frequency of pyelonephritis observed in pregnant women with untreated asymptomatic bacteriuria, supported a conclusion that asymptomatic bacteriuria was harmful. Subsequent screening and long term follow-up programs for asymptomatic bacteriuria in schoolgirls and women reported an increased frequency of symptomatic urinary tract infection for subjects with asymptomatic bacteriuria, but no increased morbidity from renal failure or hypertension, or increased mortality. Treatment of asymptomatic bacteriuria did not decrease the frequency of symptomatic infection. Prospective, randomized, comparative trials enrolling premenopausal women, children, elderly populations, patients with long term catheters, and diabetic patients consistently report no benefits with antimicrobial treatment of asymptomatic bacteriuria, and some evidence of harm. Several studies have also reported that antimicrobial treatment of asymptomatic bacteriuria increases the short term risk of pyelonephritis. Current investigations are exploring the potential therapeutic intervention of establishing asymptomatic bacteriuria with an avirulent Escherichia coli strain to prevent symptomatic urinary tract infection for selected patients. PMID:27104571
Lindsay E. Nicolle
Full Text Available Asymptomatic bacteriuria, also called asymptomatic urinary infection, is a common finding in healthy women, and in women and men with abnormalities of the genitourinary tract. The characterization and introduction of the quantitative urine culture in the 1950s first allowed the reliable recognition of asymptomatic bacteriuria. The observations that a substantial proportion of patients with chronic pyelonephritis at autopsy had no history of symptomatic urinary infection, and the high frequency of pyelonephritis observed in pregnant women with untreated asymptomatic bacteriuria, supported a conclusion that asymptomatic bacteriuria was harmful. Subsequent screening and long term follow-up programs for asymptomatic bacteriuria in schoolgirls and women reported an increased frequency of symptomatic urinary tract infection for subjects with asymptomatic bacteriuria, but no increased morbidity from renal failure or hypertension, or increased mortality. Treatment of asymptomatic bacteriuria did not decrease the frequency of symptomatic infection. Prospective, randomized, comparative trials enrolling premenopausal women, children, elderly populations, patients with long term catheters, and diabetic patients consistently report no benefits with antimicrobial treatment of asymptomatic bacteriuria, and some evidence of harm. Several studies have also reported that antimicrobial treatment of asymptomatic bacteriuria increases the short term risk of pyelonephritis. Current investigations are exploring the potential therapeutic intervention of establishing asymptomatic bacteriuria with an avirulent Escherichia coli strain to prevent symptomatic urinary tract infection for selected patients.
Sudha Biradar Kerure; Rajeshwari Surpur; Sheela S. Sagarad; Sneha Hegadi
Background: Urinary tract infections (UTIs) are the most common bacterial infections during pregnancy. Asymptomatic bacteriuria (ASB) is a major risk factor for the development of urinary tract infections during pregnancy and with further risk of preterm birth & pyelonephritis if untreated. Aims & Objectives: This study was carried out to determine the prevalence of asymptomatic bacteriuria (ASB) in pregnant women & to isolate, identify and establish antimicrobial susceptibility of pathogens....
Paul Erhunmwunse Imade; Patience Emiolu Izekor; Nosakhare Odeh Eghafona; Onaiwu Idahosa Enabulele; Endurance Ophori
Background: Asymptomatic bacteriuria is the significant presence of bacteria in the urine of an individual without symptoms. In pregnancy, the apparent reduction in immunity of pregnant women tends to encourage the growth of pathogens. Aim : This study was carried out to determine the prevalence of asymptomatic bacteriuria in pregnant women attending a primary health centre in Benin City, Nigeria. Materials and Methods: A total of 1,228 pregnant women were recruited for this study. All subjec...
Sudha Biradar Kerure
Full Text Available Background: Urinary tract infections (UTIs are the most common bacterial infections during pregnancy. Asymptomatic bacteriuria (ASB is a major risk factor for the development of urinary tract infections during pregnancy and with further risk of preterm birth & pyelonephritis if untreated. Aims & Objectives: This study was carried out to determine the prevalence of asymptomatic bacteriuria (ASB in pregnant women & to isolate, identify and establish antimicrobial susceptibility of pathogens. Methods: A total of 500 pregnant women were studied over a period of one year. Clean catch midstream urine sample was collected into a sterile container & then subjected to culture method. Results: Significant bacteriuria was noted in 45 patients (9%. 3% patients had insignificant bacteriuria. Growth of contaminants was noted in 8%. 80% samples were sterile with no growth. E. coli was the most common etiological agent, followed by Staphylococcus aureus. Conclusions: Asymptomatic bacteriuria is not uncommon in antenatal patients. All pregnant women should be screened by urine culture to detect asymptomatic bacteriuria at their first visit to prevent overt UTI & other complications in both mother & fetus. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000: 213-216
Full Text Available Purpose: Escherichia coli isolated from asymptomatic bacteriuria (ABU correlated genotypically and phenotypically with cystitis isolates may help in distinguishing urovirulence determinants from 'fitness factors', latter necessary only for survival of E. coli in urinary tract; for gaining insight into the pathogenesis of urinary tract infection. Materials and Methods: In this cross-sectional study, we compared genotypic (phylogroups and 15 putative virulence genes, and phenotypic profiles of ABU E. coli strains with our previously genotyped collection of cystitis isolates. Virulence score was calculated for each isolate as a number of virulence genes detected. Results: Significant differences were observed in the proportion of four phylogenetic groups (P = 0.009 amongst cystitis and ABU isolates. Average virulence score was higher for ABU isolates (6.6 than cystitis strains (4.2; and hlyA (P = 0.001, cytotoxic necrotising factor 1 (P = 0.00, fyuA (P = 0.00, ibeA (P = 0.00, kpsMII (P = 0.01, and malX/pathogenicity-associated island (P = 0.01 were more frequently present in ABU strains. Conclusions: The expression of adhesins, haemolysin, aerobactin, and capsule synthesis gene were similar in two groups suggesting their role as fitness factors. ABU isolates were better biofilm producers, reflecting its importance in silent persistence. Serum resistance gene which was more expressed in cystitis isolates may represent virulence determinant. Genetic makeup of E. coli does not change much rather genes helping in survival and colonisation are expressed equally in ABU and cystitis isolates as opposed to phenotypic attenuation of those that helps in invasion or inflammation in ABU isolates.
Full Text Available "nPregnant women are at increased risk for urinary tract infection (UTI but in many cases infection is asymptomatic. This study was performed to determine the incidence of asymptomatic bacteriuria and pyuria in pregnant women. A total of 86 pregnant women during first trimester and 56 nonpregnant women were evaluated. All subjects were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine samples were collected for both groups. Urine samples were examined microscopically and were cultured. Bacteriological examination revealed asymptomatic bacteriuria in 25 (29.1% and 3 (5.4% of the study group and controls, respectively (P < 0.05. Microscopic analysis of urine revealed pyuria in 18 (20.9% and 3 (5.4% of the study group and controls, respectively (P < 0.05. In study group, Escherichia coli were found in 20%, Staphylococcus epidermidis in 36%, Staphylococcus haemolyticus in 12%, streptococcus group D in 12%, Staphylococcus saprophyticus in 12% and Proteus mirabilis in 8%. In control group, E. coli were found in 33.3% and S. epidermidis in 66.7%. Our results show that the incidence of asymptomatic bacteriuria is significantly higher in pregnant women than nonpregnant women. The main finding in the present study was that 29.1% of the pregnant women who were in first trimester had asymptomatic bacteriuria which is much higher than figures reported from other countries. The use of microscopic urinanalysis was not an effective method of detecting asymptomatic bacteriuria and urine culture is necessary for screening these pregnant women.
Sarı O et al.
Most of the complications caused by asymptomatic bacteriuria (ABU) in pregnancy can be avoided by early treatment. In our study, we aimed to determine the urinary infection prevalence and the pathogen agent identification in the pregnant women observing in our clinic. 240 asymptomatic pregnant women having no antibiotic treatment history during last 1 week and were enrolled to the study. Urine specimens were collected from 12th and 16th week pregnant women, and were examined by light microsco...
Full Text Available A total of 500 antenatal women in their first or second trimesters were screened over a period of 2 years for asymptomatic bacteriuria. Out of them, 8.4% (42 were culture positive. A control group of 100 non-pregnant women, both married and unmarried, was also simultaneously screened. The control group yielded an overall culture positivity of 3% (4% in the married non-pregnant women and 2% in the unmarried women. Primigravida had highest percent culture positivity of 66.6%. The incidence was higher in less than 20 years age group i.e. 71.42%. Of the screening tests, Gram stained smear when compared with the standard loop method, showed the highest sensitivity of 95.2%. The specificity of the screening tests was high [Gram stained smear (98.6%, catalase test (97.1% and pus cell count(96.5%]. Escherichia coli was the most common organism isolated in the test and control groups. The organisms were sensitive to cephalexin, nitrofurantoin, amoxycillin and norfloxacin in decreasing order. Incidence of prematurity was 75% and that of low birth weight was 50% in untreated patients.
Lavanya S; Jogalakshmi D
A total of 500 antenatal women in their first or second trimesters were screened over a period of 2 years for asymptomatic bacteriuria. Out of them, 8.4% (42) were culture positive. A control group of 100 non-pregnant women, both married and unmarried, was also simultaneously screened. The control group yielded an overall culture positivity of 3% (4% in the married non-pregnant women and 2% in the unmarried women). Primigravida had highest percent culture positivit...
M.H. Shirazi; Sadeghifard, N; R Ranjbar; E. Daneshyar; A Ghasemi
Incidence of asymptomatic bacteriuria during pregnancy among Iranian women was examined. Midstream urine was collected from 380 pregnant women and streaked on blood agar and incubated for 24 to 48 h. Growth was considered significant if 105 mL-1 bacteria were present. Among the pregnant women, 10.1% had asymptomatic bacteriuria. Age, past history of abortion, proteinuria, level of education, number of fertility had no significant association with asymptomatic bacteriuria occurrence. But lower...
Hancock, Viktoria; Klemm, Per
Urinary tract infections (UTIs) are an important health problem worldwide, with many million cases each year. Escherichia coli is the most common organism causing UTIs in humans. The asymptomatic bacteriuria E. coli strain 83972 is an excellent colonizer of the human urinary tract, where it causes...... seen between the in vivo expression profiles of strain 83972 in three patients and the corresponding in vitro expression profiles in lab medium and human urine. The data revealed an in vivo lifestyle of microaerobic growth with respiration of nitrate coupled to degradation of sugar acids and amino...... acids, with no signs of attachment to host tissues. Interestingly, genes involved in NO protection and metabolism showed significant up-regulation in the patients. This is one of the first studies to address bacterial whole-genome expression in humans and the first study to investigate global gene...
V.M. García Nieto
Full Text Available En 1956, Edward H. Kass describió, especialmente, en mujeres sanas y libres de síntomas, la existencia de lo que denominó “infecciones asintomáticas del tracto urinario”. En los años 60 y 70, la práctica cada vez más extendida y rutinaria de la realización de urocultivos, confirmó la descripción de Kass, lo que condujo a la aceptación de lo que pasó a denominarse bacteriuria asintomática o bacteriuria encubierta...
Anjana Verma; Anamika Vyas; Lalit Shrimali; Medhavi Sharma
Background: Urinary tract infections are more common in women than in men and still more in pregnant women because of anatomical and physiological changes during pregnancy. Incidence of asymptomatic bacteriuria is 2-10% globally and it is still more in developing countries. Untreated asymptomatic bacteriuria can lead to many prenatal and maternal complications; hence early detection and treatment is of considerable importance. Methods: Total 220 pregnant women at their first visit were scr...
Schnarr, J; Smaill, F
Symptomatic and asymptomatic bacteriuria is common in pregnant women. A history of previous urinary tract infections and low socioeconomic status are risk factors for bacteriuria in pregnancy. Escherichia coli is the most common aetiologic agent in both symptomatic and asymptomatic infection and quantitative culture is the gold standard for diagnosis. Treatment of asymptomatic bacteriuria has been shown to reduce the rate of pyelonephritis in pregnancy and therefore screening for and treatment of asymptomatic bacteriuria has become a standard of obstetrical care. Antibiotic treatment of asymptomatic bacteriuria is associated with a decrease in the incidence of low birth weight, but the methodological quality of the studies limits the strength of the conclusions that can be drawn. Debate exists in the literature as to whether treated pyelonephritis is associated with adverse fetal outcomes. There is no clear consensus in the literature on antibiotic choice or duration of therapy for infection. With increasing antibiotic resistance, consideration of local resistance rates is necessary when choosing therapy. PMID:18826482
Ferriéres, L.; Hancock, Viktoria; Klemm, Per
urine was investigated. It was found that there is a strong bias for biofilm formation by the ABU strains. Not only were the ABU strains significantly better biofilm formers than UPEC strains, they were also able to out-compete UPEC strains as well as uropathogenic strains of Klebsiella spp. during......Many bacterial infections are associated with biofilm formation. In the urinary tract bacterial biofilms develop on both living surfaces and artificial implants, producing chronic and often intractable infections. Escherichia coli is the most common organism associated with urinary tract infections...... biofilm formation. The results support the notion of bacterial prophylaxis employing selected ABU strains to eliminate UPEC strains and other pathogens in patients prone to recalcitrant infections....
Hancock, Viktoria; Schembri, M.A.; Ulett, G.C.; Klemm, Per
Escherichia coli is the most common organism associated with asymptomatic bacteriuria (ABU). In contrast to uropathogenic E. coli (UPEC), which causes symptomatic urinary tract infection (UTI), very little is known about the mechanisms by which these strains colonize the urinary tract. Bacterial...... adhesion conferred by specific surface-associated adhesins is normally considered as a prerequisite for colonization of the urinary tract. The prototype ABU E. coli strain 83972 was originally isolated from a girl who had carried it asymptomatically for 3 years. This study characterized the molecular...... although strain 83972 contains a seemingly intact foc gene cluster, F1C fimbriae are not expressed. Sequencing and genetic complementation revealed that the focD gene, encoding a component of the F1C transport and assembly system, was non-functional, explaining the inability of strain 83972 to express this...
Hancock, Viktoria; Schembri, M.A.; Ulett, G.C.;
adhesin. The data imply that E. coli 83972 has lost its ability to express this important colonization factor as a result of host-driven evolution. The ancestor of the strain seems to have been a pyelonephritis strain of phylogenetic group B2. Strain 83972 therefore represents an example of bacterial......Escherichia coli is the most common organism associated with asymptomatic bacteriuria (ABU). In contrast to uropathogenic E. coli (UPEC), which causes symptomatic urinary tract infection (UTI), very little is known about the mechanisms by which these strains colonize the urinary tract. Bacterial...... adhesion conferred by specific surface-associated adhesins is normally considered as a prerequisite for colonization of the urinary tract. The prototype ABU E. coli strain 83972 was originally isolated from a girl who had carried it asymptomatically for 3 years. This study characterized the molecular...
M Rahimkhani; H Khavari-Daneshvar; Sharifian, R.
"nPregnant women are at increased risk for urinary tract infection (UTI) but in many cases infection is asymptomatic. This study was performed to determine the incidence of asymptomatic bacteriuria and pyuria in pregnant women. A total of 86 pregnant women during first trimester and 56 nonpregnant women were evaluated. All subjects were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine samples were collected for both groups. Urine samples were examin...
Awolude, Olutosin A; Adesina, Olubukola A; Oladokun, Adesina; Mutiu, W B; Adewole, Isaac F
The prognostic significance of asymptomatic bacteriuria resides in the observation that the prevalence is, relatively, high in persons with certain medical conditions, such as diabetes mellitus and pregnancy. This prevalence might, even, be higher in patients with human immunodeficiency virus infection. Hence, this study set out to determine the prevalence of asymptomatic bacteriuria among symptom free and newly enrolled HIV infected pregnant women attending PMTCT unit of Antiretroviral Clinic of University College Hospital, Ibadan, Nigeria between 1st May and 30th September 2007.Information was obtained on the socio-demographic characteristics of the subjects, CD4 count and viral load. Microbial culture was carried out on aseptically collected urines from the patients. Statistical analysis was done with SPSS 12 package. There were 161 analyzable samples from the participants. The mean age and gestational age at presentation of participants was 30.49 ± 4.3 years and 27.3 ± 3.2 weeks, respectively with modal parity of 2. Twenty-five (15.5%) of the urine samples significantly grew bacteria. The CD4 cells were significantly lower and the viral loads significantly higher(250.52 vs. 355.57 cells/mm3; 88,731 vs. 55,384 copies/ml; p = asymptomatic bacteriuria among PLWHAs is high. The microbial isolate from the urine samples were not different from those of HIV-negative patients. PMID:21178431
Cai, Tommaso; Mazzoli, Sandra; Lanzafame, Paolo;
Asymptomatic bacteriuria (ABU) is a common clinical condition that often leads to unnecessary antimicrobial use. The reduction of antibiotic overuse for ABU is consequently an important issue for antimicrobial stewardship and to reduce the emergence of multidrug resistant strains. There are two...... risk factor, and screening and treatment are not considered necessary. On the other hand, in the case of all procedures entering the urinary tract, ABU should be treated in line with the results of a urine culture obtained before the procedure. In patients affected by rUTIs, ABU can even have a...
Rezavand, Negin; Veisi, Firooze; Zangane, Mrayam; Amini, Roghaye; Almasi, Afshin
Asymptomatic bacteriuria is one of the most common and important bacterial infections during pregnancy and can result in progressive infections and endanger maternal as well as fetal health. In this study, we assessed the relationship between asymptomatic bacteriuria and pre-eclampsia. In this case-control study, pregnant women who presented to Imam Reza Hospital in Kermanshah in 2013-14 were studied. The minimum sample size was calculated as 125 pregnant women in each group with a total of 250 subjects. There were 125 women with pre-eclampsia and 125 women without pre-eclampsia (control group). Matching was done for age, gestational age, and parity between case and control groups. Matching was verified by a P value of 0.061 for maternal age and gestational age and 0.77 for parity. The statistical analyses were done by applying the chi-squared test and determining odds ratio (OR) for having bacteriuria in univariate logistic regression as well as multivariate regression with adjusting the effect of maternal age, gestational age, and parity. Pyuria and bacteriuria were significantly more common in pre-eclampsia group than in control group. The results showed that a significant association existed between asymptomatic bacteriuria and pre-eclampsia. The rate of asymptomatic bacteriuria was 6.8 times higher in women with pre-eclampsia compared to those without pre-eclampsia. Further studies are required for better clarification of association between asymptomatic bacteriuria and pre-eclampsia. PMID:26925912
Babital; Sanjeev,; Shankar
Asymptomatic bacteriuria (ASB) is infection in pregnancy which requires medical treatment. If left untreated, may lead to prematurity, intrauteri ne death and pyelonephrit i s. The diagnosis is done by culture and its antibiotic sensitivity helped the women in treatment.
Ghafarnezhad M; Shams
Asymptomatic bacteriuria is prevalent during pregnancy. It can lead to pyelonephritis, premature pregnancy and low birth weight. In this prospective study, to determine prevalence and risk factors of asymptomatic bacteriuria, 205 consecutive pregnant women who visited our prenatal care clinic in Mirza-Koochakkhan Hospital and had no urinary symptom were entered. Patients data were recorded using a questionnaire and urine samples were obtained for urinalysis and urine culture. We analysed data...
Ghafarnezhad M; Shams
Asymptomatic bacteriuria is prevalent during pregnancy. It can lead to pyelonephritis, premature pregnancy and low birth weight. In this prospective study, to determine prevalence and risk factors of asymptomatic bacteriuria, 205 consecutive pregnant women who visited our prenatal care clinic in Mirza-Koochakkhan Hospital and had no urinary symptom were entered. Patients data were recorded using a questionnaire and urine samples were obtained for urinalysis and urine culture. We analysed data...
Aderemi O. Kehinde; Adedapo, Kayode S.; Aimaikhu, Christopher O.; Odukogbe, Akin-tunde A.; Olayemi, Oladapo; Salako, Babatunde
Untreated asymptomatic bacteriuria can lead to urinary tract infection (UTI) in pregnancy with devastating maternal and neonatal effects such as prematurity and low birth weight, higher fetal mortality rates and significant maternal morbidity. We carried out a two year (April 2007 to March 2009) cross-sectional epidemiological study to determine the prevalence of significant bacteriuria among asymptomatic antenatal clinic attendees at two antenatal clinics (ANCs) in University College Hospita...
Full Text Available To evaluate the prevalence, predisposing factors and aetiological agents of asymptomatic bacteriuria in pregnant women attending antenatal clinic at State Hospital, Ado-Ekiti, Ekiti State, Nigeria. One hundred (100 pregnant women were screened. Clean catch midstream urine samples were collected, examined microscopically and cultured. Questionnaires were administered to determine the possible predisposing factors to asymptomatic bacteriuria. 52(52% out of the 100 women screened were positive for asymptomatic bacteriuria. 6(11.5% out of these had mixed bacterial growth while 46(88.5% subjects had one type of bacteria. 36% had non-significant bacterial growth. 12(12% yielded viable growth of Candida albicans. Staphylococcus aureus was the predominant bacteria followed by Escherichia coli. Pregnant women in their third trimester had the highest prevalence of asymptomatic bacteriuria (60.3%. The age group 30-40 years had the highest prevalence (62.5%.Women with parity range of 1-2 has the highest prevalence rate of 80% while the least 27.3% was found in parity range of 0 (no previous pregnancy Full time housewives had highest prevalence while Christian pregnant women had higher prevalent rate (66.7% than their Muslim counterparts (58.1% Routine screening of the urine of pregnant women for asymptomatic bacteriuria and personal hygiene was emphasized so as to reduce maternal and foetal complications associated with pregnancy.
Full Text Available Asymptomatic bacteriuria is prevalent during pregnancy. It can lead to pyelonephritis, premature pregnancy and low birth weight. In this prospective study, to determine prevalence and risk factors of asymptomatic bacteriuria, 205 consecutive pregnant women who visited our prenatal care clinic in Mirza-Koochakkhan Hospital and had no urinary symptom were entered. Patients data were recorded using a questionnaire and urine samples were obtained for urinalysis and urine culture. We analysed data by using fisher exact and chi-squared test. 14 cases had positive urine culture (6.8%. Significant correlation was seen between asymptomatic bacteriuria and age, parity, past history of kidney stone, pyelonephritis, urinary tract infection, preterm delivery and pyuria pvalue <0.05. We suggest routine urine culture in first visit of high risk and 16th week of low risk pregnancies.
Full Text Available Asymptomatic bacteriuria is prevalent during pregnancy. It can lead to pyelonephritis, premature pregnancy and low birth weight. In this prospective study, to determine prevalence and risk factors of asymptomatic bacteriuria, 205 consecutive pregnant women who visited our prenatal care clinic in Mirza-Koochakkhan Hospital and had no urinary symptom were entered. Patients data were recorded using a questionnaire and urine samples were obtained for urinalysis and urine culture. We analysed data by using fisher exact and chi-squared test. 14 cases had positive urine culture (6.8%. Significant correlation was seen between asymptomatic bacteriuria and age, parity, past history of kidney stone, pyelonephritis, urinary tract infection, preterm delivery and pyuria pvalue <0.05. We suggest routine urine culture in first visit of high risk and 16th week of low risk pregnancies.
Hooton, T M; Hillier, S; Johnson, C; Roberts, P L; Stamm, W E
We evaluated the effects of contraceptive method on the occurrence of bacteriuria and vaginal colonization with Escherichia coli in 104 women who were evaluated prior to having sexual intercourse, the morning after intercourse, and 24 hours later. After intercourse, the prevalence of E coli bacteriuria increased slightly in oral contraceptive users but dramatically in both foam and condom users and diaphragm-spermicide users. Twenty-four hours later, the prevalence of bacteriuria remained significantly elevated only in the latter two groups. Similarly, vaginal colonization with E coli was more dramatic and persistent in users of diaphragm-spermicide and foam and condoms. Vaginal colonization with Candida species, enterococci, and staphylococci also increased significantly in diaphragm-spermicide users after intercourse. We conclude that use of the diaphragm with spermicidal jelly or use of a spermicidal foam with a condom markedly alters normal vaginal flora and strongly predisposes users to the development of vaginal colonization and bacteriuria with E coli. PMID:1859519
Ikefuna Anthony N
Full Text Available Abstract Background Urinary tract infection (UTI is a common cause of childhood morbidity and mortality in the tropics. Children with sickle cell anemia (SCA may have compromised kidney function arising from repeated vaso-occlusive episodes and recurrent symptomatic or asymptomatic UTI. Objectives This study aims at determining the prevalence of asymptomatic bacteriuria and sensitivity pattern in children with homozygous sickle haemoglobin compared to children with normal haemoglobin. Methods One hundred children with SCA in stable state and 100 children with normal haemoglobin aged 2-12 years were screened for asymptomatic bacteriuria using midstream urine samples. The samples were incubated aerobically at 37°C for 24 hours within one hour of collection. Children whose urine samples yielded significant bacteriuria (≥105cfu/ml on two consecutive cultures were regarded as having asymptomatic bacteriuria. Results Asymptomatic bacteriuria was noted in 6% of children with SCA and occurred more in females than males (F: M = 5:1 when compared to 2% in children with normal haemoglobin. Escherichia coli was the commonest organism isolated (33.3%. All the organisms were resistant to co-trimoxazole and ampicillin while most were sensitive to gentamicin, ceftriaxone and the quinolones. Conclusion The risk of asymptomatic bacteriuria is three times more common in children with sickle cell anemia than in children with normal haemoglobin. It is therefore important to screen SCA patients, especially the females for UTI and should be treated according to the sensitivity result of the cultured organisms.
