The prevalence of asymptomatic urinary-tract infection in pre-school children.
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Urine samples from 1000 pre-school children aged 4 weeks to 5 years, attending welfare centres, nursery schools or day nurseries in one London borough, were cultured by the dip-slide method. Five children had asymptomatic bacteriuria, a prevalence of 0-5 per cent. The need for screening the urine of pre-school children is discussed.Keywords:
Asymptomatic Bacteriuria
Borough
Pre school
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A positive urine culture does not prove that a patient has a urinary tract infection (UTI). The term asymptomatic bacteriuria (ASB) is used to suggest that a patient has bacteria in the urine but not a true infection; a true UTI is bacteriuria in association with specific symptoms arising from the urinary tract. Women without urinary tract symptoms but with two consecutive urine cultures containing 100,000 colony-forming units per milliliter (cfu/mL) of a single isolate, obtained by clean catch of a voided specimen, have, by definition, ASB. ASB in men is defined in a similar way, except that only one urine culture with 100,000 cfu/mL of a single organism is needed to meet the definition. A catheter specimen from asymptomatic men or women that grows 100 cfu/mL also meets the definition of ASB. Patients without urinary tract symptoms but with significant bacteria in their urine have ASB and not a UTI.
Asymptomatic Bacteriuria
Pyuria
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We read with interest the article of Geerlings et al. (1) that analyzed asymptomatic bacteriuria as a complication in diabetic women. It is known that urinary tract infections (UTIs) are an important problem in diabetic individuals, and bacteriuria is more common in diabetic women than in nondiabetic women (2) because of several factors that predispose diabetic individuals to infection (3). Furthermore, many UTIs are asymptomatic, and, as observed by Vejlsgaard (4), it is not clear if symptomatic infections are preceded by asymptomatic bacteriuria (ASB). Several studies confirm that there is a higher prevalence of ASB in diabetic women than in nondiabetic women (1). Unfortunately, ASB is not easily detected, even if there are some elements and clinical signs that indicate the presence of ASB. Furthermore, …
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The test for antibody-coated bacteria in urine for the diagnosis of the anatomical level of urinary tract infections was evaluated in children with UTI. The ability of the test to differentiate between an upper and lower infection is influenced by the antiglobulin preparation used, since too sensitive an antiglobulin probably detects nonspecifically bound antibodies. Staphylococcal protein A seems to be well suited for use as an antiglobulin in this test. Using staphylococcal protein A all children with X-ray findings suggesting renal damage had antibody-coated bacteria in the urine, however, nine infants and 5 children and clinical symptoms of pyelonephritis had a negative test. Of 28 children with clinical symptoms of cystitis only one had a positive test. Of 50 children with asymptomatic bacteriuria 9 had antibody-coated bacteria in the urine; 41 had not. The findings indicate that the method might be useful in establishing the anatomical level of urinary tract infection and might also be useful for screening children with asymptomatic bacteriuria who risk developing kidney infections.
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Upper urinary tract
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