Mayo Clinic, Department of Emergency Medicine, Jacksonville, Florida.
Mayo Clinic, Division of Clinical Trials and Biostatistics, Scottsdale, Arizona.
West J Emerg Med. 2024 May;25(3):358-367. doi: 10.5811/westjem.60033.
Bacterial urinary tract infections (UTI) and some sexually transmitted infections (STI) can have overlapping signs and symptoms or nonspecific findings, such as pyuria on urinalysis. Furthermore, results from the urine culture and the nucleic acid amplification test for an STI may not be available during the clinical encounter. We sought to determine whether gonorrhea, chlamydia, and trichomoniasis are associated with bacteriuria, information that might aid in the differentiation of STIs and UTIs.
We used multinomial logistic regression to analyze 9,650 encounters of female patients who were aged ≥18 years and who underwent testing for STIs. The ED encounters took place from April 18, 2014-March 7, 2017. We used a multivariable regression analysis to account for patient demographics, urinalysis findings, vaginal wet-mount results, and positive or negative (or no) findings from the urine culture and testing for or
In multivariable analysis, infection with , or was not associated with having a urine culture yielding 10,000 or more colony-forming units per mililiter (CFU/mL) of bacteria compared with a urine culture yielding less than 10,000 CFU/mL or no urine culture obtained. The diagnosis of a UTI in the ED was not associated with having a urine culture yielding 10,000 or more CFU/mL compared with a urine culture yielding less than 10,000 CFU/mL.
After adjusting for covariates, no association was observed between urine culture results and testing positive for trichomoniasis, gonorrhea, or chlamydia. Our results suggest that having a concurrent STI and bacterial UTI is unlikely.
细菌性尿路感染(UTI)和一些性传播感染(STI)可能具有重叠的症状或非特异性发现,例如尿液分析中的脓尿。此外,在临床就诊期间,尿液培养和 STI 的核酸扩增试验的结果可能无法获得。我们试图确定淋病、衣原体和滴虫病是否与菌尿有关,这些信息可能有助于区分 STI 和 UTI。
我们使用多项逻辑回归分析了 9650 名年龄≥18 岁的女性患者的就诊情况,这些患者接受了 STI 检测。ED 就诊发生在 2014 年 4 月 18 日至 2017 年 3 月 7 日之间。我们使用多变量回归分析来解释患者的人口统计学特征、尿液分析结果、阴道湿片结果以及尿液培养和检测的阳性或阴性(或无)结果。
在多变量分析中,与感染 、 或 相比,尿液培养中每毫升产生 10,000 个或更多菌落形成单位(CFU/mL)的细菌与尿液培养中产生少于 10,000 CFU/mL 的细菌或未进行尿液培养无关。ED 中 UTI 的诊断与尿液培养中每毫升产生 10,000 个或更多 CFU/mL 的细菌与尿液培养中产生少于 10,000 CFU/mL 的细菌或未进行尿液培养无关。
在调整协变量后,尿液培养结果与检测出滴虫病、淋病或衣原体阳性之间没有观察到关联。我们的结果表明,同时患有 STI 和细菌性 UTI 的可能性不大。