Asymptomatic bacteriuria in women with autoimmune rheumatic disease: prevalence, risk factors, and clinical significance.
BACKGROUND
Data regarding the prevalence and clinical significance of asymptomatic bacteriuria (AB) in women with autoimmune rheumatic disease (ARD) are scarce.


METHODS
In this prospective, case-control study, consecutive female outpatients with ARD were screened for AB. For each patient, demographics, type, duration, and treatment of underlying ARD, and risk factors for urinary tract infection (UTI), were recorded. Age-matched women with endocrine disease, without any autoimmune disease, not receiving immunosuppressive agents were used as controls. Subjects were followed up for 1 year for the development of symptomatic UTI.


RESULTS
Two hundred sixty patients with ARD (mean age, 52.4 [standard deviation {SD}, 14.6] years) and 238 controls (mean age, 51.2 [SD, 16.5] years) were enrolled. The majority of patients with ARD (93.5%; 95% confidence interval [CI], 89.7%-95.9%) were receiving immunosuppressive agents. AB was detected in 24 patients with ARD (9.2%; 95% CI, 6.2%-13.4%) and in 22 controls (9.2%; 95% CI, 5.5%-12.9%) (P = 1.000). The most prevalent pathogen was Escherichia coli (16/24 [66%]). Independent predictors for AB among patients were diabetes (odds ratio [OR], 6.6; P = .008) and a longer ARD duration (>84 months; OR, 4.3; P = .018). During the 1-year follow-up, 9 patients with baseline AB remained persistently bacteriuric, whereas 11 were intermittently bacteriuric. Symptomatic UTI developed in 4 of 24 patients (16.7%; 95% CI, 6.1%-36.5%) with baseline AB vs 29 of 236 (12.3%; 95% CI, 8.6%-17.1%) without AB (P = .522).


CONCLUSIONS
In our study, the prevalence of AB among women with ARD was not higher than that of controls, and AB was not associated with higher risk for symptomatic UTI. Risk factors for AB were longer duration of ARD and diabetes.
['Georgiadou|Sarah P|SP|', 'Gamaletsou|Maria N|MN|', 'Mpanaka|Ioanna|I|', 'Vlachou|Aggeliki|A|', 'Goules|Andreas V|AV|', 'Ziogas|Dimitrios C|DC|', 'Syriou|Vassiliki|V|', 'Tektonidou|Maria G|MG|', 'Kaltsas|Gregory|G|', 'Manoussakis|Menelaos N|MN|', 'Sipsas|Nikolaos V|NV|']
D000328:Adult D000368:Aged D058345:Asymptomatic Infections D001327:Autoimmune Diseases D001437:Bacteriuria D016022:Case-Control Studies D004926:Escherichia coli D005260:Female D005500:Follow-Up Studies D006801:Humans D016867:Immunocompromised Host D007166:Immunosuppressive Agents D008875:Middle Aged D011247:Pregnancy D011254:Pregnancy in Diabetics D015995:Prevalence D011446:Prospective Studies D012216:Rheumatic Diseases D012307:Risk Factors D014552:Urinary Tract Infections
asymptomatic bacteriuria autoimmune rheumatic disease immunocompromised patients