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Sample records for bacteriuria

  1. Escherichia coli bacteriuria and contraceptive method.

    Science.gov (United States)

    Hooton, T M; Hillier, S; Johnson, C; Roberts, P L; Stamm, W E

    1991-01-01

    We evaluated the effects of contraceptive method on the occurrence of bacteriuria and vaginal colonization with Escherichia coli in 104 women who were evaluated prior to having sexual intercourse, the morning after intercourse, and 24 hours later. After intercourse, the prevalence of E coli bacteriuria increased slightly in oral contraceptive users but dramatically in both foam and condom users and diaphragm-spermicide users. Twenty-four hours later, the prevalence of bacteriuria remained significantly elevated only in the latter two groups. Similarly, vaginal colonization with E coli was more dramatic and persistent in users of diaphragm-spermicide and foam and condoms. Vaginal colonization with Candida species, enterococci, and staphylococci also increased significantly in diaphragm-spermicide users after intercourse. We conclude that use of the diaphragm with spermicidal jelly or use of a spermicidal foam with a condom markedly alters normal vaginal flora and strongly predisposes users to the development of vaginal colonization and bacteriuria with E coli. PMID:1859519

  2. [Onset and significance of postoperative bacteriuria].

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    Riss, P; Schieder, K; Bartl, W

    1984-06-01

    In 52 patients an indwelling transurethral catheter was inserted after gynaecological surgery for 5 days; no patient received antibiotics. At the time of removal of the catheter on the 6th postoperative day and 2 days later (8th postoperative day) a urine culture was set up. At the time of removal of the catheter on the 6th day, 26/52 patients (50%) had significant bacteriuria greater than or equal to 10(5)/ml. In 11 out of the 26 patients with bacteriuria the urine cleared spontaneously within 2 days; on the other hand, 10/26 patients with a negative culture at the time of removal of the catheter had significant bacteriuria 2 days later. As a group these women also had delayed spontaneous onset of voiding and persistence of residual urine. Younger patients (less than 45 years) had significantly fewer bacteriurias on the 6th day than older patients. A positive urine culture at the time of removal of the catheter should be treated with antibiotics; a negative urine culture should be repeated whenever spontaneous voiding is delayed, when there is persistent residual urine, or when the clinical signs of urinary tract infection are present.

  3. The Paradigm Shift to Non-Treatment of Asymptomatic Bacteriuria

    Science.gov (United States)

    Nicolle, Lindsay E.

    2016-01-01

    Asymptomatic bacteriuria, also called asymptomatic urinary infection, is a common finding in healthy women, and in women and men with abnormalities of the genitourinary tract. The characterization and introduction of the quantitative urine culture in the 1950s first allowed the reliable recognition of asymptomatic bacteriuria. The observations that a substantial proportion of patients with chronic pyelonephritis at autopsy had no history of symptomatic urinary infection, and the high frequency of pyelonephritis observed in pregnant women with untreated asymptomatic bacteriuria, supported a conclusion that asymptomatic bacteriuria was harmful. Subsequent screening and long term follow-up programs for asymptomatic bacteriuria in schoolgirls and women reported an increased frequency of symptomatic urinary tract infection for subjects with asymptomatic bacteriuria, but no increased morbidity from renal failure or hypertension, or increased mortality. Treatment of asymptomatic bacteriuria did not decrease the frequency of symptomatic infection. Prospective, randomized, comparative trials enrolling premenopausal women, children, elderly populations, patients with long term catheters, and diabetic patients consistently report no benefits with antimicrobial treatment of asymptomatic bacteriuria, and some evidence of harm. Several studies have also reported that antimicrobial treatment of asymptomatic bacteriuria increases the short term risk of pyelonephritis. Current investigations are exploring the potential therapeutic intervention of establishing asymptomatic bacteriuria with an avirulent Escherichia coli strain to prevent symptomatic urinary tract infection for selected patients. PMID:27104571

  4. ASYMPTOMATIC BACTERIURIA AND PYURIA IN PREGNANCY

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    M Rahimkhani

    2008-11-01

    Full Text Available "nPregnant women are at increased risk for urinary tract infection (UTI but in many cases infection is asymptomatic. This study was performed to determine the incidence of asymptomatic bacteriuria and pyuria in pregnant women. A total of 86 pregnant women during first trimester and 56 nonpregnant women were evaluated. All subjects were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine samples were collected for both groups. Urine samples were examined microscopically and were cultured. Bacteriological examination revealed asymptomatic bacteriuria in 25 (29.1% and 3 (5.4% of the study group and controls, respectively (P < 0.05. Microscopic analysis of urine revealed pyuria in 18 (20.9% and 3 (5.4% of the study group and controls, respectively (P < 0.05. In study group, Escherichia coli were found in 20%, Staphylococcus epidermidis in 36%, Staphylococcus haemolyticus in 12%, streptococcus group D in 12%, Staphylococcus saprophyticus in 12% and Proteus mirabilis in 8%. In control group, E. coli were found in 33.3% and S. epidermidis in 66.7%. Our results show that the incidence of asymptomatic bacteriuria is significantly higher in pregnant women than nonpregnant women. The main finding in the present study was that 29.1% of the pregnant women who were in first trimester had asymptomatic bacteriuria which is much higher than figures reported from other countries. The use of microscopic urinanalysis was not an effective method of detecting asymptomatic bacteriuria and urine culture is necessary for screening these pregnant women.

  5. Asymptomatic bacteriuria and antibacterial susceptibility during pregnancy

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    Anjana Verma

    2016-02-01

    Conclusions: Ectopic pregnancy can have varied presentations and misdiagnosis can be seen in Surgical, Medical and Gynaecology Universal screening of aymptomatic bacteriuria is recommended because of its high prevalence and prenatal and maternal complications, if left untreated. Nitrofurantoin can be advocated because of its low cost and high effectiveness where culture is not possible because of inadequate resources. [Int J Reprod Contracept Obstet Gynecol 2016; 5(2.000: 407-410

  6. Prevalence and risk factors of asymptomatic bacteriuria in pregnancy1

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    Ghafarnezhad M

    2000-07-01

    Full Text Available Asymptomatic bacteriuria is prevalent during pregnancy. It can lead to pyelonephritis, premature pregnancy and low birth weight. In this prospective study, to determine prevalence and risk factors of asymptomatic bacteriuria, 205 consecutive pregnant women who visited our prenatal care clinic in Mirza-Koochakkhan Hospital and had no urinary symptom were entered. Patients data were recorded using a questionnaire and urine samples were obtained for urinalysis and urine culture. We analysed data by using fisher exact and chi-squared test. 14 cases had positive urine culture (6.8%. Significant correlation was seen between asymptomatic bacteriuria and age, parity, past history of kidney stone, pyelonephritis, urinary tract infection, preterm delivery and pyuria pvalue <0.05. We suggest routine urine culture in first visit of high risk and 16th week of low risk pregnancies.

  7. Prevalence and risk factors of asymptomatic bacteriuria in pregnancy

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    Ghafarnezhad M

    2001-07-01

    Full Text Available Asymptomatic bacteriuria is prevalent during pregnancy. It can lead to pyelonephritis, premature pregnancy and low birth weight. In this prospective study, to determine prevalence and risk factors of asymptomatic bacteriuria, 205 consecutive pregnant women who visited our prenatal care clinic in Mirza-Koochakkhan Hospital and had no urinary symptom were entered. Patients data were recorded using a questionnaire and urine samples were obtained for urinalysis and urine culture. We analysed data by using fisher exact and chi-squared test. 14 cases had positive urine culture (6.8%. Significant correlation was seen between asymptomatic bacteriuria and age, parity, past history of kidney stone, pyelonephritis, urinary tract infection, preterm delivery and pyuria pvalue <0.05. We suggest routine urine culture in first visit of high risk and 16th week of low risk pregnancies.

  8. Efficacy of Dip slide test in assessing the asymptomatic bacteriuria in pregnancy

    OpenAIRE

    N. Hemalatha; N. Syamala

    2016-01-01

    Background: Asymptomatic bacteriuria is identified only when significant number of bacteria is demonstrated in urine. As bacterial culture takes at least 3 to 4 days, early diagnosis is a problem. Hence a reliable and cost effective screening test for bacteriuria is of great value. The aim of the study was conducted to know the prevalence of asymptomatic bacteriuria and to evaluate the diagnostic efficacy of Dip slide test. Methods: This study was conducted at Government Maternity Hospit...

  9. Circumcision for the prevention of significant bacteriuria in boys.

    Science.gov (United States)

    Nayir, A

    2001-12-01

    The aim of this study was to determine whether circumcision affects significant bacteriuria in boys. During a 60-month prospective study, 100 boys with microbiologically confirmed symptomatic urinary tract infection (UTI) were evaluated. Twelve patients with abnormal ultrasonography findings were excluded from the study. Eighteen of the boys had not been circumcised due to parental choice. The remaining 70 boys with normal renal ultrasonography were randomly allocated into two groups. In the first group 35 boys ranging in age from 6 months to 10 years (mean 33.2+/-30.9 months) were observed for 6 months and urinary cultures were taken monthly. When they had a positive urine culture (with or without any symptoms), they received antibiotic treatment. After 6 months they were circumcised and then observed for another 6-month period. Group 2 comprised 35 boys aged from 3 months to 9 years (mean 29.1+/-36.7 months). They were circumcised immediately after the first UTI and were followed for 6 months. Urine samples were obtained by the bag technique in infants and by the mid-stream technique in older patients. In the uncircumcised group, the rate of significant bacteriuria per patient did not change in two 6-month follow-up periods (3.46+/-0.91 and 3.33+/-0.97 episodes). In group 1, the rate of positive urine cultures dropped from 3.57+/-1.11 to 0.14+/-0.35 episodes after circumcision (Pcircumcision. Among the uncircumcised patients, symptomatic UTI was observed in 6 cases (3 cases in the first period of group 1, 1 case in the first and 2 cases in the second period of the uncircumcised group), whereas after circumcision no patient had symptomatic UTI. The mean age at circumcision was 42.7+/-28.4 months. No complication due to circumcision occurred in any patient. UTI may also occur in boys after the 1st year of life. The present study indicated that circumcision in boys decreases the rate of positive urine cultures. Therefore circumcision could be considered as a part of

  10. Bacteriuria with group B streptococcus and preterm birth

    DEFF Research Database (Denmark)

    Khalil, M. R.; Uldbjerg, N.; Thorsen, P.;

    2015-01-01

    Objectives: Preterm delivery (PTD) contributes to 70% of all perinatal deaths and nearly 50% of permanent neurological damages in children. Treatment and follow-up to prevent recolonization in pregnant women with Group B Streptococcus (GBS) in the urine may reduce the frequency of PTD. In a Cochr......Objectives: Preterm delivery (PTD) contributes to 70% of all perinatal deaths and nearly 50% of permanent neurological damages in children. Treatment and follow-up to prevent recolonization in pregnant women with Group B Streptococcus (GBS) in the urine may reduce the frequency of PTD...... tests including Chi-square, Student's t-test, stratified analyzes, and multivariate regression analyzes. Results: Out of 13,417 singleton deliveries, 6.9% (n 921) of women had asymptomatic GBS BU during their pregnancy, and 9.1% (n 1,218) delivered preterm. Among women with GBS BU 133 delivered preterm...... (10.9%), while among the GBS BU negative 1,085 (8.7%) delivered preterm; indicating an association between GBS BU and PTD in crude analyzes (Odds Ratio 1.8; 95% Confidence Interval 1.5-2.2; P30, and 19.0% were smokers in pregnancy. Conclusions: Group B Streptococcus bacteriuria might be a risk factor...

  11. An association study of Schistosoma haematobium infection and bacteriuria in young South African females

    DEFF Research Database (Denmark)

    Kildemoes, Anna M. O.; Kjetland, Eyrun F; Taylor, Myra;

    2013-01-01

    , proteinuria and leukocytes with Neotest4 dipsticks and 10ml urine was added to 1ml 5% formalin solution and preserved for later egg count microscopy. Furthermore samples were tested for bacteriuria with Uricult dipslides (cut-off point;105CFU/ml). Results: The mean overall prevalence for S. haematobium was 18...... of leukocytes was positively associated with bacteriuria (P = 0.002) probably due to detection of neutrophils rather than eosinophils with the dipstick. As expected, intensity of S. haematobium infection was positively correlated with degree of micro-haematuria (r = 0.505; P = 0.01). Proteinuria was positively...

  12. Contamination Rates of Three Urine-Sampling Methods to Assess Bacteriuria in Pregnant Women

    NARCIS (Netherlands)

    Schneeberger, Caroline; van den Heuvel, Edwin R.; Erwich, Jan Jaap H. M.; Stolk, Ronald P.; Visser, Caroline E.; Geerlings, Suzanne E.

    2013-01-01

    OBJECTIVE: To estimate and compare contamination rates of three different urine-sampling methods in pregnant women to assess bacteriuria. METHODS: In this cross-sectional study, 113 pregnant women collected three different midstream urine samples consecutively: morning (first void); midstream (void

  13. Staphylococcus aureus bacteriuria as a prognosticator for outcome of Staphylococcus aureus bacteremia: a case-control study

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    Weinstein Robert A

    2010-07-01

    Full Text Available Abstract Background When Staphylococcus aureus is isolated in urine, it is thought to usually represent hematogenous spread. Because such spread might have special clinical significance, we evaluated predictors and outcomes of S. aureus bacteriuria among patients with S. aureus bacteremia. Methods A case-control study was performed at John H. Stroger Jr. Hospital of Cook County among adult inpatients during January 2002-December 2006. Cases and controls had positive and negative urine cultures, respectively, for S. aureus, within 72 hours of positive blood culture for S. aureus. Controls were sampled randomly in a 1:4 ratio. Univariate and multivariable logistic regression analyses were done. Results Overall, 59% of patients were African-American, 12% died, 56% of infections had community-onset infections, and 58% were infected with methicillin-susceptible S. aureus (MSSA. Among 61 cases and 247 controls, predictors of S. aureus bacteriuria on multivariate analysis were urological surgery (OR = 3.4, p = 0.06 and genitourinary infection (OR = 9.2, p = 0.002. Among patients who died, there were significantly more patients with bacteriuria than among patients who survived (39% vs. 17%; p = 0.002. In multiple Cox regression analysis, death risks in bacteremic patients were bacteriuria (hazard ratio 2.9, CI 1.4-5.9, p = 0.004, bladder catheter use (2.0, 1.0-4.0, p = 0.06, and Charlson score (1.1, 1.1-1.3, p = 0.02. Neither length of stay nor methicillin-resistant Staphylococcus aureus (MRSA infection was a predictor of S. aureus bacteriuria or death. Conclusions Among patients with S. aureus bacteremia, those with S. aureus bacteriuria had 3-fold higher mortality than those without bacteriuria, even after adjustment for comorbidities. Bacteriuria may identify patients with more severe bacteremia, who are at risk of worse outcomes.

  14. Asymptomatic bacteriuria in children with sickle cell anemia at The University of Nigeria teaching hospital, Enugu, South East, Nigeria

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    Ikefuna Anthony N

    2011-09-01

    Full Text Available Abstract Background Urinary tract infection (UTI is a common cause of childhood morbidity and mortality in the tropics. Children with sickle cell anemia (SCA may have compromised kidney function arising from repeated vaso-occlusive episodes and recurrent symptomatic or asymptomatic UTI. Objectives This study aims at determining the prevalence of asymptomatic bacteriuria and sensitivity pattern in children with homozygous sickle haemoglobin compared to children with normal haemoglobin. Methods One hundred children with SCA in stable state and 100 children with normal haemoglobin aged 2-12 years were screened for asymptomatic bacteriuria using midstream urine samples. The samples were incubated aerobically at 37°C for 24 hours within one hour of collection. Children whose urine samples yielded significant bacteriuria (≥105cfu/ml on two consecutive cultures were regarded as having asymptomatic bacteriuria. Results Asymptomatic bacteriuria was noted in 6% of children with SCA and occurred more in females than males (F: M = 5:1 when compared to 2% in children with normal haemoglobin. Escherichia coli was the commonest organism isolated (33.3%. All the organisms were resistant to co-trimoxazole and ampicillin while most were sensitive to gentamicin, ceftriaxone and the quinolones. Conclusion The risk of asymptomatic bacteriuria is three times more common in children with sickle cell anemia than in children with normal haemoglobin. It is therefore important to screen SCA patients, especially the females for UTI and should be treated according to the sensitivity result of the cultured organisms.

  15. Evaluation of the Lumac kit for the detection of bacteriuria by bioluminescence.

    OpenAIRE

    Mackett, D; Kessock-Philip, S; Bascomb, S; Easmon, C S

    1982-01-01

    Four hundred and twenty-two urine samples were screened for significant bacteriuria using bioluminescence and microscopy of uncentrifuged urine. A smaller number of false-negatives were seen with bioluminescence (10%) than with microscopy (40%) while both techniques gave a similar number of false-positives (18%). The kit required a large amount of manual preparation, largely pipetting. With this and the short shelf-life of the reconstituted reagents, it is not suitable for small numbers of ur...

  16. Rapid detection of significant bacteriuria by use of an automated Limulus amoebocyte lysate assay.

    OpenAIRE

    Jorgensen, J H; Alexander, G A

    1982-01-01

    Previous studies have demonstrated that significant gram-negative bacteriuria can be detected by using the Limulus amoebocyte lysate test. A series of 580 urine specimens were tested in parallel with the automated MS-2 (Abbott Laboratories) assay and with quantitative urine bacterial cultures. The overall ability of the MS-2 Limulus amoebocyte lysate test to correctly classify urine specimens as containing either greater than or equal to 10(5) organisms or less than 10(5) organisms per ml dur...

  17. Asymptomatic bacteriuria in type 2 Iranian diabetic women: a cross sectional study

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    Salarifar Mojtaba

    2006-02-01

    Full Text Available Abstract Background The risk of developing infection in diabetic patients is higher and urinary tract is the most common site for infection. Serious complications of urinary infection occur more commonly in diabetic patients. To study the prevalence and associates of asymptomatic bacteriuria (ASB in women with type 2 diabetes mellitus in the Iranian population, this study was conducted. Methods Between February 10, 2004 and October 15, 2004; 202 nonpregnant diabetic (type 2 women (range: 31 to 78 years old with no abnormalities of the urinary tract system were included in this clinic based study. We defined ASB as the presence of at least 105 colony-forming units/ml of 1 or 2 bacterial species, in two separated cultures of clean-voided midstream urine. All the participants were free from any symptoms of urinary tract infection (UTI. Associates for developing bacteriuria was assessed and compared in participants with and without bacteriuria. Results In this study, the prevalence of ASB was 10.9% among diabetic women. E. coli was the most prevalent microorganism responsible for positive urine culture. Most of the isolated microorganisms were resistant to Co-trimoxazole, Nalidixic acid and Ciprofloxacin. Pyuria (P 1c level (P Conclusion The prevalence of ASB is higher in women with type 2 diabetes, for which pyuria and glucosuria can be considered as associates. Routine urine culture can be recommended for diabetic women even when there is no urinary symptom.

  18. Home screening for bacteriuria in children with spina bifida and clean intermittent catheterization

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    Zegers Bas SHJ

    2012-10-01

    Full Text Available Abstract Background Significant bacteriuria (SBU and urinary tract infections (UTIs are common in patients with spina bifida and neuropathic detrusor sphincter dysfunction. Laboratory agar plated culture is the gold standard to establish SBU. It has the disadvantage of diagnostic and subsequent therapeutic delay. Leukocyte esterase tests (LETs and dip slides proved to be useful in the general populations to exclude SBU and UTI. The aim of this study was to evaluate the reliability of LET and dip slide in children with spina bifida without symptoms of UTI. The reliability in children with asymptomatic SBU was not studied before. Methods In one hundred and twelve children with spina bifida on clean intermittent catheterization LETs and dip slides were compared with laboratory cultures. Both tests and agar plated cultures were performed on catheterized urine samples. The hypothesis was that the home tests are as accurate as laboratory cultures. Results A SBU was found in 45 (40% of the 112 laboratory cultures. A negative LET excluded SBU (negative predictive value 96%, while a positive LET had a positive predictive value of 72%. The false positive rate was 28%. Dip slide determination of bacterial growth had no added value, other than serving as transport medium. Conclusions In spina bifida children, leukocyte esterase testing can be used to exclude significant bacteriuria at home, while dip slide tests have no added value to diagnose or exclude significant bacteriuria.

  19. Performance of a New Rapid Immunoassay Test Kit for Point-of-Care Diagnosis of Significant Bacteriuria.

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    Stapleton, Ann E; Cox, Marsha E; DiNello, Robert K; Geisberg, Mark; Abbott, April; Roberts, Pacita L; Hooton, Thomas M

    2015-09-01

    Urinary tract infections (UTIs) are frequently encountered in clinical practice and most commonly caused by Escherichia coli and other Gram-negative uropathogens. We tested RapidBac, a rapid immunoassay for bacteriuria developed by Silver Lake Research Corporation (SLRC), compared with standard bacterial culture using 966 clean-catch urine specimens submitted to a clinical microbiology laboratory in an urban academic medical center. RapidBac was performed in accordance with instructions, providing a positive or negative result in 20 min. RapidBac identified as positive 245/285 (sensitivity 86%) samples with significant bacteriuria, defined as the presence of a Gram-negative uropathogen or Staphylococcus saprophyticus at ≥10(3) CFU/ml. The sensitivities for Gram-negative bacteriuria at ≥10(4) CFU/ml and ≥10(5) CFU/ml were 96% and 99%, respectively. The specificity of the test, detecting the absence of significant bacteriuria, was 94%. The sensitivity and specificity of RapidBac were similar on samples from inpatient and outpatient settings, from male and female patients, and across age groups from 18 to 89 years old, although specificity was higher in men (100%) compared with that in women (92%). The RapidBac test for bacteriuria may be effective as an aid in the point-of-care diagnosis of UTIs especially in emergency and primary care settings. PMID:26063858

  20. Global gene expression profiling of asymptomatic bacteriuria Escherichia coli during biofilm growth in human urine

    DEFF Research Database (Denmark)

    Hancock, Viktoria; Klemm, Per

    2007-01-01

    Urinary tract infection (UTI) is an important health problem worldwide, with many millions of cases each year, and Escherichia coli is the most common organism causing UTI in humans. Also, E. coli is responsible for most infections in patients with chronic indwelling bladder catheter. The two...... asymptomatic bacteriuria (ABU) E. coli strains 83972 and VR50 are significantly better biofilm formers in their natural growth medium, human urine, than the two uropathogenic E. coli isolates CFT073 and 536. We used DNA microarrays to monitor the expression profile during biofilm growth in urine of the two ABU...

  1. Transcriptomics and adaptive genomics of the asymptomatic bacteriuria Escherichia coli strain 83972

    DEFF Research Database (Denmark)

    Hancock, Viktoria; Seshasayee, Aswin S.; Ussery, David;

    2008-01-01

    Escherichia coli strains are the major cause of urinary tract infections in humans. Such strains can be divided into virulent, UPEC strains causing symptomatic infections, and asymptomatic, commensal-like strains causing asymptomatic bacteriuria, ABU. The best-characterized ABU strain is strain...... factors for the human urinary tract could be identified. Also, presence/absence data of the gene expression was used as an adaptive genomics tool to model the gene pool of 83972 using primarily UPEC strain CFT073 as a scaffold. In our analysis, 96% of the transcripts filtered present in strain 83972 can...

  2. The Prevalence of Asymptomatic Bacteriuria in Iranian Pregnant Women: A Systematic Review and Meta-Analysis.

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    Mahin Ghafari

    Full Text Available Asymptomatic bacteriuria (ASB is defined as the presence of bacteria in urine without having signs and symptoms. The aim of this meta-analysis was to estimate the overall prevalence of asymptomatic bacteriuria among Iranian pregnant women.Major national and international databases were searched up to November 2015, including Scientific Information Database, MagIran, Web of Science, Medline, Scopus, Science Direct and Ovid. The checklist of the STROBE statement was used for evaluating the quality of reporting. The extracted data were analyzed and the results were reported using a random-effects model with 95% confidence interval (CI.From 3709 obtained studies, 20 included in the meta-analysis, which involved 15108 pregnant women. The overall prevalence of ASB was 0.13 (95% CI: 0.09, 0.17. The prevalence of ASB in the northern and southern regions of Iran was 0.13 (95% CI: 0.09, 0.18 and 0.11 (95% CI: 0.05, 0.16, respectively.Prevalence of ASB among Iranian pregnant women is considerable. Due to the complications of ASB for pregnant women and their children, preventative planning and control of ASB among pregnant women in Iran is necessary.

  3. Etiology and resistance of asymptomatic bacteriuria isolates among school going children in Sanadaj-Iran

    Institute of Scientific and Technical Information of China (English)

    Sofei-Majidpur H; Kalantar E; Verdi F; Khaksar N; Shahsavari S; Beiranvand S

    2008-01-01

    Objective:The objective of this study was to determine the etiology and antimicrobial susceptibility patterns of asymptomatic bacteriuria pathogens isolated among school going children in Sanandaj,Iran.Methods:A total of 1 457 urine samples of 5 to 10 years children from forty different schools of Sanandaj city were screened to see asymptomatic bacteriuria during November 2007 to June 2008.Results:Bacterial colony count of over (105)colony forming units CFU /mL were found in 28 (1.90%)of total cases,with 767 (52.64%)girls and 690 (47.35%)boys.The highest class-specific prevalence was found in the fourth standard (2.8%)and the lowest in the first standard (1.0%).The dominant bacterial isolates were E.coli 20 (74.1%),followed by Klebsiella pneumoniae 04 (14.8%)and Staphylococcus aureus 04 (14.8%).Cefotaxime,Cefixime,Kana-mycin,Co-trimoxazole,nalidicxic acid,nitrofurantoin and Amoxicillin,resistance rates were above 90.0%. Ceftriaxone expressed the highest susceptibility among E.coli isolates.Surprisingly,S.aureus showed 100. 0% resistance to oxacillin.Conclusion:In the present study in which Escherichia coli is the most frequently incriminated as the causative agents.The results show a very serious antibiotic resistance of E.coli isolated. Surveillance and monitoring studies will be essential in preventing of renal scarring or other abnormalities.

  4. [The pertinence of microscopic analysis of the urine as a diagnostic test for asymptomatic bacteriuria in pregnancy].

    Science.gov (United States)

    Boucher, M; Leduc, L; Rinfret, D

    1989-01-01

    The genito-urinary tract is the most frequent site of infection during pregnancy. Asymptomatic bacteriuria is found in 2 to 12% of the obstetrical population. The importance of its detection is underlined by the fact that 20 to 40% of untreated cases will present acute pyelonephritis. Our study's first aim was determining the incidence of asymptomatic bacteriuria in our population. Our results show an incidence of 3.9%. Second, routine mandatory prenatal laboratory examinations include urinalysis and urine culture. Considering the fact that we already do a routine culture, we questioned the pertinence of the microscopic part of urinalysis for screening asymptomatic bacteriuria. Our study has shown that no amount of erythrocytes, leucocytes, bacteria, pus or combination thereof has sufficient sensitivity and/or specificity to be used for screening. We thus conclude that in our context of budget restrictions, the microscopic analysis of urine should be abandoned as a routine test. The biochemical part of urinalysis could be done easily with dipsticks at a lower cost. Urine culture remains the gold standard for detection of asymptomatic bacteriuria.

  5. Escherichia coli Isolates Causing Asymptomatic Bacteriuria in Catheterized and Noncatheterized Individuals Possess Similar Virulence Properties

    DEFF Research Database (Denmark)

    Watts, Rebecca E; Hancock, Viktoria; Ong, Cheryl-lynn Y;

    2010-01-01

    Urinary tract infections (UTIs) are among the most common infectious diseases of humans, with Escherichia coli being responsible for >80% of all cases. Asymptomatic bacteriuria (ABU) occurs when bacteria colonize the urinary tract without causing clinical symptoms and can affect both catheterized...... patients (catheter-associated ABU [CA-ABU]) and noncatheterized patients. Here, we compared the virulence properties of a collection of ABU and CA-ABU nosocomial E. coli isolates in terms of antibiotic resistance, phylogenetic grouping, specific UTI-associated virulence genes, hemagglutination...... with that previously described for the prototype ABU E. coli strain, 83972. This is the first global gene expression analysis of E. coli CA-ABU strains. Overall, our data suggest that nosocomial ABU and CA-ABU E. coli isolates possess similar virulence profiles....

  6. Prevalence of bacteriuria in Jeyaseharan Hospital of South India and their antibiogram

    Institute of Scientific and Technical Information of China (English)

    Prakash S; S Anto Jeya Dayalan; Edison N

    2011-01-01

    Objective: To investigate the prevalence of bacteriologically positive urinary tract infection (UTI) among people enrolled in the hospital during January 2010 to June 2010. Methods: In the study period, a total of 1 546 patients were screened for UTI and the antibiogram was studied. Results: A total of 744 patients were positive. It revealed that females were more vulnerable to bacteriuria than males. Organisms predominantly isolated were Esherichia coli followed byKlebsiella in both males and females. Among the antibiotics tested against the isolated organisms for sensitivity test, chloramphenicol was more effective followed by amikacin and gatifloxacin for Enterobacteriaceae. For Pseudomonas aeruginosa, chloramphenicol was not effective, amikacin was effective. Amoxycillin, amoxycillin/clavulanic acid and first generation cephalosporin were least effective against Enterobacteriaceae and Pseudomonas aeruginosa. Conclusions: This study would not only help in proper treatment of patients but also discourage the indiscriminate use of antibiotics and prevent development of drug resistance.

  7. The asymptomatic bacteriuria Escherichia coli strain 83972 outcompetes uropathogenic E. coli strains in human urine

    DEFF Research Database (Denmark)

    Hancock, Viktoria; Ulett, G.C.; Schembri, M.A.;

    2006-01-01

    Escherichia coli is the most common organism associated with asymptomatic bacteriuria (ABU). In contrast to uropathogenic E. coli (UPEC), which causes symptomatic urinary tract infections (UTI), very little is known about the mechanisms by which these strains colonize the human urinary tract...... to conventional therapy. Colonization with strain 83972 appears to prevent infection with UPEC strains in such patients despite the fact that this strain is unable to express the primary adhesins involved in UTI, viz. P and type 1 fimbriae. Here we investigated the growth characteristics of E. coli 83972 in human...... urine and show that it can outcompete a representative spectrum of UPEC strains for growth in urine. The unique ability of ABU E. coli 83972 to outcompete UPEC in urine was also demonstrated in a murine model of human UTI, confirming the selective advantage over UPEC in vivo. Comparison of global gene...

  8. Biofilm-Exclusion of Uropathogenic Bacteria by Selected Asymptomatic Bacteriuria Escherichia Coli Strains

    DEFF Research Database (Denmark)

    Ferriéres, L.; Hancock, Viktoria; Klemm, Per

    2007-01-01

    . In contrast to uropathogenic E coli (UPEC), which cause symptomatic urinary tract infection, asymptomatic bacteriuria (ABU) strains are associated with essentially symptom-free infections. Here the biofilm-forming capacity on abiotic surfaces of selected E coli ABU strains and UPEC strains in human urine...... was investigated. It was found that there is a strong bias for biofilm formation by the ABU strains. Not only were the ABU strains significantly better biofilm formers than UPEC strains, they were also able to out-compete UPEC strains as well as uropathogenic strains of Klebsiella spp. during biofilm formation....... The results support the notion of bacterial prophylaxis employing selected ABU strains to eliminate UPEC strains and other pathogens in patients prone to recalcitrant infections....

