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Sample records for bacteriuria

  1. Asymptomatic bacteriuria in pregnancy.

    Science.gov (United States)

    Smaill, Fiona

    2007-06-01

    Screening for asymptomatic bacteriuria is a standard of obstetrical care and is included in most antenatal guidelines. There is good evidence that treatment of asymptomatic bacteriuria will decrease the incidence of pyelonephritis. All pregnant women should be screened for asymptomatic bacteriuria, and there are no new data that would indicate otherwise. Antibiotic treatment of asymptomatic bacteriuria is associated with a decrease in the incidence of preterm delivery or low birth weight, but the methodological quality of the studies means any conclusion about the strength of this association needs to be drawn cautiously. A better understanding of the mechanism by which treatment of asymptomatic bacteriuria could prevent preterm delivery is needed. While several rapid screening tests have been evaluated, none perform adequately to replace urine culture for detecting asymptomatic bacteriuria. Until there are data from well-designed trials that establish the optimal duration of therapy for asymptomatic bacteriuria, standard treatment courses are recommended. PMID:17347050

  2. Bacteriuria asintomática Asymptomatic bacteriuria

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    V.M. García Nieto

    2011-01-01

    Full Text Available En 1956, Edward H. Kass describió, especialmente, en mujeres sanas y libres de síntomas, la existencia de lo que denominó “infecciones asintomáticas del tracto urinario”. En los años 60 y 70, la práctica cada vez más extendida y rutinaria de la realización de urocultivos, confirmó la descripción de Kass, lo que condujo a la aceptación de lo que pasó a denominarse bacteriuria asintomática o bacteriuria encubierta...

  3. Asymptomatic Bacteriuria in Pregnant Women

    OpenAIRE

    Samad Hazhir

    2007-01-01

    Introduction: The aim of this study was to evaluate the frequency of bacteriuria in pregnant women referred to the medical centers of Tabriz, Iran, for prenatal care. Materials and Methods: A total of 1100 healthy pregnant women who were referred to 50 medical centers in Tabriz for a regular prenatal care were evaluated for bacteriuria. Results: The frequency of asymptomatic bacteriuria was 6.1%. Maternal age was lower in the women with a positive urine culture (P = .02). Asymptomatic bact...

  4. Urinary Tract Infection and Bacteriuria in Pregnancy.

    Science.gov (United States)

    Glaser, Alexander P; Schaeffer, Anthony J

    2015-11-01

    Bacteriuria during pregnancy may be classified as asymptomatic bacteriuria, infections of the lower urinary tract (cystitis), or infections of the upper urinary tract (pyelonephritis). Lower tract bacteriuria is associated with an increased risk of developing pyelonephritis in pregnancy, which is itself associated with adverse maternal and fetal outcomes. Pregnant women should be screened for the presence of bacteriuria early in pregnancy. All bacteriuria in pregnancy should be treated, and antimicrobial choice in pregnancy should reflect safety for both the mother and the fetus. After treatment of bacteriuria, patients should be followed closely due to risk of recurrent bacteriuria. PMID:26475951

  5. Asymptomatic Bacteriuria and Bacterial Interference.

    Science.gov (United States)

    Nicolle, Lindsay E

    2015-10-01

    Asymptomatic bacteriuria is very common. In healthy women, asymptomatic bacteriuria increases with age, from asymptomatic bacteriuria, irrespective of age or gender. The prevalence is very high in residents of long-term-care facilities, from 25% to 50% of women and 15% to 40% of men. Escherichia coli is the most frequent organism isolated, but a wide variety of other organisms may occur. Bacteriuria may be transient or persist for a prolonged period. Pregnant women with asymptomatic bacteriuria identified in early pregnancy and who are untreated have a risk of pyelonephritis later in pregnancy of 20% to 30%. Bacteremia is frequent in bacteriuric subjects following mucosal trauma with bleeding, with 5% to 10% of patients developing severe sepsis or septic shock. These two groups with clear evidence of negative outcomes should be screened for bacteriuria and appropriately treated. Asymptomatic bacteriuria in other populations is benign and screening and treatment are not indicated. Antimicrobial treatment has no benefits but is associated with negative outcomes including reinfection with antimicrobial resistant organisms and a short-term increased frequency of symptomatic infection post-treatment. The observation of increased symptomatic infection post-treatment, however, has led to active investigation of bacterial interference as a strategy to prevent symptomatic episodes in selected high risk patients. PMID:26542046

  6. Asymptomatic bacteriuria among pregnant women

    OpenAIRE

    Sudha Biradar Kerure; Rajeshwari Surpur; Sheela S. Sagarad; Sneha Hegadi

    2013-01-01

    Background: Urinary tract infections (UTIs) are the most common bacterial infections during pregnancy. Asymptomatic bacteriuria (ASB) is a major risk factor for the development of urinary tract infections during pregnancy and with further risk of preterm birth & pyelonephritis if untreated. Aims & Objectives: This study was carried out to determine the prevalence of asymptomatic bacteriuria (ASB) in pregnant women & to isolate, identify and establish antimicrobial susceptibility of pathogens....

  7. Asymptomatic bacteriuria among pregnant women

    OpenAIRE

    Paul Erhunmwunse Imade; Patience Emiolu Izekor; Nosakhare Odeh Eghafona; Onaiwu Idahosa Enabulele; Endurance Ophori

    2010-01-01

    Background: Asymptomatic bacteriuria is the significant presence of bacteria in the urine of an individual without symptoms. In pregnancy, the apparent reduction in immunity of pregnant women tends to encourage the growth of pathogens. Aim : This study was carried out to determine the prevalence of asymptomatic bacteriuria in pregnant women attending a primary health centre in Benin City, Nigeria. Materials and Methods: A total of 1,228 pregnant women were recruited for this study. All subjec...

  8. Asymptomatic bacteriuria among pregnant women

    Directory of Open Access Journals (Sweden)

    Sudha Biradar Kerure

    2013-04-01

    Full Text Available Background: Urinary tract infections (UTIs are the most common bacterial infections during pregnancy. Asymptomatic bacteriuria (ASB is a major risk factor for the development of urinary tract infections during pregnancy and with further risk of preterm birth & pyelonephritis if untreated. Aims & Objectives: This study was carried out to determine the prevalence of asymptomatic bacteriuria (ASB in pregnant women & to isolate, identify and establish antimicrobial susceptibility of pathogens. Methods: A total of 500 pregnant women were studied over a period of one year. Clean catch midstream urine sample was collected into a sterile container & then subjected to culture method. Results: Significant bacteriuria was noted in 45 patients (9%. 3% patients had insignificant bacteriuria. Growth of contaminants was noted in 8%. 80% samples were sterile with no growth. E. coli was the most common etiological agent, followed by Staphylococcus aureus. Conclusions: Asymptomatic bacteriuria is not uncommon in antenatal patients. All pregnant women should be screened by urine culture to detect asymptomatic bacteriuria at their first visit to prevent overt UTI & other complications in both mother & fetus. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000: 213-216

  9. Asymptomatic bacteriuria among pregnant women

    Directory of Open Access Journals (Sweden)

    Paul Erhunmwunse Imade

    2010-06-01

    Full Text Available Background: Asymptomatic bacteriuria is the significant presence of bacteria in the urine of an individual without symptoms. In pregnancy, the apparent reduction in immunity of pregnant women tends to encourage the growth of pathogens. Aim: This study was carried out to determine the prevalence of asymptomatic bacteriuria in pregnant women attending a primary health centre in Benin City, Nigeria. Materials and Methods: A total of 1,228 pregnant women were recruited for this study. All subjects were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine sample was collected from each patient into sterile universal container. The urine samples were examined microscopically and by cultural method. Identification of isolates was by standard microbiological technique. Result: A total of 556 (45.3% were positive for significant bacteriuria. There was a significant difference in the prevalence of asymptomatic bacteriuria with respect to age (P < 0.0001. Trimester did not show any significant difference (P = 0.2006 in the prevalence of asymptomatic bacteriuria. Escherichia coli was the most predominant organism followed closely by Staphylococcus aureus. Ciprofloxacin, Ceftriaxone and Augmentin were found to be the most effective antibiotics against the urinary isolates. Conclusion: Asymptomatic bacteriuria is not uncommon among antenatal patients in the population studied. Routine urine cultural test should be carried out on all antenatal patients in order to identify any unsuspecting infection. This measure will go a long way in reducing maternal and obstetric complications associated with pregnancy.

  10. Asymptomatic bacteriuria among pregnant women

    Directory of Open Access Journals (Sweden)

    Paul Erhunmwunse Imade

    2010-01-01

    Full Text Available Background: Asymptomatic bacteriuria is the significant presence of bacteria in the urine of an individual without symptoms. In pregnancy, the apparent reduction in immunity of pregnant women tends to encourage the growth of pathogens. Aim : This study was carried out to determine the prevalence of asymptomatic bacteriuria in pregnant women attending a primary health centre in Benin City, Nigeria. Materials and Methods: A total of 1,228 pregnant women were recruited for this study. All subjects were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine sample was collected from each patient into sterile universal container. The urine samples were examined microscopically and by cultural method. Identification of isolates was by standard microbiological technique. Result: A total of 556 (45.3% were positive for significant bacteriuria. There was a significant difference in the prevalence of asymptomatic bacteriuria with respect to age (P < 0.0001. Trimester did not show any significant difference (P = 0.2006 in the prevalence of asymptomatic bacteriuria. Escherichia coli was the most predominant organism followed closely by Staphylococcus aureus. Ciprofloxacin, Ceftriaxone and Augmentin were found to be the most effective antibiotics against the urinary isolates. Conclusion : Asymptomatic bacteriuria is not uncommon among antenatal patients in the population studied. Routine urine cultural test should be carried out on all antenatal patients in order to identify any unsuspecting infection. This measure will go a long way in reducing maternal and obstetric complications associated with pregnancy.

  11. Incidence of Asymptomatic Bacteriuria During Pregnancy

    OpenAIRE

    M.H. Shirazi; Sadeghifard, N; R Ranjbar; E. Daneshyar; A Ghasemi

    2006-01-01

    Incidence of asymptomatic bacteriuria during pregnancy among Iranian women was examined. Midstream urine was collected from 380 pregnant women and streaked on blood agar and incubated for 24 to 48 h. Growth was considered significant if 105 mL-1 bacteria were present. Among the pregnant women, 10.1% had asymptomatic bacteriuria. Age, past history of abortion, proteinuria, level of education, number of fertility had no significant association with asymptomatic bacteriuria occurrence. But lower...

  12. Asymptomatic Bacteriuria Frequency in Pregnancy

    OpenAIRE

    Sarı O et al.

    2011-01-01

    Most of the complications caused by asymptomatic bacteriuria (ABU) in pregnancy can be avoided by early treatment. In our study, we aimed to determine the urinary infection prevalence and the pathogen agent identification in the pregnant women observing in our clinic. 240 asymptomatic pregnant women having no antibiotic treatment history during last 1 week and were enrolled to the study. Urine specimens were collected from 12th and 16th week pregnant women, and were examined by light microsco...

  13. Asymptomatic Bacteriuria Frequency in Pregnancy

    Directory of Open Access Journals (Sweden)

    Sarı O et al.

    2011-02-01

    Full Text Available Most of the complications caused by asymptomatic bacteriuria (ABU in pregnancy can be avoided by early treatment. In our study, we aimed to determine the urinary infection prevalence and the pathogen agent identification in the pregnant women observing in our clinic. 240 asymptomatic pregnant women having no antibiotic treatment history during last 1 week and were enrolled to the study. Urine specimens were collected from 12th and 16th week pregnant women, and were examined by light microscope and cultured at the mediums. Demographic data belonging to the patients (age, birth number, abortion number were recorded. Mean age was assigned as 24, 49±2, 74 (20-31 years. 104 patients (43,3% were primipara, 94 patients (39.2% had previous pregnancy and 42 patients (17,5% were multipara. 19,2% of the patients (n=46 had an abortion history. Mean value of leucocyte levels among pregnant women was assigned as 10045 / mm3 (6750-15200. Although positive urine culture ratio was 12,5% (n=30 at first visit, it was 10% (n=30 in the 12th week. Urine culture in 16th week was determined as negative in all pregnant women. When agent pathogen was analyzed from urine culture, the most common isolated microorganism that causes asymptomatic bacteriuria (ABU was Escherichia coli with ratio of 83%(n=200. Asymptomatic bacteriuria (ABU is common in pregnancy and can cause serious maternal and fetal complications if it’s not treated on time and properly. Therefore; all pregnant women should be screened at first antenatal visit for asymptomatic bacteriuria (ABU as a routine program and medical treatment should be required at the positive cases.

  14. Asymptomatic bacteriuria in antenatal women

    OpenAIRE

    Lavanya S; Jogalakshmi D

    2002-01-01

    A total of 500 antenatal women in their first or second trimesters were screened over a period of 2 years for asymptomatic bacteriuria. Out of them, 8.4% (42) were culture positive. A control group of 100 non-pregnant women, both married and unmarried, was also simultaneously screened. The control group yielded an overall culture positivity of 3% (4% in the married non-pregnant women and 2% in the unmarried women). Primigravida had highest percent culture positivit...

  15. Asymptomatic bacteriuria Escherichia coli strains

    DEFF Research Database (Denmark)

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

    2006-01-01

    Urinary tract infections (UTIs) affect millions of people each year. Escherichia coli is the most common organism associated with asymptomatic bacteriuria (ABU) in humans. Persons affected by ABU may carry a particular E. coli strain for extended periods of time without any symptoms. In contrast 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...

  16. 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

  17. Asymptomatic bacteriuria and antibacterial susceptibility during pregnancy

    OpenAIRE

    Anjana Verma; Anamika Vyas; Lalit Shrimali; Medhavi Sharma

    2016-01-01

    Background: Urinary tract infections are more common in women than in men and still more in pregnant women because of anatomical and physiological changes during pregnancy. Incidence of asymptomatic bacteriuria is 2-10% globally and it is still more in developing countries. Untreated asymptomatic bacteriuria can lead to many prenatal and maternal complications; hence early detection and treatment is of considerable importance. Methods: Total 220 pregnant women at their first visit were scr...

  18. Asymptomatic bacteriuria Escherichia coli strains

    DEFF Research Database (Denmark)

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

    2006-01-01

    Urinary tract infections (UTIs) affect millions of people each year. Escherichia coli is the most common organism associated with asymptomatic bacteriuria (ABU) in humans. Persons affected by ABU may carry a particular E. coli strain for extended periods of time without any symptoms. In contrast 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...

  19. Asymptomatic bacteriuria in antenatal women

    Directory of Open Access Journals (Sweden)

    Lavanya S

    2002-01-01

    Full Text Available A total of 500 antenatal women in their first or second trimesters were screened over a period of 2 years for asymptomatic bacteriuria. Out of them, 8.4% (42 were culture positive. A control group of 100 non-pregnant women, both married and unmarried, was also simultaneously screened. The control group yielded an overall culture positivity of 3% (4% in the married non-pregnant women and 2% in the unmarried women. Primigravida had highest percent culture positivity of 66.6%. The incidence was higher in less than 20 years age group i.e. 71.42%. Of the screening tests, Gram stained smear when compared with the standard loop method, showed the highest sensitivity of 95.2%. The specificity of the screening tests was high [Gram stained smear (98.6%, catalase test (97.1% and pus cell count(96.5%]. Escherichia coli was the most common organism isolated in the test and control groups. The organisms were sensitive to cephalexin, nitrofurantoin, amoxycillin and norfloxacin in decreasing order. Incidence of prematurity was 75% and that of low birth weight was 50% in untreated patients.