Mamata Sharma Neupane
Full Text Available Urinary Tract Infection (UTI refers to both microbial colonization of the urine and tissue invasion of any structure of the urinary tract. Pregnancy enhances the progression from asymptomatic to symptomatic bacteriuria which could lead to pyelonephritis and adverse obstetric outcomes such as prematurity, low-birth weight, and higher fetal mortality rates. This study was undertaken to determine the prevalence of asymptomatic bacteriuria in pregnancy; its causative agents and their antimicrobial susceptibility pattern, and also to determine the relationship between asymptomatic bacteriuria and pyuria. The total number of participants who finished the study was 392. The mean age of the participants was 29.76 ± 6.71(range, 21-37 years. Of the 392 urine specimens processed, 102 (26.0% showed significant bacteriuria. The commonest organism causing bacteriuria was Escherichia coli. The sensitivity pattern of the isolated organisms revealed that all were sensitive to ciprofloxacin and gentamicin at very high percentage. 200 (51.5% women had more than 5 pus cells in urine specimens from which 50 (12.75% had positive cultures. Women with higher number of pus cells in urine specimen had significantly higher asymptomatic bacteriuria (p < 0.0001.In conclusion, screening of bacteriuria in pregnancy and proper treatment must be considered as an essential part of antenatal care in Nepalese community. To prevent asymptomatic bacteriuria complications, all pregnant women should be screened at the first antenatal visit. A negative test for pyuria is not a reliable indicator of the absence of asymptomatic bacteriuria in pregnant women.
Full Text Available Asymptomatic bacteriuria (ASB is infection in pregnancy which requires medical treatment. If left untreated, may lead to prematurity, intrauteri ne death and pyelonephrit i s. The diagnosis is done by culture and its antibiotic sensitivity helped the women in treatment.
Jayalakshmi J; Jayaram V
To evaluate the diagnostic efficacy of various screening tests in detecting asymptomatic bacteriuria among pregnant women. Clean catch midstream urine specimens were collected from 630 consecutive pregnant women and processed. Forty-four (7.4%) of the urine samples were culture positive, with Escherichia coli as the predominant organism isolated (57.4%). The results of the four screening tests, viz., Gram′s staining of uncentrifuged urine, pus cell count, nitrite test and...
Conclusions: Ectopic pregnancy can have varied presentations and misdiagnosis can be seen in Surgical, Medical and Gynaecology Universal screening of aymptomatic bacteriuria is recommended because of its high prevalence and prenatal and maternal complications, if left untreated. Nitrofurantoin can be advocated because of its low cost and high effectiveness where culture is not possible because of inadequate resources. [Int J Reprod Contracept Obstet Gynecol 2016; 5(2.000: 407-410
Kehinde, Aderemi O; Adedapo, Kayode S; Aimaikhu, Christopher O; Odukogbe, Akin-Tunde A; Olayemi, Oladapo; Salako, Babatunde
Untreated asymptomatic bacteriuria can lead to urinary tract infection (UTI) in pregnancy with devastating maternal and neonatal effects such as prematurity and low birth weight, higher fetal mortality rates and significant maternal morbidity. We carried out a two year (April 2007 to March 2009) cross-sectional epidemiological study to determine the prevalence of significant bacteriuria among asymptomatic antenatal clinic attendees at two antenatal clinics (ANCs) in University College Hospital and Adeoyo Maternity Hospital, both in Ibadan, Nigeria.All consenting ANC attendees without UTI were enrolled in the study. Urine specimens of 5 to 10 ml collected from each subject were examined microscopically for white blood cells, red blood cells and bacteria. The specimens were further cultured on MacConkey agar using a sterile bacteriological loop that delivered 0.002 ml of urine. Colony counts yielding bacterial growth of more than 10(5)/ml of pure isolates were considered significant.Of the 473 subjects studied, 136 had significant bacteriuria, giving a prevalence rate of 28.8%. The highest age specific prevalence (47.8%) was found in the 25-29 year olds while only one (0.7%) was found in the teenage group. A large percentage (64.0%) of subjects with significant bacteriuria had tertiary education, compared with 4.4% who had no formal education but the association was not statistically significant (X(2) = 0.47, p = 0.79). The majority (75.8%) of subjects with significant bacteriuria had no previous history of abortion, while 20 (14.7%) had one previous abortion and only three (2.1%) admitted to three previous abortions (X(2) = 5.16, p = 0.16). The majority (69.8%) of those with significant bacteriuria presented at second trimester while 38 (28.0%) presented at third trimester (X(2) = 6.5, p = 37).Only 22 (4.6%) of the studied subjects presented at first trimester, and 3 (13.7%) of these had significant bacteriuria.The prevalence of asymptomatic bacteriuria is high
Nanji S Ajayi
Full Text Available Objective: To determine the prevalence of asymptomaticbacteriuria, bacteriology and sensitivity pattern in Ilorin using thegold standard of urine culture.Methods: A prospective study was carried out from 1st Julyto 31st October 2007, at the University of Ilorin TeachingHospital (UITH on 125 consenting asymptomatic pregnantwomen. A structured proforma was used to collect informationfrom the women and a midstream urine specimen collected forbacteriological culture.Results: Of the 125 pregnant women, 50 had bacteriuria on urineculture giving a prevalence of 40�20The mean age of the womenwas 28.5 years with a standard deviation of 4.95. The age rangedbetween 14 and 40 years. Staphylococcus aureus was the commonestpathogen isolated (72� followed by Proteus spp (14� Most ofthe organisms showed good sensitivity to Nitrofurantoin andgentamicin.Conclusion: The prevalence of asymptomatic bacteriuria in Ilorinis high and routine urine culture is advocated for all pregnantwomen at booking.
Bilir, Filiz; Akdemir, Nermin; Ozden, Selcuk; Cevrioglu, A Serhan; Bilir, Cemil
Background Among the pregnancy urinary tract infections, asymptomatic bacteriuria (ASB) is the most common one. Untreated ASB can progress to pyelonephritis in 30-50% of the patients and can also result in prematurity in 27% of the pregnancy so it needs immediate diagnosis and treatment. In this study, we wanted to evaluate procalcitonin levels, compared to other inflammatory in pregnant women with ASB. Methods The study was designed between the period of January 2012 and February 2013 at Sak...
Belgin Polat; Serpil Ünlü; Sibel Saygan; Rana Karayalçin; Ayla Sargin Oruç; Şevki Çelen; Nuri Danişman
Introduction. Asymptomatic bacteriuria (ASB), occurring in 2–11% of pregnancies, is a major predisposition to the development of pyelonephritis, which is associated with obstetrical complications, such as preterm labor and low birth weight infants. The aim of this study was to determine the prevalence of ASB, the antibacterial susceptibilities of the isolated microorganisms and the associated risk factors in an outpatient clinical setting in Zekai Tahir Burak Women's Health Education and Rese...
Maral G. Nogayeva; Svetlana A. Tuleutayeva
Urinary tract morbidity has increased by 7% in Kazakhstan between 2007 to 2011. Pregnant women with extragenital pathologies or kidney diseases had the greatest prevalence of morbidity. Asymptomatic bacteriuria (AB) is one of the most important risk factors of pyelonephritis development in pregnant women, and it can affect the course and outcome of pregnancy, delivery, and postnatal period. AB prevention requires prevention of pregnancy complications including early diagnostic of urinary trac...
Full Text Available OBJECTIVES: Determine the prevalence of asymptomatic urinary tract infection (AUTI among pregnant women. We also determined the antibacterial susceptibility of the isolates to various antibiotics and associated risk factors in AUTI. MATERIALS AND METHODS: One thousand five hundred and five consecutive pregnant women were included in the study. Mid-stream urine specimen for complete examination of urine was obtained. RESULTS: Of 1505 pregnant women, 134 (8.9% had bacteriuria. The mean age of the all the pregnant women included in the study was 28.40 years with a standard deviation of 6.16. Age ranged from 15 to 45 years of age. The urine culture of the asymptomatic pregnant women (1505 cases showed growth in only 134 cases (8.9%. Escherichia coli was the commonest organism 79 (58.96% followed by CN Staphylococcus 22 (16.8% and S aureus 18 (13.43%. Escherichia coli, which comprised 58.96% (79 of the isolates, were 88.62%, 87.35%, and 83.55% sensitive to cefotaxime, ciprofloxacin and cefotizoxime respectively. Similarly, E. coli were 89%, 70%, and 20% resistant to ampicillin, cotrimoxazole, and nitrofurantoin respectively (OR 1.57 95% CI 1.01, 2.44. After analyzing, four variables, hemoglobin levels seem to be independently associated with asymptomatic bacteriuria (OR = 9.41 (1.65-50.38. CONCLUSION: Prevalence of asymptomatic bacteriuria among pregnant women was 8.9%. The predominant organisms were Escherichia coli 79 (58.96%, followed by CN Staphylococcus 22 (16.8%. Most strains of Escherichia coli showed that they were resistant to ampicillin, tetracycline and gentamicin.
Ullah, M Anayet; Barman, A; Siddique, M A; Haque, A K M E
This was a cross-sectional followed by cohort type of study conducted among the pregnant mothers of second trimester in the rural areas of Rajshahi district. Initially 1800 pregnant mothers ofsecond trimester were selected from 18 unions applying 2-stage random sampling. A total of 216 pregnant mothers with asymptomatic bacteriuria were paired among the rest of the healthy pregnant mothers (without bacteriuria) on the basis of age, gravida and economic status for cohort study to relate asymptomatic bacteriuria with the incidence of symptomatic bacteriuria, hypertensive disorders in pregnancy (HDP) and pre-term delivery. The matched paired pregnant mothers werefollowed monthly interval up to delivery. The prevalence of asymptomatic bacteriuria was 12% among the pregnant mothers in rural Rajshahi. E. Coli was the commonest causative agent of both asymptomatic and symptomatic bacteriuria. The results of this study suggest that asymptomatic bacteriuria were more prone to develop symptomatic bacteriuria, hypertensive disorders in pregnancy and pre-term delivery than that of the healthy mothers (without bacteriuria). Screening of bacteriuria in pregnancy and proper treatment must be considered as an essential part of antenatal care in this rural community. PMID:18481440
Kheya Mukherjee; Saroj Golia; Vasudha CL; Babita; Debojyoti Bhattacharjee; Goutam Chakroborti
Background: Asymptomatic bacteriuria is common in women with prevalence of 4-7% in pregnancy. The traditional reference test for bacteriuria is quantitative culture of urine which is relatively expensive time consuming and laborious. The aim of this study was to know the prevalence of asymptomatic bacteriuria in pregnancy, to identify pathogens and their antibiotic susceptibility patterns and to device a single or combined rapid screening method as an acceptable alternative to urine culture. ...
N. Hemalatha; N. Syamala
Background: Asymptomatic bacteriuria is identified only when significant number of bacteria is demonstrated in urine. As bacterial culture takes at least 3 to 4 days, early diagnosis is a problem. Hence a reliable and cost effective screening test for bacteriuria is of great value. The aim of the study was conducted to know the prevalence of asymptomatic bacteriuria and to evaluate the diagnostic efficacy of Dip slide test. Methods: This study was conducted at Government Maternity Hospit...
Maral G. Nogayeva
Full Text Available Urinary tract morbidity has increased by 7% in Kazakhstan between 2007 to 2011. Pregnant women with extragenital pathologies or kidney diseases had the greatest prevalence of morbidity. Asymptomatic bacteriuria (AB is one of the most important risk factors of pyelonephritis development in pregnant women, and it can affect the course and outcome of pregnancy, delivery, and postnatal period. AB prevention requires prevention of pregnancy complications including early diagnostic of urinary tract infections, timely optimization of therapy at outpatient facilities, and dynamic follow-up.
Trautner, Barbara W
Asymptomatic bacteriuria (ABU) is a condition in which bacteria are present in a noncontaminated urine sample collected from a patient without signs or symptoms related to the urinary tract. ABU must be distinguished from symptomatic UTI by the absence of signs and symptoms compatible with UTI or by clinical determination that a nonurinary etiology accounts for the patient's symptoms. Interactions between the organism, the host, and the bladder environment determine whether bacteriuria leads to ABU or to UTI. ABU is a very common condition that is often treated unnecessarily with antibiotics-it should be detected and treated in pregnant women and patients undergoing urologic surgery, but in most other patient groups, treatment does not confer benefit and can be harmful. A change in prescribing behavior for ABU has been achieved through several fairly high-intensity interventions, such as interactive educational sessions for physicians, but whether these improvements persist beyond the study period is not known. Further research is needed to determine whether screening for and treatment of ABU is beneficial in patients with renal transplants, patients with orthotopic neobladders, patients undergoing prosthetic joint implantation, and patients with neutropenia. PMID:22143416
Ivanov, M-L; Malinverni, R
Who should be screened for asymptomatic bacteriuria (AB) and who should be treated? This review updates some aspects of the management of AB in different patient populations. A systematic screening for AB is recommended for pregnant women because of a significant risk of complications. In these cases as well as before any uro-gynecologic surgical procedure treatment of AB is strongly recommended. The management of AB in immunosuppressed or transplanted patients is more controversial. In other populations treating AB is not recommended and the outcome seems to be worse in case of treatment due to possible side effects and selection of resistant organisms. Recent studies have shown a considerable gap between clinical practice and recommendations. PMID:19086489
Ananthi Kasinathan; Prasad Thirumal
Background: Asymptomatic bacteriuria is the presence of actively multiplying bacteria within the urinary tract in the absence of any symptoms. Antenatal women are more susceptible to urinary tract infection because of the anatomical and physiological changes which occur during pregnancy. Aim of current study was the aim of this study was to determine the prevalence of asymptomatic bacteriuria in pregnant women, the organisms responsible and to treat the same. Methods: A total of 174 antena...
Jain, Vaishali; Das, Vinita; Agarwal, Anjoo; Pandey, Amita
Background & objectives: Asymptomatic bacteriuria during pregnancy if left untreated, may lead to acute pyelonephritis, preterm labour, low birth weight foetus, etc. Adequate and early treatment reduces the incidence of these obstetric complications. The present study was done to determine presence of asymptomatic bacteriuria (ASB) and obstetric outcome following treatment in early versus late pregnancy. Methods: A prospective cohort study was conducted at a tertiary care teaching hospital of...
There is a shortage of evidence for clinical guidelines on diagnosis and management of both asymptomatic bacteriuria (the presence of bacteria in urine without symptoms of an infection) and urinary tract infections in women with diabetes and pregnant women. Asymptomatic bacteriuria and urinary tract infections in these two risk groups may have far-reaching consequences such as pyelonephritis and preterm birth. The results of the studies in this thesis can be used to fill some of the knowledge...
Ilusanya, O. A. F.; T.O. Adesetan; H.O. Egberongbe; A.T. Otubushin
To evaluate the prevalence, predisposing factors and aetiological agents of asymptomatic bacteriuria in pregnant women attending antenatal clinic at State Hospital, Ado-Ekiti, Ekiti State, Nigeria. One hundred (100) pregnant women were screened. Clean catch midstream urine samples were collected, examined microscopically and cultured. Questionnaires were administered to determine the possible predisposing factors to asymptomatic bacteriuria. 52(52%) out of the 100 women screened were positive...
This study aims to determine the asymptomatic bacteriuria in pregnancy due to GBS and its antimicrobial sensitivity pattern for planning strategy for the management of these cases and also to determine the relationship between asymptomatic bacteriuria and pyuria. A total of 3863 consecutive urine specimens were collected from 3863 pregnant women with asymptomatic bacteriuria attending the obstetrics and gynaecology department of our hospital over a period of two years. Specimens were processed using standard microbiological procedures. All the subjects were evaluated for bacteriuria. The prevalence of asymptomatic bacteriuria due to group B streptococci (GBS) was 82/3863 (2.1%) among pregnant women in Saudi Arabia. Among these, 69/82 patients (84.2%) had clinical and microbiological features consistent with cystitis, versus 13/82 (15.8%) for pyelonephritis. About 51.2% (42/82) of the patients who had urine analysis performed had positive results based on positive urinary leucocyte esterase and pyuria. Disc-diffusion analysis of all 82 GBS isolates showed that they were highly susceptible to Augmentin and linezolid. Screening for bacteriuria in pregnancy and proper treatment must be considered as an essential part of antenatal care in this community. To prevent asymptomatic bacteriuria complications, all pregnant women should be screened at the first antenatal visit. A negative test for pyuria is not a reliable indicator of the absence of asymptomatic bacteriuria in pregnant women. Further, ongoing surveillance and evaluation of outcomes in pregnancies complicated by GBS bacteriuria is required to optimise maternal and newborn care. PMID:26510270
Sofei-Majidpur H; Kalantar E; Verdi F; Khaksar N; Shahsavari S; Beiranvand S
Objective:The objective of this study was to determine the etiology and antimicrobial susceptibility patterns of asymptomatic bacteriuria pathogens isolated among school going children in Sanandaj,Iran.Methods:A total of 1 457 urine samples of 5 to 10 years children from forty different schools of Sanandaj city were screened to see asymptomatic bacteriuria during November 2007 to June 2008.Results:Bacterial colony count of over (105)colony forming units CFU /mL were found in 28 (1.90%)of total cases,with 767 (52.64%)girls and 690 (47.35%)boys.The highest class-specific prevalence was found in the fourth standard (2.8%)and the lowest in the first standard (1.0%).The dominant bacterial isolates were E.coli 20 (74.1%),followed by Klebsiella pneumoniae 04 (14.8%)and Staphylococcus aureus 04 (14.8%).Cefotaxime,Cefixime,Kana-mycin,Co-trimoxazole,nalidicxic acid,nitrofurantoin and Amoxicillin,resistance rates were above 90.0%. Ceftriaxone expressed the highest susceptibility among E.coli isolates.Surprisingly,S.aureus showed 100. 0% resistance to oxacillin.Conclusion:In the present study in which Escherichia coli is the most frequently incriminated as the causative agents.The results show a very serious antibiotic resistance of E.coli isolated. Surveillance and monitoring studies will be essential in preventing of renal scarring or other abnormalities.
Celen, Sevki; Oruç, Ayla Sargin; Karayalçin, Rana; Saygan, Sibel; Unlü, Serpil; Polat, Belgin; Danişman, Nuri
Introduction. Asymptomatic bacteriuria (ASB), occurring in 2-11% of pregnancies, is a major predisposition to the development of pyelonephritis, which is associated with obstetrical complications, such as preterm labor and low birth weight infants. The aim of this study was to determine the prevalence of ASB, the antibacterial susceptibilities of the isolated microorganisms and the associated risk factors in an outpatient clinical setting in Zekai Tahir Burak Women's Health Education and Research Hospital in Ankara, Turkey. Material and Methods. Between December 2009 and May 2010, pregnant women admitted to the antenatal outpatient clinic were included in this study. The results of a complete urine analysis, midstream urine culture and antibacterial susceptibility were evaluated. Results. Of the 2011 pregnant women included, 171 had ASB (8.5%). E. coli was the most frequently isolated microorganism (76.6%), followed by Klebsiella pneumonia (14.6%). Both microorganisms were highly sensitive to fosfomycin, sensivity being 99.2% for E. coli and 88% for Klebsiella pneumonia. Conclusions. In this certain geographical region, we found E. coli as the most common causative agent of ASB in the obstetric population and it is very sensitive to fosfomycin. We recommend fosfomycin for ASB in pregnant women due to its high sensitivity, ease of administration and safety for use in pregnancy. PMID:21647231
Full Text Available Asymptomatic bacteriuria (ABU is a common clinical condition that often leads to unnecessary antimicrobial use. The reduction of antibiotic overuse for ABU is consequently an important issue for antimicrobial stewardship and to reduce the emergence of multidrug resistant strains. There are two issues in everyday urological practice that require special attention: the role of ABU in pre-operative prophylaxis and in women affected by recurrent urinary tract infections (rUTIs. Nowadays, this is the time to think over our practice and change our way of thinking. Here, we aimed to summarize the current literature knowledge in terms of ABU management in patients undergoing urological surgery and in patients with rUTIs. In the last years, the approach to patient with ABU has changed totally. Prior to all surgical procedures that do not enter the urinary tract, ABU is generally not considered as a risk factor, and screening and treatment are not considered necessary. On the other hand, in the case of all procedures entering the urinary tract, ABU should be treated in line with the results of a urine culture obtained before the procedure. In patients affected by rUTIs, ABU can even have a protective role in preventing symptomatic recurrence, particularly when Enterococcus faecalis (E. faecalis has been isolated.
Full Text Available BACKGROUND: Asymptomatic bacteriuria (ASB is common in pregnancy, if left untreated it may lead to adverse maternal and fetal complications like abortion, premature delivery and low birth weight. Early diagnosis and treatment have reduced the risk of pyelonephritis in pregnant women with ASB from 20-30% to 2-4% Increasing Resistance trends of uropathogens to commonly prescribed first line antibiotics has posed a great threat with limited therapeutic options. AIMS & OBJECTIVES: The present study was carried out to determine the prevalence of asymptomatic bacteriuria in pregnant women attending antenatal clinic of our tertiary care hospital and also to study the bacteriological profile and determine antimicrobial susceptibility pattern of the pathogens responsible for Asymptomatic Bacteriuria. SETTINGS & DESIGN: A Cross sectional study. METHODS & MATERIALS: Midstream urine samples from 281 pregnant women without urinary symptoms who attended antenatal clinic during March 2012 and March 2013 were included in this study. Samples were processed and isolates were identified as per the CLSI guidelines. Antibiotic susceptibility was done by Kirby bauer disk diffusion method. RESULTS: The overall prevalence of ASB was 13.87%. There was no significant association of ASB occurrence with respect to age [P>0.05]. A significant association with gravid status and trimester [P<0.001] was observed. Escherichia coli was the most predominant with total 26 [66.66%] followed by Staphylococcus aureus 6[15.38%], Klebsiella pneumoniae 5[12.82%] and CONS 2[5.13%]. Amoxicillin [96%], Norfloxacin [84%], ceftriaxone [89%] and Augmentin [94%] were found to be the most effective antibiotics against the uropathogens isolated. CONCLUSIONS: Our study revealed that Asymptomatic bacteriuria is not uncommon in our population studied. Keeping in view that screening, often prevents severe complications, we emphasize the need to include urine culture as a part of antenatal care in
Full Text Available Asymptomatic bacteriuria (ASB is the commonest bacterial infec-tion which requires medical treatment in pregnancy. Untreated ASB in 25-30% of can cases lead to pyelonephritis which may lead to increased risk of abortions, intrauterine fetal deaths, prematurity and low birth weight. A cross-sectional study was conducted at Gandhi Hospital over a period of ten months with 125 asymptomatic pregnant women in the age group of 15-35 years. The objectives of the study were to determine prevalence of asymptomatic bacteriuria, to identify its risk factors and to compare the screening methods. Of the 125 pregnant women, significant bacteriuria was seen in 21 (16%. The prevalence of bacteriuria showed a rise with increasing maternal age and increasing gestational period. Anemics and hypertensives were at greater risk. The most common isolates were Klebsiella pneumoniae and Staphylococcus aureus (28% each. Culture proved to be the gold standard for diagnosis. Catalase and Nitrate reduction tests were used as screening methods with a sensitivity of 90.48% and 71.43% respectively. Multiple drug resistance was observed in Gram-positive and Gram-negative isolates. Routine screening for asymptomatic bacteriuria is therefore recommended throughout pregnancy to avoid adverse fetal and maternal outcomes.
Full Text Available Background: Asymptomatic bacteriuria is common in women with prevalence of 4-7% in pregnancy. The traditional reference test for bacteriuria is quantitative culture of urine which is relatively expensive time consuming and laborious. The aim of this study was to know the prevalence of asymptomatic bacteriuria in pregnancy, to identify pathogens and their antibiotic susceptibility patterns and to device a single or combined rapid screening method as an acceptable alternative to urine culture. Methods: Clean catch mid-stream urine were collected from 250 pregnant women aged between 18-45 years attending antenatal clinic, for a period of one year (November 2008-2009. Screening tests such as gram staining of uncentrifuged urine, pus cell count, nitrite test and leukocyte esterase test were done. Identification of organisms and antibiotic sensitivity tests were performed as per standard methods. Results: Out of the 250 pregnant women, 21 (8.4% had significant bacteriuria. High percentage of asymptomatic bacteriuria was seen in 2nd trimester (42.86% and in primigravidas (52.38%. E. coli (57.14% was the most common organism. Among screening tests gram staining of uncentrifuged urine had a sensitivity of 85.71%. Nitrite and leukocyte esterase tests alone showed sensitivity of 71.42%. However, the combination of these two tests, either tests positive, showed sensitivity and negative predictive value of 90.47% and 99.09% respectively. Conclusion: Asymptomatic bacteriuria in pregnancy can be identified by simple and combined rapid screening methods and urine culture along with antibiogram so that early treatment can be started thereby preventing complications. [Int J Res Med Sci 2014; 2(3.000: 1085-1091
Rajaratnam, Annie; Baby, Neha Maria; Thomas S Kuruvilla; Machado, Santhosh
Background: Asymptomatic bacteriuria (AB) is common inwomen and increases in prevalence with age or sexual activity. Prompt detection and treatment of this condition and associated factors decreases complications like acute pyleonephritis, intrauterine growth retardation and preterm labour. Chromogenic media is a versatile tool in rapid primary screening of the causative organisms considerably reducing daily routine workload.
Michova, M; Ivanov, St; Batashki, I
Asymptomatic bacteriuria (AB) and cystitis affect 4-9% of pregnancies and are associated with pyelonephritis and preterm labor. Screening for AB and adequate antimicrobal therapy prevent most of these serious complications. Twenty- nine pregnant patients, suffering from AB and 9 cases with cystitis were treated with single dose Monura (Fosfomycin trometamol) in a prospective study. PMID:20387275
Sujatha, R.; Nawani, Manju
Background: Symptomatic and asymptomatic bacteriuria (ASB) is common in pregnant women. Pregnancy enhances the progression from ASB to symptomatic bacteriuria, which if left untreated, could lead to acute pyelonephritis and other adverse outcomes such as prematurity, postpartum, hypertensive disease, anaemia, UTIs and higher foetal mortality rates.
