Frequency of different uro-pathogens causing asymptomatic bacteriuria or bacteriuria without pyuria

Objective: This study determines the frequency of different isolates identified in urine culture, which were identified as asymptomatic bacteriuria on urine RE. Material and Methods: This descriptive cross-sectional study was conducted at the Department of Microbiology at Izzat Ali Shah Hospital, Wah Cantt from August 2022 to August 2023. A total of 275 urine specimens were included in the study. Mid-stream urine specimens were obtained and routine examination was performed on a fully automated FUS-2000 urinalysis system. Urine culture was performed by inoculating the specimen on CLED and Blood agar plates. The plates were incubated at 37ºC in ambient air for 24-48 hours. Growth was observed and identified based on gram stain and biochemical tests. Results: Out of 275 specimens, growth was observed in 100 specimens. 175 specimens did not show any growth. Out of the 100 positive urine culture specimens, majority of the isolates belonged to Enterobacterales group. Out of these, 40% were Escherichia coli while 25% were Klebsiella pneumoniae. Growth of Staphylococcus saprophyticus was seen in 12% of specimens. Growth of Pseudomonas aeruginosa, Enterococcus faecalis, and Streptococcus agalactae was seen in 5% of specimens each, followed by Enterobacter cloacae, Enterobacter aerogenes, and Citrobacter koseri in 2% of specimens each. Growth of Proteus mirabilis and Serratia marcescens was seen in 1% of specimens each. Conclusion: In conclusion, among the positive urine cultures, Enterobacterales group dominated followed by Escherichia coli and klebsiella pneumoniae as major isolates. Additionally, Staphylococcus saprophyticus was also identified in a few specimens. These findings highlight the importance of accurate differentiation between urinary tract infection and asymptomatic bacteriuria by correlating urine culture results with routine examination.