AbstractsWomens Studies

There is a shortage of evidence for clinical guidelines on diagnosis and management of both asymptomatic bacteriuria (the presence of bacteria in urine without symptoms of an infection) and urinary tract infections in women with diabetes and pregnant women. Asymptomatic bacteriuria and urinary tract infections in these two risk groups may have far-reaching consequences such as pyelonephritis and preterm birth. The results of the studies in this thesis can be used to fill some of the knowledge gaps. Treatment of urinary tract infections in women with diabetes: Schneeberger found that women with diabetes more often experienced a recurrent urinary tract infection despite the fact that they more often received a longer initial antibiotic treatment than women without diabetes. Diagnosis of bacteriuria in pregnant women: contamination of urine samples with for example skin flora may distort the diagnosis of bacteriuria. In pregnant women, the contamination rate of midstream samples is comparable with thecontamination rates of clean-catch samples, which are more unpractical and time-consuming. Therefore, we recommend a midstream sample to assess bacteriuria in pregnant women. Recurrent urinary tract infections in pregnant women: a systematic literature review showed that there are no sufficient studies to identify the optimal intervention to prevent recurrent urinary tract infections in pregnant women. Screening for asymptomatic bacteriuria: A low (<5%) number of pregnant women with and without diabetes with asymptomatic bacteriuria were identified. Neither asymptomatic bacteriuria nor urinary tract infections were associated with preterm birth or low birth weight babies in this population. Our data discourage a routine screen and treat policy for asymptomatic bacteriuria in pregnant women with DM.