794. Asymptomatic Bacteriuria in Young Healthy Women
Session: Abstracts: Oral Abstract Session: Bacterial Clinical Studies I
Friday, October 22, 2010: 2:00 PM
109-110

Background: Asymptomatic bacteriuria (ASB) is defined as >105 cfu per mL of a uropathogen in a voided midstream urine specimen (MSU). Little is known about the natural history of ASB in non-pregnant women. In a previous study of young women who submitted monthly MSUs, we found that persistent ASB was rare. In the current study, we have further explored ASB in women who performed daily self-collected MSUs over a 3-month period.

Methods: 101 healthy women, age 18-49, with acute cystitis were enrolled in a prospective cohort study and self-collected MSUs daily for 3 months. Escherichia coli were characterized as B-hemolytic (BHEC) or nonhemolytic (NHEC). Days with ≥105 cfu/mL of uropathogens were evaluated on days that did not fall on or 7 days after the enrollment or recurrent UTI (rUTI). An ASB episode was defined as ≥1 consecutive days with ≥105 cfu/mL of a given uropathogen.

Results: ASB was present in 3.14% of 6300 daily MSU specimens. BHEC, NHEC, enterococci, and Group B strep (GBS) were the most common uropathogens. The 44 BHEC ASB constituted 20 episodes (range, 1-10 days) in 10 women, while the 41 NHEC ASB constituted 23 episodes (range, 1-5 days) in 20 women. 50% and 43%, respectively, of episodes lasted >1 day and 25% and 17%, respectively, lasted >2 days. BHEC ASB occurred in fewer women, but tended to be more persistent than NHEC ASB. GBS ASB occurred on 33 days, enterococci 24 days, Klebsiellae 11 days, Staphylococcus saprophyticus 4 days, S. aureus 4 days, Citrobacter 1 day, and Enterobacter, Proteus, Serratia, Pseudomonas, and Morganella morganii 0 days. 61% of NHEC episodes, 35% of BHEC episodes, 24% of the 25 GBS episodes, and none of the 23 enterococci episodes occurred within 1 week of a rUTI.

Conclusion: In this detailed study of young healthy women submitting daily self-collected MSUs, we have confirmed that ASB, including E. coli ASB, is intermittent and transient. Even ASB episodes that last for 2 consecutive days (the conventional definition of ASB) rarely last more than a few days. E. coli ASB often precedes subsequent rUTI.


Subject Category: C. Clinical studies of bacterial infections and antibacterials including sexually transmitted diseases and mycobacterial infections (surveys, epidemiology, and clinical trials)

Speakers:
Thomas M. Hooton, MD , Medicine, University of Miami Miller School of Medicine, Miami, FL
Pacita L. Roberts, MS , Medicine, University of Washington, Seattle, WA
Walter Stamm, MD , Medicine, University of Washington, Seattle, WA
Ann E. Stapleton, MD , Medicine, University of Washington, Seattle, WA

Disclosures:

T. M. Hooton, None

P. L. Roberts, None

W. Stamm, None

A. E. Stapleton, None

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