Urinary Tract Infection among Women Attending a Clinic for Sexually Transmitted Diseases

The symptoms, signs, and laboratory findings for 69 women who were seen at a sexually transmitted disease (STD) clinic and who had acute urinary tract infection (UTI) were compared with those for women who had vaginitis, gonorrhea, or chlamydial infection. Escherichia coli and Staphylococcus saproph...

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Bibliographic Details
Published in:Sexually transmitted diseases 1984-01, Vol.11 (1), p.18-23
Main Authors: WONG, EDWARD S., FENNELL, CYNTHIA L., STAMM, WALTER E.
Format: Article
Language:English
Subjects:
Acute Disease
Anti-Bacterial Agents - pharmacology
Bacteria - drug effects
Bacteriuria - microbiology
Chlamydia Infections - pathology
Cystitis - microbiology
Cystitis - pathology
Female
Gonorrhea - pathology
Humans
Microbial Sensitivity Tests
Original Articles
Pyuria - microbiology
Sexually Transmitted Diseases - microbiology
Sexually Transmitted Diseases - pathology
Urinary Tract Infections - microbiology
Urinary Tract Infections - pathology
Uterine Cervical Diseases - microbiology
Uterine Cervical Diseases - pathology
Vaginitis - pathology
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Summary:The symptoms, signs, and laboratory findings for 69 women who were seen at a sexually transmitted disease (STD) clinic and who had acute urinary tract infection (UTI) were compared with those for women who had vaginitis, gonorrhea, or chlamydial infection. Escherichia coli and Staphylococcus saprophyticus were the two most common causes of acute cystitis in this population and accounted for 62 (90%) of 69 infections. Forty-three percent of the women had positive tests for antibody-coated bacteria (ACB), an observation implying renal infection although symptoms of upper tract infection were infrequent. Frequency, urgency, dysuria, and suprapubic tenderness were significantly associated with cystitis, whereas vaginal discharge and vulvar itching were associated with vaginitis. There was, however, considerable overlap in symptoms among the four groups of women, and their accurate differentiation required objective information based upon pelvic examination, examination of vaginal fluid, and urinalysis. In the absence of vaginitis on wet mount and mucopurulent cervicitis on examination, pyuria, as determined by examination of centrifuged urine, had an 88% sensitivity, 76% specificity, 61% positive predictive value, and 93% negative predictive value for acute UTI. Because of the high prevalence of positive ACB tests and the possibility that infection with Chlamydia trachomatis and/or Neisseria gonorrhoeae may be mistaken for cystitis, we prefer a five- to seven-day course of antibiotics over single-dose therapy for treatment of patients with possible UTI in the setting of an STD clinic.
ISSN:0148-5717
1537-4521
DOI:10.1097/00007435-198401000-00004