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The Journal of Urology Mar 1986A total of 664 urine samples collected from 254 asymptomatic, ambulatory, elderly men was examined for pyuria with a standardized glass slide microscopy method. The...
A total of 664 urine samples collected from 254 asymptomatic, ambulatory, elderly men was examined for pyuria with a standardized glass slide microscopy method. The presence or absence of more than 10 polymorphonuclear leukocytes per high power field was highly predictive of the presence or absence of significant bacteriuria, respectively. The determination of pyuria in this select population may be a useful and inexpensive test to screen for bacteriuria.
Topics: Aged; Ambulatory Care; Bacteriuria; Humans; Male; Pyuria
PubMed: 3944898
DOI: 10.1016/s0022-5347(17)45718-1 -
Nephrology (Carlton, Vic.) Nov 2013
Topics: Adult; Female; Humans; Pyuria; Tomography, X-Ray Computed; Tuberculosis, Renal
PubMed: 24571746
DOI: 10.1111/nep.12110 -
British Journal of Urology Feb 1992Little 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...
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.
Topics: Adult; Catheters, Indwelling; Humans; Pyuria; Spinal Cord Injuries; Urinary Catheterization; Urinary Tract Infections
PubMed: 1537025
DOI: 10.1111/j.1464-410x.1992.tb15485.x -
BMJ (Clinical Research Ed.) Oct 1995
Topics: Adolescent; Child; Child, Preschool; Female; Fever; Humans; Infant; Infant, Newborn; Male; Pyuria
PubMed: 7580553
DOI: 10.1136/bmj.311.7010.924 -
Pediatrics International : Official... Apr 2013The aim of this study was to identify factors for differentiating roseola infantum from urinary tract infection (UTI) and to describe a cohort of infants diagnosed with... (Comparative Study)
Comparative Study
BACKGROUND
The aim of this study was to identify factors for differentiating roseola infantum from urinary tract infection (UTI) and to describe a cohort of infants diagnosed with roseola infantum and sterile pyuria.
METHODS
The medical records of infants diagnosed with roseola infantum or UTI were examined. Multivariate analysis was performed to identify factors associated with UTI. Demographic and clinical variables were compared between infants who had roseola infantum with or without sterile pyuria.
RESULT
There were 301 infants included: 158 in the roseola group (21, 13.3% with sterile pyuria) and 143 in the UTI group. The relative risk of UTI over roseola infantum: increased with leukocytosis (white blood cell [WBC] count >10,000/mm(3), odds ratio [OR] = 85.62) and pyuria (OR = 18.97); decreased with age (OR = 0.90); increased in boys (OR = 2.48); increased with WBC count 4000-10,000/mm(3) (OR = 4.24); and decreased with duration of fever (OR = 0.84). There was a significantly higher proportion of girls in the roseola pyuria group (81.0%) compared with the no pyuria group (44.5%, P = 0.002). A significantly higher proportion of infants in the roseola pyuria group (76.2%) received antibiotics than infants in the no pyuria group (38.0%, P = 0.002).
CONCLUSION
Leukocytosis is the strongest predictor of UTI over roseola infantum. Sterile pyuria may occur in infants with roseola infantum.
Topics: Diagnosis, Differential; Exanthema Subitum; Female; Follow-Up Studies; Humans; Infant, Newborn; Male; Pyuria; Retrospective Studies; Urinalysis; Urinary Tract Infections
PubMed: 23190314
DOI: 10.1111/ped.12015 -
Actas Urologicas Espanolas 2013Urinalysis alterations are common after prostatic surgery. However, time to normalization has not been established. Presence of pyuria and microhematuria can lead to...
OBJECTIVE
Urinalysis alterations are common after prostatic surgery. However, time to normalization has not been established. Presence of pyuria and microhematuria can lead to unnecessary diagnostic procedures. The objective of this study is to determine the time to normalization for both parameters.
