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Pyuria is common in asymptomatic bacteriuria (ASB) and urinary tract infections (UTIs), but whether degree of pyuria is useful for predicting bacteriuria is unknown. In this cross-sectional study, researchers in a single U.S. health system compared rates of urine culture positivity at four cutoffs of white blood cells per high-power field (WBC/hpf) to define an optimal value for pyuria as a predictor of bacteriuria. Data were drawn from 46,000 hospitalizations of adults (mean age, 57; 80% women) who had both urinalysis and urine culture.
Bacteriuria was defined as any bacterial growth on urine culture, regardless of amount. At WBC/hpf cutoffs of 0 to 5, 5 to 10, 10 to 25, and >25, prevalence of bacteriuria was 25%, 28%, 33%, and 54%, respect…