Urinary tract infection in general practice

Abstract

In three studies, 616 patients (610 female and six male) presented with symptoms suggesting urinary tract infection (UTI). Of these, 321 had greater than 100 X 10(6) bacteria per litre in a midstream urine sample. None of the presenting symptoms could be considered to be a reliable indicator of bacteriuria. Ninety percent of infected urines and 44 percent of uninfected urines had a raised white cell concentration. Escherichia coli was the most common infecting organism (71.3 percent). Next were Gram positive cocci at 15.6 percent, Proteus mirabilis (7.5 percent), and Klebsiella-Enterobacter species (0.7 percent). At follow-up over 30 days 25.6 percent of patients initially infected again had infected urine. The organisms isolated from initial MSUs were sensitive to most antibacterial agents by disc-sensitivity testing. The expected urine levels of drugs used in the study greatly exceeded the measured minimum inhibitory concentration.