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At least 19 recordsLinked to original sources
PubMed1989

[Postoperative pyuria after TUR-P: the study of postoperative pyuria by using NFLX].

The postoperative duration of pyuria was studied in 35 patients who underwent transurethral resection of the prostate (TUR-P). The average postoperative duration of pyuria was 58.0 +/- 23.6 days. The age over 70 years, preoperative indwelling of urethral catheter and the preoperative urinary tract infection did not make the duration of pyuria longer. The volume of resected prostatic tissue over 20 g and the existence of diabetes mellitus make it significantly longer. It is effective and safe to use a low-dose antibacterial agent such as NFLX which has a broad spectrum and hardly develops bacterial resistance after TUR-P. It is suggested unnecessary to change the anti-bacterial agent even when pyuria continues.

Aged↗
PubMed2001

Significance of isolated hematuria and isolated pyuria in systemic lupus erythematosus.

Hematuria or sterile pyuria as isolated urinary findings present a clinical dilemma for the treating physician. Our objective was to determine whether isolated hematuria and isolated sterile pyuria are associated with active systemic lupus erythematosus (SLE) with respect to renal and non-renal disease activity. This is a descriptive study from a large SLE cohort followed prospectively at the University of Toronto Lupus Clinic. All episodes of isolated hematuria and isolated pyuria between 1970 and 2000 were identified from our database. Isolated hematuria was defined as > 5 red blood cells per high power field; isolated sterile pyuria was defined as > 5 white blood cells per high power field in the absence of urinary infection and other renal manifestations. Non-renal disease activity (defined as nrSLEDAI > 1) was determined at first episode of isolated hematuria and pyuria. Renal disease activity was assessed by scoring renal biopsies within 3 months of detecting isolated hematuria or sterile pyuria. Thirty-four percent (323/946) of our cohort had at least one episode of isolated hematuria. Seventy-seven percent of these patients had concurrent non-renal disease activity. Of the 22 biopsies scored with isolated hematuria, 96% were abnormal (WHO > class I), including 52% with active nephritis. Twenty-three percent (215/946) had at least one episode of isolated sterile pyuria. Seventy-eight percent of these patients had concurrent non-renal disease activity. All 12 biopsies scored with isolated pyuria were abnormal (WHO Class > 1), including 75% with active nephritis. The appearance of isolated hematuria and isolated pyuria is associated with active renal and non-renal disease activity. An ongoing debate has emerged regarding the significance of isolated hematuria and isolated pyuria with respect to SLE disease activity. The results of this study suggest that isolated hematuria and isolated pyuria is associated with active renal and non-renal disease activity. Thus isolated hematuria and isolated sterile pyuria should be considered manifestations of active SLE.

Biopsy↗
PubMed1996

Pyuria among chronically incontinent but otherwise asymptomatic nursing home residents.

OBJECTIVE: To determine the prevalence of pyuria and its relationship to bacteriuria in a representative sample of chronically incontinent nursing home residents. DESIGN: Prospective, descriptive case series. SETTING: Six nursing homes. PARTICIPANTS: Two hundred fourteen chronically incontinent, but otherwise asymptomatic, nursing home residents who were enrolled in a clinical intervention trial for urinary incontinence. MEASURES: Two hundred fourteen urine specimens were collected by a validated clean catch technique. Each specimen underwent dipstick testing for leukocyte esterase, microscopic urinalysis to determine the number of white blood cells per high power field of centrifuged urine, and quantitative urine culture using standard laboratory techniques. RESULTS: The overall prevalence of pyuria was 45%, as defined by > 10 white blood cells per high field of spun urine, and the overall prevalence of bacteriuria was 43%, as defined by the growth of > 100,000 colony forming units of a urinary pathogen. Fifty-nine percent of the specimens with bacteriuria and 34% of the specimens without bacteriuria had pyuria. Of specimens with pyuria, 56% had bacteriuria, and of specimens without pyuria, 31% had bacteriuria. When any colon change on the leukocyte esterase pad was considered positive, this finding had a sensitivity of 83% and a specificity of 52% for pyuria on microscopic urinalysis. CONCLUSIONS: Pyuria is common among chronically incontinent nursing home residents, both in the presence and absence of bacteriuria. Clinicians must therefore be cautious in interpreting the presence of pyuria to indicate symptomatic infection in this population. Using pyuria to determine the need for antimicrobial treatment could result in unnecessary expense and morbidity as well as contribute to the development of resistant organisms in nursing homes. Research is needed to define pyuria better, to determine its prevalence and relationship to bacteriuria among nursing home residents with symptoms of acute urinary tract infection, and to elucidate the etiology and significance of sterile pyuria in this population.