  20. 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

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

    Directory of Open Access Journals (Sweden)

    Lindsay E. Nicolle

    2016-04-01

    Full Text Available 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.

  2. 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.

  3. ASYMPTOMATIC BACTERIURIA AND PYURIA IN PREGNANCY

    OpenAIRE

    M Rahimkhani; H Khavari-Daneshvar; Sharifian, R.

    2008-01-01

    "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 examin...

  4. Asymptomatic bacteriuria and antibacterial susceptibility during pregnancy

    Directory of Open Access Journals (Sweden)

    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

  5. Asymptomatic bacteriuria among HIV positive pregnant women.

    Science.gov (United States)

    Awolude, Olutosin A; Adesina, Olubukola A; Oladokun, Adesina; Mutiu, W B; Adewole, Isaac F

    2010-01-01

    The prognostic significance of asymptomatic bacteriuria resides in the observation that the prevalence is, relatively, high in persons with certain medical conditions, such as diabetes mellitus and pregnancy. This prevalence might, even, be higher in patients with human immunodeficiency virus infection. Hence, this study set out to determine the prevalence of asymptomatic bacteriuria among symptom free and newly enrolled HIV infected pregnant women attending PMTCT unit of Antiretroviral Clinic of University College Hospital, Ibadan, Nigeria between 1st May and 30th September 2007.Information was obtained on the socio-demographic characteristics of the subjects, CD4 count and viral load. Microbial culture was carried out on aseptically collected urines from the patients. Statistical analysis was done with SPSS 12 package. There were 161 analyzable samples from the participants. The mean age and gestational age at presentation of participants was 30.49 ± 4.3 years and 27.3 ± 3.2 weeks, respectively with modal parity of 2. Twenty-five (15.5%) of the urine samples significantly grew bacteria. The CD4 cells were significantly lower and the viral loads significantly higher(250.52 vs. 355.57 cells/mm3; 88,731 vs. 55,384 copies/ml; p = asymptomatic bacteriuria among PLWHAs is high. The microbial isolate from the urine samples were not different from those of HIV-negative patients. PMID:21178431

  6. Association between Asymptomatic Bacteriuria and Pre-Eclampsia.

    Science.gov (United States)

    Rezavand, Negin; Veisi, Firooze; Zangane, Mrayam; Amini, Roghaye; Almasi, Afshin

    2016-01-01

    Asymptomatic bacteriuria is one of the most common and important bacterial infections during pregnancy and can result in progressive infections and endanger maternal as well as fetal health. In this study, we assessed the relationship between asymptomatic bacteriuria and pre-eclampsia. In this case-control study, pregnant women who presented to Imam Reza Hospital in Kermanshah in 2013-14 were studied. The minimum sample size was calculated as 125 pregnant women in each group with a total of 250 subjects. There were 125 women with pre-eclampsia and 125 women without pre-eclampsia (control group). Matching was done for age, gestational age, and parity between case and control groups. Matching was verified by a P value of 0.061 for maternal age and gestational age and 0.77 for parity. The statistical analyses were done by applying the chi-squared test and determining odds ratio (OR) for having bacteriuria in univariate logistic regression as well as multivariate regression with adjusting the effect of maternal age, gestational age, and parity. Pyuria and bacteriuria were significantly more common in pre-eclampsia group than in control group. The results showed that a significant association existed between asymptomatic bacteriuria and pre-eclampsia. The rate of asymptomatic bacteriuria was 6.8 times higher in women with pre-eclampsia compared to those without pre-eclampsia. Further studies are required for better clarification of association between asymptomatic bacteriuria and pre-eclampsia. PMID:26925912

  7. Asymptomatic Bacteriuria in Clinical Urological Practice

    DEFF Research Database (Denmark)

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

    2016-01-01

    Asymptomatic bacteriuria (ABU) is a common clinical condition that often leads to unnecessary antimicrobial use. The reduction of antibiotic overuse for ABU is consequently an important issue for antimicrobial stewardship and to reduce the emergence of multidrug resistant strains. There are two...... risk factor, and screening and treatment are not considered necessary. On the other hand, in the case of all procedures entering the urinary tract, ABU should be treated in line with the results of a urine culture obtained before the procedure. In patients affected by rUTIs, ABU can even have a...

  8. HOSPITAL BASED STUDY FOR ASYMPTOMATIC BACTERIURIA IN PREGNANT WOMEN

    OpenAIRE

    Babital; Sanjeev,; Shankar

    2013-01-01

    Asymptomatic bacteriuria (ASB) is infection in pregnancy which requires medical treatment. If left untreated, may lead to prematurity, intrauteri ne death and pyelonephrit i s. The diagnosis is done by culture and its antibiotic sensitivity helped the women in treatment.

  9. Prevalence and risk factors of asymptomatic bacteriuria in pregnancy

    OpenAIRE

    Ghafarnezhad M; Shams

    2001-01-01

    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...

  10. Prevalence and risk factors of asymptomatic bacteriuria in pregnancy1

    OpenAIRE

    Ghafarnezhad M; Shams

    2000-01-01

    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...

  11. Significant Bacteriuria Among Asymptomatic Antenatal Clinic Attendees In Ibadan, Nigeria

    OpenAIRE

    Aderemi O. Kehinde; Adedapo, Kayode S.; Aimaikhu, Christopher O.; Odukogbe, Akin-tunde A.; Olayemi, Oladapo; Salako, Babatunde

    2011-01-01

    Untreated asymptomatic bacteriuria can lead to urinary tract infection (UTI) in pregnancy with devastating maternal and neonatal effects such as prematurity and low birth weight, higher fetal mortality rates and significant maternal morbidity. We carried out a two year (April 2007 to March 2009) cross-sectional epidemiological study to determine the prevalence of significant bacteriuria among asymptomatic antenatal clinic attendees at two antenatal clinics (ANCs) in University College Hospita...

  12. Epidemiology and Clinical Outcomes of Patients with Carbapenem-Resistant Klebsiella pneumoniae Bacteriuria

    OpenAIRE

    Qureshi, Zubair A.; Syed, Alveena; Clarke, Lloyd G.; Doi, Yohei; Shields, Ryan K.

    2014-01-01

    Carbapenem-resistant Klebsiella pneumoniae (CRKP) bacteriuria is a frequently encountered clinical condition, but its clinical impact is unknown. We conducted a retrospective cohort study to define the epidemiology and outcomes for patients with CRKP bacteriuria. Patients with positive urine cultures for CRKP were classified as having asymptomatic bacteriuria (ASB) or symptomatic urinary tract infection (UTI). Among 105 patients with CRKP bacteriuria, 80% (84/105 patients) and 20% (21/105 pat...

  13. 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

    was positively associated both with bacteriuria (P = 0.002) and S. haematobium (P < 0.001). Conclusions: No association between bacteriuria and uro-genital schistosomiasis was demonstrated. Bacteriuria appears not to be a confounder for using micro-haematuria as diagnostic measure for S. haematobium...

  14. Asymptomatic bacteriuria and symptomatic urinary tract infections in pregnancy.

    Science.gov (United States)

    Schnarr, J; Smaill, F

    2008-10-01

    Symptomatic and asymptomatic bacteriuria is common in pregnant women. A history of previous urinary tract infections and low socioeconomic status are risk factors for bacteriuria in pregnancy. Escherichia coli is the most common aetiologic agent in both symptomatic and asymptomatic infection and quantitative culture is the gold standard for diagnosis. Treatment of asymptomatic bacteriuria has been shown to reduce the rate of pyelonephritis in pregnancy and therefore screening for and treatment of asymptomatic bacteriuria has become a standard of obstetrical care. Antibiotic treatment of asymptomatic bacteriuria is associated with a decrease in the incidence of low birth weight, but the methodological quality of the studies limits the strength of the conclusions that can be drawn. Debate exists in the literature as to whether treated pyelonephritis is associated with adverse fetal outcomes. There is no clear consensus in the literature on antibiotic choice or duration of therapy for infection. With increasing antibiotic resistance, consideration of local resistance rates is necessary when choosing therapy. PMID:18826482

  15. Prevalence and risk factors of asymptomatic bacteriuria in pregnancy1

    Directory of Open Access Journals (Sweden)

    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.

  16. Prevalence and risk factors of asymptomatic bacteriuria in pregnancy

    Directory of Open Access Journals (Sweden)

    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.

  17. Significant bacteriuria among asymptomatic antenatal clinic attendees in ibadan, Nigeria.

    Science.gov (United States)

    Kehinde, Aderemi O; Adedapo, Kayode S; Aimaikhu, Christopher O; Odukogbe, Akin-Tunde A; Olayemi, Oladapo; Salako, Babatunde

    2011-09-01

    Untreated asymptomatic bacteriuria can lead to urinary tract infection (UTI) in pregnancy with devastating maternal and neonatal effects such as prematurity and low birth weight, higher fetal mortality rates and significant maternal morbidity. We carried out a two year (April 2007 to March 2009) cross-sectional epidemiological study to determine the prevalence of significant bacteriuria among asymptomatic antenatal clinic attendees at two antenatal clinics (ANCs) in University College Hospital and Adeoyo Maternity Hospital, both in Ibadan, Nigeria.All consenting ANC attendees without UTI were enrolled in the study. Urine specimens of 5 to 10 ml collected from each subject were examined microscopically for white blood cells, red blood cells and bacteria. The specimens were further cultured on MacConkey agar using a sterile bacteriological loop that delivered 0.002 ml of urine. Colony counts yielding bacterial growth of more than 10(5)/ml of pure isolates were considered significant.Of the 473 subjects studied, 136 had significant bacteriuria, giving a prevalence rate of 28.8%. The highest age specific prevalence (47.8%) was found in the 25-29 year olds while only one (0.7%) was found in the teenage group. A large percentage (64.0%) of subjects with significant bacteriuria had tertiary education, compared with 4.4% who had no formal education but the association was not statistically significant (X(2) = 0.47, p = 0.79). The majority (75.8%) of subjects with significant bacteriuria had no previous history of abortion, while 20 (14.7%) had one previous abortion and only three (2.1%) admitted to three previous abortions (X(2) = 5.16, p = 0.16). The majority (69.8%) of those with significant bacteriuria presented at second trimester while 38 (28.0%) presented at third trimester (X(2) = 6.5, p = 37).Only 22 (4.6%) of the studied subjects presented at first trimester, and 3 (13.7%) of these had significant bacteriuria.The prevalence of asymptomatic bacteriuria is high

  18. Prevalence of asymptomatic bacteriuria and its consequences in pregnancy in a rural community of Bangladesh.

    Science.gov (United States)

    Ullah, M Anayet; Barman, A; Siddique, M A; Haque, A K M E

    2007-08-01

    This was a cross-sectional followed by cohort type of study conducted among the pregnant mothers of second trimester in the rural areas of Rajshahi district. Initially 1800 pregnant mothers ofsecond trimester were selected from 18 unions applying 2-stage random sampling. A total of 216 pregnant mothers with asymptomatic bacteriuria were paired among the rest of the healthy pregnant mothers (without bacteriuria) on the basis of age, gravida and economic status for cohort study to relate asymptomatic bacteriuria with the incidence of symptomatic bacteriuria, hypertensive disorders in pregnancy (HDP) and pre-term delivery. The matched paired pregnant mothers werefollowed monthly interval up to delivery. The prevalence of asymptomatic bacteriuria was 12% among the pregnant mothers in rural Rajshahi. E. Coli was the commonest causative agent of both asymptomatic and symptomatic bacteriuria. The results of this study suggest that asymptomatic bacteriuria were more prone to develop symptomatic bacteriuria, hypertensive disorders in pregnancy and pre-term delivery than that of the healthy mothers (without bacteriuria). Screening of bacteriuria in pregnancy and proper treatment must be considered as an essential part of antenatal care in this rural community. PMID:18481440

  19. HOSPITAL BASED STUDY FOR ASYMPTOMATIC BACTERIURIA IN PREGNANT WOMEN

    Directory of Open Access Journals (Sweden)

    Babital

    2013-10-01

    Full Text Available Asymptomatic bacteriuria (ASB is infection in pregnancy which requires medical treatment. If left untreated, may lead to prematurity, intrauteri ne death and pyelonephrit i s. The diagnosis is done by culture and its antibiotic sensitivity helped the women in treatment.

  20. A study on asymptomatic bacteriuria in pregnancy: prevalence, etiology and comparison of screening methods

    OpenAIRE

    Kheya Mukherjee; Saroj Golia; Vasudha CL; Babita; Debojyoti Bhattacharjee; Goutam Chakroborti

    2014-01-01

    Background: Asymptomatic bacteriuria is common in women with prevalence of 4-7% in pregnancy. The traditional reference test for bacteriuria is quantitative culture of urine which is relatively expensive time consuming and laborious. The aim of this study was to know the prevalence of asymptomatic bacteriuria in pregnancy, to identify pathogens and their antibiotic susceptibility patterns and to device a single or combined rapid screening method as an acceptable alternative to urine culture. ...

  1. 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...

  2.  Asymptomatic Bacteriuria in Antenatal Patients in Ilorin, Nigeria

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    Nanji S Ajayi

    2012-01-01

    Full Text Available  Objective: To determine the prevalence of asymptomaticbacteriuria, bacteriology and sensitivity pattern in Ilorin using thegold standard of urine culture.Methods: A prospective study was carried out from 1st Julyto 31st October 2007, at the University of Ilorin TeachingHospital (UITH on 125 consenting asymptomatic pregnantwomen. A structured proforma was used to collect informationfrom the women and a midstream urine specimen collected forbacteriological culture.Results: Of the 125 pregnant women, 50 had bacteriuria on urineculture giving a prevalence of 40�20The mean age of the womenwas 28.5 years with a standard deviation of 4.95. The age rangedbetween 14 and 40 years. Staphylococcus aureus was the commonestpathogen isolated (72� followed by Proteus spp (14� Most ofthe organisms showed good sensitivity to Nitrofurantoin andgentamicin.Conclusion: The prevalence of asymptomatic bacteriuria in Ilorinis high and routine urine culture is advocated for all pregnantwomen at booking.

  3. Asymptomatic Bacteriuria in Clinical Urological Practice: Preoperative Control of Bacteriuria and Management of Recurrent UTI

    Directory of Open Access Journals (Sweden)

    Tommaso Cai

    2016-01-01

    Full Text Available Asymptomatic bacteriuria (ABU is a common clinical condition that often leads to unnecessary antimicrobial use. The reduction of antibiotic overuse for ABU is consequently an important issue for antimicrobial stewardship and to reduce the emergence of multidrug resistant strains. There are two 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 as a risk factor, and screening and treatment are not considered necessary. On the other hand, in the case of all procedures entering the urinary tract, ABU should be treated in line with the results of a urine culture obtained before the procedure. In patients affected by rUTIs, ABU can even have a protective role in preventing symptomatic recurrence, particularly when Enterococcus faecalis (E. faecalis has been isolated.

  4. Increased serum procalcitonin levels in pregnant patients with asymptomatic bacteriuria

    OpenAIRE

    Bilir, Filiz; Akdemir, Nermin; Ozden, Selcuk; Cevrioglu, A Serhan; Bilir, Cemil

    2013-01-01

    Background Among the pregnancy urinary tract infections, asymptomatic bacteriuria (ASB) is the most common one. Untreated ASB can progress to pyelonephritis in 30-50% of the patients and can also result in prematurity in 27% of the pregnancy so it needs immediate diagnosis and treatment. In this study, we wanted to evaluate procalcitonin levels, compared to other inflammatory in pregnant women with ASB. Methods The study was designed between the period of January 2012 and February 2013 at Sak...

