Screening for Asymptomatic Urinary-Tract Infection in Schoolgirls

Asscher, A. W.; Jones, R. Verrier; Sussman, M.; McLachlan, M. S. F.; Meller, S T; Harrison, Sylvie; Johnston, H. H.; Sleight, Gillian; Fletcher, E. W. L.

doi:10.1016/s0140-6736(73)91943-0

Cited by 79 publications

(33 citation statements)

References 5 publications

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“…Intravenous pyelography (IVP) in those patients documented renal damage consistent with pyelonephritis in 10-15% and damage progressed over time. 23,[35][36][37][38] Evidence derived from the evaluation of these schoolgirls with ABU indicates that symptoms consistent with UTI may have been overlooked. If the diagnosis had not been considered, a urine culture would not have been obtained and an opportunity for early diagnosis missed.…”

Section: Discussionmentioning

confidence: 99%

UTI: Diagnosis and Evaluation in Symptomatic Pediatric Patients

Heidrich

Barone

Spiegler

2000

Clin Pediatr (Phila)

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We retrospectively reviewed data on 260 hospitalized pediatric patients with symptomatic urinary tract infection (UTI). To ascertain the colony-forming units (CFU)/mL compatible with the diagnosis of UTI, a culture from a catheterized urine specimen containing >1,000 CFU/mL was considered diagnostic of UTI and resulted in imaging by renal ultrasound, voiding cystourethrography, and renal nuclear scan with Tc99m dimercaptosuccinic acid (DMSA). A positive DMSA renal scan is indicative of pyelonephritis. We used logistic regression analysis to determine which patient characteristics were predictive of pyelonephritis. We determined that, in hospitalized pediatric patients, the colony count of the positive urine culture, the type of organism grown in culture, and the voiding cystourethrography (VCUG) result (positive or negative for vesicoureteral reflux) did not predict which patients had pyelonephritis. In females, advancing age of the patient and positive renal ultrasound results were predictive of which patients had pyelonephritis when we controlled for other factors. We feel this emphasizes the importance of a thorough evaluation of hospitalized symptomatic patients, including patients with colony counts of 1,000 to 50,000 CFU/mL, to locate the level of infection and plan appropriate therapy.

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Section: Discussionmentioning

confidence: 99%

UTI: Diagnosis and Evaluation in Symptomatic Pediatric Patients

Heidrich

Barone

Spiegler

2000

Clin Pediatr (Phila)

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“…Post-mortem focal and segmental glomeru lar lesions were found in this experiment in animals with impaired kidney function. Hudson and Cotran [11] and Torres et al [24] suggested that the glomerular lesions of CPN are akin to those which develop whenever function ing kidney tissue is reduced and that they are the result of hyperfiltration by remnant glomeruli as proposed by Hostetler and Brenner [2). Olson et al [18] showed that the development of focal and segmental glomerular sclerosis in remnant glomeruli is accompanied by haemodynamic changes which lead to an increase of glomerular perme ability to protein and other macromolecules.…”

Section: Discussionmentioning

confidence: 99%

“…This is because the anatomical configuration of the renal papillae in the upper and lower poles allows urine to reflux into the collecting ducts [20]. At least 1 in 400 apparently healthy schoolgirls have been shown to have one or more pyelonephritic scars [2]. Some of these girls develop a rise in blood pressure later in life, particularly when they become pregnant or when they commence oral contraception [21].…”

Section: Introductionmentioning

confidence: 99%

Progression of Chronic Pyelonephritis in the Rat

Mackenzie¹,

Aw²

1986

Nephron

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Thirteen of 20 female Wistar rats developed perihilar kidney scars 6 weeks after ascending infection with Escherichia coli 078. After removal of the lesser scarred kidney from 6 of the aminals, all animals were followed for 54 weeks. Proteinuria ( > 18 mg/24 h) developed at 20 weeks in the uninephrectomised infected rats and at 34 weeks in the 2-kidney infected model. In 10 uninephrectomised controls significant proteinuria did not appear until 52 weeks. In 9 2-kidney controls proteinuria did not develop at all. The speed of onset and severity of proteinuria was related to the extent of the renal parenchymal loss. Pyelonephritic scars did not show macroscopic progression over the 54-week observation period, even though the original renal infection persisted. Uninephrectomised animals with infected scars developed a highly significant rise of creatinine/body weight (p < 0.02) and of heart weight/body weight p < 0.02) ratios compared with the non-infected controls. Their kidneys showed focal and segmental hyalinosis and sclerosis of the glomeruli adjacent to the scars. Immunofluorescent staining for serum proteins was negative, but mesangial deposits of Tamm-Horsfall protein were found in the glomeruli between the scars in animals with renal impairment. These findings establish that progressive renal impairment in rats with infected kidney scars is associated with the development of proteinuria and a glomerulopathy. The cause of the glomerulopathy is not clear, both glomerular hyperfiltration and deposition of Tamm-Horsfall protein in glomerular mesangial cells may be involved.

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“…whether covert or symptomatic, has been re ported to be 1.1-2.8% in school girls (7,8), about 4% in women (aged 16-65 years) but only 0.5% in men (9). Relapse and reinfection occur frequently after treatment (6).…”

Section: Introductionmentioning

confidence: 99%

Dip-Slide in Patients at High Risk of Urinary Tract Infection

Bonadio¹

1980

Urol Int

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146 initial and follow-up urine specimens of a urinary tract infection clinic were processed simultaneously by a dip-slide and by a standard pour plate method to evaluate the reliability of this simplified urine culture technique in a population with a high incidence of urinary tract infections. The dip-slide method gave false-negative results in only 8.7% of infected urines ( > 10⁵ cfu/ml urine), as determined by pour plate method. 1.3% false-positives were recorded. The false-negative rate rose to 22.2% when the dip-slide was used on the urines from patients on antimicrobial therapy. Our findings suggest that this simplified urine culture method is a useful tool even in populations with high incidence of urinary infections, although more careful evaluation of these test results is necessary when antimicrobial drugs are present in the urine specimens.

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Screening for Asymptomatic Urinary-Tract Infection in Schoolgirls

Cited by 79 publications

References 5 publications

UTI: Diagnosis and Evaluation in Symptomatic Pediatric Patients

UTI: Diagnosis and Evaluation in Symptomatic Pediatric Patients

Progression of Chronic Pyelonephritis in the Rat

Dip-Slide in Patients at High Risk of Urinary Tract Infection

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