Cargando…
Predictive Value of Urinalysis and Recent Antibiotic Exposure to Distinguish Between Bacteriuria, Candiduria, and No-Growth Urine
PURPOSE: Urinary tract infections are diagnosed by clinical symptoms and detection of causative uropathogen. Antibiotics are usually not indicated in candiduria and no-growth urine. We aimed to develop a predictive score to distinguish bacteriuria, candiduria, and no-growth urine, and to describe th...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8722576/ https://www.ncbi.nlm.nih.gov/pubmed/35002261 http://dx.doi.org/10.2147/IDR.S343021 |
_version_ | 1784625541860556800 |
---|---|
author | Chotiprasitsakul, Darunee Kijnithikul, Akara Uamkhayan, Anuchat Santanirand, Pitak |
author_facet | Chotiprasitsakul, Darunee Kijnithikul, Akara Uamkhayan, Anuchat Santanirand, Pitak |
author_sort | Chotiprasitsakul, Darunee |
collection | PubMed |
description | PURPOSE: Urinary tract infections are diagnosed by clinical symptoms and detection of causative uropathogen. Antibiotics are usually not indicated in candiduria and no-growth urine. We aimed to develop a predictive score to distinguish bacteriuria, candiduria, and no-growth urine, and to describe the distribution of microorganisms in urine. PATIENTS AND METHODS: A single-center, retrospective cohort study was conducted between January 2017 and November 2017. Patients with concomitant urinalysis and urine culture were randomly sorted for a clinical prediction model. Multivariable regression analysis was performed to determine factors associated with bacteriuria, candiduria, and no-growth urine. A scoring system was constructed by rounding the regression coefficient for each predictor to integers. Accuracy of the score was measured by the concordance index (c-index). RESULTS: There were 8091 positive urine cultures: bacteria 85.6%, Candida 13.7%. Randomly selected cases were sorted into derivation and validation cohorts (448 cases and 272 cases, respectively). Numerous yeast on urinalysis predicted candiduria with complete accuracy; therefore, it was excluded from a score construction. We developed a NABY score based on: positive nitrite, 1 point; Antibiotic exposure within 30 days, –2 points; numerous Bacteria in urine, 2 points; few Yeast in urine, –2 points; moderate Yeast in urine, –5 points. The c-index was 0.85 (derivation) and 0.82 (validation). A score ≥0 predicted 76% and 54% of bacteriuria in the derivation and validation cohorts, respectively. A score ≤−3 predicted 96% of candiduria in both cohorts. CONCLUSION: Numerous yeast on urinalysis and the NABY score may help identify patients with a low risk of bacteriuria in whom empiric antibiotics for UTIs can be avoided. |
format | Online Article Text |
id | pubmed-8722576 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-87225762022-01-06 Predictive Value of Urinalysis and Recent Antibiotic Exposure to Distinguish Between Bacteriuria, Candiduria, and No-Growth Urine Chotiprasitsakul, Darunee Kijnithikul, Akara Uamkhayan, Anuchat Santanirand, Pitak Infect Drug Resist Original Research PURPOSE: Urinary tract infections are diagnosed by clinical symptoms and detection of causative uropathogen. Antibiotics are usually not indicated in candiduria and no-growth urine. We aimed to develop a predictive score to distinguish bacteriuria, candiduria, and no-growth urine, and to describe the distribution of microorganisms in urine. PATIENTS AND METHODS: A single-center, retrospective cohort study was conducted between January 2017 and November 2017. Patients with concomitant urinalysis and urine culture were randomly sorted for a clinical prediction model. Multivariable regression analysis was performed to determine factors associated with bacteriuria, candiduria, and no-growth urine. A scoring system was constructed by rounding the regression coefficient for each predictor to integers. Accuracy of the score was measured by the concordance index (c-index). RESULTS: There were 8091 positive urine cultures: bacteria 85.6%, Candida 13.7%. Randomly selected cases were sorted into derivation and validation cohorts (448 cases and 272 cases, respectively). Numerous yeast on urinalysis predicted candiduria with complete accuracy; therefore, it was excluded from a score construction. We developed a NABY score based on: positive nitrite, 1 point; Antibiotic exposure within 30 days, –2 points; numerous Bacteria in urine, 2 points; few Yeast in urine, –2 points; moderate Yeast in urine, –5 points. The c-index was 0.85 (derivation) and 0.82 (validation). A score ≥0 predicted 76% and 54% of bacteriuria in the derivation and validation cohorts, respectively. A score ≤−3 predicted 96% of candiduria in both cohorts. CONCLUSION: Numerous yeast on urinalysis and the NABY score may help identify patients with a low risk of bacteriuria in whom empiric antibiotics for UTIs can be avoided. Dove 2021-12-30 /pmc/articles/PMC8722576/ /pubmed/35002261 http://dx.doi.org/10.2147/IDR.S343021 Text en © 2021 Chotiprasitsakul et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Chotiprasitsakul, Darunee Kijnithikul, Akara Uamkhayan, Anuchat Santanirand, Pitak Predictive Value of Urinalysis and Recent Antibiotic Exposure to Distinguish Between Bacteriuria, Candiduria, and No-Growth Urine |
title | Predictive Value of Urinalysis and Recent Antibiotic Exposure to Distinguish Between Bacteriuria, Candiduria, and No-Growth Urine |
title_full | Predictive Value of Urinalysis and Recent Antibiotic Exposure to Distinguish Between Bacteriuria, Candiduria, and No-Growth Urine |
title_fullStr | Predictive Value of Urinalysis and Recent Antibiotic Exposure to Distinguish Between Bacteriuria, Candiduria, and No-Growth Urine |
title_full_unstemmed | Predictive Value of Urinalysis and Recent Antibiotic Exposure to Distinguish Between Bacteriuria, Candiduria, and No-Growth Urine |
title_short | Predictive Value of Urinalysis and Recent Antibiotic Exposure to Distinguish Between Bacteriuria, Candiduria, and No-Growth Urine |
title_sort | predictive value of urinalysis and recent antibiotic exposure to distinguish between bacteriuria, candiduria, and no-growth urine |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8722576/ https://www.ncbi.nlm.nih.gov/pubmed/35002261 http://dx.doi.org/10.2147/IDR.S343021 |
work_keys_str_mv | AT chotiprasitsakuldarunee predictivevalueofurinalysisandrecentantibioticexposuretodistinguishbetweenbacteriuriacandiduriaandnogrowthurine AT kijnithikulakara predictivevalueofurinalysisandrecentantibioticexposuretodistinguishbetweenbacteriuriacandiduriaandnogrowthurine AT uamkhayananuchat predictivevalueofurinalysisandrecentantibioticexposuretodistinguishbetweenbacteriuriacandiduriaandnogrowthurine AT santanirandpitak predictivevalueofurinalysisandrecentantibioticexposuretodistinguishbetweenbacteriuriacandiduriaandnogrowthurine |