Junior Resident, Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Additional Professor, Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Trop Doct. 2021 Oct;51(4):535-538. doi: 10.1177/00494755211006990. Epub 2021 Apr 13.
Studies indicate that asymptomatic bacteriuria in medical inpatients is often inappropriately treated with antibiotics. We prospectively studied the proportion of asymptomatic bacteriuria among 200 positive urine cultures which were ordered in hospitalised medical inpatients of a teaching hospital in southern India. We used pre-defined criteria to classify patients as urinary tract infection and asymptomatic bacteriuria. Median age of patients was 53.5 (42-65) years, and 51% were male. In all, 157 (78.5%) patients had urinary tract infection (131 [66.5%] definite and 26 [13%] probable) and 43 (21.5%) had asymptomatic bacteriuria. In patients with asymptomatic bacteriuria, 18 (41.8%) received urinary tract infection-directed antibiotics; broad spectrum antibiotics were used in 10 (23%). Patients with asymptomatic bacteriuria were younger, more likely to be on a urinary catheter, had higher prevalence of chronic kidney disease and congestive cardiac failure and had lower prevalence of pyuria and lower total leucocyte counts. Urine cultures should be ordered only in indicated patients. Inappropriate antibiotic treatment in patients with asymptomatic bacteriuria should be avoided.
研究表明，住院的内科患者无症状菌尿常被不合理地用抗生素治疗。我们前瞻性地研究了印度南部一所教学医院住院内科患者的 200 例阳性尿液培养中无症状菌尿的比例。我们使用预先定义的标准将患者分为尿路感染和无症状菌尿。患者的中位年龄为 53.5（42-65）岁，51%为男性。共有 157 例（78.5%）患者患有尿路感染（131 例[66.5%]为确诊，26 例[13%]为可能），43 例（21.5%）为无症状菌尿。在无症状菌尿患者中，18 例（41.8%）接受了尿路感染靶向抗生素治疗；10 例（23%）使用了广谱抗生素。无症状菌尿患者更年轻，更可能使用导尿管，慢性肾脏病和充血性心力衰竭的患病率更高，脓尿和总白细胞计数更低。只有在有指征的患者中才应进行尿液培养。应避免对无症状菌尿患者不合理地使用抗生素治疗。
