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Can I read Current Pyuria Cutoffs Promote Inappropriate Urinary Tract Infection Diagnosis in Older Women on EtoBox?
Current Pyuria Cutoffs Promote Inappropriate Urinary Tract Infection Diagnosis in Older Women by Manu P Bilsen; Margaretha J Aantjes; Esther van Andel; Janneke E Stalenhoef; Cees van Nieuwkoop; Eliane M S Leyten; Nathalie M Delfos; Martijn Sijbom; Mattijs E Numans; Wilco P Achterberg; Simon P Mooijaart; Martha T van der Beek; Christa M Cobbaert; Simon P Conroy; Leo G Visser; Merel M C Lambregts is a Medicine article available to read on EtoBox.
What is Current Pyuria Cutoffs Promote Inappropriate Urinary Tract Infection Diagnosis in Older Women about?
## Abstract ## Background Pre-existing lower urinary tract symptoms (LUTS), cognitive impairment, and the high prevalence of asymptomatic bacteriuria (ASB) complicate the diagnosis of urinary tract infection (UTI) in older women. The presence of pyuria remains the cornerstone of UTI diagnosis. However, >90% of ASB patients have pyuria, prompting unnecessary treatment. We quantified pyuria by automated microscopy and flowcytometry to determine the diagnostic accuracy for UTI and to derive pyuria thresholds for UTI in older women. ## Methods Women ≥65 years with ≥2 new-onset LUTS and 1 uropathogen ≥10^4^ colony-forming units (CFU)/mL were included in the UTI group. Controls were asymptomatic and classified as ASB (1 uropathogen ≥10^5^ CFU/mL), negative culture, or mixed flora. Patients with an indwelling catheter or antimicrobial pretreatment were excluded. Leukocyte medians were compared and sensitivity–specificity pairs were derived from a receiver operating characteristic curve. ## Results We included 164 participants. UTI patients had higher median urinary leukocytes compared with control patients (microscopy: 900 vs 26 leukocytes/μL; flowcytometry: 1575 vs 23 leukocytes/μL; __P_
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- Author
- Manu P Bilsen; Margaretha J Aantjes; Esther van Andel; Janneke E Stalenhoef; Cees van Nieuwkoop; Eliane M S Leyten; Nathalie M Delfos; Martijn Sijbom; Mattijs E Numans; Wilco P Achterberg; Simon P Mooijaart; Martha T van der Beek; Christa M Cobbaert; Simon P Conroy; Leo G Visser; Merel M C Lambregts
- Publisher
- Oxford University Press (OUP)
- Published
- 2023
- Language
- EN
- Field
- Medicine (Health Sciences)