Prevalence of "low-count" bacteriuria in female urinary incontinence versus continent female controls: a cross-sectional study
Abstract
INTRODUCTION AND HYPOTHESIS: Older studies suggesting an association between detrusor overactivity and bacteriuria used an outdated microbiological threshold. We hypothesised that bacteriuria ≥10(3) CFU/ml would be more prevalent in women with urinary incontinence than continent controls.
METHODS: A prospective, cross-sectional study of prevalence of bacteriuria ≥10(3) colony-forming units (CFU)/ml on catheter specimens. Sample estimates suggested 62 women per arm would yield 80% power. Multivariate regression analysis was performed using risk factors including, age, diabetes, menopausal status, sexual activity and cystocele.
RESULTS: Among 213 participants, bacteriuria ≥10(3) CFU/ml was more prevalent in incontinent women than continent controls (odds ratio [OR] 4.06; p = 0.036). Two thirds of bacteriuric specimens grew "low-count" bacteriuria. On multivariate analysis, only cystocele ≥ grade II was independently associated with bacteriuria (p = 0.025). On sub-analysis by diagnosis, the only significant finding was with bladder oversensitivity (OR 13.8; p = 0.0017).
CONCLUSIONS: Bacteriuria, including "low-count" bacteriuria, is more prevalent in urinary incontinence when compared to continent female controls.
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 213 participants or records.
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