TY - JOUR
T1 - Localization of urinary tract infection in patients with spinal cord injury
AU - Hooton, Thomas M.
AU - O'Shaughnessy, Edward J.
AU - Clowers, Diane
AU - Mack, Larry
AU - Cardenas, Diana D.
AU - Stamm, Walter E.
N1 - Funding Information:
Received for publication December 27, 1983, and in revised form March 19, 1984. Informed consent was obtained from all patients in this study, and the guidelines of the Human Subjects Review Committee of the University of Washington were followed in the conduct of this research. This study was supported in part by research grant G008100052 from the National Institute of Handicapped Research. We thank Eve Kelly for assistance in performing bladder washouts and Grada Grootes-Reuvecamp for performing the antibody-coated bacteria tests and quantitative leukocyte counts. Please address requests for reprints to Dr. Thomas M. Hooton, Department of Medicine, Harborview Medical Center, 325 9th Avenue, Seattle, Washington 98104.
PY - 1984
Y1 - 1984
N2 - The site of urinary tract infection (UTI) was localized in asymptomatic bacteriuric patients with spinal cord injury who underwent intermittent bladder catheterization by the bladder washout (BWO) test, antibody-coated bacteria (ACB) test, quantitative urinary leukocyte count, ultrasonography, and excretory urography. Thirty-two (43%) of 74 UTIs were localized by BWO to the upper tract and 42 (57%) to the lower tract. Sensitivity of the ACB test in detecting upper UTI as defined by BWO was 0.28, and specificity was 0.86. The median urinary leukocyte count in 22 BWO-positive infections tested was 420 vs. 94 in 24 BWO-negative infections (P = .01). Patients with polymicrobic infections or with upper tract abnormalities, as detected by ultrasound or excretory urography, were more likely to have BWO-positive infections. We conclude that negative BWOs are usually associated with negative ACB tests in this population, but further comparisons of both tests with ureteral catheterization are needed to clarify the meaning of results in either assay.
AB - The site of urinary tract infection (UTI) was localized in asymptomatic bacteriuric patients with spinal cord injury who underwent intermittent bladder catheterization by the bladder washout (BWO) test, antibody-coated bacteria (ACB) test, quantitative urinary leukocyte count, ultrasonography, and excretory urography. Thirty-two (43%) of 74 UTIs were localized by BWO to the upper tract and 42 (57%) to the lower tract. Sensitivity of the ACB test in detecting upper UTI as defined by BWO was 0.28, and specificity was 0.86. The median urinary leukocyte count in 22 BWO-positive infections tested was 420 vs. 94 in 24 BWO-negative infections (P = .01). Patients with polymicrobic infections or with upper tract abnormalities, as detected by ultrasound or excretory urography, were more likely to have BWO-positive infections. We conclude that negative BWOs are usually associated with negative ACB tests in this population, but further comparisons of both tests with ureteral catheterization are needed to clarify the meaning of results in either assay.
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U2 - 10.1093/infdis/150.1.85
DO - 10.1093/infdis/150.1.85
M3 - Article
C2 - 6379063
AN - SCOPUS:0021245484
VL - 150
SP - 85
EP - 91
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
SN - 0022-1899
IS - 1
ER -