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[Urinary infection and pyelonephritis].

J de la Cruz París

    Boletin Medico Del Hospital Infantil De Mexico
    |September 1, 1979
    PubMed
    Summary
    This summary is machine-generated.

    Accurate diagnosis of urinary tract infections (UTIs) and pyelonephritis relies on reliable urine sample collection. Serial midstream cultures or suprapubic aspiration are recommended for precise bacterial identification and effective patient management.

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    Area of Science:

    • Urology
    • Infectious Diseases
    • Clinical Microbiology

    Context:

    • Urinary tract infections (UTIs) and pyelonephritis are common clinical disorders with evolving diagnostic and management concepts.
    • Accurate etiological diagnosis is crucial for effective treatment and prognosis.

    Purpose:

    • To evaluate the reliability of different urine sample collection techniques for diagnosing UTIs.
    • To identify predisposing factors associated with UTIs and their impact on clinical outcomes.

    Summary:

    • Bacteriological analysis of 245 urine samples assessed suprapubic puncture, single midstream voiding culture, and serial midstream cultures.
    • Escherichia coli was the predominant pathogen (91% of initial episodes, 87% of recurrences).
    • Suprapubic puncture demonstrated the highest reliability, avoiding sample contamination. Serial midstream cultures showed good correlation with suprapubic puncture, while single midstream cultures yielded a 50% false-positive rate. Predisposing factors, particularly intra-urinary tract issues like vesicoureteral reflux (52% in affected patients), were present in 68% of UTI cases.

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    Impact:

    • Highlights the importance of reliable urine culture techniques for accurate UTI diagnosis.
    • Emphasizes the critical role of identifying predisposing factors in managing UTIs, influencing infection site, recurrence, chronicity, treatment, and prognosis.
    • Recommends suprapubic aspiration or serial midstream cultures for improved diagnostic accuracy in UTI cases.