Diagnosis of Coliform Infection in Acutely Dysuric Women

Stamm, Walter E.; Counts, George W.; Running, Katherine R.; Fihn, Stephen; Turck, Marvin; Holmes, King K.

doi:10.1056/nejm198208193070802

Cited by 760Urinary Tract Infections ManagementUrinary Bladder and Prostate ResearchPediatric Urology and Nephrology Studies

Diagnosis of Coliform Infection in Acutely Dysuric Women

Stamm, Walter E., Counts, George W., Running, Katherine R., Fihn, Stephen, Turck, Marvin, Holmes, King K.·1982·New England Journal of Medicine

DOI 10.1056/nejm198208193070802

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Abstract

We reevaluated conventional criteria for diagnosing coliform infection of the lower urinary tract in symptomatic women by obtaining cultures of the urethra, vagina, midstream urine, and bladder urine. The traditional diagnostic criterion, greater than or equal to 10(5) bacteria per milliliter of midstream urine, identified only 51 per cent of women whose bladder urine contained coliformis. We found the best diagnostic criterion to be greater than or equal to 10(2) bacteria per milliliter (sensitivity, 0.95; specificity, 0.85). Although isolation of less than 10(5) coliforms per milliliter of midstream urine has had a low predictive value of previous studies of asymptomatic women, the predictive value of the criterion of greater than or equal to 10(2) per milliliter was high (0.88) among symptomatic women the prevalence of coliform infection exceeded 50 per cent. In view of these findings, clinicians and microbiologists should alter their approach to the diagnosis and treatment of women with acute symptomatic coliform infection of the lower urinary tract.

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Urine cultures with less than 10^5 CFU/mL may indicate urinary tract infection in symptomatic women.
“Urine cultures with less than 105CFU/mL may indicate urinary tract infection in symptomatic women.19-22”
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Authors: Stamm, W. E., Counts, G. W., Running, K. R., Fihn, S., Turck, M., & Holmes, K. K.
ORCID: Holmes, King K.
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 1982-08-19
Volume: 307
Issue: 8
Pages: 463-468
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejm198208193070802
OpenAlex: W2323054812
Cited by: 760
References: 17
Citations by year: 2026: 6 · 2025: 9 · 2024: 18 · 2023: 20 · 2022: 18 · 2021: 16 · 2020: 13 · 2019: 17 · 2018: 18 · 2017: 11 · 2016: 28 · 2015: 23 · 2014: 20 · 2013: 16 · 2012: 17
FWCI: 34.48
Type: journal article
Language: en
Open access: closed
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Epidemiology › Urinary Tract Infections Management
Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Urology and Nephrology Studies
Keywords: lower urinary tract infection, dysuria, women, diagnostic criteria, midstream urine culture, urethral culture, vaginal culture, sensitivity and specificity, asymptomatic women
MeSH terms: Acute Disease, Enterobacteriaceae, Enterobacteriaceae Infections, Female, Humans, Specimen Handling, Urinary Tract Infections, Urination Disorders, Urine

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