MATERIAL AND METHODS
We reviewed medical records of patients who underwent prostatic surgery without infectious complications during follow-up. We included patients who underwent transurethral resection of the prostate (TURP) with either monopolar or bipolar energy, or open prostatectomy (OP). Kaplan-Meier curves were used to determine the time of persistence of both parameters. ANOVA was used to compare the 3 groups according to the type of surgery. We analyzed the impact of preoperative use of 5-α-reductase inhibitors, and searched for a correlation between the weight of resected tissue and persistence of both parameters.
RESULTS
85 patients were analyzed: 44 underwent monopolar TURP, 27 bipolar TURP, and 14 OP. Persistence of pyuria was significantly longer than microhematuria with a median of 274 days vs. 176 days. Neither the use of monopolar or bipolar energy, nor the use of preoperative 5α-reductase inhibitors affected the persistence time. We found a positive correlation between the resected tissue weight and the persistence of leukocyturia after endoscopic surgery: 23 g was the best cut-off point.
CONCLUSIONS
Pyuria persists longer than microhematuria regardless of the type of surgery. There is a correlation between the resected tissue weight and the persistence of pyuria. The presence of pyuria and microhematuria after prostatic surgery is not always a pathological finding.
Topics: Aged; Aged, 80 and over; Hematuria; Humans; Male; Middle Aged; Prostatectomy; Pyuria; Retrospective Studies
PubMed: 23768502
DOI: 10.1016/j.acuro.2013.02.014 -
The Journal of Pediatrics Apr 1994Results of urinalysis and culture of 2181 urine specimens obtained by catheter from febrile children aged less than 24 months were analyzed to determine the following:...
Results of urinalysis and culture of 2181 urine specimens obtained by catheter from febrile children aged less than 24 months were analyzed to determine the following: (1) an optimal cutoff point in considering a bacterial colony count clinically "significant," (2) the accuracy of leukocyte esterase and nitrite tests in identification of pyuria and bacteriuria, and (3) the utility of pyuria (defined as > or = 10 leukocytes/mm3) in the discrimination of urinary tract infection from asymptomatic bacteriuria. Among 110 urine cultures with > or = 10,000 colony-forming units per milliliter, 92 (84%) had > or = 100,000 CFU/ml, 10 (9%) had 50,000 to 99,000 CFU/CFU/ml and 8 (7%) had 10,000 to 49,000 CFU/ml. Urine specimens with 1000 to 49,000 CFU/ml were more likely than specimens with > or = 50,000 CFU/ml to yield Gram-positive or mixed organisms (36/60 vs 7/109; p < 0.001). A count of < 10 leukocytes/mm3 was almost invariably associated with a sterile culture; a count of > or = 10 leukocytes/mm3 was found in 93 of 102 patients with > or = 50,000 CFU/ml. The dipstick leukocyte esterase test had sensitivities of 52.9% and 66.7% in detecting > or = 10 leukocytes/mm3 and > or = 20 leukocytes/mm3, respectively. The dipstick nitrite test had a sensitivity of 31.4% in detecting bacteriuria (> or = 50,000 CFU/ml). Acute pyelonephritis was diagnosed by a renal scan with dimercaptosuccinic acid labeled with technetium 99m in 50 (77%) of 65 patients with > or = 10 leukocytes/mm3 but in none of five patients with < 10 leukocytes/mm3 (p < 0.01). The findings in these five patients were consistent with colonization of the urinary tract rather than infection. For urine specimens obtained by catheter, we believe that urinary tract infection is best defined by both a leukocyte count > or 10/mm3 and a CFU count > or = 50,000/ml. This definition almost always discriminates among true urinary tract infection, bacteriuria resulting from contamination of the urine specimen, and asymptomatic bacteriuria.
Topics: Bacteriuria; Catheterization; Fever; Humans; Infant; Leukocyte Count; Predictive Value of Tests; Pyuria; Sensitivity and Specificity; Urinalysis; Urinary Tract Infections; Urine
PubMed: 8151463
DOI: 10.1016/s0022-3476(05)83127-0 -
Journal of Pediatric Urology Aug 2021Urethral catheterization (CATH) and suprapubic aspiration (SA) are reliable methods of collecting urine for the diagnosis of urinary tract infections (UTIs), but both...