  9. Identification of Genes Important for Growth of Asymptomatic Bacteriuria Escherichia coli in Urine

    DEFF Research Database (Denmark)

    Vejborg, Rebecca Munk; de Evgrafov, Mari Cristina Rodriguez; Phan, Minh Duy;

    2012-01-01

    Escherichia coli is the most important etiological agent of urinary tract infections (UTIs). Unlike uropathogenic E. coli, which causes symptomatic infections, asymptomatic bacteriuria (ABU) E. coli strains typically lack essential virulence factors and colonize the bladder in the absence...... and the clinical ABU E. coli strain VR89. Six genes involved in the biosynthesis of various amino acids and nucleobases were identified (carB, argE, argC, purA, metE, and ilvC), and site-specific mutants were subsequently constructed in E. coli 83972 and E. coli VR89 for each of these genes. In all cases......, these mutants exhibited reduced growth rates and final cell densities in human urine. The growth defects could be complemented in trans as well as by supplementation with the appropriate amino acid or nucleobase. When assessed in vivo in a mouse model, E. coli 83972carAB and 83972argC showed a significantly...

  10. Profile and microbiological isolates of asymptomatic bacteriuria among pregnant women in Abakaliki, Nigeria

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    Onu FA

    2015-07-01

    Full Text Available Fidelis Agwu Onu,1 Leonard Ogbonna Ajah,1 Paul Olisaemeka Ezeonu,1 Odidika Ugochukwu Joannes Umeora,1 Perpetus Chudi Ibekwe,1 Monique Iheoma Ajah2 1Department of Obstetrics and Gynaecology, Federal Teaching Hospital, 2Department of Microbiology, Ebonyi State University, Abakaliki, Nigeria Background: Detecting and treating asymptomatic bacteriuria (ASB prevents urinary tract infection and its consequences. The cost-effectiveness of routine screening for ASB in pregnancy is controversial. In populations with high prevalence, however, it is worthwhile and justifiable. Aim: To determine the profile, prevalence, microbiological isolates, and risk factors of ASB among booking antenatal clinic attendees in Abakaliki, Nigeria. Materials and methods: This was a cross-sectional study involving booking antenatal clinic attendees at the Federal Teaching Hospital, Abakaliki, who met the inclusion criteria. This study occurred between January and December, 2012. The midstream urine samples of these women were subjected to microscopy, culture, and sensitivity. Results: A total of 300 randomly selected booking antenatal clinic attendees participated in the study; 74 of them had ASB, giving a prevalence of 24.7%. With the exception of rural residence, sociodemographic and obstetric characteristics did not influence the risk of ASB among the participants in this study. Staphylococcus aureus was the commonest organism isolated. The majority of the organisms were sensitive to ofloxacin and ceftriaxone. Conclusion: There is a high prevalence of ASB among pregnant women in Abakaliki. With the exception of rural dwelling, sociodemographic and obstetric characteristics did not significantly influence the risk of ASB among these pregnant women. Therefore, routine ASB screening of pregnant women is recommended in our environment. Keywords: asymptomatic bacteriuria, pregnant women, Abakaliki

  11. Genetic variation of the human urinary tract innate immune response and asymptomatic bacteriuria in women.

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    Thomas R Hawn

    Full Text Available BACKGROUND: Although several studies suggest that genetic factors are associated with human UTI susceptibility, the role of DNA variation in regulating early in vivo urine inflammatory responses has not been fully examined. We examined whether candidate gene polymorphisms were associated with altered urine inflammatory profiles in asymptomatic women with or without bacteriuria. METHODOLOGY: We conducted a cross-sectional analysis of asymptomatic bacteriuria (ASB in 1,261 asymptomatic women ages 18-49 years originally enrolled as participants in a population-based case-control study of recurrent UTI and pyelonephritis. We genotyped polymorphisms in CXCR1, CXCR2, TLR1, TLR2, TLR4, TLR5, and TIRAP in women with and without ASB. We collected urine samples and measured levels of uropathogenic bacteria, neutrophils, and chemokines. PRINCIPAL FINDINGS: Polymorphism TLR2_G2258A, a variant associated with decreased lipopeptide-induced signaling, was associated with increased ASB risk (odds ratio 3.44, 95%CI; 1.65-7.17. Three CXCR1 polymorphisms were associated with ASB caused by gram-positive organisms. ASB was associated with urinary CXCL-8 levels, but not CXCL-5, CXCL-6, or sICAM-1 (P< or =0.0001. Urinary levels of CXCL-8 and CXCL-6, but not ICAM-1, were associated with higher neutrophil levels (P< or =0.0001. In addition, polymorphism CXCR1_G827C was associated with increased CXCL-8 levels in women with ASB (P = 0.004. CONCLUSIONS: TLR2 and CXCR1 polymorphisms were associated with ASB and a CXCR1 variant was associated with urine CXCL-8 levels. These results suggest that genetic factors are associated with early in vivo human bladder immune responses prior to the development of symptomatic UTIs.

  12. Similar Neutrophil-Driven Inflammatory and Antibacterial Responses in Elderly Patients with Symptomatic and Asymptomatic Bacteriuria.

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    Yu, Yanbao; Zielinski, Martin D; Rolfe, Melanie A; Kuntz, Melissa M; Nelson, Heidi; Nelson, Karen E; Pieper, Rembert

    2015-10-01

    Differential diagnosis of asymptomatic bacteriuria (ASB) and urinary tract infection (UTI) is based on the presence of diverse symptoms, including fever (≥38.5°C), rigors, malaise, lethargy, flank pain, hematuria, suprapubic discomfort, dysuria, and urgent or frequent urination. There is consensus in the medical community that ASB warrants antibiotic treatment only for patients undergoing urological procedures that lead to mucosal bleeding, catheterized individuals whose ASB persists for more than 48 h after catheter removal, and pregnant women. Pyuria is associated with UTI and implicates host immune responses via release of antibacterial effectors and phagocytosis of pathogens by neutrophils. Such responses are not sufficiently described for ASB. Metaproteomic methods were used here to identify the pathogens and evaluate molecular evidence of distinct immune responses in cases of ASB compared to UTI in elderly patients who were hospitalized upon injury. Neutrophil-driven inflammatory responses to invading bacteria were not discernible in most patients diagnosed with ASB compared to those with UTI. In contrast, proteomic urine analysis for trauma patients with no evidence of bacteriuria, including those who suffered mucosal injuries via urethral catheterization, rarely showed evidence of neutrophil infiltration. The same enzymes contributing to the synthesis of leukotrienes LTB4 and LTC4, mediators of inflammation and pain, were found in the UTI and ASB cohorts. These data support the notion that the pathways mediating inflammation and pain in most elderly patients with ASB are not quantitatively different from those seen in most elderly patients with UTI and warrant larger clinical studies to assess whether a common antibiotic treatment strategy for elderly ASB and UTI patients is justified. PMID:26238715

  13. Asymptomatic bacteriuria

    Science.gov (United States)

    ... be checked for a bladder or kidney infection. Images ... by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, ...

  14. Asymptomatic bacteriuria in children with sickle cell anemia at The University of Nigeria teaching hospital, Enugu, South East, Nigeria

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    Ikefuna Anthony N; Okafor Henrietta U; Chukwu Bartholomew F

    2011-01-01

    Abstract Background Urinary tract infection (UTI) is a common cause of childhood morbidity and mortality in the tropics. Children with sickle cell anemia (SCA) may have compromised kidney function arising from repeated vaso-occlusive episodes and recurrent symptomatic or asymptomatic UTI. Objectives This study aims at determining the prevalence of asymptomatic bacteriuria and sensitivity pattern in children with homozygous sickle haemoglobin compared to children with normal haemoglobin. Metho...

  15. Socio-demographic factors associated with asymptomatic bacteriuria in children with sickle cell anemia in a tertiary health facility in South eastern, Nigeria

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    B F Chukwu

    2010-01-01

    Full Text Available Background: Urinary tract infection (UTI is a common cause of chronic kidney disease in children. It is second only to respiratory tract infection in developed countries as a cause of morbidity and mortality arising from microbial infections. It is also common in a developing country like Nigeria and is the commonest cause of renal disorders in Port Harcourt, South South, Nigeria. UTI can be symptomatic or asymptomatic (asymptomatic bacteriuria. Asymptomatic bacteriuria is said to be more common in school aged girls and children of low socio-economic class. It has also been documented to be more common in children with sickle cell anaemia. Objectives:To determine the relationship between asymptomatic bacteriuria and age, sex and socio-economic status of children with sickle cell anaemia. Methods: One hundred children with sickle cell anaemia in stable state were screened for asymptomatic bacteriuria using midstream urine samples. The age, sex and social class of the children were obtained through a structured questionnaire administered to the parents/care-givers. The relationship between age, sex and social class with asymptomatic bacteriuria in these children was analyzed using SPSS software. Results: The age of the children ranged from 2-12 years. Six of the 100 children were noted to have asymptomatic bacteriuria and five of the six children were females (p=0.04.Five (83.3% of the six children were five years and above. There was a predominance of positive cases (66.7% in the higher socioeconomic class (p=0.03. Conclusion: Asymptomatic bacteriuria is commoner in school aged female sickle cell anaemia children of higher socioeconomic class. However, we suggest that further studies be done to confirm this finding especially with regards to the socioeconomic status of these children.

  16. Asymptomatic bacteriuria in sickle cell disease: a cross-sectional study

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    Roye-Green Karen

    2006-03-01

    Full Text Available Background It is known that there is significant morbidity associated with urinary tract infection and with renal dysfunction in sickle cell disease (SCD. However, it is not known if there are potential adverse outcomes associated with asymptomatic bacteriuria (ASB infections in sickle cell disease if left untreated. This study was undertaken to determine the prevalence of ASB, in a cohort of patients with SCD. Methods This is a cross-sectional study of patients in the Jamaican Sickle Cell Cohort. Aseptically collected mid-stream urine (MSU samples were obtained from 266 patients for urinalysis, culture and sensitivity analysis. Proteinuria was measured by urine dipsticks. Individuals with abnormal urine culture results had repeat urine culture. Serum creatinine was measured and steady state haematology and uric acid concentrations were obtained from clinical records. This was completed at a primary care health clinic dedicated to sickle cell diseases in Kingston, Jamaica. There were 133 males and 133 females in the sample studied. The mean age (mean ± sd of participants was 26.6 ± 2.5 years. The main outcome measures were the culture of ≥ 105 colony forming units of a urinary tract pathogen per milliliter of urine from a MSU specimen on a single occasion (probable ASB or on consecutive occasions (confirmed ASB. Results Of the 266 urines collected, 234 were sterile and 29 had significant bacteriuria yielding a prevalence of probable ASB of 10.9% (29/266. Fourteen patients had confirmed ASB (prevalence 5.3% of which 13 had pyuria. Controlling for genotype, females were 14.7 times more likely to have confirmed ASB compared to males (95%CI 1.8 to 121.0. The number of recorded visits for symptomatic UTI was increased by a factor of 2.5 (95% CI 1.4 to 4.5, p Conclusion ASB is a significant problem in individuals with SCD and may be the source of pathogens in UTI. However, further research is needed to determine the clinical significance of ASB in

  17. Virulence versus fitness determinants in Escherichia coli isolated from asymptomatic bacteriuria in healthy nonpregnant women

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    Sugandha Srivastava

    2016-01-01

    Full Text Available Purpose: Escherichia coli isolated from asymptomatic bacteriuria (ABU correlated genotypically and phenotypically with cystitis isolates may help in distinguishing urovirulence determinants from 'fitness factors', latter necessary only for survival of E. coli in urinary tract; for gaining insight into the pathogenesis of urinary tract infection. Materials and Methods: In this cross-sectional study, we compared genotypic (phylogroups and 15 putative virulence genes, and phenotypic profiles of ABU E. coli strains with our previously genotyped collection of cystitis isolates. Virulence score was calculated for each isolate as a number of virulence genes detected. Results: Significant differences were observed in the proportion of four phylogenetic groups (P = 0.009 amongst cystitis and ABU isolates. Average virulence score was higher for ABU isolates (6.6 than cystitis strains (4.2; and hlyA (P = 0.001, cytotoxic necrotising factor 1 (P = 0.00, fyuA (P = 0.00, ibeA (P = 0.00, kpsMII (P = 0.01, and malX/pathogenicity-associated island (P = 0.01 were more frequently present in ABU strains. Conclusions: The expression of adhesins, haemolysin, aerobactin, and capsule synthesis gene were similar in two groups suggesting their role as fitness factors. ABU isolates were better biofilm producers, reflecting its importance in silent persistence. Serum resistance gene which was more expressed in cystitis isolates may represent virulence determinant. Genetic makeup of E. coli does not change much rather genes helping in survival and colonisation are expressed equally in ABU and cystitis isolates as opposed to phenotypic attenuation of those that helps in invasion or inflammation in ABU isolates.

  18. Costs and effects of screening and treating low risk women with a singleton pregnancy for asymptomatic bacteriuria, the ASB study

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    Kazemier Brenda M

    2012-06-01

    Full Text Available Abstract Background The prevalence of asymptomatic bacteriuria (ASB in pregnancy is 2-10% and is associated with both maternal and neonatal adverse outcomes as pyelonephritis and preterm delivery. Antibiotic treatment is reported to decrease these adverse outcomes although the existing evidence is of poor quality. Methods/Design We plan a combined screen and treat study in women with a singleton pregnancy. We will screen women between 16 and 22 weeks of gestation for ASB using the urine dipslide technique. The dipslide is considered positive when colony concentration ≥105 colony forming units (CFU/mL of a single microorganism or two different colonies but one ≥105 CFU/mL is found, or when Group B Streptococcus bacteriuria is found in any colony concentration. Women with a positive dipslide will be randomly allocated to receive nitrofurantoin or placebo 100 mg twice a day for 5 consecutive days (double blind. Primary outcomes of this trial are maternal pyelonephritis and/or preterm delivery before 34 weeks. Secondary outcomes are neonatal and maternal morbidity, neonatal weight, time to delivery, preterm delivery rate before 32 and 37 weeks, days of admission in neonatal intensive care unit, maternal admission days and costs. Discussion This trial will provide evidence for the benefit and cost-effectiveness of dipslide screening for ASB among low risk women at 16–22 weeks of pregnancy and subsequent nitrofurantoin treatment. Trial registration Dutch trial registry: NTR-3068

  19. The effect of education, marital status and sexual behaviour on the incidence of puerperal endometritis and bacteriuria.

    Science.gov (United States)

    Rehu, M

    1980-12-01

    During a one year study period, 5058 patients were delivered in the State Maternity Hospital of Helsinki. Caesarean section was performed on 774 patients (15.3%). The puerperal endometritis rate was 1.8% after vaginal delivery and 9.8% after Caesarean section. After vaginal delivery, the frequency of endometritis in unmarried women (3.9%) was more than twice as high as in married women (1.5%) (p less than 0.001). After Caesarean section, endometritis occurred in 20.7% of unmarried and in 8.9% of married women (p less than 0.001). Patients who had sexual intercourse during the last week of pregnancy had endometritis after vaginal delivery at a rate of 2.4% and in 20.0% after Caesarean section. In patients who had not sexual intercourse the percentages were 1.6 and 8.3 respectively. In vaginal deliveries the difference was small but in Caesarean sections statistically significant (p less than 0.05). Maternal education had no significant effect on the frequency of endometritis. Bacteriuria corresponding to greater than or equal to 10(5) bacteria/ml of urine was found in 179 patients (5.0%). The frequency of bacteriuria did not have a statistically significant correlation with the marital status of the patients, nor with their education or sexual behaviour during the last week of pregnancy. PMID:7235607

  20. Asymptomatic bacteriuria Escherichia coli strain 83972 carries mutations in the foc locus and is unable to express F1C fimbriae

    DEFF Research Database (Denmark)

    Hancock, Viktoria; Schembri, M.A.; Ulett, G.C.;

    2006-01-01

    Escherichia coli is the most common organism associated with asymptomatic bacteriuria (ABU). In contrast to uropathogenic E. coli (UPEC), which causes symptomatic urinary tract infection (UTI), very little is known about the mechanisms by which these strains colonize the urinary tract. Bacterial...

  1. Genetic control of the variable innate immune response to asymptomatic bacteriuria.

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    Jenny Grönberg-Hernández

    Full Text Available The severity of urinary tract infection (UTI reflects the quality and magnitude of the host response. While strong local and systemic innate immune activation occurs in patients with acute pyelonephritis, the response to asymptomatic bacteriuria (ABU is low. The immune response repertoire in ABU has not been characterized, due to the inherent problem to distinguish bacterial differences from host-determined variation. In this study, we investigated the host response to ABU and genetic variants affecting innate immune signaling and UTI susceptibility. Patients were subjected to therapeutic urinary tract inoculation with E. coli 83972 to ensure that they were exposed to the same E. coli strain. The innate immune response repertoire was characterized in urine samples, collected from each patient before and after inoculation with bacteria or PBS, if during the placebo arm of the study. Long-term E. coli 83972 ABU was established in 23 participants, who were followed for up to twelve months and the innate immune response was quantified in 233 urine samples. Neutrophil numbers increased in all but two patients and in an extended urine cytokine/chemokine analysis (31 proteins, the chemoattractants IL-8 and GRO-α, RANTES, Eotaxin-1 and MCP-1, the T cell chemoattractant and antibacterial peptide IP-10, inflammatory regulators IL-1-α and sIL-1RA and the T lymphocyte/dendritic cell product sIL-2Rα were detected and variably increased, compared to sterile samples. IL-6, which is associated with symptomatic UTI, remained low and numerous specific immune mediators were not detected. The patients were also genotyped for UTI-associated IRF3 and TLR4 promoter polymorphisms. Patients with ABU associated TLR4 polymorphisms had low neutrophil numbers, IL-6, IP-10, MCP-1 and sIL-2Rα concentrations. Patients with the ABU-associated IRF3 genotype had lower neutrophils, IL-6 and MCP-1 responses than the remaining group. The results suggest that the host

  2. A Controlled Quasi-Experimental Study of an Educational Intervention to Reduce the Unnecessary Use of Antimicrobials For Asymptomatic Bacteriuria.

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    Neal Irfan

    Full Text Available Asymptomatic bacteriuria (ABU should only be treated in cases of pregnancy or in-patients undergoing urologic procedures; however, unnecessary treatment of ABU is common in clinical practice.To identify risk factors for unnecessary treatment and to assess the impact of an educational intervention focused on these risk factors on treatment of ABU.Quasi-experimental study with a control group.Two tertiary teaching adult care hospitals.Consecutive patients with positive urine cultures between January 30th and April 17th, 2012 (baseline and January 30th and April 30th, 2013 (intervention.In January 2013, a multifaceted educational intervention based on risk factors identified during the baseline period was provided to medical residents (monthly on one clinical teaching unit (CTU at one hospital site, with the CTU of the other hospital serving as the control.During the baseline period, 160/341 (46.9% positive urine cultures were obtained from asymptomatic patients at the two hospitals, and 94/160 (58.8% were inappropriately treated with antibiotics. Risk factors for inappropriate use included: female gender (OR 2.1, 95% CI 1.1-4.3, absence of a catheter (OR 2.5, 1.2-5, bacteriuria versus candiduria (OR 10.6, 3.8-29.4, pyuria (OR 2.0, 1.1-3.8, and positive nitrites (OR 2.2, 1.1-4.5. In 2013, only 2/24 (8% of ABU patients were inappropriately treated on the intervention CTU as compared to 14/29 (52% on the control CTU (OR 0.10; 95% CI 0.02-0.49. A reduction was also observed as compared to baseline on the intervention CTU (OR 0.1, 0.02-0.7 with no significant change noted on the control CTU (OR 0.47, 0.13-1.7.A multifaceted educational intervention geared towards medical residents with a focus on identified risk factors for inappropriate management of ABU was effective in reducing unnecessary antibiotic use.

  3. Evaluation of dipstick analysis among elderly residents to detect bacteriuria: a cross-sectional study in 32 nursing homes

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    Sundvall Pär-Daniel

    2009-07-01

    Full Text Available Abstract Background Few studies have evaluated dipstick urinalysis for elderly and practically none present confidence intervals. Furthermore, most previous studies combine all bacteria species in a "positive culture". Thus, their evaluation may be inappropriate due to Yule-Simpson's paradox. The aim of this study was to evaluate diagnostic accuracy of dipstick urinalysis for the elderly in nursing homes. Methods In this cross-sectional study voided urine specimens were collected from 651 elderly individuals in nursing homes. Dipstick urinalysis for nitrite, leukocyte esterase and urine culture were performed. Sensitivity, specificity, positive and negative predictive values with 95% confidence intervals were calculated. Visual readings were compared to readings with a urine chemistry analyzer. Results 207/651 (32% of urine cultures showed growth of a potentially pathogenic bacterium. Combining the two dipsticks improved test characteristics slightly compared to using only one of the dipsticks. When both dipsticks are negative, presence of potentially pathogenic bacteria can be ruled out with a negative predictive value of 88 (84–92%. Visual and analyzer readings had acceptable agreement. Conclusion When investigating for bacteriuria in elderly people at nursing homes we suggest nitrite and leukocyte esterase dipstick be combined. There are no clinically relevant differences between visual and analyzer dipstick readings. When dipstick urinalysis for nitrite and leukocyte esterase are both negative it is unlikely that the urine culture will show growth of potentially pathogenic bacteria and in a patient with an uncomplicated illness further testing is unnecessary.

  4. Preditores clínicos de bacteriúria assintomática na gestação Clinical predictors of asymptomatic bacteriuria during pregnancy

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    Omar Ismail Santos Pereira Darzé

    2011-08-01

    Full Text Available OBJETIVOS: Estimar a prevalência de bacteriúria assintomática (BAS entre gestantes atendidas em pré-natal de Serviço Universitário e identificar prováveis preditores clínicos. MÉTODOS: Estudo prospectivo de corte transversal, envolvendo 260 gestantes matriculadas em serviço de pré-natal de baixo risco entre agosto de 2008 e outubro de 2009, sem sintomas de infecção do trato urinário. Foram excluídas aquelas com febre, disúria, tenesmo vesical, dor lombar, presença de sangramento genital, perda de líquido amniótico, uso de antimicrobianos nos últimos 30 dias e aquelas que não desejaram participar do projeto. A presença de colonização bacteriana ≥10(5 UFC/mL de único patógeno, na amostra urinária obtida do jato médio, foi considerada como a variável dependente. As variáveis estudadas foram: idade, raça, estado civil, nível de instrução, história obstétrica, idade gestacional, anemia, traço falciforme, colpite, passado de infecção do trato urinário, polaciúria, urgência miccional e incontinência urinária. Dados do sumário de urina também foram analisados, como a presença de leucocitúria, flora bacteriana aumentada, hematúria, proteinúria e nitrito. A análise estatística foi realizada com o programa Statistical Package for the Social Sciences (SPSS 13.0 e a significância estatística foi previamente definida por valor pPURPOSE: To estimate the prevalence of asymptomatic bacteriuria among pregnant women attended at our university prenatal care clinic and to identify probable clinical predictors. METHODS: Across-sectional study was carried out from August 2008 to October 2009 at the Bahiana School of Medicine involving 260 pregnant women without symptoms of urinary tract infection. The following exclusion criteria were considered: presence of clinical signs such as fever, dysuria, vesical tenesmus, lumbar pain, history of active genital bleeding or loss of amniotic fluid, use of antimicrobial

  5. Fatores associados à bacteriúria após sondagem vesical na cirurgia ginecológica Factors associated with bacteriuria after indwelling urethral catheterization in gynecologic surgery

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    Sonia Cristina Araújo Hinrichsen

    2009-01-01

    Full Text Available OBJETIVOS: Determinar a frequência e os principais fatores associados à bacteriúria após a sondagem vesical em mulheres submetidas à cirurgia ginecológica eletiva. MÉTODOS: Realizou-se um estudo do tipo coorte em mulheres submetidas à cirurgia ginecológica após sondagem vesical no Instituto de Medicina Integral Prof. Fernando Figueira, no período de janeiro a maio de 2007. As uroculturas foram coletadas até 24 horas após a retirada da sonda e 7/10 dias após a sondagem vesical. A análise estatística bivariada e multivariada foi realizada calculando-se a razão de risco e os seus intervalos de confiança a 95%. RESULTADOS: Foram incluídas no estudo 249 mulheres. A frequência de uroculturas positivas até 24 horas depois da retirada da sonda foi de 23,6%, diminuindo para 11,1% 7/10 dias após a sondagem. Destas, apenas 2,4% eram sintomáticas. Verificou-se menor risco de bacteriúria com 7/10 dias após a sondagem vesical quando a paciente referiu vulvovaginite tratada nos últimos três meses, não permanecendo estatisticamente significativa após a análise multivariada. Não houve associação significativa com idade, escolaridade, número de gestações, paridade, fase da vida reprodutiva, tipo e duração da cirurgia, tipo da anestesia, uso de antibiótico profilático, profissional que colocou a sonda e o tempo de permanência da sonda vesical. CONCLUSÃO: A frequência de bacteriúria foi de 23,6% e 11,1% com 24 horas e 7/10 dias, respectivamente. Não se encontrou associação significativa das variáveis pesquisadas com a bacteriúria evidenciada na urocultura com 7/10 dias.OBJECTIVES: To determine the frequency and risk factors associated to bacteriuria after urinary catheterization in women submitted to elective gynecological surgery. METHODS: A cohort study was carried out among women submitted to gynecological surgery after urinary catheterization. This study took place at the "Instituto de Medicina Integral Professor

  6. A hospital-site controlled intervention using audit and feedback to implement guidelines concerning inappropriate treatment of catheter-associated asymptomatic bacteriuria

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    Hysong Sylvia

    2011-04-01

    Full Text Available Abstract Background Catheter-associated urinary tract infection (CAUTI is one of the most common hospital-acquired infections. However, many cases treated as hospital-acquired CAUTI are actually asymptomatic bacteriuria (ABU. Evidence-based guidelines recommend that providers neither screen for nor treat ABU in most catheterized patients, but there is a significant gap between these guidelines and clinical practice. Our objectives are (1 to evaluate the effectiveness of an audit and feedback intervention for increasing guideline-concordant care concerning catheter-associated ABU and (2 to measure improvements in healthcare providers' knowledge of and attitudes toward the practice guidelines associated with the intervention. Methods/Design The study uses a controlled pre/post design to test an intervention using audit and feedback of healthcare providers to improve their compliance with ABU guidelines. The intervention and the control sites are two VA hospitals. For objective 1 we will review medical records to measure the clinical outcomes of inappropriate screening for and treatment of catheter-associated ABU. For objective 2 we will survey providers' knowledge and attitudes. Three phases of our protocol are proposed: the first 12-month phase will involve observation of the baseline incidence of inappropriate screening for and treatment of ABU at both sites. This surveillance for clinical outcomes will continue at both sites throughout the study. Phase 2 consists of 12 months of individualized audit and feedback at the intervention site and guidelines distribution at both sites. The third phase, also over 12 months, will provide unit-level feedback at the intervention site to assess sustainability. Healthcare providers at the intervention site during phase 2 and at both sites during phase 3 will complete pre/post surveys of awareness and familiarity (knowledge, as well as of acceptance and outcome expectancy (attitudes regarding the relevant

  7. Genomic analysis of a pathogenicity island in uropathogenic Escherichia coli CFT073: distribution of homologous sequences among isolates from patients with pyelonephritis, cystitis, and Catheter-associated bacteriuria and from fecal samples.

    Science.gov (United States)

    Guyer, D M; Kao, J S; Mobley, H L

    1998-09-01

    Urinary tract infection is the most frequently diagnosed kidney and urologic disease and Escherichia coli is by far the most common etiologic agent. Uropathogenic strains have been shown to contain blocks of DNA termed pathogenicity islands (PAIs) which contribute to their virulence. We have defined one of these regions of DNA within the chromosome of a highly virulent E. coli strain, CFT073, isolated from the blood and urine of a woman with acute pyelonephritis. The 57,988-bp stretch of DNA has characteristics which define PAIs, including a size greater than 30 kb, the presence of insertion sequences, distinct segmentation of K-12 and J96 origin, GC content (42.9%) different from that of total genomic DNA (50.8%), and the presence of virulence genes (hly and pap). Within this region, we have identified 44 open reading frames; of these 44, 10 are homologous to entries in the complete K-12 genome sequence, 4 are nearly identical to the sequences of E. coli J96 encoding the HlyA hemolysin, 11 encode P fimbriae, and 19 show no homology to J96 or K-12 entries. To determine whether sequences found within the junctions of the PAI of CFT073 were common to other uropathogenic strains of E. coli, 11 probes were isolated along the length of the PAI and were hybridized to dot blots of genomic DNA isolated from clinical isolates (67 from patients with acute pyelonephritis, 38 from patients with cystitis, 49 from patients with catheter-associated bacteriuria, and 27 from fecal samples). These sequences were found significantly more often in strains associated with the clinical syndromes of acute pyelonephritis (79%) and cystitis (82%) than in those associated with catheter-associated bacteriuria (58%) and in fecal strains (22%) (P < 0.001). From these regions, we have identified a putative iron transport system and genes other than hly and pap that may contribute to the virulent phenotype of uropathogenic E. coli strains.

  8. ASYMPTOMATIC BACTERIURIA IN DIABETIC WOMEN

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    Patil Nilima R

    2012-12-01

    Full Text Available To study the prevalence of ASB in diabetic women and to compare microbiological profile among diabetic and non- diabetic women. Material and methods:- In this prospective study, 100 midstream urine samples were collected from diabetic women without any signs and symptoms of urinary tract infection. Routine standard laboratory methods were used for isolation and identification of uropathogens. Antibiotic sensitivity test was done on MHA media by using Kirby Bauers disk diffusion method. Result: Prevalence of ASB was 13% in diabetic and 6% in non-diabetic women.E-coli found to be leading pathogen among diabetic and in non-diabetic women. Nitrofurantoin and Amikacin were found to be the most effective drugs against large types of bacteria. Conclusion:- The initial choice of empirical antimicrobial therapy should be based on Gram stain and urine culture. Choice of antimicrobial therapy should integrate local sensitivity patterns of infecting organisms.

  9. Asymptomatic bacteriuria Escherichia coli strains

    DEFF Research Database (Denmark)

    Hancock, Viktoria; Nielsen, E.M.; Klemm, Per

    2006-01-01

    to uropathogenic E. coli (UPEC) that cause symptomatic UTI, very little is known about the mechanisms by which these strains colonize the urinary tract. Here, we have investigated the growth characteristics in human urine as well as adhesin repertoire of nine ABU strains; the ability of ABU strains to compete...... against the UPEC strain CFT073 was also studied. The different ABU strains displayed a wide variety of the measured characteristics. Half of the ABU strains displayed functional type 1 fimbriae while only one expressed functional P fimbriae. A good correlation between the growth rate of a particular...

  10. Integrated next-generation sequencing of 16S rDNA and metaproteomics differentiate the healthy urine microbiome from asymptomatic bacteriuria in neuropathic bladder associated with spinal cord injury

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    Fouts Derrick E

    2012-08-01

    Full Text Available Abstract Background Clinical dogma is that healthy urine is sterile and the presence of bacteria with an inflammatory response is indicative of urinary tract infection (UTI. Asymptomatic bacteriuria (ABU represents the state in which bacteria are present but the inflammatory response is negligible. Differentiating ABU from UTI is diagnostically challenging, but critical because overtreatment of ABU can perpetuate antimicrobial resistance while undertreatment of UTI can result in increased morbidity and mortality. In this study, we describe key characteristics of the healthy and ABU urine microbiomes utilizing 16S rRNA gene (16S rDNA sequencing and metaproteomics, with the future goal of utilizing this information to personalize the treatment of UTI based on key individual characteristics. Methods A cross-sectional study of 26 healthy controls and 27 healthy subjects at risk for ABU due to spinal cord injury-related neuropathic bladder (NB was conducted. Of the 27 subjects with NB, 8 voided normally, 8 utilized intermittent catheterization, and 11 utilized indwelling Foley urethral catheterization for bladder drainage. Urine was obtained by clean catch in voiders, or directly from the catheter in subjects utilizing catheters. Urinalysis, urine culture and 16S rDNA sequencing were performed on all samples, with metaproteomic analysis performed on a subsample. Results A total of 589454 quality-filtered 16S rDNA sequence reads were processed through a NextGen 16S rDNA analysis pipeline. Urine microbiomes differ by normal bladder function vs. NB, gender, type of bladder catheter utilized, and duration of NB. The top ten bacterial taxa showing the most relative abundance and change among samples were Lactobacillales, Enterobacteriales, Actinomycetales, Bacillales, Clostridiales, Bacteroidales, Burkholderiales, Pseudomonadales, Bifidobacteriales and Coriobacteriales. Metaproteomics confirmed the 16S rDNA results, and functional human protein

  11. Rapid detection of bacteriuria by laser nephelometry.

    OpenAIRE

    Richet, H; Bayardelle, P; Lemarie, J C

    1984-01-01

    A total of 1,002 urine specimens were evaluated by laser nephelometry. This technique was compared with both colony counts, done with a calibrated loop, and serial dilutions. For urine specimens containing between 10(4) and 10(5) bacteria per ml, laser nephelometry detected 75.4% of those detected by colony count and 65.6% of those detected by serial dilution. For specimens where the concentration of bacteria was greater than 10(5) per ml, laser nephelometry detected 95.8 and 92.4% of those d...