Okusanya, B O; Aigere, E O S; Eigbefoh, J O; Okome, G B O; Gigi, C E
Detection of asymptomatic bacteriuria (ASB) in pregnancy is important to avert the attendant morbidities. Therefore, we assessed the use of chlorhexidine reaction to detect ASB in pregnancy. This was a prospective study, which compared chlorhexidine reaction with dipstick tests and urine culture in 150 asymptomatic pregnant women. Urine cultures detected bacteriuria in seven women (4.7%). Chlorhexidine detected ASB in 72 women (48%) and had sensitivity, specificity and accuracy of 100%, 54% and 56%, respectively. Leucocyte esterase (LE) and nitrite detected bacteriuria in 31 (20.7%) women and 12 (8.0%) women, respectively. Singly, LE had a sensitivity and specificity of 14.3% and 79%, respectively, while nitrite's sensitivity and specificity was 42.9% and 93.7%, respectively. Combined, LE and nitrite had better sensitivity (97.9%) and accuracy (94%). Since the accuracy of chlorhexidine is low, other than urine culture, combined dipstick urinalysis of leucocyte esterase and nitrite tests is good to detect asymptomatic bacteriuria in pregnancy. PMID:24359043
Full Text Available The apparent decline in immunity of pregnant women appears to promote the growth of both com-mensal and non-commensal microorganisms. The objective of the study was to determine the prevalence of asymptomatic bacteriuria in pregnant women visiting the University hospital, Ku-masi. This prospective hospital-based study was carried out between April-June 2009. A total of 200 pregnant women were recruited for this study. The ages of the women ranged from 15 to 46 years. About 5-10mls of clean catch urine was cultured on Cysteine Lactose Electrolyte Deficient (CLED agar aerobically at 37oC . Isolates were identified to the species level using standard proto-col. Antibiotic sensitivity test were carried out using the Kirby-Bauer disc diffusion method. Of the 200 women examined, 19 had significant bacteriuria representing a prevalence of 9.5% in the study population. Pregnant women in their second trimester from the study had the highest prevalence of significant bacteriuria (52.6% with age ranges between 30-34 years having the highest prevalence (36.8%. Nulliparous women were 35 (17.5% with 3 (8.6% testing positive for bacteriuria and 165 (82.5% were multiparous with 16 (9.7% testing positive for bacteriuria. E. coli (36.8% was the common bacteria isolate from this study. From this study, asymptomatic bacteriuria is common among antenatal women in the population studied. It is therefore recommended that periodic test-ing of pregnant women is advocated and those found to be infected need to be treated to avoid complications.
Jayalakshmi, J; Jayaram, V S
To evaluate the diagnostic efficacy of various screening tests in detecting asymptomatic bacteriuria among pregnant women. Clean catch midstream urine specimens were collected from 630 consecutive pregnant women and processed. Forty-four (7.4%) of the urine samples were culture positive, with Escherichia coli as the predominant organism isolated (57.4%). The results of the four screening tests, viz., Gram's staining of uncentrifuged urine, pus cell count, nitrite test and leukocyte esterase (LE) test, were compared against urine culture. Gram's stain of the uncentrifuged urine was found to be the single most useful test with a sensitivity and negative predictive value (NPV) of 85.1% and 98.8%, respectively. Pus cell count was the least sensitive. Neither the nitrite test nor the LE test alone was sensitive enough with 74.4% and 61.7%, respectively. However, when either or both tests positive were considered, it increased the sensitivity and NPV comparable with Gram's staining results, with 82.9% and 98.8%, respectively. With the potential to be used as an office diagnostic procedure, the combined nitrite and LE dipstick test may provide an acceptable alternative. PMID:18723963
Full Text Available To evaluate the diagnostic efficacy of various screening tests in detecting asymptomatic bacteriuria among pregnant women. Clean catch midstream urine specimens were collected from 630 consecutive pregnant women and processed. Forty-four (7.4% of the urine samples were culture positive, with Escherichia coli as the predominant organism isolated (57.4%. The results of the four screening tests, viz., Gram′s staining of uncentrifuged urine, pus cell count, nitrite test and leukocyte esterase (LE test, were compared against urine culture. Gram′s stain of the uncentrifuged urine was found to be the single most useful test with a sensitivity and negative predictive value (NPV of 85.1% and 98.8%, respectively. Pus cell count was the least sensitive. Neither the nitrite test nor the LE test alone was sensitive enough with 74.4% and 61.7%, respectively. However, when either or both tests positive were considered, it increased the sensitivity and NPV comparable with Gram′s staining results, with 82.9% and 98.8%, respectively. With the potential to be used as an office diagnostic procedure, the combined nitrite and LE dipstick test may provide an acceptable alternative.
Awoleke, J O; Adanikin, A I; Ajayi, D D; Ayosanmi, O S
This study aims at identifying predictors of asymptomatic bacteriuria (AB) among pregnant women in a low-resource setting, with the intent of recommending a guideline for screening during antenatal care. A total of 266 healthy pregnant women were antenatally recruited after informed consent. They had routine antenatal investigations, a 1 h 50-g oral glucose tolerance test and quantitative urine culture and sensitivity. The data collected were analysed using statistical software package SPSS v. 17. Prevalence of AB was 23 (8.6%). Escherichia coli was the commonest isolate (6, 26.1%), closely followed by Staphylococcus aureus (5, 21.7%). AB was commoner among patients aged 25-34 years, of low parity and higher education. Blood group B- rhesus-positive significantly predicts the likelihood of developing AB in pregnancy (adjusted OR: 0.36; 95% CI: 0.14-0.96). We conclude that blood group B-rhesus-positive in association with other patients' characteristics, such as age 25-34 years, low parity and higher education could form guidelines for a screening algorithm in our environment. PMID:25029095
Screening women for asymptomatic bacteriuria (ASB) on the first antenatal visit is a part of standard obstetric care. Treating women with ASB decreases the chances of maternal and foetal complications. This study was conducted to find out the spectrum of urine pathogens and their drug susceptibility pattern for ASB during pregnancy. The study was conducted in the Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre Karachi, from September 2001 to March 2002. Two hundred and ninety women, apparently normal with confirmed pregnancy, were registered. A voided midstream urine specimen was collected and cultured. A significant growth i.e. >105 organisms/ml was identified with Analytical Profile Index 20 tests for identification of Enterobacteriaceae (API-20-E) and for Gram positive cocci by other standard methods. The prevalence of ASB was found 6.2%. Antimicrobial sensitivity was determined by disc diffusion Kirby Bauyer method after matching the turbidity with 0.5 McFarland's standard. Most of the recommended drugs were found to have encouraging results, however, Escherichia coli showed 66.67% resistance to ampicillins and sulphonamides. Enterobacters showed 100% resistance to ampicillins, cephalosporins and nitrofurantoin. Staphylococcus saprophyticus showed 66.67% resistance to ampicillins and sulphonamides. It was concluded that detection of ASB during pregnancy and appropriate use of antimicrobials is only possible after culture of urine. Empirical anti-microbial therapy cannot be relied upon because of possible risk of resistance. (author)
Abirami Lakshmy Jayachandran
Results: Out of the 120 samples 14 (11.66% were positive for asymptomatic bacteriuria. The Gram staining showed specificity and negative predictive value of 95.2% and 98.1% respectively. Pus cell count showed a specificity and negative predictive value of 96.29% and 98.11% respectively. Escherichia coli were the predominant species isolated 5 (35.7%. Among the gram negative bacteria, amikacin and nitrofurantoin showed a susceptibility of 90% and 80% each. All the staphylococcus aureus isolates showed 100% sensitivity for nitrofurantoin. Two Klebsiella spp and one Escherichia coli isolate were identified as ESBL producers. Among the S. aureus isolates 3 were identified as Methicillin resistant (MRSA. Conclusions: Urine culture should be performed for all pregnant women irrespective of the symptoms and should be treated promptly to prevent the complications arising out of ASB. [Int J Res Med Sci 2016; 4(2.000: 540-544
Mamata Sharma Neupane; Kalpana Sharma Dhakal; Harish Chandra Neupane; Shital Adhikari; Bijay Aryal
Urinary Tract Infection (UTI) refers to both microbial colonization of the urine and tissue invasion of any structure of the urinary tract. Pregnancy enhances the progression from asymptomatic to symptomatic bacteriuria which could lead to pyelonephritis and adverse obstetric outcomes such as prematurity, low-birth weight, and higher fetal mortality rates. This study was undertaken to determine the prevalence of asymptomatic bacteriuria in pregnancy; its causative agents and their antimicrobi...
Abirami Lakshmy Jayachandran; Ukkiravel Gnanasambandam; Balan K.; Sangeetha, A.V.; T. S. Vijayalakshmi
Background: Asymptomatic bacteriuria (ASB) occurring in pregnant women can lead onto complications like acute pyelonephritis, hypertensive disease of pregnancy, premature delivery and intrauterine growth retardation if untreated. Methods: The present study aims to estimate the occurrence of asymptomatic bacteriuria in antenatal women and to study the antibiotic susceptibility pattern of the isolates. The Gram staining, pus cell count and culture was performed for 120 urine samples. Antibi...
McKenna, David S.; Ike Northern; Scott Matson
Objective: To determine the rate of positive group B streptococcus (GBS) cultures at 35–37 weeks gestation in women who have first trimester asymptomatic GBS bacteriuria. Methods: Pregnant women with asymptomatic first trimester GBS bacteriuria had genital cultures for GBS performed at 35–37 weeks gestational age. Serotyping was performed by the standard Lancefield capillary precipitin method. Results: Fifty-three women with positive urine cultures had genital cultures performed at 35–37 week...
Tincello, D. G.; Richmond, D. H.
OBJECTIVE: To evaluate the performance of reagent test strips in screening pregnant women for asymptomatic bacteriuria at their first visit to an antenatal clinic. DESIGN: Prospective case series. SETTING: Antenatal clinic of a large inner city maternity hospital. SUBJECTS: All women attending for their first antenatal clinic. Patients taking antibiotics for any reason and those with urinary tract symptoms were excluded. INTERVENTION: A midstream urine specimen was divided; half was sent for ...
Kalantar Enayat; Farhadifar Fariba; Nikkho Bahram
OBJECTIVES: Determine the prevalence of asymptomatic urinary tract infection (AUTI) among pregnant women. We also determined the antibacterial susceptibility of the isolates to various antibiotics and associated risk factors in AUTI. MATERIALS AND METHODS: One thousand five hundred and five consecutive pregnant women were included in the study. Mid-stream urine specimen for complete examination of urine was obtained. RESULTS: Of 1505 pregnant women, 134 (8.9%) had bacteriuria. The mean age of...
Harold Fernando Maldonado Cárdenas; Lily Yadira Antolinez Ardila; Marcela Nancy Carolina Solano Prada; Mónica Liliana Tejeiro Rico; Andrés Ricardo Valbuena Parra
The asymptomatic bacteriuria (AB) refers to the bacterial colonization of the urinary tract that multiply in an active way without producing any symptoms. The prevalence varies between 4 to 7% and the consequences of having this pathology are the development of pyelonephritis or may be the cause for early deliveries and low-weight babies. Objectives. To determine the AB prevalence among women in their 12 to 16 weeks of pregnancy, attending a prenatal clinic at two medical institutions in the ...
Meenakshi Lallar; Anam ul Haq; Rajesh Nandal
Background: Infection of urinary tract occurs frequently during pregnancy ranging from Asymptomatic Bacteriuria (ASB) to potentially life threatening acute pyelonephritis. The incidence varies from 5% to 20% and it is an important risk factor for preterm labor and perinatal morbidity and mortality. The present study was performed to correlate preterm labor and to define other risk factors associated with ASB like gravida status, socioeconomic status, and anaemia in pregnant women with ASB in ...
Onu FA; Ajah LO; Ezeonu PO; Umeora OUJ; Ibekwe PC; Ajah MI
Fidelis Agwu Onu,1 Leonard Ogbonna Ajah,1 Paul Olisaemeka Ezeonu,1 Odidika Ugochukwu Joannes Umeora,1 Perpetus Chudi Ibekwe,1 Monique Iheoma Ajah2 1Department of Obstetrics and Gynaecology, Federal Teaching Hospital, 2Department of Microbiology, Ebonyi State University, Abakaliki, Nigeria Background: Detecting and treating asymptomatic bacteriuria (ASB) prevents urinary tract infection and its consequences. The cost-effectiveness of routine screening for ASB in pregnancy is controversial. In...
Ipe, Deepak S; Sundac, Lana; Benjamin, William H; Moore, Kate H; Ulett, Glen C
Bacteriuria, or the presence of bacteria in urine, is associated with both asymptomatic and symptomatic urinary tract infection and underpins much of the dynamic of microbial colonization of the urinary tract. The prevalence of bacteriuria in dissimilar patient groups such as healthy adults, institutionalized elderly, pregnant women, and immune-compromised patients varies widely. In addition, assessing the importance of 'significant bacteriuria' in infected individuals represents a diagnostic challenge, partly due to various causal microorganisms, and requires careful consideration of the distinct etiologies of bacteriuria in different populations and circumstances. Recent molecular discoveries have revealed how some bacterial traits can enable organisms to grow in human urine, which, as a fitness adaptation, is likely to influence the progression of bacteriuria in some individuals. In this review, we comprehensively analyze currently available data on the prevalence of causal organisms with a focus on asymptomatic bacteriuria in dissimilar populations. We evaluate recent advances in the molecular detection of bacteriuria from a diagnostic viewpoint and briefly discuss the potential benefits and some of the challenges of these approaches. Overall, this review provides an update on the comparative prevalence and etiology of bacteriuria from both microbiological and clinical perspectives. PMID:23808987
Aruna Rajkumari; Humera Qudsia Fatima Ansari
Asymptomatic bacteriuria (ASB) is the commonest bacterial infec-tion which requires medical treatment in pregnancy. Untreated ASB in 25-30% of can cases lead to pyelonephritis which may lead to increased risk of abortions, intrauterine fetal deaths, prematurity and low birth weight. A cross-sectional study was conducted at Gandhi Hospital over a period of ten months with 125 asymptomatic pregnant women in the age group of 15-35 years. The objectives of the study were to determine prevalence o...
Alvarez, Jesus R; Fechner, Adam J; Williams, Shauna F; Ganesh, Vijaya L; Apuzzio, Joseph J
We sought to determine if gravidas with pregestational diabetes mellitus (DM) are at increased risk for asymptomatic bacteriuria (ASB) compared with nondiabetic gravidas. This is a retrospective case-control study of 150 pregnant patients with pregestational DM and 294 nondiabetic controls. Rates of ASB and any colony count of group B streptococcus (GBS) bacteriuria were reviewed. The incidence of ASB among pregestational diabetics was higher compared with nondiabetic gravidas (18% versus 8.2%, odds ratio [OR] 2.47, 95% confidence interval [CI] 1.37 to 4.45). GBS was the most common organism in diabetic gravidas (26%). There was no difference in incidence of ASB recurrence (OR 1.26, 95% CI 0.37 to 4.36), but antibiotic resistance was higher in the control group (OR 0.28, 95% CI 0.09 to 0.91). Diabetic gravidas with ASB or any level of GBS bacteriuria had higher hemoglobin A (1c) values compared with diabetics without ASB (8.31 +/- 1.89 versus 7.31 +/- 1.84, P = 0.0035). Our results demonstrate that gravidas with DM are at increased risk of ASB including GBS bacteriuria compared with non-diabetic gravidas. PMID:19834868
Prasanna Byna; Naimisha Muvva; Swathi Kolli; Mahaboob V. Shaik
Background: The present study is undertaken to know the risk factors and consequences of asymptomatic bacteriuria in pregnant women attending Narayana Medical College Hospital, Nellore. Methods: 500 pregnant women were recruited for the study after their consent for participation. 85 women with culture positive for ASB were paired with 85 healthy pregnant women without bacteriuria to compare feto maternal outcome. Results: Antenatal complications like anemia (35%), PROM (14%), preter...
Nanji S Ajayi; Fakeye, Olurotimi O.; Aboyeji, Abiodun P.; Charles Nwabuisi; Ajayi, Akinola B.; Adeola Fowotade
Objective: To determine the prevalence of asymptomaticbacteriuria, bacteriology and sensitivity pattern in Ilorin using thegold standard of urine culture.Methods: A prospective study was carried out from 1st Julyto 31st October 2007, at the University of Ilorin TeachingHospital (UITH) on 125 consenting asymptomatic pregnantwomen. A structured proforma was used to collect informationfrom the women and a midstream urine specimen collected forbacteriological culture.Results: Of the 125 pregnant...
Full Text Available Abstract Background The risk of developing infection in diabetic patients is higher and urinary tract is the most common site for infection. Serious complications of urinary infection occur more commonly in diabetic patients. To study the prevalence and associates of asymptomatic bacteriuria (ASB in women with type 2 diabetes mellitus in the Iranian population, this study was conducted. Methods Between February 10, 2004 and October 15, 2004; 202 nonpregnant diabetic (type 2 women (range: 31 to 78 years old with no abnormalities of the urinary tract system were included in this clinic based study. We defined ASB as the presence of at least 105 colony-forming units/ml of 1 or 2 bacterial species, in two separated cultures of clean-voided midstream urine. All the participants were free from any symptoms of urinary tract infection (UTI. Associates for developing bacteriuria was assessed and compared in participants with and without bacteriuria. Results In this study, the prevalence of ASB was 10.9% among diabetic women. E. coli was the most prevalent microorganism responsible for positive urine culture. Most of the isolated microorganisms were resistant to Co-trimoxazole, Nalidixic acid and Ciprofloxacin. Pyuria (P 1c level (P Conclusion The prevalence of ASB is higher in women with type 2 diabetes, for which pyuria and glucosuria can be considered as associates. Routine urine culture can be recommended for diabetic women even when there is no urinary symptom.
Acheampong, I.; N. Amidu; Bio, F.Y.; Quaye, L; Obirikorang, C.; Addo, K.
The apparent decline in immunity of pregnant women appears to promote the growth of both com-mensal and non-commensal microorganisms. The objective of the study was to determine the prevalence of asymptomatic bacteriuria in pregnant women visiting the University hospital, Ku-masi. This prospective hospital-based study was carried out between April-June 2009. A total of 200 pregnant women were recruited for this study. The ages of the women ranged from 15 to 46 years. About 5-10mls of clean ca...
Ullah, A; Barman, A; Ahmed, I; Salam, A
In Bangladesh, a number of screening tests for asymptomatic bacteriuria in pregnancy are in practice. The objective of this study was to assess the validity and cost-effectiveness of these screening tests. A total of 600 apparently healthy pregnant mothers were included in this study. The validity of the screening tests was calculated against the urine culture as 'gold standard'. Incremental cost-effective ratio between the screening test methods and the least costly method (microscopic urine analysis) was calculated. Bacterial count/oil-immersion field in Gram-stained smear of urine was the most sensitive (91.7%) and specific (97.2%). Incremental cost per additional positive cases of bacterial count, leukocyte esterase and combination of leukocyte esterase and nitrite were US$3, US$25 and US$23, respectively. Gram staining may be the alternative approach to traditional routine urinalysis for the screening of asymptomatic bacteriuria during pregnancy in clinical practice in Bangladesh, as well as other developing countries. PMID:22185534
Pam S; Shittu S.O; Olayinka A.T; Adaji S.E; Ejembi J
Background: Asymptomatic bacteruria in pregnancy is a common condition affecting pregnant women because of both anatomical and physiological changes in pregnancy. This condition appears to be commoner in people living with HIV because of the added immunosuppression caused by the virus. Aim: The study was to identify the pattern of microbial isolates and microbial sensitivity among HIV positive pregnant women with asymptomatic bacteriuria in Zaria, Nigeria. Methods: This was a p...
Ikefuna Anthony N; Okafor Henrietta U; Chukwu Bartholomew F
Abstract Background Urinary tract infection (UTI) is a common cause of childhood morbidity and mortality in the tropics. Children with sickle cell anemia (SCA) may have compromised kidney function arising from repeated vaso-occlusive episodes and recurrent symptomatic or asymptomatic UTI. Objectives This study aims at determining the prevalence of asymptomatic bacteriuria and sensitivity pattern in children with homozygous sickle haemoglobin compared to children with normal haemoglobin. Metho...
... be checked for a bladder or kidney infection. Images ... by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, ...
Methods: A total of 174 antenatal women of and #8804;28 weeks of gestation who had no clinical features of urinary tract infection were recruited for this study over a period of 6 months. Midstream urine sample was collected and sent for routine examination and culture-sensitivity testing. Results: Significant bacteriuria was detected in 22 (12.6% antenatal women. Of them 13 (59.1% belonged to the age group 26-30 years. Nearly half of the culture positive cases, that is 10 (45.5% were educated upto primary school and they belonged to socioeconomic status class 4. Majorities (68% were in the second trimester of pregnancy and the commonest organism isolated was E. coli. Conclusions: Undetected and untreated asymptomatic bacteriuria leads to chronic drug resistant infection, hypertension, anemia, etc. in the mother and prematurity, intrauterine growth restriction etc. in the fetus. Hence it is important to do urine culture for all women during antenatal check-up. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 437-441
Full Text Available Fidelis Agwu Onu,1 Leonard Ogbonna Ajah,1 Paul Olisaemeka Ezeonu,1 Odidika Ugochukwu Joannes Umeora,1 Perpetus Chudi Ibekwe,1 Monique Iheoma Ajah2 1Department of Obstetrics and Gynaecology, Federal Teaching Hospital, 2Department of Microbiology, Ebonyi State University, Abakaliki, Nigeria Background: Detecting and treating asymptomatic bacteriuria (ASB prevents urinary tract infection and its consequences. The cost-effectiveness of routine screening for ASB in pregnancy is controversial. In populations with high prevalence, however, it is worthwhile and justifiable. Aim: To determine the profile, prevalence, microbiological isolates, and risk factors of ASB among booking antenatal clinic attendees in Abakaliki, Nigeria. Materials and methods: This was a cross-sectional study involving booking antenatal clinic attendees at the Federal Teaching Hospital, Abakaliki, who met the inclusion criteria. This study occurred between January and December, 2012. The midstream urine samples of these women were subjected to microscopy, culture, and sensitivity. Results: A total of 300 randomly selected booking antenatal clinic attendees participated in the study; 74 of them had ASB, giving a prevalence of 24.7%. With the exception of rural residence, sociodemographic and obstetric characteristics did not influence the risk of ASB among the participants in this study. Staphylococcus aureus was the commonest organism isolated. The majority of the organisms were sensitive to ofloxacin and ceftriaxone. Conclusion: There is a high prevalence of ASB among pregnant women in Abakaliki. With the exception of rural dwelling, sociodemographic and obstetric characteristics did not significantly influence the risk of ASB among these pregnant women. Therefore, routine ASB screening of pregnant women is recommended in our environment. Keywords: asymptomatic bacteriuria, pregnant women, Abakaliki
Yu, Yanbao; Zielinski, Martin D; Rolfe, Melanie A; Kuntz, Melissa M; Nelson, Heidi; Nelson, Karen E; Pieper, Rembert
Differential diagnosis of asymptomatic bacteriuria (ASB) and urinary tract infection (UTI) is based on the presence of diverse symptoms, including fever (≥38.5°C), rigors, malaise, lethargy, flank pain, hematuria, suprapubic discomfort, dysuria, and urgent or frequent urination. There is consensus in the medical community that ASB warrants antibiotic treatment only for patients undergoing urological procedures that lead to mucosal bleeding, catheterized individuals whose ASB persists for more than 48 h after catheter removal, and pregnant women. Pyuria is associated with UTI and implicates host immune responses via release of antibacterial effectors and phagocytosis of pathogens by neutrophils. Such responses are not sufficiently described for ASB. Metaproteomic methods were used here to identify the pathogens and evaluate molecular evidence of distinct immune responses in cases of ASB compared to UTI in elderly patients who were hospitalized upon injury. Neutrophil-driven inflammatory responses to invading bacteria were not discernible in most patients diagnosed with ASB compared to those with UTI. In contrast, proteomic urine analysis for trauma patients with no evidence of bacteriuria, including those who suffered mucosal injuries via urethral catheterization, rarely showed evidence of neutrophil infiltration. The same enzymes contributing to the synthesis of leukotrienes LTB4 and LTC4, mediators of inflammation and pain, were found in the UTI and ASB cohorts. These data support the notion that the pathways mediating inflammation and pain in most elderly patients with ASB are not quantitatively different from those seen in most elderly patients with UTI and warrant larger clinical studies to assess whether a common antibiotic treatment strategy for elderly ASB and UTI patients is justified. PMID:26238715
Madhu; Nithyalakshmi; Sumathi; Swapna
BACKGROUND: Asymptomatic bacteriuria (ASB) is common in pregnancy, if left untreated it may lead to adverse maternal and fetal complications like abortion, premature delivery and low birth weight. Early diagnosis and treatment have reduced the risk of pyelonephritis in pregnant women with ASB from 20-30% to 2-4% Increasing Resistance trends of uropathogens to commonly prescribed first line antibiotics has posed a great threat with limited therapeutic options. AIMS & OBJECT...
Daniyan S. Y.; M. E. Abalaka
Objective: To evaluate the occurrences of asymptomatic bacteriuria among healthy pregnant women attending ante-natal clinic of General Hospital Minna, Nigeria. To test for sensitivity to commonly used treatments. Methodology: Two hundred mid- stream urine samples were collected in a sterile universal bottle. The cultured plates were examined. The morphological and biochemical characteristics were determined. Results: The bacteria isolates recovered from urine samples includes E. coli 32 (51.6...
B F Chukwu
Full Text Available Background: Urinary tract infection (UTI is a common cause of chronic kidney disease in children. It is second only to respiratory tract infection in developed countries as a cause of morbidity and mortality arising from microbial infections. It is also common in a developing country like Nigeria and is the commonest cause of renal disorders in Port Harcourt, South South, Nigeria. UTI can be symptomatic or asymptomatic (asymptomatic bacteriuria. Asymptomatic bacteriuria is said to be more common in school aged girls and children of low socio-economic class. It has also been documented to be more common in children with sickle cell anaemia. Objectives:To determine the relationship between asymptomatic bacteriuria and age, sex and socio-economic status of children with sickle cell anaemia. Methods: One hundred children with sickle cell anaemia in stable state were screened for asymptomatic bacteriuria using midstream urine samples. The age, sex and social class of the children were obtained through a structured questionnaire administered to the parents/care-givers. The relationship between age, sex and social class with asymptomatic bacteriuria in these children was analyzed using SPSS software. Results: The age of the children ranged from 2-12 years. Six of the 100 children were noted to have asymptomatic bacteriuria and five of the six children were females (p=0.04.Five (83.3% of the six children were five years and above. There was a predominance of positive cases (66.7% in the higher socioeconomic class (p=0.03. Conclusion: Asymptomatic bacteriuria is commoner in school aged female sickle cell anaemia children of higher socioeconomic class. However, we suggest that further studies be done to confirm this finding especially with regards to the socioeconomic status of these children.
