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

Publisher Website
Google Scholar
Abstract
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 2 most common causes of acute cystitis in this population and accounted for 62 (90%) of 69 infections. Of the women, 43% had positive tests for antibody-coated bacteria (ACB), an observation implying renal infection; symptoms of upper tract infection were infrequent. Frequency, urgency, dysuria and suprapubic tenderness were significantly associated with cystitis; vaginal discharge and vulvar itching were associated with vaginitis. There was considerable overlap in symptoms among the 4 groups of women; 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, a 5-7 day course of antibiotics is preferred over single-dose therapy for treatment of patients with possible UTI in the setting of an STD clinic.