Causes of Frequency and Dysuria in Women

Abstract

Bacteria in excess of 10⁴ colony-forming units per ml (CFU/ml), were isolated from voided urine specimens from 127 (79%) of 160 women, 15–45 years of age, consulting in general practice due to frequency and dysuria. Escherichia coli was the species most frequently isolated, followed by Staphylococcus saprophyticus. Chlamydia trachomatis was isolated from 8 (5%) patients, in 6 of whom >10⁴ CFU/ml urine were isolated. A 2-fold titre increase in micro-immunofluorescence antibodies to C. trachomatis was demonstrated in 8 cases, the organism itself being isolated in 1 case only. No viruses were isolated in any of 18 women with negative urine cultures. Proteinuria and/or haematuria was found more frequently in patients with S. saprophyticus than in patients with gram-negative rods. Tests for nitrite indicated bacteriuria in only 58% of the patients with >10⁴ CFU/ml urine, which can be partly explained by the fact that S. saprophyticus only occasionally reduces nitrate. Cocci were noted in urine sediment in 75% of patients in whom S. saprophyticus was isolated.