Aged↗
PubMed1992

Detection of bacteriuria and pyuria by URISCREEN a rapid enzymatic screening test.

A multicenter study was performed to evaluate the ability of the URISCREEN (Analytab Products, Plainview, N.Y.), a 2-min catalase tube test, to detect bacteriuria and pyuria. This test was compared with the Chemstrip LN (BioDynamics, Division of Boehringer Mannheim Diagnostics, Indianapolis, Ind.), a 2-min enzyme dipstick test; a semiquantitative plate culture method was used as the reference test for bacteriuria, and the Gram stain or a quantitative chamber count method was used as the reference test for pyuria. Each test was evaluated for its ability to detect probable pathogens at greater than or equal to 10(2) CFU/ml and/or greater than or equal to 1 leukocyte per oil immersion field, as determined by the Gram stain method, or greater than 10 leukocytes per microliter, as determined by the quantitative count method. A total of 1,500 urine specimens were included in this evaluation. There were 298 specimens with greater than or equal 10(2) CFU/ml and 451 specimens with pyuria. Of the 298 specimens with probable pathogens isolated at various colony counts, 219 specimens had colony counts of greater than or equal to 10(5) CFU/ml, 51 specimens had between 10(4) and 10(5) CFU/ml, and 28 specimens had between 10(2) and less than 10(4) CFU/ml. Both the URISCREEN and the Chemstrip LN detected 93% (204 of 219) of the specimens with probable pathogens at greater than or equal to 10(5) CFU/ml. For the specimens with probable pathogens at greater than or equal to 10(2) CFU/ml, the sensitivities of the URISCREEN and the Chemstrip LN were 86% (256 of 298) and 81% (241 of 298), respectively. Of the 451 specimens with pyuria, the URISCREEN detected 88% (398 of 451) and Chemstrip LN detected 78% (350 if 451). There were 204 specimens with both greater than or equal to 10(2) CFU/ml and pyuria; the sensitivities of both methods were 95% (193 of 204) for these specimens. Overall, there were 545 specimens with probable pathogens at greater than or equal to 10(2) CFU/ml and/or pyuria. The URISCREEN detected 85% (461 of 545), and the Chemstrip LN detected 73% (398 of 545). A majority (76%) of the false-negative results obtained with either method were for specimens without leukocytes in the urine. There were 955 specimens with no probable pathogens or leukocytes. Of these, 28% (270 of 955) were found positive by the URISCREEN and 13% (122 of 955) were found positive by the Chemstrip LN. A majority of the false-positive results were probably due, in part, to the detection of enzymes present in both bacterial and somatic cells by each of the test systems. Overall, the URISCREEN is rapid, manual, easy-to-perform enzymatic test that yields findings similar to those yielded by the Chemstrip LN for specimens with both greater than or equal to 10(2) CFU/ml and pyuria or for specimens with greater than or equal to 10(5) CFU/ml and with or without pyuria. However, when the data were analyzed for either probable pathogens at less 10(5) CFU/ml or pyuria, the sensitivity of the URISCREEN was higher (P less than 0.05).

Bacteriological Techniques↗
PubMed1994

[Asymptomatic bacteriuria and pyuria during pregnancy].

