title: Asymptomatic bacteriuria in women with autoimmune rheumatic disease: prevalence, risk factors, and clinical significance.
abstract: 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.
authors.affiliation: Pathophysiology Department and First Department of Internal Medicine, Laikon General Hospital and Medical School, National and Kapodistrian University of Athens, Greece.
authors.forename: Sarah P
authors.initials: SP
authors.lastname: Georgiadou
authors.affiliation: Pathophysiology Department and First Department of Internal Medicine, Laikon General Hospital and Medical School, National and Kapodistrian University of Athens, Greece.
authors.forename: Maria N
authors.initials: MN
authors.lastname: Gamaletsou
authors.affiliation: Pathophysiology Department and First Department of Internal Medicine, Laikon General Hospital and Medical School, National and Kapodistrian University of Athens, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Mpanaka
authors.affiliation: Pathophysiology Department and First Department of Internal Medicine, Laikon General Hospital and Medical School, National and Kapodistrian University of Athens, Greece.
authors.forename: Aggeliki
authors.initials: A
authors.lastname: Vlachou
authors.affiliation: Pathophysiology Department and First Department of Internal Medicine, Laikon General Hospital and Medical School, National and Kapodistrian University of Athens, Greece.
authors.forename: Andreas V
authors.initials: AV
authors.lastname: Goules
authors.affiliation: Pathophysiology Department and First Department of Internal Medicine, Laikon General Hospital and Medical School, National and Kapodistrian University of Athens, Greece.
authors.forename: Dimitrios C
authors.initials: DC
authors.lastname: Ziogas
authors.affiliation: Pathophysiology Department and First Department of Internal Medicine, Laikon General Hospital and Medical School, National and Kapodistrian University of Athens, Greece.
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Syriou
authors.affiliation: Pathophysiology Department and First Department of Internal Medicine, Laikon General Hospital and Medical School, National and Kapodistrian University of Athens, Greece.
authors.forename: Maria G
authors.initials: MG
authors.lastname: Tektonidou
authors.affiliation: Pathophysiology Department and First Department of Internal Medicine, Laikon General Hospital and Medical School, National and Kapodistrian University of Athens, Greece.
authors.forename: Gregory
authors.initials: G
authors.lastname: Kaltsas
authors.affiliation: Pathophysiology Department and First Department of Internal Medicine, Laikon General Hospital and Medical School, National and Kapodistrian University of Athens, Greece.
authors.forename: Menelaos N
authors.initials: MN
authors.lastname: Manoussakis
authors.affiliation: Pathophysiology Department and First Department of Internal Medicine, Laikon General Hospital and Medical School, National and Kapodistrian University of Athens, Greece.
authors.forename: Nikolaos V
authors.initials: NV
authors.lastname: Sipsas
mesh_terms: D000328:Adult; D000368:Aged; D058345:Asymptomatic Infections / Q000453:epidemiology*; D001327:Autoimmune Diseases / Q000150:complications*; D001437:Bacteriuria / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D016022:Case-Control Studies; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008875:Middle Aged; D011247:Pregnancy; D011254:Pregnancy in Diabetics; D015995:Prevalence; D011446:Prospective Studies; D012216:Rheumatic Diseases / Q000150:complications*; D012307:Risk Factors; D014552:Urinary Tract Infections / Q000150:complications / Q000382:microbiology*
chemical_list: D007166:Immunosuppressive Agents
keywords: asymptomatic bacteriuria; autoimmune rheumatic disease; immunocompromised patients