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Diagnosis of Coliform Infection in Acutely Dysuric Women
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 105CFU/mL may indicate urinary tract infection in symptomatic women.19-22”
From Performance of the dipstick screening test as a predictor of negative urine culture (2017) · cites this paper as [19]
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Barr, J., Ritchie, J. W. K., Henry, O. M., SHEIKH, M. E., & DEEB, K. E. (1985) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1985.tb01356.x · Cited by 26
Stange, R., Schneider, B., Albrecht, U., Mueller, V., Schnitker, J., & Michalsen, A. (2017) · Research and Reports in Urology · doi:10.2147/rru.s121203 · Cited by 25
Altered urothelial ATP signaling in a major subset of human overactive bladder patients with pyuria
Contreras‐Sanz, A., Krska, L., Balachandran, A., Curtiss, N. L., Khasriya, R., Kelley, S. P., Strutt, M., Gill, H., Taylor, K. M. G., Mansfield, K. J., et al. (2016) · American Journal of Physiology-Renal Physiology · doi:10.1152/ajprenal.00339.2015 · Cited by 25
Alidjanov, J. F., Naber, K. G., Abdufattaev, U. A., Pilatz, A. M. E., & Wagenlehner, F. R. A. (2018) · Antibiotics · doi:10.3390/antibiotics7010006 · Cited by 25
Low urinary counts of P-fimbriated Escherichia coli in presumed acute pyelonephritis.
Bollgren, I., Engström, C., Hammarlind, M., Källenius, G., Ringertz, H. G., & Svenson, S. B. (1984) · Archives of Disease in Childhood · doi:10.1136/adc.59.2.102 · Cited by 25
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Metadata
- 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
- 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 › Urology › 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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