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June 1986

Use of Clinical Findings in Diagnosis of Urinary Tract Infection in Women

Author Affiliations

Rockford, Ill.

Arch Intern Med. 1986;146(6):1232-1235. doi:10.1001/archinte.1986.00360180252053

To the Editor.  —I found the article by Wigton et al,1 in the December 1985 issue of the Archives an interesting and thoughtful investigation into a common medical problem, but I have several questions and comments.The authors defined a positive urine culture as one with a colony count greater than 104 colonies per milliliter. However, they did not specify the species of bacteria that were considered pathogenic. Were coagulase-negative staphylococci, such as Staphylococcus saprophyticus, identified? This pathogen has been shown to be the second most common organism identified in urinary tract infections in young women.2 Consequently, if S saprophyticus was ignored, many cultures interpreted as demonstrating skin contaminants may have actually represented infection with this organism.How many patients seen in the emergency room had a pelvic examination? This can be a very important factor in selecting those patients in whom a urinary culture would be

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