Asymptomatic Bacteriuria Clinical Trial
Official title:
The Frequency of Leukocytes and Nitrites in the Urine of Healthy Adults
This is a prospective, observational study assessing the results of urine dipsticks on adult volunteers with no acute symptoms. We seek to determine the frequency of leukocytes or nitrites in this group of individuals.
The urinalysis (UA) is one of the most commonly utilized tests in the emergency department
(ED). In some busy EDs, a UA is routinely ordered by protocol on patients with abdominal
pain, and in elderly patients, a UA is often ordered for a variety of chief complaints
including dizziness and altered mental status. When these patients, who often do not
specifically have symptoms of a urinary tract infection, have a urinalysis demonstrating
pyuria or bacteria, it may be interpreted as an atypical presentation of a UTI. However, it
is possible that these patients do not have urinary tract infections, but have baseline
pyuria or bacteriuria. One prior study found that 5% of sexually active healthy women 18-40
have asymptomatic bacteriuria [1], and the rate of asymptomatic bacteriuria increases with
age, such that it is present in 8-10% of women from 70-80 years of age [2]. Moreover, one
prior article stated that 30-50% of residents of long term nursing facilities have positive
urine cultures at any given time [3].
The above statistics come from the results of urine cultures. In the ED, the decision to
treat or not treat a patient for a UTI is not made based upon culture results, but upon a
urinalysis (microscopic or dipstick). Only one prior study has looked at the frequency of
abnormal urinalyses in healthy individuals, and it found that over a third of asymptomatic
women had at least 1+ leukocytes in their urine [4]. This is evidence that a substantial
number of people who do not have symptomatic UTIs have UAs that could be interpreted as UTIs.
If these results could be replicated and expanded to include a wider group of individuals
(males, elderly patients, various races, etc.), it would provide valuable information about
how we can better interpret and utilize the results of a UA.
Thus, the investigators propose a prospective study to assess the frequency of abnormal UAs
in a wide variety of individuals without acute symptoms.
Urine samples will be obtained from adults with no acute symptoms, and performed urine
dipsticks to assess the frequency of leukocytes or nitrites in the urine. Patients will be
divided into groups to determine if there are certain factors (gender, age, or medical
history) that increase the chance of having leukocytes or nitrites in the urine.
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