Relapse and Reinfection in Chronic Bacteriuria

To examine the relation between the pattern of recurrence and the site of chronic bacteriuria, 54 patients with well documented recurrent infections were studied by bilateral ureteral catheterizations. Twenty-nine had renal bacteriuria, and in 25 infection was confined to the bladder. Fifty-two of 65 recurrences in patients with renal bacteriuria were due to relapse with the same species and strain of micro-organism that was present before therapy. In contrast, 27 of 38 recurrent infections among 25 patients with bladder bacteriuria were characterized by reinfection with new organisms. These data indicate that the pattern of recurrence after seemingly effective chemotherapy is of prognostic importance and is helpful in localizing the site of chronic bacteriuria and in guiding further treatment.