  5. Asymptomatic Bacteriuria and Antibacterial Susceptibility Patterns in an Obstetric Population

    OpenAIRE

    Belgin Polat; Serpil Ünlü; Sibel Saygan; Rana Karayalçin; Ayla Sargin Oruç; Şevki Çelen; Nuri Danişman

    2011-01-01

    Introduction. Asymptomatic bacteriuria (ASB), occurring in 2–11% of pregnancies, is a major predisposition to the development of pyelonephritis, which is associated with obstetrical complications, such as preterm labor and low birth weight infants. The aim of this study was to determine the prevalence of ASB, the antibacterial susceptibilities of the isolated microorganisms and the associated risk factors in an outpatient clinical setting in Zekai Tahir Burak Women's Health Education and Rese...

  6. Asymptomatic Bacteriuria in Pregnant Women in Outpatient Facilities

    OpenAIRE

    Maral G. Nogayeva; Svetlana A. Tuleutayeva

    2015-01-01

    Urinary tract morbidity has increased by 7% in Kazakhstan between 2007 to 2011. Pregnant women with extragenital pathologies or kidney diseases had the greatest prevalence of morbidity. Asymptomatic bacteriuria (AB) is one of the most important risk factors of pyelonephritis development in pregnant women, and it can affect the course and outcome of pregnancy, delivery, and postnatal period. AB prevention requires prevention of pregnancy complications including early diagnostic of urinary trac...

  7. Which antibiotics are appropriate for treating bacteriuria in pregnancy?

    Science.gov (United States)

    Christensen, B

    2000-09-01

    Bacteriuria in pregnancy, with or without clinical symptoms, is frequent. If left untreated, it can in 20-30% of cases lead to acute pyelonephritis, which is a serious threat to the mother and fetus, increasing the risk of preterm labour and low birthweight infants. This paper is a review of the literature concerning antibacterial treatment of bacteriuria in pregnancy. It is crucial to ensure that drugs to be used in pregnancy are safe and effective. Established first-line drugs such as ampicillin (pivampicillin) and amoxycillin, and other commonly used treatments such as trimethoprim-sulphamethoxazole, are associated with a high degree of resistance in Escherichia coli, the most common pathogen in the urinary tract. A recent survey of physicians in Denmark, Finland, Norway and Sweden confirms that beta-lactam antibiotics (particularly pivmecillinam) and nitrofurantoin are the drugs of first choice in the treatment of bacteriuria in pregnancy in the Nordic countries. No teratogenic effects have been associated with these agents. In contrast to nitrofurantoin, pivmecillinam is also efficient against pyelonephritis. In spite of resistance in E. coli and possible adverse effects on the fetus, many physicians still prescribe sulphonamides during the first two trimesters of pregnancy. PMID:11051621

  8. Asymptomatic Bacteriuria in Pregnant Women in Outpatient Facilities

    Directory of Open Access Journals (Sweden)

    Maral G. Nogayeva

    2015-02-01

    Full Text Available Urinary tract morbidity has increased by 7% in Kazakhstan between 2007 to 2011. Pregnant women with extragenital pathologies or kidney diseases had the greatest prevalence of morbidity. Asymptomatic bacteriuria (AB is one of the most important risk factors of pyelonephritis development in pregnant women, and it can affect the course and outcome of pregnancy, delivery, and postnatal period. AB prevention requires prevention of pregnancy complications including early diagnostic of urinary tract infections, timely optimization of therapy at outpatient facilities, and dynamic follow-up.

  9. 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...... 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...

  10. Asymptomatic group B streptococcal bacteriuria among pregnant women in Saudi Arabia.

    Science.gov (United States)

    Ahmad, S

    2015-01-01

    This study aims to determine the asymptomatic bacteriuria in pregnancy due to GBS and its antimicrobial sensitivity pattern for planning strategy for the management of these cases and also to determine the relationship between asymptomatic bacteriuria and pyuria. A total of 3863 consecutive urine specimens were collected from 3863 pregnant women with asymptomatic bacteriuria attending the obstetrics and gynaecology department of our hospital over a period of two years. Specimens were processed using standard microbiological procedures. All the subjects were evaluated for bacteriuria. The prevalence of asymptomatic bacteriuria due to group B streptococci (GBS) was 82/3863 (2.1%) among pregnant women in Saudi Arabia. Among these, 69/82 patients (84.2%) had clinical and microbiological features consistent with cystitis, versus 13/82 (15.8%) for pyelonephritis. About 51.2% (42/82) of the patients who had urine analysis performed had positive results based on positive urinary leucocyte esterase and pyuria. Disc-diffusion analysis of all 82 GBS isolates showed that they were highly susceptible to Augmentin and linezolid. Screening for bacteriuria in pregnancy and proper treatment must be considered as an essential part of antenatal care in this community. To prevent asymptomatic bacteriuria complications, all pregnant women should be screened at the first antenatal visit. A negative test for pyuria is not a reliable indicator of the absence of asymptomatic bacteriuria in pregnant women. Further, ongoing surveillance and evaluation of outcomes in pregnancies complicated by GBS bacteriuria is required to optimise maternal and newborn care. PMID:26510270

  11. Asymptomatic bacteriuria: when the treatment is worse than the disease.

    Science.gov (United States)

    Trautner, Barbara W

    2012-02-01

    Asymptomatic bacteriuria (ABU) is a condition in which bacteria are present in a noncontaminated urine sample collected from a patient without signs or symptoms related to the urinary tract. ABU must be distinguished from symptomatic UTI by the absence of signs and symptoms compatible with UTI or by clinical determination that a nonurinary etiology accounts for the patient's symptoms. Interactions between the organism, the host, and the bladder environment determine whether bacteriuria leads to ABU or to UTI. ABU is a very common condition that is often treated unnecessarily with antibiotics-it should be detected and treated in pregnant women and patients undergoing urologic surgery, but in most other patient groups, treatment does not confer benefit and can be harmful. A change in prescribing behavior for ABU has been achieved through several fairly high-intensity interventions, such as interactive educational sessions for physicians, but whether these improvements persist beyond the study period is not known. Further research is needed to determine whether screening for and treatment of ABU is beneficial in patients with renal transplants, patients with orthotopic neobladders, patients undergoing prosthetic joint implantation, and patients with neutropenia. PMID:22143416

  12. Prevalence of asymptomatic bacteriuria in antenatal women attending a tertiary care hospital

    OpenAIRE

    Ananthi Kasinathan; Prasad Thirumal

    2014-01-01

    Background: Asymptomatic bacteriuria is the presence of actively multiplying bacteria within the urinary tract in the absence of any symptoms. Antenatal women are more susceptible to urinary tract infection because of the anatomical and physiological changes which occur during pregnancy. Aim of current study was the aim of this study was to determine the prevalence of asymptomatic bacteriuria in pregnant women, the organisms responsible and to treat the same. Methods: A total of 174 antena...

  13. Asymptomatic bacteriuria & obstetric outcome following treatment in early versus late pregnancy in north Indian women

    OpenAIRE

    Jain, Vaishali; Das, Vinita; Agarwal, Anjoo; Pandey, Amita

    2013-01-01

    Background & objectives: Asymptomatic bacteriuria during pregnancy if left untreated, may lead to acute pyelonephritis, preterm labour, low birth weight foetus, etc. Adequate and early treatment reduces the incidence of these obstetric complications. The present study was done to determine presence of asymptomatic bacteriuria (ASB) and obstetric outcome following treatment in early versus late pregnancy. Methods: A prospective cohort study was conducted at a tertiary care teaching hospital of...

  14. Asymptomatic bacteriuria and urinary tract infections in women: focus on diabetes mellitus and pregnancy

    OpenAIRE

    Schneeberger, Caroline

    2014-01-01

    There is a shortage of evidence for clinical guidelines on diagnosis and management of both asymptomatic bacteriuria (the presence of bacteria in urine without symptoms of an infection) and urinary tract infections in women with diabetes and pregnant women. Asymptomatic bacteriuria and urinary tract infections in these two risk groups may have far-reaching consequences such as pyelonephritis and preterm birth. The results of the studies in this thesis can be used to fill some of the knowledge...

  15. Asymptomatic Bacteriuria in Ante-Natal Patients Attending State Hopital, Ado-Ekiti , Ekiti State, Nigeria

    OpenAIRE

    Ilusanya, O. A. F.; T.O. Adesetan; H.O. Egberongbe; A.T. Otubushin

    2012-01-01

    To evaluate the prevalence, predisposing factors and aetiological agents of asymptomatic bacteriuria in pregnant women attending antenatal clinic at State Hospital, Ado-Ekiti, Ekiti State, Nigeria. One hundred (100) pregnant women were screened. Clean catch midstream urine samples were collected, examined microscopically and cultured. Questionnaires were administered to determine the possible predisposing factors to asymptomatic bacteriuria. 52(52%) out of the 100 women screened were positive...

  16. Bacteriuria amongst Pregnant Women in the Buea Health District, Cameroon: Prevalence, Predictors, Antibiotic Susceptibility Patterns and Diagnosis

    OpenAIRE

    Mokube, Morike Ngoe; Atashili, Julius; Halle-Ekane, Gregory Edie; Ikomey, George M.; Ndumbe, Peter M

    2013-01-01

    Background Bacteriuria is associated with significant maternal and foetal risks. However, its prevalence is not known in our community. Objectives This study was carried out to determine the prevalence and predictors of bacteriuria in pregnant women of the Buea Health District (BHD) as well as the antibiotic sensitivity patterns of bacterial isolates. It also sought to determine the diagnostic performance of the nitrite and leucocyte esterase tests in detecting bacteriuria in these women. Met...

  17. [The management of asymptomatic bacteriuria in different patient population].

    Science.gov (United States)

    Ivanov, M-L; Malinverni, R

    2008-11-12

    Who should be screened for asymptomatic bacteriuria (AB) and who should be treated? This review updates some aspects of the management of AB in different patient populations. A systematic screening for AB is recommended for pregnant women because of a significant risk of complications. In these cases as well as before any uro-gynecologic surgical procedure treatment of AB is strongly recommended. The management of AB in immunosuppressed or transplanted patients is more controversial. In other populations treating AB is not recommended and the outcome seems to be worse in case of treatment due to possible side effects and selection of resistant organisms. Recent studies have shown a considerable gap between clinical practice and recommendations. PMID:19086489

  18. Asymptomatic bacteriuria: prevalence rates of causal microorganisms, etiology of infection in different patient populations, and recent advances in molecular detection.

    Science.gov (United States)

    Ipe, Deepak S; Sundac, Lana; Benjamin, William H; Moore, Kate H; Ulett, Glen C

    2013-09-01

    Bacteriuria, or the presence of bacteria in urine, is associated with both asymptomatic and symptomatic urinary tract infection and underpins much of the dynamic of microbial colonization of the urinary tract. The prevalence of bacteriuria in dissimilar patient groups such as healthy adults, institutionalized elderly, pregnant women, and immune-compromised patients varies widely. In addition, assessing the importance of 'significant bacteriuria' in infected individuals represents a diagnostic challenge, partly due to various causal microorganisms, and requires careful consideration of the distinct etiologies of bacteriuria in different populations and circumstances. Recent molecular discoveries have revealed how some bacterial traits can enable organisms to grow in human urine, which, as a fitness adaptation, is likely to influence the progression of bacteriuria in some individuals. In this review, we comprehensively analyze currently available data on the prevalence of causal organisms with a focus on asymptomatic bacteriuria in dissimilar populations. We evaluate recent advances in the molecular detection of bacteriuria from a diagnostic viewpoint and briefly discuss the potential benefits and some of the challenges of these approaches. Overall, this review provides an update on the comparative prevalence and etiology of bacteriuria from both microbiological and clinical perspectives. PMID:23808987

  19. Prevalence of Asymptomatic Bacteriuria and its Antibacterial Susceptibility Pattern Among Pregnant Women Attending the Antenatal Clinic at Kanpur, India

    OpenAIRE

    Sujatha, R.; Nawani, Manju

    2014-01-01

    Background: Symptomatic and asymptomatic bacteriuria (ASB) is common in pregnant women. Pregnancy enhances the progression from ASB to symptomatic bacteriuria, which if left untreated, could lead to acute pyelonephritis and other adverse outcomes such as prematurity, postpartum, hypertensive disease, anaemia, UTIs and higher foetal mortality rates.

  20. Prevalence of asymptomatic bacteriuria and associated risk factors among antenatal women attending a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Aruna Rajkumari

    2011-07-01

    Full Text Available Asymptomatic bacteriuria (ASB is the commonest bacterial infec-tion which requires medical treatment in pregnancy. Untreated ASB in 25-30% of can cases lead to pyelonephritis which may lead to increased risk of abortions, intrauterine fetal deaths, prematurity and low birth weight. A cross-sectional study was conducted at Gandhi Hospital over a period of ten months with 125 asymptomatic pregnant women in the age group of 15-35 years. The objectives of the study were to determine prevalence of asymptomatic bacteriuria, to identify its risk factors and to compare the screening methods. Of the 125 pregnant women, significant bacteriuria was seen in 21 (16%. The prevalence of bacteriuria showed a rise with increasing maternal age and increasing gestational period. Anemics and hypertensives were at greater risk. The most common isolates were Klebsiella pneumoniae and Staphylococcus aureus (28% each. Culture proved to be the gold standard for diagnosis. Catalase and Nitrate reduction tests were used as screening methods with a sensitivity of 90.48% and 71.43% respectively. Multiple drug resistance was observed in Gram-positive and Gram-negative isolates. Routine screening for asymptomatic bacteriuria is therefore recommended throughout pregnancy to avoid adverse fetal and maternal outcomes.

  1. Asymptomatic Bacteriuria in Ante-Natal Patients Attending State Hopital, Ado-Ekiti , Ekiti State, Nigeria

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    O.A.F. Ilusanya

    2012-04-01

    Full Text Available To evaluate the prevalence, predisposing factors and aetiological agents of asymptomatic bacteriuria in pregnant women attending antenatal clinic at State Hospital, Ado-Ekiti, Ekiti State, Nigeria. One hundred (100 pregnant women were screened. Clean catch midstream urine samples were collected, examined microscopically and cultured. Questionnaires were administered to determine the possible predisposing factors to asymptomatic bacteriuria. 52(52% out of the 100 women screened were positive for asymptomatic bacteriuria. 6(11.5% out of these had mixed bacterial growth while 46(88.5% subjects had one type of bacteria. 36% had non-significant bacterial growth. 12(12% yielded viable growth of Candida albicans. Staphylococcus aureus was the predominant bacteria followed by Escherichia coli. Pregnant women in their third trimester had the highest prevalence of asymptomatic bacteriuria (60.3%. The age group 30-40 years had the highest prevalence (62.5%.Women with parity range of 1-2 has the highest prevalence rate of 80% while the least 27.3% was found in parity range of 0 (no previous pregnancy Full time housewives had highest prevalence while Christian pregnant women had higher prevalent rate (66.7% than their Muslim counterparts (58.1% Routine screening of the urine of pregnant women for asymptomatic bacteriuria and personal hygiene was emphasized so as to reduce maternal and foetal complications associated with pregnancy.