INTRODUCTION
Urethral catheterization (CATH) and suprapubic aspiration (SA) are reliable methods of collecting urine for the diagnosis of urinary tract infections (UTIs), but both are invasive and difficult. Therefore, urine collection through a sterile urine bag (SUB) is commonly used for UTI screening. However, when pyuria is found in SUB specimens, it is difficult to interpret whether this result is true or false.
OBJECTIVE
We aimed to determine the diagnostic performance of the urinary NAG/Cr ratio in detecting true pyuria in SUB specimens for children with suspected UTIs.
STUDY DESIGN
This retrospective study included children 2-24 months of age presenting to the pediatric emergency department (PED) and in whom urinary NAG and creatinine levels were measured and a urine culture was performed between January 1, 2018, and December 31, 2019. Children with the presence of pyuria in SUB specimens were categorized into true or false pyuria groups depending on whether pyuria was present in CATH specimens. The diagnostic performance of the urinary NAG/Cr ratio in detecting true pyuria was identified using receiver operating characteristic (ROC) curve analysis. The optimal cutoff was calculated based on ROC curve analysis. Sensitivity, specificity, and positive and negative likelihood ratios were assessed for optimal cutoff values.
RESULTS
Among 606 children with measured urinary NAG levels, 144 children with pyuria in SUB specimens were included in the analyses. Pyuria was consistently present in the CATH specimens of 67 (46.5%) children and absent in those of 77 (44.5%) children. The urinary NAG/Cr ratio was significantly higher in the true pyuria group than in the false pyuria group (21.5 IU/g; 95% confidence interval [CI]: 12.3-35.6; vs 9.6 IU/g; 95% CI: 6.7-16.1, P < 0.001). The area under the ROC curve (AUC) for the urinary NAG/Cr ratio was 0.776 (95% CI: 0.700-0.851). The optimal cutoff of 18.85 IU/g corresponded to the best combination of sensitivity (58.2, 95% CI: 46.4-70.0) and specificity (83.3, 95% CI: 74.7-91.6), with positive and negative likelihood ratios of 3.49 (95% CI: 2.04-5.97) and 0.50 (95% CI: 0.37-0.68), respectively.
CONCLUSION
The urinary NAG/Cr ratio may be a potential indicator discriminating true pyuria from false pyuria in SUB specimens in the PED. However, large prospective studies are required to implement the NAG/Cr ratio in clinical practice.
Topics: Acetylglucosaminidase; Child; Creatinine; Humans; Pyuria; Retrospective Studies; Urinary Tract Infections
PubMed: 34092512
DOI: 10.1016/j.jpurol.2021.05.001 -
JPMA. the Journal of the Pakistan... Dec 1997Six hundred and nine urine samples were analyzed for pyuria to assess its efficacy as a predictor of bacteriuria, in catheterized patients, using different techniques of...
Six hundred and nine urine samples were analyzed for pyuria to assess its efficacy as a predictor of bacteriuria, in catheterized patients, using different techniques of pus cells estimation. In 235 and 323 urine samples, pus cells were counted per high power field in centrifuged and uncentrifuged urine respectively, while in 51 urine samples pus cells were counted per cubic millimeter in uncentrifuged urine. All the urine samples were simultaneously cultured. Pyuria (pus cells > 10/HPF or CMM) was correlated with bacteriuria (colony count > 10(5) per ml). The overall efficacy of pyuria as a predictor of bacteriuria was low (52.01-60.78%) and there was no significant difference among the different techniques. It was concluded that pyuria as predictor of bacteriuria is the least reliable technique to be recommended in routine clinical practice.
Topics: Bacteriuria; Humans; Predictive Value of Tests; Pyuria; Sensitivity and Specificity
PubMed: 9510640
DOI: No ID Found -
The Journal of Urology Mar 1948
Topics: Diabetes Complications; Diabetes Mellitus; Humans; Pyuria
PubMed: 18903548
DOI: 10.1016/S0022-5347(17)69387-X