Predictors of Symptom Duration and Bacteriuria in Uncomplicated Urinary Tract Infection

Figures & data

Figure 1. Data were collected at Oslo Accident and Emergency Outpatient Clinic, Norway 2010–2011. The results have been previously published: http://www.tandfonline.com/doi/full/10.3109/02813432.2015.1041827 [20].

Table 1. Predictors of a longer duration of urinary tract symptoms after empirical antibiotic treatment.

	Univariate analyses			Multivariate analyses
	IRR* (B)	95% CI	p	IRR (B)	95% CI	p
Two strong symptoms and urgency n = 89	1.12	0.92–1.37	0.27	1.18	0.94–1.46	0.15
(reference: weak symptoms n = 344)
Age, years
(reference: 16–22)
16–22 n = 151	1.0			1.0
23–28 n = 146	1.05	0.87–1.28	0.60	1.04	0.83–1.29	0.76
≥29 n = 136	1.14	0.94–1.39	0.19	1.06	0.85–1.32	0.59
Leukocytes
(reference: negative n = 44)
3+ n = 121	0.82	0.61–1.10	0.19	1.22	0.80–1.86	0.37
2+ n = 129	0.86	0.64–1.14	0.30	1.18	0.78–1.80	0.43
1+ n = 55	1.27	0.91–1.75	0.16	1.93	1.23–3.01	<0.01
Leukocytes, all positive n = 305	0.92	0.70–1.20	0.53
(reference: negative n = 44)
Nitrite positive n = 58	1.13	0.89–1.44	0.31
(reference: negative n = 289)
Erythrocytes positive n = 294	0.82	0.64–1.05	0.11
(reference: negative n = 54)
Negative urine dipstick n = 22	0.86	0.60–1.23	0.41	0.65	0.38-1.12	0.12
(reference: any positive dipstick finding n = 324)
Microbe susceptibility to given treatment
(reference: sensitive n = 179)
Resistant n = 47	1.51	1.16–1.97	<0.01	1.41	1.07–1.89	0.02
No susceptibility testing performed n = 187	1.02	0.85–1.21	0.86	0.92	0.75–1.12	0.40
Doctors’ consultation n = 191	1.12	0.95–1.31	0.18
(reference: algorithm group n = 242)
Significant bacteriuria n = 233	1.06	0.89–1.25	0.53
(reference: negative n = 173)

* IRR = incidence rate ratio;

  CI = confidence interval.

The predictors of longer duration of urinary tract symptoms after empirical antibiotic treatment were identified using the traditional negative binomial model. The data were collected at Oslo Accident and Emergency Outpatient Clinic, Norway, 2010–2011.

Table 2. Symptoms and signs that predicted significant bacteriuria in acute uncomplicated cystitis.

Symptoms and signs	Growth + (%)	Growth – (%)	Total (%)	Sensitivity	Specificity	PPV*
	N = 233	N = 173	N = 406
Pain at urination (all)	233 (100)	173 (100)	406 (100)
Strong	77 (33)	54 (31)	131 (32)	0.33	0.69	0.58
Urinary frequency (all)	233 (100)	173 (100)	406 (100)
Strong	81 (35)	65 (38)	146 (36)	0.35	0.62	0.56
Urgency (n = 405)^^	228 (98)	172 (99)	400 (99)	0.98	0.58	0.57
Two strong symptoms and urgency	53 (23)	35 (20)	88 (22)	0.23	0.80	0.60
Age, years (all)	233 (100)	173 (100)	406 (100)
16–22	73 (31)	67 (39)	140 (35)	0.31	0.61	0.52
23–28	80 (34)	57 (33)	137 (34)	0.34	0.67	0.58
≥29	80 (34)	49 (28)	129 (32)	0.34	0.72	0.62
Urine dipstick findings
Leukocytes (n = 327)	192 (59)	135 (41)
3+	75 (39)	40 (30)	115 (32)	0.39	0.70	0.65
2+	79 (41)	39 (29)	118 (36)	0.41	0.71	0.67
1+	25 (13)	27 (20)	52 (16)	0.13	0.80	0.48
Leukocytes, all positive	179 (93)	106 (79)	285 (87)	0.93	0.21	0.63
Negative	13 (7)	29 (22)	42 (13)
Nitrite positive (n = 325)	44 (23)	10 (8)	54 (17)	0.23	0.93	0.81
Erythrocytes positive (n = 326)	174 (91)	103 (77)	277 (85)	0.91	0.23	0.63

* PPV = positive predictive value.

The sensitivity, specificity and PPV of symptoms and signs that predicted significant bacteriuria were identified using data collected at Oslo Accident and Emergency Outpatient Clinic, Norway, 2010–2011.

^{^} 1 patient did not respond.

Table 3. Predictors of the presence of significant bacteriuria in urine samples from women with diagnosed acute uncomplicated cystitis.

	Univariate analyses			Multivariate analyses
	OR* (B)	95% CI	p	OR (B)	95% CI	p
Two strong symptoms and urgency, n = 89	1.16	0.72–1.88	0.54
(reference: weak, n = 344)
Age, years
16–22, n = 151	1.00			1.00
(reference)
23–28, n = 146	1.29	0.80–2.07	0.30	1.35	0.75–2.40	0.31
≥29, n = 136	1.50	0.92–2.44	0.10	1.44	0.80–2.56	0.22
Urine dipstick findings
Leukocytes	1.0			1.0
(reference: negative, n = 44)
3+, n = 121	4.18	1.96–8.93	<0.01	2.40	0.88–6.05	0.09
2+, n = 129	4.52	2.12–9.65	<0.01	2.51	0.92–6.83	0.07
1+, n = 55	2.07	0.88–4.84	0.10	1.38	0.46–4.19	0.57
Leukocytes, all positive, n = 305	3.77	1.88–7.56	<0.01
(reference: negative, n = 44)
Nitrite positive, n = 58	3.71	1.79–7.68	<0.01	3.22	1.58–7.01	<0.01
(reference: negative, n = 289)
Erythrocytes positive, n = 294	2.91	1.55–5.46	<0.01	1.40	0.60–3.25	0.45
(reference: negative, n = 54)
Positive urine dipstick, 324 (reference: negative, n = 22)	9.18	2.63–32.02	<0.01	2.73	0.47–15.73	0.26

* OR = odds ratio;

  CI = confidence interval.

The predictors of the presence of significant bacteriuria were identified in a logistic regression analysis of data collected at Oslo Accident and Emergency Outpatient Clinic, Norway, 2010–2011.

Figure 2. Correlations between the presence of leukocyte esterase, nitrite, age and significant bacteriuria. CI = confidence interval. Receiver-operator characteristic (ROC) analysis of the relationship between the presence of leukocyte esterase, nitrite, age and significant bacteriuria. The data were collected at Oslo Accident and Emergency Outpatient Clinic, Norway, 2010–2011.

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