  2. Post-stroke bacteriuria among stroke patients attending a physiotherapy clinic in Ghana: a cross-sectional study

    Science.gov (United States)

    Donkor, Eric S; Akumwena, Amos; Amoo, Philip K; Owolabi, Mayowa O; Aspelund, Thor; Gudnason, Vilmundur

    2016-01-01

    Background Infections are known to be a major complication of stroke patients. In this study, we evaluated the risk of community-acquired bacteriuria among stroke patients, the associated factors, and the causative organisms. Methods This was a cross-sectional study involving 70 stroke patients and 83 age- and sex-matched, apparently healthy controls. Urine specimens were collected from all the study subjects and were analyzed by standard microbiological methods. Demographic and clinical information was also collected from the study subjects. For stroke patients, the information collected also included stroke parameters, such as stroke duration, frequency, and subtype. Results Bacteriuria was significantly higher among stroke patients (24.3%, n=17) than among the control group (7.2%, n=6), with a relative risk of 3.36 (confidence interval [CI], 1.40–8.01, P=0.006). Among the control group, all six bacteriuria cases were asymptomatic, whereas the 17 stroke bacteriuria cases comprised 15 cases of asymptomatic bacteriuria and two cases of symptomatic bacteriuria. Female sex (OR, 3.40; CI, 1.12–10.30; P=0.03) and presence of stroke (OR, 0.24; CI, 0.08–0.70; P=0.009) were significantly associated with bacteriuria. The etiology of bacteriuria was similar in both study groups, and coagulase-negative Staphylococcus spp. were the most predominant organisms isolated from both stroke patients (12.9%) and the control group (2.4%). Conclusion Stroke patients in the study region have a significantly higher risk of community-acquired bacteriuria, which in most cases is asymptomatic. Community-acquired bacteriuria in stroke patients appears to have little or no relationship with clinical parameters of stroke such as stroke subtype, duration and frequency. PMID:27051289

  3. Asymptomatic bacteriuria and antibacterial susceptibility patterns in an obstetric population.

    Science.gov (United States)

    Celen, Sevki; Oruç, Ayla Sargin; Karayalçin, Rana; Saygan, Sibel; Unlü, Serpil; Polat, Belgin; Danişman, Nuri

    2011-01-01

    Introduction. Asymptomatic bacteriuria (ASB), occurring in 2-11% of pregnancies, is a major predisposition to the development of pyelonephritis, which is associated with obstetrical complications, such as preterm labor and low birth weight infants. The aim of this study was to determine the prevalence of ASB, the antibacterial susceptibilities of the isolated microorganisms and the associated risk factors in an outpatient clinical setting in Zekai Tahir Burak Women's Health Education and Research Hospital in Ankara, Turkey. Material and Methods. Between December 2009 and May 2010, pregnant women admitted to the antenatal outpatient clinic were included in this study. The results of a complete urine analysis, midstream urine culture and antibacterial susceptibility were evaluated. Results. Of the 2011 pregnant women included, 171 had ASB (8.5%). E. coli was the most frequently isolated microorganism (76.6%), followed by Klebsiella pneumonia (14.6%). Both microorganisms were highly sensitive to fosfomycin, sensivity being 99.2% for E. coli and 88% for Klebsiella pneumonia. Conclusions. In this certain geographical region, we found E. coli as the most common causative agent of ASB in the obstetric population and it is very sensitive to fosfomycin. We recommend fosfomycin for ASB in pregnant women due to its high sensitivity, ease of administration and safety for use in pregnancy. PMID:21647231

  4. Asymptomatic Bacteriuria among Pregnant Women Attending An-tenatal Clinic at the University Hospital, Kumasi, Ghana

    Directory of Open Access Journals (Sweden)

    Acheampong, I.

    2012-01-01

    Full Text Available The apparent decline in immunity of pregnant women appears to promote the growth of both com-mensal and non-commensal microorganisms. The objective of the study was to determine the prevalence of asymptomatic bacteriuria in pregnant women visiting the University hospital, Ku-masi. This prospective hospital-based study was carried out between April-June 2009. A total of 200 pregnant women were recruited for this study. The ages of the women ranged from 15 to 46 years. About 5-10mls of clean catch urine was cultured on Cysteine Lactose Electrolyte Deficient (CLED agar aerobically at 37oC . Isolates were identified to the species level using standard proto-col. Antibiotic sensitivity test were carried out using the Kirby-Bauer disc diffusion method. Of the 200 women examined, 19 had significant bacteriuria representing a prevalence of 9.5% in the study population. Pregnant women in their second trimester from the study had the highest prevalence of significant bacteriuria (52.6% with age ranges between 30-34 years having the highest prevalence (36.8%. Nulliparous women were 35 (17.5% with 3 (8.6% testing positive for bacteriuria and 165 (82.5% were multiparous with 16 (9.7% testing positive for bacteriuria. E. coli (36.8% was the common bacteria isolate from this study. From this study, asymptomatic bacteriuria is common among antenatal women in the population studied. It is therefore recommended that periodic test-ing of pregnant women is advocated and those found to be infected need to be treated to avoid complications.

  5. A study on asymptomatic bacteriuria in pregnancy: prevalence, etiology and comparison of screening methods

    Directory of Open Access Journals (Sweden)

    Kheya Mukherjee

    2014-06-01

    Full Text Available Background: Asymptomatic bacteriuria is common in women with prevalence of 4-7% in pregnancy. The traditional reference test for bacteriuria is quantitative culture of urine which is relatively expensive time consuming and laborious. The aim of this study was to know the prevalence of asymptomatic bacteriuria in pregnancy, to identify pathogens and their antibiotic susceptibility patterns and to device a single or combined rapid screening method as an acceptable alternative to urine culture. Methods: Clean catch mid-stream urine were collected from 250 pregnant women aged between 18-45 years attending antenatal clinic, for a period of one year (November 2008-2009. Screening tests such as gram staining of uncentrifuged urine, pus cell count, nitrite test and leukocyte esterase test were done. Identification of organisms and antibiotic sensitivity tests were performed as per standard methods. Results: Out of the 250 pregnant women, 21 (8.4% had significant bacteriuria. High percentage of asymptomatic bacteriuria was seen in 2nd trimester (42.86% and in primigravidas (52.38%. E. coli (57.14% was the most common organism. Among screening tests gram staining of uncentrifuged urine had a sensitivity of 85.71%. Nitrite and leukocyte esterase tests alone showed sensitivity of 71.42%. However, the combination of these two tests, either tests positive, showed sensitivity and negative predictive value of 90.47% and 99.09% respectively. Conclusion: Asymptomatic bacteriuria in pregnancy can be identified by simple and combined rapid screening methods and urine culture along with antibiogram so that early treatment can be started thereby preventing complications. [Int J Res Med Sci 2014; 2(3.000: 1085-1091

  6. ASYMPTOMATIC BACTERIURIA AMONG PREGNANT WOMEN ATTENDING THE OUTPATIENT CLINIC OF CHITWAN MEDICAL COLLEGE TEACHING HOSPITAL, CHITWAN, NEPAL

    Directory of Open Access Journals (Sweden)

    Mamata Sharma Neupane

    2012-11-01

    Full Text Available Urinary Tract Infection (UTI refers to both microbial colonization of the urine and tissue invasion of any structure of the urinary tract. Pregnancy enhances the progression from asymptomatic to symptomatic bacteriuria which could lead to pyelonephritis and adverse obstetric outcomes such as prematurity, low-birth weight, and higher fetal mortality rates. This study was undertaken to determine the prevalence of asymptomatic bacteriuria in pregnancy; its causative agents and their antimicrobial susceptibility pattern, and also to determine the relationship between asymptomatic bacteriuria and pyuria. The total number of participants who finished the study was 392. The mean age of the participants was 29.76 ± 6.71(range, 21-37 years. Of the 392 urine specimens processed, 102 (26.0% showed significant bacteriuria. The commonest organism causing bacteriuria was Escherichia coli. The sensitivity pattern of the isolated organisms revealed that all were sensitive to ciprofloxacin and gentamicin at very high percentage. 200 (51.5% women had more than 5 pus cells in urine specimens from which 50 (12.75% had positive cultures. Women with higher number of pus cells in urine specimen had significantly higher asymptomatic bacteriuria (p < 0.0001.In conclusion, screening of bacteriuria in pregnancy and proper treatment must be considered as an essential part of antenatal care in Nepalese community. To prevent asymptomatic bacteriuria complications, all pregnant women should be screened at the first antenatal visit. A negative test for pyuria is not a reliable indicator of the absence of asymptomatic bacteriuria in pregnant women.

  7. Analysis of the disagreement between automated bioluminescence-based and culture methods for detecting significant bacteriuria, with proposals for standardizing evaluations of bacteriuria detection methods.

    OpenAIRE

    Nichols, W. W.; Curtis, G D; Johnston, H H

    1982-01-01

    A fully automated method for detecting significant bacteriuria is described which uses firefly luciferin and luciferase to detect bacterial ATP in urine. The automated method was calibrated and evaluated, using 308 urine specimens, against two reference culture methods. We obtained a specificity of 0.79 and sensitivity of 0.75 using a quantitative pour plate reference test and a specificity of 0.79 and a sensitivity of 0.90 using a semiquantitative standard loop reference test. The majority o...

  8. Virulence potential of Escherichia coli strains causing asymptomatic bacteriuria during pregnancy.

    Science.gov (United States)

    Lavigne, Jean-Philippe; Boutet-Dubois, Adeline; Laouini, Dorsaf; Combescure, Christophe; Bouziges, Nicole; Marès, Pierre; Sotto, Albert

    2011-11-01

    We compared the virulence properties of a collection of asymptomatic bacteriuria (ABU) Escherichia coli strains to urinary tract infection (UTI) strains isolated from pregnant women in a university hospital over 1 year. The in vitro and in vivo studies suggest that ABU strains presented a virulence behavior similar to that of strains isolated from cases of cystitis. PMID:21918033

  9. Diagnosis of Asymptomatic Bacteriuria and Associated Risk Factors Among Pregnant Women in Mangalore, Karnataka, India

    OpenAIRE

    Rajaratnam, Annie; Baby, Neha Maria; Thomas S Kuruvilla; Machado, Santhosh

    2014-01-01

    Background: Asymptomatic bacteriuria (AB) is common inwomen and increases in prevalence with age or sexual activity. Prompt detection and treatment of this condition and associated factors decreases complications like acute pyleonephritis, intrauterine growth retardation and preterm labour. Chromogenic media is a versatile tool in rapid primary screening of the causative organisms considerably reducing daily routine workload.

  10. [Application of Monural to treat pregnant women with asymptomatic bacteriuria and acute cystitis].

    Science.gov (United States)

    Michova, M; Ivanov, St; Batashki, I

    2009-01-01

    Asymptomatic bacteriuria (AB) and cystitis affect 4-9% of pregnancies and are associated with pyelonephritis and preterm labor. Screening for AB and adequate antimicrobal therapy prevent most of these serious complications. Twenty- nine pregnant patients, suffering from AB and 9 cases with cystitis were treated with single dose Monura (Fosfomycin trometamol) in a prospective study. PMID:20387275

  11. Asymptomatic bacteriuria in pregestational diabetic pregnancies and the role of group B streptococcus.

    Science.gov (United States)

    Alvarez, Jesus R; Fechner, Adam J; Williams, Shauna F; Ganesh, Vijaya L; Apuzzio, Joseph J

    2010-03-01

    We sought to determine if gravidas with pregestational diabetes mellitus (DM) are at increased risk for asymptomatic bacteriuria (ASB) compared with nondiabetic gravidas. This is a retrospective case-control study of 150 pregnant patients with pregestational DM and 294 nondiabetic controls. Rates of ASB and any colony count of group B streptococcus (GBS) bacteriuria were reviewed. The incidence of ASB among pregestational diabetics was higher compared with nondiabetic gravidas (18% versus 8.2%, odds ratio [OR] 2.47, 95% confidence interval [CI] 1.37 to 4.45). GBS was the most common organism in diabetic gravidas (26%). There was no difference in incidence of ASB recurrence (OR 1.26, 95% CI 0.37 to 4.36), but antibiotic resistance was higher in the control group (OR 0.28, 95% CI 0.09 to 0.91). Diabetic gravidas with ASB or any level of GBS bacteriuria had higher hemoglobin A (1c) values compared with diabetics without ASB (8.31 +/- 1.89 versus 7.31 +/- 1.84, P = 0.0035). Our results demonstrate that gravidas with DM are at increased risk of ASB including GBS bacteriuria compared with non-diabetic gravidas. PMID:19834868

  12. Is a chlorhexidine reaction test better than dipsticks to detect asymptomatic bacteriuria in pregnancy?

    Science.gov (United States)

    Okusanya, B O; Aigere, E O S; Eigbefoh, J O; Okome, G B O; Gigi, C E

    2014-01-01

    Detection of asymptomatic bacteriuria (ASB) in pregnancy is important to avert the attendant morbidities. Therefore, we assessed the use of chlorhexidine reaction to detect ASB in pregnancy. This was a prospective study, which compared chlorhexidine reaction with dipstick tests and urine culture in 150 asymptomatic pregnant women. Urine cultures detected bacteriuria in seven women (4.7%). Chlorhexidine detected ASB in 72 women (48%) and had sensitivity, specificity and accuracy of 100%, 54% and 56%, respectively. Leucocyte esterase (LE) and nitrite detected bacteriuria in 31 (20.7%) women and 12 (8.0%) women, respectively. Singly, LE had a sensitivity and specificity of 14.3% and 79%, respectively, while nitrite's sensitivity and specificity was 42.9% and 93.7%, respectively. Combined, LE and nitrite had better sensitivity (97.9%) and accuracy (94%). Since the accuracy of chlorhexidine is low, other than urine culture, combined dipstick urinalysis of leucocyte esterase and nitrite tests is good to detect asymptomatic bacteriuria in pregnancy. PMID:24359043

  13. Virulence Potential of Escherichia coli Strains Causing Asymptomatic Bacteriuria during Pregnancy ▿

    OpenAIRE

    Lavigne, Jean-Philippe; Boutet-Dubois, Adeline; Laouini, Dorsaf; Combescure, Christophe; Bouziges, Nicole; Marès, Pierre; Sotto, Albert

    2011-01-01

    We compared the virulence properties of a collection of asymptomatic bacteriuria (ABU) Escherichia coli strains to urinary tract infection (UTI) strains isolated from pregnant women in a university hospital over 1 year. The in vitro and in vivo studies suggest that ABU strains presented a virulence behavior similar to that of strains isolated from cases of cystitis.

  14. ASYMPTOMATIC BACTERIURIA AMONG PREGNANT WOMEN ATTENDING THE OUTPATIENT CLINIC OF CHITWAN MEDICAL COLLEGE TEACHING HOSPITAL, CHITWAN, NEPAL

    OpenAIRE

    Mamata Sharma Neupane; Kalpana Sharma Dhakal; Harish Chandra Neupane; Shital Adhikari; Bijay Aryal

    2012-01-01

    Urinary Tract Infection (UTI) refers to both microbial colonization of the urine and tissue invasion of any structure of the urinary tract. Pregnancy enhances the progression from asymptomatic to symptomatic bacteriuria which could lead to pyelonephritis and adverse obstetric outcomes such as prematurity, low-birth weight, and higher fetal mortality rates. This study was undertaken to determine the prevalence of asymptomatic bacteriuria in pregnancy; its causative agents and their antimicrobi...

  15. Analysis of Escherichia coli Strains Causing Bacteriuria during Pregnancy: Selection for Strains That Do Not Express Type 1 Fimbriae

    OpenAIRE

    Graham, J. C.; Leathart, J. B. S.; Keegan, S. J.; Pearson, J.; Bint, A; Gally, D.L.

