984. Persistence of Asymptomatic Bacteriuria (ASB) in Young Healthy Women
Session: Poster Abstract Session: Clinical Studies of Bacterial Infection
Saturday, October 22, 2011
Room: Poster Hall B1
Background: ASB is defined as >105 cfu per mL of a uropathogen in a voided midstream urine specimen (MSU). We have previously demonstrated that persistent ASB at >105 cfu per mL is rare in young health women, but it is possible that intermittent fluctuations in colony count, due to hydration, etc, might mask longer consecutive episodes of ASB. We have explored ASB in women using different definitions of ASB.

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). Consecutive episodes of ASB with a given uropathogen were compared using the standard definition of ≥105 cfu/mL vs. an alternative definition of an ASB episode allowing for consecutive days with ≥103 cfu/mL before and/or after days with ≥105 cfu/mL.

Results: Using the standard definition of an ASB episode vs. the alternative definition, there were 10 women with BHEC ASB,  20 episodes (range 1-10 days) using the standard definition vs. 12 episodes (range 1-21 days) using the alternative definition.  Twenty women had NHEC ASB, comprised of 23 episodes (range 1-5 days) vs. 21 episodes (range 1-16 days). For Group B strep, there were 12 women with 25 episodes (range 1-4 days) vs. 24 episodes (range 1-9 days).  For Klebsiella, Citrobacter, or Staphylococcus saprophyticus, ≥105 cfu per mL was infrequent, and rarely found on consecutive days, even with allowing for drops to 103 cfu/mL.

Conclusion: Allowing for lower colony counts on days adjacent to days with ≥105 cfu results in fewer but longer ASB episodes in young healthy women, and possibly captures the true duration of colonization. NHEC ASB is more common than BHEC ASB, but BHEC ASB tends to persist for longer durations.


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

Thomas Hooton, MD, FIDSA1, Pacita Roberts, MS2 and Ann Stapleton, MD2, (1)Medicine, University of Miami, Miami, FL, (2)University of Washington, Seattle, WA

Disclosures:

T. Hooton, None

P. Roberts, None

A. Stapleton, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.