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PubMed1987

[The analysis of prognostic factors on postsurgical pyuria of benign prostatic hypertrophy].

The outcome of postsurgical pyuria in benign prostatic hypertrophy was studied in 87 patients, and the factors that might affect the outcome were determined. No significant differences were found between operation method and duration until normalization of pyuria, which was 75.5 +/- 46.0 days for transurethral resection of the prostate, 72.7 +/- 30.6 days for suprapubic prostatectomy and 69.3 +/- 32.7 days for retropubic prostatectomy. Prognostic factors were statistically analyzed preoperatively, at operation, and postoperatively. The definite prognostic factors were preoperative diabetes mellitus, preoperative pyuria, preoperative bacteriuria, and postoperative hypoproteinemia. The probable prognostic factors were old-age, preoperative indwelling catheters, heavy prostate tissue, postoperative bacteriuria, postoperative anemia and postoperative complications.

Aged↗

PubMed1996

Evaluation of dipstrips, direct gram stain and pyuria as screening tests for the detection of bacteriuria.

Two hundred and fifty cases of clinically suspected urinary tract infection were analysed for the detection of bacteriuria. Parameters studied included direct Gram staining, pyuria on microscopic examination of uncentrifuged urine and dip strip method for the detection of blood, protein, nitrite and leucocyte esterase. Significant bacteriuria (colony count 10(5) per ml) was found in 112 cases with a positivity ranging from 65 to 83% for the presence of blood, protein, nitrite and leucocyte esterase. Highest positive predictive values were obtained with the presence of nitrite and leucocyte esterase (98%), blood, protein and nitrite (94%) as well as with blood, protein, nitrite and leucocyte esterase (98%). Both pyuria and direct Gram staining were positive in 85% cases. The combined presence of both these parameters gave 100% positive predictive value. Gram staining combined with pyuria was more effective and economical as compared to the dipstrips for the detection of bacteriuria.

Bacteriological Techniques↗

PubMedDate not supplied

Detection of pyuria and bacteriuria in symptomatic ambulatory women.

OBJECTIVE: To compare the abilities of two methods for rapid detection of pyuria and three methods of urinalysis to predict significant bacteriuria in symptomatic ambulatory women. DESIGN: Prospective simultaneous comparison of the results of dipstick urinalysis, standard microscopic urinalysis, and hemocytometric cell counting and Gram staining with the results of a standard urine culture. SETTING: Two outpatient ambulatory care facilities serving predominantly minority and uninsured individuals. SELECTION CRITERIA: Nonpregnant women presenting with symptoms of urinary tract infection without symptoms of vaginal infection. MEASUREMENTS AND MAIN RESULTS: 105 women with symptoms were evaluated. The sensitivities of the dipstick urinalysis and the microscopic urinalysis in predicting pyuria as defined by hemocytometry were 0.76 and 0.77, respectively, and their specificities were 0.94 and 0.97, respectively. The sensitivities and specificities of the three methods of urinalysis in predicting greater than or equal to 10(4) colony-forming units (CFU)/mm3 in a urine culture were 0.88 and 0.70 for the leukocyte esterase-nitrite dipstick urinalysis, 0.98 and 0.68 for the standard microscopic urinalysis, and 1.00 and 0.49 for the Gram staining and hemocytometric cell counting. CONCLUSIONS: The standard urinalysis was the most accurate single method to predict significant bacteriuria in symptomatic ambulatory women. Sequencing the dipstick urinalysis with the standard urinalysis may be a cost-effective approach to evaluating these patients in clinical practice.

Adolescent↗

PubMed2006

The prevalence of asymptomatic pyuria in diabetic patients: comparison of the Sysmex UF-100 automated urinalysis analyzer with Fuchs-Rosenthal hemacytometer.