  12. Asymptomatic Bacteriuria in Clinical Urological Practice

    DEFF Research Database (Denmark)

    Cai, Tommaso; Mazzoli, Sandra; Lanzafame, Paolo;

    2016-01-01

    issues in everyday urological practice that require special attention: the role of ABU in pre-operative prophylaxis and in women affected by recurrent urinary tract infections (rUTIs). Nowadays, this is the time to think over our practice and change our way of thinking. Here, we aimed to summarize...... the current literature knowledge in terms of ABU management in patients undergoing urological surgery and in patients with rUTIs. In the last years, the approach to patient with ABU has changed totally. Prior to all surgical procedures that do not enter the urinary tract, ABU is generally not considered...

  13. Meta-analysis of antibiotic prophylaxis for postoperative bacteriuria in patients undergoing transrectal prostatic biopsy%抗生素对经直肠前列腺活检术后菌尿预防效果的荟萃分析

    Institute of Scientific and Technical Information of China (English)

    杨明根; 赵晓昆; 吴志平; 肖宁; 吕晨; 侯轶

    2009-01-01

    Objective To investigate whether antibiotic prophylaxis can reduce the risk of postoperative bacteriuria in patients undergoing transrectal prostatic biopsy (TPB) who have sterile preoperative urine. Methods MEDLINE, EMBASE, Cochrane Collaboration Reviews, CMCC, and CNKI were searched for randomized controlled trials (RCTs) comparing antibiotic prophylaxis with placebo/blank controls for patients undergoing TPB with preoperative sterile urine. The search strategy was made according to the Collaborative Review Group search strategy. Data were extracted by two reviewers using the designed extraction form. The software RevMan4.2 was used to review management and data analysis. Results 67 relevant RCTs were found, of which 12 qualified ones were included into the analysis. Antibiotic prophylaxis significantly decreased the rate of bacteriuria within the period 1 week after TPB (corresponding pooled relative risk (RR) and 95% CI was 0. 32 ( 0. 23 - 0. 46, P < 0. 01 ). The effective antibiotics included quinolones and quinolones combined with nitroimidazole , with the pooled RR and 95% CI of 0. 31 (0. 18 - 0. 53, P<0. 01) and 0. 32 (0. 17 -0. 60, P=0. 0004) respectively. There was no significant difference in the effect between short treatment course protocol and long course protocol (P = 0. 41 ). Conclusion Prophylactic antibiotics can significantly decrease the incidence of post-TPB bacteriuria. A significant decrease in bacteriuria incidence can be achieved with a range of antibiotic agents, including quinolones and-quinolones combined with nitroimidazole. Treatment protocols of any duration are effective.%目的 分析预防性抗生素能否减少术前为清洁尿、行经直肠前列腺活检术(TPB)患者术后菌尿的发生率.方法 制定原始文献的纳入标准、排除标准及检索策略,在美国医学索引MEDLINE(1966年1月至2007年12月)、荷兰医学文摘EMBASE(1988年1月至2007年12月)、Cochrane图书馆、中国生物

  14. Infecção do trato urinário relacionada com a utilização do catéter vesical de demora: resultados da bacteriúria e da microbiota estudadas Urinary tract infection related to the use of catheter-delay bladder: results of bacteriuria and microbiota studied

    Directory of Open Access Journals (Sweden)

    João Leão e Souza Neto

    2008-02-01

    Full Text Available OBJETIVO: Avaliar o momento do início da bacteriúria e o germe mais freqüentemente relacionado à infecção urinária nos pacientes submetidos à sondagem vesical de demora. MÉTODO: No período de setembro de 2003 a outubro de 2004, foram avaliados os pacientes com 13 anos ou mais, submetidos à operações eletivas com cateterismo vesical de demora. Na inserção do cateter foi colhida a primeira amostra de urina, denominada Amostra 1, e outras seqüencialmente a cada 12 horas. Estas foram analisadas quanto a bacteriúria, leucocitúria, e cultura. A infecção do trato urinário foi definida como a presença de 100.000 unidades formadoras de colônias ou mais, após o isolamento da mesma bactéria ou fungo em culturas de urina de amostras distintas, desde a inserção até a remoção do cateter urinário; a leucocitúria como contagem de leucócitos igual ou superior a 10.000 leucócitos/mm³; e bacteriúria como presença de bactéria de uma única espécie na amostra analisada. RESULTADOS: A amostra foi composta de 63 pacientes, 46 sexo masculino (73% e 17 sexo feminino (27%. Apenas três deles apresentaram leucocitúria na primeira coleta. Nas Amostras 1 houve variação de 1.000 a 20.000 leucócitos/mm³, todas com cultura negativa. O número de amostras variou de 1 a 8 (84h após a realização do cateterismo vesical. As leucocitúrias nas amostras finais variaram de 1.000 a 204.000 leucócitos/mm³, todas com urocultura e bacteriúria negativa. 62 pacientes (98,4% utilizaram antibioticoterapia de curta duração para o sítio cirúrgico. CONCLUSÃO: Até 84h - 3,5 dias - não houve Infecção em nenhuma das amostras coletadas e cultivadas. A antibioticoterapia de curta duração pode ter contribuído para o resultado observado.BACKGROUND: To evaluate the moment of the beginning of bacteriuria and the most frequently germ related to the urinary infection in patients submitted to delayed vesical catheterization. METHODS: During

  15. Molecular characterization of the Escherichia coli asymptomatic bacteriuria strain 83972

    DEFF Research Database (Denmark)

    Klemm, Per; Hancock, Viktoria; Ulett, G.C.;

    2006-01-01

    Escherichia coli 83972 is a clinical asymptomatia bacteriuric isolate that is able to colonize the human urinary bladder without inducing an immune response. Here we demonstrate that one of the mechanisms by which this strain has become attenuated is through the mutation of its genes encoding type...

  16. Detecting bacteriuria in a primary maternal and child health care programme

    OpenAIRE

    Joseph, K.S.; Brahmadathan, K. N.; Abraham, Sulochana; Joseph, Abraham

    1988-01-01

    Urinary tract infection in pregnancy has not been adequately dealt with in developing countries, though its consequences are well recognised. This is primarily because of constraints on resources coupled with a lack of technological infrastructure. An evaluation of the Griess test for the mass screening of urinary tract infection among antenatal women was carried out prospectively using a case-control method.

  17. Disease: H01339 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available H01339 Asymptomatic bacteriuria The term asymptomatic bacteriuria is generally used...es does not always cause symptoms and tissue damage. Asymptomatic bacteriuria has been attracting attention ...Experimental colonization of the canine urinary tract with the asymptomatic bacteriuria Escherichia coli strain 83972. Vet Microbiol 147:205-8 (2011) ...

  18. Outbreak caused by Proteus mirabilis isolates producing weakly expressed TEM-derived extended-spectrum β-lactamase in spinal cord injury patients with recurrent bacteriuria.

    Science.gov (United States)

    Cremet, Lise; Bemer, Pascale; Rome, Joanna; Juvin, Marie-Emmanuelle; Navas, Dominique; Bourigault, Celine; Guillouzouic, Aurelie; Caroff, Nathalie; Lepelletier, Didier; Asseray, Nathalie; Perrouin-Verbe, Brigitte; Corvec, Stephane

    2011-12-01

    We performed a retrospective extended-spectrum β-lactamase (ESBL) molecular characterization of Proteus mirabilis isolates recovered from urine of spinal cord injury patients. A incorrectly detected TEM-24-producing clone and a new weakly expressed TEM-derived ESBL were discovered. In such patients, ESBL detection in daily practice should be improved by systematic use of a synergy test in strains of P. mirabilis resistant to penicillins.

  19. Role of interspecies interactions in dual-species biofilms developed in vitro by uropathogens isolated from polymicrobial urinary catheter-associated bacteriuria.

    Science.gov (United States)

    Galván, E M; Mateyca, C; Ielpi, L

    2016-10-01

    Most catheter-associated urinary tract infections are polymicrobial. Here, uropathogen interactions in dual-species biofilms were studied. The dual-species associations selected based on their prevalence in clinical settings were Klebsiella pneumoniae-Escherichia coli, E. coli-Enterococcus faecalis, K. pneumoniae-E. faecalis, and K. pneumoniae-Proteus mirabilis. All species developed single-species biofilms in artificial urine. The ability of K. pneumoniae to form biofilms was not affected by E. coli or E. faecalis co-inoculation, but was impaired by P. mirabilis. Conversely, P. mirabilis established a biofilm when co-inoculated with K. pneumoniae. Additionally, E. coli persistence in biofilms was hampered by K. pneumoniae but not by E. faecalis. Interestingly, E. coli, but not K. pneumoniae, partially inhibited E. faecalis attachment to the surface and retarded biofilm development. The findings reveal bacterial interactions between uropathogens in dual-species biofilms ranged from affecting initial adhesion to outcompeting one bacterial species, depending on the identity of the partners involved.

  20. Molecular Analysis of Asymptomatic Bacteriuria Escherichia coli Strain VR50 Reveals Adaptation to the Urinary Tract by Gene Acquisition

    DEFF Research Database (Denmark)

    Beatson, Scott A.; Ben Zakour, Nouri L.; Totsika, Makrina;

    2015-01-01

    mutant with GI-VR50-pheV deleted was attenuated in a mouse model of UTI in vivo. We established that Afa is the island-encoded factor responsible for this phenotype using two independent deletion (Afa operon and AfaE adhesin) mutants. E. coli VR50afa and VR50afaE displayed significantly decreased ability...... evolution and molecular mechanisms that underpin ABU, the genome of the ABU E. coli strain VR50 was sequenced. Analysis of the complete genome indicated that it most resembles E. coli K-12, with the addition of a 94-kb genomic island (GI-VR50-pheV), eight prophages, and multiple plasmids. GI-VR50-pheV has a...... mosaic structure and contains genes encoding a number of UTI-associated virulence factors, namely, Afa (afimbrial adhesin), two autotransporter proteins (Ag43 and Sat), and aerobactin. We demonstrated that the presence of this island in VR50 confers its ability to colonize the murine bladder, as a VR50...

  1. Preliminary study on serum paraoxonase-1 status and chemokine (C-C motif) ligand 2 in hospitalized elderly patients with catheter-associated asymptomatic bacteriuria.

    Science.gov (United States)

    Iftimie, S; García-Heredia, A; Pujol, I; Ballester, F; Fort-Gallifa, I; Simó, J M; Joven, J; Camps, J; Castro, A

    2016-09-01

    Urinary tract infections (UTI) are common among elderly patients in residential care facilities, as well as in the hospital setting. Identifying new biochemical markers of UTI is an active line of research since UTI management is resource intensive. Paraoxonase-1 (PON1) forms part of the patient's immune system, the response-to-injury and inflammation. Our study sought to evaluate alterations in inflammation-related paraoxonase-1 (PON1) and chemokine (C-C motif) ligand 2 (CCL2) in patients with an indwelling catheter to assess their potential usefulness as biomarkers of infection. Patients (n = 142) who had had the urinary catheter removed and 100 healthy volunteers were recruited. In all participants we measured serum PON1 activity, PON1 concentration, CCL2, procalcitonin and C-reactive protein (CRP). Results indicated that patients had higher CCL2, CRP and procalcitonin concentrations than the control group, and lower paraoxonase activity. There were no significant differences in PON1 concentrations. When comparing the diagnostic accuracy of CRP, procalcitonin, CCL2 and the PON1-related variables in discriminating between patients with and those without UTI, we found a considerable degree of overlap between groups, i.e., a low diagnostic accuracy. However, there were significant inverse logarithmic correlations between serum paraoxonase activity and the number of days the urinary catheter had been in situ. Our results suggest that measurement of these biochemical variables may be useful in investigating complications of long-term use of these devices and help to improve the economic and clinical investment required in the management of the often-associated infection. PMID:27334497

  2. Role of interspecies interactions in dual-species biofilms developed in vitro by uropathogens isolated from polymicrobial urinary catheter-associated bacteriuria.

    Science.gov (United States)

    Galván, E M; Mateyca, C; Ielpi, L

    2016-10-01

    Most catheter-associated urinary tract infections are polymicrobial. Here, uropathogen interactions in dual-species biofilms were studied. The dual-species associations selected based on their prevalence in clinical settings were Klebsiella pneumoniae-Escherichia coli, E. coli-Enterococcus faecalis, K. pneumoniae-E. faecalis, and K. pneumoniae-Proteus mirabilis. All species developed single-species biofilms in artificial urine. The ability of K. pneumoniae to form biofilms was not affected by E. coli or E. faecalis co-inoculation, but was impaired by P. mirabilis. Conversely, P. mirabilis established a biofilm when co-inoculated with K. pneumoniae. Additionally, E. coli persistence in biofilms was hampered by K. pneumoniae but not by E. faecalis. Interestingly, E. coli, but not K. pneumoniae, partially inhibited E. faecalis attachment to the surface and retarded biofilm development. The findings reveal bacterial interactions between uropathogens in dual-species biofilms ranged from affecting initial adhesion to outcompeting one bacterial species, depending on the identity of the partners involved. PMID:27642801

  3. Fatores associados à bacteriúria após sondagem vesical na cirurgia ginecológica Factors associated with bacteriuria after indwelling urethral catheterization in gynecologic surgery

    OpenAIRE

    Sonia Cristina Araújo Hinrichsen; Alex Sandro Rolland Souza; Aurélio Costa; Melania Maria Ramos Amorim; Maria Gabriela M.L. Hinrichsen; Sylvia Lemos Hinrichsen

    2009-01-01

    OBJETIVOS: Determinar a frequência e os principais fatores associados à bacteriúria após a sondagem vesical em mulheres submetidas à cirurgia ginecológica eletiva. MÉTODOS: Realizou-se um estudo do tipo coorte em mulheres submetidas à cirurgia ginecológica após sondagem vesical no Instituto de Medicina Integral Prof. Fernando Figueira, no período de janeiro a maio de 2007. As uroculturas foram coletadas até 24 horas após a retirada da sonda e 7/10 dias após a sondagem vesical. A análise estat...

  4. Diagnosis, treatment and registration of urinary tract infections in geriatric patients

    DEFF Research Database (Denmark)

    Friis-Møller, Alice; Lüneborg-Nielsen, Margrethe

    2002-01-01

    aeruginosa, Proteus mirabilis. The antimicrobial therapy is not advised for asymptomatic bacteriuria. In the case of symptomatic bacteriuria it is advised to take urine for culture and to perform sensitivity testing as well as blood culture and to start a "blind therapy". In order to use the antimicrobial...

  5. Diagnosis, treatment and registration of urinary tract infections in geriatric patients

    DEFF Research Database (Denmark)

    Friis-Møller, Alice; Lüneborg-Nielsen, Margrethe

    2002-01-01

    Bacteriuria (> or = 10(5) CFU/ml) is a very common phenomenon in elderly people, occurring twice as frequently in women than in men. There are symptomatic and asymptomatic types of bacteriuria. Risk factors include: a decrease in the estrogen level in women after the menopause, catheterisation, u...

  6. [Comparative study of two protocols of antibiotic prophylaxis in endoscopic urologic surgery].

    Science.gov (United States)

    Lepage, J Y; Malinowsky, J M; Cozian, A; Viers, M F; Rolland, M T; Péron, M; Souron, R; Baron, D

    1990-06-01

    We report an open, prospective, randomized and double-blind study which compared two groups of patients without preoperative bacteriuria, undergoing transurethral urologic surgery. A first group received cefazoline 3 g perioperatively and a second group a single preoperative dose of cefotiam 1 g. A hundred patients were included in each group which were well matched on all essential characteristics, risk factors, surgery, anesthesia and postoperative temperature. The incidence of postoperative infection (bacteriemia and bacteriuria) was the same in both groups (16%). It is concluded that in transurethral urologic surgery performed in patients without preoperative bacteriuria, 1 preoperative dose cefotiam is as efficacious as 3 perioperative doses cefazoline.

  7. Disease: H01350 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available g surgery. Morganella morganii can cause bacteremia and lead to major clinical problems, which are usually associated with common cau...ses of catheter-associated bacteriuria, infections of th

  8. Urinary tract infections due to extended-spectrum beta-lactamase-producing Gram-negative bacteria: identification of risk factors and outcome predictors in an Australian tertiary referral hospital

    Directory of Open Access Journals (Sweden)

    Michael Osthoff

    2015-05-01

    Conclusions: Our results emphasize the need for culture of a mid-stream urine specimen prior to commencing antibacterials, especially in patients with the risk factors identified herein associated with ESBL-GNB UTI/bacteriuria.

  9. IS URINE CULTURE ROUTINELY NECESSARY BEFORE PROSTATE BIOPSY ?

    OpenAIRE

    Bruyere, Franck; Faivre D'Arcier, Benjamin; Boutin, Jean-Michel; Haillot, Olivier

    2010-01-01

    Abstract Objectives: The objective of this study was to assess the value of a urine bacterial culture performed before prostate biopsy. Methods: We performed a prospective study on 353 patients who underwent prostate biopsy. All patients had a urine bacterial culture performed before biopsy. We compared the outcomes of patients with bacteriuria (left untreated) to those of patients without bacteriuria. Results: Of the 353 men, 12 had a pre-biopsy positive bacterial culture an...

  10. Molecular Basis of Commensalism in the Urinary Tract: Low Virulence or Virulence Attenuation?▿ †

    OpenAIRE

    Zdziarski, Jaroslaw; Svanborg, Catharina; Wullt, Björn; Hacker, Jörg; Dobrindt, Ulrich

    2007-01-01

    In some patients, Escherichia coli strains establish significant bacteriuria without causing symptoms of urinary tract infection (UTI). These asymptomatic-bacteriuria (ABU) strains have been shown to express fewer virulence factors than the uropathogenic E. coli (UPEC) strains that cause severe, symptomatic UTI. Paradoxically, ABU strains carry many typical UPEC virulence genes, and the molecular basis of their low virulence therefore remains unclear. This study examined whether ABU strains m...

  11. A real-time PCR-based semi-quantitative breakpoint to aid in molecular identification of urinary tract infections.

    Science.gov (United States)

    Hansen, Wendy L J; van der Donk, Christina F M; Bruggeman, Cathrien A; Stobberingh, Ellen E; Wolffs, Petra F G

    2013-01-01

    This study presents a novel approach to aid in diagnosis of urinary tract infections (UTIs). A real-time PCR assay was used to screen for culture-positive urinary specimens and to identify the causative uropathogen. Semi-quantitative breakpoints were used to screen for significant bacteriuria (presence of ≥ 10(5) CFU/ml of uropathogens) or low-level bacteriuria (containing between 10(3) and 10(4) CFU/ml of uropathogens). The 16S rDNA-based assay could identify the most prevalent uropathogens using probes for Escherichia coli, Pseudomonas species, Pseudomonas aeruginosa, Staphylococcus species, Staphylococcus aureus, Enterococcus species and Streptococcus species. 330 urinary specimens were analysed and results were compared with conventional urine culture. Using a PCR Ct value of 25 as semi-quantitative breakpoint for significant bacteriuria resulted in a sensitivity and specificity of 97% and 80%, respectively. In 78% of the samples with monomicrobial infections the assay contained probes to detect the bacteria present in the urine specimens and 99% of these uropathogens was correctly identified. Concluding, this proof-of-concept approach demonstrates that the assay can distinguish bacteriuria from no bacteriuria as well as detect the involved uropathogen within 4 hours after sampling, allowing adequate therapy decisions within the same day as well as drastically reduce consequent urine culturing.

  12. Predictors of ertapenem therapeutic efficacy in the treatment of urinary tract infections (UTIs) in hospitalized adults: the importance of renal insufficiency and urinary pH.

    Science.gov (United States)

    Cunha, B A; Giuga, J; Gerson, S

    2016-04-01

    In hospitalized adults acute uncomplicated cystitis (AUC) and catheter associated bacteriuria (CAB) may be treated with oral antibiotics. With AUC or CAB due to extended spectrum ß-lactamase (ESBL) + Gram negative bacilli (GNB) physicians often use intravenous therapy, e.g., ertapenem. We reviewed our recent experience in hospitalized adults with AUC and CAB treated with ertapenem. Therapeutic efficacy of ertapenem was assessed by decreased pyuria/bacteriuria, and elimination of the uropathogen. The effectiveness of ertapenem in the presence of renal insufficiency (CrCl ertapenem was highly effective in eliminating bacteriuria (TTNC 3 days) in patients with decreased renal function and alkaline urinary pH. We reviewed 45 hospitalized adults with AUC or CAB to determine if renal insufficiency and or alkaline urinary pH affected ertapenem efficacy. In the 33 adult hospitalized patients with AUC and 12 with CAB, we found that ertapenem was consistently effective in eliminating the GNB bacteriuria. In hospitalized adults, the presence of renal insufficiency and acid urine, bacteriuria was eliminated in  3 days which has not been previously reported. PMID:26873378

  13. Predictors of ertapenem therapeutic efficacy in the treatment of urinary tract infections (UTIs) in hospitalized adults: the importance of renal insufficiency and urinary pH.

    Science.gov (United States)

    Cunha, B A; Giuga, J; Gerson, S

    2016-04-01

    In hospitalized adults acute uncomplicated cystitis (AUC) and catheter associated bacteriuria (CAB) may be treated with oral antibiotics. With AUC or CAB due to extended spectrum ß-lactamase (ESBL) + Gram negative bacilli (GNB) physicians often use intravenous therapy, e.g., ertapenem. We reviewed our recent experience in hospitalized adults with AUC and CAB treated with ertapenem. Therapeutic efficacy of ertapenem was assessed by decreased pyuria/bacteriuria, and elimination of the uropathogen. The effectiveness of ertapenem in the presence of renal insufficiency (CrCl 3 days) in patients with decreased renal function and alkaline urinary pH. We reviewed 45 hospitalized adults with AUC or CAB to determine if renal insufficiency and or alkaline urinary pH affected ertapenem efficacy. In the 33 adult hospitalized patients with AUC and 12 with CAB, we found that ertapenem was consistently effective in eliminating the GNB bacteriuria. In hospitalized adults, the presence of renal insufficiency and acid urine, bacteriuria was eliminated in i.e., time to negative cultures (TTNC) was prolonged, i.e., > 3 days which has not been previously reported.

  14. Application of biotinylated and 32P probes for detection of P-fimbriae in urinary E. coli.

    Science.gov (United States)

    Jusková, E; Ciznár, I

    1993-01-01

    Escherichia coli is the common causative agent of urinary tract infections. Twenty-six strains of Escherichia coli were isolated from children with pyelonephritis, symptomatic urinary tract infections and asymptomatic bacteriuria. Biotinylated and 32P-DNA probes were prepared for detection of P-fimbriae in the isolates. Of the 13 strains isolated from patients with pyelonephritis 11 were positive for the presence of the P gene by both probes. Strains isolated from cases of symptomatic urinary tract infections revealed the presence of P gene only in three samples of the total of nine isolated. None of the isolated E. coli strains from asymptomatic bacteriuria was found positive for the presence of the P gene. The biotinylated probe was simple and easily applicable in standard laboratory conditions and therefore the authors recommend it for use in diagnostic laboratories.

  15. Optimization and evaluation of Flexicult(®) Vet for detection, identification and antimicrobial susceptibility testing of bacterial uropathogens in small animal veterinary practice

    DEFF Research Database (Denmark)

    Guardabassi, Luca; Hedberg, Sandra; Jessen, Lisbeth Rem;

    2015-01-01

    BACKGROUND: Urinary tract infection (UTI) is a common reason for antimicrobial prescription in dogs and cats. The objective of this study was to optimize and evaluate a culture-based point-of-care test for detection, identification and antimicrobial susceptibility testing of bacterial uro......-pathogens in veterinary practice. METHODS: Seventy-two urine samples from dogs and cats with suspected UTI presenting to seven veterinary facilities were used by clinical staff and an investigator to estimate sensitivity and specificity of Flexicult Vet A compared to laboratory reference standards for culture...... isolates. RESULTS: Bacteriuria was reported by the laboratory in 25 (35 %) samples from the field study. The sensitivity and specificity of Flexicult Vet A for detection of bacteriuria were 83 and 100 %, respectively. Bacterial species were correctly identified in 53 and 100 % of the positive samples...

  16. Urinary pH and urea concentration correlate to the bacterial colonization rate in gastric, colonic, ileal and myoperitoneal bladder augmentation.

    Science.gov (United States)

    Lauvetz, R W; Monda, J M; Kramer, S A; Husmann, D A

    1995-08-01

    We investigated how various types of augmentation cystoplasty alter the native bacteriostatic properties of urine, particularly urinary urea and pH, in the Sprague-Dawley rat. The augmentation cystoplasties studied included 1 cm.2 and 2 cm.2 patches of colon, ileum and stomach as well as myoperitoneal bladder flaps. Augmentations in order of decreasing incidence of bacteriuria and urinary pH are 2 cm.2 ileal greater than 1 cm.2 ileal greater than 2 cm.2 colonic greater than 1 cm.2 colonic greater than myoperitoneal greater than cystotomy alone greater than 1 cm.2 gastric greater than 2 cm.2 gastric. Urinary urea concentrations were similar between cystotomy alone, and myoperitoneal and gastric augments. In contrast, all colonic and ileal augments had significantly lower urea concentrations compared to the aforementioned groups. Our findings suggest that the type and size of augmentation directly affect urinary pH and urea nitrogen concentration, and the incidence of bacteriuria.

  17. Whole-genome sequencing and identification of Morganella morganii KT pathogenicity-related genes

    OpenAIRE

    2012-01-01

    Background The opportunistic enterobacterium, Morganella morganii, which can cause bacteraemia, is the ninth most prevalent cause of clinical infections in patients at Changhua Christian Hospital, Taiwan. The KT strain of M. morganii was isolated during postoperative care of a cancer patient with a gallbladder stone who developed sepsis caused by bacteraemia. M. morganii is sometimes encountered in nosocomial settings and has been causally linked to catheter-associated bacteriuria, complex in...

  18. Molecular characterization and drug resistance of Escherichia coli strains isolated from urine from long-term care facility residents in Cracow, Poland

    OpenAIRE

    Pobiega, Monika; Wojkowska-Mach, Jadwiga; Chmielarczyk, Agnieszka; Romaniszyn, Dorota; Adamski, Paweł; Heczko, Piort B.; Gryglewska, Barbara; Grodzicki, Tomasz

    2013-01-01

    Background The aim of this study was to assess the prevalence of multidrug-resistant Escherichia coli and extended-spectrum β-lactamases (ESBL) pathogens isolated from asymptomatic bacteriuria and urinary tract infections (UTIs), and the relationship between the phylogeny, antimicrobial resistance, and virulence among isolates in residents of 3 long-term care facilities (LTCF) in Krakow, Poland. Material/Methods This was point prevalence study and prospective infection control in a group of 2...

  19. Evaluation of the in vitro growth of urinary tract infection-causing gram-negative and gram-positive bacteria in a proposed synthetic human urine (SHU) medium.

    Science.gov (United States)

    Ipe, Deepak S; Ulett, Glen C

    2016-08-01

    Bacteriuria is a hallmark of urinary tract infection (UTI) and asymptomatic bacteriuria (ABU), which are among the most frequent infections in humans. A variety of gram-negative and gram-positive bacteria are associated with these infections but Escherichia coli contributes up to 80% of cases. Multiple bacterial species including E. coli can grow in human urine as a means to maintain colonization during infections. In vitro bacteriuria studies aimed at modeling microbial growth in urine have utilized various compositions of synthetic human urine (SHU) and a Composite SHU formulation was recently proposed. In this study, we sought to validate the recently proposed Composite SHU as a medium that supports the growth of several bacterial species that are known to grow in normal human urine and/or artificial urine. Comparative growth assays of gram-negative and gram-positive bacteria E. coli, Pseudomonas aeruginosa, Proteus mirabilis, Streptococcus agalactiae, Staphylococcus saprophyticus and Enterococcus faecalis were undertaken using viable bacterial count and optical density measurements over a 48h culture period. Three different SHU formulations were tested in various culture vessels, shaking conditions and volumes and showed that Composite SHU can support the robust growth of gram-negative bacteria but requires supplementation with 0.2% yeast extract to support the growth of gram-positive bacteria. Experiments are also presented that show an unexpected but major influence of P. mirabilis towards the ability to measure bacterial growth in generally accepted multiwell assays using absorbance readings, predicted to have a basis in the release of volatile organic compound(s) from P. mirabilis during growth in Composite SHU medium. This study represents an essential methodological validation of a more chemically defined type of synthetic urine that can be applied to study mechanisms of bacteriuria and we conclude will offer a useful in vitro model to investigate the

  20. Pathogenesis of Streptococcus urinary tract infection depends on bacterial strain and β-hemolysin/cytolysin that mediates cytotoxicity, cytokine synthesis, inflammation and virulence

    OpenAIRE

    Leclercq, Sophie Y.; Sullivan, Matthew J.; Ipe, Deepak S.; Joshua P. Smith; Cripps, Allan W.; Ulett, Glen C.

    2016-01-01

    Streptococcus agalactiae can cause urinary tract infection (UTI) including cystitis and asymptomatic bacteriuria (ABU). The early host-pathogen interactions that occur during S. agalactiae UTI and subsequent mechanisms of disease pathogenesis are poorly defined. Here, we define the early interactions between human bladder urothelial cells, monocyte-derived macrophages, and mouse bladder using uropathogenic S. agalactiae (UPSA) 807 and ABU-causing S. agalactiae (ABSA) 834 strains. UPSA 807 adh...

  1. PREVALENCE OF URINARY TRACT INFECTION IN PREGNANT W OMEN

    OpenAIRE

    Nawaz; Siddesh; Sirwar

    2012-01-01

    ABSTRACT: Urinary tract infection is one of the most frequen tly seen medical complications in pregnancy. UTI in pregnancy is an important concern, as it possesses risk of complications such as acute and chronic pyelonephritis, toxaemia, anaemi a, hypertension, intrauterine growth retardation and increased perinatal mortality. The detection of bacteriuria allows an approach to be made for the prevention of chronic urinary dis ease in ...

  2. ASSESSMENT OF UTI IN POSTMENOPAUSAL WOMEN ATTENDING OPD CLINIC OF CHITWAN MEDICAL COLLEGE, BHARATPUR, CHITWAN, NEPAL

    OpenAIRE

    Mamata Sharma Neupane; Kalpana Dhakal Sharma; Sangharshila Basnet; Pratik Adhikary; Harish Chandra Neupane; Bijay Aryal

    2013-01-01

    Urinary tract infection (UTI) is the most common bacterial infection in young and elderly women. Despite the higher incidence of bacteriuria in elderly women, most UTI research has been conducted in young women. Hence, the present paper investigates the assessment of UTI in postmenopausal women attending OPD Clinic of Chitwan Medical College, Bharatpur, Chitwan, Nepal. A cross-sectional study was conducted in OPD clinic of Chitwan Medical College Teaching Hospital from December, 2012 to April...

