OBJECTIVE: The pathogens responsible for urinary infection originate from the digestive tract prior passage through the genital region. Samples were obtained from this region in an attempt to identify women with these pathogens. We have analyzed the most frequently colonized areas of the genital region in order to develop a method for obtaining samples. Risk factors were evaluated by determining the relationship of the samples with factors implicated in the pathogenesis of recurrent infection. METHODS: Samples were obtained from 146 women of all ages that consulted for recurrent urinary tract infection. The samples from the genital region (perimeatal vulva, vagina, urethral and intraurethral meatus) and urine obtained through a catheter were cultured. RESULTS: The overall incidence of positive samples was 41%; 23% of the patients showed urinary infection (urine obtained by catheterization) at the time the samples were taken. The vaginal samples were the most frequently colonized and the intraurethral samples were the most sensitive when compared with the urinary samples. The sensitivity, specificity, positive and negative predictive values of these two samples were the same as those of the other samples together. In regard to colonization, a difference was found only between menopausal and premenopausal women, and in proportion to the duration of the history of infection. CONCLUSIONS: The study shows that it is unnecessary to obtain various samples; vaginal and intraurethral smears are sufficient. Menopausal women who referred two symptomatic episodes a year were found to be at a higher risk for vaginal infection, and in proportion to the number of years they have had recurrent infection.
OBJECTIVE: The pathogens responsible for urinary infection originate from the digestive tract prior passage through the genital region. Samples were obtained from this region in an attempt to identify women with these pathogens. We have analyzed the most frequently colonized areas of the genital region in order to develop a method for obtaining samples. Risk factors were evaluated by determining the relationship of the samples with factors implicated in the pathogenesis of recurrent infection. METHODS: Samples were obtained from 146 women of all ages that consulted for recurrent urinary tract infection. The samples from the genital region (perimeatal vulva, vagina, urethral and intraurethral meatus) and urine obtained through a catheter were cultured. RESULTS: The overall incidence of positive samples was 41%; 23% of the patients showed urinary infection (urine obtained by catheterization) at the time the samples were taken. The vaginal samples were the most frequently colonized and the intraurethral samples were the most sensitive when compared with the urinary samples. The sensitivity, specificity, positive and negative predictive values of these two samples were the same as those of the other samples together. In regard to colonization, a difference was found only between menopausal and premenopausal women, and in proportion to the duration of the history of infection. CONCLUSIONS: The study shows that it is unnecessary to obtain various samples; vaginal and intraurethral smears are sufficient. Menopausal women who referred two symptomatic episodes a year were found to be at a higher risk for vaginal infection, and in proportion to the number of years they have had recurrent infection.