Harold Fernando Maldonado Cárdenas
Full Text Available The asymptomatic bacteriuria (AB refers to the bacterial colonization of the urinary tract that multiply in an active way without producing any symptoms. The prevalence varies between 4 to 7% and the consequences of having this pathology are the development of pyelonephritis or may be the cause for early deliveries and low-weight babies. Objectives. To determine the AB prevalence among women in their 12 to 16 weeks of pregnancy, attending a prenatal clinic at two medical institutions in the City of Bucaramanga. Method: Transverse Study with social and demographic information, as well as GYN features and urine cultures results. Results: We included 114 patients, with a mean age of 26.0 +-6-5. 92% of them came from the city of the study.Mean gestational age was 14.7+-1.2 weeks. 50% were on their firstor second pregnancy. AB prevalence was 7.9% (95%CI 3.7–14. ABwas related to less number of pregnancies and low school grading.The most common bacterium was E. Coli (89.0%. Conclusions:Our results show a higher incidence of AB, compare to the onesreported in the medical literature. These results emphasize the factthat ordering urine culture among pregnant women, preventingpyelonephritis, is a good screening practice.
Full Text Available Background It is known that there is significant morbidity associated with urinary tract infection and with renal dysfunction in sickle cell disease (SCD. However, it is not known if there are potential adverse outcomes associated with asymptomatic bacteriuria (ASB infections in sickle cell disease if left untreated. This study was undertaken to determine the prevalence of ASB, in a cohort of patients with SCD. Methods This is a cross-sectional study of patients in the Jamaican Sickle Cell Cohort. Aseptically collected mid-stream urine (MSU samples were obtained from 266 patients for urinalysis, culture and sensitivity analysis. Proteinuria was measured by urine dipsticks. Individuals with abnormal urine culture results had repeat urine culture. Serum creatinine was measured and steady state haematology and uric acid concentrations were obtained from clinical records. This was completed at a primary care health clinic dedicated to sickle cell diseases in Kingston, Jamaica. There were 133 males and 133 females in the sample studied. The mean age (mean ± sd of participants was 26.6 ± 2.5 years. The main outcome measures were the culture of ≥ 105 colony forming units of a urinary tract pathogen per milliliter of urine from a MSU specimen on a single occasion (probable ASB or on consecutive occasions (confirmed ASB. Results Of the 266 urines collected, 234 were sterile and 29 had significant bacteriuria yielding a prevalence of probable ASB of 10.9% (29/266. Fourteen patients had confirmed ASB (prevalence 5.3% of which 13 had pyuria. Controlling for genotype, females were 14.7 times more likely to have confirmed ASB compared to males (95%CI 1.8 to 121.0. The number of recorded visits for symptomatic UTI was increased by a factor of 2.5 (95% CI 1.4 to 4.5, p Conclusion ASB is a significant problem in individuals with SCD and may be the source of pathogens in UTI. However, further research is needed to determine the clinical significance of ASB in
Full Text Available Background: Asymptomatic bacteruria in pregnancy is a common condition affecting pregnant women because of both anatomical and physiological changes in pregnancy. This condition appears to be commoner in people living with HIV because of the added immunosuppression caused by the virus. Aim: The study was to identify the pattern of microbial isolates and microbial sensitivity among HIV positive pregnant women with asymptomatic bacteriuria in Zaria, Nigeria. Methods: This was a prospective cross sectional study among symptom-free HIV positive pregnant women attending the prevention of mother to child transmission of HIV (PMTCT antenatal clinic in Zaria, Nigeria between 1st March and 31st August 2011. A structured, closeended questionnaire was administered and mid-stream urine samples were obtained and processed within 2 hours of collection in the laboratory. Results: A total of 220 consenting, asymptomatic, HIV positive pregnant women were screened for bacteriuria out of the 240 eligible women who were approached to participate in the study. Sixteen (16 women were positive for significant bacteriuria, giving a prevalence of 7.3%. A total of six (6 different isolates were isolated with Staphylococcus aureus (8 making 50%, E. Coli (4 18.8%, Klebsiella spp (2 12.5%, Streptococcus spp (2 12.5% and Proteus spp (1 6.2%. All the isolated organisms were sensitive to gentamycin, cefuroxime, ceftazidime, ciprofloxacin and nitrofurantoin. Conclusion: This study found Staphylococcus aureus as the most common organism isolated in the urine of asymptomatic patients with HIV infection in pregnancy. The isolated organisms were sensitive to gentamycin, cefuroxime, ceftazidime, ciprofloxaxin and nitrofurantoin.
Full Text Available Background: Infection of urinary tract occurs frequently during pregnancy ranging from Asymptomatic Bacteriuria (ASB to potentially life threatening acute pyelonephritis. The incidence varies from 5% to 20% and it is an important risk factor for preterm labor and perinatal morbidity and mortality. The present study was performed to correlate preterm labor and to define other risk factors associated with ASB like gravida status, socioeconomic status, and anaemia in pregnant women with ASB in low resource settings. Methods: A total of 1000 pregnant mothers in second and third trimester of pregnancy were screened for ASB by using two rapid reagent strip tests, namely nitrate and leukocyte esterase reagent strip tests. Out of those screened positive hundred consecutive pregnant women were taken as cases, after positive urine culture and out of those screened negative, two hundred patients were followed as controls after matching and pairing with cases. A detailed history was taken from each patient to determine all risk factors for ASB. The cases and controls were followed prospectively till delivery. Results: Mean gestational age at the time of labor in 100 cases of ASB was 35.6 +/- 2.9 weeks and in 200 controls was 37.9 +/- 0.6 weeks. The difference between mean gestational age at the time of labor in cases and controls was statistically significant (P value 0.000. The likelihood of preterm labor in the cases was 14.5 times more than the control and the difference was significant (P <0.05. Conclusions: ASB leads to a higher rate of preterm labor and is more frequently seen in population with anemia, illiteracy, rural background and low socioeconomic status. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 403-408
Niro Manesh S; Amiri A; Ali yari Sh
In this study, 1600 pregnant women who had referred to two prenatal clinics (Imam Khomeini and Mirza Kochek-Khan) were investigated. Ninety cases of asymptomatic bacteriuria were observed; 77 of those cooperated with us until the end of our study. The subjects, who were within the 14-36 weeks of gestational age, were randomly divided into two groups: Group A received the medicine (Amoxicillin) in a single-dose (3gr.); and, group B received it within seven days (1gr. TDS). The rate of recovery...
Graham, J. C.; Leathart, J. B. S.; Keegan, S. J.; Pearson, J.; Bint, A; Gally, D.L.
Escherichia coli isolates from patients with bacteriuria of pregnancy were compared by PCR with isolates from patients with community-acquired cystitis for the presence of established virulence determinants. The strains from patients with bacteriuria of pregnancy were less likely to carry genes for P-family, S-family, and F1C adhesins, cytotoxic necrotizing factor 1, and aerobactin, but virtually all of the strains carried the genes for type 1 fimbriae. Standard mannose-sensitive agglutinatio...
Kazemier Brenda M
Full Text Available Abstract Background The prevalence of asymptomatic bacteriuria (ASB in pregnancy is 2-10% and is associated with both maternal and neonatal adverse outcomes as pyelonephritis and preterm delivery. Antibiotic treatment is reported to decrease these adverse outcomes although the existing evidence is of poor quality. Methods/Design We plan a combined screen and treat study in women with a singleton pregnancy. We will screen women between 16 and 22 weeks of gestation for ASB using the urine dipslide technique. The dipslide is considered positive when colony concentration ≥105 colony forming units (CFU/mL of a single microorganism or two different colonies but one ≥105 CFU/mL is found, or when Group B Streptococcus bacteriuria is found in any colony concentration. Women with a positive dipslide will be randomly allocated to receive nitrofurantoin or placebo 100 mg twice a day for 5 consecutive days (double blind. Primary outcomes of this trial are maternal pyelonephritis and/or preterm delivery before 34 weeks. Secondary outcomes are neonatal and maternal morbidity, neonatal weight, time to delivery, preterm delivery rate before 32 and 37 weeks, days of admission in neonatal intensive care unit, maternal admission days and costs. Discussion This trial will provide evidence for the benefit and cost-effectiveness of dipslide screening for ASB among low risk women at 16–22 weeks of pregnancy and subsequent nitrofurantoin treatment. Trial registration Dutch trial registry: NTR-3068
Niro Manesh S
Full Text Available In this study, 1600 pregnant women who had referred to two prenatal clinics (Imam Khomeini and Mirza Kochek-Khan were investigated. Ninety cases of asymptomatic bacteriuria were observed; 77 of those cooperated with us until the end of our study. The subjects, who were within the 14-36 weeks of gestational age, were randomly divided into two groups: Group A received the medicine (Amoxicillin in a single-dose (3gr.; and, group B received it within seven days (1gr. TDS. The rate of recovery (65% in group A and 56.8% in group B, based on chi-squared test, showed no significant difference (P=0.747%. According to the results of this study, we can conclude that single-dose treatment has the same value as a seven-day treatment and the advantages such as decreased total dose, lower cost, and a better patient compliance.
Keating, Gillian M
Fosfomycin trometamol (fosfomycin tromethamine) [Monuril(®), Monurol(®), Monural(®)] is approved in numerous countries worldwide, mainly for the treatment of uncomplicated urinary tract infections (UTIs). Fosfomycin has good in vitro activity against common uropathogens, such as Escherichia coli (including extended-spectrum β-lactamase-producing E. coli), Proteus mirabilis, Klebsiella pneumoniae and Staphylococcus saprophyticus, and the susceptibility of uropathogens to fosfomycin has remained relatively stable over time. A single oral dose of fosfomycin trometamol 3 g (the approved dosage) achieves high concentrations in urine. Results of recent randomized trials indicate that single-dose fosfomycin trometamol had similar clinical and/or bacteriological efficacy to 3- to 7-day regimens of ciprofloxacin, norfloxacin, cotrimoxazole or nitrofurantoin in women with uncomplicated lower UTIs. In addition, single-dose fosfomycin trometamol had similar bacteriological efficacy to a 5-day course of cefuroxime axetil or a 7-day course of amoxicillin/clavulanic acid in pregnant women with asymptomatic bacteriuria, and similar clinical and/or bacteriological efficacy to a 5-day course of cefuroxime axetil or amoxicillin/clavulanic acid or a 3-day course of ceftibuten in pregnant women with a lower UTI. Single-dose fosfomycin trometamol was generally well tolerated, with gastrointestinal adverse events (e.g. diarrhoea, nausea) reported most commonly. In conclusion, single-dose fosfomycin trometamol is an important option for the first-line empirical treatment of uncomplicated lower UTIs. PMID:24202878
Rafal'skiĭ, V V; Dovgan', E V; Kozyrev, Iu V; Gustovarova, T A; Khlybova, S V; Novoselova, A V; Filippenko, N G; Likhikh, D G
The study was aimed to the evaluation of efficacy and safety of cefixime and amoxicillin/clavulanate in the treatment of asymptomatic bacteriuria in pregnant women. A prospective, multicenter, randomized study that included 112 pregnant women with asymptomatic bacteriuria was performed. 58 women were randomized in group 1 (cefixime [suprax solutab] 400 mg 1 time a day, 7 days), 54 women were included in group 2 (amoxicillin/clavulanate [amoksiklav] 625 mg 3 times a day, 7 days). The average age of the patients in group 1 was 25.2 +/- 6.6; in group 2--26.6 +/- 5.8 years. Physical examination, evaluation of complaints, collection of data on adverse reactions, and bacteriological analysis of urine were performed after enrollment in the study at visit 2 (day 10 +/- 1) and 3 (day 35 +/- 2). Comparable effectiveness of cefixime and amoxicillin/clavulanate in the treatment of asymptomatic bacteriuria in pregnant women was found. Eradication of the pathogen and sustained bacteriological response were observed in 94.8 and 92.7% of women treated with cefixime, and in 98.2 and 92.5% of women treated with amoxicillin/clavulanate, respectively (P > 0.05). At the same time, the use of amoxicillin/clavulanate compared with cefixime significantly higher was followed by the development of adverse reactions (13% and 1.7; respectively; P = 0.02). Seven-day courses of cefixime at a dose 400 mg 1 time a day and amoxicillin/clavulanate at a dose of 625 mg 3 times a day are high-effective treatment regimens for asymptomatic bacteriuria in pregnant women in Russia. The use of amoxicillin/clavulanate is significantly more often accompanied by the development of adverse reactions compared with cefixime. PMID:24437236
Glaser, Alexander P; Schaeffer, Anthony J
Bacteriuria during pregnancy may be classified as asymptomatic bacteriuria, infections of the lower urinary tract (cystitis), or infections of the upper urinary tract (pyelonephritis). Lower tract bacteriuria is associated with an increased risk of developing pyelonephritis in pregnancy, which is itself associated with adverse maternal and fetal outcomes. Pregnant women should be screened for the presence of bacteriuria early in pregnancy. All bacteriuria in pregnancy should be treated, and antimicrobial choice in pregnancy should reflect safety for both the mother and the fetus. After treatment of bacteriuria, patients should be followed closely due to risk of recurrent bacteriuria. PMID:26475951
Estebanez, A; Pascual, R; Gil, V; Ortiz, F; Santibáñez, M; Pérez Barba, C
The purpose of this paper was to compare the efficacy of a single dose of 3 g of fosfomycin to that of a 7-day regimen of amoxicillin-clavulanate in the treatment of asymptomatic bacteriuria during pregnancy. A randomised, prospective, interventional, analytical, longitudinal study was undertaken, in which the efficacy of two antibiotic regimens (one short and the other long) in the treatment of pregnant women with asymptomatic bacteriuria is compared. One hundred and nine patients were randomly assigned to two groups: 56 were treated with amoxicillin-clavulanate and 53 with fosfomycin. The two groups were similar in terms of co-morbidity, treatments received during pregnancy, obstetric, gynaecological and surgical history and laboratory data. The efficacy of the two regimens was similar and the eradication rate was over 80% in both groups (P = 0.720) (relative risk [RR] 1.195, 95% confidence interval [CI]: 0.451-3.165). The number of reinfections was greater in the amoxicillin-clavulanate group (P = 0.045). The secondary effects were lower in the fosfomycin group (P = 0.008). There were no significant differences in the number of persistences (P = 0.39), development of symptomatic urinary infections (P = 0.319) or recurrences (P = 0.96). Treatment with a single dose of fosfomycin is as effective as the standard course of treatment with amoxicillin-clavulanate and may be preferable due to its simpler administration and the smaller number of reinfections. PMID:19768649
Omar Ismail Santos Pereira Darzé
Full Text Available OBJETIVOS: Estimar a prevalência de bacteriúria assintomática (BAS entre gestantes atendidas em pré-natal de Serviço Universitário e identificar prováveis preditores clínicos. MÉTODOS: Estudo prospectivo de corte transversal, envolvendo 260 gestantes matriculadas em serviço de pré-natal de baixo risco entre agosto de 2008 e outubro de 2009, sem sintomas de infecção do trato urinário. Foram excluídas aquelas com febre, disúria, tenesmo vesical, dor lombar, presença de sangramento genital, perda de líquido amniótico, uso de antimicrobianos nos últimos 30 dias e aquelas que não desejaram participar do projeto. A presença de colonização bacteriana ≥10(5 UFC/mL de único patógeno, na amostra urinária obtida do jato médio, foi considerada como a variável dependente. As variáveis estudadas foram: idade, raça, estado civil, nível de instrução, história obstétrica, idade gestacional, anemia, traço falciforme, colpite, passado de infecção do trato urinário, polaciúria, urgência miccional e incontinência urinária. Dados do sumário de urina também foram analisados, como a presença de leucocitúria, flora bacteriana aumentada, hematúria, proteinúria e nitrito. A análise estatística foi realizada com o programa Statistical Package for the Social Sciences (SPSS 13.0 e a significância estatística foi previamente definida por valor pPURPOSE: To estimate the prevalence of asymptomatic bacteriuria among pregnant women attended at our university prenatal care clinic and to identify probable clinical predictors. METHODS: Across-sectional study was carried out from August 2008 to October 2009 at the Bahiana School of Medicine involving 260 pregnant women without symptoms of urinary tract infection. The following exclusion criteria were considered: presence of clinical signs such as fever, dysuria, vesical tenesmus, lumbar pain, history of active genital bleeding or loss of amniotic fluid, use of antimicrobial
Vejborg, Rebecca Munk; de Evgrafov, Mari Cristina Rodriguez; Phan, Minh Duy;
clinical ABU E. coli strain VR89. Six genes involved in the biosynthesis of various amino acids and nucleobases were identified (carB, argE, argC, purA, metE, and ilvC), and site-specific mutants were subsequently constructed in E. coli 83972 and E. coli VR89 for each of these genes. In all cases, these...
Full Text Available Abstract Background Catheter-associated urinary tract infection (CAUTI is one of the most common hospital-acquired infections. However, many cases treated as hospital-acquired CAUTI are actually asymptomatic bacteriuria (ABU. Evidence-based guidelines recommend that providers neither screen for nor treat ABU in most catheterized patients, but there is a significant gap between these guidelines and clinical practice. Our objectives are (1 to evaluate the effectiveness of an audit and feedback intervention for increasing guideline-concordant care concerning catheter-associated ABU and (2 to measure improvements in healthcare providers' knowledge of and attitudes toward the practice guidelines associated with the intervention. Methods/Design The study uses a controlled pre/post design to test an intervention using audit and feedback of healthcare providers to improve their compliance with ABU guidelines. The intervention and the control sites are two VA hospitals. For objective 1 we will review medical records to measure the clinical outcomes of inappropriate screening for and treatment of catheter-associated ABU. For objective 2 we will survey providers' knowledge and attitudes. Three phases of our protocol are proposed: the first 12-month phase will involve observation of the baseline incidence of inappropriate screening for and treatment of ABU at both sites. This surveillance for clinical outcomes will continue at both sites throughout the study. Phase 2 consists of 12 months of individualized audit and feedback at the intervention site and guidelines distribution at both sites. The third phase, also over 12 months, will provide unit-level feedback at the intervention site to assess sustainability. Healthcare providers at the intervention site during phase 2 and at both sites during phase 3 will complete pre/post surveys of awareness and familiarity (knowledge, as well as of acceptance and outcome expectancy (attitudes regarding the relevant
Qureshi, Zubair A.; Syed, Alveena; Clarke, Lloyd G.; Doi, Yohei; Shields, Ryan K.
Carbapenem-resistant Klebsiella pneumoniae (CRKP) bacteriuria is a frequently encountered clinical condition, but its clinical impact is unknown. We conducted a retrospective cohort study to define the epidemiology and outcomes for patients with CRKP bacteriuria. Patients with positive urine cultures for CRKP were classified as having asymptomatic bacteriuria (ASB) or symptomatic urinary tract infection (UTI). Among 105 patients with CRKP bacteriuria, 80% (84/105 patients) and 20% (21/105 pat...
André Becker Saidenberg; Neiva Maria Robaldo Guedes; Gláucia Helena Fernandes Seixas; Mariangela da Costa Allgayer; Erica Pacífico de Assis; Luis Fabio Silveira; Priscilla Anne Melville; Nilson Roberti Benites
Parrots in captivity are frequently affected by Escherichia coli (E. coli) infections. The objective of this study was to collect information on the carrier state for E. coli pathotypes in asymptomatic free-ranging parrots. Cloacal swabs were collected from nestlings of Hyacinth, Lear’s macaws and Blue-fronted Amazon parrots and tested by polymerase chain reaction (PCR) for virulence factors commonly found in enteropathogenic, avian pathogenic, and uropathogenic E. coli strains. In total, 44 ...
Hancock, Viktoria; Klemm, Per
seen between the in vivo expression profiles of strain 83972 in three patients and the corresponding in vitro expression profiles in lab medium and human urine. The data revealed an in vivo lifestyle of microaerobic growth with respiration of nitrate coupled to degradation of sugar acids and amino...
Echeverria, P; Cross, J H
Thirty-two asymptomatic travellers who had recently journeyed in the Near, Middle, and Far East and had experienced a high incidence of diarrhoeal disease were screened for heat-labile enterotoxigenic Escherichia coli (ent+ E. coli) and other bacterial and parasitic pathogens. Six percent were colonized with ent+ E. coli and while other bacterial pathogens were not found, the intestinal protozoa Giardia lamblia (13%), Entamoeba histolytica (6%), Entamoeba coli (6%), Endolimax nana (6%), and Entamoeba hartmanni (3%) were detected in the stools. Ent+ E. coli, G. lamblia and E. histolytica should be considered in the differential diagnosis of gastrointestinal disease in travellers returning from the Orient. Furthermore, these travellers may be a potential source for the introduction of ent+ E. coli into communities where such organisms are relatively rare. PMID:351820
Becker Saidenberg, André; Robaldo Guedes, Neiva Maria; Fernandes Seixas, Gláucia Helena; da Costa Allgayer, Mariangela; Pacífico de Assis, Erica; Fabio Silveira, Luis; Anne Melville, Priscilla; Benites, Nilson Roberti
Parrots in captivity are frequently affected by Escherichia coli (E. coli) infections. The objective of this study was to collect information on the carrier state for E. coli pathotypes in asymptomatic free-ranging parrots. Cloacal swabs were collected from nestlings of Hyacinth, Lear's macaws and Blue-fronted Amazon parrots and tested by polymerase chain reaction (PCR) for virulence factors commonly found in enteropathogenic, avian pathogenic, and uropathogenic E. coli strains. In total, 44 samples were cultured and E. coli isolates were yielded, from which DNA was extracted and processed by PCR. Genes commonly found in APEC isolates from Blue-fronted Amazon parrots and Hyacinth macaws were expressed in 14 of these 44 samples. One atypical EPEC isolate was obtained from a sample from Lear's macaw. The most commonly found gene was the increased serum survival (iss) gene. This is the first report, that describes such pathotypes in asymptomatic free-living parrots. The findings of this study suggest the presence of a stable host/parasite relationship at the time of the sampling brings a new understanding to the role that E. coli plays in captive and wild parrots. Such information can be used to improve husbandry protocols as well as help conservation efforts of free-living populations. PMID:23738135
Fouts Derrick E
Full Text Available Abstract Background Clinical dogma is that healthy urine is sterile and the presence of bacteria with an inflammatory response is indicative of urinary tract infection (UTI. Asymptomatic bacteriuria (ABU represents the state in which bacteria are present but the inflammatory response is negligible. Differentiating ABU from UTI is diagnostically challenging, but critical because overtreatment of ABU can perpetuate antimicrobial resistance while undertreatment of UTI can result in increased morbidity and mortality. In this study, we describe key characteristics of the healthy and ABU urine microbiomes utilizing 16S rRNA gene (16S rDNA sequencing and metaproteomics, with the future goal of utilizing this information to personalize the treatment of UTI based on key individual characteristics. Methods A cross-sectional study of 26 healthy controls and 27 healthy subjects at risk for ABU due to spinal cord injury-related neuropathic bladder (NB was conducted. Of the 27 subjects with NB, 8 voided normally, 8 utilized intermittent catheterization, and 11 utilized indwelling Foley urethral catheterization for bladder drainage. Urine was obtained by clean catch in voiders, or directly from the catheter in subjects utilizing catheters. Urinalysis, urine culture and 16S rDNA sequencing were performed on all samples, with metaproteomic analysis performed on a subsample. Results A total of 589454 quality-filtered 16S rDNA sequence reads were processed through a NextGen 16S rDNA analysis pipeline. Urine microbiomes differ by normal bladder function vs. NB, gender, type of bladder catheter utilized, and duration of NB. The top ten bacterial taxa showing the most relative abundance and change among samples were Lactobacillales, Enterobacteriales, Actinomycetales, Bacillales, Clostridiales, Bacteroidales, Burkholderiales, Pseudomonadales, Bifidobacteriales and Coriobacteriales. Metaproteomics confirmed the 16S rDNA results, and functional human protein
Tadesse, Endale; Teshome, Million; Merid, Yared; Kibret, Belayhun; Shimelis, Techalew
Background Untreated asymptomatic bacteriuria (ASB) during pregnancy may cause serious complications including pyelonephritis and delivery of premature or low-birth-weight infants. However, little is known about asymptomatic bacteriuria in pregnancy in Ethiopia. This study aimed to assess the prevalence of asymptomatic bacteriuria, bacterial agents, and their antibiotic susceptibility pattern in pregnant women attending antenatal clinic of the Hawassa Teaching and Referral Hospital. Methods A...
Donkor, Eric S; Akumwena, Amos; Amoo, Philip K; Owolabi, Mayowa O; Aspelund, Thor; Gudnason, Vilmundur
Background Infections are known to be a major complication of stroke patients. In this study, we evaluated the risk of community-acquired bacteriuria among stroke patients, the associated factors, and the causative organisms. Methods This was a cross-sectional study involving 70 stroke patients and 83 age- and sex-matched, apparently healthy controls. Urine specimens were collected from all the study subjects and were analyzed by standard microbiological methods. Demographic and clinical information was also collected from the study subjects. For stroke patients, the information collected also included stroke parameters, such as stroke duration, frequency, and subtype. Results Bacteriuria was significantly higher among stroke patients (24.3%, n=17) than among the control group (7.2%, n=6), with a relative risk of 3.36 (confidence interval [CI], 1.40–8.01, P=0.006). Among the control group, all six bacteriuria cases were asymptomatic, whereas the 17 stroke bacteriuria cases comprised 15 cases of asymptomatic bacteriuria and two cases of symptomatic bacteriuria. Female sex (OR, 3.40; CI, 1.12–10.30; P=0.03) and presence of stroke (OR, 0.24; CI, 0.08–0.70; P=0.009) were significantly associated with bacteriuria. The etiology of bacteriuria was similar in both study groups, and coagulase-negative Staphylococcus spp. were the most predominant organisms isolated from both stroke patients (12.9%) and the control group (2.4%). Conclusion Stroke patients in the study region have a significantly higher risk of community-acquired bacteriuria, which in most cases is asymptomatic. Community-acquired bacteriuria in stroke patients appears to have little or no relationship with clinical parameters of stroke such as stroke subtype, duration and frequency. PMID:27051289
Pobiega, Monika; Wojkowska-Mach, Jadwiga; Chmielarczyk, Agnieszka; Romaniszyn, Dorota; Adamski, Paweł; Heczko, Piort B.; Gryglewska, Barbara; Grodzicki, Tomasz
Background The aim of this study was to assess the prevalence of multidrug-resistant Escherichia coli and extended-spectrum β-lactamases (ESBL) pathogens isolated from asymptomatic bacteriuria and urinary tract infections (UTIs), and the relationship between the phylogeny, antimicrobial resistance, and virulence among isolates in residents of 3 long-term care facilities (LTCF) in Krakow, Poland. Material/Methods This was point prevalence study and prospective infection control in a group of 2...