  3. Evaluation of the in vitro growth of urinary tract infection-causing gram-negative and gram-positive bacteria in a proposed synthetic human urine (SHU) medium.

    Science.gov (United States)

    Ipe, Deepak S; Ulett, Glen C

    2016-08-01

    Bacteriuria is a hallmark of urinary tract infection (UTI) and asymptomatic bacteriuria (ABU), which are among the most frequent infections in humans. A variety of gram-negative and gram-positive bacteria are associated with these infections but Escherichia coli contributes up to 80% of cases. Multiple bacterial species including E. coli can grow in human urine as a means to maintain colonization during infections. In vitro bacteriuria studies aimed at modeling microbial growth in urine have utilized various compositions of synthetic human urine (SHU) and a Composite SHU formulation was recently proposed. In this study, we sought to validate the recently proposed Composite SHU as a medium that supports the growth of several bacterial species that are known to grow in normal human urine and/or artificial urine. Comparative growth assays of gram-negative and gram-positive bacteria E. coli, Pseudomonas aeruginosa, Proteus mirabilis, Streptococcus agalactiae, Staphylococcus saprophyticus and Enterococcus faecalis were undertaken using viable bacterial count and optical density measurements over a 48h culture period. Three different SHU formulations were tested in various culture vessels, shaking conditions and volumes and showed that Composite SHU can support the robust growth of gram-negative bacteria but requires supplementation with 0.2% yeast extract to support the growth of gram-positive bacteria. Experiments are also presented that show an unexpected but major influence of P. mirabilis towards the ability to measure bacterial growth in generally accepted multiwell assays using absorbance readings, predicted to have a basis in the release of volatile organic compound(s) from P. mirabilis during growth in Composite SHU medium. This study represents an essential methodological validation of a more chemically defined type of synthetic urine that can be applied to study mechanisms of bacteriuria and we conclude will offer a useful in vitro model to investigate the

  4. The epidemiology and clinical presentation of urinary tract infections in children younger than 2 years of age.

    Science.gov (United States)

    Roberts, K B; Akintemi, O B

    1999-10-01

    UTI in young infants generally presents with fever. Among the youngest infants, boys and girls are equally affected. The incidence of UTI in uncircumcised boys is comparable with that in girls, whereas the rate in circumcised boys is much lower. Based on gender and race, white girls have the highest incidence of UTI. A full understanding of the epidemiology of UTI is complicated by the presence of asymptomatic bacteriuria and by incomplete evidence regarding the significance of scarring and the risk of sequelae.

  5. Vulvovaginitis: causes and management.

    OpenAIRE

    Pierce, A M; Hart, C. A.

    1992-01-01

    Over a period of 33 months in a paediatric accident and emergency department, the clinical pattern and possible causes of vulvovaginitis were studied prospectively in 200 girls presenting with genital discharge, irritation, pain, or redness. The major causes were poor hygiene and threadworms. The suspicion of sexual abuse arose in a few girls but no organisms of sexually transmitted disease were found. Urinary symptoms were common but only 20 patients had a significant bacteriuria and 40 had ...

  6. Study of antibody-coated fungi in patients with funguria and suspected disseminated fungal infections or primary fungal pyelonephritis1

    OpenAIRE

    Hall, William J.

    1980-01-01

    The direct immunofluorescence method for the detection of antibody-coated bacteria in urine sediments has been used by investigators to distinguish invasive bacterial disease of the renal parenchyma from noninvasive bladder bacteriuria. The purpose of the present investigation was to test the usefulness of the demonstration of urinary fungal immunoglobulins and complement in distinguishing patients with fungal cystitis from those with suspected disseminated fungal disease. Twenty-one patients...

  7. Frequency of pap and pil operons in Escherichia coli strains associated with urinary infections.

    Science.gov (United States)

    Perugini, M R; Vidotto, M C

    1996-03-01

    Strains of E. coli isolated from patients with urinary tract infection were examined for P and type 1 adhesin production by colony hybridization with pap and pil operons. The P pili probe detected 45 (46.4%) of the total of 97 strains studied and the type 1 pili probe detected 83 (85.6%). The pap operon was detected in 39 (53.4%) of 73 strains isolated from urine of patients with urinary disease and in 6 (25.0%) of 24 strains isolated from feces of healthy individuals employed as controls (P = 0.029), and the pil operon was detected in 67 (91.8%) of the urinary strains and in 16 (66.6%) of the fecal strains (P = 0.007). Our data did not show significant differences in frequency of P pili among isolates from pyelonephritis (78.5%), cystitis (45.8%) and asymptomatic bacteriuria (54.5%). Type 1 pili were not associated with the different types of infection; the frequency of these pili was 100% in pyelonephritis and in asymptomatic bacteriuria, and 87.5% in cystitis. The incidence of pap operon in strains isolated from pyelonephritis and from asymptomatic bacteriuria was higher in 11- to 40-year old women. These data show a high frequency of pap and pil operons among uropathogenic strains of E. coli, which seems to be an important factor in the development of urinary infection.

  8. Urinary Tract Infections Due to Catheterization and Drug Resistance Patterns of Isolated Bacteria

    Directory of Open Access Journals (Sweden)

    M. Mosavian

    2004-07-01

    Full Text Available UTI is the most common infection in all ages and urinary catheters especially long-term catheterization are important predisposing factors of UTI. Urinary catheters are used in different hospital wards as a complementary curative method for the patients who are undergone various surgical procedures, such as : cesarean, hysterectomy , laparotomy, etc and they who are unable to control their voided urine . 226 urine specimens were collected from 119 catheterized patients which had been hospitalized in seven wards of Razi and Golestan hospitals in Ahwas city . At least two urine specimens were collected from each patient , before and after the insertion of the catheter . All of the specimens were inoculated to suitable Media, after transportation to the Microbiology Lab . Isolated colonies were identified and their resistance patterns were determined by the standard disk diffusion method (Kirby –Bauer procedure to 8 different antibiotics. 38 cases (43.6% out of 87 patients showed Bacteriuria in the end of catheterization . They had no bacteriuria symptoms or sign before the catheterization. The most cases(28.9% of bacteriuria occured in 30-39 years group and the lowest cases (2.6 % of them occured in 60-69 years group. Out of 50 bacterial strains isolated from urine cultures , E.coil (with 17 cases was the highest (34% and Staphylococcus aureus , Klebsiella pneumoniae , Edwardsiella tarda , Enterobacter sakazakii (with 2% for each were the lowest cases. E.coli, Enterobacter and Kl. rhinoscleromatis , showed the most resistance to Ampicillin, Penicillin , Cephalexin , and the lowest rate to Nalidixic acid, Gentamicin and Nitrofurantoin . Staphylococcus epidermidis isolates ,also,showed the most resistance (100% to Penicillin and Ampicillin , and the lowest rate to Gentamicin (with 66.7%, Cotrimoxazol and Nitrofurantoin (with 50% .The results of this study suggested that catheterization , especially long- term catheterization causes the rise of

  9. Oral antibiotics in trans-rectal prostate biopsy and its efficacy to reduce infectious complications: Systematic review

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    Mohand Deeb Yaghi

    2015-01-01

    Full Text Available For the diagnosis of prostate cancer trans-rectal prostate biopsy (TRPB is used commonly, the procedure is associated with infective complications. There is evidence that antibiotics (ABx decrease infective events after TRPB, but different regimens are used. To systematically review different regimens of prophylactic oral ABx in TRPB. MEDLINE, EMBASE, clinical trials site, and Cochrane library were searched, experts were consulted for relevant studies. Randomized clinical trials conducted in the last 20 years, which investigated the different oral antibiotic regimens in TRPB, and compared their efficacy to reduce infectious complications were analyzed. Primary outcomes were bacteriuria, urinary tract infection (UTI, fever, bacteremia, and sepsis. Secondary outcomes were the hospitalization rate and the prevalence of ABx-resistant bacteria. Nine trials were eligible with 3012 patients. ABx prevented bacteriuria (3.5% vs. 9.88%, UTI (4.46% vs. 9.75%, and hospitalization (0.21% vs. 2.13% significantly in comparison with placebo or no treatment. No significant difference was found in all the outcomes of the review between the single dose regimen and the 3 days. The single dose regimen was as effective as the multiple doses except in bacteriuria (6.75% vs. 3.25%, and the prevalence of ABx-resistant bacteria (1.57% vs. 0.27%. Quinolones reduced only UTI significantly in comparison with other ABx (chloramphenicol, trimethoprim-sulfamethoxazol. It is essential to prescribe prophylactic ABx in TRPB. No conclusive evidence could be claimed about the superiority of the multiple or the 3 days regimens to the single dose regimen. Unexpectedly, ABx-resistant bacteria were identified more often in the single dose cohorts.

  10. PREVALENCE OF URINARY TRACT INFECTION IN PREGNANT W OMEN

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    Nawaz

    2012-10-01

    Full Text Available ABSTRACT: Urinary tract infection is one of the most frequen tly seen medical complications in pregnancy. UTI in pregnancy is an important concern, as it possesses risk of complications such as acute and chronic pyelonephritis, toxaemia, anaemi a, hypertension, intrauterine growth retardation and increased perinatal mortality. The detection of bacteriuria allows an approach to be made for the prevention of chronic urinary dis ease in the community and to avoid complications in pregnancy at an early stage. OBJECTIVES: (1 To study the prevalence of bacterial pathogens causing urinary tract infection among pregnant women; (2 To evaluate the sensitivity of the screening test with culture. MATERIALS AND METHODS : A total of 500 samples were investigated from pregnant women aged be tween 18 to 35 years, with varying gravida and from all three trimesters were included in a period of one year i.e., from January to December 2011. The samples were collected asepticall y from women attending the antenatal clinic at the Khaja Banda Nawaz Hospital, Gulbarga. Urine was collected in the sterile urine container. Both macroscopic and microscopic examinat ion was done. Screening tests like Griess Nitrite test and TTC tests were done. Cultu re was done by standard loop technique. RESULTS : The prevalence rate of UTI in pregnancy was 10.40% i.e., with significant bacteriuria (1,00,000 or more bacterial count/ ml of urine by Kass concept. The incidence of bacteriuria increased along with age and rising parity. Inciden ce was similar during all three trimesters. Gram’s staining, TTC and Griess nitrite gave 88.46% , 73.07% and 57.69% respectively correlate with culture positive bacteriurics. CONCLUSIONS : UTI, the most commonly seen complications in pregnancy was 10.4%. Early treatment of bacteriu ria not only averts the occurrence of other complications, but also diminishes the risk of premat ure and perinatal mortality

  11. Creencias, prácticas y actitudes de mujeres embarazadas frente a las infecciones urinarias

    OpenAIRE

    Édgar Castro F.; Liliana Caldas A.; Carmita Cepeda; Briseida Huertas; Nini Jiménez

    2008-01-01

    En las vías urinarias de las mujeres embarazadas se producen cambios importantes, uno de ellos es ser propensas a padecer infección de vías urinarias. Tanto la bacteriuria asintomática, como la infección de vía urinaria (IVU) requieren detección y tratamiento oportunos para evitar complicaciones, y es en estos procesos en los cuales el papel activo y decidido de la actitud de la gestante frente a su cuidado y el apoyo del personal de enfermería son relevantes. Objetivo: describir las creen...

  12. Comparative Genomics of Escherichia coli Strains Causing Urinary Tract Infections

    DEFF Research Database (Denmark)

    Vejborg, Rebecca Munk; Hancock, Viktoria; Schembri, Mark A.;

    2011-01-01

    The virulence determinants of uropathogenic Escherichia coli have been studied extensively over the years, but relatively little is known about what differentiates isolates causing various types of urinary tract infections. In this study, we compared the genomic profiles of 45 strains from a range...... of different clinical backgrounds, i.e., urosepsis, pyelonephritis, cystitis, and asymptomatic bacteriuria (ABU), using comparative genomic hybridization analysis. A microarray based on 31 complete E. coli sequences was used. It emerged that there is little correlation between the genotypes of the strains...

  13. Biofilm formation by asymptomatic and virulent urinary tract infectious Escherichia coli strains

    DEFF Research Database (Denmark)

    Hancock, Viktoria; Ferrieres, Lionel; Klemm, Per

    2007-01-01

    Escherichia coli is the most common organism associated with asymptomatic bacteriuria (ABU) in humans. In contrast to uropathogenic E. coli (UPEC) that cause symptomatic urinary tract infection, very little is known about the mechanisms by which these strains colonize the urinary tract. Here, we...... have investigated the biofilm-forming capacity on abiotic surfaces of groups of ABU strains and UPEC strains in human urine. We found that there is a strong bias; ABU strains were significantly better biofilm formers than UPEC strains. Our data suggest that biofilm formation in urinary tract infectious...

  14. Specific selection for virulent urinary tract infectious Escherichia coli strains during catheter-associated biofilm formation

    DEFF Research Database (Denmark)

    Ferrieres, Lionel; Hancock, Viktoria; Klemm, Per

    2007-01-01

    microorganisms can attach. Urinary tract infectious (UTI) Escherichia coli range in pathogenicity and the damage they cause - from benign asymptomatic bacteriuria (ABU) strains, which inflict no or few problems to the host, to uropathogenic E. coli (UPEC) strains, which are virulent and often cause severe...... symptoms and complications. We have found that whereas ABU strains produce better biofilms on polystyrene and glass, UPEC strains have a clear competitive advantage during biofilm growth on catheter surfaces. Our results indicate that some silicone and silicone-latex catheters actually select...

  15. The Genetics of Urinary Tract Infections and the Innate Defense of the Kidney and Urinary tract.

    Science.gov (United States)

    Ambite, Ines; Rydstrom, Gustav; Schwaderer, Andrew L; Hains, David S

    2016-03-01

    The urinary tract is a sterile organ system. Urinary tract infections (UTIs) are common and often serious infections. Research has focused on uropathogen, environment, and host factors leading to UTI pathogenesis. A growing body of evidence exists implicating genetic factors that can contribute to UTI risks. In this review, we highlight genetic variations in aspects of the innate immune system critical to the host response to uropathogens. This overview includes genetic variations in pattern recognition receptor molecules, chemokines/cytokines, and neutrophil activation. We also comprehensively cover murine knockout models of UTI, genetic variations involved in renal scarring as a result of ascending UTIs, and asymptomatic bacteriuria. PMID:27617139

  16. Characterization of adhesion associated surface properties of uropathogenic Escherichia coli.

    Science.gov (United States)

    Bartková, G; Ciznár, I; Lehotská, V; Kernová, T

    1994-01-01

    Escherichia coli was isolated from the urine of patients with pyelonephritis, with urinary tract infections other than pyelonephritis and with asymptomatic bacteriuria. Surface properties of the strains were analyzed by the salting-out aggregation test (SAT), hydrophobic interaction chromatography (HIC), Congo red binding (Crb), agglutination of erythrocytes (MRHA) and latex particles covered by digalactoside (PF) and by adherence to tissue culture cells. In addition, a DNA probe for the pap gene was used. The DNA probe detected the highest proportion of strains with pap gene in the group of patients with pyelonephritis, lower in the urinary tract infections other than pyelonephritis and the lowest in the group with asymptomatic bacteriuria. Tests for P-fimbriae (PF, MRHA) showed a similar distribution. Hydrophobicity measured by SAT and by HIC did not show differences among the tested groups of strains. The results suggest that factors other than the P-fimbriae and hydrophobicity may contribute to the persistence of E. coli in the urinary tract.

  17. Variation in endogenous oxidative stress in Escherichia coli natural isolates during growth in urine

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    Aubron Cecile

    2012-06-01

    Full Text Available Abstract Background Uropathogenic strains of Escherichia coli cause symptomatic infections whereas asymptomatic bacteriuria (ABU strains are well adapted for growth in the human urinary tract, where they establish long-term bacteriuria. Human urine is a very complex growth medium that could be perceived by certain bacteria as a stressful environment. To investigate a possible imbalance between endogenous oxidative response and antioxidant mechanisms, lipid oxidative damage estimated as thiobarbituric acid reactive substances (TBARS content was evaluated in twenty-one E. coli belonging to various pathovars and phylogenetic groups. Antioxidant defense mechanisms were also analysed. Results During exponential growth in urine, TBARS level differs between strains, without correlation with the ability to grow in urine which was similarly limited for commensal, ABU and uropathogenic strains. In addition, no correlation between TBARS level and the phylogroup or pathogenic group is apparent. The growth of ABU strain 83972 was associated with a high level of TBARS and more active antioxidant defenses that reduce the imbalance. Conclusions Our results indicate that growth capacity in urine is not a property of ABU strains. However, E. coli isolates respond very differently to this stressful environment. In strain ABU 83972, on one hand, the increased level of endogenous reactive oxygen species may be responsible for adaptive mutations. On the other hand, a more active antioxidant defense system could increase the capacity to colonize the bladder.

  18. The study of infectious agents of the urinary tract infections in Durrës, Albania

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    Aurora Bakaj (Çizmja

    2013-09-01

    Full Text Available Urinary tract infections (UTI are characterized by the presence of infectious agents in the genital-urinary tract that cannot be explained by contamination. These agents have the potential to invade the tissues of the urinary tract and adjacent structures. Settings and Design: Prospective study was done in the Health Directory in Durrës. Methods and Material: The study included all the patients who were admitted or visited the outpatient departments in the Health Directory and had urinary tract infection confirmed by positive urine culture reports. Results: A total 3160 urine samples were analyzed for isolation and identification of bacterial isolates. Out of which 956 (30.25% samples were found to have significant bacteriuria and remaining 2204 samples were found to have either non significant bacteriuria or very low bacterial count or sterile urine. In the present study, out of 223 isolated pathogens the most common isolate was Escherichia coli (25.89%, followed by Staphylococcus aureus (2.94%, Proteus vulgaris (1.04% and Pseudomonas aeruginosa (0.38 %. Age group most affected by Escherichia coli is 61-75 years (38.8%. Conclusions: Women are more susceptible to urinary tract infections, especially against Escherichia coli, resulting positive in 52.4% of cases; while Proteus vulgaris have a female percentage of 57.7%. This percentage increased slightly among women infected with Staphylococcus saprophyticus in 58% and low in 61.5% infected with Pseudomonas aeruginosa.

  19. Bacterial profile and drug susceptibility pattern of urinary tract infection in pregnant women at University of Gondar Teaching Hospital, Northwest Ethiopia

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    Alemu Agersew

    2012-04-01

    Full Text Available Abstract Background Urinary tract infection (UTI is a common health problem among pregnant women. Proper investigation and prompt treatment are needed to prevent serious life threatening condition and morbidity due to urinary tract infection that can occur in pregnant women. Recent report in Addis Ababa, Ethiopia indicated the prevalence of UTI in pregnant women was 11.6 % and Gram negative bacteria was the predominant isolates and showed multi drug resistance. This study aimed to assess bacterial profile that causes urinary tract infection and their antimicrobial susceptibility pattern among pregnant women visiting antenatal clinic at University of Gondar Teaching Hospital, Northwest Ethiopia. Methods A cross-sectional study was conducted at University of Gondar Teaching Hospital from March 22 to April 30, 2011. Mid stream urine samples were collected and inoculated into Cystine Lactose Electrolyte Deficient medium (CLED. Colony counts yielding bacterial growth of 105/ml of urine or more of pure isolates were regarded as significant bacteriuria for infection. Colony from CLED was sub cultured onto MacConkey agar and blood agar plates. Identification was done using cultural characteristics and a series of biochemical tests. A standard method of agar disc diffusion susceptibility testing method was used to determine susceptibility patterns of the isolates. Results The overall prevalence of UTI in pregnant women was 10.4 %. The predominant bacterial pathogens were Escherichia coli 47.5 % followed by coagulase-negative staphylococci 22.5 %, Staphylococcus aureus 10 %, and Klebsiella pneumoniae 10 %. Gram negative isolates were resulted low susceptibility to co-trimoxazole (51.9 % and tetracycline (40.7 % whereas Gram positive showed susceptibility to ceftriaxon (84.6 % and amoxicillin–clavulanic acid (92.3 %. Multiple drug resistance (resistance to two or more drugs was observed in 95 % of the isolates. Conclusion

  20. Risk of Infections in Patients with Chronic Diseases

    DEFF Research Database (Denmark)

    Mor, Anil; Thomsen, Reimar W.

    2013-01-01

    This review provides an update on the risk of several important community-acquired infections seen in patients with diabetes: respiratory tract infections, urinary tract infections, and bacteremia. Respiratory tract infections: Recent epidemiological evidence shows a modest (1.25 to 1.75-fold) risk...... tuberculosis. Limited data is available for diabetes and influenza, yet both influenza and pneumococcal vaccination is recommended in patients with diabetes. Urinary tract infections: The risk of asymptomatic bacteriuria and cystitis is 1.5 to 2 times increased in diabetes patients, while their risk of...... bacteremia. Conclusions: Increased infection surveillance and unmeasured confounding factors among diabetic patients may contribute to the observed increased infection risk, yet outcomes following infection are similar or worse in diabetes patients. In conclusion, there is epidemiological evidence that...

  1. Comparative analysis of antibiotic resistance and phylogenetic group patterns in human and porcine urinary tract infectious Escherichia coli

    DEFF Research Database (Denmark)

    Hancock, Viktoria; Nielsen, E.M.; Krag, L.;

    2009-01-01

    Urinary tract infections (UTIs) are one of the most common infectious diseases in humans and domestic animals such as pigs. The most frequent infectious agent in such infections is Escherichia coli. Virulence characteristics of E. coli UTI strains range from highly virulent pyelonephritis strains...... to relatively benign asymptomatic bacteriuria strains. Here we analyse a spectrum of porcine and human UTI E. coli strains with respect to their antibiotic resistance patterns and their phylogenetic groups, determined by multiplex PCR. The clonal profiles of the strains differed profoundly; whereas human...... strains predominantly belonged to clonal types B2 and D, these were not seen among the porcine strains, which all belonged to the E. coli clonal groups A and B1. Contrary to the human strains, the majority of the porcine strains were multidrug resistant. The distinct profiles of the porcine strains...

  2. [Urinary infection in the pregnant woman].

    Science.gov (United States)

    Delcroix, M; Zone, V; Cheront, C; Adam, M H; Duquesne, G; Noel, A M

    1994-05-01

    Urinary tract infections are common during pregnancy. When unrecognized, they can be responsible for complications such as threatened premature labour and impaired intra-uterine development. Detection and appropriate treatment are thus essential. This article reviews the pathophysiology of urinary tract infections during pregnancy and the three major entities involved--different but related to each other--are detailed (significant asymptomatic bacteriuria or SAB, acute cystitis and acute pyelonephritis), together with their specific treatment. SAB tends to persist during pregnancy, then leading in the absence of treatment to a potentially serious complication (acute pyelonephritis) in approximately one woman in five. SAB should be sought at the first prenatal visit by microscopic and bacteriological examination of a properly obtained urine specimen. Lower genital infections should also be sought and treated, without forgetting to remind the patient of preventive measures (adequate hygiene, sufficient urine output, post-coital micturition, regular bowel habit). PMID:8036390

  3. Bluish Discolouration of Urine Drainage Tube and Bag in a Female Patient with Spina Bifida, Paraplegia, and Suprapubic Cystostomy

    Directory of Open Access Journals (Sweden)

    Subramanian Vaidyanathan

    2007-01-01

    Full Text Available We present a female patient with spina bifida, paraplegia, suprapubic cystostomy, and chronic constipation, who became anxious when she noticed a bluish discolouration of her urine drainage system. Urine microbiology revealed growth of Providencia stuartii and Staphylococcus aureus. There were no systemic features of infection and, therefore, antibiotics were not prescribed for asymptomatic bacteriuria. This patient was advised to change the urine bag every day, and was prescribed senna to facilitate bowel evacuation. She was reassured that bluish discolouration of the urine drainage tube and bag was a transient, benign phenomenon and not indicative of any underlying pathology. Over the next 7 days, the bluish discolouration gradually faded away. Clinical characteristics of patients who are likely to develop this phenomenon and the underlying biochemical mechanism for bluish discolouration of the urine drainage system are discussed in brief.

  4. Robot-Assisted Laparoscopic Repair of Spontaneous Appendicovesical Fistula

    Science.gov (United States)

    Kibar, Yusuf; Yalcin, Serdar; Kopru, Burak; Topuz, Bahadir; Ebiloglu, Turgay

    2016-01-01

    Abstract Background: To report the first case of the spontaneous appendicovesical fistulas' (AVF) repair with robot assisted laparoscopy. Case Presentation: A 29-year-old male patient with urgent persistant bacteriuria and dysuria was referred to our clinic. Physical examination and blood tests were normal. He had used various antibiotics due to recurrent UTI for about 20 years. Computed tomography revealed the fistula tract between the distal end of the appendix and right lateral wall of the bladder dome. He was successfully treated with robot-assisted laparoscopic repair. Following this surgery, the patient's complaints were resolved completely. Conclusion: AVF is the rare condition. Robot-assisted laparoscopy repair of AVF is safe and effective treatment option.

  5. Detection of Extended Spectrum β-lactamase Production Among Uropathogens

    Science.gov (United States)

    Aggarwal, Ritu; Chaudhary, Uma; Sikka, Rama

    2009-01-01

    Background: Detection of extended spectrum β-lactamase (ESBL) production among uropathogens is an important marker of endemicity. Aim: Intervention of this endemic transmission is important for the control of initial outbreak of ESBL producing organisms in a hospital or specialized unit of hospital. Materials and Methods: During the study period of one and a half months, 1,551 urine samples were processed for significant bacteriuria. Two hundred gram negative bacterial isolates were tested for ESBL production. Antimicrobial sensitivity pattern was ascertained for ESBL producing isolates. Results: ESBL production was seen in 36% of isolates. All the isolates were multidrug resistant with uniform sensitivity to imipenem. Conclusion: This study reveals the significant prevalence of ESBL producing organisms in this north Indian tertiary care hospital. Constant revision of antibiotic policies with infection control interventions is suggested. PMID:21938241

  6. [The bioregulatory therapy of patients with chronic pyelonephritis].

    Science.gov (United States)

    al-Shukri, S Kh; Gorbachev, A G; Kuz'min, I V

    1997-01-01

    Prostatilen (5 mg/day i.m. for 5 days) was given to 46 patients with chronic pyelonephritis in the latent inflammation phase. The treatment resulted in relief of clinical symptoms, positive trend in laboratory indices characterizing activity of renal inflammation, albumin-globulin ratio. There was a decrease in leukocyturia, bacteriuria, ESR, blood fibrinogen and ceruloplasmin levels. Prostatilen reduced hypercoagulation and enhanced fibrinolytic activity of blood. The immunograms showed prostatilen-induced correction of immunity: T-lymphocyte count and functional activity increased, proportion of T-cell subpopulations returned to normal, metabolic activity of phagocyte oxygen-dependent substances became more intensive. The ability of prostatilen to initiate normalization of hemocoagulation and immunity is thought to be an essential factor of its therapeutic efficacy in chronic pyelonephritis.

  7. Host imprints on bacterial genomes--rapid, divergent evolution in individual patients.

    Directory of Open Access Journals (Sweden)

    Jaroslaw Zdziarski

    Full Text Available Bacteria lose or gain genetic material and through selection, new variants become fixed in the population. Here we provide the first, genome-wide example of a single bacterial strain's evolution in different deliberately colonized patients and the surprising insight that hosts appear to personalize their microflora. By first obtaining the complete genome sequence of the prototype asymptomatic bacteriuria strain E. coli 83972 and then resequencing its descendants after therapeutic bladder colonization of different patients, we identified 34 mutations, which affected metabolic and virulence-related genes. Further transcriptome and proteome analysis proved that these genome changes altered bacterial gene expression resulting in unique adaptation patterns in each patient. Our results provide evidence that, in addition to stochastic events, adaptive bacterial evolution is driven by individual host environments. Ongoing loss of gene function supports the hypothesis that evolution towards commensalism rather than virulence is favored during asymptomatic bladder colonization.

  8. ENDOCARDITIS WITH AN UNCOMMON GERM

    Directory of Open Access Journals (Sweden)

    M. Gharouni

    2006-07-01

    Full Text Available Enterococci are normal inhabitants of gastrointestinal tract, being responsible for 5 to 18% of infective endocarditis and the incidence appears to be increasing. Eleven patients with enterococcal endocarditis were studied. In a case series group, 10 men (average 57 years and one woman (37 years were studied. Two patients had rheumatic heart disease, 5 patients arteriosclerotic disease and one patient chronic renal failure on hemodialysis. Ten patients were treated with ampicillin and gentamycin. Valve replacement was performed in 3 patients with aortic valve endocarditis, one on 8th day and two at the end of the treatment. Overall clinical cure was achieved in 9 patients. Two relapses occurred and 2 patients died as a result of refractory congestive heart failure and cerebral emboli. All of the enterococcal endocarditis cases were community acquired. In conclusion, infective endocarditis in patients with preexistent valvular heart disease, community acquisition and non specific symptoms with bacteriuria should be considered as enterococcal endocarditis.

