S. Akerlund et al., BACTERIURIA IN PATIENTS WITH A CONTINENT ILEAL RESERVOIR FOR URINARY-DIVERSION DOES NOT REGULARLY REQUIRE ANTIBIOTIC-TREATMENT, British Journal of Urology, 74(2), 1994, pp. 177-181
Objective To elucidate the importance of bacteriuria in patients with
a continent urinary diversion. Patients and methods Eighteen asymptoma
tic patients (16 women and two men, with a mean age of 53 years [range
22-731) with ileal reservoirs coupled to the skin for urinary diversi
on were studied. Consecutive urine cultures were performed oner 5 mont
hs. Concomitant measurements of antibody titres against Escherichia co
li and Proteus, and C-reactive protein (CRP) values were made. Results
The results of the urine cultures varied considerably between samples
. Increased titres of antibodies against E. coli were seen in several
patients but the correlation with bacteriuria caused by E. coli was we
ak (sensitivity 33%, specificity 56%). Increased titres of antibodies
against Proteus were rarely seen and in no patient correlated with bac
teriuria caused by Proteus. Increased levels of CRP were seen in three
patients. Conclusion The present results indicate that asymptomatic b
acteriuria in patients with a continent ileal reservoir for urinary di
version is generally of no clinical importance and should not be treat
ed with antibiotics. This conclusion is based on the observations that
the bacterial strains growing in the reservoir changed spontaneously
indicating colonization rather than infection. Raised titres of antibo
dies against E. coli correlated weakly with bacterial growth. The obse
rved elevations in antibody titres were usually just above the normal
upper limit.