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Polymicrobic bacteriuria: significant association with bacteremia

P A Gross, M Flower, G Barden

    Journal of Clinical Microbiology
    |March 1, 1976
    PubMed
    Summary
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    Discarding urine cultures with multiple bacteria may miss serious infections. This study found polymicrobic bacteriuria frequently occurs with bacteremia, even with proper collection methods, highlighting its clinical significance.

    Area of Science:

    • Clinical Microbiology
    • Infectious Diseases
    • Urology

    Background:

    • Current practice often discards urine cultures with three or more isolates, assuming contamination.
    • The clinical significance of polymicrobic bacteriuria (multiple bacterial species in urine) is not fully understood.

    Purpose of the Study:

    • To evaluate the validity of discarding urine cultures with multiple isolates.
    • To determine the association between polymicrobic bacteriuria and bacteremia originating from the urinary tract.

    Main Methods:

    • Retrospective review of patients with positive blood cultures and urinary tract infections.
    • Analysis of bacterial isolates and antibiograms from blood and urine cultures.
    • Prospective reculturing of patients with polymicrobic bacteriuria to confirm findings.

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    Main Results:

    • Of 18 patients with bacteremia and urinary tract infections, 11 (61%) had polymicrobic bacteriuria.
    • Patients with polymicrobic bacteriuria often had prolonged indwelling bladder catheter use.
    • Prospective cultures confirmed polymicrobic bacteriuria in 78% of cases, suggesting it is not always due to contamination.

    Conclusions:

    • Polymicrobic bacteriuria is clinically significant and frequently associated with urinary tract infection-related bacteremia.
    • Current practice of discarding such specimens may lead to missed diagnoses.
    • Further investigation into the management of polymicrobic bacteriuria is warranted.