Bacteriuria

What is bacteriuria?

Bacteriuria is a medical term for the presence of significant amounts of bacteria in the urine. The detection of these microorganisms is a probable indicator of urinary infections in progress, given that the urine is normally sterile (unlike the faeces, which are very rich in bacteria).

However, there is the possibility that the bacteriuria is fictitious, because it is caused by bacterial contamination of the urine sample during collection or transport, for example due to poor hygiene of the hands or external genitalia.

Causes - Urinary infections

Most bacteria ascend the urinary tract from the fecal reservoir through the urethra, the duct that conveys the urine accumulated by the bladder to the outside. In the urinary tract, bacterial loads can still reach - albeit with greater difficulty - also from various locations of the organism, through the blood or lymphatic pathway.

Bacteriuria is generally associated with the presence of a single bacterial strain in the urine, the most common of which is Escherichia Coli; other Gram negative (Proteus, Klebsiella) and Gram positive (Enterococcus faecalis) enterobacteria are mainly responsible for outpatient infections.

In the hospital setting, on the other hand, urinary infections are mainly sustained by Escherichia Coli, Enterococcus faecalis but also by Klebsiella, Enterobacter, Citrobacter, Pseudomonas Aeruginosa and others.

Symptoms

The clinical picture associated with bacteriuria is extremely varied; it can in fact go from the complete absence of symptoms (in this case we speak of asymptomatic bacteriuria) in the presence of local symptoms, in particular urinary disorders. Among these, the symptoms typically associated with urinary infections are represented by: painful, difficult and hesitant urination (difficulty in emptying the bladder, weak or intermittent stream of urine), frequent urination but not associated with increased urine output, and bladder tenesmus, that is, a painful and involuntary contraction of the urinary sphincter, associated with the continuous need to urinate and superubic discomfort. Sometimes bacteriuria is also associated with general symptoms such as fever, malaise, nausea and vomiting, especially if the infection has spread to the kidneys (pyelonephritis).

Diagnosis

The diagnosis of bacteriuria is made by analyzing a urine sample, which must be collected from the patient in the manner described in the urine culture article.

The diagnosis of urinary infection is positive if the urine culture shows a significant bacterial load (> 105 colonies / ml).

The antibiogram, on the other hand, provides very useful information on the type of bacterium that generated the infection and its susceptibility to specific antibiotics. In recent years, automated systems have been developed that can speed up the response times of the various urine samples to be subjected to research for bacteriuria.

Bacteriuria in Pregnancy

At the extremities of life, the incidence of bacteriuria, while remaining higher in females, is similar between the two sexes, while in adulthood women are much more prone to this condition than men. During pregnancy, various predisposing factors are added to an "innate physiological predisposition - given by a" urethra close to the vaginal meatus, close to the anus and shorter than the male one - which make bacteriuria a rather common problem. research for bacteria in the urine (urine culture) is performed for screening purposes around the sixteenth week of gestation. This test is necessary to avoid the risk of ongoing bacteriuria - whether symptomatic or not - complicating pyelonephritis (kidney infections), which in turn are associated with a modest increase in premature births and a reduction in the weight and general development of the unborn child.

Care

Among the general measures to be taken after the diagnosis of bacteriuria, rest and good hydration are important (more than 2 liters of water in 24 hours); also the use of special herbal teas can be helpful for this purpose, diluting the bacterial load present in the bladder and facilitating its expulsion.

The medical treatment of bacteriuria is based on the use of antibiotics, such as cephalosporins and quinolones.

For more information, read: Medicines for the Treatment of Cystitis »

To avoid antibiotic resistance, it is important that the patient completes the prescribed course of therapy, even if the condition improves significantly after a few days of treatment.

During pregnancy, antibiotic intervention is also recommended in the presence of asymptomatic bacteriuria, due to the aforementioned risks of kidney infection with possible negative consequences on the health and development of the fetus.

For more information, read: Drugs to Treat Pregnancy Cystitis "