Low-count bacteriuria in refractory idiopathic detrusor overactivity versus controls

Background. Previous studies suggest an association between idiopathic detrusor overactivity (IDO) and high-count bacteriuria (>105 CFU/mL). Recently, the importance of low-count bacteriuria (103–105 CFU/mL) in dysuric women with has been recognised. However, the optimal microbiological thresho...

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Main Authors: Colin Walsh, Wendy Allen, Katrina Parkin, Chinmoy Mukerjee, Kate Moore
Format: Article
Language:English
Published: PAGEPress Publications 2011-07-01
Series:Urogynaecologia International Journal
Subjects:
Online Access:http://www.urogynaecologia.org/index.php/uij/article/view/77
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author Colin Walsh
Wendy Allen
Katrina Parkin
Chinmoy Mukerjee
Kate Moore
author_facet Colin Walsh
Wendy Allen
Katrina Parkin
Chinmoy Mukerjee
Kate Moore
author_sort Colin Walsh
collection DOAJ
description Background. Previous studies suggest an association between idiopathic detrusor overactivity (IDO) and high-count bacteriuria (>105 CFU/mL). Recently, the importance of low-count bacteriuria (103–105 CFU/mL) in dysuric women with has been recognised. However, the optimal microbiological threshold for women with overactive bladder (OAB) symptoms remains unclear. Design and Methods A 2-year prospective cohort study, to examine the incidence of low-count and high-count bacteriuria in women with refractory IDO (RIDO) versus a control group without OAB symptoms. Women with dysuria, voiding dysfunction or recent urethral instrumentation were excluded. Mid-stream urine (MSU) specimens were collected during acute symptomatic exacerbation in the IDO group and cultured at the 103 CFU/mL threshold. Statistical analysis was performed using Statsdirect statistical package 2.7.2. Results. Between November 2007 and November 2009, 218 study MSU specimens were collected. Both the overall incidence of any significant bacteriuria ≥103 CFU/mL (P<0.0001) and the incidence of low-count bacteriuria (P=0.0091) were significantly higher in the RIDO women than the controls. There were no baseline differences in age, menopausal status or prior continence surgery between the groups. In the RIDO group, specimens positive for low-count bacteriuria only were less likely to be associated with significant pyuria P<0.0001) and were cultured from younger women (P=0.0009), than specimens positive for high-count bacteriuria. Conclusions The prevalence of bacteriuria in women with RIDO during symptomatic exacerbation is 40%, which is significantly higher than the incidence in similarly-aged women without OAB. One-third of positive cultures show low-count bacteriuria only. The management of women with RIDO should include a search for bacteriuria, including low-count bacteriuria.
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spelling doaj.art-a812a4191a104729b3437e536787d4952022-12-22T02:07:16ZengPAGEPress PublicationsUrogynaecologia International Journal1121-30862038-83142011-07-0125110.4081/uij.2011.e4Low-count bacteriuria in refractory idiopathic detrusor overactivity versus controlsColin WalshWendy AllenKatrina ParkinChinmoy MukerjeeKate MooreBackground. Previous studies suggest an association between idiopathic detrusor overactivity (IDO) and high-count bacteriuria (>105 CFU/mL). Recently, the importance of low-count bacteriuria (103–105 CFU/mL) in dysuric women with has been recognised. However, the optimal microbiological threshold for women with overactive bladder (OAB) symptoms remains unclear. Design and Methods A 2-year prospective cohort study, to examine the incidence of low-count and high-count bacteriuria in women with refractory IDO (RIDO) versus a control group without OAB symptoms. Women with dysuria, voiding dysfunction or recent urethral instrumentation were excluded. Mid-stream urine (MSU) specimens were collected during acute symptomatic exacerbation in the IDO group and cultured at the 103 CFU/mL threshold. Statistical analysis was performed using Statsdirect statistical package 2.7.2. Results. Between November 2007 and November 2009, 218 study MSU specimens were collected. Both the overall incidence of any significant bacteriuria ≥103 CFU/mL (P<0.0001) and the incidence of low-count bacteriuria (P=0.0091) were significantly higher in the RIDO women than the controls. There were no baseline differences in age, menopausal status or prior continence surgery between the groups. In the RIDO group, specimens positive for low-count bacteriuria only were less likely to be associated with significant pyuria P<0.0001) and were cultured from younger women (P=0.0009), than specimens positive for high-count bacteriuria. Conclusions The prevalence of bacteriuria in women with RIDO during symptomatic exacerbation is 40%, which is significantly higher than the incidence in similarly-aged women without OAB. One-third of positive cultures show low-count bacteriuria only. The management of women with RIDO should include a search for bacteriuria, including low-count bacteriuria.http://www.urogynaecologia.org/index.php/uij/article/view/77BacteriuriaDetrusor overactivityOveractive bladderRefractoryUrinary tract infection
spellingShingle Colin Walsh
Wendy Allen
Katrina Parkin
Chinmoy Mukerjee
Kate Moore
Low-count bacteriuria in refractory idiopathic detrusor overactivity versus controls
Urogynaecologia International Journal
Bacteriuria
Detrusor overactivity
Overactive bladder
Refractory
Urinary tract infection
title Low-count bacteriuria in refractory idiopathic detrusor overactivity versus controls
title_full Low-count bacteriuria in refractory idiopathic detrusor overactivity versus controls
title_fullStr Low-count bacteriuria in refractory idiopathic detrusor overactivity versus controls
title_full_unstemmed Low-count bacteriuria in refractory idiopathic detrusor overactivity versus controls
title_short Low-count bacteriuria in refractory idiopathic detrusor overactivity versus controls
title_sort low count bacteriuria in refractory idiopathic detrusor overactivity versus controls
topic Bacteriuria
Detrusor overactivity
Overactive bladder
Refractory
Urinary tract infection
url http://www.urogynaecologia.org/index.php/uij/article/view/77
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AT katrinaparkin lowcountbacteriuriainrefractoryidiopathicdetrusoroveractivityversuscontrols
AT chinmoymukerjee lowcountbacteriuriainrefractoryidiopathicdetrusoroveractivityversuscontrols
AT katemoore lowcountbacteriuriainrefractoryidiopathicdetrusoroveractivityversuscontrols