Beatson, Scott A.; Ben Zakour, Nouri L.; Totsika, Makrina;
mutant with GI-VR50-pheV deleted was attenuated in a mouse model of UTI in vivo. We established that Afa is the island-encoded factor responsible for this phenotype using two independent deletion (Afa operon and AfaE adhesin) mutants. E. coli VR50afa and VR50afaE displayed significantly decreased ability...... evolution and molecular mechanisms that underpin ABU, the genome of the ABU E. coli strain VR50 was sequenced. Analysis of the complete genome indicated that it most resembles E. coli K-12, with the addition of a 94-kb genomic island (GI-VR50-pheV), eight prophages, and multiple plasmids. GI-VR50-pheV has a...... mosaic structure and contains genes encoding a number of UTI-associated virulence factors, namely, Afa (afimbrial adhesin), two autotransporter proteins (Ag43 and Sat), and aerobactin. We demonstrated that the presence of this island in VR50 confers its ability to colonize the murine bladder, as a VR50...
Dobrindt, Ulrich; Wullt, Björn; Svanborg, Catharina
During asymptomatic bacteriuria (ABU), bacteria colonize the urinary tract for extended periods of time without causing symptoms of urinary tract infection. Previous studies indicate that many Escherichia coli (E. coli) strains that cause ABU have evolved from uropathogenic E. coli (UPEC) by reductive evolution and loss of the ability to express functional virulence factors. For instance, the prototype ABU strain 83972 has a smaller genome than UPEC strains with deletions or point mutations in several virulence genes. To understand the mechanisms of bacterial adaptation and to find out whether the bacteria adapt in a host-specific manner, we compared the complete genome sequences of consecutive reisolates of ABU strain 83972 from different inoculated individuals and compared them with the genome of the parent strain. Reisolates from different hosts exhibited individual patterns of genomic alterations. Non-synonymous SNPs predominantly occurred in coding regions and often affected the amino acid sequence of proteins with global or pleiotropic regulatory function. These gene products are involved in different bacterial stress protection strategies, and metabolic and signaling pathways. Our data indicate that adaptation of E. coli 83972 to prolonged growth in the urinary tract involves responses to specific growth conditions and stresses present in the individual hosts. Accordingly, modulation of gene expression required for survival and growth under stress conditions seems to be most critical for long-term growth of E. coli 83972 in the urinary tract. PMID:26891332
Bacteriuria in pregnancy, with or without clinical symptoms, is frequent. If left untreated, it can in 20-30% of cases lead to acute pyelonephritis, which is a serious threat to the mother and fetus, increasing the risk of preterm labour and low birthweight infants. This paper is a review of the literature concerning antibacterial treatment of bacteriuria in pregnancy. It is crucial to ensure that drugs to be used in pregnancy are safe and effective. Established first-line drugs such as ampicillin (pivampicillin) and amoxycillin, and other commonly used treatments such as trimethoprim-sulphamethoxazole, are associated with a high degree of resistance in Escherichia coli, the most common pathogen in the urinary tract. A recent survey of physicians in Denmark, Finland, Norway and Sweden confirms that beta-lactam antibiotics (particularly pivmecillinam) and nitrofurantoin are the drugs of first choice in the treatment of bacteriuria in pregnancy in the Nordic countries. No teratogenic effects have been associated with these agents. In contrast to nitrofurantoin, pivmecillinam is also efficient against pyelonephritis. In spite of resistance in E. coli and possible adverse effects on the fetus, many physicians still prescribe sulphonamides during the first two trimesters of pregnancy. PMID:11051621
Full Text Available INTRODUCTION: The largest known outbreak caused by a rare hybrid strain of Shiga toxin-producing E.coli (STEC and enteroaggregative E. coli (EAEC (E.coli O104:H4 of serotype O104:H4 occurred in Germany in 2011. Fenugreek sprouts acted as a transmission vehicle and were widely consumed in the outbreak area at the time of the epidemic. In total 3,842 people developed a clinical illness caused by this strain; however the rates of asymptomatic infections remain unclear. We aimed to develop a serological assay for detection of E.coli O104 LPS specific antibodies and to establish the post-outbreak levels of seropositivity among people with documented exposure to contaminated sprouts. RESULTS AND DISCUSSION: Developed serological assays (ELISA with 84% sensitivity, 63% specificity and Western Blot with 100% sensitivity, 82.5% specificity identified 33% (16/49 level of asymptomatic infection. Relatively small sample size and a significant time- lapse between the onset of symptoms and serum samples collection (appr. 8 weeks might explain the assay variability. No association was found between clinical or demographic characteristics and assay positivity. Larger studies are needed to understand the complexity of human immune response and factors influencing development of clinical symptoms. Development of intra-outbreak research plans will substantially aid the conduct of more thorough scientific investigation during an outbreak period.
Stapleton, Ann E; Cox, Marsha E; DiNello, Robert K; Geisberg, Mark; Abbott, April; Roberts, Pacita L; Hooton, Thomas M
Urinary tract infections (UTIs) are frequently encountered in clinical practice and most commonly caused by Escherichia coli and other Gram-negative uropathogens. We tested RapidBac, a rapid immunoassay for bacteriuria developed by Silver Lake Research Corporation (SLRC), compared with standard bacterial culture using 966 clean-catch urine specimens submitted to a clinical microbiology laboratory in an urban academic medical center. RapidBac was performed in accordance with instructions, providing a positive or negative result in 20 min. RapidBac identified as positive 245/285 (sensitivity 86%) samples with significant bacteriuria, defined as the presence of a Gram-negative uropathogen or Staphylococcus saprophyticus at ≥10(3) CFU/ml. The sensitivities for Gram-negative bacteriuria at ≥10(4) CFU/ml and ≥10(5) CFU/ml were 96% and 99%, respectively. The specificity of the test, detecting the absence of significant bacteriuria, was 94%. The sensitivity and specificity of RapidBac were similar on samples from inpatient and outpatient settings, from male and female patients, and across age groups from 18 to 89 years old, although specificity was higher in men (100%) compared with that in women (92%). The RapidBac test for bacteriuria may be effective as an aid in the point-of-care diagnosis of UTIs especially in emergency and primary care settings. PMID:26063858
Zegers Bas SHJ
Full Text Available Abstract Background Significant bacteriuria (SBU and urinary tract infections (UTIs are common in patients with spina bifida and neuropathic detrusor sphincter dysfunction. Laboratory agar plated culture is the gold standard to establish SBU. It has the disadvantage of diagnostic and subsequent therapeutic delay. Leukocyte esterase tests (LETs and dip slides proved to be useful in the general populations to exclude SBU and UTI. The aim of this study was to evaluate the reliability of LET and dip slide in children with spina bifida without symptoms of UTI. The reliability in children with asymptomatic SBU was not studied before. Methods In one hundred and twelve children with spina bifida on clean intermittent catheterization LETs and dip slides were compared with laboratory cultures. Both tests and agar plated cultures were performed on catheterized urine samples. The hypothesis was that the home tests are as accurate as laboratory cultures. Results A SBU was found in 45 (40% of the 112 laboratory cultures. A negative LET excluded SBU (negative predictive value 96%, while a positive LET had a positive predictive value of 72%. The false positive rate was 28%. Dip slide determination of bacterial growth had no added value, other than serving as transport medium. Conclusions In spina bifida children, leukocyte esterase testing can be used to exclude significant bacteriuria at home, while dip slide tests have no added value to diagnose or exclude significant bacteriuria.
Barletta, Francesca; Mercado, Erik; Ruiz, Joaquim; Ecker, Lucie; Lopez, Giovanni; Mispireta, Monica; Gil, Ana I.; Lanata, Claudio F.; Cleary, Thomas G.
Background. Enteropathogenic Escherichia coli (EPEC) strains are pediatric pathogens commonly isolated from both healthy and sick children with diarrhea in areas of endemicity. The aim of this study was to compare the bacterial load of EPEC isolated from stool samples from children with and without diarrhea to determine whether bacterial load might be a useful tool for further study of this phenomenon. Methods. EPEC was detected by polymerase chain reaction (PCR) of colonies isolated on MacConkey plates from 53 diarrheal and 90 healthy children aged <2 years. DNA was isolated from stool samples by cetyltrimethylammonium bromide extraction. To standardize quantification by quantitative real-time PCR (qRT-PCR), the correlation between fluorescence threshold cycle and copy number of the intimin gene of EPEC E2348/69 was determined. Results. The detection limit of qRT-PCR was 5 bacteria/mg stool. The geometric mean load in diarrhea was 299 bacteria/mg (95% confidence interval [CI], 77–1164 bacteria/mg), compared with 29 bacteria/mg (95% CI, 10–87 bacteria/mg) in control subjects (P = .016). Bacterial load was significantly higher in children with diarrhea than in control subjects among children <12 months of age (178 vs 5 bacteria/mg; P = .006) and among children with EPEC as the sole pathogen (463 vs 24 bacteria/mg; P = .006). Conclusions. EPEC load measured by qRT-PCR is higher in diarrheal than in healthy children. qRT-PCR may be useful to study the relationship between disease and colonization in settings of endemicity. PMID:22028433
Full Text Available Abstract Background Uropathogenic strains of Escherichia coli cause symptomatic infections whereas asymptomatic bacteriuria (ABU strains are well adapted for growth in the human urinary tract, where they establish long-term bacteriuria. Human urine is a very complex growth medium that could be perceived by certain bacteria as a stressful environment. To investigate a possible imbalance between endogenous oxidative response and antioxidant mechanisms, lipid oxidative damage estimated as thiobarbituric acid reactive substances (TBARS content was evaluated in twenty-one E. coli belonging to various pathovars and phylogenetic groups. Antioxidant defense mechanisms were also analysed. Results During exponential growth in urine, TBARS level differs between strains, without correlation with the ability to grow in urine which was similarly limited for commensal, ABU and uropathogenic strains. In addition, no correlation between TBARS level and the phylogroup or pathogenic group is apparent. The growth of ABU strain 83972 was associated with a high level of TBARS and more active antioxidant defenses that reduce the imbalance. Conclusions Our results indicate that growth capacity in urine is not a property of ABU strains. However, E. coli isolates respond very differently to this stressful environment. In strain ABU 83972, on one hand, the increased level of endogenous reactive oxygen species may be responsible for adaptive mutations. On the other hand, a more active antioxidant defense system could increase the capacity to colonize the bladder.
Bacteriuria in pregnancy with or without clinical symptoms is frequent and increases the risk of pyelonephritis, preterm labour, and low birth weight infants. Commonly used antibiotics such as ampicillin (pivampicillin), amoxicillin, trimethoprim, and sulphonamide are currently associated with a high degree of resistance of the most common pathogen in the urinary tract, Escherichia coli. During the past few decades a number of new and efficient antibacterial antibiotics have been developed. The presumption that a specific drug is safe for both the pregnant woman and the foetus depends on how widely the drug has been used. A recent survey among general practitioners and obstetricians in Denmark, Finland, Norway, and Sweden confirmed that the beta-lactam antibiotic pivmecillinam and nitrofurantoin are the most commonly used agents in the treatment of bacteriuria in pregnancy in the Nordic countries. However, a surprisingly high number of physicians reported that they prescribe sulphonamides during the first two trimesters in spite of resistance of E. coli and possible adverse effects on the foetus. PMID:11295409
Morrone, A. [Univ. of Pittsburgh School of Medicine, PA (United States)]|[Univ. of Florence (Italy); Hoffman, E.P.; Hoop, R.C. [Univ. of Pittsburgh School of Medicine, PA (United States)] [and others
A 4-year-old girl was referred for evaluation for a mild but persistent serum aspartate aminotransferase (AST) elevation detected incidentally during routine blood screening for a skin infection. Serum creatine kinase activity was found to be increased. Immuno-histochemical study for dystrophin in her muscle biopsy showed results consistent with a carrier state for muscular dystrophy. Molecular work-up showed the proposita to be a carrier of a deletion mutation of exon 48 of the dystrophin gene. Four male relatives also had the deletion mutation, yet showed no clinical symptoms of muscular dystrophy (age range 8-58 yrs). Linkage analysis of the dystrophin gene in the family showed a spontaneous change of an STR45 allele, which could be due to either an intragenic double recombination event, or CA repeat length mutation leading to identical size alleles. To our knowledge, this is the first documentation of an asymptomatic dystrophinopathy in multiple males of advanced age. Based on molecular findings, this family would be given a diagnosis of Becker muscular dystrophy. This diagnosis implies the development of clinical symptoms, even though this family is clearly asymptomatic. This report underscores the caution which must be exercised when giving presymptomatic diagnoses based on molecular studies. 28 refs., 4 figs., 1 tab.
Kildemoes, Anna M. O.; Kjetland, Eyrun F; Taylor, Myra;
was positively associated both with bacteriuria (P = 0.002) and S. haematobium (P < 0.001). Conclusions: No association between bacteriuria and uro-genital schistosomiasis was demonstrated. Bacteriuria appears not to be a confounder for using micro-haematuria as diagnostic measure for S. haematobium...
Full Text Available To determine the prevalence of asymptomatic urinary abnormalities in adolescents, first morning clean mid-stream urine specimens were obtained from 2500 individuals and examined by dipstick and light microscopy. Adolescents with abnormal screening results were reexamined after two weeks and those who had abnormal results twice were subjected to systemic clinical examination and further clinical and laboratory investigations. Eight hundred and three (32.1% individuals had urinary abnormalities at the first screening, which significantly decreased to 345 (13.8% at the second screening, (P <0.001. Hematuria was the most common urinary abnormalities detected in 245 (9.8% adolescents who had persistent urine abnormalities; 228 (9.1% individuals had non glomerular hematuria. The hematuria was isolated in 150 (6% individuals, combined with leukocyturia in 83 (3.3% individuals, and combined with proteinuria in 12 (0.5% individuals. Leukocyturia was detected in 150 (6% of all studied adolescents; it was isolated in 39 (1.6% individuals and combined with proteinuria in 28 (1.1% of them. Asymp- tomatic bacteriuria was detected in 23 (0.9% of all studied adolescents; all the cases were females. Proteinuria was detected in 65 (2.6% of all the studied adolescents; 45 (1.8% indivi- duals had <0.5 g/day and twenty (0.8% individuals had 0.5-3 g/day. Asymptomatic urinary abnormalities were more common in males than females and adolescents from rural than urban areas (P <0.01 and (P <0.001, respectively. The present study found a high prevalence of asymptomatic urinary abnormalities among adolescents in our population.
Dada, Oluyemi Ebenezer; Akharaiyi, Fred Coolborn; Lawal, Opeyemi Zaynab
Bacteriuria in urinary tract infection is severe and associated with considerable morbidity if left untreated. Therefore, the aim of the study was to evaluate the prevalence of bacteriuria among primary and secondary school pupils in Akure North Local Government Area. The study included subjects from the highly populated schools in this local government area. The samples analyzed were exclusively collected from volunteer pupils whose age and sex were documented by the questionnaire distributed to them. Urine samples were collected randomly under aseptic conditions from 250 pupils aged 5-20 attending primary and secondary schools. Urine samples were subjected to microbiological analysis by culturing 1 mL each on nutrient agar, mannitol salt agar, cystine lactose electrolyte deficient agar, plate count agar and chocolate agar for possible isolation of any bacteria. Bacterial colonies were enumerated and identified to the species level. Analytical indices revealed bacteriuria to be more common in female (41.2%) than male (3.2%) subjects. The highest bacterial count in female urine samples was 281 x 10(3) against 149 x 10(3) in male samples. A higher infection rate was recorded in secondary school pupils aged 11-20. Escherichia coli predominated among isolated bacteria species with 48.8%. Laboratory results confirmed urinary tract infection in some of the study pupils. As only volunteer pupils submitted their samples for analysis, this small population was represented in the study, predominated by female subjects. None of the pupils showed signs of infection, therefore routine laboratory checkup is important among children in order to limit damage to some of their vital tissues. PMID:23330403
Raïssa Mayer Ramalho Catão; João Batista de Sousa Neto; Caroline Evelin Nascimento Kluczynik; Danielle Rocha Silva
Objectives: describing the epidemiological profile of pregnant teenagers in a public maternity in Campina Grande-PB and evaluating the prenatal care offered. Methods: this is about a cross-sectional, exploratory study, developed through interviews, with 52 women who fulfilled the following prerequisites: seen at prenatal ISEA, were less than 19 years, were in the gestational period of not less than 16 weeks and agreed to participate in this study, after approval by the Ethics in Research Stat...
Khalil, M. R.; Uldbjerg, N.; Thorsen, P.;
Objectives: Preterm delivery (PTD) contributes to 70% of all perinatal deaths and nearly 50% of permanent neurological damages in children. Treatment and follow-up to prevent recolonization in pregnant women with Group B Streptococcus (GBS) in the urine may reduce the frequency of PTD. In a...... delivered preterm (10.9%), while among the GBS BU negative 1,085 (8.7%) delivered preterm; indicating an association between GBS BU and PTD in crude analyzes (Odds Ratio 1.8; 95% Confidence Interval 1.5-2.2; P30, and 19.0% were smokers in pregnancy. Conclusions: Group B Streptococcus bacteriuria might be a...
Vaidya, Ashima; Singhal, Suman; Dhall, Sonia; Manohar, Ashish; Mahajan, Harsh
Cysticercosis is a common problem world wide. However, disseminated cysticercosis is rare. Still rarer is asymptomatic disseminated cysticercosis. We are reporting here a rare case of asymptomatic disseminated cysticercosis which involved brain, face, orbit, lungs, heart, pancreas and spleen in a young Nigerian male, who sought medical attention for dysphagia which was diagnosed as achalasia cardia. Despite widespread dissemination of cysticercosis which involves multiple organs, the individu...
Marahatta, R; Dhungel, B Acharya; Pradhan, P; Rai, S K; Choudhury, D Roy
Urinary tract infection is the commonest bacterial infection in pregnancy. The overall incidence is 5.0-10.0% of all pregnancy. During pregnancy bacterial growth is favoured by increased urinary content of glucose, aminoacids and other nutrients. Other factors responsible for infection are basically related to hormonal effect and mechanical factors. Prolonged stasis of urine in urinary bladder favours growth of micro organism, relaxation of vesico-ureteric junction leads to reflux of urine from bladder to ureter and later up to renal pelvis and later can affect the renal parenchyma affecting the function of kidneys. In addition, some maternal defense mechanism are less effective during pregnancy. Bacteriuria either asymptomatic (5.0%) or symptomatic is common in pregnancy, if left untreated, asymptomatic bacteriuria will lead to acute pyelonephritis in 20.0-30.0%. This may result in abortion, premature delivery, low birth baby and even still birth. About 12.0% of antenatal admission are sepsis due to pyelonephritis. Keeping in mind that UTI in pregnancy leads to increase in maternal morbidity as well as neonatal morbidity and mortality. In this prospective study all asymptomatic consecutive antenatal women were included 200 from each trimester with total of 600 in number to see the incidence in different trimester, most prevalent organisms and it's sensitivity. They were followed up till delivery to see the incidence of asymptomatic bacteriurea in different trimester and its outcome in terms of type of delivery, baby weight, apgar score given at the time of birth and hospital admission for morbidity. PMID:22364093
Mokube, Morike Ngoe; Atashili, Julius; Halle-Ekane, Gregory Edie; Ikomey, George M.; Ndumbe, Peter M
Background Bacteriuria is associated with significant maternal and foetal risks. However, its prevalence is not known in our community. Objectives This study was carried out to determine the prevalence and predictors of bacteriuria in pregnant women of the Buea Health District (BHD) as well as the antibiotic sensitivity patterns of bacterial isolates. It also sought to determine the diagnostic performance of the nitrite and leucocyte esterase tests in detecting bacteriuria in these women. Met...
It is estimated that at least 50% of fibroids are asymptomatic, but this figure is likely to be an underestimate as it is based on women in whom fibroids are found incidentally during another procedure (e.g. cervical screening), and there is little, if any, data from population studies on the true incidence of fibroids. If a prevalence of 50% by 50 years of age is accepted, a large number of women have asymptomatic fibroids. Working on the cliché, 'if it ain't broken, don't fix it', it may seem surprising that there should be a chapter dedicated to the issue of asymptomatic fibroids, since the simplistic approach might be to leave the asymptomatic fibroids well alone. However, asymptomatic fibroids may become symptomatic in the future, so it may be wiser to treat fibroids before they grow to a size when they become symptomatic, or treatment becomes more challenging, especially in young women who may desire fertility at a later stage, and in view of the fact that many women are starting their families in their mid-thirties when they have a 30% chance of having a fibroid(s). Despite their common occurrence, fibroids are still poorly understood. It is not known why they form in the first place, what determines their number and ultimate size, the best treatment approaches, or the factors that determine which women develop symptoms. Even when women present with disorders such as infertility, pelvic pain and abnormal bleeding, it is not always possible to be certain that a given myoma is not simply an innocent bystander rather than the cause of the symptom. This chapter addresses the challenging issue of what to do when fibroids are diagnosed incidentally. Firstly, there is the need to ascertain that the pelvic mass palpated is indeed a fibroid, and not an early, more sinister tumour, especially if conservative management is adopted. In addition, there is the issue of size, position and potential for becoming symptomatic at a later date. With the availability of uterine
Livingstone, Verity H; Turner, Bradley
A retrospective chart review was performed in a family-practice office, which looked at the prevalence and significance of asymptomatic microscopic hematuria (AMH). Various methods were used to identify the relevant charts and to define the practice demographics, some of which hitherto had not been described. At least 2% of the men and 5% of the women over 44 years old in the practice were found to have AMH; in none of these patients, however, were any significant urological abnormalities det...
Onanuga, Adebola; Selekere, Tamaradobra Laurretta
Background: Asymptomatic bacteriuria frequently occurs among all ages with the possibility of developing into urinary tract infections, and the antimicrobial resistance patterns of the etiologic organisms are essential for appropriate therapy. Thus, we investigated the virulence and antimicrobial resistance patterns of common urinary bacteria in asymptomatic students of Niger Delta University, Amassoma, Bayelsa State, Nigeria in a cross-sectional study. Materials and Methods: Clean catch mid-stream early morning urine samples collected from 200 asymptomatic University students of aged ranges 15–30 years were cultured, screened and common bacteria were identified using standard microbiological procedures. The isolates were screened for hemolysin production and their susceptibility to antibiotics was determined using standard disc assay method. Results: A total prevalence rate of 52.0% significant bacteriuria was detected and it was significantly higher among the female with a weak association (χ2 = 6.01, phi = 0.173, P = 0.014). The Klebsiella pneumoniae and Staphylococcus aureus isolates were most frequently encountered among the isolated bacteria and 18 (12.7%) of all the bacterial isolates produced hemolysins. All the bacterial isolates exhibited 50–100% resistance to the tested beta-lactam antibiotics, tetracycline and co-trimoxazole. The isolated bacteria were 85-100% multi-drug resistant. However, most of the isolates were generally susceptible to gentamicin and ofloxacin. The phenotypic detection of extended-spectrum beta-lactamases was 9 (9.6%) among the tested Gram-negative bacterial isolates. Conclusions: The observed high proportions of multidrug resistant urinary bacteria among asymptomatic University students call for the need of greater control of antibiotic use in this study area. PMID:26957865
For the purpose of studying the incidence, pathomorphology and etiology of asymptomatic ischemic cerebral lesions, we carried out a brain MRI study on 65 patients with diabetes mellitus accompanied with hypertension who are thought to belong to a high risk group of ischemic cerebrovascular diseases. Excluding the abnormality of tendon reflex due to diabetic neuropathy, sixty percent of the total patients had some mild neurological signs and symptoms, most of them was discrepancy in tendon reflex. The percentage of the patients in whom MRI disclosed some abnormalities was as high as 70%, they were lacunar stroke, multiple lacunar state, cortical infarct, and patchy high signal lesions visible only in the T2 weighted image. Lacunes or these patchy high signal lesions (considered to be the dilatation of the perivascular space or true lacunes) tended to be found along the border zone or the terminal zone. These results indicate that asymptomatic patients in whom MRI discloses the abnormalities should be considered as candidates for the future onset of multi-infarct. (author)
Full Text Available infertility. It outlines the fallopian tubes and uterine cavity. Aim: To review the hysterosalpingographic (HSG findings in women investigated for infertility in a tertiary care center in the Niger Delta. Methods: The study reviewed 137 consecutive HSG films of women investigated for infertility between 1st January to 30th May, 2014. Result: The commonest age group was 26-30yrs (46.7%. Majority of the women were investigated for secondary infertility 98 (71.5%. Abnormal findings were found in 99(72.3% and the commonest abnormality was tubal 67(48.9% with bilateral tubal blockage in 20 (14.6%. Other findings include submucous fibroids in 28 (20.4%, uterine synechia 26(19.0% and bi-cornuate uterus in 1(0.7%. Conclusion: HSG is relevant in the investigation of infertile women. Bilateral tubal occlusion from pelvic inflammatory disease, puerperal sepsis and unsafe abortions remains a major challenge in the Niger delta.
Kiridi E.K; Ibrahim I.A; Lawani L
infertility. It outlines the fallopian tubes and uterine cavity. Aim: To review the hysterosalpingographic (HSG) findings in women investigated for infertility in a tertiary care center in the Niger Delta. Methods: The study reviewed 137 consecutive HSG films of women investigated for infertility between 1st January to 30th May, 2014. Result: The commonest age group was 26-30yrs (46.7%). Majority of the women were investigated for secondary infertility 98 (71.5%). Abnormal find...
