Bacteriuria and pyelonephritis, diagnosis and treatment

According to Kass, a significant bacteriuria means that there are more than 105 germs/ml in the urine. Every bacteriuria needs intensive therapy, otherwise, even if asymptomatic, in a high percentage pyelonephritis will develop. A comparative investigation of 1167 urine samples showed that of the screening tests the modified Griess test was the most reliable (91.8%). The TTC test was positive in 76%. More than 90% positive results were obtained by Gram staining of centrifuged urine. Midstream collection of urine was used in every case. The results in chronic pyelonephritis and pregnancy with bacteriuria emphasize the necessity of intermittent long-term treatment. For this therapy schedule was developed. Preconditions for a successful treatment are: a differentiation of germs and the preparation of an antibiogram.