Aprospective study of urinary-tract infections in a Dutch general practice

In a Dutch general practice the adult female population was screened for asymptomatic bacteriuria (A.B.) by repeated urine culture after vulval cleansing. The prevalence of signficant A.B. was 4.7% and increased with age. Women with significant A.B. were followed up for one year. All symptomatic urinary-tract infections were recorded during the same period (incidence 59 per 1000 population). Women with significant A.B. at screening were divided into three groups according to the pattern of the follow-up results: transitory A.B., symptomatic A.B., and persistent A.B. The last group differed from the penultimate group with regare to the site of their urinary-tract involvement, symptomatic cases having predominantly upper-urinary-tract involvement and persistent cases lower-urinary-tract infection. In the matched control group the acquisition-rate of both symptomatic and asymptomatic 0acteriuria was over 12%, a figure similar to the percentage of women present in the practice population during one year with transient, symptomatic, and persistent A.B. Screening for A.B. in the general non-pregnant female population is not advocated at present. Screening and treatment of existing A.B. should be carried out in pregnant women who run an increased risk.