Female Urinary Tract Infection in Primary Health Care: Bacteriological and Clinical Characteristics

Abstract

Female patients with symptoms of urinary tract infection (n=1136) were studied in primary health care with respect to (a) clinical symptoms as predictors of bacteriuria; (b) relation between aetiological agent and clinical picture, especially for P-fimbriated Escherichia coli; and (c) clinical findings in cases with 10²-<10⁵ CFU/ml of E. coli. Prevalence of bacteriuria (≥10⁵ CFU/ml) was 61%. Concurrence of urgency/frequency and dysuria, short duration of symptoms and hematuria increased the probability of bacteriuria and were also significantly more frequent among cases with low counts of E. coli (10²-<10⁵ CFU/ml in pure culture or mixed flora) than among cases with sterile urine, indicating an aetiological role of E. coli in many of those cases. Infections with P-fimbriated E. coli were as benign as the P-fimbriae-negative. The rate of P-fimbriation was 29% in specimens containing ≥10⁵s CFU/ml of E. coli, 30% among specimens with <10⁵ CFU/ml in pure culture and 10% in specimens containing <10⁵ CFU/ml of E. coli in mixed culture. Patients infected with Klebsiclla, Enterobacter or Proteus did not show a higher rate of previous urinary tract disease or anomalies.