Conclusions: ASB is commonly encountered in pregnant women especially in women with anaemia. Untreated ASB is a risk factor for pyelonephritis, anaemia, PROM, preterm labour in mother. IUGR and neonatal infections are more common in fetus. Routine screening for ASB as a part of antenatal care reduces the maternal and fetal complications. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1300-1305
Analysis of the disagreement between automated bioluminescence-based and culture methods for detecting significant bacteriuria, with proposals for standardizing evaluations of bacteriuria detection methods.
Nichols, W. W.; Curtis, G D; Johnston, H H
A fully automated method for detecting significant bacteriuria is described which uses firefly luciferin and luciferase to detect bacterial ATP in urine. The automated method was calibrated and evaluated, using 308 urine specimens, against two reference culture methods. We obtained a specificity of 0.79 and sensitivity of 0.75 using a quantitative pour plate reference test and a specificity of 0.79 and a sensitivity of 0.90 using a semiquantitative standard loop reference test. The majority o...
Weinstein Robert A
Full Text Available Abstract Background When Staphylococcus aureus is isolated in urine, it is thought to usually represent hematogenous spread. Because such spread might have special clinical significance, we evaluated predictors and outcomes of S. aureus bacteriuria among patients with S. aureus bacteremia. Methods A case-control study was performed at John H. Stroger Jr. Hospital of Cook County among adult inpatients during January 2002-December 2006. Cases and controls had positive and negative urine cultures, respectively, for S. aureus, within 72 hours of positive blood culture for S. aureus. Controls were sampled randomly in a 1:4 ratio. Univariate and multivariable logistic regression analyses were done. Results Overall, 59% of patients were African-American, 12% died, 56% of infections had community-onset infections, and 58% were infected with methicillin-susceptible S. aureus (MSSA. Among 61 cases and 247 controls, predictors of S. aureus bacteriuria on multivariate analysis were urological surgery (OR = 3.4, p = 0.06 and genitourinary infection (OR = 9.2, p = 0.002. Among patients who died, there were significantly more patients with bacteriuria than among patients who survived (39% vs. 17%; p = 0.002. In multiple Cox regression analysis, death risks in bacteremic patients were bacteriuria (hazard ratio 2.9, CI 1.4-5.9, p = 0.004, bladder catheter use (2.0, 1.0-4.0, p = 0.06, and Charlson score (1.1, 1.1-1.3, p = 0.02. Neither length of stay nor methicillin-resistant Staphylococcus aureus (MRSA infection was a predictor of S. aureus bacteriuria or death. Conclusions Among patients with S. aureus bacteremia, those with S. aureus bacteriuria had 3-fold higher mortality than those without bacteriuria, even after adjustment for comorbidities. Bacteriuria may identify patients with more severe bacteremia, who are at risk of worse outcomes.
Mackett, D; Kessock-Philip, S; Bascomb, S; Easmon, C S
Four hundred and twenty-two urine samples were screened for significant bacteriuria using bioluminescence and microscopy of uncentrifuged urine. A smaller number of false-negatives were seen with bioluminescence (10%) than with microscopy (40%) while both techniques gave a similar number of false-positives (18%). The kit required a large amount of manual preparation, largely pipetting. With this and the short shelf-life of the reconstituted reagents, it is not suitable for small numbers of ur...
Jorgensen, J H; Alexander, G A
Previous studies have demonstrated that significant gram-negative bacteriuria can be detected by using the Limulus amoebocyte lysate test. A series of 580 urine specimens were tested in parallel with the automated MS-2 (Abbott Laboratories) assay and with quantitative urine bacterial cultures. The overall ability of the MS-2 Limulus amoebocyte lysate test to correctly classify urine specimens as containing either greater than or equal to 10(5) organisms or less than 10(5) organisms per ml dur...
Wuthier, Phil; Sublett, Karen; Riehl, Lance
Urologic studies suggest that urinary catheter dependent loops (tubing low points) may be a contributing cause of bacteriuria and urinary tract infection among catheterized patients. The means by which this type of contaminant transmission occurs, however, remains poorly understood. An observational, cross-sectional study was conducted to provide a foundational look at catheter dependent loops and their possible role in catheter-acquired urinary tract infections, and as a building block for further research. PMID:27093758
Tashjian, J H; Coulam, C B; Washington, J A
Four groups of 25 asymptomatic women--pregnant, premenopausal and taking oral contraceptives, premenopausal and not taking oral contraceptives, and postmenopausal--were studied for the presence in vaginal specimens of aerobic bacteria, anaerobic bacteria, fungi, Mycoplasma, Chlamydia, herpes simplex virus, mycobacteria, and Trichomonas. No significant differences in microbial flora were found among the groups. PMID:957791
Prakash S; S Anto Jeya Dayalan; Edison N
Objective: To investigate the prevalence of bacteriologically positive urinary tract infection (UTI) among people enrolled in the hospital during January 2010 to June 2010. Methods: In the study period, a total of 1 546 patients were screened for UTI and the antibiogram was studied. Results: A total of 744 patients were positive. It revealed that females were more vulnerable to bacteriuria than males. Organisms predominantly isolated were Esherichia coli followed byKlebsiella in both males and females. Among the antibiotics tested against the isolated organisms for sensitivity test, chloramphenicol was more effective followed by amikacin and gatifloxacin for Enterobacteriaceae. For Pseudomonas aeruginosa, chloramphenicol was not effective, amikacin was effective. Amoxycillin, amoxycillin/clavulanic acid and first generation cephalosporin were least effective against Enterobacteriaceae and Pseudomonas aeruginosa. Conclusions: This study would not only help in proper treatment of patients but also discourage the indiscriminate use of antibiotics and prevent development of drug resistance.
Bint, A; Bullock, D; Reeves, D; Wilkinson, P
A comparative trial of pivmecillinam and ampicillin was performed on 100 women with bacteriuria of pregnancy. They received either 400 mg pivmecillinam four times daily or 500 mg ampicillin four times daily for seven days. Cure rates at two weeks were 88% in the pivmecillinam group and 85% in the ampicillin group. At six weeks the respective rates were 76% and 64%. Failure of therapy was not associated with the appearance of bacterial resistance in either treatment group. Side-effects, particularly vomiting and premature cessation of therapy, were significantly more frequent in the pivmecillinam group. No significant effects on liver function were found. In subsequent patients treated in a non-comparative manner with 200 mg pivmecillinam three times daily, the incidence of side effects was markedly reduced with no loss of efficacy. PMID:232697
Brumfitt, W; Franklin, I; Hamilton-Miller, J; Anderson, F
48 non-pregnant domiciliary patients referred by general practitioners and 50 pregnant women were treated for bacteriuria with either 500 mg cephradine or 400 mg pivmecillinam every 6 h for 7 days. In the pregnant women, cure rates were over 90% after 2 weeks for both compounds, and after 6 weeks were 86% for cephradine and 78% for pivmecillinam. Cure rates in the non-pregnant were 83% for cephradine and 95% for pivmecillinam at 6 weeks. Seven patients (3 given cephradine, 4 given pivmecillinam) stopped treatment due to side-effects. Overall, side-effects (many of which were trivial) were more common in patients treated with cephradine (51%) than in those receiving pivmecillinam (33%). It is concluded that both drugs are highly effective in these two common types of urinary infection. PMID:231299
Woodrow, G; Patel, S.; Berman, P; Morgan, A G; Burden, R. P.
Urinary tract infections in the elderly are common, often asymptomatic and usually benign. We report three patients who presented with acute renal failure due to acute pyelonephritis in the absence of clinical findings of infection or urinary tract obstruction. Blood and urine cultures grew Escherichia coli in two of the patients and in two patients renal biopsy confirmed acute pyogenic pyelonephritis. Antimicrobial therapy and haemodialysis led to improvement, though one patient subsequently...
Zdziarski, Jaroslaw; Svanborg, Catharina; Wullt, Björn; Hacker, Jörg; Dobrindt, Ulrich
In some patients, Escherichia coli strains establish significant bacteriuria without causing symptoms of urinary tract infection (UTI). These asymptomatic-bacteriuria (ABU) strains have been shown to express fewer virulence factors than the uropathogenic E. coli (UPEC) strains that cause severe, symptomatic UTI. Paradoxically, ABU strains carry many typical UPEC virulence genes, and the molecular basis of their low virulence therefore remains unclear. This study examined whether ABU strains m...
Ewa Majos, MD; Rafal Dabrowski MD, PhD
Full Text Available Atrial fibrillation (AF is a common and refractory arrhythmia. Prevalence of AF increases with age. Asymptomatic AF is a state of asymptomatic episodes of arrhythmia and its exact prevalence remains unknown. Ablation and therapy with antiarrhythmic agents may predispose to asymptomatic AF. Detection of silent AF is crucial for prevention of ischaemic stroke. Progress in continuous ECG monitoring by Holter ECG, telemetry methods or implantable devices can provide a useful tools for identifying silent AF. Simple screening procedures like pulse examination and ambulatory ECG may be helpful in arrhythmia detection and logically – ischemic stroke prevention.
Omar Ismail Santos Pereira Darzé; Ubirajara Barroso; Maurício Lordelo
OBJETIVOS: Estimar a prevalência de bacteriúria assintomática (BAS) entre gestantes atendidas em pré-natal de Serviço Universitário e identificar prováveis preditores clínicos. MÉTODOS: Estudo prospectivo de corte transversal, envolvendo 260 gestantes matriculadas em serviço de pré-natal de baixo risco entre agosto de 2008 e outubro de 2009, sem sintomas de infecção do trato urinário. Foram excluídas aquelas com febre, disúria, tenesmo vesical, dor lombar, presença de sangramento genital, per...
Iftimie, S; García-Heredia, A; Pujol, I; Ballester, F; Fort-Gallifa, I; Simó, J M; Joven, J; Camps, J; Castro, A
Urinary tract infections (UTI) are common among elderly patients in residential care facilities, as well as in the hospital setting. Identifying new biochemical markers of UTI is an active line of research since UTI management is resource intensive. Paraoxonase-1 (PON1) forms part of the patient's immune system, the response-to-injury and inflammation. Our study sought to evaluate alterations in inflammation-related paraoxonase-1 (PON1) and chemokine (C-C motif) ligand 2 (CCL2) in patients with an indwelling catheter to assess their potential usefulness as biomarkers of infection. Patients (n = 142) who had had the urinary catheter removed and 100 healthy volunteers were recruited. In all participants we measured serum PON1 activity, PON1 concentration, CCL2, procalcitonin and C-reactive protein (CRP). Results indicated that patients had higher CCL2, CRP and procalcitonin concentrations than the control group, and lower paraoxonase activity. There were no significant differences in PON1 concentrations. When comparing the diagnostic accuracy of CRP, procalcitonin, CCL2 and the PON1-related variables in discriminating between patients with and those without UTI, we found a considerable degree of overlap between groups, i.e., a low diagnostic accuracy. However, there were significant inverse logarithmic correlations between serum paraoxonase activity and the number of days the urinary catheter had been in situ. Our results suggest that measurement of these biochemical variables may be useful in investigating complications of long-term use of these devices and help to improve the economic and clinical investment required in the management of the often-associated infection. PMID:27334497
Detection of previous cerebral infarction on CT films of patients with no history of stroke is a common occurrence. The incidence of silent cerebral infarction was reported to be about 10 to 11 percent, but very few reports concerning asymptomatic cerebral hemorrhage available. However, recent clinical application of MRI has resulted in the detection of old asymptomatic hemorrhage in patients with no history known stroke-like episodes. The purpose of this study was to elucidate the incidence, the cause and the character of the asymptomatic cerebral hemorrhage among patients who had undergone MRI examinations. From September 1987 through June 1990, 2757 patients have undergone 3474 MR scans of the brain with 1.0 Tesla Siemens Magneton unit in our hospital. Seventeen patients showed no clinical signs or symptoms suggesting a stroke episode corresponding to the detected hemorrhagic lesion. The 17 patients corresponded to 0.6% of the patients who underwent MRI, 1.5% of the patients with cerebrovascular disease and 9.5% of the patients with intracerebral hemorrhage(ICH), which was rather higher than expected. Among the 17 patients, 12 were diagnosed as primary ICH and 5 as secondary ICH. Most of the primary asymptomatic hemorrhage were hypertensive ones and slit-like curvilinear lesions between the putamen and claustrum or external capsule. The secondary asymptomatic hemorrhage were due to AVM and angiomas in the frontal cortex, thalamus and pons. (author)
Nakajima, Yumi; Ohsuga, Hitoshi; Yamamoto, Masahiro; Shinohara, Yukito (Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine)
Detection of previous cerebral infarction on CT films of patients with no history of stroke is a common occurrence. The incidence of silent cerebral infarction was reported to be about 10 to 11 percent, but very few reports concerning asymptomatic cerebral hemorrhage available. However, recent clinical application of MRI has resulted in the detection of old asymptomatic hemorrhage in patients with no history known stroke-like episodes. The purpose of this study was to elucidate the incidence, the cause and the character of the asymptomatic cerebral hemorrhage among patients who had undergone MRI examinations. From September 1987 through June 1990, 2757 patients have undergone 3474 MR scans of the brain with 1.0 Tesla Siemens Magneton unit in our hospital. Seventeen patients showed no clinical signs or symptoms suggesting a stroke episode corresponding to the detected hemorrhagic lesion. The 17 patients corresponded to 0.6% of the patients who underwent MRI, 1.5% of the patients with cerebrovascular disease and 9.5% of the patients with intracerebral hemorrhage(ICH), which was rather higher than expected. Among the 17 patients, 12 were diagnosed as primary ICH and 5 as secondary ICH. Most of the primary asymptomatic hemorrhage were hypertensive ones and slit-like curvilinear lesions between the putamen and claustrum or external capsule. The secondary asymptomatic hemorrhage were due to AVM and angiomas in the frontal cortex, thalamus and pons. (author).
Glovinski, Peter V; Lauritsen, Morten L; Bay-Nielsen, Morten;
Body packing takes advantage of the human storage capacity within the alimentary tract. Body packing is used for the smuggling of drugs such as heroin, cocaine, amphetamine, hashish and ecstasy. Most body packers are asymptomatic. However, packets may rupture or obstruct the alimentary tract...
Full Text Available A one-year-old child being investigated for urinary tract infection was diagnosed with a multiseptate gallbladder. The patient remains asymptomatic, and investigations demonstrate no associated anomalies. Forty-three cases, including 13 cases in children were identified in the literature. Their presentation and management were reviewed.
Thompson, C J; Baylis, P. H.
Lithium salts are widely recognized to cause biochemical hypothyroidism and have been used to treat thyrotoxicosis. We present a case of Graves' disease which developed during lithium therapy. The patient was asymptomatic until the lithium was discontinued; she subsequently developed florid symptoms of thyrotoxicosis.
Kamel, Shereen R.; Omar, Gihan M.; Darwish, Ayman F.; Asklany, Hany T.; Abdou S. Ellabban
Introduction: Pulmonary arterial hypertension (PAH) is a serious and often fatal complication of systemic lupus erythematosus (SLE). Because the diagnosis of PAH often is made years after symptom onset, early diagnostic strategies are essential. Doppler echocardiography currently is considered the noninvasive screening test of choice for evaluating pulmonary hypertension. Aim: Screening for asymptomatic pulmonary hypertension in systemic lupus erythematosus patients using Doppler echocardiogr...
The article contains results of research interrelationship from colonization of vagina and urinary tract diseases. E.coli one of the main factors in development asymptomatic bacterium. Presented high effects of penicillin medicaments and nitrofurans in treatment of asymptomatic bacterium
Goodsell, David S.
Diverse biological data may be used to create illustrations of molecules in their cellular context. I describe the scientific results that support a recent textbook illustration of an "Escherichia coli cell". The image magnifies a portion of the bacterium at one million times, showing the location and form of individual macromolecules. Results…
Sarkozy, Clémentine; Salles, Gilles
Follicular lymphoma is a heterogeneous disease in which some patients present an indolent evolution for decades and others, a rather aggressive form of the disease requiring immediate therapy. While immunochemotherapy has emerged as a standard of care for symptomatic patients, treatment of the asymptomatic population remains controversial. Since the disease is still considered incurable, delayed initiation of therapy is an acceptable option. However, four single injections of rituximab can result in an acceptable clinical response and can improve the duration of the interval without cytotoxic therapy. With recent therapeutic approaches that enable substantial improvements in life expectancy for follicular lymphoma patients, limiting short- or long-term treatment toxicities appears as a new concern in the asymptomatic population. Based on these options, the challenge is to preserve patient quality of life and prolong survival: from the patient's perspective, his/her opinion is therefore of significant importance. PMID:24219551
We studied the relationship between cortical grey matter flow (CBF) and age, cerebrovascular risk factors and the severity of subcortical hypersignals (HS, hyperintensity score in MRI) in 47 asymptomatic subjects with cerebrovascular risk factors. Multiple regression analysis revealed that HS was most strongly related to CBF, and that hematocrit, age and evidence of ischemic change detected in the electrocardiogram also appeared to be independent determinants of CBF. Both the severity and location of hypersignals were correlated with CBF. The most significant negative correlation observed was that between CBF and HS in the basal ganglia-thalamic region, where the degree of signal abnormality was modest. Decreased CBF in asymptomatic subjects with cerebrovascular risk factors may be related to microcirculatory disturbance associated with elevated hematocrit and an increase in the number of risk factors, and functional suppression of cerebral cortex due to the neuronal disconnection associated with subcortical lesions. In addition, impaired cerebral circulation may be related to MRI signal abnormalities. (author)
Stansby, G.; MacDonald, S.; Allison, R; de Belder, M; Brown, MM; Dark, J; Featherstone, R; Flather, M; Ford, GA; Halliday, A.; Malik, I; R. Naylor; Pepper, J.; Rothwell, PM
The Carotid Disease and Cardiac Surgery Consensus Meeting was convened as a multidisciplinary gathering to consider the management of patients undergoing cardiac surgery who are found to have asymptomatic carotid artery disease. There are no randomized trials concerning whether carotid interventions are of value in this situation and the natural history is unclear. Bilateral carotid artery disease (≥70% stenosis) should be regarded clinically relevant when considering hemodynamic and short-te...
M. Amin El-Gohary
We report a case of intra-abdominal testicular torsion, of eight years old boy who presented with asymptomatic left impalpable testis. Diagnostic laparoscopy revealed a twisted small intra-abdominal testis in which the spermatic cord twisted 3 times over a band attached to the internal ring. The cord was long enough to bring the small testis into the scrotal sac. This case highlights the pole of laparoscopy in the management of impalpable testes.
Lääveri, T; Antikainen, J; Pakkanen, S H; Kirveskari, J; Kantele, A
Travellers' diarrhoea (TD) remains the most frequent health problem encountered by visitors to the (sub)tropics. Traditional stool culture identifies the pathogen in only 15% of cases. Exploiting PCR-based methods, we investigated TD pathogens with a focus on asymptomatic travellers and severity of symptoms. Pre- and post-travel stools of 382 travellers with no history of antibiotic use during travel were analysed with a multiplex quantitative PCR for Salmonella, Yersinia, Campylobacter, Shigella, Vibrio cholerae and five diarrhoeagenic Escherichia coli: enteroaggregative (EAEC), enteropathogenic (EPEC), enterotoxigenic (ETEC), enterohaemorrhagic (EHEC) and enteroinvasive (EIEC). The participants were categorized by presence/absence of TD during travel and on return, and by severity of symptoms. A pathogen was indentified in 61% of the asymptomatic travellers, 83% of those with resolved TD, and 83% of those with ongoing TD; 25%, 43% and 53% had multiple pathogens, respectively. EPEC, EAEC, ETEC and Campylobacter associated especially with ongoing TD symptoms. EAEC and EPEC proved more common than ETEC. To conclude, modern methodology challenges our perception of stool pathogens: all pathogens were common both in asymptomatic and symptomatic travellers. TD has a multibacterial nature, but diarrhoeal symptoms mostly associate with EAEC, EPEC, ETEC and Campylobacter. PMID:26970046
Bokil, Nilesh J.
Uropathogenic E. coli (UPEC) are the primary cause of urinary tract infections. Recent studies have demonstrated that UPEC can invade and replicate within epithelial cells, suggesting that this bacterial pathogen may occupy an intracellular niche within the host. Given that many intracellular pathogens target macrophages, we assessed the interactions between UPEC and macrophages. Colonization of the mouse bladder by UPEC strain CFT073 resulted in increased expression of myeloid-restricted genes, consistent with the recruitment of inflammatory macrophages to the site of infection. In in vitro assays, CFT073 was able to survive within primary mouse bone marrow-derived macrophages (BMM) up to 24h post-infection. Three additional well-characterized clinical UPEC isolates associated with distinct UTI symptomatologies displayed variable long-term survival within BMM. UPEC strains UTI89 and VR50, originally isolated from patients with cystitis and asymptomatic bacteriuria respectively, showed elevated bacterial loads in BMM at 24h post-infection as compared to CFT073 and the asymptomatic bacteriuria strain 83972. These differences did not correlate with differential effects on macrophage survival or initial uptake of bacteria. E. coli UTI89 localized to a Lamp1 + vesicular compartment within BMM. In contrast to survival within mouse BMM, intracellular bacterial loads of VR50 were low in both human monocyte-derived macrophages (HMDM) and in human T24 bladder epithelial cells. Collectively, these data suggest that some UPEC isolates may subvert macrophage anti-microbial pathways, and that host species differences may impact on intracellular UPEC survival. © 2011 Elsevier GmbH.
Bolton, R P; Tait, S K; Dear, P R; Losowsky, M. S.
In a prospective survey of infants born in a single maternity unit, asymptomatic faecal colonisation by Clostridium difficile occurred in 31 (47%) of 66 babies who provided a faecal sample during week one of life and at age 14 and 28 days, and in 46 (30.7%) of the total of 150 babies for whom at least one faecal sample was obtained during the month of study. There was no evidence for acquisition of the organism from the mother during delivery and colonisation was unrelated to the means of del...
Full Text Available A Total of 11 patients of pyoderma gangrenosum (PG; 5 males and 6 females were observed over 8 years. The ages ranged between 35-72 years. Nine patients were associated with ulcerative colitis, one with chronic renal failure, and one was labelled idiopathic. Three of the 9 patients of PG, who had ulcerative colitis presented first with skin lesions and had clinically silent, but acute, ulcerative colitis, diagnosed only after colonoscopy and rectal biopsy. This highlights the need for investigation including colonoscopy and biopsy even in asymptomatic patients of PG. Most of the cases benefitted from medical treatment (Corticosteroids + Salazopyrin.
Parker, Sarah E.; Pula, John H.
Introduction. Syphilis is a sexually transmitted disease that is known as “the great imitator” due to its wide variety of clinical presentations, including ocular disorders. There has been an increase in the rate of syphilis in the United States, especially in persons with HIV. We report a case of optic perineuritis in an asymptomatic male secondary to central nervous system (CNS) syphilis. Case Report. A 41-year-old man was found to have bilateral disc edema on a routine exam. Brain MRI was ...
Borowitz, S M; Cox, D J; Sutphen, J L
No studies have compared toileting-specific behaviors of encopretic children with those of asymptomatic children and have controlled for environmental factors such as parental attitudes, parenting styles, and bathroom facilities. This study prospectively examined the toileting habits of 86 chronically encopretic children compared with those of 27 asymptomatic siblings and 35 asymptomatic nonsiblings. Although encopretic children experienced significantly more soiling than did controls, the total number of daily bowel movements passed in the toilet (+/-SD) was comparable in the three groups (.92 +/- .76 in encopretic children compared with 1.14 +/- .43 and 1.08 +/- .47 in siblings and nonsiblings, respectively). Encopretic children experienced pain with defecation more often than did controls. During the 14-day study period, encopretic children complained of pain on 2.75 +/- 4.03 days compared with .58 +/- 1.84 days among sibling controls and 2.31 +/- 3.21 days among nonsibling controls. The mean pain score in encopretic children was .76 +/- 1.00 compared with .05 +/- .15 and .26 +/- .38 among siblings and nonsiblings, respectively. All three groups of children sat on the toilet without parental prompting the same number of times each day. In summary, children with chronic encopresis do not seem to avoid toileting, and they exhibit toileting behaviors that are very similar to those of asymptomatic siblings as well as to those of nonsibling controls. PMID:10393070
Sarah E. Parker
Full Text Available Introduction. Syphilis is a sexually transmitted disease that is known as “the great imitator” due to its wide variety of clinical presentations, including ocular disorders. There has been an increase in the rate of syphilis in the United States, especially in persons with HIV. We report a case of optic perineuritis in an asymptomatic male secondary to central nervous system (CNS syphilis. Case Report. A 41-year-old man was found to have bilateral disc edema on a routine exam. Brain MRI was unremarkable, and lumbar puncture revealed a normal opening pressure, with an elevated cerebrospinal fluid white cell count. Orbit MRI showed optic nerve sheath expansion and enhancement, consistent with optic perineuritis. He tested positive for syphilis based on serum RPR and FTA-ABS. Conclusion. Ophthalmologic findings, including disc edema, may be the presenting features of CNS syphilis. Even in asymptomatic persons, perineuritis should be considered early, as diagnosis and treatment are imperative given the progressive nature of the disease.
Robins-Browne, Roy M.; Bordun, Anne-Marie; Tauschek, Marija; Bennett-Wood, Vicki R.; Russell, Jacinta; Oppedisano, Frances; Lister, Nicole A.; Bettelheim, Karl A.; Fairley, Christopher K.; Sinclair, Martha I; Hellard, Margaret E
As part of a study to determine the effects of water filtration on the incidence of community-acquired gastroenteritis in Melbourne, Australia, we examined fecal samples from patients with gastroenteritis and asymptomatic persons for diarrheagenic strains of Escherichia coli. Atypical strains of enteropathogenic E. coli (EPEC) were the most frequently identified pathogens of all bacterial, viral, and parasitic agents in patients with gastroenteritis. Moreover, atypical EPEC were more common i...