OBJECTIVE: We investigated the prevalence of asymptomatic pyuria (ASP) in diabetic patients and compared the Sysmex UF-100 with Fuchs-Rosenthal hemacytometer. DESIGN AND METHODS: ASP prevalence was investigated in 227 diabetic patients. Imprecision, accuracy and correlation of UF-100 with hemacytometer in measuring leukocyte counts were determined. RESULTS: Diabetic women and men had significantly higher ASP prevalence than non-diabetic women (21.4 vs. 8.7%) and men (12.2 vs. 3.4%). Disease duration and HbA(1C) levels were similar in diabetic patients with and without ASP. UF-100 and hemacytometer readings correlated significantly (r=0.88) without a significant bias. Within-run coefficients of variations for UF-100 (8.14, 6.35 and 12.18%) and hemacytometer (5.14, 5.18 and 8.03%) did not differ significantly. CONCLUSIONS: Prevalence of ASP is increased in diabetic patients and not affected by duration of disease or control of hyperglycemia. UF-100 seemed to be a reliable, precise and accurate system to determine pyuria.

Aged↗

PubMed2005

Mycoplasma hominis and Ureaplasma urealyticum in patients with sterile pyuria.

OBJECTIVES: Mycoplasma hominis and Ureaplasma urealyticum are associated with various diseases of the urogenital tract, but they are usually not detected by routine microbiological diagnosis. The aim of this study was to asses the prevalence of these organisms in patients with sterile pyuria. METHODS: From December 2000 to June 2001 all urine samples sent in to microbiological diagnosis, which yielded > or =500 leucocytes/ml and <10(4) bacteria/ml, were collected for this study. Thirty-three samples from 30 patients (female: 21, male: nine; median age: 60 years, range: 23-91 years) met these criteria and were subjected to PCR for detection of M. hominis and U. urealyticum, respectively. RESULTS: M. hominis and U. urealyticum were detected in 2 (7%) and 6 samples (20%), respectively. With regard to the underlying diseases of the patients, glomerulonephritis was significantly associated with the detection of urogenital mycoplasmas (p=0.02). CONCLUSION: The prevalence of M. hominis and U. urealyticum found in this study corresponds to the expected prevalence in the general population. This finding does not indicate an association of sterile pyuria with urogenital mycoplasma infection/colonization.

Adult↗

PubMed1994

Pyuria and bacteriuria in urine specimens obtained by catheter from young children with fever.

Results of urinalysis and culture of 2181 urine specimens obtained by catheter from febrile children aged less than 24 months were analyzed to determine the following: (1) an optimal cutoff point in considering a bacterial colony count clinically "significant," (2) the accuracy of leukocyte esterase and nitrite tests in identification of pyuria and bacteriuria, and (3) the utility of pyuria (defined as > or = 10 leukocytes/mm3) in the discrimination of urinary tract infection from asymptomatic bacteriuria. Among 110 urine cultures with > or = 10,000 colony-forming units per milliliter, 92 (84%) had > or = 100,000 CFU/ml, 10 (9%) had 50,000 to 99,000 CFU/CFU/ml and 8 (7%) had 10,000 to 49,000 CFU/ml. Urine specimens with 1000 to 49,000 CFU/ml were more likely than specimens with > or = 50,000 CFU/ml to yield Gram-positive or mixed organisms (36/60 vs 7/109; p < 0.001). A count of < 10 leukocytes/mm3 was almost invariably associated with a sterile culture; a count of > or = 10 leukocytes/mm3 was found in 93 of 102 patients with > or = 50,000 CFU/ml. The dipstick leukocyte esterase test had sensitivities of 52.9% and 66.7% in detecting > or = 10 leukocytes/mm3 and > or = 20 leukocytes/mm3, respectively. The dipstick nitrite test had a sensitivity of 31.4% in detecting bacteriuria (> or = 50,000 CFU/ml). Acute pyelonephritis was diagnosed by a renal scan with dimercaptosuccinic acid labeled with technetium 99m in 50 (77%) of 65 patients with > or = 10 leukocytes/mm3 but in none of five patients with < 10 leukocytes/mm3 (p < 0.01). The findings in these five patients were consistent with colonization of the urinary tract rather than infection. For urine specimens obtained by catheter, we believe that urinary tract infection is best defined by both a leukocyte count > or 10/mm3 and a CFU count > or = 50,000/ml. This definition almost always discriminates among true urinary tract infection, bacteriuria resulting from contamination of the urine specimen, and asymptomatic bacteriuria.

