Urological Survey Infection and Inflammation of the Genitourinary Tract Re: Voided Midstream Urine Culture and Acute Cystitis in Premenopausal Women T. M. Hooton, P. L. Roberts, M. E. Cox and A. E. Stapleton Department of Medicine, School of Medicine, University of Miami, Miami, Florida, and University of Washington, Seattle, Washington N Engl J Med 2013; 369: 1883e1891.
Abstract available at http://jurology.com/ Editorial Comment: These authors investigated the positive and negative predictive values of midstream urine cultures compared to catheterized urine cultures in women presenting with symptoms of cystitis. Uropathogens grew in 78% of midstream and 70% of catheterized urine cultures. The most common organism detected was Escherichia coli, which was cultured in 65% of cases. Most of the time (91% of cases) midstream urine cultures accurately predicted bladder bacteriuria as determined by catheterized specimen. In contrast, gram-positive pathogens detected in clean catch specimens poorly correlated with bladder cultures obtained by catheterization. In addition, the authors report that in 61% of cases in which gram-positive uropathogens were detected E. coli was also cultured. The authors conclude that in women with symptoms of urinary tract infection clean catch urine cultures accurately demonstrate evidence of bladder infections with gram-negative uropathogens. The data also call into question whether gram-positive organisms, in an isolated fashion, cause symptomatic infections, as most of the time gram-positive organisms were detected as mixed flora along with E. coli. Edward M. Schaeffer, MD, PhD
Re: Cranberry Products and Prevention of Urinary Tract Infections R. Jepson, J. Craig and G. Williams Centre for Population Health Sciences, Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, Edinburgh, Scotland JAMA 2013; 310: 1395e1396.
Abstract available at http://jurology.com/ Editorial Comment: This updated review nicely summarizes findings from 13 studies evaluating the use of cranberry products and prevention of urinary tract infections. Although safe, no association was seen between the use of cranberry products and decreased rates of urinary tract infections. Edward M. Schaeffer, MD, PhD
0022-5347/14/1915-1300/0 THE JOURNAL OF UROLOGY® © 2014 by AMERICAN UROLOGICAL ASSOCIATION EDUCATION
1300
j
www.jurology.com
AND
RESEARCH, INC.
http://dx.doi.org/10.1016/j.juro.2014.01.024 Vol. 191, 1300, May 2014 Printed in U.S.A.
Abstract available at http://jurology.com/ Editorial Comment: These authors investigated the positive and negative predictive values of midstream urine cultures compared to catheterized urine cultures in women presenting with symptoms of cystitis. Uropathogens grew in 78% of midstream and 70% of catheterized urine cultures. The most common organism detected was Escherichia coli, which was cultured in 65% of cases. Most of the time (91% of cases) midstream urine cultures accurately predicted bladder bacteriuria as determined by catheterized specimen. In contrast, gram-positive pathogens detected in clean catch specimens poorly correlated with bladder cultures obtained by catheterization. In addition, the authors report that in 61% of cases in which gram-positive uropathogens were detected E. coli was also cultured. The authors conclude that in women with symptoms of urinary tract infection clean catch urine cultures accurately demonstrate evidence of bladder infections with gram-negative uropathogens. The data also call into question whether gram-positive organisms, in an isolated fashion, cause symptomatic infections, as most of the time gram-positive organisms were detected as mixed flora along with E. coli. Edward M. Schaeffer, MD, PhD
Re: Cranberry Products and Prevention of Urinary Tract Infections R. Jepson, J. Craig and G. Williams Centre for Population Health Sciences, Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, Edinburgh, Scotland JAMA 2013; 310: 1395e1396.
Abstract available at http://jurology.com/ Editorial Comment: This updated review nicely summarizes findings from 13 studies evaluating the use of cranberry products and prevention of urinary tract infections. Although safe, no association was seen between the use of cranberry products and decreased rates of urinary tract infections. Edward M. Schaeffer, MD, PhD
0022-5347/14/1915-1300/0 THE JOURNAL OF UROLOGY® © 2014 by AMERICAN UROLOGICAL ASSOCIATION EDUCATION
1300
j
www.jurology.com
AND
RESEARCH, INC.
http://dx.doi.org/10.1016/j.juro.2014.01.024 Vol. 191, 1300, May 2014 Printed in U.S.A.