    2001-01-01

    Escherichia coli isolates from patients with bacteriuria of pregnancy were compared by PCR with isolates from patients with community-acquired cystitis for the presence of established virulence determinants. The strains from patients with bacteriuria of pregnancy were less likely to carry genes for P-family, S-family, and F1C adhesins, cytotoxic necrotizing factor 1, and aerobactin, but virtually all of the strains carried the genes for type 1 fimbriae. Standard mannose-sensitive agglutinatio...

  16. Asymptomatic bacteriuria among antenatal women attending a tertiary care hospital in Kanchipuram: evaluation of screening tests and antibiotic susceptibility pattern

    OpenAIRE

    Abirami Lakshmy Jayachandran; Ukkiravel Gnanasambandam; Balan K.; Sangeetha, A.V.; T. S. Vijayalakshmi

    2016-01-01

    Background: Asymptomatic bacteriuria (ASB) occurring in pregnant women can lead onto complications like acute pyelonephritis, hypertensive disease of pregnancy, premature delivery and intrauterine growth retardation if untreated. Methods: The present study aims to estimate the occurrence of asymptomatic bacteriuria in antenatal women and to study the antibiotic susceptibility pattern of the isolates. The Gram staining, pus cell count and culture was performed for 120 urine samples. Antibi...

  17. Maternal Group B Streptococcal (GBS) Genital Tract Colonization at Term in Women who Have Asymptomatic GBS Bacteriuria

    OpenAIRE

    McKenna, David S.; Ike Northern; Scott Matson

    2003-01-01

    Objective: To determine the rate of positive group B streptococcus (GBS) cultures at 35–37 weeks gestation in women who have first trimester asymptomatic GBS bacteriuria. Methods: Pregnant women with asymptomatic first trimester GBS bacteriuria had genital cultures for GBS performed at 35–37 weeks gestational age. Serotyping was performed by the standard Lancefield capillary precipitin method. Results: Fifty-three women with positive urine cultures had genital cultures performed at 35–37 week...

  18. A study of risk factors and consequences of asymptomatic bacteriuria in pregnant women and feto-maternal outcome

    OpenAIRE

    Prasanna Byna; Naimisha Muvva; Swathi Kolli; Mahaboob V. Shaik

    2015-01-01

    Background: The present study is undertaken to know the risk factors and consequences of asymptomatic bacteriuria in pregnant women attending Narayana Medical College Hospital, Nellore. Methods: 500 pregnant women were recruited for the study after their consent for participation. 85 women with culture positive for ASB were paired with 85 healthy pregnant women without bacteriuria to compare feto maternal outcome. Results: Antenatal complications like anemia (35%), PROM (14%), preter...

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Evaluation of reagent strips in detecting asymptomatic bacteriuria in early pregnancy: prospective case series.

    OpenAIRE

    Tincello, D. G.; Richmond, D. H.

    1998-01-01

    OBJECTIVE: To evaluate the performance of reagent test strips in screening pregnant women for asymptomatic bacteriuria at their first visit to an antenatal clinic. DESIGN: Prospective case series. SETTING: Antenatal clinic of a large inner city maternity hospital. SUBJECTS: All women attending for their first antenatal clinic. Patients taking antibiotics for any reason and those with urinary tract symptoms were excluded. INTERVENTION: A midstream urine specimen was divided; half was sent for ...

  2. Evaluation of various screening tests to detect asymptomatic bacteriuria in pregnant women

    OpenAIRE

    Jayalakshmi J; Jayaram V

    2008-01-01

    To evaluate the diagnostic efficacy of various screening tests in detecting asymptomatic bacteriuria among pregnant women. Clean catch midstream urine specimens were collected from 630 consecutive pregnant women and processed. Forty-four (7.4%) of the urine samples were culture positive, with Escherichia coli as the predominant organism isolated (57.4%). The results of the four screening tests, viz., Gram′s staining of uncentrifuged urine, pus cell count, nitrite test and...

  3. Asymptomatic bacteriuria among pregnant women referred to outpatient clinics in Sanandaj, Iran

    OpenAIRE

    Kalantar Enayat; Farhadifar Fariba; Nikkho Bahram

    2008-01-01

    OBJECTIVES: Determine the prevalence of asymptomatic urinary tract infection (AUTI) among pregnant women. We also determined the antibacterial susceptibility of the isolates to various antibiotics and associated risk factors in AUTI. MATERIALS AND METHODS: One thousand five hundred and five consecutive pregnant women were included in the study. Mid-stream urine specimen for complete examination of urine was obtained. RESULTS: Of 1505 pregnant women, 134 (8.9%) had bacteriuria. The mean age of...

  4. Asymptomatic bacteriuria among women on their 12 to 16 weeks of pregnancy.

    OpenAIRE

    Harold Fernando Maldonado Cárdenas; Lily Yadira Antolinez Ardila; Marcela Nancy Carolina Solano Prada; Mónica Liliana Tejeiro Rico; Andrés Ricardo Valbuena Parra

    2005-01-01

    The asymptomatic bacteriuria (AB) refers to the bacterial colonization of the urinary tract that multiply in an active way without producing any symptoms. The prevalence varies between 4 to 7% and the consequences of having this pathology are the development of pyelonephritis or may be the cause for early deliveries and low-weight babies. Objectives. To determine the AB prevalence among women in their 12 to 16 weeks of pregnancy, attending a prenatal clinic at two medical institutions in the ...

  5. Asymptomatic bacteriuria: predisposing factors and correlation with preterm labor in low resource settings

    OpenAIRE

    Meenakshi Lallar; Anam ul Haq; Rajesh Nandal

    2014-01-01

    Background: Infection of urinary tract occurs frequently during pregnancy ranging from Asymptomatic Bacteriuria (ASB) to potentially life threatening acute pyelonephritis. The incidence varies from 5% to 20% and it is an important risk factor for preterm labor and perinatal morbidity and mortality. The present study was performed to correlate preterm labor and to define other risk factors associated with ASB like gravida status, socioeconomic status, and anaemia in pregnant women with ASB in ...

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

    OpenAIRE

    Onu FA; Ajah LO; Ezeonu PO; Umeora OUJ; Ibekwe PC; Ajah MI

    2015-01-01

    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...

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

    OpenAIRE

    Sugandha Srivastava; Jyotsna Agarwal; Bharti Mishra; Richa Srivastava

    2016-01-01

    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 o...

  8. 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...

  9. 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...

  10. Urinary Catheter Dependent Loops as a Potential Contributing Cause of Bacteriuria: An Observational Study.

    Science.gov (United States)

    Wuthier, Phil; Sublett, Karen; Riehl, Lance

    2016-01-01

    Urologic studies suggest that urinary catheter dependent loops (tubing low points) may be a contributing cause of bacteriuria and urinary tract infection among catheterized patients. The means by which this type of contaminant transmission occurs, however, remains poorly understood. An observational, cross-sectional study was conducted to provide a foundational look at catheter dependent loops and their possible role in catheter-acquired urinary tract infections, and as a building block for further research. PMID:27093758

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

    Directory of Open Access Journals (Sweden)

    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.

  12. 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.

  13. Use of antibiotics to treat bacteriuria of pregnancy in the Nordic countries. Which antibiotics are appropriate to treat bacteriuria of pregnancy?

    Science.gov (United States)

    Christensen, B

    2001-04-01

    Bacteriuria in pregnancy with or without clinical symptoms is frequent and increases the risk of pyelonephritis, preterm labour, and low birth weight infants. Commonly used antibiotics such as ampicillin (pivampicillin), amoxicillin, trimethoprim, and sulphonamide are currently associated with a high degree of resistance of the most common pathogen in the urinary tract, Escherichia coli. During the past few decades a number of new and efficient antibacterial antibiotics have been developed. The presumption that a specific drug is safe for both the pregnant woman and the foetus depends on how widely the drug has been used. A recent survey among general practitioners and obstetricians in Denmark, Finland, Norway, and Sweden confirmed that the beta-lactam antibiotic pivmecillinam and nitrofurantoin are the most commonly used agents in the treatment of bacteriuria in pregnancy in the Nordic countries. However, a surprisingly high number of physicians reported that they prescribe sulphonamides during the first two trimesters in spite of resistance of E. coli and possible adverse effects on the foetus. PMID:11295409

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

    Science.gov (United States)

    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

  15. Asymptomatic bacteriuria among pregnant women referred to outpatient clinics in Sanandaj, Iran

    Directory of Open Access Journals (Sweden)

    Kalantar Enayat

    2008-12-01

    Full Text Available OBJECTIVES: Determine the prevalence of asymptomatic urinary tract infection (AUTI among pregnant women. We also determined the antibacterial susceptibility of the isolates to various antibiotics and associated risk factors in AUTI. MATERIALS AND METHODS: One thousand five hundred and five consecutive pregnant women were included in the study. Mid-stream urine specimen for complete examination of urine was obtained. RESULTS: Of 1505 pregnant women, 134 (8.9% had bacteriuria. The mean age of the all the pregnant women included in the study was 28.40 years with a standard deviation of 6.16. Age ranged from 15 to 45 years of age. The urine culture of the asymptomatic pregnant women (1505 cases showed growth in only 134 cases (8.9%. Escherichia coli was the commonest organism 79 (58.96% followed by CN Staphylococcus 22 (16.8% and S aureus 18 (13.43%. Escherichia coli, which comprised 58.96% (79 of the isolates, were 88.62%, 87.35%, and 83.55% sensitive to cefotaxime, ciprofloxacin and cefotizoxime respectively. Similarly, E. coli were 89%, 70%, and 20% resistant to ampicillin, cotrimoxazole, and nitrofurantoin respectively (OR 1.57 95% CI 1.01, 2.44. After analyzing, four variables, hemoglobin levels seem to be independently associated with asymptomatic bacteriuria (OR = 9.41 (1.65-50.38. CONCLUSION: Prevalence of asymptomatic bacteriuria among pregnant women was 8.9%. The predominant organisms were Escherichia coli 79 (58.96%, followed by CN Staphylococcus 22 (16.8%. Most strains of Escherichia coli showed that they were resistant to ampicillin, tetracycline and gentamicin.

  16. Asymptomatic Bacteriuria among Pregnant Women Attending An-tenatal Clinic at the University Hospital, Kumasi, Ghana

    OpenAIRE

    Acheampong, I.; N. Amidu; Bio, F.Y.; Quaye, L; Obirikorang, C.; Addo, K.

    2012-01-01

    The apparent decline in immunity of pregnant women appears to promote the growth of both com-mensal and non-commensal microorganisms. The objective of the study was to determine the prevalence of asymptomatic bacteriuria in pregnant women visiting the University hospital, Ku-masi. This prospective hospital-based study was carried out between April-June 2009. A total of 200 pregnant women were recruited for this study. The ages of the women ranged from 15 to 46 years. About 5-10mls of clean ca...

  17. Prevalence of asymptomatic bacteriuria and associated risk factors among antenatal women attending a tertiary care hospital

    OpenAIRE

    Aruna Rajkumari; Humera Qudsia Fatima Ansari

    2011-01-01

    Asymptomatic bacteriuria (ASB) is the commonest bacterial infec-tion which requires medical treatment in pregnancy. Untreated ASB in 25-30% of can cases lead to pyelonephritis which may lead to increased risk of abortions, intrauterine fetal deaths, prematurity and low birth weight. A cross-sectional study was conducted at Gandhi Hospital over a period of ten months with 125 asymptomatic pregnant women in the age group of 15-35 years. The objectives of the study were to determine prevalence o...

  18. 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

    Many bacterial infections are associated with biofilm formation. In the urinary tract bacterial biofilms develop on both living surfaces and artificial implants, producing chronic and often intractable infections. Escherichia coli is the most common organism associated with urinary tract infections....... 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...... 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....

  19. Asymptomatic bacteriuria in pregnant mothers: a valid and cost-effective screening test in Bangladesh.

    Science.gov (United States)

    Ullah, A; Barman, A; Ahmed, I; Salam, A

    2012-01-01

    In Bangladesh, a number of screening tests for asymptomatic bacteriuria in pregnancy are in practice. The objective of this study was to assess the validity and cost-effectiveness of these screening tests. A total of 600 apparently healthy pregnant mothers were included in this study. The validity of the screening tests was calculated against the urine culture as 'gold standard'. Incremental cost-effective ratio between the screening test methods and the least costly method (microscopic urine analysis) was calculated. Bacterial count/oil-immersion field in Gram-stained smear of urine was the most sensitive (91.7%) and specific (97.2%). Incremental cost per additional positive cases of bacterial count, leukocyte esterase and combination of leukocyte esterase and nitrite were US$3, US$25 and US$23, respectively. Gram staining may be the alternative approach to traditional routine urinalysis for the screening of asymptomatic bacteriuria during pregnancy in clinical practice in Bangladesh, as well as other developing countries. PMID:22185534

  20. Prevalence of asymptomatic bacteriuria in antenatal women attending a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Ananthi Kasinathan

    2014-04-01

    Methods: A total of 174 antenatal women of and #8804;28 weeks of gestation who had no clinical features of urinary tract infection were recruited for this study over a period of 6 months. Midstream urine sample was collected and sent for routine examination and culture-sensitivity testing. Results: Significant bacteriuria was detected in 22 (12.6% antenatal women. Of them 13 (59.1% belonged to the age group 26-30 years. Nearly half of the culture positive cases, that is 10 (45.5% were educated upto primary school and they belonged to socioeconomic status class 4. Majorities (68% were in the second trimester of pregnancy and the commonest organism isolated was E. coli. Conclusions: Undetected and untreated asymptomatic bacteriuria leads to chronic drug resistant infection, hypertension, anemia, etc. in the mother and prematurity, intrauterine growth restriction etc. in the fetus. Hence it is important to do urine culture for all women during antenatal check-up. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 437-441

  1. 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.

  2. 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.

  3. 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...... 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....

  4. A comparative trial of pivmecillinam and ampicillin in bacteriuria of pregnancy.

    Science.gov (United States)

    Bint, A; Bullock, D; Reeves, D; Wilkinson, P

    1979-01-01

    A comparative trial of pivmecillinam and ampicillin was performed on 100 women with bacteriuria of pregnancy. They received either 400 mg pivmecillinam four times daily or 500 mg ampicillin four times daily for seven days. Cure rates at two weeks were 88% in the pivmecillinam group and 85% in the ampicillin group. At six weeks the respective rates were 76% and 64%. Failure of therapy was not associated with the appearance of bacterial resistance in either treatment group. Side-effects, particularly vomiting and premature cessation of therapy, were significantly more frequent in the pivmecillinam group. No significant effects on liver function were found. In subsequent patients treated in a non-comparative manner with 200 mg pivmecillinam three times daily, the incidence of side effects was markedly reduced with no loss of efficacy. PMID:232697

  5. Comparison of pivmecillinam and cephradine in bacteriuria in pregnancy and in acute urinary tract infection.

    Science.gov (United States)

    Brumfitt, W; Franklin, I; Hamilton-Miller, J; Anderson, F

    1979-01-01

    48 non-pregnant domiciliary patients referred by general practitioners and 50 pregnant women were treated for bacteriuria with either 500 mg cephradine or 400 mg pivmecillinam every 6 h for 7 days. In the pregnant women, cure rates were over 90% after 2 weeks for both compounds, and after 6 weeks were 86% for cephradine and 78% for pivmecillinam. Cure rates in the non-pregnant were 83% for cephradine and 95% for pivmecillinam at 6 weeks. Seven patients (3 given cephradine, 4 given pivmecillinam) stopped treatment due to side-effects. Overall, side-effects (many of which were trivial) were more common in patients treated with cephradine (51%) than in those receiving pivmecillinam (33%). It is concluded that both drugs are highly effective in these two common types of urinary infection. PMID:231299

  6. 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

    be found in CFT073, and genes on six of the seven pathogenicity islands were expressed in 83972. Despite the very different patient symptom profiles, the two strains seem to be very similar. Genes expressed in CFT073 but not in 83972 were identified and can be considered as virulence factor......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...