Bacteriuria↗

PubMed1987

Significance of immediate preoperative bacteriuria with pyuria in renal transplant recipients.

The presence of bacteriuria and pyuria on urinalysis immediately before renal transplantation has resulted in cancellation of surgery because of concern about post-transplant wound infection. Of 113 renal transplant recipients reviewed 41 (36 per cent) had 5 or more white blood cells per high power field with bacteria in either a voided urine or bladder washout specimen obtained just before grafting. Of those 41 patients 2 suffered postoperative wound infections. Of 72 patients (64 per cent) with less than 5 white blood cells or no bacteria on a preoperative specimen 1 suffered a wound infection (p not significant by Fisher's exact test). Preoperative urine cultures and operative bladder cultures of all 3 patients failed to yield the organisms found later in the wound infections. The factors of sex, insulin-dependent diabetes, delayed graft function, living related versus cadaver donor and pre-transplant splenectomy had no significant relationship to wound infection rates. Renal transplantation can be performed safely in patients who have pyuria and bacteriuria but no signs or symptoms of infection.

Adult↗

PubMed1986

Pyuria: its predictive value of asymptomatic bacteriuria in ambulatory elderly men.

A total of 664 urine samples collected from 254 asymptomatic, ambulatory, elderly men was examined for pyuria with a standardized glass slide microscopy method. The presence or absence of more than 10 polymorphonuclear leukocytes per high power field was highly predictive of the presence or absence of significant bacteriuria, respectively. The determination of pyuria in this select population may be a useful and inexpensive test to screen for bacteriuria.

Aged↗

PubMed1983

Association of bacteriuria and pyuria during intermittent catheterization after spinal cord injury.

Because patients on intermittent catheterization often suffer asymptomatic bacteriuria it is important to know how serious such a colonization may be. We followed 156 hospitalized spinal cord injury subjects on intermittent catheterization. Daily bacterial cultures were performed. When bacteriuria was detected bacterial cultures and uncentrifuged urinary leukocytes were quantified. Gram-positive bacteria, such as Staphylococcus epidermidis and Streptococcus faecalis, produced minimal white cell response, even in high colony counts. However, gram-negative and fungal organisms elicited significant pyuria. Analysis of pyuria in conjunction with urine cultures may serve as a clinical guide to treatment of significant bacteriuria.

Bacteriuria↗

PubMed1993

Occurrence of pyuria and bacteriuria in asymptomatic hemodialysis patients.

Patients with end-stage renal disease on hemodialysis have documented defects in their immune responses, and infections contribute significantly to their morbidity and mortality. This study prospectively detected and quantitated leukocyturia and bacteriuria in asymptomatic hemodialysis patients. Thirty-one percent of asymptomatic hemodialysis patients had significant pyuria (> 10 white blood cells per high-power field) and 25% had bacteriuria of pathologic dimensions, (> 1 x 10(5)/mL of a single microorganism). Pyuria was a good marker for significant bacteriuria in these patients. These results demonstrate that the urinary tract, even in ESRD patients on hemodialysis, may represent a significant reservoir for infection.

Bacteriuria↗

PubMed1995

A prospective study of bacteriuria and pyuria in catheter specimens from hospitalized children, Durban, South Africa.

In a prospective study of 180 children admitted consecutively to King Edward VIII Hospital, bacteriuria (BU) was detected in 47 (26%), associated with pyuria in 35. BU occurred in association with other common childhood diseases in all but one child: acute lower respiratory tract infection (LRTI) in 43%, gastro-enteritis (GE) in 34% and protein energy malnutrition (PEM) in 26%. Conversely, BU was detected in 24% of children with LRTI, 33% with GE and 38% with PEM. Children with or without BU thus presented with similar symptoms and signs, except for vomiting and dehydration which were more frequent in those with BU. The male:female ratio was higher in BU under 2 years of age. Localizing urinary tract symptoms and signs were infrequent. Only one of the 35 children in whom ultrasonography was performed showed structural defects. The organisms detected (mainly Escherichia coli) were resistant to commonly used antibacterial drugs. There was a high specificity for dipstix testing, but low sensitivity, possibly because of sampling by catheter. There were seven deaths, three with and four without BU. Other illnesses contributed to death in all cases. Our findings have implications for the management of children who are hospitalized for common diseases in developing countries. It is not clear whether pyuria and BU were transient or indicative of serious disease of the kidney and urinary tract.