BACKGROUND: The presence of pyuria and the role of mixed culture in the diagnosis of asymptomatic bacteriuria in pregnant women have been evaluated METHODS: One hundred and sixty four pregnant women without any symptomatology have been studied using two cultures of mid-stream urine samples and pyuria quantification. In addition culture of bladder urine has been carried out in 17 of these patients (12 with pure cultures and 5 with mixed cultures). RESULTS: 110 samples were culture negative without pyuria; 7 were pure cultures with pyuria; 19 pure culture without pyuria and the remaining 28 patients yielded mixed culture with or without pyuria in the first culture. Twenty of these 28 mixed cultures were negative in the second culture. A estimated frequency of asymptomatic bacteriuria in pregnancy was 16% and pyuria was only found in 27% of pregnant women with asymptomatic bacteriuria. CONCLUSION: The pyuria is not a useful marker for the diagnosis of asymptomatic bacteriuria in pregnancy.

Bacteria↗
PubMed2000

The relationship between pyuria and infection in patients with indwelling urinary catheters: a prospective study of 761 patients.

BACKGROUND: Pyuria is universally considered as essential for identifying urinary tract infections in noncatheterized patients. The utility of pyuria in the catheterized patient, to identify catheter-associated urinary tract infection (CAUTI), has not been adequately defined. METHODS: We prospectively studied 761 newly catheterized patients in a university hospital; 82 (10.8%) developed nosocomial CAUTI (> 10(3) colony-forming units per milliliter). While catheterized, each patient was seen daily, a quantitative urine culture was obtained, and the urine white blood cell concentration was measured quantitatively using a hemocytometer. RESULTS: The mean urine leukocyte count in patients with CAUTI was significantly higher than in patients without infections (71 vs 4 per microliter; P= .006). Pyuria was most strongly associated with CAUTI caused by gram-negative bacilli (white blood cell count, 121 vs 4 per microliter; P = .03); infection with coagulase-negative staphylococci and enterococci (white blood cell count, 39 vs 4 per microliter; P = .25) or yeasts (white blood cell count, 25 vs 4 per microliter; P = .15) produced much less pyuria. Pyuria with a white blood cell count greater than 10 per microliter (>5 per high-power field in a conventional urinalysis) had a specificity of 90% for predicting CAUTI with greater than 10(5) colony-forming units per milliliter but a sensitivity of only 37%. CONCLUSIONS: In patients with short-term indwelling urinary catheters, pyuria is less strongly correlated with CAUTI than in noncatheterized patients with urinary tract infection. The strongest association is with CAUTI caused by gram-negative bacilli; the association is far weaker for infections caused by gram-positive cocci or yeasts. Most patients with CAUTI are asymptomatic and do not have associated fever. Pyuria should not be used as the sole criterion to obtain a urine culture in a patient with a catheter.

Adult↗
PubMed1983

Measurement of pyuria and its relation to bacteriuria.

Excluding specimen contamination, bacteriuria indicates either urinary colonization (replication of bacteria in urine without evidence of tissue invasion) or urinary tract infection (bacteriuria associated with clinical, histologic, or immunologic evidence of host injury). Practically speaking, measuring pyuria is the most readily available means of establishing the presence of host injury, thus differentiating colonization from infection. Careful studies have established the nonpathologic limits for pyuria (less than 10 leukocytes/mm3 in uncentrifuged urine) and have compared methods for its measurement. The most commonly used method, determination of cells per high power field in centrifuged urine, is not reproducible and does not correlate with either the actual leukocyte excretion rate or the cells per cubic millimeter as enumerated in a counting chamber. When clinical studies using the latter method of determining pyuria were reviewed, the following conclusions emerged: (1) 10 leukocytes/mm3 or greater occur in less than 1 percent of asymptomatic, nonbacteriuric patients but in greater than 96 percent of symptomatic men and women with significant bacteriuria; (2) most symptomatic women with pyuria but without significant bacteriuria have urinary infection either with bacterial uropathogens present in colony counts less than 10(5)/ml or with Chlamydia trachomatis; (3) women with asymptomatic bacteriuria probably should be divided into two subgroups: those with true asymptomatic infection (associated with pyuria) and those with transient, self-limited bladder colonization; and (4) most patients with catheter-associated bacteriuria also have pyuria and hence infection. In view of its potential value to both clinicians and microbiologists, pyuria should be accurately determined and expressed as cells per cubic millimeter in uncentrifuged urine.

