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Enterococci, GBS Appear to Rarely Cause Acute Cystitis

Enterococci, GBS Appear to Rarely Cause Acute Cystitis

Though found in midstream voided urine in younger women, typically not detected in catheter urine

WEDNESDAY, Nov. 13 (HealthDay News) -- Although organisms such as enterococci or group B streptococci are often detected along with Escherichia coli in cultures of voided midstream urine, they usually are not found in cultures of catheter urine, according to research published in the Nov. 14 issue of the New England Journal of Medicine.

Thomas M. Hooton, M.D., of the University of Miami, and colleagues analyzed 202 paired specimens of midstream urine and catheter urine from 226 women, aged 18 to 49 years, who had symptoms of cystitis, to assess the predictive values for detection of enterococcus and group B streptococci in midstream urine.

The researchers found that even low levels of E. coli had a high positive predictive value (93 percent at 10² colony-forming units per milliliter) for bladder bacteriuria. In contrast, though found in cultures of midstream urine, enterococci (10 percent of cultures) and group B streptococci (12 percent of cultures) did not predict bladder bacteriuria at any colony count.

"Cultures of voided midstream urine in healthy premenopausal women with acute uncomplicated cystitis accurately showed evidence of bladder E. coli but not of enterococci or group B streptococci, which are often isolated with E. coli but appear to rarely cause cystitis by themselves," the authors write.

One author disclosed financial ties to pharmaceutical companies.

Full Text (subscription or payment may be required) (http://www.nejm.org/doi/full/10.1056/NEJMoa1302186?query=featured_home )Editorial (subscription or payment may be required) (http://www.nejm.org/doi/full/10.1056/NEJMe1312412?query=featured_home )