Frequency of different uro-pathogens causing asymptomatic bacteriuria or bacteriuria without pyuria

Authors

  • Naila Iqbal Izzat Ali Shah Hospital, Wah Cantt Taxila, Rawalpindi Pakistan
  • Muhammad Zeeshan Khalid Tehsil Headquarters Hospital Pindigheb, Attock Pakistan
  • Abdul Rehman Tehsil Headquarters Hospital Pindigheb, Attock Pakistan
  • Humera Javed HBS Medical and Dental College, Islamabad Pakistan
  • Amber Jamil Siddiqi Izzat Ali Shah Hospital, Wah Cantt Taxila, Rawalpindi Pakistan
  • Saira Salim Awan Islamabad Diagnostic Center, Wah Cantt Taxila, Rawalpindi Pakistan

DOI:

https://doi.org/10.55629/pakjpathol.v35i2.799

Abstract

Objective: This study determines the frequency of different isolates identified in urine culture, which were identified as asymptomatic bacteriuria on urine RE.

Material and Methods:  This descriptive cross-sectional study was conducted at the Department of Microbiology at Izzat Ali Shah Hospital, Wah Cantt from August 2022 to August 2023.  A total of 275 urine specimens were included in the study. Mid-stream urine specimens were obtained and routine examination was performed on a fully automated FUS-2000 urinalysis system. Urine culture was performed by inoculating the specimen on CLED and Blood agar plates. The plates were incubated at 37ºC in ambient air for 24-48 hours. Growth was observed and identified based on gram stain and biochemical tests.

Results: Out of 275 specimens, growth was observed in 100 specimens. 175 specimens did not show any growth. Out of the 100 positive urine culture specimens, majority of the isolates belonged to Enterobacterales group. Out of these, 40% were Escherichia coli while 25% were Klebsiella pneumoniae. Growth of Staphylococcus saprophyticus was seen in 12% of specimens. Growth of Pseudomonas aeruginosa, Enterococcus faecalis, and Streptococcus agalactae was seen in 5% of specimens each, followed by Enterobacter cloacae, Enterobacter aerogenes, and Citrobacter koseri in 2% of specimens each. Growth of Proteus mirabilis and Serratia marcescens was seen in 1% of specimens each.

Conclusion: In conclusion, among the positive urine cultures, Enterobacterales group dominated followed by Escherichia coli and klebsiella pneumoniae as major isolates. Additionally, Staphylococcus saprophyticus was also identified in a few specimens. These findings highlight the importance of accurate differentiation between urinary tract infection and asymptomatic bacteriuria by correlating urine culture results with routine examination.

Keywords: Asymptomatic bacteriuria, Pyuria, Uropathogens

References

Nicolle LE, Gupta K, Bradley SF, Colgan R, DeMuri GP, Drekonja D, et al. Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2019;68(10):e83-e110. DOI: https://doi.org/10.1093/cid/ciy1121

Cheng B, Zaman M, Cox W. Correlation of pyuria and bacteriuria in acute care. Am J Med. 2022;135(9): e353-e8.

DOI: https://doi.org/10.1016/j.amjmed.2022.04.022

Givler DN, Givler A. Asymptomatic Bacteriuria. [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441848/

Hooton TM, Scholes D, Stapleton AE, Roberts PL, Winter C, Gupta K, et al. A prospective study of asymptomatic bacteriuria in sexually active young women. N Engl J Med. 2000; 343(14): 992-7.

DOI:https://doi.org/10.1056/nejm200010053431402

Fonseca J, Mavrides D, Graham P, McHugh T. Results of urinary bacterial cultures and antibiotic susceptibility testing of dogs and cats in the UK. J Small Anim Pract. 2021; 62(12): 1085-91.

DOI: https://doi.org/10.1111/jsap.13406

Cash MC, Hile G, Johnson J, Stone T, Smith J, Ohl C, et al. Sustained impact of an antibiotic stewardship initiative targeting asymptomatic bacteriuria and pyuria in the emergency department. Antimicrob Steward Healthc Epidemiol. 2022;2(1): e148.

