Prevalence of "low-count" bacteriuria in female urinary incontinence versus continent female controls: a cross-sectional study

Abstract

Introduction and hypothesis: Older studies suggesting an association between detrusor overactivity and bacteriuria used an outdated microbiological threshold. We hypothesised that bacteriuria ≥10(3) CFU/ml would be more prevalent in women with urinary incontinence than continent controls.

Methods: A prospective, cross-sectional study of prevalence of bacteriuria ≥10(3) colony-forming units (CFU)/ml on catheter specimens. Sample estimates suggested 62 women per arm would yield 80% power. Multivariate regression analysis was performed using risk factors including, age, diabetes, menopausal status, sexual activity and cystocele.

Results: Among 213 participants, bacteriuria ≥10(3) CFU/ml was more prevalent in incontinent women than continent controls (odds ratio [OR] 4.06; p = 0.036). Two thirds of bacteriuric specimens grew "low-count" bacteriuria. On multivariate analysis, only cystocele ≥ grade II was independently associated with bacteriuria (p = 0.025). On sub-analysis by diagnosis, the only significant finding was with bladder oversensitivity (OR 13.8; p = 0.0017).

Conclusions: Bacteriuria, including "low-count" bacteriuria, is more prevalent in urinary incontinence when compared to continent female controls.