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At least 19 recordsLinked to original sources
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↗
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↗
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↗
PubMed1976

[Evaluation of diagnostic parameters in chronic recurrent urinary tract infection in children. III. Pyuria, hematuria, and proteinuria (author's transl)].

Pyuria, proteinuria and haematuria have been shown to be unreliable parameters for the diagnosis of bacteriuria in 171 children with 455 recurrences of chronic urinary tract infection. Bacteriuria caused haematuria in 5%, proteinuria in 18% and even pyuria in only 47% of all instances. Pyuria has been also found in 11% of sterile urines. The incidence of pyuria increases with the age of the children and depends on the type of the organisms, but the latter was true mainly in children with obstructive lesions of the urinary tract. Children with repeated proteinuria during follow-up tend to have a higher incidence of pathologic findings on the i.v.-pyelogram.

Age Factors↗
PubMed1991

Presence of platelet-activating factor in pyuria in humans.

The relationship between the occurrence of platelet-activating factor (PAF) and neutrophils in urine from patients with urinary tract infection was examined. PAF was detected in human pyuria, when leukocyte levels reached at least 300 cells/microL (n = 45), but not in normal urine (n = 12). The amount of PAF found in pyuria, measured by platelet aggregation assay, was 0.01 to 13.3 pmol/mL. A close correlation was seen between the amount of PAF present and the number of urinary leukocytes (p less than 0.01, r = 0.70). The leukocytes in pyuria consisted almost entirely of neutrophils (96 +/- 4%, mean +/- S.D.). Our findings suggest that the occurrence of PAF is associated with the accumulation of neutrophils in urine.

Animals↗
PubMed1992

[Multifactorial analysis of the pyuria after transurethral prostatectomy].

Multifactorial analysis on 395 patients revealed important factors which prolong the pyuria after transurethral prostatectomy. They were the age of the patient, anemia and leukocytosis before surgery. These are factors which relate with the defense mechanism of the patient. Local factors, such as the duration of indwelling urethral catheter, the size of the prostate or prostatic bed and preoperative infection, were not so important for prolonging the pyuria after transurethral prostatectomy. The time of the resection and weight of the prostate had an intimate relation each other, and the former was the more important factor. The use of antimicrobials probably controlled these local risk factors, thus making them unimportant in the prolongation of the pyuria after transurethral prostatectomy.

Age Factors↗
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↗
PubMed1991

First catch urine sediment for Chlamydia trachomatis and Neisseria gonorrhoeae culture in adolescent males with pyuria.

Traditionally, only symptomatic males or those with a history of exposure are tested for sexually transmitted diseases (STDs). Since urethral infections with Chlamydia trachomatis and Neisseria gonorrhoeae are frequently asymptomatic, a practical, sensitive, and acceptable screening method is desirable. Fifty sexually active males with pyuria (age 13 to 22 years old) diagnosed with 1+ or 2+ leukocyte esterase (LE) dipstick on first catch urine (FCU) were further evaluated by culture of urethral swabs and centrifuged FCU samples for N. gonorrhoeae and C. trachomatis. Eighty-six percent had one or more positive cultures: 17 (34%) N. gonorrhoeae, 18 (36%) C. trachomatis, and 8 (16%) both organisms. FCU culture for N. gonorrhoeae had a 100% sensitivity, specificity, and positive and negative predictive value when compared to urethral swab cultures. FCU culture for C. trachomatis had a 32% sensitivity, 95% specificity, 89% positive predictive value, and a 53% negative predictive value compared to urethral culture. On the basis of the results of this study, one urethral swab can be eliminated when evaluating male adolescents for urethritis by using spun FCU culture for N. gonorrhoeae. Continued efforts should be made to develop optimal tests to detect STDs which are reliable and encourage compliance in this high-risk group.

Adolescent↗
PubMed1978

Studies on the prevalence of renal disease and hypertension in relation to schistosomiasis. III. Proteinuria, haematuria, pyuria and bacteriuria in the rural community of Nigeria.

Midstream specimen of urine was collected from the total population of two rural communities in the immediate environs of Ibadan. One has a higher and the other a low endemicity of urinary schistosomiasis. Proteinuria, haematuria, pyuria and bacteriuria were found to be significantly more frequent in the area of high than low endemicity.

Adolescent↗
PubMed1991

Prolonged fever and pyuria: an uncommon manifestation of Q fever.

A patient with Q fever is described who had been ill for a year before the diagnosis was made on the basis of serological data. In addition it was possible to isolate Coxiella burnetii, the causative agent by culture from the urine. This is very exceptional and is to our knowledge only the second case in which this has been achieved. The patient made a full recovery after lengthy treatment with tetracycline. Q fever should be considered in patients with pyrexia of unknown origin, particularly in travellers.

Adult↗