Carbonetti, N H; Boonchai, S; Parry, S H; Väisänen-Rhen, V; Korhonen, T K; Williams, P H
A total of 516 strains of Escherichia coli were screened for the presence and expression of the aerobactin iron uptake system. The incidence was markedly higher among clinical isolates from patients with septicemia (68.8%), pyelonephritis (74.6%), and symptomatic (59.8%) and asymptomatic (63.2%) lower urinary tract infections than among normal human fecal isolates (34.3%).
Friedrich, Alexander W; Bielaszewska, Martina; Zhang, Wen-Lan; Pulz, Matthias; Kuczius, Thorsten; Ammon, Andrea; Karch, Helge
Shiga toxin (Stx)-producing Escherichia coli (STEC) from patients with hemolytic-uremic syndrome (HUS), patients with diarrhea without HUS, or asymptomatic subjects were genotyped to assess associations between stx2 variants and clinical manifestations of infection. Neither stx2d nor stx2e was found
In order to clarify the relationship between brain atrophy and asymptomatic cerebral lesions, total of 235 subjects (130 males and 105 females), who had neither neurologic deficits nor organic lesions on cerebral computed tomography, were studied. The subjects' ages ranged from 40 to 86 years (mean 66). They were divided into two groups: 90 controls without hypertension or diabetes mellitus (Group C), and 145 patients with essential hypertension (Group H). Brain atrophy was diagnosed using the caudate head index (CHI). Asymptomatic cerebral lesions on magnetic resonance imaging were defined as asymptomatic lacunae and white matter lesions. Caudate head index was higher in Group H than it was in Group C, and CHI in both groups was significantly correlated with the number of asymptomatic lacunae and the severity of white matter lesions on magnetic resonance imaging. These results indicate that brain atrophy may progress along with asymptomatic cerebral lesions. (author)
Reyes, David; Locke, James
Introduction: Management guidelines were created to screen and manage asymptomatic renal stones in U.S. astronauts. The risks for renal stone formation in astronauts due to bone loss and hypercalcuria are unknown. Astronauts have a stone risk which is about the same as commercial aviation pilots, which is about half that of the general population. However, proper management of this condition is still crucial to mitigate health and mission risks in the spaceflight environment. Methods: An extensive review of the literature and current aeromedical standards for the monitoring and management of renal stones was done. The NASA Flight Medicine Clinic's electronic medical record and Longitudinal Survey of Astronaut Health were also reviewed. Using this work, a screening and management algorithm was created that takes into consideration the unique operational environment of spaceflight. Results: Renal stone screening and management guidelines for astronauts were created based on accepted standards of care, with consideration to the environment of spaceflight. In the proposed algorithm, all astronauts will receive a yearly screening ultrasound for renal calcifications, or mineralized renal material (MRM). Any areas of MRM, 3 millimeters or larger, are considered a positive finding. Three millimeters approaches the detection limit of standard ultrasound, and several studies have shown that any stone that is 3 millimeters or less has an approximately 95 percent chance of spontaneous passage. For mission-assigned astronauts, any positive ultrasound study is followed by low-dose renal computed tomography (CT) scan, and flexible ureteroscopy if CT is positive. Other specific guidelines were also created. Discussion: The term "MRM" is used to account for small areas of calcification that may be outside the renal collecting system, and allows objectivity without otherwise constraining the diagnostic and treatment process for potentially very small calcifications of uncertain
In a period of 6 years 144 asymptomatic boys with cryptorchidism, of mean age 7 ± SD 3.5 years, underwent orchiopexy. None of these boys referred to a history of a known urological anomaly, urinary tract infection haematuria, palpable mass in the renal region, bladder extrophy, epispadias, hypospadias or anorectal malformation. On the third day after orchiopexy an intravenous pyelography was done in every boy following testicular protection against irradiation. Ultrasonic investigation was not available at that time. There were minor urological abnormalities in 36 (25%) boys and major ones in 8 (5.5%) boys. A major anomaly is defined as one resulting in significant loss of renal substance (one case of single kidney and three cases of unilateral renal hypoplasia), or requiring surgical correction for conservation of the renal substance (one case of ureterocele, two cases of pelviureteric stenosis and one case of vesicoureteric stenosis with ipsilateral hydronephrosis). The unsuspected major urological abnormalities are usually ipsilateral to the more undescended testis. They may be associated with a hernia and are more frequent in bilateral cryptorchidism. In conclusion we encourage the routine use of IVP, or ultrasonic investigation or dynamic renal scanning (99mTc-DTPA), if it is possible, in all patients undergoing orchiopexy for the detection of an unsuspected major renal anomaly. (orig.)
To find the real incidence and risk factors in asymptomatic cerebral infarction, a retrospective review was made on magnetic resonance (MR) images, which were obtained from 713 outpatients seen at the Geriatrics Research Institute Hospital between March and November of 1990. The criteria for asymptomatic cerebral infarction are: high signal intensity areas larger than 3 mm in diameter on T2-weighted image; no history of stroke; no neurological and psychological signs or symptoms with or without subjective symptoms. Symptomatic cerebral stroke was defined as stroke episodes associated with neurological signs and infarction lesions on CT or MR imaging. Of a total of 713 patients, 215 (30.2%) had symtomatic cerebral infarction and 384 (53.9%) had no cerebral lesions. The incidence of asymptomatic cerebral infarction increased with aging. Cerebral risk factors, i.e. hypertension, atrial fibrillation, and diabetes mellitus, were more significantly common in both symptomatic and asymptomatic groups than the normal control group. In the group of asymptomatic patients, T2-weighted images showed hyperintensity in the corona radiata in 60.9%, in the frontal lobe in 32.1%, in the semioval center in 28.8%, and in the basal ganglia in 23.7%. Periventricular hyperintensity was present in 124 of all 713 patients (17.4%). Common complaints in asymptomatic patients were headache (40.0%), dizziness (14.4%), and neck muscle contraction (9.8%). In conclusion, MR imaging may contribute to manage asymptomatic patients. (N.K.)
Cold is thought to provoke angina in patients with coronary disease either by an increase in myocardial demand or an increase in coronary vascular resistance. We investigated and compared the effects of cold pressor stimulation and symptom-limited supine bicycle exercise on regional myocardial perfusion in 35 patients with stable angina and coronary disease and in 10 normal subjects. Regional myocardial perfusion was assessed with positron emission tomography and rubidium-82. Following cold pressor stimulation 24 of 35 patients demonstrated significant abnormalities of regional myocardial perfusion with reduced cation uptake in affected regions of myocardium: 52 +/- 9 to 43 +/- 9 (p less than 0.001 vs normal subjects). Among these 24 patients only nine developed ST depression and only seven had angina. In contrast, 29 of 35 patients underwent supine exercise, and abnormal regional myocardial perfusion occurred in all 29, with a reduction in cation intake from 48 +/- 10 to 43 +/- 14 (p less than 0.001 vs normal subjects). Angina was present in 27 of 29 and ST depression in 25 of 29. Although the absolute decrease in cation uptake was somewhat greater following cold as opposed to exercise, the peak heart rate after cold was significantly lower than that after exercise (82 +/- 12 vs 108 +/- 16 bpm, p less than 0.05). Peak systolic blood pressures after cold and exercise were similar (159 +/- 24 vs 158 +/- 28). Thus, cold produces much more frequent asymptomatic disturbances of regional myocardial perfusion in patients with stable angina and coronary disease than is suggested by pain or ECG changes
Full Text Available BACKGROUND Almost all patients presenting with chronic hyperamylasemia undergo an expensive, long, difficult and often repeated diagnostic workup even if this occurrence is not associated with symptoms or with known pancreatotoxic factors. This is in relationship with the poor knowledge that, beside hyperenzymemia secondary to pancreatic diseases and systemic illnesses, various non-pathological forms of chronic hyperamylasemia can occur in clinical practice. AIM OF THE STUDY This study was addressed to assess the clinical characteristics of patients presenting with chronic hyperamylasemia unrelated to pancreatic diseases (CHUPD. PATIENTS AND METHODS Data of all patients with CHUPD were retrospectively reviewed (June 1997-March 2007. Forty patients were included in the study; median follow- up was 33 months (range 3-84 months. CHUPD was secondary to: a chronic benign pancreatic hyperamylasemia, 16 patients (40%; b macroamylasemia, 15 patients (37.5%; c salivary hyperamylasemia, 9 patients (22.5%. Gilbert’s syndrome was present in 13 patients (32.5%; 8 with macroamylasemia and hyperdyslipidemia in 8 patients (20%; 5 with chronic benign pancreatic hyperamylasemia. Diagnostic exams (all in the normal range performed before our observation were: Ca19-9 serum level in 37/40 (92.5%, ultrasonography and computed tomography-scan in all patients, endoscopic retrograde cholangiopancreatography in 21/40 (52.5%, abdominal magnetic resonance in 14/40 (35%. Previous diagnosis in these asymptomatic subjects were: chronic pancreatitis in 26 cases (65%; recurrent pancreatitis in 10 cases (25%; the remaining 4 patients (10% were addressed without a specific diagnosis. CONCLUSIONS In clinical practice, the occurrence of an unexplained chronic hyperamylasemia very often allows to an unappropriate diagnostic workup due to the poor familiarity with CHUPD conditions.
Maria Beatriz Sobral-Oliveira
Full Text Available CONTEXT: Alcoholism may interfere with nutritional status, but reports are often troubled by uncertainties about ingested diet and organ function, as well as by ongoing abuse and associated conditions. OBJECTIVE: To identify nutritional and body compartment changes in stable alcoholics without confounding clinical and dietetic variables, a prospective observational pilot study was designed. Three well-matched populations were considered: subjects with chronic alcoholic pancreatitis, alcoholics without visceral disease, and healthy never-drinking adults (controls. METHODS: Subjects (n = 60 were asymptomatic males with adequate diet, no superimposed disease or complication, and alcohol-free for at least 6 months. After exclusions, 48 patients were compared. Variables encompassed dietary recall, bioimpedance analysis, biochemical profile and inflammatory markers. Main outcome measures were body fat, lean body mass, serum lipids, C-reactive protein, and selected minerals and vitamins. RESULTS: Both alcoholic populations suffered from reduced lean body mass (P = 0.001, with well-maintained body fat.Magnesium was depleted, and values of vitamin D and B12 correlated with alcohol abuse. LDL and total cholesterol was increased in alcoholics without pancreatitis (P = 0.04, but not in those with visceral damage. C-reactive protein and serum amyloid A correlated with duration of excessive drinking (P = 0.01. CONCLUSIONS: Undernutrition (diminished lean body mass, risk of magnesium and vitamin deficiencies contrasted with dyslipidemia and increased cardiovascular risk. This second danger was masked during chronic pancreatitis but not in alcoholics without visceral disease. Further studies should focus special requirements of this population.
Nicolaides, Andrew N; Kakkos, Stavros K; Kyriacou, Efthyvoulos;
The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis....
Titelman, Emilia; Iversen, Aina; Kalin, Mats; Giske, Christian G
To evaluate the clinical and bacteriological efficacy of pivmecillinam against lower urinary tract infection (UTI) caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae, patients treated for lower UTI with pivmecillinam (n=8) were studied. Patients treated with nitrofurantoin (n=3) and trimethoprim (n=3) or a combination of these agents with pivmecillinam (n=3) were included as a control group. Antimicrobial susceptibility was determined with EUCAST methodology. Bacteriologic cure was defined as pivmecillinam had good clinical response (8/8), but bacteriological cure rates were low (2/8). However, none of the patients with persisting bacteriuria had a relapse of UTI symptoms within 6 months. All isolates were susceptible to the given antimicrobial. Most isolates belonged to the CTX-M-1 group (n=11, 65%) or CTX-M-9-group (n=4, 24%). Four E. coli isolates belonged to the international clone O25b-ST131 (25%). In conclusion, pivmecillinam had good clinical activity against lower UTI caused by ESBL-producing Enterobacteriaceae, but bacteriological cure rates were low. The persistent bacteriuria appears to be of little clinical importance, but larger clinical studies are needed to determine the usefulness of pivmecillinam in infections caused by ESBL-producing bacteria. PMID:22204597
Chafetz, N; Baumrind, S; Murray, W R; Genant, H K
A radiographic stereophotogrammetric technique (SPG) was used to evaluate quantitatively the presence of early femoral prosthesis subsidence after total hip arthroplasty (THA). This paper focuses on the measurement of subsidence in 12 patients who remained asymptomatic during the first two years after surgery. Only one of these had SPG estimated subsidence in excess of one millimeter at any timepoint. These findings are consistent with the conclusion that early postoperative subsidence is not a common finding among asymptomatic THA patients. PMID:6469528
Meyer, Christopher T.; McBride, William; Goldblatt, Robert S.; Borak, Jonathan; Marignani, Pierluigi; Black, Henry R.; McCallum, Richard W.
The purpose of this study was to evaluate the diagnostic yield of flexible sigmoidoscopy when performed as a routine procedure in asymptomatic patients over the age of 40 being referred for a complete physical examination. The preliminary results of this ongoing program are presented together with the diagnostic yield in 408 patients with symptoms and signs suggestive of colorectal disease who were of similar age (56.6 vs. 56.5 years) and sex distribution (79 percent male) to the asymptomatic...
Loja, Melissa N; Pevec, William C
True aneurysms of the external carotid artery (ECA) are extremely rare with an unknown incidence and natural history. We present the successful operative management of an asymptomatic 65-year-old man found to have bilateral internal carotid artery stenosis and bilateral ECA aneurysms. His bilateral carotid arteries were reconstructed with bifurcated interposition grafts in a staged fashion. The patient recovered without sequelae and continues to be asymptomatic 1 year after reconstruction. We present the operative management of this rare case. PMID:26802292
Chauhan, V S; Suprakash Chaudhury; Sudarsanan, S.; Kalpana Srivastava
Background: Psychiatric morbidity in human immunodeficiency virus (HIV) patients is being studied all over the world. There is paucity of Indian literature particularly in asymptomatic HIV individuals. Aim: The aim of the following study is to establish the prevalence and the determinants of psychiatric morbidity in asymptomatic HIV patients. Materials and Methods: A cross-sectional study was undertaken to assess psychiatric morbidity as per ICD-10 dacryocystorhinostomy criteria in 100 consec...
Nunn, M.E.; Fish, M.D.; Garcia, R.I.; Kaye, E.K.; R. Figueroa; Gohel, A.; Ito, M; Lee, H J.; Williams, D E; Miyamoto, T
Prophylactic extraction of unerupted asymptomatic third molars is the most common oral surgery procedure in the United States. However, limited evidence exists to justify its costs and associated morbidity. We analyzed data collected over 25 years from 416 adult men enrolled in the Veterans Affairs Dental Longitudinal Study to evaluate the association of retained asymptomatic third molars with risk of adjacent second molar pathology (caries and/or periodontitis), based on third molar status (...
Hancock, Viktoria; Ferrieres, Lionel; Klemm, Per
have investigated the biofilm-forming capacity on abiotic surfaces of groups of ABU strains and UPEC strains in human urine. We found that there is a strong bias; ABU strains were significantly better biofilm formers than UPEC strains. Our data suggest that biofilm formation in urinary tract infectious...
Phillips, Gemma; Lopman, Ben; Rodrigues, Laura C; Tam, Clarence C
Rotavirus is a major cause of infectious intestinal disease in young children; a substantial prevalence of asymptomatic infection has been reported across all age groups. In this study, the authors determined characteristics of asymptomatic rotavirus infection and potential risk factors for infection. Healthy persons were recruited at random from the general population of England during the Study of Infectious Intestinal Disease in England (1993-1996). Rotavirus infection was identified using reverse-transcription polymerase chain reaction. Multivariable logistic regression was used to compare exposures reported by participants with rotavirus infection with those of participants who tested negative. Multiple imputation was used to account for missing responses in the data set. The age-adjusted prevalence of asymptomatic rotavirus infection was 11%; prevalence was highest in children under age 18 years. Attendance at day care was a risk factor for asymptomatic rotavirus infection in children under age 5 years; living in a household with a baby that was still in diapers was a risk factor in older adults. The results suggest that asymptomatic rotavirus infection is transmitted through the same route as rotavirus infectious intestinal disease: person-to-person contact. More work is needed to understand the role of asymptomatic infections in transmission leading to rotavirus disease. PMID:20392863
Newman, K L; Moe, C L; Kirby, A E; Flanders, W D; Parkos, C A; Leon, J S
Noroviruses (NoV) are the most common cause of epidemic gastroenteritis world-wide. NoV infections are often asymptomatic, although individuals still shed large amounts of NoV in their stool. Understanding the differences between asymptomatic and symptomatic individuals would help in elucidating mechanisms of NoV pathogenesis. Our goal was to compare the serum cytokine responses and faecal viral RNA titres of asymptomatic and symptomatic NoV-infected individuals. We tested serum samples from infected subjects (n = 26; 19 symptomatic, seven asymptomatic) from two human challenge studies of GI.1 NoV for 16 cytokines. Samples from prechallenge and days 1-4 post-challenge were tested for these cytokines. Cytokine levels were compared to stool NoV RNA titres quantified previously by reverse transcription-polymerase chain reaction (RT-qPCR). While both symptomatic and asymptomatic groups had similar patterns of cytokine responses, the symptomatic group generally exhibited a greater elevation of T helper type 1 (Th1) and Th2 cytokines and IL-8 post-challenge compared to the asymptomatic group (all P viral RNA titre was associated positively with daily IL-6 concentration and negatively with daily IL-12p40 concentration (all P viral RNA titre, duration of viral shedding or cumulative shedding. Symptomatic individuals, compared to asymptomatic, have greater immune system activation, as measured by serum cytokines, but they do not have greater viral burden, as measured by titre and shedding, suggesting that symptoms may be immune-mediated in NoV infection. PMID:26822517
Optimal management for asymptomatic severe aortic stenosis (AS) remains controversial. Considering the increase in elderly patients, improved surgical outcomes and the introduction of transcatheter aortic valve implantation, we must reconsider the optimal management of asymptomatic severe AS. In this article, previous studies regarding the natural history of asymptomatic severe AS were reviewed to obtain a clinical perspective of AS in the growing elderly patient population. The incidence of sudden death in asymptomatic severe AS varies among studies from 0.25% to 1.7% per year, with differences related to study design and patient background. Except for very severe AS, sudden death or AS-related cardiac death without preceding symptoms is uncommon if 'watchful' waiting strategy is possible. Therefore, early operation is reasonable in very severe AS, but it is not recommended for all patients with severe AS. Using exercise tests, plasma levels of natriuretic peptides and other parameters, risk stratification of asymptomatic severe AS is needed to select patients who may have greater benefit following early operation. On the other hand, 'watchful' waiting is not always possible in real world of our practice. Patient education and periodic echocardiography are essential in 'watchful' waiting, which is not simply waiting strategy without careful monitoring. Individualised discussion regarding the indication for early operation is necessary, considering age, clinical background, predicted natural history and operative risk in each patient. PMID:27091844
Theddeus Octavianus Hari Prasetyono
Full Text Available Even though Silicone injection for breast augmentation has been related to disastrous long-term effects and complications, some patients do not develop significant symptoms at all (asymptomatic. Unfortunately, the management of asymptomatic Silicone-injected breast is still unclear and has never been reported exclusively. We present two cases of asymptomatic patients with a history of liquid Silicone injections who refused to have a mastectomy. They were concerned with the breast ptosis and chose to undergo reduction mammoplasty to improve the appearance of the breasts. Magnetic resonance imaging may be useful as an additional screening tool to confirm the diagnosis and exclude the presence of malignancy in breasts with injected Silicone. We believe that breast reduction may be the alternative option for women with a history of liquid Silicone injection who have no symptoms but desire to preserve their breasts and improve their aesthetics.
Zukauskaite, Ruta; Schmidt, Henrik; Asmussen, Jon T;
The aim of the study was to identify the frequency of asymptomatic brain metastases detected by computed tomography (CT) scans in patients with metastatic cutaneous melanoma referred to first-line systemic treatment. Between 1995 and 2009, 697 Danish patients were screened with a contrast......-enhanced CT scan of the brain before the start of interleukin-2 (IL-2)-based immunotherapy. Among the 697 patients, 80 had asymptomatic brain metastases (12%). Patients' characteristics did not differ significantly between groups with and without brain metastases. Patients received systemic treatment (IL-2......-based or cytotoxic chemotherapy), local treatment (stereotactic radiotherapy, whole-brain radiotherapy or surgery), or best supportive care only. The survival was significantly shorter for patients with asymptomatic brain metastases compared with patients without brain metastases (P...
Prasetyono, Theddeus Octavianus Hari; Sadikin, Patricia Marcellina
Even though Silicone injection for breast augmentation has been related to disastrous long-term effects and complications, some patients do not develop significant symptoms at all (asymptomatic). Unfortunately, the management of asymptomatic Silicone-injected breast is still unclear and has never been reported exclusively. We present two cases of asymptomatic patients with a history of liquid Silicone injections who refused to have a mastectomy. They were concerned with the breast ptosis and chose to undergo reduction mammoplasty to improve the appearance of the breasts. Magnetic resonance imaging may be useful as an additional screening tool to confirm the diagnosis and exclude the presence of malignancy in breasts with injected Silicone. We believe that breast reduction may be the alternative option for women with a history of liquid Silicone injection who have no symptoms but desire to preserve their breasts and improve their aesthetics. PMID:26933290
V S Chauhan
Full Text Available Background: Psychiatric morbidity in human immunodeficiency virus (HIV patients is being studied all over the world. There is paucity of Indian literature particularly in asymptomatic HIV individuals. Aim: The aim of the following study is to establish the prevalence and the determinants of psychiatric morbidity in asymptomatic HIV patients. Materials and Methods: A cross-sectional study was undertaken to assess psychiatric morbidity as per ICD-10 dacryocystorhinostomy criteria in 100 consecutive asymptomatic seropositive HIV patients and an equal number of age, sex, education, economic and marital status matched HIV seronegative control. All subjects were assessed with the general health questionnaire (GHQ, mini mental status examination, hospital anxiety and depression scale (HADS and sensation seeking scale (SSS and the scores were analyzed statistically. Results: Asymptomatic HIV positive patients had significantly higher GHQ caseness and depression but not anxiety on HADS as compared to HIV seronegative controls. On SSS asymptomatic HIV seropositive subjects showed significant higher scores in thrill and adventure seeking, experience seeking and boredom susceptibility as compared to controls. HIV seropositive patients had significantly higher incidence of total psychiatric morbidity. Among the individual disorders, alcohol dependence syndrome, sexual dysfunction and adjustment disorder were significantly increased compared with HIV seronegative controls. Conclusion: Psychiatric morbidity is higher in asymptomatic HIV patients when compared to HIV seronegative controls. Among the individual disorders, alcohol dependence syndrome, sexual dysfunction and adjustment disorder were significantly increased compared with HIV seronegative controls. High sensation seeking and substance abuse found in HIV seropositive patients may play a vital role in engaging in high-risk behavior resulting in this dreaded illness.
Full Text Available Incidence of missing IUCD iy is 0.5% - 2%. U s ually the cause is either expulsion or perforation of uterus. Sometimes the perforated IUCD remains asymptomatic for years together and found incidentally later on. We hereby presenting a case of 55 yrs female presenting with prolapsed uterus , planned for vaginal hysterectomy. During vaginal hysterectomy asymptomatic missing IUCD was detected which was found on the anterior surface of body of uterus with omentum adherent to it. KEY WORDS: M issing Cu T , IUCD , O mentum , P erforation .
Sillesen, Henrik; Falk, Erling
Measurement of ankle-brachial index (ABI) was developed to assess peripheral artery disease (PAD) in patients with symptoms of peripheral ischemia being present at rest or only functionally dependent (intermittent claudication). Reduced ABI is caused by arterial obstruction between the aortic arch....... Measuring ABI identifies asymptomatic persons at increased risk of cardiovascular morbidity and mortality: an ABI 25% in people between 80 and 90 years of age. The majority of persons with reduced ABI are asymptomatic and therefore unaware of the increased risk they are living with, thus, screening by...
Katayama, Minako; Chaliki, Hari P
Aortic stenosis (AS) is a disease that progresses slowly for years without symptoms, so patients need to be carefully managed with appropriate follow up and referred for aortic valve replacement in a timely manner. Development of symptoms is a clear indication for aortic valve intervention in patients with severe AS. The decision for early surgery in patients with asymptomatic severe AS is more complex. In this review, we discuss how to identify high-risk patients with asymptomatic severe AS who may benefit from early surgery. PMID:26981214
N Sivalingam; Loh KY
Urinary tract infections frequently affect pregnant mothers. This problem causes significant morbidity and healthcare expenditure. Three common clinical manifestations of UTIs in pregnancy are: asymptomatic bacteriuria, acute cystitis and acute pyelonephritis. Escherichia coli remains the most frequent organism isolated in UTIs. All pregnant mothers should be screened for UTIs in pregnancy and antibiotics should be commenced without delay. Urine culture and sensitivity is the gold standard in...
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Using monodisperse aerosols radiolabeled with 99mTc, we studied the effectiveness of ough and rapid inhalations for clearing mucus in en asymptomatic smokers. On three eparate study days, each subject breathed 5 um (MMAD) 99mTc-iron oxide particles under ontrolled breathing condi...
Wolsk, Helene M.; Følsgaard, Nilofar V.; Birch, Sune;
Bacterial airway colonization is known to alter the airway mucosa immune response in neonates whereas the impact of viruses is unknown. The objective was therefore to examine the effect of respiratory viruses on the immune signature in the airways of asymptomatic neonates. Nasal aspirates from 57...