Bacteria↗
PubMed1998

[Study on the duration of pyuria after transurethral resection of prostate].

A retrospective study was conducted on the duration of pyuria after transurethral resection of the prostate (TURP) and the factors affecting the duration in 273 patients, who were diagnosed as having benign prostatic hyperplasia (BPH) with postoperative resolution of pyuria among those who underwent TURP over the last ten years at our clinic. In the 273 patients, the mean (+/- SD) weight of the resected prostate was 13.2 +/- 10.2 g (range : 1-52 g), the mean operating time was 74.3 +/- 29.8 min (25-215 min), the duration of pyuria was 110.6 +/- 38.3 days (23-273 days), and the resected weight to operating time ratio was 0.172 +/- 0.093 g/min (0.018-0.500 g/min). There was a significant correlation between the duration of pyuria and the patient's age, resected weight, operating time, or resected weight/operating time ratio, resected weight being the most important factor. The surgeon, the postoperative antibiotics used, and the preoperative existence of pyuria did not have any significant effect on the duration of postoperative pyuria. Investigation after stratification by the resected weight in 10 g increments suggested that a shorter operating time was important to reduce the duration of postoperative pyuria, particularly in BPH patients with a resected weight of 20-29 g.

Age Factors↗
PubMed1978

Significance of pyuria in urinary sediment.

Microscopic examination of the urinary sediment to determine the degree of pyuria is an accepted method to screen for urinary tract infection. We investigated the significance of pyuria in relation to the method of specimen acquistion, number of white blood cells and isolation of pathogens on culture. Only 36 per cent of our patients with more than 10 white blood cells per high power field on examination of the first random specimen had more than 10 white blood cells per high power field when a repeat clean catch midstream specimen was examined, and only 20 per cent of the patients had more than 10(5) pathogens per ml. on culture. However, the finding of more than 10 white blood cells per high power field on a clean catch mid stream specimen indicated more than 10(5) pathogens per ml. in 40 per cent of the cases. The use of a higher threshold for significant pyuria (more than 20 white blood cells per high power field) on examination of a random specimen increased the incidence of more than 10(5) bacteriuria found in specimens with initial pyuria by 43 per cent and represents the additional detection of 8.7 per cent of the total poputation studied. These data indicate that when screening for pyuria and infection one should either obtain a clean catch midstream specimen for examination of urinary sediment or increase the threshold for significant pyuria on a random specimen.

Adult↗
PubMed1996

Regression of pyuria during the treatment of symptomatic urinary tract infection in patients with spinal cord injury.

Pyuria is frequently present in patients who require bladder instrumentation. Using the hemocytometer chamber method, we prospectively studied the regression of pyuria in 29 spinal cord-injured (SCI) men with symptomatic urinary tract infection (UTI) who were grouped according to the method of bladder drainage: (a) Intermittent catheterization program (ICP; 10 patients); (b) Suprapubic tube (SPT; 10 patients); and (c) Indwelling foley catheters (IFC; 9 patients). All of the patients experienced relief of presenting symptoms within 3-4 days of receiving appropriate antibiotic therapy. The clinical response was associated with > or = 65% and > or = 87% reduction in the levels of pyuria at mid-therapy and after completion of antimicrobial therapy, respectively. Using a one-way analysis of variance, the group of patients who underwent ICP had significantly lower residual levels of pyuria at mid-therapy and after completion of therapy when compared to the other two groups (P < 0.05). The findings of relatively lower absolute levels of pyuria in the ICP group vs the SPT and IFC group of patients suggest that the response of pyuria to appropriate therapy for symptomatic UTI can be assessed better and earlier in patients who undergo ICP.

Adult↗
PubMed1992

Pyuria: index of infection in patients with spinal cord injuries.