DOI: https://doi.org/10.1017%2Fash.2022.289

Colgan R, Jaffe GA, Nicolle LE. Asymptomatic bacteriuria. Am Fam Physician. 2020; 102(2): 99-104.

Norden CW, Kass E. Bacteriuria of pregnancy--a critical appraisal. Annual Review of Medicine. 1968;19(1):431-70.

DOI: https://doi.org/10.1146/annurev.me.19.020 168.002243

Luu T, Albarillo FS. Asymptomatic bacteriuria: Prevalence, diagnosis, management, and current antimicrobial stewardship implementations. The Am J Med. 2022. 135(8): 236-44.

DOI: https://doi.org/10.1016/j.amjmed.2022. 03.015

Yasmin H, Niaz WA, Zahoor S, Shamsher S, Shaikh M. Prevalence of urinary tract infection with asymptomatic bacteriuria among gravid females: A Pakistani multicenter cross-sectional study. Professional Med J. 2024;31(01):107-12.

Szasz M, Lehotkai N, Kristóf K, Szabó D, Nagy K. Prevalence and antimicrobial resistance of uropathogens in different inpatient wards. Acta Microbiol Immunol Hung. 2009; 56(4): 375-87.

DOI: https://doi.org/10.1556/amicr.56.2009.4.7

Hamzah AM, Kadim HK. Isolation and identification of Enterococcus faecalis from cow milk samples and vaginal swab from human. J Entomol Zoology Studies. 2018; 6: 218-22.

Roos V, Ulett GC, Schembri MA, Klemm P. The asymptomatic bacteriuria Escherichia coli strain 83972 outcompetes uropathogenic E. coli strains in human urine. Infect Immun. 2006; 74(1): 615-24.

DOI: https://doi.org/10.1128/iai.74.1.615-624.2006

Johnson JR, Russo TA. Molecular epidemiology of extraintestinal pathogenic Escherichia coli. EcoSal Plus. 2018;8(1).

DOI: https://doi.org/10.1128/ecosalplus.esp-0004-2017

Tamma PD, Avdic E, Li DX, Dzintars K, Cosgrove SE. Association of adverse events with antibiotic use in hospitalized patients. JAMA Intern Med. 2017; 177(9): 1308-15.

Gołębiewska JE, Krawczyk B, Wysocka M, Dudziak A, Dębska-Ślizień A. Asymptomatic bacteriuria in kidney transplant recipients-a narrative review. Medicina (Kaunas). 2023; 59(2): 198.

DOI: https://doi.org/10.3390/medicina59020198

Hooton TM, Roberts PL, Stapleton AE. Asymptomatic bacteriuria and pyuria in premenopausal women. Clin Infect Dis. 2021;72(8):1332-8.

DOI: https://doi.org/10.1093/cid/ciaa274

Greve VH, Greve T, Helmig RB. Bacteriuria in pregnancy in a Danish contemporary cohort of women. Infect Dis Obstet Gynecol. 2020; 2020. 8398537.

DOI: https://doi.org/10.1155/2020/8398537

Sonkar N, Banerjee M, Gupta S, Ahmad A. Asymptomatic bacteriuria among pregnant women attending tertiary care hospital in Lucknow, India. Dubai Med J. 2021; 4(1): 18-25.

DOI: https://doi.org/10.1159/000513626

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Published

02-07-2024

How to Cite

1.
Iqbal N, Khalid MZ, Rehman A, Javed H, Siddiqi AJ, Awan SS. Frequency of different uro-pathogens causing asymptomatic bacteriuria or bacteriuria without pyuria. Pak J Pathol [Internet]. 2024 Jul. 2 [cited 2024 Oct. 16];35(2):87-91. Available from: https://pakjpath.com/index.php/Pak-J-Pathol/article/view/799