  9. Frequency of urinary tract infection (UTI) and commonest causative organisms in spinal cord injury patients with various voiding modes

    International Nuclear Information System (INIS)

    To determine the frequency of urinary tract infection and commonest causative organisms in spinal cord injury patients with various modes of voiding in rehabilitation setup in Pakistan. Study Design: A descriptive study of 100 spinal cord injury patients. Place and Duration of the Study: The Armed Forces Institute of Rehabilitation Medicine (AFIRM) Rawalpindi from September 2007 to March 2008 on clinical samples received from admitted patients in CMH Rawalpindi and AFIRM. Material and Methods: In 100 patients of spinal cord urine samples were subjected to Urine Routine examination and Urine Culture sensitivity. Urine culture revealing a bacterial colony count of 105 cfu/ml or higher were considered positive for urinary tract infection (UTI) if present with symptoms. Significant bacteriuria was investigated for spectrum and sensitivity pattern as well. Results: Of all 100 spinal cord patients 52 patients (52%) had symptoms suggestive of UTI but only 37 patients (37%) had significant bacteriuria on urine culture supported by high level pyuria were declared to have UTI. E-coli was the most commonly isolated organism with total no of 20 cases (54.1%) followed by Pseudomonas 6 cases (16.2%), Klebsiella pneumoniae 3 cases (8.1%), Proteus mirabilis 3 cases (8.1%), Citrobacter freundi 2 cases (5.4%) and the least frequent was Morganella morganii with 1 case (2.7%). UTI was most frequent in patients with indwelling catheter and was least associated with self voiding. Conclusion: Urinary Tract Infection was commonly observed among spinal cord injury patients. E-coli was the commonest isolated pathogen followed by Pseudomonas, Klebsiella pneumoniae, Proteus mirabilis, Citrobacter freundi, Candida and Morganella morganii in descending order of frequency. UTI was most frequent in patients using indwelling catheter as a mode of voiding. (author)

  10. Antibiotic resistance pattern of bacterial isolates from cases of urinary tract infections among hospitalized and out-patients at a tertiary health facility in South Western Nigeria

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    Oyekale Oluwalana Timothy

    2014-01-01

    Full Text Available Aim: Urinary tract infections (UTIs are among the most common human infections with distribution of causative agents and their susceptibility pattern to antibiotics varying from region to region. This study aimed at determining the bacterial uropathogens and their antibiotic resistance profile among patients in a Nigerian tertiary health care facility. Materials and Methods: Appropriate urine specimens (midstream/catheter specimen urine of all suspected cases of UTI by clinicians were processed in the medical microbiology laboratory for detection of significant bacteriuria. Bacteria uropathogens isolated were identified by standard biochemical tests and antibiotic susceptibility test to eight antibiotics was carried out on them using Kirby-Bauer disc diffusion technique. Methicillin-resistant Staphylococcus aureus (MRSA was identified by cefoxitin disc diffusion technique and extended-spectrum beta-lactamase (ESBL producing enterobacteria were detected using double-disc synergy test. Results: Of the total 157 males and 189 females investigated, 35.7% and 66.1% respectively had significant bacteriuria. Escherichia coli was the most commonly isolated bacterial pathogen both among in- and out-patients (52.6% vs. 65.5%. Other isolated organisms were S. aureus (13.4% vs. 19.0%, Pseudomonas aeruginosa (10.3% vs. 2.4%, Klebsiella pneumoniae (7.2% vs. 7.1% and K. aerogenes (7.2% vs. 1.2%. Resistance rate of uropathogens to antibiotics was higher among in-patients. Resistance rate to ofloxacin, ceftazidime and ceftriaxone was generally very low compared to other tested antibiotics. Multiple resistant bacteria: MRSA and ESBL-producing enterobacteria were detected among both in-and out-patient with no significant difference in isolation rate. Conclusion: There is a need for continuous monitoring of uropathogens and their antibiotic sensitivity profile for evidence-based empirical treatment of UTI. There is an urgent need for the establishment of antibiotic

  11. MICROBIAL FLORA AND RISK FACTORS ASSOCIATED WITH CATHETER ASSOCIATED URINARY TRACT INFECTIONS

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    Ravi Prakash

    2015-05-01

    Full Text Available INTRODUCTION: Catheter associated Urinary Tract Infection (UTI represent the most common type of nosocomial infection and is a major health concern due to its complications and frequent recurrence. Among the nosocomial infections UTI contributes a major part. About 80% of nosocomial UTI are associated with using indwelling urinary catheters and most of them are asymptomatic. Only 5% of them develop s symptomatic UTI which leads to development of complications like bacteremia & pyelonephritis. MATERIALS AND METHODS: In th e present study a random collection of 100 urine samples from different clinical “groups ˮ like surgery, urology, AMCU, Ob stetrics & Gynecology patients with indwelling urinary catheter of different durations of catheter stay. Organisms isolated in culture, biochemical c haracterization, and antibiotic susceptibility was done. RESULTS: Among the samples tested 41/100 (41% showed culture positivity. within them surgery patients were 40.90% (18/41 , Urology accounted for, 71.42 % (20/28, in AMCU patients 20% (2/10, with more than 3 days of duration of catheter stay and in Obs & Gyn department showed 0 culture positivity. The predominant organism isolated is pseudomonas aeruginosa (34.2%, followed by Escherichia coli (22%, enterococci (12.19%, Klebsiella (12.19% and Ca ndida 19.5%. Among GNB 90% showed ESBL production, 10% ß - lactam inhibitors resistance, 90% quinolones resistant, 50% resistant to amikacin, 100% to gentamycin was o bserved. CONCLUSION: Incidence of bacteriuria in patients with indwelling urinary catheters is 41 %. Onset of bacteriuria is as early as on 3 rd day of catheterization, and gradually increases with duration of stay, technique of insertion and daily catheter care done. Pseudomonas aeruginosa and Escherichia coli are common organisms isolated. Use o f prophylactic antibiotics without doing culture, and antibiotic susceptibility testing leads to development of drug resistant organisms. So, active

  12. Intramacrophage survival of uropathogenic Escherichia coli: Differences between diverse clinical isolates and between mouse and human macrophages

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    Bokil, Nilesh J.

    2011-11-01

    Uropathogenic E. coli (UPEC) are the primary cause of urinary tract infections. Recent studies have demonstrated that UPEC can invade and replicate within epithelial cells, suggesting that this bacterial pathogen may occupy an intracellular niche within the host. Given that many intracellular pathogens target macrophages, we assessed the interactions between UPEC and macrophages. Colonization of the mouse bladder by UPEC strain CFT073 resulted in increased expression of myeloid-restricted genes, consistent with the recruitment of inflammatory macrophages to the site of infection. In in vitro assays, CFT073 was able to survive within primary mouse bone marrow-derived macrophages (BMM) up to 24h post-infection. Three additional well-characterized clinical UPEC isolates associated with distinct UTI symptomatologies displayed variable long-term survival within BMM. UPEC strains UTI89 and VR50, originally isolated from patients with cystitis and asymptomatic bacteriuria respectively, showed elevated bacterial loads in BMM at 24h post-infection as compared to CFT073 and the asymptomatic bacteriuria strain 83972. These differences did not correlate with differential effects on macrophage survival or initial uptake of bacteria. E. coli UTI89 localized to a Lamp1 + vesicular compartment within BMM. In contrast to survival within mouse BMM, intracellular bacterial loads of VR50 were low in both human monocyte-derived macrophages (HMDM) and in human T24 bladder epithelial cells. Collectively, these data suggest that some UPEC isolates may subvert macrophage anti-microbial pathways, and that host species differences may impact on intracellular UPEC survival. © 2011 Elsevier GmbH.

  13. Bacteriological study of urinary tract infection in antenatal care patients

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    Srivastava Ritu, Singh Brij N, Begum Rehana, Yadav Ramesh

    2014-04-01

    Full Text Available Aims & Objective: To isolate and diagnose the Uropathogens and its antibiotic sensitivity pattern in anti-natal care patient suffering from Urinary tract Infections. Material and Methods: 150 samples were collected by consent pregnant women between the age group of 18 to 40 years. A midstream clean catch is adequate, provided by all pregnant women’s through given careful instructions. For enumeration of bacteria we perform standard loop techniques method. The number of colonies counted or estimated, and this number used to calculate the number of viable bacteria per ml of urine. The bacterial strains were identified by colonies character stick, gram staining, morphological and biochemical character. The bacterial strains identification was done up to genus and species level. The antibiotics sensitivity test of bacterial strains was done as per CLSI guidelines by Kirby-Baure Disc Diffusion Methods. Results: The significant bactiurea was found in 50 patients among 150 patients used. The most commonly isolated bacteria was Escherichia coli 23(40% Klebsiellaaerogens 11 (22% Staphylococcus aureus 10 (20% Pseudomonas aerugenosa 4(8%.The incidence of bacteriuria among in their first pregnancy was 22.2%.The higher incidence of UTI in 2nd and 3rd trimester was found to have 31.4% & 40%. These studies were showing high level of resistance to first line antibiotics such as Cotrimaxozole. Conclusion: To minimizing the complication of the pregnant women should be educated about the physiology of pregnancy clinical presentation includes asymptomatic bacteria, acute cystitis & pyelonephritis. Pregnant women should be screened for asymptomatic bacteriuria by urine culture and treated with appropriate antibiotics. After the post treatment pregnant women should be examine again to confirm post treatment urine sterility.

  14. Intramacrophage survival of uropathogenic Escherichia coli: differences between diverse clinical isolates and between mouse and human macrophages.

    Science.gov (United States)

    Bokil, Nilesh J; Totsika, Makrina; Carey, Alison J; Stacey, Katryn J; Hancock, Viktoria; Saunders, Bernadette M; Ravasi, Timothy; Ulett, Glen C; Schembri, Mark A; Sweet, Matthew J

    2011-11-01

    Uropathogenic E. coli (UPEC) are the primary cause of urinary tract infections. Recent studies have demonstrated that UPEC can invade and replicate within epithelial cells, suggesting that this bacterial pathogen may occupy an intracellular niche within the host. Given that many intracellular pathogens target macrophages, we assessed the interactions between UPEC and macrophages. Colonization of the mouse bladder by UPEC strain CFT073 resulted in increased expression of myeloid-restricted genes, consistent with the recruitment of inflammatory macrophages to the site of infection. In in vitro assays, CFT073 was able to survive within primary mouse bone marrow-derived macrophages (BMM) up to 24h post-infection. Three additional well-characterized clinical UPEC isolates associated with distinct UTI symptomatologies displayed variable long-term survival within BMM. UPEC strains UTI89 and VR50, originally isolated from patients with cystitis and asymptomatic bacteriuria respectively, showed elevated bacterial loads in BMM at 24h post-infection as compared to CFT073 and the asymptomatic bacteriuria strain 83972. These differences did not correlate with differential effects on macrophage survival or initial uptake of bacteria. E. coli UTI89 localized to a Lamp1(+) vesicular compartment within BMM. In contrast to survival within mouse BMM, intracellular bacterial loads of VR50 were low in both human monocyte-derived macrophages (HMDM) and in human T24 bladder epithelial cells. Collectively, these data suggest that some UPEC isolates may subvert macrophage anti-microbial pathways, and that host species differences may impact on intracellular UPEC survival.

  15. Virulence and antimicrobial resistance of common urinary bacteria from asymptomatic students of Niger Delta University, Amassoma, Bayelsa State, Nigeria

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    Onanuga, Adebola; Selekere, Tamaradobra Laurretta

    2016-01-01

    Background: Asymptomatic bacteriuria frequently occurs among all ages with the possibility of developing into urinary tract infections, and the antimicrobial resistance patterns of the etiologic organisms are essential for appropriate therapy. Thus, we investigated the virulence and antimicrobial resistance patterns of common urinary bacteria in asymptomatic students of Niger Delta University, Amassoma, Bayelsa State, Nigeria in a cross-sectional study. Materials and Methods: Clean catch mid-stream early morning urine samples collected from 200 asymptomatic University students of aged ranges 15–30 years were cultured, screened and common bacteria were identified using standard microbiological procedures. The isolates were screened for hemolysin production and their susceptibility to antibiotics was determined using standard disc assay method. Results: A total prevalence rate of 52.0% significant bacteriuria was detected and it was significantly higher among the female with a weak association (χ2 = 6.01, phi = 0.173, P = 0.014). The Klebsiella pneumoniae and Staphylococcus aureus isolates were most frequently encountered among the isolated bacteria and 18 (12.7%) of all the bacterial isolates produced hemolysins. All the bacterial isolates exhibited 50–100% resistance to the tested beta-lactam antibiotics, tetracycline and co-trimoxazole. The isolated bacteria were 85-100% multi-drug resistant. However, most of the isolates were generally susceptible to gentamicin and ofloxacin. The phenotypic detection of extended-spectrum beta-lactamases was 9 (9.6%) among the tested Gram-negative bacterial isolates. Conclusions: The observed high proportions of multidrug resistant urinary bacteria among asymptomatic University students call for the need of greater control of antibiotic use in this study area. PMID:26957865

  16. Bladder management methods and urological complications in spinal cord injury patients

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    Roop Singh

    2011-01-01

    Full Text Available Background: The optimal bladder management method should preserve renal function and minimize the risk of urinary tract complications. The present study is conducted to assess the overall incidence of urinary tract infections (UTI and other urological complications in spinal cord injury patients (SCI, and to compare the incidence of these complications with different bladder management subgroups. Materials and Methods: 545 patients (386 males and 159 females of traumatic spinal cord injury with the mean age of 35.4±16.2 years (range, 18 - 73 years were included in the study. The data regarding demography, bladder type, method of bladder management, and urological complications, were recorded. Bladder management methods included indwelling catheterization in 224 cases, clean intermittent catheterization (CIC in 180 cases, condom drainage in 45 cases, suprapubic cystostomy in 24 cases, reflex voiding in 32 cases, and normal voiding in 40 cases. We assessed the incidence of UTI and bacteriuria as the number of episodes per hundred person-days, and other urological complications as percentages. Results: The overall incidence of bacteriuria was 1.70 / hundred person-days. The overall incidenceof urinary tract infection was 0.64 / hundered person-days. The incidence of UTI per 100 person-days was 2.68 for indwelling catheterization, 0.34 for CIC, 0.34 for condom drainage, 0.56 for suprapubic cystostomy, 0.34 for reflex voiding, and 0.32 for normal voiding. Other urological complications recorded were urethral stricture (n=66, 12.1%, urethritis (n=78, 14.3%, periurethral abscess (n=45, 8.2%, epididymorchitis (n=44, 8.07%, urethral false passage (n=22, 4.03%, urethral fistula (n=11, 2%, lithiasis (n=23, 4.2%, hematuria (n=44, 8.07%, stress incontinence (n=60, 11%, and pyelonephritis (n=6, 1.1%. Clean intermittent catheterization was associated with lower incidence of urological complications, in comparison to indwelling catheterization. Conclusions

  17. Impressive Performance: New Disposable Digital Ureteroscope Allows for Extreme Lower Pole Access and Use of 365 μm Holmium Laser Fiber

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    Kelly, Emily Fell

    2016-01-01

    Abstract Background: Since the development of the first flexible ureteroscope, in 1964, technological advances in image quality, flexibility, and deflection have led to the development of the first single-use digital flexible ureteroscope, LithoVue™ (Boston Scientific, Marlborough, MA). With respect to reusable fiber-optic and now digital ureteroscopes, there is an initial capital cost of several thousand dollars (USD) as well as, controversy regarding durability, the cost of repairs and the burdensome reprocessing steps of ureteroscopy. The single-use LithoVue eliminates the need for costly repairs, the occurrence of unpredictable performance, and procedural delays. Renal stones located in the lower pole of the kidney can be extremely challenging as extreme deflections of greater than 160° are difficult to maintain and are often further compromised when using stone treatment tools, such as laser fibers and baskets. This case describes an initial use of the LithoVue digital disposable ureteroscope in the effective treatment of lower pole calculi using a 365 μm holmium laser fiber. Case Report: A 35-year-old female, with a medical history significant for chronic bacteriuria, and recurrent symptomatic culture proven urinary tract infections, underwent localization studies. Retrograde ureteropyelography demonstrated two calcifications adjoining, measuring a total of 1.4 cm, overlying the left renal shadow. Urine aspirated yielded clinically significant, >100,000, Escherichia coli and Streptococcus anginosus bacteriuria, which was felt to be originating from the left lower calix. This case used the newly FDA-approved LithoVue flexible disposable ureteroscope. The two stones were seen using the ureteroscope passed through an ureteral access sheath in the lower pole calix. A 365 μm holmium laser fiber was inserted into the ureteroscope and advanced toward the stones. There was no loss of deflection as the ureteroscope performed reproducibly. The laser was used

  18. Pregnancy in Adolescents of the “Rafael Valdes” Policlinic during the Year 2009 Embarazo en adolescentes del Policlínico “Rafael Valdés” en el año 2009

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    Melissa Serra Ruíz

    2011-11-01

    Full Text Available Background: the situation of teen pregnancy is now a health problem worldwide, associated with increased maternal morbidity. Objective: to estimate the rate of teen pregnancy and related maternal morbidity characterized. Method: prospective descriptive study conducted in the Area of Health Polyclinic "Rafael Valdés Cotorro Municipality during the year 2009. The sample consisted of 79 pregnant teenagers, to which they were asked informed consent to participate in research. The variables studied were: conditions during pregnancy and related complications that were taken from obstetric card and processed using the SPSS statistical system-11, 5, using frequencies and percentages and descriptive statistical techniques. Results: the rate of teen pregnancy in 2009 was 226 x 1000 and shows an increasing trend. Vaginal infection (98, 7 %, anemia (58, 2 % and asymptomatic bacteriuria (38 % were the most common morbidities. Conclusion: pregnancy in adolescence is a health problem today is growing and continues to be necessary to examine.Fundamento: la situación del embarazo en la adolescencia es hoy una problemática de salud a nivel internacional, asociada a un incremento de la morbilidad materna. Objetivo: estimar la tasa de embarazo en adolescentes y caracterizar la morbilidad materna asociada. Método: estudio descriptivo y prospectivo, realizado en el Área de Salud del Policlínico “Rafael Valdés del Municipio Cotorro, durante el año 2009. La muestra estuvo constituida por 79 adolescentes gestantes, a las cuales se les solicitó el consentimiento informado para participar en la investigación. Las variables estudiadas fueron: afecciones durante el embarazo y complicaciones relacionadas, que se tomaron del carnet obstétrico y se procesaron mediante el sistema estadístico SPSS-11,5, utilizando frecuencias y

  19. Routine Urine Culture at the Time of Percutaneous Urinary Drainage: Does Every Patient Need One?

    International Nuclear Information System (INIS)

    Purpose. To determine the clinical variables associated with bacteriuria in patients undergoing primary percutaneous antegrade urinary drainage procedures in order to predict the utility of routinely obtaining urine cultures at the time of the procedure. Methods. Between October 1995 and March 1998 urine cultures were prospectively obtained in all patients undergoing a primary percutaneous antegrade urinary drainage procedure. One hundred and eighty-seven patients underwent 264 procedures. Results were available in 252 cases. Culture results were correlated with clinical, laboratory, and demographic variables. Anaerobic cultures were not uniformly performed. Results. Urine cultures were positive in 24 of 252 (9.5%) cases. An indwelling or recently removed ipsilateral device (catheter or stent) and a history of previous cystectomy with urinary diversion were significant predictors of a positive culture. Patients without either of these predictors, and without clinical or laboratory evidence of infection, were rarely found to have positive cultures. Conclusion. The likelihood of a positive urine culture can be predicted on the basis of the aforementioned clinical variables. In the absence of these clinical indicators routine urine cultures are neither useful nor cost-effective

  20. Functional changes in the lower urinary tract following to irradiation of the cervix carcinoma

    International Nuclear Information System (INIS)

    104 patients submitted to primary irradiation for cervix carcinoma were examined by means of urodynamic methods of diagnosis in order to investigate the functional changes of the lower urinary tract induced by therapy. 34 patients could be examined prior the therapy, 19 and 12 patients, respectively, were examined six and 18 months on an average after the treatment. Another group of 70 patients had retrospective check-up examinations with average intervals of five and ten years. Hydronephroses occured only as a late result after more than six years in 12% of the irradiated women. The incidence of residual urine, significant bacteriuria, and disturbed sensory function of the bladder was not important. All patients were incontinent two years after the irradiation; 60% of these cases of incontinence were due to the bladder and 40% to the urethra. The increase of urge incontinences is possibly caused by a radiofibrotic reaction of the bladder, as is shown by correspondent cystonometric alterations: The bladder tonicity increased, whereas the bladder capacity decreased. These alterations were only partially reversible. The stress incontinence, however, was found already before the treatment. The maximum urethral closing pressure, which often indicates incontinences due to the urethra, was not modified by the irradiation. An increased stress incontinence, probably caused by advanced age, was found only after six years or later. The problems resulting from functional changes should be taken into consideration in the course of posttherapeutic care, i.e. the patients concerned should be given instructions for a regular bladder training. (orig.)

  1. Is Antibiotic Prophylaxis Necessary in Patients Undergoing Ureterolithotripsy?

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    Ali Pasha Meysamie

    2011-08-01

    Full Text Available Transurethral Ureterolithotripsy (TUL is a frequently used procedure in urology departments. Many urologists perform TUL without antibiotic prophylaxis; however the use of chemoprophylaxis before TUL remains a controversial issue in urology. Thisstudy was carried out to assess the safety of omitting antibiotic prophylaxis prior to TUL. In a prospective randomized clinical trial from January 2005 to December 2007, 114 patients with ureteral stones were enrolled; Fifty seven had preoperative antibiotic prophylaxis administered before TUL and fifty seven patients underwent TUL without antibiotic prophylaxis. The rate of postoperative infectious complications (fever, positive blood culture, significant bactriuria, the length of hospital stay and overall stone free rate were compared between the two groups. There was no statistically significant difference between two groups in the operation time, length of hospital stay, postoperative bacteriuria, positive urine culture, postoperative fever and overall success rate of TUL. It appears that the incidence of infectious complications does not increase in patients undergoing TUL without antibiotic prophylaxis if they have negative pre-operative urine culture and antiseptic technique have been performed thorough the procedure.

  2. Hemagglutinin, urease, and hemolysin production by Proteus mirabilis from clinical sources.

    Science.gov (United States)

    Mobley, H L; Chippendale, G R

    1990-03-01

    Proteus mirabilis, a common cause of urinary tract infection, can lead to serious complications including pyelonephritis. Adherence factors, urease, and hemolysin may be virulence determinants. These factors were compared for bacteria cultured from 16 patients with acute pyelonephritis and 35 with catheter-associated bacteriuria and for 20 fecal isolates. Pyelonephritis isolates were more likely (P less than .05) to express the mannose-resistant/Proteus-like (MR/P) hemagglutinin in the absence of mannose-resistant/Klebsiella-like (MR/K) hemagglutinin than were catheter-associated or fecal isolates. Pyelonephritis isolates produced urease activity of 63 +/- 27 (mean +/- SD) mumol of NH3/min/mg of protein, not significantly different from catheter-associated or fecal isolates. Hybridization of Southern blots of P. mirabilis chromosomal DNA with two urease gene probes demonstrated that urease gene sequences were conserved in all isolates. Geometric mean of reciprocal hemolytic titers for pyelonephritis isolates was 27.9; for urinary catheter isolates, 18.0; and for fecal isolates, 55.7 (not significantly different, P greater than .1). Although in vivo expression of urease and hemolysin may not be reliable indexes of virulence, MR/P hemagglutination in the absence of MR/K hemagglutination may be necessary for development of pyelonephritis.

  3. Assessment of biological and colony hybridization assays for detection of the aerobactin system in Escherichia coli from urinary tract infections.

    Science.gov (United States)

    Orskov, I; Williams, P H; Svanborg Edén, C; Orskov, F

    1989-01-01

    A total of 466 E. coli strains from urinary tract infections (UTI) were screened for the presence and expression of the aerobactin system by a colony hybridization test and a bioassay. A probe carrying part of the genes for aerobactin synthesis was used. A total of 43.1% (201) of the strains were positive in the probe test and undoubtedly positive in the bioassay. When doubtfully positive bioassays were included, this figure rose to 49.8% (232). An additional 4.9% (23) of the strains were positive in the colony hybridization test only while 44% (205) of the strains were negative in both tests. Doubtfully positive bioassays were probably due either to a false positive reaction or to a weak expression of the aerobactin system. 01:K1:H- strains were characteristically probe positive and doubtfully positive in the bioassay. The incidence of isolates positive by both methods or by only one of them was significantly higher among isolates from cases of pyelonephritis (Py) than among those from asymptomatic bacteriuria (ABU) and normal feces (FN) (P less than 0.01).

  4. Detection by molecular hybridization of pap, afa, and sfa adherence systems in Escherichia coli strains associated with urinary and enteral infections.

    Science.gov (United States)

    Archambaud, M; Courcoux, P; Labigne-Roussel, A

    1988-01-01

    The genetic determinants responsible for the adherence of Escherichia coli to uroepithelial cells have been identified in recent years by genetic and molecular methods. Specific DNA probes for each of the three operons which have been cloned so far (pap, afa, sfa/foc operons) have been used in colony hybridization experiments to detect the presence of each of these operons in the chromosomal DNA of 443 strains of E. coli; 186 strains were from patients with urinary tract infections (pyelonephritis, 106 strains; cystitis, 59; asymptomatic bacteriuria, 21) and 257 were strains from the stools of healthy subjects (61) or from patients with various enteral infections (196). E. coli strains harbouring the pap operon were found more frequently in the urine of patients with pyelonephritis (p less than 0.001) and cystitis (p less than 0.01) than in control stools. The presence of two operons (pap + afa) or (pap + sfa/foc) was only observed in uropathogenic strains (p less than 0.02). Pap and sfa/foc operons were never found in strains causing enteral infection; however, the afa operon was found in 7.6% of the enteropathogenic E. coli.

  5. PATTERN OF ANTIMICROBIAL USE FOR URINARY TRACT INFECTION DURING PREGNANCY IN A TERTIARY CARE TEACHING HOSPITAL

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    Haldia Priyanka, Sharma Taruna, Nautiyal Ruchira

    2015-04-01

    Full Text Available Background: Urinary Tract Infection (UTI may be classified as lower (cystitis and asymptomatic bacteriuria or upper urinary tract infections (pyelonephritis. The recommended antibiotics for use in pregnancy for management of ASB include amoxicillin, oral cephalosporins and nitrofurantoin; and for the treatment of lower UTI during pregnancy include penicillins, oral cephalosporins. Data from the antibiotic usage study in UTI during pregnancy will help in establishing a proper antibiotic utilisation guideline and promotes rational prescribing of medicines. Aim: To study the antimicrobial prescription practices for urinary tract infection during pregnancy. Materials & Methods: The study was conducted in the Department of Pharmacology and Department of Obstetrics & Gynaecology, Himalayan Institute of Medical Sciences (HIMS, Dehradun, over a period of 12 months. This was an observational cross sectional study done in 45 pregnant women with or without symptoms of UTI. Results: 29.4% of the pregnant women with symptomatic UTI were culture positive while all were culture positive who had asymptomatic UTI. Cephalosporins were most frequently prescribed followed by nitrofurantoin. Conclusion: Urine culture should be performed as a screening and diagnostic tool for UTI during pregnancy. Various classes of antimicrobials were being prescribed for UTI during pregnancy.

  6. Embarazo en adolescentes del Policlínico “Rafael Valdés” en el año 2009

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    Melissa Serra Ruíz

    2011-11-01

    Full Text Available Fundamento: la situación del embarazo en la adolescencia es hoy una problemática de salud a nivel internacional, asociada a un incremento de la morbilidad materna. Objetivo: estimar la tasa de embarazo en adolescentes y caracterizar la morbilidad materna asociada. Método: estudio descriptivo y prospectivo, realizado en el Área de Salud del Policlínico “Rafael Valdés del Municipio Cotorro, durante el año 2009. La muestra estuvo constituida por 79 adolescentes gestantes, a las cuales se les solicitó el consentimiento informado para participar en la investigación. Las variables estudiadas fueron: afecciones durante el embarazo y complicaciones relacionadas, que se tomaron del carnet obstétrico y se procesaron mediante el sistema estadístico SPSS-11,5, utilizando frecuencias y porcentajes como técnicas de estadística descriptiva. Resultados: la tasa de embarazo en adolescentes en el año 2009, fue de 226 x 1000 y muestra una tendencia al aumento. La infección vaginal (98,7 %, la anemia (58,2 % y la bacteriuria asintomática (38 %, fueron las morbilidades más frecuentes. Conclusión: el embarazo en la adolescencia es un problema de salud que hoy está en aumento y que continúa siendo necesario investigar.

  7. Urinary tract infections in patients with type 2 diabetes mellitus: review of prevalence, diagnosis, and management

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    Nitzan O

    2015-02-01

    Full Text Available Orna Nitzan,1–3 Mazen Elias,2,4 Bibiana Chazan,1,2 Walid Saliba2,4 1Infectious Disease Unit, Ha’emek Medical Center, Afula, Israel; 2Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel; 3Infectious Disease Unit, Padeh-Poriya Medical Center, 4Department of Internal Medicine C, Ha’emek Medical Center, Afula, Israel Abstract: Urinary tract infections are more common, more severe, and carry worse outcomes in patients with type 2 diabetes mellitus. They are also more often caused by resistant pathogens. Various impairments in the immune system, poor metabolic control, and incomplete bladder emptying due to autonomic neuropathy may all contribute to the enhanced risk of urinary tract infections in these patients. The new anti-diabetic sodium glucose cotransporter 2 inhibitors have not been found to significantly increase the risk of symptomatic urinary tract infections. Symptoms of urinary tract infection are similar to patients without diabetes, though some patients with diabetic neuropathy may have altered clinical signs. Treatment depends on several factors, including: presence of symptoms, severity of systemic symptoms, if infection is localized in the bladder or also involves the kidney, presence of urologic abnormalities, accompanying metabolic alterations, and renal function. There is no indication to treat diabetic patients with asymptomatic bacteriuria. Further studies are needed to improve the treatment of patients with type 2 diabetes and urinary tract infections. Keywords: diabetes mellitus, diagnosis, management, prevalence, urinary tract infection

  8. E. coli Induced Experimental Model of Primary Biliary Cirrhosis: At Last

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    Andreas L. Koutsoumpas

    2014-01-01

    Full Text Available Recurrent urinary tract infections (UTI have been considered potential triggers of primary biliary cirrhosis (PBC, an autoimmune cholestatic liver disease characterised by progressive destruction of intrahepatic bile ducts. Additional support for the link made between PBC and UTI was based on early observations of recurrent episodes of bacteriuria in female patients with PBC. A series of large epidemiological studies demonstrated a strong correlation between recurrent UTI and PBC, initiating a series of studies investigating the role of Escherichia coli (E. coli, the most prevalent organism isolated in women with UTI as a trigger of PBC. Immunological evidence of B- and T-cell cross-reactive responses implicating PBC-specific autoantigens and E. coli mimics have been clearly demonstrated, adding support to the notion that E. coli is a potential infectious inducer of PBC in susceptible individuals. One of the major limitations in proving the E. coli/PBC association was the lack of reliable E. coli-infected animal models of PBC. This review provides an overview of the evidence linking this infectious agent with PBC and discusses the pros and cons of a recently developed E. coli-infected animal model of PBC.

  9. E. coli Induced Experimental Model of Primary Biliary Cirrhosis: At Last.

    Science.gov (United States)

    Koutsoumpas, Andreas L; Smyk, Daniel S; Bogdanos, Dimitrios P

    2014-01-01

    Recurrent urinary tract infections (UTI) have been considered potential triggers of primary biliary cirrhosis (PBC), an autoimmune cholestatic liver disease characterised by progressive destruction of intrahepatic bile ducts. Additional support for the link made between PBC and UTI was based on early observations of recurrent episodes of bacteriuria in female patients with PBC. A series of large epidemiological studies demonstrated a strong correlation between recurrent UTI and PBC, initiating a series of studies investigating the role of Escherichia coli (E. coli, the most prevalent organism isolated in women with UTI) as a trigger of PBC. Immunological evidence of B- and T-cell cross-reactive responses implicating PBC-specific autoantigens and E. coli mimics have been clearly demonstrated, adding support to the notion that E. coli is a potential infectious inducer of PBC in susceptible individuals. One of the major limitations in proving the E. coli/PBC association was the lack of reliable E. coli-infected animal models of PBC. This review provides an overview of the evidence linking this infectious agent with PBC and discusses the pros and cons of a recently developed E. coli-infected animal model of PBC.

  10. Risk assessment and management to prevent preterm birth.

    Science.gov (United States)

    Koullali, B; Oudijk, M A; Nijman, T A J; Mol, B W J; Pajkrt, E

    2016-04-01

    Preterm birth is the most important cause of neonatal mortality and morbidity worldwide. In this review, we review potential risk factors associated with preterm birth and the subsequent management to prevent preterm birth in low and high risk women with a singleton or multiple pregnancy. A history of preterm birth is considered the most important risk factor for preterm birth in subsequent pregnancy. General risk factors with a much lower impact include ethnicity, low socio-economic status, maternal weight, smoking, and periodontal status. Pregnancy-related characteristics, including bacterial vaginosis and asymptomatic bacteriuria, appear to be of limited value in the prediction of preterm birth. By contrast, a mid-pregnancy cervical length measurement is independently associated with preterm birth and could be used to identify women at risk of a premature delivery. A fetal fibronectin test may be of additional value in the prediction of preterm birth. The most effective methods to prevent preterm birth depend on the obstetric history, which makes the identification of women at risk of preterm birth an important task for clinical care providers.

  11. Oral immunotherapy of recurrent urinary tract infections: a double-blind placebo-controlled multicenter study.

    Science.gov (United States)

    Schulman, C C; Corbusier, A; Michiels, H; Taenzer, H J

    1993-09-01

    We treated 166 patients suffering from recurrent urinary tract infections under double-blind conditions for 3 months with 1 capsule daily of either the immunostimulating bacterial extract (85) or a placebo (81), followed by a 3-month observation period without the test drugs. The bacterial extract exerted a significant beneficial curative action and long-term consolidative effect on the frequency of recurrent urinary tract infections with marked improvements in the characteristic signs and symptoms. It was significantly superior to placebo for the majority of the assessed parameters: number of recurrent urinary tract infections, bacteriuria, leukocyturia, erythrocyturia, nitrituria, albuminuria and casts in urine. Consumption of antibiotics, chemotherapeutics, urinary antiseptics or disinfectants was significantly less under active drug therapy compared to placebo. Tolerance was good with only 2 side effects reported in 2 patients (2%) in the active group compared to 11 among 5 (6%) in the placebo group. Therefore, the bacterial extract can be considered an efficient and well tolerated drug for the treatment of urinary tract infections, and their accompanying signs and symptoms, as well as for decreasing the risk of recurrences and the need for antibiotics and other antibacterial drugs.

