Tuesday, May 5, 2015

Historical Contribution: 1969, Schwarz, et al., UTI Correlation to Fecal Bacteria


1969

Schwarz H, Schirmer HKA, Ehlers B, Post B. Urinary Tract Infections: Correlation between Organisms Obtained Simultaneously from the Urine and Feces of Patients with Bacteriuria and Pyuria. J Urol. 1969. 101:765-767.

 

It was well established that gram-negative bacteria caused approximately 80% of UTI (urinary tract infections) and the colon was believed to be the source of most of these bacteria. In a study of 148 hospitalized individuals with bacteria in their urine, researchers from Johns Hopkins correlated the urinary organism with stool cultures from the same patients. Limited by difficulties in bacterial culture and identification of the time period, Dr. Schwarz and colleagues were able to demonstrate that urinary and fecal organisms were correlated in 60% to 100% of cases, depending on the bacteria. The authors then postulated that the colon was the most likely source of urinary bacteria, and perhaps, treating colonic flora could control the spread of infectious urinary organisms.

 

While we now know that the relationship between the colon, urinary bacteria and antimicrobial agents is more complex than a simple causal relationshipWe now understand that each patient has risk factors for infection, each bacteria has different methods for causing infection and there is certainly a difference between bacteruria (bacteria in the urine) and a UTI. However , manuscripts like this 1969 historical contribution, paved the way for a better understanding of UTI.

 

Visit the Centennial Website or click here to see more about the first 100 years at the Brady.

 


HISTORICAL CONTRIBUTIONS highlight the greatest academic manuscripts from the Brady Urological Institute over the past 100 years.  As the Brady Urological Institute approaches its centennial, we will present a HISTORICAL CONTRIBUTION from each of the past 100 years.  In the most recent experience, the most highly cited article from each year is selected; older manuscripts were selected based on their perceived impact on the field.  We hope you enjoy! 

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  2. I agree - we definitely need more studies like this and Mike/Dick continue to guide us all with excellent editorials. Nice to move beyond partial lunar cycle durations. The one thing I wish these "boring" studies would add are pre/post treatment surveillance cultures for resistant pathogens. It is unclear to me if "shorter" duration is always associated with lower risk of MDRO acquisition. It is possible that longer or even double/triple coverage might be associated with lower resistance. I would like to see surveillance cultures included so we can eventually understand the epidemiology of resistance and move beyond the dogma of shorter always equals better or "narrow" is always better than broad-spectrum. And maybe the dogma is correct, I just want data to prove it. However, I do agree that reducing exposure does lead to lower CDI risk, which is excellent. - See more at: http://haicontroversies.blogspot.in/2015/06/this-study-is-boring-and-we-need-more.html#comment-form

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