Radiological Abnormalities and Asymptomatic Bacteriuria in Patients with Sickle Cell Disease

Objective: The prevalence of asymptomatic bacteriuria (ASB) in sickle cell disease (SCD) in Jamaica is 5.3%. This study sought to determine the association between ASB and anatomical urological abnormalities and symptomatic urinary tract infections (UTIs). Methods: A matched case-controlled study of 11 patients with a history of ASB from the Jamaican Sickle Cell Cohort and 11 controls who did not have a history of ASB or recurrent UTIs but who had SCD was conducted. Midstream urine collected aseptically was obtained for urinalysis and culture and sensitivity analysis. Serum creatinine was measured. Voiding cystourethrogram (VCUG) and kidney-ureter-bladder ultrasound were done. History of UTIs was recorded in all cases. Results: The mean +/- sd age of the group (cases and controls) was 34.2 +/- 7.2 years. All VCUGs were normal. There was no difference in mean cortical thickness or renal scarring between cases and controls. All serum creatinine values were normal: cases (mean +/- sd: 55.9 +/- 15.3; min-max: 32-90 mu mol/L) and controls (mean + sd: 59.6 + 18.5; min-max: 41-95 mu mol/L). There was no difference in symptomatic UTIs between cases and controls. Conclusion: There was no association between anatomical urinary tract abnormalities and ASB in patients with SCD. Asymptomatic bacteriuria in SCD was not associated with increased numbers of symptomatic UTIs.