Huppert Jill S, Biro Frank, Lan Dongmei, Mortensen Joel E, Reed Jennifer, Slap Gail B
Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA.
J Adolesc Health. 2007 May;40(5):418-24. doi: 10.1016/j.jadohealth.2006.12.010. Epub 2007 Mar 9.
To determine if urinary symptoms or urinary tract infections (UTI) were associated with sexually transmitted infections (STI) and which history, clinical, and laboratory findings could distinguish these infections in symptomatic women.
A cross-sectional sample of 296 sexually active females aged 14-22 years attending a hospital-based teen health center or emergency department were recruited. Genitourinary symptoms, medical and sexual history, and urinalysis results were recorded. STI was defined as a vaginal swab positive for Trichomonas vaginalis or urine nucleic acid amplification test positive for Neisseria gonorrheae or Chlamydia trachomatis. A urine culture with >10,000 colonies of a single pathogen was considered a positive UTI.
In the full sample, prevalence of UTI and STI were 17% and 33%, respectively. Neither urinary symptoms nor UTI was significantly associated with STI. Further analyses are reported for the 154 (51%) with urinary symptoms: Positive urine leukocytes, more than one partner in the last three months and history of STI predicted STI. Urinalysis results identified four groups: (1) Normal urinalysis-67% had no infection; (2) Positive nitrites or protein-55% had UTI; (3) Positive leukocytes or blood-62% had STI; and (4) Both nitrites/protein and leukocytes/blood positive-28% had STI and 65% had UTI. Those without a documented UTI were more likely to have trichomoniasis than those with a UTI, and 65% of those with sterile pyuria had STI, mainly trichomoniasis or gonorrhea.
Adolescent females with urinary symptoms should be tested for both UTI and STIs. Urinalysis results may be helpful to direct initial therapy.
确定泌尿系统症状或尿路感染（UTI）是否与性传播感染（STI）相关，以及哪些病史、临床和实验室检查结果可用于鉴别有症状女性的这些感染。
招募了296名年龄在14至22岁之间、在医院青少年健康中心或急诊科就诊的性活跃女性作为横断面样本。记录泌尿生殖系统症状、病史和性史以及尿液分析结果。STI定义为阴道拭子检测阴道毛滴虫阳性或尿液核酸扩增试验检测淋病奈瑟菌或沙眼衣原体阳性。单一病原体菌落数>10,000的尿培养被视为UTI阳性。
在整个样本中，UTI和STI的患病率分别为17%和33%。泌尿系统症状和UTI均与STI无显著相关性。对154名（51%）有泌尿系统症状的患者进行了进一步分析：尿白细胞阳性、过去三个月有多个性伴侣以及有STI病史可预测STI。尿液分析结果分为四组：（1）尿液分析正常——67%无感染；（2）亚硝酸盐或蛋白质阳性——55%有UTI；（3）白细胞或血液阳性——62%有STI；（4）亚硝酸盐/蛋白质和白细胞/血液均阳性——28%有STI且65%有UTI。未记录有UTI的患者比有UTI的患者更易患滴虫病，65%无菌性脓尿患者患有STI，主要为滴虫病或淋病。
有泌尿系统症状的青春期女性应同时检测UTI和STIs。尿液分析结果可能有助于指导初始治疗。
