Prevalência de infecções do trato urinário e bacteriuria em gestantes da clínica ginecológica do ambulatório materno infantil de Tubarão – SC no ano de 2005 / Prevalence of urinary infection and asymptomatic bacteriuria in pregnant in a clinics in south Brazil

Introdução: A prevalência de bacteriúria assintomática é de 10 % na gravidez. A Escherichia coli corresponde a 80-90% das infecções. A cultura de urina deveser usada como um procedimento de rotina na primeira visita pré-natal. O tratamento da bacteriúria assintomáticaprevine complicações na gestação como pielonefrite aguda. Objetivos: Determinar a prevalência de infecção dotrato urinário em gestantes da clínica ginecológica do Ambulatório Materno Infantil de Tubarão-SC no período de 2005. Métodos: Foi realizado um estudo observacional, descritivo sobre registros secundários de todas as gestantes(17 - 40 anos) do Ambulatório Materno Infantil de Tubarão no período 01/01/2005 a 31/12/2005. Resultados: Das 192 gestantes, 70 (36,46%) pacientes foram incluídas com alterações clínicas e/ou laboratoriais de infecção do trato urinário. A solicitação de urocultura foi realizada em 28 (40%) pacientes. Destas, 11 (39,29%) apresentaram urocultura positiva, sendo a Escherichia coli mais prevalente em 45,45%. Prevalência de tratamento medicamentoso nas gestantes queapresentaram alterações clínicas e/ou laboratoriais foi de 45,71%. Conclusões: Urocultura continua sendo o melhor método diagnóstico para infecção do trato urinário. Solicitá-la precocemente na primeira visita pré-natal para diagnosticar e tratar os casos de bacteriúria assintomática torna-se imprescindível para prevenir uma futuracomplicação.

Introduction: The prevalence of asymptomatic bacteriuria is 10% during pregnancy. The Escherichia coli bacterium is responsible for 80-90% of the infections. The urine culture should be used as a routine procedure in the first pre-natal visit. The treatment of asymptomatic bacterium prevents complications during pregnancy such as acute pyelonephritis. Objectives: To determinate the prevalence of urinarytract infection in pregnant women at the Ambulatório Materno Infantil – Tubarão– SC during the period of 2005. Methodology: A descriptive Observational study was realized using secondary records of all pregnant woman (17-40 years old) of the Ambulatório Materno Infantil ofTubarão in the period from January 1st 2005 through December 31st 2005. The information was typed in a file created by the “Epi-data Program” and analyzed in the “Epi-Info Program”. The averages were compared by Kruskal-Wallis test, the proportions by qui-square testor Fisher exact test, when correspondent. Results: Of the 192 pregnant woman, 70 (36,46%)patients were included with clinical and/or laboratorial alterations of urinary tract infection. The uroculture request was realized in 28 (40%) patients. Among them, 11 (39,29%) presented positive uroculture, Escherichia coli being the most prevalent bacteria (45,45%). Theprevalence of the women that presented clinical and/or laboratorial alterations that were treated was 45,71%.Conclusions: Uroculture continues to be the best diagnostics methods for infection of urinary tract. Its earlyrequest in the fist pre-natal visit to diagnose and treat the asymptomatic bacteriuria becomes indispensable inpreventing future complications.

Infección urinaria en el geronte / Urinary tract infection in the elderly

La infección urinaria es una patología común en el geronte. Esta población presenta diversos factores de riesgo, tales como la edad, la insuficiencia renal crónica y otras comorbilidades, el uso frcuente de sondas vesicales, que favorecen la incidencia de dichas infecciones. Se describe una actualización acerca de la etiología, las manifestaciones clínicas, el diagnóstico y tratamiento de las infecciones urinarias en grupos epidemiológicos seleccionados.

Bacteriúria assintomática / Asymptomatic bacteriuria

A bacteriúria assintomática (BA) é um evento relativamente freqüente na prática médica e que confronta o médico da necessidade de tratá-Ia ou não. A seguir, serão feitas algumas considerações sobre o achado de BA na urocultura

Asymptomatic bacteriuria in patients with diabetes mellitus

The study was carried on 300 cases to assess the rate of asymptomatic bacteriuria in patients with diabetes mellitus. Cases were grouped into three groups. The first group included 100 diabetic patients with diabetic complications. The second group included 100 diabetic patients without diabetic complications. A third group included 100 non diabetic apparently healthy persons as a control group. 34% of complicated diabetics [group [I]] and 25% of uncomplicated diabetics [group [II]] had significant bacteriuria. While only 12% of the control group had significant bacteriuria compared with 29.5% of the two diabetic groups. There was significant difference in pyuria between the diabetic group and the control group [6.5% and 1% respectively]. The association between bacteriuria and pyuria was highly significant in all studied groups. Also there was significant difference as regards the significant bacteriuria between each studied group in females [54%, 36%, and 18% for complicated, uncomplicated and control group respectively], While the difference between each group in males was insignificant [14%, 14%, and 6%]. Organisms causing asymptomatic bacteriuria were aerobic in 85.3% of group [I], 96% in group [II] and 100% in control persons. The anaerobic organisms were detected in the remaining of diabetic cases. The difference between the three studied groups as regards isolated organisms is insignificant. E. coli was the prevalent causative agent of significant bacteriuria in all studied groups [47% in group [I], 48% in group [II], and 50% in controls]. The isolated aerobic organisms was significantly higher than anaerobic organisms. Urine specimens were examined by direct immuofluorescence test for detection of antibody coated bacteria [IF-A CB]. ACB was detected in 32.4% of complicated diabetic patients and 12% of uncomplicated diabetics, with significant bacteriuria. The rate of significant bacteriuria was found to increase with the age of patients and the duration of diabetes especially the complicated one, but not with degree of control of diabetes

new criterion for laboratory diagnosis of symptomatic urinary tract infection in women

One hundred and twenty urine specimens from symptomatic and asymptomatic women patients suspected of urinary tract infection [UTI] were tested for the presence of true bacteriuria. Specimens from symptomatic patients were cultured by a dual-plating method and specimens from asymptomatic patients by the standard loop technique. The results were compared with microscopic examinations. It is shown that in symptomatic patients with lower UTI, 100 or more colony forming units per milliliter [CFU/ml] of urine is a better criterion for the detection of true bacteriuria

Frequency of symptomatic bacteriuria in pregnant diabetics

Bacteriuria was assessed in clean mid stream urine specimens using the biotest uricount dip slide method and reference procedure in 100 pregnant females with diabetes mellitus and 100 non-diabetic pregnant females, all had no urinary troubles. The frequency of significant asymptomatic bacteriuria [SAB] was significantly higher in the diabetic [44%] than in the non-diabetic pregnant females [12%], in poorly controlled cases [75%] than in adequately controlled cases [27%], in non-glucosuric diabetic [67.74] than in non- glucosuric non- diabetic cases [11.7%] and in non-glucosuric [67.74%] than in glucosuric diabetic cases [33.3%]. The age, parity, duration of pregnancy and pH had no significant effect on the frequency of SAB among the diabetic and non-diabetic groups or among the cases of each group. Escherichia coli was the most common microorganism in both groups. By comparison, the dip slide method detected 53 of the 56 significant asymptomatic bacteriuria found by culture in both groups