  12. Study of the risk factors related to acquisition of urinary tract infections in patients submitted to renal transplant

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    Mayra Gonçalves Menegueti

    2015-06-01

    Full Text Available INTRODUCTION: Urinary tract infections (UTI among transplant recipients are usually caused by gram-negative microorganisms and can provoke a high incidence of morbidity and mortality. The aim of this study was to evaluate the risk factors associated with the acquisition of UTIs during the first year after renal transplantation. METHODS: Here, we report a single-center retrospective cohort study of 99 renal transplant patients followed for the first year after surgery. The definition of a UTI episode was a urine culture showing bacterial growth and leucocyturia when patients presented with urinary symptoms. The absence of infection (asymptomatic bacteriuria was defined as an absence of symptoms with negative urine culture or bacterial growth with any number of colonies. RESULTS: Ninety-nine patients were included in the study. During the study, 1,847 urine cultures were collected, and 320 (17.3% tested positive for bacterial growth. Twenty-six (26.2% patients developed a UTI. The most frequent microorganisms isolated from patients with UTIs were Klebsiella pneumoniae (36%, with 33% of the strains resistant to carbapenems, followed by Escherichia coli (20%. There were no deaths or graft losses associated with UTI episodes. CONCLUSIONS: Among the UTI risk factors studied, the only one that was associated with a higher incidence of infection was female sex. Moreover, the identification of drug-resistant strains is worrisome, as these infections have become widespread globally and represent a challenge in the control and management of infections, especially in solid organ transplantation.

  13. Meta分析抗生素对经直肠前列腺活检术后感染性并发症的预防效果%Meta-analysis of antibiotic prophylaxis use in transrectal prostatic biopsy

    Institute of Scientific and Technical Information of China (English)

    杨明根; 赵晓昆; 吴志平; 肖宁; 吕晨

    2009-01-01

    ObjectiveTo determine whether antibiotic prophylaxis can reduce the risk of postoperative infective complications in men undergoing transrectal prostatic biopsy (TPB) who had sterile preoperative urine.MethodsMEDLINE, EMBASE, Cochrane Collaboration Reviews, Chinese Medical Current Contents (CMCC), and National Knowledge Infrastructure (CNKI) were searched for rando-mized controlled trials that compared the effect of antibiotic prophylaxis with placebo or active controls for men undergoing TPB with preoperative sterile urine. Two reviewers independently extracted the data of patient characteristics and outcomes based on a prospectively developed protocol.ResultsA total of 12 trials (3 placebo controlled, 3 non-treatment controlled, and 6 activly controlled) involving 1 987 patients, met the inclusion criteria. Prophylactic antibiotic use in patients at low risk undergoing TPB significantly decreased bacteriuria and middle degree fever incidence, but could not decrease the incidence of bacteremia. The relative risk for post-TPB bacteriuria, middle degree fever, and bacteremia were 0.32 (95% CI 0.23 to 0.46), 0.37 (95% CI 0.17 to 0.77), and 0.96 (95% CI 0.61 to 1.50), respectively. Effective antibiotic classes included quinolone, co-quinolone and nitroimidazole, and co-trimethoprim and sulfamethoxazole. Treatment protocols of any duration were effective.ConclusionAntibiotic prophylaxis obviously decreases the incidence of bacteriuria and middle degree fever but not bacteremia in men with preoperative sterile urine undergoing TPB. A significant decrease in bacteriuria incidence can be achieved with a range of antibiotic agents, including quinolones and co-quinolone and nitroimidazole. Treatment protocols of any duration are effective with no heterogeneity.%目的:分析预防性抗生素能否减少术前为清洁尿、行经直肠前列腺活检术(TPB)患者的术后感染性并发症.方法:制定原始文献的纳入标准、排除标准及检索策略,

  14. Risk assessment and management to prevent preterm birth.

    Science.gov (United States)

    Koullali, B; Oudijk, M A; Nijman, T A J; Mol, B W J; Pajkrt, E

    2016-04-01

    Preterm birth is the most important cause of neonatal mortality and morbidity worldwide. In this review, we review potential risk factors associated with preterm birth and the subsequent management to prevent preterm birth in low and high risk women with a singleton or multiple pregnancy. A history of preterm birth is considered the most important risk factor for preterm birth in subsequent pregnancy. General risk factors with a much lower impact include ethnicity, low socio-economic status, maternal weight, smoking, and periodontal status. Pregnancy-related characteristics, including bacterial vaginosis and asymptomatic bacteriuria, appear to be of limited value in the prediction of preterm birth. By contrast, a mid-pregnancy cervical length measurement is independently associated with preterm birth and could be used to identify women at risk of a premature delivery. A fetal fibronectin test may be of additional value in the prediction of preterm birth. The most effective methods to prevent preterm birth depend on the obstetric history, which makes the identification of women at risk of preterm birth an important task for clinical care providers. PMID:26906339

  15. Nosocomial urinary tract infections: A review.

    Science.gov (United States)

    Iacovelli, Valerio; Gaziev, Gabriele; Topazio, Luca; Bove, Pierluigi; Vespasiani, Giuseppe; Finazzi Agrò, Enrico

    2014-01-01

    Nosocomial urinary tract infections are a common complication in healthcare systems worldwide. A review of the literature was performed in June 2014 using the Medical Literature Analysis and Retrieval System Online (MEDLINE) database, through either PubMed or Ovid as a search engine, to identify publications regarding nosocomial urinary tract infections (NUTIs) definition, epidemiology, etiology and treatment.According to current definitions, more than 30% of nosocomial infections are urinary tract infections (UTIs). A UTI is defined 'nosocomial' (NUTI) when it is acquired in any healthcare institution or, more generally, when it is related to patient management. The origin of nosocomial bacteria is endogenous (the patient's flora) in two thirds of the cases. Patients with indwelling urinary catheters, those undergoing urological surgery and manipulations, long-stay elderly male patients and patients with debilitating diseases are at high risk of developing NUTIs. All bacterial NUTIs should be treated, whether the patient is harboring a urinary catheter or not. The length of treatment depends on the infection site. There is abundance of important guidance which should be considered to reduce the risk of NUTIs (hand disinfection with instant hand sanitizer, wearing non-sterile gloves permanently, isolation of infected or colonized catheterized patients). Patients with asymptomatic bacteriuria can generally be treated initially with catheter removal or catheter exchange, and do not necessarily need antimicrobial therapy. Symptomatic patients should receive antibiotic therapy. Resistance of urinary pathogens to common antibiotics is currently a topic of concern. PMID:25451882

  16. [TREATMENT MODALITIES OF LABIAL FUSION IN PREPUBERTAL GIRLS].

    Science.gov (United States)

    Morić, Bernardica Valent; Lesar, Tatjana

    2014-12-01

    Labial adhesion is a thin membranous fusion of the labia minora of varying length. It is not a rare condition in prepubertal girls, but since it is often asymptomatic, it remains undiagnosed. It is usually discovered during regular check-ups or when the fusion results in post-void dripping, bacteriuria, vaginal irritation, dysuria, urinary tract infection or obstruction. The cause of labial adhesions is unclear. Chronic irritation of the vulva in combination with poor hygiene is believed to be important etiologic factors. A theory of hypoestrogenic status in prepubertal girls as a potential etiologic factor for labial adhesions is no longer widely accepted, since a recent study concluded that there was no difference in estrogen levels between children with and those without labial adhesions. Treatment options include conservative management with topical estrogen or betmethasone creams or, when indicated, manual separation or surgery. Topical estrogen and betamethasone creams are generally considered safe and effective treatment of labial adhesions, even over prolonged periods of time, with minimal if any side effects. No guidelines have been structured for the limits or duration of topical therapy, but most authors agree that optimal treatment should last from 1 to 2 or 3 months on twice-a-day regimen. Parental education concerning appropriate application technique is important not only for the success of treatment, but also to avoid the possible side effects. PMID:26285472

  17. Prevalence of asymptomatic urinary abnormalities among adolescents.

    Science.gov (United States)

    Fouad, Mohamed; Boraie, Maher

    2016-05-01

    To determine the prevalence of asymptomatic urinary abnormalities in adolescents, first morning clean mid-stream urine specimens were obtained from 2500 individuals and examined by dipstick and light microscopy. Adolescents with abnormal screening results were reexamined after two weeks and those who had abnormal results twice were subjected to systemic clinical examination and further clinical and laboratory investigations. Eight hundred and three (32.1%) individuals had urinary abnormalities at the first screening, which significantly decreased to 345 (13.8%) at the second screening, (P adolescents who had persistent urine abnormalities; 228 (9.1%) individuals had non glomerular hematuria. The hematuria was isolated in 150 (6%) individuals, combined with leukocyturia in 83 (3.3%) individuals, and combined with proteinuria in 12 (0.5%) individuals. Leukocyturia was detected in 150 (6%) of all studied adolescents; it was isolated in 39 (1.6%) individuals and combined with proteinuria in 28 (1.1%) of them. Asymptomatic bacteriuria was detected in 23 (0.9%) of all studied adolescents; all the cases were females. Proteinuria was detected in 65 (2.6%) of all the studied adolescents; 45 (1.8%) individuals had adolescents from rural than urban areas (P adolescents in our population.

  18. ASSESSMENT OF UTI IN POSTMENOPAUSAL WOMEN ATTENDING OPD CLINIC OF CHITWAN MEDICAL COLLEGE, BHARATPUR, CHITWAN, NEPAL

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    Mamata Sharma Neupane

    2013-06-01

    Full Text Available Urinary tract infection (UTI is the most common bacterial infection in young and elderly women. Despite the higher incidence of bacteriuria in elderly women, most UTI research has been conducted in young women. Hence, the present paper investigates the assessment of UTI in postmenopausal women attending OPD Clinic of Chitwan Medical College, Bharatpur, Chitwan, Nepal. A cross-sectional study was conducted in OPD clinic of Chitwan Medical College Teaching Hospital from December, 2012 to April, 2013. Total 400 patients suspected with UTI were reviewed, out of which 173 (43.3 % of the suspected samples showed presence of potential pathogens causing UTI in postmenopausal women. Escherichia coli (E. coli was the predominant (65.1% bacterial pathogen. Amikacin was found to be most sensitive antimicrobial followed by Nitrofurantoin and Gentamcin. Ampicillin showed the higher percentage of resistant, compared to other antimicrobials. In conclusion, drug resistance among bacterial pathogens is an evolving process, regular surveillance and monitoring is necessary to provide effective treatment of UTIs.

  19. Complicated Urinary Tract Infection in Adults

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    LE Nicolle

    2005-01-01

    Full Text Available BACKGROUND: Complicated urinary tract infection occurs in individuals with functional or structural abnormalities of the genitourinary tract.OBJECTIVE: To review current knowledge relevant to complicated urinary tract infection, and to provide evidence-based recommendations for management.METHODS: The literature was reviewed through a PubMed search, and additional articles were identified by journal reference review. A draft guideline was prepared and critically reviewed by members of the Association of Medical Microbiology and Infectious Disease Canada Guidelines Committee, with modifications incorporated following the review.RESULTS: Many urological abnormalities may be associated with complicated urinary infection. There is a wide spectrum of potential infecting organisms, and isolated bacteria tend to be more resistant to antimicrobial therapy. Morbidity and infection outcomes in subjects with complicated urinary infection are principally determined by the underlying abnormality rather than the infection. Principles of management include uniform collection of a urine specimen for culture before antimicrobial therapy, characterization of the underlying genitourinary abnormality, and nontreatment of asymptomatic bacteriuria except before an invasive genitourinary procedure. The antimicrobial regimen is determined by clinical presentation, patient tolerance, renal function and known or anticipated infecting organisms. If the underlying abnormality contributing to the urinary infection cannot be corrected, then early post-treatment recurrence of infection is anticipated.CONCLUSIONS: The management of complicated urinary infection is individualized depending on patient variables and the infecting organism. Further clinical investigations are necessary to assist in determining optimal antimicrobial regimens.

  20. A Capacitive Touch Screen Sensor for Detection of Urinary Tract Infections in Portable Biomedical Devices

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    Carlos Honrado

    2014-07-01

    Full Text Available Incidence of urinary tract infections (UTIs is the second highest among all infections; thus, there is a high demand for bacteriuria detection. Escherichia coli are the main cause of UTIs, with microscopy methods and urine culture being the detection standard of these bacteria. However, the urine sampling and analysis required for these methods can be both time-consuming and complex. This work proposes a capacitive touch screen sensor (CTSS concept as feasible alternative for a portable UTI detection device. Finite element method (FEM simulations were conducted with a CTSS model. An exponential response of the model to increasing amounts of E. coli and liquid samples was observed. A measurable capacitance change due to E. coli presence and a tangible difference in the response given to urine and water samples were also detected. Preliminary experimental studies were also conducted on a commercial CTSS using liquid solutions with increasing amounts of dissolved ions. The CTSS was capable of distinguishing different volumes of liquids, also giving an exponential response. Furthermore, the CTSS gave higher responses to solutions with a superior amount of ions. Urine samples gave the top response among tested liquids. Thus, the CTSS showed the capability to differentiate solutions by their ionic content.

  1. Particle motion in unsteady two-dimensional peristaltic flow with application to the ureter

    Science.gov (United States)

    Jiménez-Lozano, Joel; Sen, Mihir; Dunn, Patrick F.

    2009-04-01

    Particle motion in an unsteady peristaltic fluid flow is analyzed. The fluid is incompressible and Newtonian in a two-dimensional planar geometry. A perturbation method based on a small ratio of wave height to wavelength is used to obtain a closed-form solution for the fluid velocity field. This analytical solution is used in conjunction with an equation of motion for a small rigid sphere in nonuniform flow taking Stokes drag, virtual mass, Faxén, Basset, and gravity forces into account. Fluid streamlines and velocity profiles are calculated. Theoretical values for pumping rates are compared with available experimental data. An application to ureteral peristaltic flow is considered since fluid flow in the ureter is sometimes accompanied by particles such as stones or bacteriuria. Particle trajectories for parameters that correspond to calcium oxalates for calculosis and Escherichia coli type for bacteria are analyzed. The findings show that retrograde or reflux motion of the particles is possible and bacterial transport can occur in the upper urinary tract when there is a partial occlusion of the wave. Dilute particle mixing is also investigated, and it is found that some of the particles participate in the formation of a recirculating bolus, and some of them are delayed in transit and eventually reach the walls. This can explain the failure of clearing residuals from the upper urinary tract calculi after successful extracorporeal shock wave lithotripsy. The results may also be relevant to the transport of other physiological fluids and industrial applications in which peristaltic pumping is used.

  2. Urinary Tract Infection in Children: A Review

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    Farzana Hamid

    2013-07-01

    Full Text Available Urinary tract infection (UTI is one of the most common paediatric infections. By the time children are 5 years old, about 8% of girls and about 1-2% of boys have had at least one episode of UTI. UTIs are caused mainly by colonic bacteria, such as Escherichia coli, followed by Klebsiella and Proteus. However, any organism that gains access to the urinary tract system may cause infection, including fungi (Candida species and viruses. In some instances, UTI results in recognition of an important underlying structural abnormality of the urinary tract. The febrile infant or child with clinically significant bacteriuria and no other site of infection to explain the fever, even in the absence of systemic symptoms has UTI. Signs and symptoms of UTIs vary depending on the child's age and on which part of the urinary tract is infected. The diagnosis of UTI is based on routine microscopic examination and culture of a properly collected urine specimen. Imaging studies are done in selected patients to identify anatomic abnormalities. Most cases of uncomplicated UTI respond readily to outpatient antibiotic treatment without further sequelae. All patients should have close follow-up to evaluate response to antibiotics and to prevent the development of long term complication.

  3. NOSOCOMIAL INFECTIONS IN PATIENTS WITH UROLITHIASIS IN THE POSTOPERATIVE PERIOD

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    F. S. Sadulloev

    2015-01-01

    Full Text Available Abstract:Objective: To determine the most frequent causative agents of nosocomial infection in patients with urolithiasis in the postoperative period.Material and Methods. The study is based on the results of comprehensive studies conducted in 122 patients with nosocomial urinary tract infection, detected in 823 patients with urolithiasis treated by various methods. A cohort of 823 patients is isolated from 2688 patients treated without at admission signs of infections in the urinary tract for the period 2011–2014. All patients were treated at the Urological department of Avicenna Tajik State Medical University in the Republican Clinical Center of Urology. Main results. By the method of randomly selected 823 medical records of patients with urolithiasis various operations we carried out with 122 patients revealed cases of nosocomial infections. The diagnosis of nosocomial infections on the basis of established symptomatic urinary tract infection, asymptomatic bacteriuria or the presence of wound infection, use during the hospital stay for treatment of antibiotics, antiseptics, physiotherapy and other therapies. The incidence of nosocomial infections was studied in dependence with the severity of the underlying disease, the volume of surgical, invasive, endoscopic and other urological procedures, the timing and frequency of tests, the proportion of individual clinical manifestations in the overall structure of urinary tract infections, sex and age of patients.Conclusions. The leading microflora causing nosocomial infection in patients with urolithiasis in all treatments are gram-negative microorganisms, including prevailing E.coli (24,0%.

  4. Epidemiology and natural history of urinary tract infections in children.

    Science.gov (United States)

    Stull, T L; LiPuma, J J

    1991-03-01

    Recent retrospective surveys have supported previous investigations in demonstrating the incidence of UTI during infancy; 0.3% to 1.2% of infants develop symptomatic UTI during the first year of life. Boys are more commonly infected during the first 3 months of life. After the first year, symptomatic UTI is much more frequent among girls. Similarly, asymptomatic bacteriuria is more frequently detected in boys than in girls during the first 12 months of life. Thereafter, the incidence decreases markedly in boys but increases in girls. Recent investigations indicate that lack of circumcision is a risk factor for UTI among male infants. Recurrent UTI is common and frequently asymptomatic. The most important microbiologic factor that is associated with E. coli causing acute pyelonephritis is adherence mediated by P fimbriae. Other factors, such as capsule, lipopolysaccharide, aerobactin production, and serum resistance, also determine the invasiveness of E. coli. Vesicoureteral reflux appears to be an important host factor predisposing to UTI. Microbiologic and host factors that are determinants of renal scarring are under investigation.

  5. Paper-based ELISA to rapidly detect Escherichia coli.

    Science.gov (United States)

    Shih, Cheng-Min; Chang, Chia-Ling; Hsu, Min-Yen; Lin, Jyun-Yu; Kuan, Chen-Meng; Wang, Hsi-Kai; Huang, Chun-Te; Chung, Mu-Chi; Huang, Kui-Chou; Hsu, Cheng-En; Wang, Chun-Yuan; Shen, Ying-Cheng; Cheng, Chao-Min

    2015-12-01

    Escherichia coli is a generic indicator of fecal contamination, and certain serotypes cause food- and water-borne illness such as O157:H7. In the clinic, detection of bacteriuria, which is often due to E. coli, is critical before certain surgical procedures or in cases of nosocomial infection to prevent further adverse events such as postoperative infection or sepsis. In low- and middle-income countries, where insufficient equipment and facilities preclude modern methods of detection, a simple, low-cost diagnostic device to detect E. coli in water and in the clinic will have significant impact. We have developed a simple paper-based colorimetric platform to detect E. coli contamination in 5h. On this platform, the mean color intensity for samples with 10(5)cells/mL is 0.118±0.002 (n=4), and 0.0145±0.003 (Ppaper-based ELISA is an innovative point-of-care diagnostic tool to rapidly detect E. coli, and possibly other pathogens when customized as appropriate, especially in areas that lack advanced clinical equipment.

  6. Strongyloides stercoralis: an example of unusual finding of larvae in urinary sediment

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    Siriana Berti

    2009-12-01

    Full Text Available This report deals with the unusual finding of S. stercoralis in a urine sample. For the standard examination of urines our laboratory employs an automated system suited to determining chemical and physical parameters (Clinitek® Atlas™ as well as morphological parameters (Sysmex UF100 flow cytometer™. Samples showing inconsistencies between the two systems, the clinically significant or the unusual ones, need to be explained by analyzing the sediments after centrifugation. In June 2009 a urine sample from a girl approximately two-years-old appeared cloudy, and presented bacteriuria, proteinuria, and cylindruria. Microscopic examination indicated definite signs of faecal contamination by larvae of S. stercoralis, so that the sample was not suitable for further analysis.Additional data revealed the presence of hematological eosinophilia, while the parasitological stool examination confirmed the infestation. The physician, who was immediately informed, reported that the patient, originally from India, had recently been adopted and for this reason was submitted to the prescribed clinical screening.The relevance of this unexpected finding is that important clinical information can be retrieved even from materials not properly collected. By the present finding it is prudent to be wary of underestimating biological samples: sometimes one can get important, albeit unanticipated, clinical observations.

  7. Disseminated tuberculosis after extracorporeal shock-wave lithotripsy in an AIDS patient presenting with urosepsis.

    Science.gov (United States)

    Tourchi, Ali; Ebadi, Maryam; Hosseinzadeh, Alireza; Shabaninia, Mahsa

    2014-03-01

    Haematogenous dissemination of undiagnosed urinary tuberculosis after performing extracorporeal shock-wave lithotripsy (ESWL) is extremely rare. Herein, we report a 41-year-old male who presented with urosepsis to the emergency room; catheterization was performed and retention resolved. He had a tattoo on his left arm and a five-year history of intravenous drug use. Blood tests indicated anaemia, leukocytosis, elevated CRP and ESR and mild hyponatraemia; haematuria, moderate bacteriuria and 2+ proteinuria on urinanalysis were observed. Chest X-ray revealed lesions suggestive of miliary tuberculosis, which was confirmed by chest CT scan. Brain CT and MRI suggested brain involvement in the setting of tuberculosis. On further investigations, HIV infection and hepatitis C seropositivity were detected and the patient remained in a coma for five days with a Glasgow Coma Scale of 6/15. Finally, the diagnosis of haematogenous dissemination of tuberculosis following lithotripsy was established. Anti-tuberculosis and anti-retroviral therapy were prescribed and monthly follow-up visits were scheduled. In conclusion, in a patient diagnosed with ureterolithiasis, a thorough history and physical examination, with specific attention to HIV and tuberculosis predisposing factors, should be carried out and preoperative screening tests considering the possibility of urinary tuberculosis are required. Finally, if urinary tuberculosis is detected, ESWL must be postponed until after appropriate treatment of tuberculosis. PMID:23970650

  8. Comparison of the serum sensitivity of uropathogenic strains of Escherichia coli isolated from different diagnostic groups

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    J. Vraneš,

    2005-02-01

    Full Text Available The bactericidal activity of serum caused by complement system is an important defence mechanism protecting the host organism against infection. The capacity to resist bactericidal activity of normal human serum contributes to the virulence of many gram-negative pathogens. Serum resistance in bacteria has been attributed to their surface components, but exact mechanism of resistance which most likely involves multiple factors is not well understood. In this study, the capacity of Escherichia coli to resist the bactericidal action of serum was examined in 85 clinical isolates obtained from patients with acute pyelonephritis (n=23, acute cystitis (n=22, chronic pyelonephritis (n=22 and asymptomatic bacteriuria (n=18. Serum sensitivity was also examined in relation to the serogroup specificity and expression of the different adhesins of the strains.Bacterial susceptibility to serum killing was measured by assessing regrowth after incubation in serum according to Schiller and Hatch method. The adhesins of E. coli were determined by hemagglutination and inhibition of hemagglutiation, and serotyping was performed on glass slides and confirmed using a mechanized microtechnique.The significant correlation between serum resistance of uropathogenic strains of E. coli and expression of P-fimbriae and O6 serogroup was observed.Theincidence of serum-resistant E. coli strains was significantly higher in strains isolated from urine of patients with acute pyelonephritis, as compared to strains isolated in other diagnostic groups, which is in accordance with higher virulence and invasive potential of these strains.

  9. Pathogenesis of Streptococcus urinary tract infection depends on bacterial strain and β-hemolysin/cytolysin that mediates cytotoxicity, cytokine synthesis, inflammation and virulence.

    Science.gov (United States)

    Leclercq, Sophie Y; Sullivan, Matthew J; Ipe, Deepak S; Smith, Joshua P; Cripps, Allan W; Ulett, Glen C

    2016-01-01

    Streptococcus agalactiae can cause urinary tract infection (UTI) including cystitis and asymptomatic bacteriuria (ABU). The early host-pathogen interactions that occur during S. agalactiae UTI and subsequent mechanisms of disease pathogenesis are poorly defined. Here, we define the early interactions between human bladder urothelial cells, monocyte-derived macrophages, and mouse bladder using uropathogenic S. agalactiae (UPSA) 807 and ABU-causing S. agalactiae (ABSA) 834 strains. UPSA 807 adhered, invaded and killed bladder urothelial cells more efficiently compared to ABSA 834 via mechanisms including low-level caspase-3 activation, and cytolysis, according to lactate dehydrogenase release measures and cell viability. Severe UPSA 807-induced cytotoxicity was mediated entirely by the bacterial β-hemolysin/cytolysin (β-H/C) because an β-H/C-deficient UPSA 807 isogenic mutant, UPSA 807ΔcylE, was not cytotoxic in vitro; the mutant was also significantly attenuated for colonization in the bladder in vivo. Analysis of infection-induced cytokines, including IL-8, IL-1β, IL-6 and TNF-α in vitro and in vivo revealed that cytokine and chemokine responses were dependent on expression of β-H/C that also elicited severe bladder neutrophilia. Thus, virulence of UPSA 807 encompasses adhesion to, invasion of and killing of bladder cells, pro-inflammatory cytokine/chemokine responses that elicit neutrophil infiltration, and β-H/C-mediated subversion of innate immune-mediated bacterial clearance from the bladder. PMID:27383371

  10. Urine Stasis Predisposes to Urinary Tract Infection by an Opportunistic Uropathogen in the Megabladder (Mgb Mouse.

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    Brian Becknell

    Full Text Available Urinary stasis is a risk factor for recurrent urinary tract infection (UTI. Homozygous mutant Megabladder (Mgb-/- mice exhibit incomplete bladder emptying as a consequence of congenital detrusor aplasia. We hypothesize that this predisposes Mgb-/- mice to spontaneous and experimental UTI.Mgb-/-, Mgb+/-, and wild-type female mice underwent serial ultrasound and urine cultures at 4, 6, and 8 weeks to detect spontaneous UTI. Urine bacterial isolates were analyzed by Gram stain and speciated. Bladder stones were analyzed by x-ray diffractometry. Bladders and kidneys were subject to histologic analysis. The pathogenicity of coagulase-negative Staphylococcus (CONS isolated from Mgb-/- urine was tested by transurethral administration to culture-negative Mgb-/- or wild-type animals. The contribution of urinary stasis to CONS susceptibility was evaluated by cutaneous vesicostomy in Mgb-/- mice.Mgb-/- mice develop spontaneous bacteriuria (42% and struvite bladder stones (31% by 8 weeks, findings absent in Mgb+/- and wild-type controls. CONS was cultured as a solitary isolate from Mgb-/- bladder stones. Bladders and kidneys from mice with struvite stones exhibit mucosal injury, inflammation, and fibrosis. These pathologic features of cystitis and pyelonephritis are replicated by transurethral inoculation of CONS in culture-negative Mgb-/- females, whereas wild-type animals are less susceptible to CONS colonization and organ injury. Cutaneous vesicostomy prior to CONS inoculation significantly reduces the quantity of CONS recovered from Mgb-/- urine, bladders, and kidneys.CONS is an opportunistic uropathogen in the setting of urinary stasis, leading to enhanced UTI incidence and severity in Mgb-/- mice.

  11. Urine Stasis Predisposes to Urinary Tract Infection by an Opportunistic Uropathogen in the Megabladder (Mgb) Mouse

    Science.gov (United States)

    Becknell, Brian; Mohamed, Ahmad Z.; Li, Birong; Wilhide, Michael E.; Ingraham, Susan E.

    2015-01-01

    Purpose Urinary stasis is a risk factor for recurrent urinary tract infection (UTI). Homozygous mutant Megabladder (Mgb-/-) mice exhibit incomplete bladder emptying as a consequence of congenital detrusor aplasia. We hypothesize that this predisposes Mgb-/- mice to spontaneous and experimental UTI. Methods Mgb-/-, Mgb+/-, and wild-type female mice underwent serial ultrasound and urine cultures at 4, 6, and 8 weeks to detect spontaneous UTI. Urine bacterial isolates were analyzed by Gram stain and speciated. Bladder stones were analyzed by x-ray diffractometry. Bladders and kidneys were subject to histologic analysis. The pathogenicity of coagulase-negative Staphylococcus (CONS) isolated from Mgb-/- urine was tested by transurethral administration to culture-negative Mgb-/- or wild-type animals. The contribution of urinary stasis to CONS susceptibility was evaluated by cutaneous vesicostomy in Mgb-/- mice. Results Mgb-/- mice develop spontaneous bacteriuria (42%) and struvite bladder stones (31%) by 8 weeks, findings absent in Mgb+/- and wild-type controls. CONS was cultured as a solitary isolate from Mgb-/- bladder stones. Bladders and kidneys from mice with struvite stones exhibit mucosal injury, inflammation, and fibrosis. These pathologic features of cystitis and pyelonephritis are replicated by transurethral inoculation of CONS in culture-negative Mgb-/- females, whereas wild-type animals are less susceptible to CONS colonization and organ injury. Cutaneous vesicostomy prior to CONS inoculation significantly reduces the quantity of CONS recovered from Mgb-/- urine, bladders, and kidneys. Conclusions CONS is an opportunistic uropathogen in the setting of urinary stasis, leading to enhanced UTI incidence and severity in Mgb-/- mice. PMID:26401845

  12. Prevalence of asymptomatic urinary abnormalities among adolescents

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    Mohamed Fouad

    2016-01-01

    Full Text Available To determine the prevalence of asymptomatic urinary abnormalities in adolescents, first morning clean mid-stream urine specimens were obtained from 2500 individuals and examined by dipstick and light microscopy. Adolescents with abnormal screening results were reexamined after two weeks and those who had abnormal results twice were subjected to systemic clinical examination and further clinical and laboratory investigations. Eight hundred and three (32.1% individuals had urinary abnormalities at the first screening, which significantly decreased to 345 (13.8% at the second screening, (P <0.001. Hematuria was the most common urinary abnormalities detected in 245 (9.8% adolescents who had persistent urine abnormalities; 228 (9.1% individuals had non glomerular hematuria. The hematuria was isolated in 150 (6% individuals, combined with leukocyturia in 83 (3.3% individuals, and combined with proteinuria in 12 (0.5% individuals. Leukocyturia was detected in 150 (6% of all studied adolescents; it was isolated in 39 (1.6% individuals and combined with proteinuria in 28 (1.1% of them. Asymp- tomatic bacteriuria was detected in 23 (0.9% of all studied adolescents; all the cases were females. Proteinuria was detected in 65 (2.6% of all the studied adolescents; 45 (1.8% indivi- duals had <0.5 g/day and twenty (0.8% individuals had 0.5-3 g/day. Asymptomatic urinary abnormalities were more common in males than females and adolescents from rural than urban areas (P <0.01 and (P <0.001, respectively. The present study found a high prevalence of asymptomatic urinary abnormalities among adolescents in our population.

