A Randomized Clinical Trial of Standard Versus Expanded Cultures to Diagnose Urinary Tract Infections in Women. Journal Article

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Authors: Barnes, HC; Wolff, B; Abdul-Rahim, O; Harrington, A; Hilt, EE; Price, TK; Halverson, T; Hochstedler, BR; Pham, T; Acevedo-Alvarez, M; Joyce, C; Fitzgerald, CM; Schreckenberger, PC; Brubaker, L; Wolfe, AJ; Mueller, ER
Article Title: A Randomized Clinical Trial of Standard Versus Expanded Cultures to Diagnose Urinary Tract Infections in Women.
Abstract: OBJECTIVES: To compare urinary tract infection (UTI) symptom resolution rates at 7-10 days in symptomatic women randomized to treatment based on standard urine culture (SUC) versus expanded quantitative urine culture (EQUC) results. METHODS: Women =18 years old who responded "yes" to "do you feel you have a UTI?" agreed to urethral catheterization, and follow-up. Symptoms were assessed using the validated UTI Symptom Assessment (UTISA) questionnaire. Culture method was randomized 2:1 (SUC:EQUC); antibiotics were prescribed to women with positive cultures. The primary outcome, UTI symptom resolution, was determined 7-10 days following enrollment on all participants regardless of treatment. RESULTS: Demographic data were similar between groups. 63% and 74% of the SUC and EQUC groups had positive cultures (p=0.10). 97% of participants with positive cultures received antibiotics. 215 of 225 participants provided primary outcome data (SUC 143 [95%], EQUC 72 [97%]). At primary outcome assessment, 64% and 69% in the SUC and EQUC groups, respectively, reported UTI symptom resolution (p=0.46); UTISA scores improved from baseline in the EQUC arm compared to SUC arm (p=0.04). In the subset of women (n=76) predominated by non-, there was a trend toward more symptom resolution in the EQUC arm (21%, p=0.08). CONCLUSION: Symptom resolution was similar for the overall population ( non-) of women treated for UTI symptoms based on SUC or EQUC. Although the sample size limits conclusions regarding the utility of EQUC in women with non- uropathogens, the detected trend indicates that this understudied clinical subset warrants further study.
Journal Title: The Journal of urology
ISSN: 1527-3792; 0022-5347
Publisher: Unknown  
Date Published: 2021