  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. The...... prototype ABU E. coli strain 83972 was originally isolated from a girl who had carried it asymptomatically for 3 years. Deliberate colonization of UTI-susceptible individuals with E. coli 83972 has been used successfully as an alternative approach for the treatment of patients who are refractory 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...

  8. 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...... strains 83972 and VR50. Significant differences in expression levels were seen between the biofilm expression profiles of the two strains with the corresponding planktonic expression profiles in morpholinepropanesulfonic acid minimal laboratory medium and human urine; 417 and 355 genes were up- and down...... 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...

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

    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

  11. A STUDY ON THE PREVALENCE OF ASYMPTOMATIC BACTERIURIA AND THEIR ANTIBIOGRAM PATTERN AMONG PREGNANT WOMEN IN A TERTIARY CARE HOSPITAL

    OpenAIRE

    Madhu; Nithyalakshmi; Sumathi; Swapna

    2014-01-01

    BACKGROUND: Asymptomatic bacteriuria (ASB) is common in pregnancy, if left untreated it may lead to adverse maternal and fetal complications like abortion, premature delivery and low birth weight. Early diagnosis and treatment have reduced the risk of pyelonephritis in pregnant women with ASB from 20-30% to 2-4% Increasing Resistance trends of uropathogens to commonly prescribed first line antibiotics has posed a great threat with limited therapeutic options. AIMS & OBJECT...

  12. Pattern of microbial isolates and microbial sensitivity among HIV positive pregnant women with asymptomatic bacteriuria in Zaria, Nigeria

    OpenAIRE

    Pam S; Shittu S.O; Olayinka A.T; Adaji S.E; Ejembi J

    2015-01-01

    Background: Asymptomatic bacteruria in pregnancy is a common condition affecting pregnant women because of both anatomical and physiological changes in pregnancy. This condition appears to be commoner in people living with HIV because of the added immunosuppression caused by the virus. Aim: The study was to identify the pattern of microbial isolates and microbial sensitivity among HIV positive pregnant women with asymptomatic bacteriuria in Zaria, Nigeria. Methods: This was a p...

  13. INCIDENCE OF ASYMPTOMATIC BACTERIURIA IN ANTE- NATAL PATIENTS ATTENDING GENERAL HOSPITAL MINNA – NIGER STATE

    OpenAIRE

    Daniyan S. Y.; M. E. Abalaka

    2010-01-01

    Objective: To evaluate the occurrences of asymptomatic bacteriuria among healthy pregnant women attending ante-natal clinic of General Hospital Minna, Nigeria. To test for sensitivity to commonly used treatments. Methodology: Two hundred mid- stream urine samples were collected in a sterile universal bottle. The cultured plates were examined. The morphological and biochemical characteristics were determined. Results: The bacteria isolates recovered from urine samples includes E. coli 32 (51.6...

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

    OpenAIRE

    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. A STUDY ON THE PREVALENCE OF ASYMPTOMATIC BACTERIURIA AND THEIR ANTIBIOGRAM PATTERN AMONG PREGNANT WOMEN IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Madhu

    2014-07-01

    Full Text Available BACKGROUND: Asymptomatic bacteriuria (ASB is common in pregnancy, if left untreated it may lead to adverse maternal and fetal complications like abortion, premature delivery and low birth weight. Early diagnosis and treatment have reduced the risk of pyelonephritis in pregnant women with ASB from 20-30% to 2-4% Increasing Resistance trends of uropathogens to commonly prescribed first line antibiotics has posed a great threat with limited therapeutic options. AIMS & OBJECTIVES: The present study was carried out to determine the prevalence of asymptomatic bacteriuria in pregnant women attending antenatal clinic of our tertiary care hospital and also to study the bacteriological profile and determine antimicrobial susceptibility pattern of the pathogens responsible for Asymptomatic Bacteriuria. SETTINGS & DESIGN: A Cross sectional study. METHODS & MATERIALS: Midstream urine samples from 281 pregnant women without urinary symptoms who attended antenatal clinic during March 2012 and March 2013 were included in this study. Samples were processed and isolates were identified as per the CLSI guidelines. Antibiotic susceptibility was done by Kirby bauer disk diffusion method. RESULTS: The overall prevalence of ASB was 13.87%. There was no significant association of ASB occurrence with respect to age [P>0.05]. A significant association with gravid status and trimester [P<0.001] was observed. Escherichia coli was the most predominant with total 26 [66.66%] followed by Staphylococcus aureus 6[15.38%], Klebsiella pneumoniae 5[12.82%] and CONS 2[5.13%]. Amoxicillin [96%], Norfloxacin [84%], ceftriaxone [89%] and Augmentin [94%] were found to be the most effective antibiotics against the uropathogens isolated. CONCLUSIONS: Our study revealed that Asymptomatic bacteriuria is not uncommon in our population studied. Keeping in view that screening, often prevents severe complications, we emphasize the need to include urine culture as a part of antenatal care in

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

    Directory of Open Access Journals (Sweden)

    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.

  17. 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, ...

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

    Directory of Open Access Journals (Sweden)

    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

  19. Evaluation of various screening tests to detect asymptomatic bacteriuria in pregnant women.

    Science.gov (United States)

    Jayalakshmi, J; Jayaram, V S

    2008-01-01

    To evaluate the diagnostic efficacy of various screening tests in detecting asymptomatic bacteriuria among pregnant women. Clean catch midstream urine specimens were collected from 630 consecutive pregnant women and processed. Forty-four (7.4%) of the urine samples were culture positive, with Escherichia coli as the predominant organism isolated (57.4%). The results of the four screening tests, viz., Gram's staining of uncentrifuged urine, pus cell count, nitrite test and leukocyte esterase (LE) test, were compared against urine culture. Gram's stain of the uncentrifuged urine was found to be the single most useful test with a sensitivity and negative predictive value (NPV) of 85.1% and 98.8%, respectively. Pus cell count was the least sensitive. Neither the nitrite test nor the LE test alone was sensitive enough with 74.4% and 61.7%, respectively. However, when either or both tests positive were considered, it increased the sensitivity and NPV comparable with Gram's staining results, with 82.9% and 98.8%, respectively. With the potential to be used as an office diagnostic procedure, the combined nitrite and LE dipstick test may provide an acceptable alternative. PMID:18723963

  20. Evaluation of various screening tests to detect asymptomatic bacteriuria in pregnant women

    Directory of Open Access Journals (Sweden)

    Jayalakshmi J

    2008-07-01

    Full Text Available To evaluate the diagnostic efficacy of various screening tests in detecting asymptomatic bacteriuria among pregnant women. Clean catch midstream urine specimens were collected from 630 consecutive pregnant women and processed. Forty-four (7.4% of the urine samples were culture positive, with Escherichia coli as the predominant organism isolated (57.4%. The results of the four screening tests, viz., Gram′s staining of uncentrifuged urine, pus cell count, nitrite test and leukocyte esterase (LE test, were compared against urine culture. Gram′s stain of the uncentrifuged urine was found to be the single most useful test with a sensitivity and negative predictive value (NPV of 85.1% and 98.8%, respectively. Pus cell count was the least sensitive. Neither the nitrite test nor the LE test alone was sensitive enough with 74.4% and 61.7%, respectively. However, when either or both tests positive were considered, it increased the sensitivity and NPV comparable with Gram′s staining results, with 82.9% and 98.8%, respectively. With the potential to be used as an office diagnostic procedure, the combined nitrite and LE dipstick test may provide an acceptable alternative.

  1. Predictors of asymptomatic bacteriuria among pregnant women in a low-resource setting.

    Science.gov (United States)

    Awoleke, J O; Adanikin, A I; Ajayi, D D; Ayosanmi, O S

    2015-01-01

    This study aims at identifying predictors of asymptomatic bacteriuria (AB) among pregnant women in a low-resource setting, with the intent of recommending a guideline for screening during antenatal care. A total of 266 healthy pregnant women were antenatally recruited after informed consent. They had routine antenatal investigations, a 1 h 50-g oral glucose tolerance test and quantitative urine culture and sensitivity. The data collected were analysed using statistical software package SPSS v. 17. Prevalence of AB was 23 (8.6%). Escherichia coli was the commonest isolate (6, 26.1%), closely followed by Staphylococcus aureus (5, 21.7%). AB was commoner among patients aged 25-34 years, of low parity and higher education. Blood group B- rhesus-positive significantly predicts the likelihood of developing AB in pregnancy (adjusted OR: 0.36; 95% CI: 0.14-0.96). We conclude that blood group B-rhesus-positive in association with other patients' characteristics, such as age 25-34 years, low parity and higher education could form guidelines for a screening algorithm in our environment. PMID:25029095

  2. Asymptomatic bacteriuria among women on their 12 to 16 weeks of pregnancy.

    Directory of Open Access Journals (Sweden)

    Harold Fernando Maldonado Cárdenas

    2005-08-01

    Full Text Available The asymptomatic bacteriuria (AB refers to the bacterial colonization of the urinary tract that multiply in an active way without producing any symptoms. The prevalence varies between 4 to 7% and the consequences of having this pathology are the development of pyelonephritis or may be the cause for early deliveries and low-weight babies. Objectives. To determine the AB prevalence among women in their 12 to 16 weeks of pregnancy, attending a prenatal clinic at two medical institutions in the City of Bucaramanga. Method: Transverse Study with social and demographic information, as well as GYN features and urine cultures results. Results: We included 114 patients, with a mean age of 26.0 +-6-5. 92% of them came from the city of the study.Mean gestational age was 14.7+-1.2 weeks. 50% were on their firstor second pregnancy. AB prevalence was 7.9% (95%CI 3.7–14. ABwas related to less number of pregnancies and low school grading.The most common bacterium was E. Coli (89.0%. Conclusions:Our results show a higher incidence of AB, compare to the onesreported in the medical literature. These results emphasize the factthat ordering urine culture among pregnant women, preventingpyelonephritis, is a good screening practice.

  3. Antimicrobial sensitivity pattern of urine isolates from asymptomatic bacteriuria during pregnancy

    International Nuclear Information System (INIS)

    Screening women for asymptomatic bacteriuria (ASB) on the first antenatal visit is a part of standard obstetric care. Treating women with ASB decreases the chances of maternal and foetal complications. This study was conducted to find out the spectrum of urine pathogens and their drug susceptibility pattern for ASB during pregnancy. The study was conducted in the Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre Karachi, from September 2001 to March 2002. Two hundred and ninety women, apparently normal with confirmed pregnancy, were registered. A voided midstream urine specimen was collected and cultured. A significant growth i.e. >105 organisms/ml was identified with Analytical Profile Index 20 tests for identification of Enterobacteriaceae (API-20-E) and for Gram positive cocci by other standard methods. The prevalence of ASB was found 6.2%. Antimicrobial sensitivity was determined by disc diffusion Kirby Bauyer method after matching the turbidity with 0.5 McFarland's standard. Most of the recommended drugs were found to have encouraging results, however, Escherichia coli showed 66.67% resistance to ampicillins and sulphonamides. Enterobacters showed 100% resistance to ampicillins, cephalosporins and nitrofurantoin. Staphylococcus saprophyticus showed 66.67% resistance to ampicillins and sulphonamides. It was concluded that detection of ASB during pregnancy and appropriate use of antimicrobials is only possible after culture of urine. Empirical anti-microbial therapy cannot be relied upon because of possible risk of resistance. (author)

  4. Asymtomatic Bacteriuria as a Model to Study the Coevolution of Hosts and Bacteria.

    Science.gov (United States)

    Dobrindt, Ulrich; Wullt, Björn; Svanborg, Catharina

    2016-01-01

    During asymptomatic bacteriuria (ABU), bacteria colonize the urinary tract for extended periods of time without causing symptoms of urinary tract infection. Previous studies indicate that many Escherichia coli (E. coli) strains that cause ABU have evolved from uropathogenic E. coli (UPEC) by reductive evolution and loss of the ability to express functional virulence factors. For instance, the prototype ABU strain 83972 has a smaller genome than UPEC strains with deletions or point mutations in several virulence genes. To understand the mechanisms of bacterial adaptation and to find out whether the bacteria adapt in a host-specific manner, we compared the complete genome sequences of consecutive reisolates of ABU strain 83972 from different inoculated individuals and compared them with the genome of the parent strain. Reisolates from different hosts exhibited individual patterns of genomic alterations. Non-synonymous SNPs predominantly occurred in coding regions and often affected the amino acid sequence of proteins with global or pleiotropic regulatory function. These gene products are involved in different bacterial stress protection strategies, and metabolic and signaling pathways. Our data indicate that adaptation of E. coli 83972 to prolonged growth in the urinary tract involves responses to specific growth conditions and stresses present in the individual hosts. Accordingly, modulation of gene expression required for survival and growth under stress conditions seems to be most critical for long-term growth of E. coli 83972 in the urinary tract. PMID:26891332

  5. Pattern of microbial isolates and microbial sensitivity among HIV positive pregnant women with asymptomatic bacteriuria in Zaria, Nigeria

    Directory of Open Access Journals (Sweden)

    Pam S

    2015-04-01

    Full Text Available Background: Asymptomatic bacteruria in pregnancy is a common condition affecting pregnant women because of both anatomical and physiological changes in pregnancy. This condition appears to be commoner in people living with HIV because of the added immunosuppression caused by the virus. Aim: The study was to identify the pattern of microbial isolates and microbial sensitivity among HIV positive pregnant women with asymptomatic bacteriuria in Zaria, Nigeria. Methods: This was a prospective cross sectional study among symptom-free HIV positive pregnant women attending the prevention of mother to child transmission of HIV (PMTCT antenatal clinic in Zaria, Nigeria between 1st March and 31st August 2011. A structured, closeended questionnaire was administered and mid-stream urine samples were obtained and processed within 2 hours of collection in the laboratory. Results: A total of 220 consenting, asymptomatic, HIV positive pregnant women were screened for bacteriuria out of the 240 eligible women who were approached to participate in the study. Sixteen (16 women were positive for significant bacteriuria, giving a prevalence of 7.3%. A total of six (6 different isolates were isolated with Staphylococcus aureus (8 making 50%, E. Coli (4 18.8%, Klebsiella spp (2 12.5%, Streptococcus spp (2 12.5% and Proteus spp (1 6.2%. All the isolated organisms were sensitive to gentamycin, cefuroxime, ceftazidime, ciprofloxacin and nitrofurantoin. Conclusion: This study found Staphylococcus aureus as the most common organism isolated in the urine of asymptomatic patients with HIV infection in pregnancy. The isolated organisms were sensitive to gentamycin, cefuroxime, ceftazidime, ciprofloxaxin and nitrofurantoin.