  13. Bacterial Suppression of RNA Polymerase II-Dependent Host Gene Expression

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    Ines Ambite

    2016-07-01

    Full Text Available Asymptomatic bacteriuria (ABU is a bacterial carrier state in the urinary tract that resembles commensalism at other mucosal sites. ABU strains often lack the virulence factors that characterize uropathogenic Escherichia coli (E. coli strains and therefore elicit weak innate immune responses in the urinary tract. In addition, ABU strains are active modifiers of the host environment, which they influence by suppressing RNA polymerase II (Pol II-dependent host gene expression. In patients inoculated with the ABU strain E. coli 83972, gene expression was markedly reduced after 24 h (>60% of all regulated genes. Specific repressors and activators of Pol II-dependent transcription were modified, and Pol II Serine 2 phosphorylation was significantly inhibited, indicating reduced activity of the polymerase. This active inhibition included disease–associated innate immune response pathways, defined by TLR4, IRF-3 and IRF-7, suggesting that ABU strains persist in human hosts by active suppression of the antibacterial defense. In a search for the mechanism of inhibition, we compared the whole genome sequences of E. coli 83972 and the uropathogenic strain E. coli CFT073. In addition to the known loss of virulence genes, we observed that the ABU strain has acquired several phages and identified the lytic Prophage 3 as a candidate Pol II inhibitor. Intact phage particles were released by ABU during in vitro growth in human urine. To address if Prophage 3 affects Pol II activity, we constructed a Prophage 3 negative deletion mutant in E. coli 83972 and compared the effect on Pol II phosphorylation between the mutant and the E. coli 83972 wild type (WT strains. No difference was detected, suggesting that the Pol II inhibitor is not encoded by the phage. The review summarizes the evidence that the ABU strain E. coli 83972 modifies host gene expression by inhibition of Pol II phosphorylation, and discusses the ability of ABU strains to actively create an

  14. [The role of E. coli adhesins in the pathogenesis of urinary infection].

    Science.gov (United States)

    Dalet Escribá, F; Segovia Talero, T; del Río Pérez, G

    1991-06-01

    One thousand five hundred strains obtained from patients suffering from different clinical forms of urinary infections (UI) and dependent glands have been studied with the aim of establishing the pathogenic responsibility of E. coli adhesion protein (ADH) in urinary infections (UI). ADH were determined using agglutination techniques with guinea pig and human red cells, C. albicans and S. cerevisiae spores and GAL-GAL sensitized latex. In non complicated UI, the presence of ADH is the main invasion mechanism for E. coli. The frequency of adherent strains is very high (569/648) in acute cases (207/247 cystitis + 69/98 recurrent cystitis + 108/114 pyelonephritis + 140/154 prostatitis + 28/35 orchyepidimitis and scarce (14/184) in asymptomatic or chronic cases (6/107 bacteriurias + 7/67 prostatitis + 1/10 orchyepidimitis). A close relationship is established between the presence of ADH and clinical symptoms. The acute cases with general symptoms are caused in 85% of cases (188/216) by strains with ADH type MR specially subtype P. The acute cases with local symptoms (only urinary syndrome) are caused in 77% of cases (297/387) by strains with ADH type Ms. In complicated UI the expression of adhesion proteins does not constitute and essential requisite in order to invade the urinary tract. It is suggested that males are significantly more resistant the females to UI both parenchymal and urinary tract. It is deduced that underlying factors are more predisposing to UI the smaller the adherence rate of isolated strains is. Thus, reflux and neurogenic bladder probes are by far more aggressive alterations than prostatic adenoma, bladder tumor and lithiasis.

  15. Novel antiseptic urinary catheters for prevention of urinary tract infections: correlation of in vivo and in vitro test results.

    Science.gov (United States)

    Hachem, Ray; Reitzel, Ruth; Borne, Agatha; Jiang, Ying; Tinkey, Peggy; Uthamanthil, Rajesh; Chandra, Jyotsna; Ghannoum, Mahmoud; Raad, Issam

    2009-12-01

    Urinary catheters are widely used for hospitalized patients and are often associated with high rates of urinary tract infection. We evaluated in vitro the antiadherence activity of a novel antiseptic Gendine-coated urinary catheter against several multidrug-resistant bacteria. Gendine-coated urinary catheters were compared to silver hydrogel-coated Foley catheters and uncoated catheters. Bacterial biofilm formation was assessed by quantitative culture and scanning electron microscopy. These data were further correlated to an in vivo rabbit model. We challenged 31 rabbits daily for 4 days by inoculating the urethral meatus with 1.0 x 10(9) CFU streptomycin-resistant Escherichia coli per day. In vitro, Gendine-coated urinary catheters reduced the CFU of all organisms tested for biofilm adherence compared with uncoated and silver hydrogel-coated catheters (P < 0.004). Scanning electron microscopy analysis showed that a thick biofilm overlaid the control catheter and the silver hydrogel-coated catheters but not the Gendine-coated urinary catheter. Similar results were found with the rabbit model. Bacteriuria was present in 60% of rabbits with uncoated catheters and 71% of those with silver hydrogel-coated catheters (P < 0.01) but not in those with Gendine-coated urinary catheters. No rabbits with Gendine-coated urinary catheters had invasive bladder infections. Histopathologic assessment revealed no differences in toxicity or staining. Gendine-coated urinary catheters were more efficacious in preventing catheter-associated colonization and urinary tract infections than were silver hydrogel-coated Foley catheters and uncoated catheters.

  16. Neurogenic bladder evaluation and management after spinal cord injury: Current practice among urologists working in Saudi Arabia

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    Waleed Al Taweel

    2011-01-01

    Full Text Available Aim: The aim of this study is to determine the current trends in the management and surveillance of the NB population secondary to spinal cord injury (SCI or myelomeningocele by certified urologist working in Saudi Arabia and to compare it to the current guidelines. Materials and Methods: A cross-sectional study was conducted using a 12-points questionnaire distributed to urologists working in Saudi Arabia and registered at the Saudi medical association. The assessment and follow-up of upper and lower urinary tract function in neurogenic bladder patients, their optimal frequency and management of related infections were the topics of inquiry. Results: Of the 272 urologists surveyed, 105 responded, yielding a response rate of 38%. Eighty-nine percent of respondents said that ultrasound was their diagnostic tool of choice for upper tract evaluation. Sixty-one percent of respondents said that they would follow their patients with a multichannel urodynamic study. Forty percent of urologists stated that they would treat asymptomatic bacteriuria. Clean intermittent catheterization (CIC was the most common modality chosen for the management of neurogenic bladder in patients with emptying difficulties. Conclusion: This study confirms that most urologists in Saudi Arabia involved with neurogenic bladder management. However, more than one third of the urologists do not have urodynamic machine and only two of the reporting practitioners has a videourodynamic machine. The results emphasize the need for clear guidelines in this field of urology in Saudi Arabia. Highly specialized rehabilitation centers for neurogenic bladder secondary to SCI are required for optimal care and urologist teaching.

  17. PREDISPOSING FACTORS AND AETIOLOGY OF URINARY TRACT INFECTIONS IN PREGNANT WOMEN

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    Prem Prakash

    2016-06-01

    Full Text Available BACKGROUND Urinary tract infection (UTI is a common infection in pregnant women. It is responsible for range of complications causing perinatal and maternal morbidity and mortality. AIM To assess the associated risk factors, aetiology and their antibiogram of UTI among pregnant women. METHODOLOGY This is a cross-sectional study carried out in Department of Microbiology & Department of Obstetrics from March 2015 to February 2016. The patient details and risk factors were recorded. Midstream & catheter urine specimens from pregnant women with symptoms of UTI were collected and sent for routine microscopy, culture and sensitivity. RESULTS In 550 pregnant women, 122(22.18% had significant bacteriuria and 72(17.72% had low colony count UTI. The most affected number age group was 25-35 years (58.85% followed by 15-25 years. Of the associated risk factors, multiparity 45.31%, low socioeconomic status 42.18%, anaemia 39.06% etc. were important. Escherichia coli was most frequently isolated with a percentage of 29.14%, followed by Klebsiella species (17.49%, S. aureus (14.34% etc. Other isolated micro-organisms included Enterococci, Proteus mirabilis, Citrobacter, Pseudomonas, Acinetobacter species. The antibiotics with more than 50% sensitivity against Gram-negative isolates were Imipenem (74.7%, Levofloxacin (73.17%, Ciprofloxacin (69.10%, Amikacin (57.72%, Amoxiclav (55.28%, and Cefoperazone/Sulbactam (50.40%. The antibiotics for Gram-positive isolates were Linezolid (88.46%, Cefoxitin (78.84%, Teicoplanin (69.23% and Vancomycin (65.22%. CONCLUSION We found associated risk factors such as multiparity, low socioeconomic status, etc. E. coli was the most common bacteria isolated in our setting. Therefore, pregnant women should be assessed for associated risk factors and evaluated for the pathogenic organism during their regular follow-up. The drug sensitivity should be taken into consideration with their side effects related to pregnancy.

  18. Infarction of middle third posterior cortex of kidney: a complication of extended pyelolithotomy, intra-operative electrohydraulic lithotripsy and extraction of calyceal stones under vision using stone basket and flexible cystoscope in a spinal cord injury patient – a case report

    Science.gov (United States)

    2009-01-01

    renal calculi by discarding indwelling urinary catheters and eliminating Proteus bacteriuria. PMID:19175924

  19. Estrategias para la prevención del bajo peso al nacer en una población de alto riesgo, según la medicina basada en la evidencia.

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    Edgar Iván Ortiz

    2009-11-01

    Full Text Available Mediante el análisis de las historias clínicas de 34,983 nacimientos ocurridos en el Hospital Universitario del Valle, Cali, Colombia, de enero 1, 1997 a julio 31, 2001, se identificaron los factores de riesgo preconcepcionales y gestacionales para bajo peso al nacer y se obtuvo el riesgo atribuible en la población para cada uno de ellos, definiéndose intervenciones soportadas por la medicina basada en evidencias para su prevención. El mejoramiento del estado nutricional de la mujer en el período reproductivo, la educación y el acceso a los métodos de planificación familiar para poblaciones de alto riesgo obstétrico son las intervenciones más efectivas para prevenir el bajo peso al nacer desde la preconcepción. Un adecuado control prenatal, que se asocie con la prevención del parto pretérmino, la ruptura prematura de membranas y la preeclampsia, son las acciones más importantes para tener en cuenta durante la gestación, donde intervenciones como el diagnóstico y el manejo oportuno de la bacteriuria asintomática, las vaginosis bacterianas y los suplementos con calcio, son exitosas y tendrían gran impacto en la reducción del bajo peso al nacer. Se concluye que un programa de salud pública que contemple estos aspectos contribuiría a reducir la morbilidad y mortalidad perinatales.

  20. [Prevention of Neonatal Group B Sreptococcal Infection. Spanish Recommendations. Update 2012. SEIMC/SEGO/SEN/SEQ/SEMFYC Consensus Document].

    Science.gov (United States)

    Alós Cortés, Juan Ignacio; Andreu Domingo, Antonia; Arribas Mir, Lorenzo; Cabero Roura, Luis; de Cueto López, Marina; López Sastre, José; Melchor Marcos, Juan Carlos; Puertas Prieto, Alberto; de la Rosa Fraile, Manuel; Salcedo Abizanda, Salvador; Sánchez Luna, Manuel; Sanchez Pérez, María José; Torrejon Cardoso, Rafael

    2013-03-01

    Group B streptococci (GBS) remain the most common cause of early onset neonatal sepsis. In 2003 the Spanish Societies of Obstetrics and Gynaecology, Neonatology, Infectious Diseases and Clinical Microbiology, Chemotherapy, and Family and Community Medicine published updated recommendations for the prevention of early onset neonatal GBS infection. It was recommended to study all pregnant women at 35-37 weeks gestation to determine whether they were colonised by GBS, and to administer intrapartum antibiotic prophylaxis (IAP) to all colonised women. There has been a significant reduction in neonatal GBS infection in Spain following the widespread application of IAP. Today most cases of early onset GBS neonatal infection are due to false negative results in detecting GBS, to the lack of communication between laboratories and obstetric units, and to failures in implementing the prevention protocol. In 2010, new recommendations were published by the CDC, and this fact, together with the new knowledge and experience available, has led to the publishing of these new recommendations. The main changes in these revised recommendations include: microbiological methods to identify pregnant GBS carriers and for testing GBS antibiotic sensitivity, and the antibiotics used for IAP are updated; The significance of the presence of GBS in urine, including criteria for the diagnosis of UTI and asymptomatic bacteriuria in pregnancy are clarified; IAP in preterm labour and premature rupture of membranes, and the management of the newborn in relation to GBS carrier status of the mother are also revised. These recommendations are only addressed to the prevention of GBS early neonatal infection, are not effective against late neonatal infection.

  1. Urinary tract infections: etiology and antimicrobial susceptibility of uropathogens

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    Mario Laneve

    2009-03-01

    Full Text Available Background: Urinary tract infections are a serious health problem affecting millions of people each year.They are the second most common type of infection in the body.The objective of study was to determine the etiology and antimicrobial susceptibility patterns of urinary tract infections pathogens isolated in our Patology Clinic laboratory. Materials and Methods: During the period July 2007- July 2008,were analysed 1422 urine samples.The determination of the total microbe load were acquire with an kit of the BIO-DETECTOR while the identification of germs with Apy sistem. Antibiotic susceptibility tests were assaied with the ATB UR strip. Results: About the total of samples analysed, 320 (22% had significant bacteriuria. Escherichia coli was the most common etiologic agent isolated (62%, followed by Klebsiella ssp. (10%, Pseudomonas aeruginosa (5,95% and Proteus mirabilis (5%. Gram-positive bacteria accounted for only 7.32% , with prevalence of Staphylococcus ssp (5,32 and Enterococcus spp (2%. The most effective antibiotics for Gram- were: Imipenem, Amikacin, Ceftazidime and Cefotaxim, while for Gram+ were: Minocyclin,Vancomycin and Oxacillin. Conclusion: Escherichia coli was the microrganism more frequently isolated between Gram negative bacteria with very susceptible to Amoxicillin. Currently, the empirical use of Cotrimoxazole and Amoxicillin is not recommended for Enterobacteriaceae. Urinary tract infections are more common in women than in men. Men are more likely to get a UTI once past the age of 65. Current data on the prevalence of multidrug resistance among urinary tract isolates should be a consideration to change the current empiric treatment of IVU.

  2. Clinical Appraisal of Fosfomycin in the Era of Antimicrobial Resistance.

    Science.gov (United States)

    Sastry, Sangeeta; Clarke, Lloyd G; Alrowais, Hind; Querry, Ashley M; Shutt, Kathleen A; Doi, Yohei

    2015-12-01

    Fosfomycin is recommended as one of the first-line agents for treatment of urinary tract infections (UTIs) in the latest guidelines endorsed by the Infectious Diseases Society of America (IDSA) and the European Society for Clinical Microbiology and Infectious Diseases (ESCMID). We evaluated the use of fosfomycin among inpatients at a tertiary care hospital between 2009 and 2013. UTI cases were defined using physician diagnosis and the National Healthcare Safety Network (NHSN) surveillance definitions. The number of patients treated with fosfomycin increased from none in 2009 to 391 in 2013. Among 537 patients who received fosfomycin for any indication during this period, UTI was the most common indication (74%), followed by asymptomatic bacteriuria (10%). All except 19 patients received a single dose of fosfomycin. Escherichia coli was the most common organism involved (52%). For 119 patients with UTIs, after exclusion of those with negative urine culture results, negative urinalysis results, receipt of additional agents, or indeterminate clinical outcomes, the clinical success rate at 48 h was 74.8%. Of 89 patients who met the criteria for NHSN-defined UTIs, 89.9% had successful outcomes. Recurrent infections occurred in 4.3% of cases, and mild adverse events were observed in 2.0%. All 100 randomly selected extended-spectrum β-lactamase (ESBL)-producing E. coli clinical isolates from this period were susceptible to fosfomycin. In conclusion, the use of fosfomycin has increased substantially since implementation of the updated guidelines at this hospital. Fosfomycin was used mainly for the treatment of physician-diagnosed UTIs, and the clinical outcomes were generally favorable. Fosfomycin maintained activity against E. coli despite the increased use of the agent.

  3. Our experience on developing urinary tract infections after transrectal prostate biopsy

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    Gülay Dede

    2014-03-01

    Full Text Available Objective: Prostate cancer is a common disease in men proportionally with age. For the diagnosis of prostate cancer, prostate biopsy be performed routinely in all centers so it has become today. Complications after prostate biopsy is a surgical procedure can be seen. The most important complications are urinary tract infection and sepsis. The use of prophylactic antibiotics before the procedure reduces the risk of infectious complications. In this study, infectious complications after transrectal prostate needle biopsy were evaluated for risk reduction practices are discussed. Methods: We evaluated infective complications after transrectal prostate needle biopsy in 276 patients admitted to our hospital in October 2009- October 2011 with high level of prostate-specific antigen, abnormal signs in transrectal ultrasound, abnormal digital rectal examination due to done transrectal prostate needle biopsy. Results: Transrectal prostate needle biopsy was performed to 276 cases and 59 (21% cases with hematuria, 21 (7% cases with hematospermia, 23 (8% cases with rectal bleeding, 6 (2.1% cases with asymptomatic bacteriuria, 12 (5.3% cases with in complicated urinary tract infection was detected. Three patients (1% had sepsis. 21 (7.3% patients had positive urine culture. Of them there were 20 positive cultures of E. coli and one Klebsiella spp. respectively. All of the bacteria cultured in twenty-one patients resistant to ciprofloxacin, while 90% to amikacin, 10% to amoxicillin-clavulanate, 35% to cefuroxime sodium and 40% were susceptible to ceftriaxone. Conclusion: Transrectal prostate needle biopsies of 276 patients, 21 (7.3% patients had positive urine culture. The most frequent complication was hematuria. The most serious complication of sepsis detected in three (1% patients.

  4. Flow cytometry analysis using sysmex UF-1000i classifies uropathogens based on bacterial, leukocyte, and erythrocyte counts in urine specimens among patients with urinary tract infections.

    Science.gov (United States)

    Monsen, Tor; Rydén, Patrik

    2015-02-01

    Urinary tract infections (UTIs) are the second most common bacterial infection. Urine culture is the gold standard for diagnosis, but new techniques, such as flow cytometry analysis (FCA), have been introduced. The aim of the present study was to evaluate FCA characteristics regarding bacteriuria, leukocyturia, and erythrocyturia in relation to cultured uropathogens in specimens from patients with a suspected UTI. We also wanted to evaluate whether the FCA characteristics can identify uropathogens prior to culture. From a prospective study, 1,587 consecutive urine specimens underwent FCA prior to culture during January and February 2012. Outpatients and inpatients (79.6% and 19.4%, respectively) were included, of whom women represented 67.5%. In total, 620 specimens yielded growth, of which Escherichia coli represented 65%, Enterococcus spp. 8%, Klebsiella spp. 7%, and Staphylococcus spp. 5%. For the uropathogens, the outcome of FCA was compared against the results for specimens with E. coli and those with a negative culture. E. coli had high bacterial (median, 17,914/μl), leukocyte (median, 348/μl), and erythrocyte (median, 23/μl) counts. With the exception of Klebsiella spp., the majority of the uropathogens had considerable or significantly lower bacterial counts than that of E. coli. High leukocyte counts were found in specimens with Staphylococcus aureus, Proteus mirabilis, Pseudomonas aeruginosa, and group C streptococci. Elevated erythrocyte counts were found for P. vulgaris, P. aeruginosa, and group C streptococci, as well as for Staphylococcus saprophyticus. In essence, FCA adds new information about the bacterial, leukocyte, and erythrocyte counts in urine specimens for different uropathogens. Based on FCA characteristics, uropathogens can be classified and identified prior to culture. E. coli and Klebsiella spp. have similar FCA characteristics. PMID:25472486

  5. Toll-like receptor 4 promoter polymorphisms: common TLR4 variants may protect against severe urinary tract infection.

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    Bryndís Ragnarsdóttir

    Full Text Available BACKGROUND: Polymorphisms affecting Toll-like receptor (TLR structure appear to be rare, as would be expected due to their essential coordinator role in innate immunity. Here, we assess variation in TLR4 expression, rather than structure, as a mechanism to diversify innate immune responses. METHODOLOGY/PRINCIPAL FINDINGS: We sequenced the TLR4 promoter (4,3 kb in Swedish blood donors. Since TLR4 plays a vital role in susceptibility to urinary tract infection (UTI, promoter sequences were obtained from children with mild or severe disease. We performed a case-control study of pediatric patients with asymptomatic bacteriuria (ABU or those prone to recurrent acute pyelonephritis (APN. Promoter activity of the single SNPs or multiple allelic changes corresponding to the genotype patterns (GPs was tested. We then conducted a replication study in an independent cohort of adult patients with a history of childhood APN. Last, in vivo effects of the different GPs were examined after therapeutic intravesical inoculation of 19 patients with Escherichia coli 83972. We identified in total eight TLR4 promoter sequence variants in the Swedish control population, forming 19 haplotypes and 29 genotype patterns, some with effects on promoter activity. Compared to symptomatic patients and healthy controls, ABU patients had fewer genotype patterns, and their promoter sequence variants reduced TLR4 expression in response to infection. The ABU associated GPs also reduced innate immune responses in patients who were subjected to therapeutic urinary E. coli tract inoculation. CONCLUSIONS: The results suggest that genetic variation in the TLR4 promoter may be an essential, largely overlooked mechanism to influence TLR4 expression and UTI susceptibility.

  6. Enterococcal urinary tract infections: eight years experience at a regional hospital in Trinidad, West Indies

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective To investigate the prevalence of significant enterococcal isolates from urine and determine what factors are associated with the increased prevalence, with particular reference to antibiotic susceptibilities. Methods Retrospective analysis over an 8-year period of hospital laboratory records of urinary isolates of enterococci was done. Species were identified via colony morphology, growth in 6.5% sodium chloride and their ability to hydrolyze esculin in the presence of 40% bile salts. Susceptibility testing via the disc diffusion technique with 9 commonly used antibiotics was also done as defined by the National Committee for Clinical Laboratory Standards. Results From 39?881 urine specimens, 9116 (22.9%) were culture positive. Of this 9116, 1001 (11.0%) were enterococci, the 4th most common urinary isolate. E. coli was the most common (36.2%). Most enterococci were from pediatric patients (28.4%) and the urology unit (24.5%). All enterococci were fully sensitive to ampicillin and augmentin (amoxicillin-clavulanic acid). Sensitivity to gentamicin decreased significantly from 79% in 1990 to 58% in 1997 (P<0.005). Sensitivity to the cephalosporins and nitrofuratoin were relatively stable, but sensitivity to nalidixic acid varied. No resistance to vancomycin was detected during the study, and no cases of bacteremia complicated bacteriuria were seen. Conclusion Isolation of enterococci was relatively stable during the 8-year period, and all isolates were fully sensitive to the older β-lactams, ampicillin, cefaclor and augmentin, but displayed varying degrees of multi-resistance to other commonly used urinary agents such as nalidixic acid and co-trimoxazole (trimethoprim-sulfamethoxazole). Because of the emergence of multi-resistant enterococci in many countries, and the high cost of drugs in our society, it is imperative that vigilance be maintained in monitoring enterococcal infections in hospitals.

  7. Correlates of vaginal colonization with group B streptococci among pregnant women

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    Tsering Chomu Dechen

    2010-01-01

    Full Text Available Background: A study of genital colonization by group B streptococcus (GBS was conducted in pregnant women in their third trimester, which is a known risk factor of morbidity and mortality among newborns. Aims: The present study was undertaken to study the prevalence and the correlates of vaginal colonization by GBS among pregnant women. Setting and Design: This observational cross-sectional study was conducted during September 2002 to March 2004 on 524 pregnant women. Materials and Methods: Three high vaginal swabs were obtained from all the pregnant women admitted at term and in preterm labor. Two swabs were used for aerobic culture and the third one for gram staining. The first set of swabs was cultured on 5% Sheep blood agar plates. The second set of swabs were inoculated into Todd-Hewitt broth and then subcultured in 5% Sheep blood agar plates. The main outcome measures were the presence of GBS infection in comparison to the age group, gravida, gestational age, premature rupture of membrane (PROM, preterm labor and association with febrile spells of the present pregnancy. Results: The culture positivity rate of GBS was 4.77% and coexistent organisms isolated were Candida species (36%, Staphylococcus aureus (8% and Enterococcus species (8%. Culture positivity in the age group of 18-25 years was 5.71%, of which 5.74% were in their first pregnancy. The correlation between age group and gravida with GBS culture positivity was statistically insignificant. The culture positivity in <36 weeks of gestational age was 6.93%. This relation was statistically significant. Twenty-eight percent developed PROM. Sixty-four percent of culture positives had preterm labor. Conclusion: GBS infection among pregnant women was significantly correlated with the gestational age, PROM and preterm labor. In pregnancy GBS colonization causes asymptomatic bacteriuria or UTI. It is a well known cause of puerperal infections with amnionitis,endometritis and sepsis being

  8. NITROFURANTOIN: THE TIME-TESTED CHOICE IN UNCOMPLICATED URINARY TRACT INFECTION

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    Jayashree

    2016-04-01

    Full Text Available Uropathogenic Escherichia Coli (UPEC is the leading pathogen that causes community acquired as well as nosocomial uncomplicated urinary tract infection throughout the world. The study was conducted for one year with 2557 clinically suspected cases, both In-patients and Out-patients, to find out the most common pathogenic bacteria to cause uncomplicated urinary tract infection in a tertiary care hospital, also to determine the sensitivity pattern of the leading uropathogens against commonly prescribed antimicrobials in uncomplicated urinary tract infection. Significant bacteriuria was found in 811 cases (31.71% in this study. Amongst them, Escherichia coli was isolated in 335 (41.3% cases and female patients outnumbered the male patients (195, i.e. 58%. Enterococcus spp. (110, i.e. 13.56% heads the list of Gram positive uropathogens (155 cases, i.e. 19.11%. Candida spp. was isolated in 6.16% of total culture positive cases. Most of the isolated Escherichia coli were sensitive to nitrofurantoin (290, i.e. 87%. Majority of the nitrofurantoin sensitive Escherichia coli was found to be resistant to other broad spectrum antimicrobials. Carbapenemase producers was found to be 220 (75.86% and 255 (87.93% were Extended Spectrum Beta Lactamase (ESBL producers. Most (87.93% of the Escherichia coli isolates were resistant to Fluoroquinolones. Among nitrofurantoin resistant Escherichia coli, sensitivity to carbapenems was only 33.33%. Thus Nitrofurantoin in Urinary Tract Infection may be used as an empirical drug even in the era of super bugs

  9. A Clinical and Radiological Observation on Urolithiasis

    International Nuclear Information System (INIS)

    A clinical and radiological observation was made on 167 cases of urolithiasis among the number of 150 patients during 1 year and 6 months from June, 1981 to November, 1982. The results were summarized as follows. 1. There were 101 man and 49 women, a ratio of 2:1. The ages of the patients ranged from 2 to 74 years, showing the highest incidence in 31 to 60 years (68.1%). 2. Locational distributions of urolithiasis were 80 cases (47.9%) in the ureter, 66 cases (39.5%) in the kidney, 11 cases (6.5%) in the urethra and 10 cases (5.9%) in the bladder. 3. Among the 66 cases of renal stone, pelvis stone was 55 cases (83.3%) with staghorn types in 23 cases (34.8%), and calyceal stone was 11 cases (16.6%). 4. The location of ureteral stone was 47.5% in lower, 40% in upper ureter and 12.5% in mid-ureter. 5. The location of urethra stone was 82% in the anterior urethra and 18% in the posterior urethra. 6. The chief complain of urolithiasis was flank pain in 59.2%, gross hematuria in 20.3%, renal colic in 13.1%, dysuria in 8.3%, nausea and vomiting in 4.7%, and sudden stoppage of urine stream in 3.5%. 7. On urinalysis, gross hematuria was found in 54.4%, pyuria in 28.7%, bacteriuria in 23.3%, microscopic hematuria in 18.5% and normal in 7.1%. 8. The size of urinary stone was 0.6-2.0 cm in length in 105 cases (62.8%). 9. On I.V.P. study of renal stones (66 cases), mild and moderate hydro nephrotic changes were detected in 38 kidneys (57.5%), and the relationship between the urinary stasis and renal stone size was relatively good. 10. On I.V.P. study of ureteral stones (80 cases), mild to severe hydro nephrotic changes were detected in 64 kidneys (80%). 11. On K.U.B. film, paralytic ileus was found in 25 cases (14.9%). 12. Among the urinary stones, the radiolucent stones were detected in 8 cases (4.7%). 13. Urinary stones disappeared in 11 cases (6.5%) spontaneously or medical treatment.

  10. Potential utility of MRI in the evaluation of children at risk of renal scarring

    International Nuclear Information System (INIS)

    Background. Gadolinium-enhanced MRI has recently been employed in the diagnosis of acute pyelonephritis. Its potential utility in the diagnosis of renal scars in children is unknown. Objective. To evaluate the potential utility of MRI using fat-saturated T1-weighted (T1-W) and post-gadolinium, short-tau inversion-recovery (STIR) sequences in detecting renal scarring by comparison with technetium dimercaptosuccinic acid (99mTc-DMSA) renal scintigraphy in children at risk of renal scarring. Materials and methods. A group of 24 children with spina bifida and neurogenic bladder or anorectal anomaly was studied. No patient had a history of acute pyelonephritis. Documented urinary tract infection (UTI) was present in 10 children (42 %). The remaining 14 (58 %) children had a history of asymptomatic bacteriuria. None had clinical signs or symptoms of acute UTI at the time of the study. 99mTc-DMSA and MRI were performed to detect renal scarring. 99mTc-DMSA scans were supplemented with pinhole imaging. MRI of the kidneys employed a fat-saturated T1-W sequence and a post-gadolinium STIR sequence employing a short echo time. Results. Of the kidneys studied, 33 % (n = 16) had evidence of a renal parenchymal defect suggestive of scarring on 99mTc-DMSA. The concordance in the detection of a scarred kidney by post-gadolinium STIR sequence and 99mTc-DMSA is 94 %; that by fat-saturated T1-W sequence and 99mTc-DMSA is 82 %; that by both sequences (positive result on either sequence) and 99mTc-DMSA is 100 %. Using 99mTc-DMSA as the gold standard, MRI had a sensitivity of 100 % and a specificity of 78 % in the diagnosis of a scarred kidney. The concordance in the detection of a scarred zone by post-gadolinium STIR sequence and 99mTc-DMSA is 68 %; that by fat-saturated T1-W sequence and DMSA is 44 %; that by both sequences (positive result on either sequence) and 99mTc-DMSA is 84 %. MRI had a sensitivity of 84 % and a specificity of 86 % in the diagnosis of a scarred zone, using 99m

  11. Rapid discrimination of Gram-positive and Gram-negative bacteria in liquid samples by using NaOH-sodium dodecyl sulfate solution and flow cytometry.

    Directory of Open Access Journals (Sweden)

    Atsushi Wada

    of UTIs. The method may be easily applied in order to obtain additional information for clinical prescriptions from bacteriuria.

  12. A Clinical and Radiological Observation on Urolithiasis

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Young Sun; Byun, Moung Ho; Yoon, I Ho [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    1983-09-15

    A clinical and radiological observation was made on 167 cases of urolithiasis among the number of 150 patients during 1 year and 6 months from June, 1981 to November, 1982. The results were summarized as follows. 1. There were 101 man and 49 women, a ratio of 2:1. The ages of the patients ranged from 2 to 74 years, showing the highest incidence in 31 to 60 years (68.1%). 2. Locational distributions of urolithiasis were 80 cases (47.9%) in the ureter, 66 cases (39.5%) in the kidney, 11 cases (6.5%) in the urethra and 10 cases (5.9%) in the bladder. 3. Among the 66 cases of renal stone, pelvis stone was 55 cases (83.3%) with staghorn types in 23 cases (34.8%), and calyceal stone was 11 cases (16.6%). 4. The location of ureteral stone was 47.5% in lower, 40% in upper ureter and 12.5% in mid-ureter. 5. The location of urethra stone was 82% in the anterior urethra and 18% in the posterior urethra. 6. The chief complain of urolithiasis was flank pain in 59.2%, gross hematuria in 20.3%, renal colic in 13.1%, dysuria in 8.3%, nausea and vomiting in 4.7%, and sudden stoppage of urine stream in 3.5%. 7. On urinalysis, gross hematuria was found in 54.4%, pyuria in 28.7%, bacteriuria in 23.3%, microscopic hematuria in 18.5% and normal in 7.1%. 8. The size of urinary stone was 0.6-2.0 cm in length in 105 cases (62.8%). 9. On I.V.P. study of renal stones (66 cases), mild and moderate hydro nephrotic changes were detected in 38 kidneys (57.5%), and the relationship between the urinary stasis and renal stone size was relatively good. 10. On I.V.P. study of ureteral stones (80 cases), mild to severe hydro nephrotic changes were detected in 64 kidneys (80%). 11. On K.U.B. film, paralytic ileus was found in 25 cases (14.9%). 12. Among the urinary stones, the radiolucent stones were detected in 8 cases (4.7%). 13. Urinary stones disappeared in 11 cases (6.5%) spontaneously or medical treatment.

