To the Editor—We thank Dr. Johnson for his questions raised regarding our definitions used for asymptomatic bacteriuria (ASB), cystitis and pyelonephritis, and potential implications on interpretation of our data. Namely, he states we may have categorized some patients as ASB that in reality clinicians may be reluctant not to treat, thereby negating the significance of our findings. Specifically, (1) those with only 1 localizing symptom of cystitis and no pyuria on urinalysis (UA), and (2) those lacking ≥ 2 typical urinary symptoms in the absence of a UA. Additionally, he suggests our requirement of fever in addition to localizing symptoms for pyelonephritis is overly sensitive. We have attempted to address these concerns below.

中文翻译：

---

回复约翰逊

致编辑——我们感谢 Johnson 博士就我们用于无症状菌尿 (ASB)、膀胱炎和肾盂肾炎的定义提出的问题，以及对我们数据解释的潜在影响。也就是说，他说我们可能将一些患者归类为实际上临床医生可能不愿意不治疗的 ASB，从而否定了我们研究结果的重要性。具体来说，(1) 那些仅具有 1 种膀胱炎定位症状且尿液分析 (UA) 没有脓尿的患者，以及 (2) 在没有 UA 的情况下缺乏 ≥ 2 种典型泌尿症状的患者。此外，他认为除了定位肾盂肾炎症状外，我们对发烧的要求过于敏感。我们试图在下面解决这些问题。