Microbiology, chlamydia or gonorrhea incidence, and self-diagnosis accuracy in sexually active college women with lower urinary tract symptoms

Objective: Define microbiological characteristics of pathogens causing lower urinary tract infections (LUTI), frequency of Chlamydia trachomatis (CT) or Neisseria gonorrhea (GC), and accuracy of self-diagnosis by college women with LUTI symptoms. Participants: Sexually active women with LUTI symptoms attending a large south-eastern university. Methods: Participants completed a 15-question Qualtrics™ survey, provided urine for urinalysis and culture and a self-collected vaginal swab for CT/GC testing. Results:Escherichia coli grew in 72.3% of cultures. Cultures showed 49.1% growing ≥10⁵ and 46.1% between 10⁴ and 10⁵ colony forming units/mL (CFU/mL). Most pathogens (94.6%) were sensitive to nitrofurantoin. Three participants were positive for CT and the LUTI self-diagnosis accuracy was 72.0%. Conclusions:Escherichia coli was the primary uropathogen. Cultures with ≥10⁴ CFU/mL identified 95.2% of LUTIs, and nitrofurantoin is the empiric drug of choice. CT is rarely identified in this population and college women are accurate making a self-diagnosis of LUTI.