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Unsuspected urinary infection in general practice.

The Journal of the Royal College of General Practitioners

|July 1, 1970

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This study found that asymptomatic bacteriuria and pyuria are present in a small percentage of otherwise healthy individuals. Many patients with these conditions, and even those without, reported urinary symptoms.

Area of Science:

General Practice
Urology
Microbiology

Background:

Asymptomatic bacteriuria (ASB) is the presence of bacteria in the urine without associated symptoms.
The prevalence of ASB in healthy individuals, particularly those seeking general practitioner services, requires further investigation.
Understanding the correlation between ASB, pyuria, and urinary symptoms is crucial for accurate diagnosis and management.

Purpose of the Study:

To determine the prevalence of asymptomatic bacteriuria and pyuria in a general practice setting.
To investigate the relationship between significant bacteriuria, pyuria, and the presence of urinary symptoms.
To explore variations in incidence across different general practices.

Main Methods:

A survey was conducted involving 341 males and 456 females from 19 general practices in Lancashire and Cheshire.

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Midstream urine specimens were collected and analyzed for bacterial counts (> 10^5 bacteria/ml) and pyuria (> 50 pus cells/cu mm).

Data on patient symptoms and practice-specific incidence rates were recorded.

Main Results:

Significant bacteriuria was detected in 3 males and 45 females, while significant pyuria was found in 3 males and 26 females.
Both conditions were concurrently present in 3 males and 7 females.
The incidence of significant bacteriuria or pyuria varied between 0-24% across practices; approximately one-third of these patients had urinary symptoms.

Conclusions:

Asymptomatic bacteriuria and pyuria occur in a subset of healthy individuals attending general practice.
A notable proportion of patients with significant bacteriuria or pyuria, and even those without, reported urinary symptoms, highlighting diagnostic challenges.
The study underscores the importance of considering urine analysis in patients presenting with urinary complaints, even in the absence of overt infection symptoms.