The Role of Asymptomatic Bacteriuria in Young Women with Recurrent Urinary Tract Infections: to Treat or Not to Treat?
Clin Infect Dis. 2012 Jun 7;
Authors: Cai T, Mazzoli S, Mondaini N, Meacci F, Nesi G, D'Elia C, Malossini G, Boddi V, Bartoletti R
Abstract
Background.?Little is known about the role of asymptomatic bacteriuria (AB) treatment in young women affected by recurrent UTI. We aimed to evaluate the impact of AB treatment in recurrence rate among young women affected by recurrent UTI.Methods.?673 consecutive asymptomatic young women with demonstrated bacteriuria from January 2005 and December 2009, were prospectively enrolled. All patients were split into two groups: Group A - not treated, Group B - treated. Microbiological and clinical evaluations were performed at 3, 6 and 12 months. Quality of life was also measured. Recurrence-free rate at the end of the entire study period was the main outcome measure.Results.?312 were assigned to Group A while 361 to Group B. At the baseline, the two most commonly isolated pathogens were Escherichia coli (Group A 38.4%; Group B 39.3%) and Enterococcus faecalis (Group A 32.7%; Group B 33.2%). At the first follow-up visit, there was no difference between the two Groups (RR 1.05;95%CI, 1.01-1.10), while after 6 months, 23 (7.6%) in Group A and 98 (29.7%) in Group B showed recurrence with a statistically significant difference (RR 1.31; 95%CI, 1.21-1.42;p<0.0001). At the last follow-up, 41 (13.1%) in Group A and 169 (46.8%) in Group B showed recurrence (RR 3.17;95%CI, 2.55-3.90;p<0.0001). 1 patient in Group A and 2 patients in Group B were found to be affected by pyelonephritis.Conclusions.?This study shows that AB should not be treated when found in young women affected by UTI, hypothesizing its protective role in preventing symptomatic recurrence.
PMID: 22677710 [PubMed - as supplied by publisher]