Little is known about the significance of pyuria in patients with spinal cord injuries. The progress in hospital of 55 such patients was studied. They were divided into 2 groups according to the method of bladder drainage on admission. Group A comprised 43 patients with indwelling catheters. Group B comprised 12 patients who were able to void with tapping, with/without compression and on intermittent catheterisation. The results showed that group A had a mean pyuria level of 185 WBC/HPF on admission. The incidence of urinary tract infection was 4 per patient during hospitalisation and the mean duration of bladder training was 82 days. Group B had a mean pyuria level of 32 WBC/HPF on admission. The incidence of urinary tract infection was 1 per patient during hospitalisation and the mean duration of bladder training was 40 days. The difference between groups A and B for all 3 parameters was statistically significant. These results suggest that patients with spinal cord injuries and indwelling catheters have a higher pyuria level and an increased risk of significant morbidity secondary to urinary tract infection, especially at the pyuria level of 100 WBC/HPF. A low pyuria level of less than or equal to 30 WBC/HPF was associated with a nil or low incidence of bacteriuria and urinary tract infection in our patients.

Adult↗
PubMed1991

[Clinical studies of bacteriuria in renal transplantation recipients. Correlation with pyuria and symptomatic genitourinary tract infection].

The clinical state of bacteriuria and its correlation with pyuria and symptomatic genitourinary tract infection (GUTI) were studied in 42 renal transplantation recipients who were followed up in the Kidney Center of Tokyo Women's Medical College over 6 months and who showed bacteriuria more than 3 times between January and December in 1987. The results were as follows. 1) Of the 42 recipients, bacteriuria was found less than 5 times in 19 patients, 6 to 10 times in 18 patients and more than 11 times in 5 patients. There was a tendency for the same bacteria to be isolated several times from the same patient. The most commonly isolated bacterias were Enterobacter, Enterococcus, Serratia and E. coli. 2) Bacteriuria was accompanied by pyuria in 33 patients (79%) and by symptomatic GUTI in 12 patients (29%). Bacteriuria without pyuria was shown in 9 patients (21%) without symptomatic GUTI and it was suggested that bacteriuria did not result in graft hypofunction after two years. 3) Of 16 patients with bacteriuria accompanied by pyuria, symptomatic GUTI occurred in 9 patients (56%). Of these, one patient was found to have VUR of the transplanted kidney, another was found to have VUR of the native kidney, and a third patient died due to interstitial pneumonitis presumably as a result of overimmunosuppression. Transplantation recipients with bacteriuria accompanied by pyuria develop symptomatic GUTIs frequently and should be treated with proper antibacterial agents. When bacteriuria continues, further examination should be performed for an organic disease of the urinary tract or an overimmunosuppressed state. When a patient shows bacteriuria without pyuria, chemotherapy is not needed and it is sufficient to observe the course carefully.

Adult↗
PubMed1996

[Pyuria, bacteriuria and urinary tract infections in hospitalized patients with spinal cord injuries].

Urine specimens from 15 patients with paresis of the urinary bladder following injury of the spinal cord were examined weekly for a total number of 352 weeks. Pyuria was found in 103 specimens. In more than 95% there was concordance between microscopic and chemical evaluation. Bacteriuria was found in 144 specimens, among which pyuria was found in 76. In 77 cases there was indication for antibacterial treatment, based on bacteriological and clinical parameters. The most frequent bacterium isolated was Escherichia coli. Pyuria was present in more than three of four cases that were identified as urinary tract infections. However, almost one of every two cases with bacteriuria showed no pyuria. It is concluded that clinical symptoms of urinary tract infection together with identification of pyuria call for antibacterial treatment. Bacterial examination, should always be undertaken given symptoms of infection with no presence of pyuria.

Adult↗
PubMed1998

Brachytherapy in the presence of pyuria after pelvic irradiation for cervical cancer.

