Sterile Pyuria

Wise, Gilbert J.; Schlegel, Peter N.

doi:10.1056/nejmra1410052

Cited by 81 publications

(51 citation statements)

References 40 publications

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“…This phenomenon might indicate us that metabolic comorbidity (especially kidney involvement) could attribute to the presence of pyuria. However, little published evidence was found to support this hypothesis of the potential association between pyuria and metabolic comorbidity [12,29], and we also failed to evaluate the severity of metabolic comorbidity for lacking of the corresponding medical data. Thirdly, it would provide greater predictive value if pyuria were combined with other inflammatory biomarkers.…”

Section: Discussionmentioning

confidence: 96%

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Preoperative pyuria predicts advanced pathologic tumor stage and worse survival in patients with urothelial carcinoma of the upper urinary tract treated by radical nephroureterectomy

Liang

Wang

Liu

et al. 2016

Urologic Oncology: Seminars and Original Investigations

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Section: Discussionmentioning

confidence: 96%

“…Pyuria was defined as Z10 white blood cells (WBCs) per high power field of urine, because this cutoff value was usually used for diagnosis of urinary tract infection [12].…”

Section: Clinicopathologic Variables Evaluationmentioning

confidence: 99%

Preoperative pyuria predicts advanced pathologic tumor stage and worse survival in patients with urothelial carcinoma of the upper urinary tract treated by radical nephroureterectomy

Liang

Wang

Liu

et al. 2016

Urologic Oncology: Seminars and Original Investigations

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“…Fungal UTIs are not as common as bacterial UTIs, but patients with indwelling catheters, diabetes, or recent antibiotic use are at increased risk of fungal infection 7,8 . Urogenital tuberculosis and parasitic organisms such as Schistosoma haematobium can cause UTIs, although these infections are not common in the USA 9 . Technologies capable of rapidly identifying these pathogens and their antimicrobial susceptibility have the potential to improve and expedite diagnosis, enabling personalized treatment.…”

mentioning

confidence: 99%

New and developing diagnostic technologies for urinary tract infections

et al. 2017

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Timely and accurate identification and determination of the antimicrobial susceptibility of uropathogens is central to the management of UTIs. Urine dipsticks are fast and amenable to point-of-care testing, but do not have adequate diagnostic accuracy or provide microbiological diagnosis. Urine culture with antimicrobial susceptibility testing takes 2 3 days and requires a clinical laboratory. The common use of empirical antibiotics has contributed to the rise of multidrug-resistant organisms, reducing treatment options and increasing costs. In addition to improved antimicrobial stewardship and the development of new antimicrobials, novel diagnostics are needed for timely microbial identification and determination of antimicrobial susceptibilities. New diagnostic platforms, including nucleic acid tests and mass spectrometry, have been approved for clinical use and have improved the speed and accuracy of pathogen identification from primary cultures. Optimization for direct urine testing would reduce the time to diagnosis, yet these technologies do not provide comprehensive information on antimicrobial susceptibility. Emerging technologies including biosensors, microfluidics, and other integrated platforms could improve UTI diagnosis via direct pathogen detection from urine samples, rapid antimicrobial susceptibility testing, and point-of-care testing. Successful development and implementation of these technologies has the potential to usher in an era of precision medicine to improve patient care and public health.

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“…Laboratory criteria for the diagnosis of asymptomatic bacteriuria were as follows: 2 consecutive voided urine specimens with isolation of the same bacterial strain in quantitative counts ≥10 5 cfu/mL in women and a single urine specimen with 1 bacterial species isolated in a quantitative count ≥10 5 cfu/mL in men . Pyuria was defined as the presence of 10 or more white cells per cubic millimeter in a urine specimen . A urine culture that was reported as no growth in 48 hours was considered negative without the need to repeat the urine culture according to the study protocol.…”

Section: Methodsmentioning

confidence: 99%

“…13 Pyuria was defined as the presence of 10 or more white cells per cubic millimeter in a urine specimen. 14 A urine culture that was reported as no growth in 48 hours was considered negative without the need to repeat the urine culture according to the study protocol. Urine output was expressed as mL/24 hours.…”

Section: Methodsmentioning

confidence: 99%

A single center, open‐label, randomized, parallel group study assessing the relationship between asymptomatic bacteriuria and inflammation in maintenance hemodialysis patients

Beberashvili

Golovko

Golinsky

et al. 2017

Hemodialysis International

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Introduction: The significance of asymptomatic bacteriuria in maintenance hemodialysis (MHD) patients remains controversial. We hypothesized that the presence of asymptomatic bacteriuria as a sole clinical manifestation of urinary tract infection (UTI) in asymptomatic MHD patient may contribute to the chronic inflammatory response. Our aim was to explore the relationship between asymptomatic bacteriuria and elevated levels of inflammatory markers in MHD patients. Methods:A randomized open-label single center study of 114 MHD patients was conducted. Forty-six patients presented negative urine culture and 41 subjects were excluded due to different reasons. The remaining 27 patients (mean age of 71.5 6 12.2 years, 63% men), fulfilling the criteria for having asymptomatic bacteriuria, were randomly assigned to either the treatment group (13 patients) or the observational group (14 subjects). The treatment group received 7 days of antibiotic treatment given according to bacteriogram sensitivity. After 3 months of follow-up all measurements of the study were repeated. The primary end point was change in inflammatory biomarkers from baseline by the end of the study.Findings: There were no statistically significant differences in white blood cell changes (P 5 0.27), ferritin (P 5 0.09), C-reactive protein (P 5 0.90), and interleukin-6 (P 5 0.14) levels between the groups from baseline to the end of study or at the end of the study. Analyzing cross-sectional data, asymptomatic bacteriuria was found to not be a predictor of higher levels of inflammatory parameters at baseline.Discussion: Asymptomatic bacteriuria is not a modifiable risk factor for chronic inflammation in the MHD population.

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Sterile Pyuria

Cited by 81 publications

References 40 publications

Preoperative pyuria predicts advanced pathologic tumor stage and worse survival in patients with urothelial carcinoma of the upper urinary tract treated by radical nephroureterectomy

Preoperative pyuria predicts advanced pathologic tumor stage and worse survival in patients with urothelial carcinoma of the upper urinary tract treated by radical nephroureterectomy

New and developing diagnostic technologies for urinary tract infections

A single center, open‐label, randomized, parallel group study assessing the relationship between asymptomatic bacteriuria and inflammation in maintenance hemodialysis patients

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