Anti-Bacterial Agents↗

PubMed2004

Effect of cranberry extract on bacteriuria and pyuria in persons with neurogenic bladder secondary to spinal cord injury.

OBJECTIVE: To determine whether antibacterial effects of cranberry extract will reduce or eliminate bacteriuria and pyuria in persons with spinal cord injury (SCI). DESIGN: Randomized, double-blind, placebo-controlled study. PARTICIPANTS: Participants were people with SCI residing in the community who were 1 year or longer postinjury with neurogenic bladder managed by intermittent catheterization or external collection device and a baseline urine culture demonstrating at least 10(5) colonies per milliliter of bacteria. METHODS: Each participant ingested 2 g of concentrated cranberry juice or placebo in capsule form daily for 6 months. Baseline urinalysis and cultures were performed at the time of the initial clinic visit and monthly for 6 months. Microbiologic data were evaluated using analysis of variance with repeated measures. RESULTS: Twenty-six persons received cranberry extract and 22 persons received placebo. There were no differences or trends detected between participants and controls with respect to number of urine specimens with bacterial counts of at least 10(4) colonies per milliliter, types and numbers of different bacterial species, numbers of urinary leukocytes, urinary pH, or episodes of symptomatic urinary tract infection. CONCLUSION: Cranberry extract taken in capsule form did not reduce bacteriuria and pyuria in persons with SCI and cannot be recommended as a means to treat these conditions.

Adult↗

PubMed2005

Prolonged fever and pyuria: a urinary tract infection presentation of incomplete Kawasaki disease.

UNLABELLED: We report two patients with incomplete Kawasaki disease that presented as apparent urinary tract infection. Persistent fever and pyuria were the initial presentation without concomitant signs suggestive of Kawasaki disease; thus the patients were treated as urinary tract infection. Fever persisted despite antibiotic treatment. Diagnostic criteria of Kawasaki disease were not fulfilled for these two patients, yet aneurysmal dilatation of the coronary artery was noted 10 and 18 d, respectively, after the onset of fever. The diagnosis of incomplete Kawasaki disease was assigned when the coronary artery abnormality was detected. Fever subsided within 24 h of administration of intravenous immunoglobulin. CONCLUSION: This report highlights the potentially misleading presentation of fever and pyuria as the sole initial manifestation of incomplete Kawasaki disease. Echocardiography is indicated to detect coronary artery abnormality when fever persists in such patients after adequate antibiotic treatment and thorough urological evaluation.

Coronary Vessels↗

PubMed1994

New support for a folk remedy: cranberry juice reduces bacteriuria and pyuria in elderly women.

Cranberry juice has developed a following as a simple, nonpharmacologic means to reduce or treat urinary tract infections, yet the scientific basis for such a claim has been lacking. A new study suggests that bacterial infections (bacteriuria) and associated influx of white blood cells into the urine (pyuria) can be reduced by nearly 50% in elderly women who drink 300 mL of cranberry juice cocktail each day over the course of a 6-month study. The results of this study suggest that consumption of cranberry juice is more effective in treating than preventing bacteriuria and pyuria. Along with earlier reports on the ability of cranberry juice to inhibit bacterial adherence to urinary epithelial cells in cell culture, this new work suggests that drinking cranberry juice each day may be clinically useful. Additional work must be conducted, however, to more completely define the efficacy of cranberry juice.

Aged↗

PubMed1998

[Evaluation of pyuria by means of urinary sediment method--a comparison to the counting chamber method].