  13. Bacteraemia during Transurethral Resection of the Prostate: What Are the Risk Factors and Is It More Common than We Think?

    Science.gov (United States)

    West, Robert; Bhattarai, Selina; Eardley, Ian; Sandoe, Jonathan A. T.

    2016-01-01

    The aim of this work was to investigate the microbial causes, incidence, duration, risk factors and clinical implications of bacteraemia occurring during transurethral resection of the prostate (TURP) surgery to better inform prophylaxis strategies. An ethically approved, prospective, cohort study of patients undergoing TURP was conducted. Clinical information and follow-up details were collected using standardized data collection sheets. Blood was obtained for culture at 6 different time points peri-procedure. Standard of care antibiotic prophylaxis was given prior to surgery. Bacteriuria was assessed in a pre-procedure urine sample. Histopathology from all prostate chips was assessed for inflammation and malignancy. 73 patients were consented and 276 blood samples obtained. No patients developed symptomatic bacteraemia during the procedure, 17 patients developed asymptomatic bacteraemia (23.2%). Enterococcus faecalis and Pseudomonas aeruginosa were the most common organisms cultured. 10 minutes after the start of the TURP, the odds ratio (OR) of developing bacteraemia was 5.38 (CI 0.97–29.87 p = 0.05), and 20 minutes after the start of the procedure, the OR was 6.46 (CI 1.12–37.24, p = 0.03), compared to before the procedure. We also found an association between the development of intra-operative bacteraemia and recent antibiotic use (OR 4.34, CI 1.14–16.62, p = 0.032), the presence of a urinary catheter (OR 4.92, CI 1.13–21.51, p = 0.034) and a malignant histology (OR 4.90, CI 1.30–18.46, p = 0.019). There was no statistical relationship between pre-operative urine culture results and blood culture results. This study shows that asymptomatic bacteraemia is commonly caused by TURP and occurs in spite of antibiotic prophylaxis. Our findings challenge the commonly held view that urine is the primary source of bacteraemia in TURP-associated sepsis and raise the possibility of occult prostatic infection as a cause of bacteraemia. More work will be needed to

  14. Antibiotic sensitivity pattern of uropathogens from pregnant women with urinary tract infection in Abakaliki, Nigeria

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    Onoh RC

    2013-12-01

    Full Text Available RC Onoh,1 OUJ Umeora,1 VE Egwuatu,2 PO Ezeonu,1 TJP Onoh31Department of Obstetrics and Gynecology, Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria; 2Department of Obstetrics and Gynecology, Enugu State University Teaching Hospital, Enugu State, Nigeria; 3Department of Pathology, Federal Teaching Hospital Abakaliki, Ebonyi State, NigeriaBackground: Urinary tract infection (UTI is a common bacterial infection during pregnancy and a significant cause of perinatal and maternal morbidity and mortality. The causative bacteria have remained virtually the same although with variations in individual prevalence. There has been an increasing resistance by these bacteria to the commonly available antibiotics.Objectives: To determine the prevalence of UTI, the common causative bacteria, and their antibiotic sensitivity pattern among pregnant women with UTI.Methodology: This is a descriptive study that was carried out at the Obstetrics Department of two tertiary institutions in Abakaliki, Ebonyi State, Nigeria (Federal Medical Center and Ebonyi State University Teaching Hospital over a period of 12 months. Midstream urine specimens from selected pregnant women with clinical features of UTI were collected for microscopy, culture, and sensitivity. The results were analyzed with the 2008 Epi Info™ software.Results: A total of 542 pregnant women presented with symptoms of UTI and were recruited for the study over the study period. Of the 542 pregnant women, 252 (46.5% had significant bacteriuria with positive urine culture and varying antibiotic sensitivity pattern. The prevalence of symptomatic UTI was 3%. Escherichia coli was the most common bacteria isolated with a percentage of 50.8%. Other isolated micro organisms included Stapylococcus aereus (52 cultures, 20.6%, Proteus mirabilis (24 cultures, 9.5%, S. saprophyticus (18 cultures, 7.1%, Streptococcus spp. (14 cultures, 5.6%, Citrobacter spp. (5 cultures, 2.0%, Klebsiella spp. (4 cultures, 1

  15. Application of a nanotechnology antimicrobial spray to prevent lower urinary tract infection: a multicenter urology trial

    Science.gov (United States)

    2012-01-01

    Background Catheter-associated urinary tract infection (CAUTI) is a common nosocomial device-associated infection. It is now recognized that the high infection rates were caused by the formation of biofilm on the surface of the catheters that decreases the susceptibility to antibiotics and results in anti-microbial resistance. In this study, we performed an in vitro test to explore the mechanism of biofilm formation and subsequently conducted a multi-center clinical trial to investigate the efficacy of CAUTI prevention with the application of JUC, a nanotechnology antimicrobial spray. Methods Siliconized latex urinary catheters were cut into fragments and sterilized by autoclaving. The sterilized sample fragments were randomly divided into the therapy and control group, whereby they were sprayed with JUC and distilled water respectively and dried before use. The experimental standard strains of Escherichia coli (E. coli) were isolated from the urine samples of patients. At 16 hours and 7 days of incubation, the samples were extracted for confocal laser scanning microscopy. A total of 1,150 patients were accrued in the clinical study. Patients were randomized according to the order of surgical treatment. The odd array of patients was assigned as the therapy group (JUC), and the even array of patients was assigned as the control group (normal saline). Results After 16 hours of culture, bacterial biofilm formed on the surface of sample fragments from the control group. In the therapy group, no bacterial biofilm formation was observed on the sample fragments. No significant increase in bacterial colony count was observed in the therapy group after 7 days of incubation. On the 7th day of catheterization, urine samples were collected for bacterial culture before extubation. Significant difference was observed in the incidence of bacteriuria between the therapy group and control group (4.52% vs. 13.04%, p < 0.001). Conclusions In this study, the effectiveness of JUC in

  16. The Reten-World survey of the management of acute urinary retention: preliminary results.

    Science.gov (United States)

    Emberton, Mark; Fitzpatrick, John M

    2008-03-01

    Acute urinary retention (AUR) is a urological emergency characterized by a sudden and painful inability to pass urine. It represents a significant worldwide public health issue, as mortality within the year following an AUR episode appears much higher than in the general population, especially in younger patients. Management of AUR involves immediate bladder catheterization usually followed, until recently, by prostatic surgery. The greater morbidity and mortality associated with emergency surgery (within a few days after AUR), and the potential morbidity associated with prolonged catheterization (bacteriuria, fever, urosepsis) has led to an increasing use of a trial without catheter (TWOC). TWOC involves catheter removal after 1-3 days, allowing 23-40% of patients to void successfully, so that surgery can be performed at a later stage, if needed. Use of an alpha(1)-blocker before a TWOC may also be of help, as it has been demonstrated that it increases the chances of successful voiding after catheter removal. In the UK, this TWOC policy has resulted in a progressive decrease in the number of surgical procedures following a first episode of AUR, with the detriment of a slight increase in the AUR recurrence rate. Currently, there is no consensus on the optimal management of AUR in terms of type of catheterization, duration of catheterization and management following catheterization. The Reten-World survey is aimed at assessing current practice in the management of AUR in France, Asia, Latin America, North Africa and the Middle East. Interim results based on 3785 men with AUR associated with benign prostatic hyperplasia show that a urethral catheter is inserted in most cases (87%). Following this initial step, a TWOC after a median of 3 days' catheterization has become standard practice worldwide, with only a minority of men (6%) undergoing immediate surgery. Treatment with an alpha(1)-blocker before a TWOC improves the chances of success, regardless of the duration

  17. Antibacterial resistances in uncomplicated urinary tract infections in women: ECO·SENS II data from primary health care in Austria

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    Kamenski Gustav

    2012-09-01

    Full Text Available Abstract Background Uncomplicated urinary tract infections (UTI are a frequent reason for consultation of women in primary health care. To avoid therapy failure and development of resistances, the choice of an antibiotic should be based on the knowledge of recent local resistance data but these data are scarce for the Austrian primary health care sector. Within the context of the ECO·SENS II study it was the aim to obtain appropriate and relevant local resistance data and describe the changes in the resistance pattern in comparison to the ECO·SENS study. Methods 23 GPs from different parts of Austria participated in the study between July 2007 and November 2008. According to the defined inclusion- and exclusion criteria female patients with symptoms of an uncomplicated UTI were included and a midstream urine sample was collected. In case of significant bacteriuria susceptibility testing of E. coli against 14 antibiotics was performed. Descriptive statistical methods were used. Results In 313 patients included in the study, a total of 147 E. coli isolates (47% were detected and tested. The resistance rates were in %: Mecillinam (0.0, nitrofurantoin (0.7, fosfomycin trometamol (0.7, gentamycin (1.4, cefotaxime (2.7, ceftazidime (2.7, Cephadroxil (4.1 and ciprofloxacin (4.1. Higher resistance rates were found in amoxicillin/clavulanic acid (8.9, nalidixic acid (9.6, trimethoprim/sulphamethoxazole (14.4, trimethoprim (15.8, sulphamethoxazole (21.2 and ampicillin (28.8. Additionally, the comparison of these results with the results of the ECO·SENS study demonstrated an increase in resistance rates of ampicillin, amoxicillin/clavulanic acid, nalidixic acid and ciprofloxacin. Conclusions The resistance data for E. coli in uncomplicated UTIs in women gained by this study are the most recent data for this disease in Austria at the moment. The increased resistance rates of amoxicillin/clavulanic acid, ciprofloxacin and nalidixic acid should be

  18. Mapping of the Co-Transcriptomes of UPEC-Infected Macrophages Reveals New Insights into the Molecular Basis of Host-Pathogen Interactions in Human and Mouse

    KAUST Repository

    Mavromatis, Charalampos Harris

    2014-01-01

    Urinary tract infections (UTI) are among the most common infections in humans. Uropathogenic Escherichia coli (UPEC), the main causative agent of UTIs, can invade and replicate within bladder epithelial cells, and recent evidence demonstrated that some UPEC strains also survive within macrophages. To understand the mechanisms of host subversion that enable UPEC to survive within macrophages, and the contribution of macrophages to UPEC-mediated pathology, I performed hostpathogen co-transcriptome analyses using RNA sequencing. I developed an effective computational framework that simultaneously separated, annotated, and quantified the mammalian and bacterial transcriptomes. First, mouse bone morrow-derived macrophages (BMM) were challenged over a 24 h time course with UPEC reference strains, UTI89 (cystitis strain), 83972 and VR50 (asymptomatic bacteriuria strains) that possess contrasting intramacrophage phenotypes. My results showed that BMM responded to the three different UPEC strains with broadly similar gene expression programs. In contrast to the conserved pattern of BMM responses, the transcriptional responses of the different UPEC strains diverged markedly from each other. Hypothesizing that genes upregulated at 24 h post-infection may contribute to intramacrophage survival, I identified UTI89 genes upregulated at this time point, and showed that deletion of one of these genes (pspA) compromised intramacrophage survival of UPEC strain UTI89. Second, human monocyte-derived macrophages (HMDM) and BMM were challenged over a 24 h course with the UPEC strain EC958, a globally disseminated, multi-drug resistant strain. My analysis identified extensive divergence in UPEC-regulated orthologous gene expression between HMDM and BMM, and I validated both known and novel genes in the context of differential regulation. On the contrary, the transcriptional response of EC958 showed a broad conservation across both mammalian intramacrophage environments. My study thus

  19. Colonização materna e neonatal por estreptococo do grupo B em situações de ruptura pré-termo de membranas e no trabalho de parto prematuro Group B streptococcus maternal and neonatal colonization in preterm rupture of membranes and preterm labor

    Directory of Open Access Journals (Sweden)

    Marcelo Luís Nomura

    2009-08-01

    dois casos de sepse precoce por EGB nesta amostra, com prevalência de 10,8 casos por mil nascidos vivos e mortalidade de 50%. CONCLUSÕES: a amostra avaliada apresenta altas taxas de colonização materna por Streptococcus agalactiae. São necessários o uso de meio de cultura seletivo e a associação de culturas ano-retais e vaginais para aumentar a taxa de detecção do EGB. A incidência de sepse neonatal precoce foi elevada nesta população.PURPOSE: to indentify the prevalence and risk factors of maternal colonization by group B streptococcus (GBS in pregnant women with premature labor (PL and/or premature membrane rupture (PMR. METHODS: two anal and two vaginal swabs were collected from 203 pregnant women with diagnosis of PL or PMR assisted at the practice along one year. Pregnant women with imminent labor at admission were excluded. One swab of each source was placed in a transfer milieu and sent for culture in blood-agar plates; the two remaining swabs were incubated for 24 hours in Todd-Hewitt milieu for further sowing in blood-agar plates. Risk factors were analyzed by the chi-square test, Student's t-test (p-value set at 0.05 and 95% confidence interval and logistic regression. The following variables were analyzed: age, race, parity and mother schooling; culture results by source and type of culture; admission diagnosis; gestational age at admission; asymptomatic bacteriuria; gestational age at delivery; type of delivery; neonatal GBS colonization rate and immediate neonatal condition. RESULTS: prevalence of maternal GBS colonization was 27.6% (56 cases. The colonization rates according to gestational complications were 30% for PMR, 25.2% for PL and 17.8% for PL + PMR. Univariate analysis has shown that the variables Caucasian race, low level of schooling and bacteriuria were associated with higher colonization rates. Multivariate analysis showed that the presence of urinary infection was the only variable associated with maternal colonization. The GBS

  20. Envolvimento renal na salmonelose septicêmica prolongada

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    Edgar Carvalho Filho

    1977-10-01

    -proliferative glomerulonephritis in 5, a focal glomerular sclerosis in 2, in some a mesangio-proliferative glomerulonephritis and, in one, minimal histologic changes. Urinary tract infection due to Salmonella organisms (the same isolated from blood was observed in 3 cases. The ocorrurence of a similar histologic pattern of glomerular pathology in cases of prolonged septicemic salmonellosis when compared to just hepatosplenic schistosomiasis with glomerulonephritis suggested that S. mansoni infection was probahly the major determinant of the glomerular pathology. However, the high rate of urinary tract im/olvement and the disappearence of some of the alterations following effective therapy of the Salmonella bacteremia suggests an additional role of the bacterial agent as a determinant of the glomerular pathology. Also, the kidney intersticial mononuclear infiltration, more conspicuous and intense in cases of septicemic salmonellosis accompanied by bacteriuria, also suggested an immuno logical damage to the kidneys probably mediated by the salmonella infection.

  1. MICROORGANISMS ANTIBIOTIC SENSITIVITY DETERMINATION IN URINARY TRACT INFECTIONS

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    Shapovalova O.V.

    2016-06-01

    Full Text Available Introduction. Nowadays Urinary tract infections (UTI are considered to be the most common bacterial infections. Escherichia coli is the most frequently uropathogen. Other microorganisms of the genera Enterococcus, Klebsiella, Enterobacter, Proteus, Morganella, Citrobacter, Serratia, Pseudomonas, Streptococcus, Staphylococcus, Candida are also isolated with variable frequency. In recent years there has been a decreasing tendency of the causative agents of UTI sensitivity to various antibiotics, which causes growth of an inefficiency treatment risk. In connection with the above the investigations were carried out with the purpose to identify the actual causative agents of bacteriuria and their sensitivity to antibiotics and antifungal drugs. Materials and methods. Bacteriological examination of urine was performed at 42 patients of SI "Sytenko Institute of Spine and Joint Pathology, AMS of Ukraine" clinic. The bacteriological method for determining the number of bacteria in the test material, cultural and bacterioscopic methods for identifying microorganisms and disk-diffusion method for sensitivity of microorganisms to antibiotics determining were used. The clinical material for the study was an average portion of the morning urine or urine collected by catheter. The biological material collection and bacteriological examination was carried by quantitative method, the isolated microorganisms identification and their sensitivity to antibiotics determining was performed by standard methods in accordance with current guidelines. We used the following antibiotics group to determine the microorganisms sensitivity: penicillin, cephalosporin, karbapenems, tetracyclines, aminoglycoside, fluoroquinolones, oxazolidinones, macrolides, lincosamides, glycopeptides, antifungal antibiotics. Results and discussion. During the biological material study 55 isolates of bacterial and fungal pathogens were obtained. The microorganisms’ concentration in urine was in

  2. Potential utility of MRI in the evaluation of children at risk of renal scarring

    Energy Technology Data Exchange (ETDEWEB)

    Chan Yuleung; Chan Kamwing; Roebuck, D.J.; Chu, W.C.W.; Metreweli, C. [Dept. of Diagnostic Radiology and Organ Imaging, Chinese Univ. of Hong Kong, Shatin (China); Yeung Chungkwong; Lee Kimhung [Dept. of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong (China)

    1999-11-01

    Background. Gadolinium-enhanced MRI has recently been employed in the diagnosis of acute pyelonephritis. Its potential utility in the diagnosis of renal scars in children is unknown. Objective. To evaluate the potential utility of MRI using fat-saturated T1-weighted (T1-W) and post-gadolinium, short-tau inversion-recovery (STIR) sequences in detecting renal scarring by comparison with technetium dimercaptosuccinic acid ({sup 99} {sup m}Tc-DMSA) renal scintigraphy in children at risk of renal scarring. Materials and methods. A group of 24 children with spina bifida and neurogenic bladder or anorectal anomaly was studied. No patient had a history of acute pyelonephritis. Documented urinary tract infection (UTI) was present in 10 children (42 %). The remaining 14 (58 %) children had a history of asymptomatic bacteriuria. None had clinical signs or symptoms of acute UTI at the time of the study. {sup 99} {sup m}Tc-DMSA and MRI were performed to detect renal scarring. {sup 99} {sup m}Tc-DMSA scans were supplemented with pinhole imaging. MRI of the kidneys employed a fat-saturated T1-W sequence and a post-gadolinium STIR sequence employing a short echo time. Results. Of the kidneys studied, 33 % (n = 16) had evidence of a renal parenchymal defect suggestive of scarring on {sup 99} {sup m}Tc-DMSA. The concordance in the detection of a scarred kidney by post-gadolinium STIR sequence and {sup 99} {sup m}Tc-DMSA is 94 %; that by fat-saturated T1-W sequence and {sup 99} {sup m}Tc-DMSA is 82 %; that by both sequences (positive result on either sequence) and {sup 99} {sup m}Tc-DMSA is 100 %. Using {sup 99} {sup m}Tc-DMSA as the gold standard, MRI had a sensitivity of 100 % and a specificity of 78 % in the diagnosis of a scarred kidney. The concordance in the detection of a scarred zone by post-gadolinium STIR sequence and {sup 99} {sup m}Tc-DMSA is 68 %; that by fat-saturated T1-W sequence and DMSA is 44 %; that by both sequences (positive result on either sequence) and {sup 99

  3. Etiología y sensibilidad bacteriana en infección urinaria en niños. Hospital Infantil Club Noel y Hospital Universitario del Valle, Cali, Colombia

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    Consuelo de Rovetto

    2007-06-01

    Full Text Available Introducción: La infección del sistema urinario es la enfermedad renal más común en la edad pediátrica. El aislamiento del germen y el manejo temprano con el medicamento adecuado son prioritarios para evitar cicatrices renales permanentes. Objetivos: Describir los agentes patógenos causantes de infección urinaria y la sensibilidad a los antibióticos y quimioterápicos en niños atendidos en los hospitales Universitario del Valle e Infantil Club Noel en Cali, Colombia.Materiales y métodos: Se llevó a cabo un estudio descriptivo de corte transversal en niños menores de 14 años que recurrieron a los servicios de Urgencias y Consulta Externa de los hospitales Universitario e Infantil Club Noel con sospecha clínica y para-clínica de infección urinaria entre agosto, 2004 y febrero, 2005 a quienes se hizo urocultivo por punción suprapúbica, sonda vesical o micción espontánea. La definición de infección urinaria se basó en el recuento de colonias del urocultivo según el método de recolección. De los urocultivos positivos se tomó el germen y sensibilidad antibiótica. Se excluyeron niños con recuentos de colonias que no cumplían los criterios establecidos, con bacteriuria asintomática, en cateterismo intermitente, inmunocomprometidos, con vesicostomía y hospitalizados en cuidados intensivos.Resultados: De los 154 niños que ingresaron al estudio se excluyeron 31 por recuento de colonias menor al estipulado en el urocultivo. Quedaron para el análisis un total de 123 urocultivos. Se tomó por sonda vesical 50% de los urocultivos, 33 % por micción espontánea y 17% por punción suprapúbica; 58% de los pacientes era de género femenino. El germen que se aisló con más frecuencia (72% fue Escherichia coli, luego Klebsiella (16.4%, Proteus (2.5% y otros tipos de gérmenes (9%. Los antibióticos con sensibilidad mayor de 80% fueron: cefixime, norfloxacina, cefuroxima, cefprozil, ácido nalidíxico, ceftriaxone, amikacina y

  4. Maternal and neonatal risk factors for early-onset group B streptococcal disease: a case control study

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    Al-Kadri HM

    2013-10-01

    Full Text Available Hanan M Al-Kadri,1 Samira S Bamuhair,2 Sameera M Al Johani,3 Namsha A Al-Buriki,1 Hani M Tamim4 1Department of Obstetrics and Gynecology, 2Department of Basic Medical Sciences, 3Microbiology Division, 4Department of Medical Education, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia Objectives: To identify the prominent maternal and neonatal risk factors associated with early-onset group B streptococcus (EOGBS disease in neonates and to determine their importance by comparing them with a control group. Setting: Neonatal unit at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia. Patients: Cases were infants <7 days of age with invasive group B streptococcus (GBS disease diagnosed between January 1, 2000 and December 31, 2009. Controls were healthy infants born in the same hospital during the same period having the same birth weight and gestational age category. Main outcome measures: Maternal risk factors for developing EOGBS disease, feto–maternal and neonatal clinical data, their morbidities, mortalities, and length of hospital stay. Results: A total of 99 cases and 200 controls were included. The majority of cases presented in the first 72 hours of life (62/99 [63.9%], of which 87/99 (89.7% had at least one clinical risk factor for the development of EOGBS disease. Mothers of neonates with EOGBS disease were more likely to have GBS bacteriuria (odds ratio [OR] 10.76, 95% confidence interval [CI] 1.24–93.42, infection in the peripartum period (OR 8.92, CI 2.87–27.68, and temperature ≥38°C (OR 7.10, CI 2.50–20.17. GBS disease was associated with premature rupture of membranes and fetal tachycardia (P<0.01 for both. Neonates with EOGBS disease were more likely to have respiratory distress disease and convulsions, require tube feeding, and have longer hospital stays compared with the controls (P<0.01 for all. Stepwise multiple logistic

  5. 雌激素联合盆底康复治疗对绝经后女性泌尿生殖道萎缩的疗效分析%Vaginal estrogen combined with pelvic floor rehabilitation for urogenital atrophy in postmenopausal women

    Institute of Scientific and Technical Information of China (English)

    马明妍

    2015-01-01

    Objective To investigate the treatment effect of vaginal estrogen in the combination of pelvic floor rehabilitation for urogenital atrophy in postmenopausal women.Methods 197 postmenopausal women with urogenital atrophy treated at our hospital from February, 2014 to February, 2015 were selected and were randomly divided into an observation group and a control group.The control group were vaginally smeared with promestriene cream, 1 g: 0.01 g, 1 g once, once a day;when the symptoms were improved,promestriene cream was used twice a week, 1 g once, for 2 months.In addition, the observation group were treated with pelvic floor rehabilitation therapy for 2 months.The treatment effect were compared between these two groups.Results The symptoms of vaginal atrophy were much better after than before the treatment in both groups, with statistical differences (P<0.01).Urinary incontinence, vaginal dryness,dyspareunia, bacteriuria positiveness etc.were improve much more in the observation group than in the control group, with statistical differences (P<0.01).Conclusions Vaginal estrogen in the combination of pelvic floor rehabilitation for urogenital atrophy in postmenopausal women is effective and worth being clinically generalized.%目的 探讨阴道雌激素联合盆底康复对绝经后女性泌尿生殖道萎缩的治疗效果.方法 选取2014年2月至2015年2月于我院接收治疗的197例泌尿道萎缩绝经后女性,以随机分组法分为观察组与对照组,对照组患者采用普罗雌烯乳膏行阴道涂抹治疗,1g/次,1次/d,症状好转后用药改为2次/周,1g/次,治疗周期为2个月;观察组在对照组基础上,加以联合盆底康复治疗法,治疗周期为2个月.比较两组治疗效果.结果 两组患者阴道萎缩症状有明显好转,前后比较,差异有统计学意义(P<0.01);观察组患者尿失禁、阴道干涩、性交困难、菌尿阳性各顶指标好转情况均优于对照组,差异有统计学意义(P< 0.01).结论 阴

  6. Exame simples de urina no diagnóstico de infecção urinária em gestantes de alto risco Urine test to diagnose urinary tract infection in highh-risk pregant women

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    Gláucia Virgínia de Queiroz Lins Guerra

    2012-11-01

    , specificity, and positive (PPV and negative (NPV predictive values were also determined. RESULTS: When only the presence of pus cells in urinalysis was used as a diagnostic criterion suggesting bacteriuria, there was a poor agreement when compared to uroculture (K=0.16. Accuracy was 61%, sensitivity 62.5%, and specificity 60.6%. PPV was 27.78% and NPV was 87%. CONCLUSION: The presence of alteration of urinalysis does not necessarily indicate an ongoing urinary tract infection, with urine culture being necessary. However, when urinalysis data are normal, uroculture may be avoided.

  7. Estudo dos fatores de risco maternos associados à sepse neonatal precoce em hospital terciário da Amazônia brasileira Study of maternal risk factors associated with early-onset neonatal sepsis in a tertiary hospital of the Brazilian Amazonia

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    Rossiclei de Souza Pinheiro

    2007-08-01

    associations between bacterial vaginosis and isolated microorganisms found in the maternal urine culture and in the newborn blood culture in the delivery room. METHODS: randomized longitudinal cohort study involving 302 mothers and their newborns. All neonates were followed up for seven days in order to diagnose sepsis. RESULTS: the outcomes were the following: 16 (5.3% early-onset neonatal sepsis cases (incidence of 53 cases per 1,000 live births. The average number of prenatal appointments with a doctor was 5.2 (SD=1.8. The number of women with prenatal follow-up was 269 (89.1%, but only 117 (43.4% of them went to six or more medical appointments, 90 (29.8% had premature rupture of membranes before delivery, but only 22 (7.3% had it for more than 18 hours. A total of 123 women (40.7% complained of vaginal discharge, but only 47 (15.6% of them had bacterial vaginosis, 92 (30.4% complained of urinary infection, but only 23 (7.6% of them had bacteriuria, two (0.7% had fever at home, 122 (40.4% received intra-partum antibiotic prophylaxis, 40 (13.2% had premature delivery and 37 (12.3% had low-birth-weight babies. Gestational age was a significant risk factor (RR=92.9; IC95%:12.6-684.7, as well as the number of prenatal appointments (RR=10,8; IC95%:1,4-80,8, fever (RR=10,0; IC95%:2,3-43,5, low-birth-weight (RR=21,5; IC95%:7,3-63,2 and early neonatal death (RR=89,4; IC95%:11,16-720,6. A significant difference of 5% was found in the comparison of the averages of lower number of prenatal appointments, prematurity and lower birth weight. CONCLUSIONS: the major microorganism isolated in the newborns’ blood culture was the Streptococcus agalactiae. Prematurity, lack of prenatal follow up and low birth weight were the risk factors more associated with early neonatal sepsis.

  8. 细菌或真菌对UF-1000i尿沉渣分析仪红细胞检测的影响%Influence of different bacteria or fungi on the determination of urinary sediments by UF-1000i urinary sediment analyzer

    Institute of Scientific and Technical Information of China (English)

    郑沁; 赵儒; 黄茜; 熊明; 粟军

    2012-01-01

    (Staphylococcus aureus) isolated from urine specimens of urinary tract infection and low-concentration Blastomyces albicans ( < 10 mL) were not impact the urine RBC count detected by UF-l000i. High concentration bacteriuria specimens ( = 10 /mL) of Enterococcus faecalis caused the false-positive RBC count. The urine RBC count determined by UF-l000i was caused false-positive by Candida albicans,when the concentration of fungi was more than 10 /mL. The concentration of Candida albicans reached to 10 /mL,and the hematuria specimen RBC count would falsely increased (P =0. 006). Conclusions UF-l000i has special bacterial examination channel,and it could prevent the interference with urine RBC count obviously . However,it is hard to prevent the interference of high concentration fungi ,which would cause false-positive urine RBC count. It is recommended to correct the RBC count by manual microscopy in order to provide accurate laboratory results .

  9. Febrile Seizures: Etiology, Prevalence, and Geographical Variation

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    Ali DELPISHEH

    2014-07-01

    . 2004;89 (8:751–6.Bettis DB, Ater SB. Febrile seizures: Emergency department diagnosis and treatment. The Journal of Emergency Medicine. 1985;2 (5:341–8.Bauchner H, Philipp B, Dashefsky B, Klein J. Prevalence of bacteriuria in febrile children. Pediatr Infect Dis J. 1987;6 (3:239–42.Lee P, Verrier Jones K. Urinary tract infection in febrile convulsions. Arch Dis Child. 1991;66 (11:1287–90.Fukuyama Y, Seki T, Ohtsuka C, Miura H, Hara M. Practical guidelines for physicians in the management of febrile seizures. Brain and Development. 1996;18 (6:479–84.Mohebbi M, Holden KR. Febrile and afebrile or provoked and unprovoked seizures? Pediatric Neurology. 2005;32 (4:291.Fallah R, Karbasi S. Recurrence of febrile seizure in Yazd, Iran. Turk J Pediatr ;52 (6:618–22. 2010 Nov–Dec;52 (6:618–22.Ghotbi N, Soleimani S. Causes of seizures in children 1 month to 12 years. Journal Of Medical Sciences Kurdistan. 2002;7 (25:32–6.Golestani M, Fallah R, Akhavan Krbasi S. Hundred cases of cerebrospinal fluid in children hospitalized due to febrile seizures. Journal of Yazd Medical Sciences 2008;16 (5:3–7.Hassanpoor H, Ghofrani M, Taheri N, Ziaee A. Risk factors in the recurrence of seizures with fever. Journal of Iran Medical Sciences 2009;16 (65:46–54.Grossman P, Niemann L, Schmidt S, Walach H. Mindfulness–based stress reduction and health benefits: A meta–analysis. Journal of Psychosomatic Research. 2004;57 (1:35–43.Ades AE, Lu G, Higgins JP. The Interpretation of Random–Effects Meta–Analysis in Decision Models. Medical Decision Making. 2005;25 (6:646–54.Ahmadian M, Javadi N. Etiologic factors and risk factors in 211 patients with seizure. Hormozgan Med J. 1996;12 (2:145–8.Amini A, Kazemi A, Ghorbani A. Causes of Seizures in Children. Iran J Neurol. 2008;7 (24:355–60.Ashrafzadeh F, hashemzadeheh A, Malek A. Febrile seizure in children six months to six years. Iranian Journal of Otorhinolaryngology. 2001;16 (1 (35:33–9.Barzegar M, karegar mahe