  6. Bacteriuria among primary and secondary school pupils in Akure North Local Government Area of Ondo State, Nigeria.

    Science.gov (United States)

    Dada, Oluyemi Ebenezer; Akharaiyi, Fred Coolborn; Lawal, Opeyemi Zaynab

    2012-09-01

    Bacteriuria in urinary tract infection is severe and associated with considerable morbidity if left untreated. Therefore, the aim of the study was to evaluate the prevalence of bacteriuria among primary and secondary school pupils in Akure North Local Government Area. The study included subjects from the highly populated schools in this local government area. The samples analyzed were exclusively collected from volunteer pupils whose age and sex were documented by the questionnaire distributed to them. Urine samples were collected randomly under aseptic conditions from 250 pupils aged 5-20 attending primary and secondary schools. Urine samples were subjected to microbiological analysis by culturing 1 mL each on nutrient agar, mannitol salt agar, cystine lactose electrolyte deficient agar, plate count agar and chocolate agar for possible isolation of any bacteria. Bacterial colonies were enumerated and identified to the species level. Analytical indices revealed bacteriuria to be more common in female (41.2%) than male (3.2%) subjects. The highest bacterial count in female urine samples was 281 x 10(3) against 149 x 10(3) in male samples. A higher infection rate was recorded in secondary school pupils aged 11-20. Escherichia coli predominated among isolated bacteria species with 48.8%. Laboratory results confirmed urinary tract infection in some of the study pupils. As only volunteer pupils submitted their samples for analysis, this small population was represented in the study, predominated by female subjects. None of the pupils showed signs of infection, therefore routine laboratory checkup is important among children in order to limit damage to some of their vital tissues. PMID:23330403

  7. A comparison of a single-dose and a seven-day treatment with Amoxicillin in asymptomatic bacteriuria in pregnancy

    OpenAIRE

    Niro Manesh S; Amiri A; Ali yari Sh

    1994-01-01

    In this study, 1600 pregnant women who had referred to two prenatal clinics (Imam Khomeini and Mirza Kochek-Khan) were investigated. Ninety cases of asymptomatic bacteriuria were observed; 77 of those cooperated with us until the end of our study. The subjects, who were within the 14-36 weeks of gestational age, were randomly divided into two groups: Group A received the medicine (Amoxicillin) in a single-dose (3gr.); and, group B received it within seven days (1gr. TDS). The rate of recovery...

  8. Asymptomatic bacteriuria: predisposing factors and correlation with preterm labor in low resource settings

    Directory of Open Access Journals (Sweden)

    Meenakshi Lallar

    2014-04-01

    Full Text Available Background: Infection of urinary tract occurs frequently during pregnancy ranging from Asymptomatic Bacteriuria (ASB to potentially life threatening acute pyelonephritis. The incidence varies from 5% to 20% and it is an important risk factor for preterm labor and perinatal morbidity and mortality. The present study was performed to correlate preterm labor and to define other risk factors associated with ASB like gravida status, socioeconomic status, and anaemia in pregnant women with ASB in low resource settings. Methods: A total of 1000 pregnant mothers in second and third trimester of pregnancy were screened for ASB by using two rapid reagent strip tests, namely nitrate and leukocyte esterase reagent strip tests. Out of those screened positive hundred consecutive pregnant women were taken as cases, after positive urine culture and out of those screened negative, two hundred patients were followed as controls after matching and pairing with cases. A detailed history was taken from each patient to determine all risk factors for ASB. The cases and controls were followed prospectively till delivery. Results: Mean gestational age at the time of labor in 100 cases of ASB was 35.6 +/- 2.9 weeks and in 200 controls was 37.9 +/- 0.6 weeks. The difference between mean gestational age at the time of labor in cases and controls was statistically significant (P value 0.000. The likelihood of preterm labor in the cases was 14.5 times more than the control and the difference was significant (P <0.05. Conclusions: ASB leads to a higher rate of preterm labor and is more frequently seen in population with anemia, illiteracy, rural background and low socioeconomic status. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 403-408

  9. 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.

  10. 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

  11. A comparison of a single-dose and a seven-day treatment with Amoxicillin in asymptomatic bacteriuria in pregnancy

    Directory of Open Access Journals (Sweden)

    Niro Manesh S

    1994-05-01

    Full Text Available In this study, 1600 pregnant women who had referred to two prenatal clinics (Imam Khomeini and Mirza Kochek-Khan were investigated. Ninety cases of asymptomatic bacteriuria were observed; 77 of those cooperated with us until the end of our study. The subjects, who were within the 14-36 weeks of gestational age, were randomly divided into two groups: Group A received the medicine (Amoxicillin in a single-dose (3gr.; and, group B received it within seven days (1gr. TDS. The rate of recovery (65% in group A and 56.8% in group B, based on chi-squared test, showed no significant difference (P=0.747%. According to the results of this study, we can conclude that single-dose treatment has the same value as a seven-day treatment and the advantages such as decreased total dose, lower cost, and a better patient compliance.

  12. Asymptomatic bacteriuria among antenatal women attending a tertiary care hospital in Kanchipuram: evaluation of screening tests and antibiotic susceptibility pattern

    Directory of Open Access Journals (Sweden)

    Abirami Lakshmy Jayachandran

    2016-02-01

    Results: Out of the 120 samples 14 (11.66% were positive for asymptomatic bacteriuria. The Gram staining showed specificity and negative predictive value of 95.2% and 98.1% respectively. Pus cell count showed a specificity and negative predictive value of 96.29% and 98.11% respectively. Escherichia coli were the predominant species isolated 5 (35.7%. Among the gram negative bacteria, amikacin and nitrofurantoin showed a susceptibility of 90% and 80% each. All the staphylococcus aureus isolates showed 100% sensitivity for nitrofurantoin. Two Klebsiella spp and one Escherichia coli isolate were identified as ESBL producers. Among the S. aureus isolates 3 were identified as Methicillin resistant (MRSA. Conclusions: Urine culture should be performed for all pregnant women irrespective of the symptoms and should be treated promptly to prevent the complications arising out of ASB. [Int J Res Med Sci 2016; 4(2.000: 540-544

  13. Global gene expression profiling of the asymptomatic bacteriuria Escherichia coli strain 83972 in the human urinary tract

    DEFF Research Database (Denmark)

    Hancock, Viktoria; Klemm, Per

    2006-01-01

    Urinary tract infections (UTIs) are an important health problem worldwide, with many million cases each year. Escherichia coli is the most common organism causing UTIs in humans. The asymptomatic bacteriuria E. coli strain 83972 is an excellent colonizer of the human urinary tract, where it causes...... seen between the in vivo expression profiles of strain 83972 in three patients and the corresponding in vitro expression profiles in lab medium and human urine. The data revealed an in vivo lifestyle of microaerobic growth with respiration of nitrate coupled to degradation of sugar acids and amino...... acids, with no signs of attachment to host tissues. Interestingly, genes involved in NO protection and metabolism showed significant up-regulation in the patients. This is one of the first studies to address bacterial whole-genome expression in humans and the first study to investigate global gene...

  14. [The efficacy and safety of cefixime and amoxicillin/clavulanate in the treatment of asymptomatic bacteriuria in pregnant women: a randomized, prospective, multicenter study].

    Science.gov (United States)

    Rafal'skiĭ, V V; Dovgan', E V; Kozyrev, Iu V; Gustovarova, T A; Khlybova, S V; Novoselova, A V; Filippenko, N G; Likhikh, D G

    2013-01-01

    The study was aimed to the evaluation of efficacy and safety of cefixime and amoxicillin/clavulanate in the treatment of asymptomatic bacteriuria in pregnant women. A prospective, multicenter, randomized study that included 112 pregnant women with asymptomatic bacteriuria was performed. 58 women were randomized in group 1 (cefixime [suprax solutab] 400 mg 1 time a day, 7 days), 54 women were included in group 2 (amoxicillin/clavulanate [amoksiklav] 625 mg 3 times a day, 7 days). The average age of the patients in group 1 was 25.2 +/- 6.6; in group 2--26.6 +/- 5.8 years. Physical examination, evaluation of complaints, collection of data on adverse reactions, and bacteriological analysis of urine were performed after enrollment in the study at visit 2 (day 10 +/- 1) and 3 (day 35 +/- 2). Comparable effectiveness of cefixime and amoxicillin/clavulanate in the treatment of asymptomatic bacteriuria in pregnant women was found. Eradication of the pathogen and sustained bacteriological response were observed in 94.8 and 92.7% of women treated with cefixime, and in 98.2 and 92.5% of women treated with amoxicillin/clavulanate, respectively (P > 0.05). At the same time, the use of amoxicillin/clavulanate compared with cefixime significantly higher was followed by the development of adverse reactions (13% and 1.7; respectively; P = 0.02). Seven-day courses of cefixime at a dose 400 mg 1 time a day and amoxicillin/clavulanate at a dose of 625 mg 3 times a day are high-effective treatment regimens for asymptomatic bacteriuria in pregnant women in Russia. The use of amoxicillin/clavulanate is significantly more often accompanied by the development of adverse reactions compared with cefixime. PMID:24437236

  15. Fosfomycin in a single dose versus a 7-day course of amoxicillin-clavulanate for the treatment of asymptomatic bacteriuria during pregnancy.

    Science.gov (United States)

    Estebanez, A; Pascual, R; Gil, V; Ortiz, F; Santibáñez, M; Pérez Barba, C

    2009-12-01

    The purpose of this paper was to compare the efficacy of a single dose of 3 g of fosfomycin to that of a 7-day regimen of amoxicillin-clavulanate in the treatment of asymptomatic bacteriuria during pregnancy. A randomised, prospective, interventional, analytical, longitudinal study was undertaken, in which the efficacy of two antibiotic regimens (one short and the other long) in the treatment of pregnant women with asymptomatic bacteriuria is compared. One hundred and nine patients were randomly assigned to two groups: 56 were treated with amoxicillin-clavulanate and 53 with fosfomycin. The two groups were similar in terms of co-morbidity, treatments received during pregnancy, obstetric, gynaecological and surgical history and laboratory data. The efficacy of the two regimens was similar and the eradication rate was over 80% in both groups (P = 0.720) (relative risk [RR] 1.195, 95% confidence interval [CI]: 0.451-3.165). The number of reinfections was greater in the amoxicillin-clavulanate group (P = 0.045). The secondary effects were lower in the fosfomycin group (P = 0.008). There were no significant differences in the number of persistences (P = 0.39), development of symptomatic urinary infections (P = 0.319) or recurrences (P = 0.96). Treatment with a single dose of fosfomycin is as effective as the standard course of treatment with amoxicillin-clavulanate and may be preferable due to its simpler administration and the smaller number of reinfections. PMID:19768649

  16. 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.; Klemm, Per

    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...... adhesion conferred by specific surface-associated adhesins is normally considered as a prerequisite for colonization of the urinary tract. The prototype ABU E. coli strain 83972 was originally isolated from a girl who had carried it asymptomatically for 3 years. This study characterized the molecular...... although strain 83972 contains a seemingly intact foc gene cluster, F1C fimbriae are not expressed. Sequencing and genetic complementation revealed that the focD gene, encoding a component of the F1C transport and assembly system, was non-functional, explaining the inability of strain 83972 to express this...

  17. 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

    adhesin. The data imply that E. coli 83972 has lost its ability to express this important colonization factor as a result of host-driven evolution. The ancestor of the strain seems to have been a pyelonephritis strain of phylogenetic group B2. Strain 83972 therefore represents an example of bacterial......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...... adhesion conferred by specific surface-associated adhesins is normally considered as a prerequisite for colonization of the urinary tract. The prototype ABU E. coli strain 83972 was originally isolated from a girl who had carried it asymptomatically for 3 years. This study characterized the molecular...

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

    Directory of Open Access Journals (Sweden)

    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

  19. Fosfomycin trometamol: a review of its use as a single-dose oral treatment for patients with acute lower urinary tract infections and pregnant women with asymptomatic bacteriuria.

    Science.gov (United States)

    Keating, Gillian M

    2013-11-01

    Fosfomycin trometamol (fosfomycin tromethamine) [Monuril(®), Monurol(®), Monural(®)] is approved in numerous countries worldwide, mainly for the treatment of uncomplicated urinary tract infections (UTIs). Fosfomycin has good in vitro activity against common uropathogens, such as Escherichia coli (including extended-spectrum β-lactamase-producing E. coli), Proteus mirabilis, Klebsiella pneumoniae and Staphylococcus saprophyticus, and the susceptibility of uropathogens to fosfomycin has remained relatively stable over time. A single oral dose of fosfomycin trometamol 3 g (the approved dosage) achieves high concentrations in urine. Results of recent randomized trials indicate that single-dose fosfomycin trometamol had similar clinical and/or bacteriological efficacy to 3- to 7-day regimens of ciprofloxacin, norfloxacin, cotrimoxazole or nitrofurantoin in women with uncomplicated lower UTIs. In addition, single-dose fosfomycin trometamol had similar bacteriological efficacy to a 5-day course of cefuroxime axetil or a 7-day course of amoxicillin/clavulanic acid in pregnant women with asymptomatic bacteriuria, and similar clinical and/or bacteriological efficacy to a 5-day course of cefuroxime axetil or amoxicillin/clavulanic acid or a 3-day course of ceftibuten in pregnant women with a lower UTI. Single-dose fosfomycin trometamol was generally well tolerated, with gastrointestinal adverse events (e.g. diarrhoea, nausea) reported most commonly. In conclusion, single-dose fosfomycin trometamol is an important option for the first-line empirical treatment of uncomplicated lower UTIs. PMID:24202878

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  2. 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

    Directory of Open Access Journals (Sweden)

    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

  3. 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...

  4. 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

  5. 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

  6. Asymptomatic Bacteriuria in Antenatal Patients in Ilorin, Nigeria

    OpenAIRE

    Nanji S Ajayi; Fakeye, Olurotimi O.; Aboyeji, Abiodun P.; Charles Nwabuisi; Ajayi, Akinola B.; Adeola Fowotade

    2012-01-01

     Objective: To determine the prevalence of asymptomaticbacteriuria, bacteriology and sensitivity pattern in Ilorin using thegold standard of urine culture.Methods: A prospective study was carried out from 1st Julyto 31st October 2007, at the University of Ilorin TeachingHospital (UITH) on 125 consenting asymptomatic pregnantwomen. A structured proforma was used to collect informationfrom the women and a midstream urine specimen collected forbacteriological culture.Results: Of the 125 pregnant...

  7. 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...

  8. Occurrence of bacteriuria asymptomatic in pregnant women in a public maternity

    OpenAIRE

    Raïssa Mayer Ramalho Catão; João Batista de Sousa Neto; Caroline Evelin Nascimento Kluczynik; Danielle Rocha Silva

    2010-01-01

    Objectives: describing the epidemiological profile of pregnant teenagers in a public maternity in Campina Grande-PB and evaluating the prenatal care offered. Methods: this is about a cross-sectional, exploratory study, developed through interviews, with 52 women who fulfilled the following prerequisites: seen at prenatal ISEA, were less than 19 years, were in the gestational period of not less than 16 weeks and agreed to participate in this study, after approval by the Ethics in Research Stat...

  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

    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...

  10. 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.