Little is known about the effects of intracavitary brachytherapy (ICB) performed in the presence of pyuria resulting from external beam pelvic irradiation for cervical cancer (CC). A retrospective study of one decade of ICB for CC showed that brachytherapy was performed in the presence of pyuria in 26 women. Twelve women without pyuria during ICB served as a control group. Antibiotic therapy was routinely administered during intracavitary application. The crude survival rate at 5 years was 39% in patients with pyuria and 42% in women without pyuria; the corresponding local recurrence rates were 23% and 17%; the serious complication rates were 12% and 0% respectively. Intracavitary brachytherapy in the presence of pyuria may have a limited adverse effect on the outcome of women with cancer of the cervix.

Adult↗
PubMed2000

Pyuria in patients treated with indinavir is associated with renal dysfunction.

BACKGROUND: Indinavir therapy is associated with a continuum of crystal-related syndromes, including nephrolithiasis, renal colic, flank pain without recognizable stone formation, dysuria and asymptomatic crystalluria. A frank nephropathy has been recognized recently as part of the spectrum. METHODS: A retrospective analysis of 72 HIV-infected individuals receiving indinavir was performed to identify the frequency and risk factors for indinavir-associated nephropathy and urinary complications. Individuals treated with nucleoside analogues alone served as controls. RESULTS: Mean serum creatinine levels rose from 1.03 +/- 0.16 mg/dl to 1.11 +/- 0.22 mg/dl at week 12 and 1.15 +/- 0.27 mg/dl at week 24 (both, p < 0.01). Thirteen individuals developed serum creatinine levels > or =1.4 mg/dl. Increased serum creatinine levels were found more frequently in women (p < 0.01) and were associated with pyuria and microhematuria (p < 0.01). Frank renal colic and/or nephrolithiasis (seven patients) and urinary pH were not associated with serum creatinine levels > or =1.4 mg/dl. The mean duration of indinavir treatment, until sterile pyuria occurred, were 22 weeks and 32 weeks until the first rise of serum creatinine levels to > or =1.4 mg/dl. Ten patients showed both findings, pyuria preceded the first rise in serum creatinine levels to > or = 1.4 mg/dl (18 vs. 27 weeks, p = 0.02). Renal biopsy, done in three patients, revealed tubulointerstitial disease with crystals in collecting ducts. In 21 patients, among them 11 with pyuria, indinavir was replaced for various reasons and pyuria disappeared in nine. In these patients mean serum creatinine levels decreased from 1.43 mg/dl at withdrawal of indinavir to 1.04 mg/dl three months later (p < 0.01). CONCLUSION: Indinavir therapy is associated with a decrease in renal function which is reversible after withdrawal. In addition, indinavir-associated tubulointerstitial disease does no in patients taking indinavir may help to identify patients being at risk for nephrotoxicity.

Adult↗
PubMed2001

Evaluation of the accuracy of leukocyte esterase testing to detect pyuria in young febrile children: prospective study.

OBJECTIVE: To study the accuracy and clinical application of the dipstick leukocyte esterase test in the detection of pyuria in young febrile children suspected to have urinary tract infection. DESIGN: Prospective study. SETTING: Regional hospital, Hong Kong. PATIENTS: Urine samples were taken from 215 children younger than 2 years who were suspected to have urinary tract infection (fever without an obvious focus of infection). MAIN OUTCOME MEASURES: The accuracy of the dipstick leukocyte esterase test in detecting significant pyuria defined as a leukocyte count >or=10 mm(3) (>or=0.01 x 10(9) /L). RESULTS: Two hundred and fifty-four urine samples collected by bag, midstream clean-catch, suprapubic bladder aspiration, or urethral catheterization were examined. Using urine microscopy results as a reference, the sensitivity and specificity of the leukocyte esterase test in detecting significant pyuria were found to be 72.0% and 85.8%, respectively; the positive and negative predictive values were 55.4% and 92.6%, respectively; and the positive and negative likelihood ratios were 5.1 and 0.3, respectively. CONCLUSIONS: The dipstick leukocyte esterase test cannot accurately detect pyuria in young febrile children. It is also not appropriate as a screening test to exclude pyuria, reduce the need for the microscopic examination of urine, or indicate when a hospital admission for probable urinary tract infection is needed.

Esterases↗