We compared the urinary sediment method to counting chamber method in evaluating pyuria, in order to elucidate an issue of urinary sediment method. The KOVA system was used for counting chamber method. Three hundred and ten urine specimens from the patients who visited Fuji City Central Hospital in March, 1995, were employed. The numbers of leukocytes of each specimen was counted by means of urinary sediment method and counting chamber method, and compared. The urinary leukocyte count evaluating by means of these two methods were correlated well. However, the discrepancy of urinary leukocyte counts by means of these two methods were recognized in two specimens. In these two specimens, the leukocyte count was 1 to 4/5HPF by means of urinary sediment method, but more than 50/microliter by means of counting chamber methods. Significant bacteria (10(4) cfu/ml or more), positive esterse reaction, and high pH (8.5) were recognized in both specimens. In addition, one of two these specimens was hypotonic (specific gravity was 1.008). Therefore, it was suggested that leukocytes were sometimes disrupted with centrifugation. These results indicate that counting chamber method is more useful urinary sediment method to detect pyuria.

Adolescent↗

PubMed1985

Detection of bacteriuria and pyuria within two minutes.

A study was performed to evaluate two rapid urine screening methods, Bac-T-Screen (Marion Laboratories, Inc., Kansas City, Mo.) and Chemstrip LN (Boehringer Mannheim Diagnostics, BioDynamics, Indianapolis, Ind.), for their ability to screen for bacteriuria and pyuria within 2 min. A total of 1,000 urine specimens were tested with the Bac-T-Screen and the Chemstrip LN and compared with a semiquantitative plate culture method. Of the 1,000 specimens tested, 249 had colony counts of greater than or equal to 10(5) CFU/ml by the culture method. Of these, the Bac-T-Screen detected 94.8% (236 of 249) and the Chemstrip LN detected 84.7% (210 of 249). There were 120 pure cultures of probable pathogens of which the Bac-T-Screen detected 97.5% (117 of 120) and the Chemstrip LN detected 91.7% (110 of 120). Leukocyte counts were performed on all specimens, and both methods have the ability to detect greater than 10 leukocytes per mm3 in a majority (greater than 93%) of the specimens. The cost per test for a negative screen is approximately $1.30 for the Bac-T-Screen and $0.40 for the Chemstrip LN. Overall there is a similar negative predictive value with both methods for bacteriuria and pyuria.

Bacteriological Techniques↗

PubMed1969

Prevalence of symptomless urinary tract disease in Birmingham schoolchildren. I. Pyuria and bacteriuria.

In a pilot project 2,122 schoolchildren were screened for symptomless urinary tract disease by the examination of midstream urine specimens. These were tested for albumin, blood, and glucose with Labstix commercial strips, together with microscopy for abnormal cellular excretion.One case of renal glycosuria was found but none of previously undiagnosed diabetes mellitus. Out of 1,096 boys, 11 (1%) had pyuria-a leucocyte count greater than 10/cu.mm.-but only four showed abnormal counts on retesting. None had urinary tract infection.Out of 1,026 girls, 96 (9.3%) had pyuria initially but 35 were normal on retesting. Of the remaining 61 girls, 59 attended the outpatients department for further investigation, and in 30 vulvitis appeared to be the sole cause. Ten were proved to have significant bacteriuria and six of them showed radiological abnormalities.It is suggested that careful long-term studies are needed to study the economics and the implications of screening on a national scale.

Adolescent↗

PubMed1989

Quantification of pyuria by two methods correlation and interobserver agreement.

The aim of this study was to correlate the results of two methods of quantifying pyuria and to compare the diagnostic reliability of the two methods in terms of interobserver agreement. Three independent observers counted leucocytes in 56 urine samples by using high-power-field (HPF) microscopy on centrifuged urine sediment and by using a Bürker haemocytometer on uncentrifuged urine. The commonly accepted diagnostic level of ten leucocytes/mm3 in the haemocytometer was found to be equivalent to two leucocytes/HPF. This agrees with other reports but contrasts with the usual notion of a diagnostic level of five to ten leucocytes/HPF, and implies that urinary tract infection in the presence of symptoms should not be ruled out when less than five leucocytes/HPF are found. Kappa statistics were used to evaluate the interobserver agreement. The observers agreed on the diagnosis in 96% (K = 0.92) of the urines when the haemocytometer was used, and in 93-96% (K = 0.81-K = 0.91) when leucocytes were counted per HPF. The differences in Kappa values were not statistically significant. Our material indicates that the method of quantifying pyuria in centrifuged urine sediment by HPF microscopy may be used as the routine method in general practice.

Humans↗