The research described in this thesis concerns presence of asymptomatic vaginal Candida and vulvovaginal candidiasis. Vulvovaginal candidiasis (VVC) is an infection caused by abnormal growth of yeasts in the mucosa of the female genital tract. Acute vulvar pruritus and vaginal discharge are the usua
Acharya, Rajendra U; Faust, Oliver; Alvin, A P C; Sree, S Vinitha; Molinari, Filippo; Saba, Luca; Nicolaides, Andrew; Suri, Jasjit S
Quantitative characterization of carotid atherosclerosis and classification into symptomatic or asymptomatic type is crucial in both diagnosis and treatment planning. This paper describes a computer-aided diagnosis (CAD) system which analyzes ultrasound images and classifies them into symptomatic and asymptomatic based on the textural features. The proposed CAD system consists of three modules. The first module is preprocessing, which conditions the images for the subsequent feature extraction. The feature extraction stage uses image texture analysis to calculate Standard deviation, Entropy, Symmetry, and Run Percentage. Finally, classification is performed using AdaBoost and Support Vector Machine for automated decision making. For Adaboost, we compared the performance of five distinct configurations (Least Squares, Maximum- Likelihood, Normal Density Discriminant Function, Pocket, and Stumps) of this algorithm. For Support Vector Machine, we compared the performance using five different configurations (linear kernel, polynomial kernel configurations of different orders and radial basis function kernels). SVM with radial basis function kernel for support vector machine presented the best classification result: classification accuracy of 82.4%, sensitivity of 82.9%, and specificity of 82.1%. We feel that texture features coupled with the Support Vector Machine classifier can be used to identify the plaque tissue type. An Integrated Index, called symptomatic asymptomatic carotid index (SACI), is proposed using texture features to discriminate symptomatic and asymptomatic carotid ultrasound images using just one index or number. We hope this SACI can be used as an adjunct tool by the vascular surgeons for daily screening. PMID:21243411
Bankole Henry Oladeinde
Full Text Available This study aimed at determining the prevalence and associated risk factors for asymptomatic malaria parasitaemia and anemia among blood donors in a private medical laboratory in Benin City, Nigeria.Venous blood was collected from a total of 247 blood donors. Malaria status, ABO, Rhesus blood groups and hemoglobin concentration of all participants were determined using standard methods.The prevalence of asymptomatic malaria infection was higher among commercial blood donors than volunteer group (commercial vs volunteer donor: 27.5 %vs. 13.8%; OR = 2.373, 95% CI = 0.793, 7.107, P = 0.174. Asymptomatic malaria was not significantly affected by gender (P = 0.733, age (P = 0.581, ABO (P = 0.433 and rhesus blood groups (P = 0.806 of blood donors. Age was observed to significantly (P = 0.015 affect malaria parasite density with donors within the age group of 21-26 years having the highest risk. The prevalence of anemia was significantly higher among commercial donors (commercial vs volunteer donors: 23.4% vs 3.4%: OR = 8.551, 95% CI = 1.135, 64.437, P = 0.013 and donors of blood group O type (P = < 0.0001.Asymptomatic malaria parasitaemia and anemia was higher among commercial donors than voluntary donors. Mandatory screening of blood donors for malaria parasite is advocated to curb transfusion transmitted malaria and associated sequelae.
Goterris, Lidia; Bocanegra, Cristina; Serre-Delcor, Núria; Moure, Zaira; Treviño, Begoña; Zarzuela, Francesc; Espasa, Mateu; Sulleiro, Elena
Parasitic diseases suppose an important health problem in people from high endemic areas, so these must be discarded properly. Usually, these infections develop asymptomatically but, in propitious situations, are likely to reactivate themselves and can cause clinical symptoms and/or complications in the receiving country. Moreover, in some cases it is possible local transmission. Early diagnosis of these parasitic diseases made by appropriate parasitological techniques and its specific treatment will benefit both, the individual and the community. These techniques must be selected according to geoepidemiological criteria, patient's origin, migration route or time spent outside the endemic area; but other factors must also be considered as its sensitivity and specificity, implementation experience and availability. Given the high prevalence of intestinal parasites on asymptomatic immigrants, it is recommended to conduct a study by coproparasitological techniques. Because of its potential severity, the screening of asymptomatic malaria with sensitive techniques such as PCR (polymerase chain reaction) is also advisable. Serological screening for Chagas disease should be performed on all Latin American immigrants, except for people from the Caribbean islands. Other important parasites, which should be excluded, are filariasis and urinary schistosomiasis, by using microscopic examination. The aim of this paper is to review the different techniques for the screening of parasitic diseases and its advices within the care protocols for asymptomatic immigrants. PMID:27474244
Ekwall, E; Ljungh, A; Selander, B
The first case of asymptomatic urinary tract infection caused by Shigella sonnei in a patient, a 74-yr-old man, who was not a faecal carrier and had no history of dysentery is reported. Treatment with pivmecillinam 400 mg 3 times daily for 14 days was instituted and the bacteria were eradicated. The time and source of infection is unknown. PMID:6364325
Chu, Colin; Scanlon, Peter
Asymptomatic bilateral optic disc swelling was detected in a 19-year-old man with type 1 diabetes through routine photographic screening for retinopathy. He was found to have significant vitamin B12 deficiency which the authors believe was the cause for the optic neuropathy. After B12 replacement, visual function and optic disc appearances returned to normal.
Borry, P.; Evers-Kiebooms, G.; Cornel, M.C.; Clarke, A.; Dierickx, K.
Although various guidelines and position papers have discussed, in the past, the ethical aspects of genetic testing in asymptomatic minors, the European Society of Human Genetics had not earlier endorsed any set of guidelines exclusively focused on this issue. This paper has served as a background d
Iwabuchi, Yasuo; Hanamure, Yutaka; Hirota, Johji; Ohyama, Masaru [Kagoshima Univ. (Japan). Faculty of Medicine
The detection of lesions of the paranasal sinuses as incidental findings during magnetic resonance imaging of patients suspected of intracranial disease who have no nasal symptoms has been far more common than we expected. The present study was performed on 325 patients with a mean age of 60.7 years. Medical histories were taken whether they had any nasal symptoms or not. Asymptomatic sinus disease was present in 41.6% of the 257 patients who had no nasal symptoms, and 9.7% of the patients had either marked mucosal thickening, excessive fluid or polyps in the maxillary sinuses. Although the mean age of these patients was comparatively high, we can infer that 1 in 10 have relatively severe sinus lesions. Mucociliary transport time was measured using the saccharin method in 15 patients who had sinus disease but no nasal symptoms. The mean transport time was 15.6 minutes and within normal limits. Routine ENT examination revealed no lesions in the nasal cavity of any of the subjects. We classified the patients with asymptomatic sinus disease into two groups -- group A: patients with sinus disease associated with some nasal manifestations but who did not complain about them, and group B: patients who had sinus disease but did not have any nasal problems. Group B represents genuine asymptomatic sinus disease in the narrow sense. Most asymptomatic patients in this study appeared to belong to group B. They had some sinus disease, but because their mucociliary function in their nasal cavity was normal, they did not have any nasal symptoms. When we find patients with asymptomatic sinus disease, we have to determine which group they belong to by examining their nasal cavity and measuring their saccharin time. Patients in group A should be medically treated, but those in group B should be followed without medical treatment. (author).
The detection of lesions of the paranasal sinuses as incidental findings during magnetic resonance imaging of patients suspected of intracranial disease who have no nasal symptoms has been far more common than we expected. The present study was performed on 325 patients with a mean age of 60.7 years. Medical histories were taken whether they had any nasal symptoms or not. Asymptomatic sinus disease was present in 41.6% of the 257 patients who had no nasal symptoms, and 9.7% of the patients had either marked mucosal thickening, excessive fluid or polyps in the maxillary sinuses. Although the mean age of these patients was comparatively high, we can infer that 1 in 10 have relatively severe sinus lesions. Mucociliary transport time was measured using the saccharin method in 15 patients who had sinus disease but no nasal symptoms. The mean transport time was 15.6 minutes and within normal limits. Routine ENT examination revealed no lesions in the nasal cavity of any of the subjects. We classified the patients with asymptomatic sinus disease into two groups -- group A: patients with sinus disease associated with some nasal manifestations but who did not complain about them, and group B: patients who had sinus disease but did not have any nasal problems. Group B represents genuine asymptomatic sinus disease in the narrow sense. Most asymptomatic patients in this study appeared to belong to group B. They had some sinus disease, but because their mucociliary function in their nasal cavity was normal, they did not have any nasal symptoms. When we find patients with asymptomatic sinus disease, we have to determine which group they belong to by examining their nasal cavity and measuring their saccharin time. Patients in group A should be medically treated, but those in group B should be followed without medical treatment. (author)
Bodtger, Uffe; Poulsen, Lars K.; Malling, Hans-Jørgen
The skin prick test is the allergologic test of choice, but asymptomatic skin sensitization to aeroallergens is common. However, no data in the literature describe the clinical phenotype of asymptomatic sensitized adults....
Carlos Henrique Marques dos Santos
Full Text Available The endoscopic finding of ileal ulcers, alone or in small number, is not usual, but when it occurs in asymptomatic patients, an impasse may be generated regarding the action to be taken, since the medical literature is unclear as to how to proceed in this situation. OBJECTIVE: Evaluate patients with ileal ulcers, single or in a small number, asymptomatic, and their follow-up. METHODS: The author reports a series of asymptomatic cases (23 patients of ulcers - single or in small number - found in colonoscopy exams performed for other reasons than typical clinical manifestations of Crohn's disease. RESULTS: Most patients were not treated and remained asymptomatic during the follow-up period. CONCLUSIONS: The patients remained asymptomatic and without treatment in most cases, and, considering the small number of cases and the short observation time, this study does not allow to conclude that this is the best practice in case of asymptomatic patients with ileal ulcer.O achado endoscópico de úlceras ileais, isoladas ou em pequeno número, não é frequente, mas quando ocorre em pacientes assintomáticos pode gerar um impasse quanto à conduta a ser tomada, já que a literatura médica não é clara quanto a como se proceder nessa situação. OBJETIVO: Avaliar pacientes que apresentaram úlceras ileais solitárias ou em pequena quantidade, assintomáticos e a evolução clínica dos mesmos. MÉTODOS: O autor relata uma série de casos (23 pacientes assintomáticos que apresentaram úlceras ileais únicas ou em pequeno número em colonoscopias realizadas por outros motivos que não manifestações clínicas típicas de doença de Crohn. RESULTADOS: A maioria dos pacientes não foi tratada e permaneceu assintomática pelo período de acompanhamento. CONCLUSÕES: Os pacientes permaneceram assintomáticos e sem tratamento em sua maioria, salientando-se o reduzido número de casos e o curto tempo de observação, de modo a não permitirem a este estudo
Keeling, Aoife N
The clinical importance of angiographically detected asymptomatic lower-limb stenoses and occlusions is unknown. This study aims to (i) assess the clinical outcome of asymptomatic lesions in the lower limb, (ii) identify predictors of clinical deterioration, and (iii) determine which asymptomatic lower-limb lesions should be treated at presentation.
Full Text Available Congenital sternal defects are rare deformities frequently associated with other anomalies of the chest wall and other organ systems. Although pectus excavatum, pectus carinatum, and cleft sternum can present as isolated deformity, in most cases they are associated with heart and inner organs anomalies and described as symptoms of syndromes like Marfan syndrome, Noonan syndrome, Poland anomaly, and Cantrell pentalogy. In contrast, the etiology of an isolated defect is not well understood. We observed a short sternum (dysmorphic manubrium, hypoplastic body, and complete absence of the xiphoid process in a completely asymptomatic 13-year-old woman. A comprehensive instrumental exams panel was performed to exclude associated anomalies of the heart and of the other organ systems. The patient was completely asymptomatic and she did not need any medical or surgical treatment. To our knowledge, this is the first case of isolated short sternum reported in literature.
Furuya-Kanamori, Luis; Cox, Mitchell; Milinovich, Gabriel J.; Magalhaes, Ricardo J. Soares; Mackay, Ian M.
Influenza infection manifests in a wide spectrum of severity, including symptomless pathogen carriers. We conducted a systematic review and meta-analysis of 55 studies to elucidate the proportional representation of these asymptomatic infected persons. We observed extensive heterogeneity among these studies. The prevalence of asymptomatic carriage (total absence of symptoms) ranged from 5.2% to 35.5% and subclinical cases (illness that did not meet the criteria for acute respiratory or influenza-like illness) from 25.4% to 61.8%. Statistical analysis showed that the heterogeneity could not be explained by the type of influenza, the laboratory tests used to detect the virus, the year of the study, or the location of the study. Projections of infection spread and strategies for disease control require that we identify the proportional representation of these insidious spreaders early on in the emergence of new influenza subtypes or strains and track how this rate evolves over time and space. PMID:27191967
Objective: To select a subgroup of type-2 diabetics with two additional pre specified risk factors to see that whether there is any benefit of screening such patients. Methodology: Five hundred twenty six patients were sent for treadmill stress test or thallium scan. Those who had abnormal results were advised coronary angiography. The angiographically proven CAD was correlated with various risk factors to find the relationship between the disease and variables. Results: Two hundred thirty five (48%) patients had abnormal results and among them 158 (67%)underwent coronary angiography. Among these 21% had evidence of CAD. Coronary artery bypass grafting (CABG) was performed in 35(33%) patients, catheter based intervention (PCI) in 44(40%) patients and 30(27%) patients were not suitable for intervention. Duration of diabetes, smoking, diabetic retinopathy, albuminuria, and peripheral vascular disease were significant predictor of asymptomatic CAD. Conclusion: This study has demonstrated strong relationship between risk factors and asymptomatic CAD in type 2 diabetics. (author)
Del Puerto, Helen L; Vasconcelos, Anilton C.; Luciana Moro; Fabiana Alves; Braz, Gissandra F; Almir S. Martins
A quantitative real time polymerase chain reaction (PCR) revealed canine distemper virus presence in peripheral blood samples from asymptomatic and non vaccinated dogs. Samples from eleven domestic dogs with no signs of canine distemper and not vaccinated at the month of collection were used. Canine distemper virus vaccine samples in VERO cells were used as positive controls. RNA was isolated with Trizol®, and treated with a TURBO DNA-free kit. Primers were designed for canine distemper virus...
Babic, A.; Mathiesen, U.; Hedin, K.; Bodemar, G.; Wigertz, O.
Discovering not yet seen knowledge from clinical data is of importance in the field of asymptomatic liver diseases. Avoidance of liver biopsy which is used as the ultimate confirmation of diagnosis by making the decision based on relevant laboratory findings only, would be considered an essential support. The system based on Quinlan's ID3 algorithm was simple and efficient in extracting the sought knowledge. Basic principles of applying the AI systems are therefore described and complemented ...
Arslankoylu Ali Ertug; Kuyucu Necdet; Yilmaz Berna; Erdogan Semra
Abstract Introduction This study aimed to examine the incidence, epidemiology, and clinical characteristics of symptomatic and asymptomatic candidiasis in a pediatric intensive care unit (PICU), and to determine the risk factors associated with symptomatic candidiasis. Methods This retrospective study included 67 patients from a 7-bed PICU in a tertiary care hospital that had Candida-positive cultures between April 2007 and July 2009. Demographic and clinical characteristics of the patients, ...
Niederle, Bruno; Wémeau, Jean-Louis
A large majority of the currently diagnosed patients with hyperparathyroidism (PHPT) are mild or asymptomatic, mainly women after menopause. Following the debate held at the 16th European Congress of Endocrinology in Wroclaw (Poland) from May 3-7, 2014, arguments are here presented by a surgeon and a medical practitioner considering these situations rather have to profit from surgery, or simply from survey. For the trained endocrine surgeon, it is evident that parathyroidectomy confirms the diagnosis and undoubtedly reduces the discomfort felt by certain patients, prevents all risks of complications, removes patients and medical teams from the monitoring and represents a real individual financial benefit. On the other hand, the medical practitioner considers that mild or asymptomatic PHPT is commonly stable, and very rare are the subjects at risk of complications, particularly of fractures; prevention of vascular and metabolic disorders, nephrolithiasis and bone rarefaction justify regular physical exercise, a safe alimentation, a sufficient calcium and high water intake, the correction of the frequent deficit in vitamin D; finally has also to be considered the impossibility to refer to specialized (endocrine) surgeons, the enormous cohort of subjects more than 50 years with 'mild' or 'asymptomatic' PHPT. The surgeon and the medical practitioner agree to consider that in patients with 'mild' or 'asymptomatic' disease, there is no place for medical treatments, in particular calcimimetics and bisphophonates. Both agree that further studies are needed to clarify the long-term prognosis of operated and non-operated PHPT in term of fractures, cardiovascular risk and mortality. Individual and collective cost/benefit ratios of surgery or survey are also still imperfectly evaluated. PMID:26101370
Lee, Jo Ann; Halbert, Susan E; Dawson, William O; Robertson, Cecile J; Keesling, James E; Singer, Burton H
Huanglongbing (HLB) is a bacterial infection of citrus trees transmitted by the Asian citrus psyllid Diaphorina citri. Mitigation of HLB has focused on spraying of insecticides to reduce the psyllid population and removal of trees when they first show symptoms of the disease. These interventions have been only marginally effective, because symptoms of HLB do not appear on leaves for months to years after initial infection. Limited knowledge about disease spread during the asymptomatic phase is exemplified by the heretofore unknown length of time from initial infection of newly developing cluster of young leaves, called flush, by adult psyllids until the flush become infectious. We present experimental evidence showing that young flush become infectious within 15 d after receiving an inoculum of Candidatus Liberibacter asiaticus (bacteria). Using this critical fact, we specify a microsimulation model of asymptomatic disease spread and intensity in a grove of citrus trees. We apply a range of psyllid introduction scenarios to show that entire groves can become infected with up to 12,000 psyllids per tree in less than 1 y, before most of the trees show any symptoms. We also show that intervention strategies that reduce the psyllid population by 75% during the flushing periods can delay infection of a full grove, and thereby reduce the amount of insecticide used throughout a year. This result implies that psyllid surveillance and control, using a variety of recently available technologies, should be used from the initial detection of invasion and throughout the asymptomatic period. PMID:26034273
Rodrigo Benedet Scheidt
Full Text Available OBJECTIVE: to determine the prevalence of radiographic signs of femoroacetabular impingement (FAI in asymptomatic adults and correlate them with data from physical examinations. METHODS: We conducted a cross-sectional study with 82 asymptomatic volunteers, 164 hips, between 40 and 60 years of age, selected by convenience. They were submitted to anamnesis and clinical examination of the hip, anteroposterior (AP pelvis radiographs with three incidences, Dunn 45° and Lequesne false profile of each hip, to measure the variables. We measured the alpha angle, anterior offset of the femoral neck, cervical diaphyseal angle, CE angle of Wiberg, acetabular index, Sharp angle, and the crossing, ischial spine and posterior wall signs. RESULTS: our sample consisted of 66% women, mean age of 50.4 years. The average alpha angle was 45.10°, SD=8.6. One quarter of the hips showed alpha angle greater than or equal to 50°; among men the prevalence was 34%, and among women, 11%. We found indicative radiographic signs of femoroacetabular impingement in 42.6% of hips, whether femoral or acetabular, and the increased alpha angle was related to the decrease in hip internal rotation (p<0.001. CONCLUSION: the radiographic findings of femoroacetabular impingement in asymptomatic patients were frequent in the studied sample. The increase in alpha angle was associated with decreased internal rotation.
Dietrich, Tobias Johannes; Pfirrmann, Christian W.A. [University of Zurich, Radiology, Orthopedic University Hospital Balgrist, Zurich (Switzerland); Figueira da Silva, Flora Luciana [University of Zurich, Radiology, Orthopedic University Hospital Balgrist, Zurich (Switzerland); Radiology, Hospital Mae de Deus and Mae de Deus Center, Porto Alegre, RS (Brazil); Abreu, Marcelo Rodrigues de [Radiology, Hospital Mae de Deus and Mae de Deus Center, Porto Alegre, RS (Brazil); Klammer, Georg [University of Zurich, Orthopedic Surgery, Orthopedic University Hospital Balgrist, Zurich (Switzerland)
To evaluate the spectrum and frequency of MR findings of the first metatarsophalangeal joint (MTPJ) in asymptomatic volunteers. MR imaging of 30 asymptomatic forefeet was performed with a dedicated extremity 1.5-Tesla system. Participants were between 20 and 49 years of age (mean ± SD: 35.5 ± 8.4 years). Two radiologists assessed cartilage, bone, capsuloligamentous structures, and tendons of first MTPJs on MR images. Cartilage defects were observed in 27 % (n = 8) of first MTPJs, most frequently located at the base of the proximal phalanx (23 %, n = 7), whereas cartilage defects of the metatarsal head (13 %, n = 4) and the metatarsosesamoid compartment were rare (0 %-3 %, n = 0-1). Bone marrow oedema-like signal changes were present in 37 % (n = 11) and subchondral cysts in 20 % (n = 6) of first MTPJs. Hyperintense areas on intermediate-weighted sequences (range: 30-43 %, n = 9-13) and on fluid-sensitive sequences with fat suppression (range: 33-60 %, n = 10-18) within the medial and lateral collateral ligament complex were common. Plantar recesses (77 %, n = 23) and distal dorsal recesses (87 %, n = 26) were frequently observed. Cartilage defects, bone marrow oedema-like signal changes, subchondral cysts, plantar recesses, and distal dorsal recesses were common findings on MRI of first MTPJs in asymptomatic volunteers. The collateral ligaments were often heterogeneous in structure and showed increased signal intensity. (orig.)
Greve, Anders; Gerdts, Eva; Boman, Kurt;
BACKGROUND: The frequency and prognostic importance of atrial fibrillation (AF) in asymptomatic mild-to-moderate aortic stenosis (AS) has not been well described. METHODS: Clinical examination, electrocardiography and echocardiography were obtained in asymptomatic patients with mild-to-moderate AS...... in 55 (3.5%) and no AF in 1,421 (90.9%). Incidence of new-onset AF was 1.2%/year; highest in those with impaired LV function. In multivariable analysis, longstanding AF was compared to no AF at baseline, associated with a 4.1-fold higher risk of heart failure (CI 1.2 to 13.8, p=0.02) and a 4.8-fold...... higher risk of non-hemorrhagic stroke (CI 1.7 to 13.6, p=0.003). CONCLUSION: Rate of AF is moderate in asymptomatic AS. Longstanding but not episodic AF was, independently predictive of increased risk of heart failure and non-hemorrhagic stroke. New-onset AF was associated with cardiac decompensation....
Ali Salah K
Full Text Available Abstract Background Urinary tract infections (UTI can lead to poor maternal and perinatal outcomes. Investigating epidemiology of UTI and antibiotics sensitivity among pregnant women is fundamental for care-givers and health planners. Methods A cross sectional study has been conducted at Khartoum north teaching hospital Antenatal Care Clinic between February-June 2010, to investigate epidemiology of UTI and antibiotics resistance among pregnant women. Structured questionnaires were used to gather data from pregnant women. UTI was diagnosed using mid stream urine culture on standard culture media Results Out of 235 pregnant women included, 66 (28.0% were symptomatic and 169 (71.9% asymptomatic. the prevalence of bacteriuria among symptomatic and asymptomatic pregnant women were (12.1%, and (14.7% respectively, with no significant difference between the two groups (P = 0.596, and the overall prevalence of UTI was (14.0%. In multivariate analyses, age, gestational age, parity, and history of UTI in index pregnancy were not associated with bacteriuria. Escherichia coli (42.4% and S. aureus (39.3% were the commonest isolated bacteria. Four, 2, 2, 3, 4, 2 and 0 out of 14 E. coli isolates, showed resistance to amoxicillin, naladixic acid, nitrofurantoin, ciprofloxacin, co-trimoxazole, amoxicillin/clavulanate and norfloxacin, respectively Conclusion Escherichia coli were the most prevalent causative organisms and showing multi drug resistance pattern, asymptomatic bacteriuria is more prevalent than symptomatic among pregnant women. Urine culture for screening and diagnosis purpose for all pregnant is recommended.
Kim, Younoh; Radoias, Vlad
Asymptomatic conditions such as hypertension are generally hard to diagnose, absent routine medical examinations. This is especially problematic in developing countries, where most citizens do not engage in routine examinations due to limited economic resources. We study the roles of education and individual time preferences in asymptomatic disease detection and management. Using discrete choice models on a sample of 4209 hypertensive Indonesian adults surveyed between November 2007 and April 2008, we find that both education and individual time preferences play important roles. However, the effects are different for people in good health than they are for people in bad health. Education does not seem to matter for disease detection when respondents are in good general health, and its effects on disease management vary largely in magnitudes between these groups. In terms of disease detection, more educated respondents have a higher probability of being diagnosed, but only conditional on being in poor general health. Time preferences, on the other hand, matter for respondents in good general health, but the effect is not significant for those in bad health. More impatient respondents that are in good health have a higher probability of being under-diagnosed because they are more likely to forgo routine physicals. The findings point to two distinct channels through which education can affect health, and suggest that different types of policies need to be implemented, in order to reach the entire population. Traditional programs that stimulate education and improve the socio-economic status of individuals in developing countries are helpful, but they do not address the whole problem. Besides its more usual positive effects, education can also negatively affect the health of asymptomatic patients, because it reflects a higher opportunity cost of engaging in preventative health screenings. PMID:26722984
Xiao-Hua Jiang; Ren-Qian Zhong; Xiao-Yun Fan; Yin Hu; Feng An; Jian-Wen Sun; Xian-Tao Kong
AIM: To investigate the presence of M2 antibodies specific for pdmary biliary cirrhosis (PBC) in asymptomatic Chinese and identify patients with early PBC.METHODS: Enzyme-linked immunosorbent assay (ElISA)tests for M2 antibodies to recombinant protein were performed in 5 011 subjects (age range, 26-85 years; mean age: 45.81±15.02 years) who took an annual physical examination. M2-positive subjects were further analyzed for immunoglobulin (Ig) classes and subclasses of M2 antibodies.Clinical, biochemical and immunological data were obtained for M2-positive subjects. In addition, ultrasonography (US)or endoscopic retrograde cholangio-pancreatography (ERCP)was performed to exclude any disorders other than PBC.RESULTS: M2 antibodies were detected in 8 (0.16%) of the 5 0LL subjects studied. Of the 8 subjects, 7 were female and 1 was male (age range: 40-74 years). An unexplained increase of serum alkaline phosphatase (ALP) and gamma glutamyl transpeptidase (γ-GT) values, often to striking levels,was detected in 4 M2-positive subjects, 3 of them accorded with the diagnostic criteria recommended by the American Association for the Study of Liver Diseases, even though they had no symptoms of PBC (such as fatigue, pruritus or jaundice).Liver biopsy was performed in two M2-positive subjects and the histology was compatible with PBC in both cases.CONCLUSION: Our data, while not assessing the true prevalence of asymptomatic PBC in the general population,suggest that asymptomatic PBC is much more common in China than has been supposed.