  11. Evaluation of BiesseBioscreen as a new methodology for bacteriuria screening

    Science.gov (United States)

    Nicolai, Eleonora; Garau, Simona; Favalli, Cartesio; D’Agostini, Cartesio; Gratton, Enrico; Motolese, Guido; Rosato, Nicola

    2014-01-01

    SUMMARY Urinary tract infection is a common disease diagnosed from symptoms and clinical signs, and bacterial count per volume of urine. This study have evaluated the BiesseBioscreen analyzer as a new way to analyze urine samples enabling fast screening of urine, prior to reference standard methods currently utilized in microbiology analysis laboratory. We analyzed 962 urine samples from outpatients and inpatients of the Tor Vergata (TV) University Hospital of the University of Rome “Tor Vergata”. All samples were processed both with the BiesseBioscreen and with the standard methodology adopted by the clinical microbiology laboratory of TV Hospital and the results were compared. Of the samples analyzed 54.9% were concordant negative with the reference method and 21.6% concordant positive, 23.3% resulted false positive and 0.2% false negative. The results obtained from BiesseBioscreen showed a sensitivity of 99.0%, indicating it as a system suitable to rule out urinary tract infection. BiesseBioscreen could represent a valid method for screening negative samples to exclude from culture test with a potential reduction in time, workload and costs of the diagnosis. PMID:25387286

  12. 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

    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......Many bacterial infections are associated with biofilm formation. In the urinary tract bacterial biofilms develop on both living surfaces and artificial implants, producing chronic and often intractable infections. Escherichia coli is the most common organism associated with urinary tract infections...... 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....

  13. Pattern of microbial isolates and microbial sensitivity among HIV positive pregnant women with asymptomatic bacteriuria in Zaria, Nigeria

    Directory of Open Access Journals (Sweden)

    Kiridi E.K

    2015-04-01

    Full Text Available infertility. It outlines the fallopian tubes and uterine cavity. Aim: To review the hysterosalpingographic (HSG findings in women investigated for infertility in a tertiary care center in the Niger Delta. Methods: The study reviewed 137 consecutive HSG films of women investigated for infertility between 1st January to 30th May, 2014. Result: The commonest age group was 26-30yrs (46.7%. Majority of the women were investigated for secondary infertility 98 (71.5%. Abnormal findings were found in 99(72.3% and the commonest abnormality was tubal 67(48.9% with bilateral tubal blockage in 20 (14.6%. Other findings include submucous fibroids in 28 (20.4%, uterine synechia 26(19.0% and bi-cornuate uterus in 1(0.7%. Conclusion: HSG is relevant in the investigation of infertile women. Bilateral tubal occlusion from pelvic inflammatory disease, puerperal sepsis and unsafe abortions remains a major challenge in the Niger delta.

  14. Pattern of microbial isolates and microbial sensitivity among HIV positive pregnant women with asymptomatic bacteriuria in Zaria, Nigeria

    OpenAIRE

    Kiridi E.K; Ibrahim I.A; Lawani L

    2015-01-01

    infertility. It outlines the fallopian tubes and uterine cavity. Aim: To review the hysterosalpingographic (HSG) findings in women investigated for infertility in a tertiary care center in the Niger Delta. Methods: The study reviewed 137 consecutive HSG films of women investigated for infertility between 1st January to 30th May, 2014. Result: The commonest age group was 26-30yrs (46.7%). Majority of the women were investigated for secondary infertility 98 (71.5%). Abnormal find...

  15. A study of risk factors and consequences of asymptomatic bacteriuria in pregnant women and feto-maternal outcome

    Directory of Open Access Journals (Sweden)

    Prasanna Byna

    2015-10-01

    Conclusions: ASB is commonly encountered in pregnant women especially in women with anaemia. Untreated ASB is a risk factor for pyelonephritis, anaemia, PROM, preterm labour in mother. IUGR and neonatal infections are more common in fetus. Routine screening for ASB as a part of antenatal care reduces the maternal and fetal complications. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1300-1305

  16. Global gene expression profiling of the asymptomatic bacteriuria Escherichia coli strain 83972 in the human urinary tract

    DEFF Research Database (Denmark)

    Hancock, Viktoria; Klemm, Per

    2006-01-01

    seen between the in vivo expression profiles of strain 83972 in three patients and the corresponding in vitro expression profiles in lab medium and human urine. The data revealed an in vivo lifestyle of microaerobic growth with respiration of nitrate coupled to degradation of sugar acids and amino...

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

    OpenAIRE

    Omar Ismail Santos Pereira Darzé; Ubirajara Barroso; Maurício Lordelo

    2011-01-01

    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, per...

  18. 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

  19. 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...

  20. Diagnostic accuracy of rapid urine dipstick test to predict urinary tract infection among pregnant women in Felege Hiwot Referral Hospital, Bahir Dar, North West Ethiopia

    OpenAIRE

    Demilie, Tazebew; Beyene, Getenet; Melaku, Selabat; Tsegaye, Wondewosen

    2014-01-01

    Background Untreated bacteriuria during pregnancy has been shown to be associated with low birth-weight and premature delivery. Therefore, routine screening for bacteriuria is advocated. The decision about how to screen pregnant women for bacteriuria has always been a balance between the cost of screening versus the sensitivity and specificity. This study was designed to evaluate the diagnostic accuracy of the rapid dipstick test to predict urinary tract infection in pregnancy against the gol...

  1. Asymptomatic urinary tract infection among pregnant women attending the antenatal clinic of Hawassa Referral Hospital, Southern Ethiopia

    OpenAIRE

    Tadesse, Endale; Teshome, Million; Merid, Yared; Kibret, Belayhun; Shimelis, Techalew

    2014-01-01

    Background Untreated asymptomatic bacteriuria (ASB) during pregnancy may cause serious complications including pyelonephritis and delivery of premature or low-birth-weight infants. However, little is known about asymptomatic bacteriuria in pregnancy in Ethiopia. This study aimed to assess the prevalence of asymptomatic bacteriuria, bacterial agents, and their antibiotic susceptibility pattern in pregnant women attending antenatal clinic of the Hawassa Teaching and Referral Hospital. Methods A...

  2. 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...

  3. INCIDENCE OF URINARY TRACT INFECTION BOTH SYMPTOMATIC AND ASYMP T OMATIC PATIENTS AMONG PREGNANT WOMEN RELATING TO ISOLATION AND IDENTIFICATION WITH ANTIBIOGRAM

    OpenAIRE

    Shoukat Jahan; Radha Rani; Mittra; Anubhuti

    2015-01-01

    Urinary tract infections are the most common bacterial infections during pregnancy . Asymptomatic bacteriuria is a common problem in pregnancy and is associated with risk of preterm birth and pyelonephritis if untreated . AIMS & OBJECTIVES: The present s tudy was aimed to evaluate the incidence of urinary tract infection in S ymptomatic & A symptomatic bacteriuria in pregnant women . STUDY TYPE: Prospective Study . STUDY POPULATION: Gro...

  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. [Urinary tract infections in pregnancy: when to treat, how to treat, and what to treat with].

    Science.gov (United States)

    Kladenský, J

    2012-04-01

    Urinary tract infections (UTI) in pregnant women are a relatively frequent occurrence and the spectrum of these infections ranges from lower urinary tract disease (asymptomatic bacteriuria, acute cystitis) to upper urinary tract disease (acute pyelonephritis). Anatomical and functional changes in the urinary tract in pregnancy result in significantly higher susceptibility to progression of the infection from asymptomatic bacteriuria to the stage of acute pyelonephritis. Untreated asymptomatic bacteriuria in pregnancy leads, in as much as 40%, to the development of acute pyelonephritis with all the subsequent negative effects not only for the woman herself, but particularly for the fetus. Bacteriuria in pregnancy accounts for a significantly higher number of newborns with a low birth weight, low gestational age and higher neonatal mortality rate. Therefore, it is necessary to perform screening for bacteriuria in pregnant women and, when the finding is positive, to treat this bacteriuria. The selection of an appropriate antimicrobial agent to treat urinary tract infection in pregnancy is limited by the safety of a given drug not only for the woman, but particularly for the fetus. The article provides an overview of medications that can be safely used throughout the pregnancy or only in certain stages of pregnancy. The selection of an appropriate antibiotic should always be preceded by the result of urine culture. The article presents the principles and rules for treating asymptomatic bacteriuria, acute cystitis and acute pyelonephritis in pregnant women. PMID:22702077

  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. Disease: H01339 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available es does not always cause symptoms and tissue damage. Asymptomatic bacteriuria has been attracting attention as a model to study mecha...nisms underlying the development of commensalism. Escher

  9. Urinary tract infections in pregnancy: old and new unresolved diagnostic and therapeutic problems

    OpenAIRE

    Matuszkiewicz-Rowińska, Joanna; Małyszko, Jolanta; Wieliczko, Monika

    2015-01-01

    Urinary tract infections (UTIs) are common in pregnant women and pose a great therapeutic challenge, since the risk of serious complications in both the mother and her child is high. Pregnancy is a state associated with physiological, structural and functional urinary tract changes which promote ascending infections from the urethra. Unlike the general population, all pregnant women should be screened for bacteriuria with urine culture, and asymptomatic bacteriuria must be treated in every ca...

  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. 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...

  12. INCIDENCE OF URINARY TRACT INFECTION BOTH SYMPTOMATIC AND ASYMP T OMATIC PATIENTS AMONG PREGNANT WOMEN RELATING TO ISOLATION AND IDENTIFICATION WITH ANTIBIOGRAM

    Directory of Open Access Journals (Sweden)

    Shoukat Jahan

    2015-05-01

    Full Text Available Urinary tract infections are the most common bacterial infections during pregnancy . Asymptomatic bacteriuria is a common problem in pregnancy and is associated with risk of preterm birth and pyelonephritis if untreated . AIMS & OBJECTIVES: The present s tudy was aimed to evaluate the incidence of urinary tract infection in S ymptomatic & A symptomatic bacteriuria in pregnant women . STUDY TYPE: Prospective Study . STUDY POPULATION: Group A consists of 200 pregnant women with confirmed diagnosis of pregnancy and of all trimester with apparent signs and symptoms of UTI . Group B consists of 100 women with confirmed diagnosis of pregnancy and of all trimesters without any signs and sy mptoms of UTI and Group C consist of 20 healthy non pregnant women . MATERIAL & METHOD: Mid stream urine samples were collected from all women and processed by culture method . Isolates were identified based on colony characteristic and biochemical reactio n and antibiotic susceptibility testing was done by modified Kirby - Bauer’s disc diffusion method . RESULT: The incidence of significant bacteriuria in Group A is 15(7 . 5%, Group B is 10(10% and Group C is 1(5% . E . coli was the commonest organism isolate d from all cases . Nitrofurantoin was the most sensitive drug followed by Ciprofloxacin for gram negative bacteria . CONCLUSION: Asymptomatic bacteriuria is common among antenatal women in the study . E . coli is the most frequent isolated pathogen .

  13. Non-invasive localization of urinary tract infection

    International Nuclear Information System (INIS)

    New methods to localize the source of bacteriuria were evaluated in monkeys with experimental urinary tract infection. A high level of diagnostic accuracy was obtained with the combined study of antibody-coated urinary bacteria by immunofluorescence, 131I hippuran scintiphotos in the hydropenic state and 67gallium citrate scintiphotos. Unique patterns were found, which differentiate cystitis, ureteritis, pyelonephritis and renal or perinephric abscesses

  14. Urinary tract infections in patients with spinal injuries.

    Science.gov (United States)

    Nicolle, Lindsay E

    2014-01-01

    Urinary tract infection remains an important problem for patients with spinal cord injury. Interventions used to promote bladder emptying and maintain low-pressure voiding have variable risks for urinary tract infection. Asymptomatic bacteriuria is common in this population and should not be treated. However, identification of symptomatic infection is compromised by difficulties in ascertainment of symptoms. Use of hydrophilic coated catheters for intermittent catheterization does not influence the frequency of symptomatic urinary tract infection. Botulinum toxin injection in the detrusor muscle or the urethral sphincter improves bladder emptying and does not influence the frequency of urinary infection. Asymptomatic bacteriuria is a common finding in pregnant women with spinal cord injury, but optimal management is not clear. Other research needs include further development and evaluation of interventions to decrease the frequency of infection, improve diagnostic precision, and limit the emergence of resistant organisms. PMID:24445675

  15. Urinary tract infections in pregnancy: old and new unresolved diagnostic and therapeutic problems.

    Science.gov (United States)

    Matuszkiewicz-Rowińska, Joanna; Małyszko, Jolanta; Wieliczko, Monika

    2015-03-16

    Urinary tract infections (UTIs) are common in pregnant women and pose a great therapeutic challenge, since the risk of serious complications in both the mother and her child is high. Pregnancy is a state associated with physiological, structural and functional urinary tract changes which promote ascending infections from the urethra. Unlike the general population, all pregnant women should be screened for bacteriuria with urine culture, and asymptomatic bacteriuria must be treated in every case that is diagnosed, as it is an important risk factor for pyelonephritis in this population. The antibiotic chosen should have a good maternal and fetal safety profile. In this paper, current principles of diagnosis and management of UTI in pregnancy are reviewed, and the main problems and controversies are identified and discussed. PMID:25861291

  16. Perbandingan Profil Bakteriuria Asimtomik pada Wanita Hamil dan Wanita Tidak Hamil di RSUP Haji Adam Malik Medan

    OpenAIRE

    Nasution, Listanti Nisa

    2015-01-01

    Background: Pregnancy is a predisposing factor for the occurrence of urinary tract infections. Pregnant women who suffer from this disorder are faced with dangerous risks that may affect the well-being of the fetus and the mother's condition. Asymptomatic bacteriuria is a situation where ≥ 100,000 was found that bacteria with the same species per milliliter of urine without causing symptoms of urinary tract infection in these patients. Objective: To determine differences in patterns of an...

  17. Antimicrobial Susceptibility of Gram-Negative Uropathogens Isolated From Obstetric Patients

    OpenAIRE

    Patrick Duff; Rodney K. Edwards; Jamie, Whitney E.

    2002-01-01

    OBJECTIVE: To evaluate the antimicrobial susceptibility of Gram-negative uropathogens isolated from pregnant women. METHODS: We performed a snapshot cohort study of women receiving care in the University of Florida prenatal clinics during March 2000. Subjects with asymptomatic bacteriuria or cystitis were identified and the antimicrobial susceptibility of each pathogen was recorded. Data were analyzed using chi-square, Fisher's exact test and ninety-five percent confidence intervals, as appro...

  18. Group B streptococcus cystitis presenting in a diabetic patient with a massive abdominopelvic abscess: a case report

    OpenAIRE

    Ulett Kimberly B; Shuemaker Jennifer H; Benjamin William H; Tan Chee K; Ulett Glen C

    2012-01-01

    Abstract Introduction Streptococcus agalactiae or group B streptococcus is a Gram-positive pathogen that is typically associated with neonatal disease and infection in pregnant women. Group B streptococcus also causes invasive infections in non-pregnant adults including urinary tract infections. The spectrum of urinary tract infections caused by group B streptococcus includes cystitis, pyelonephritis, urosepsis and asymptomatic bacteriuria, which is particularly common among elderly individua...

  19. Urinary Tract Infections In Pregnancy

    OpenAIRE

    N Sivalingam; Loh KY

    2007-01-01

    Urinary tract infections frequently affect pregnant mothers. This problem causes significant morbidity and healthcare expenditure. Three common clinical manifestations of UTIs in pregnancy are: asymptomatic bacteriuria, acute cystitis and acute pyelonephritis. Escherichia coli remains the most frequent organism isolated in UTIs. All pregnant mothers should be screened for UTIs in pregnancy and antibiotics should be commenced without delay. Urine culture and sensitivity is the gold standard in...

  20. Approach to a Positive Urine Culture in a Patient Without Urinary Symptoms

    OpenAIRE

    Trautner, Barbara W.; Grigoryan, Larissa

    2013-01-01

    Asymptomatic bacteriuria (ASB) is a condition in which bacteria are present in a noncontaminated urine sample collected from a patient without signs or symptoms related to the urinary tract. ASB must be distinguished from symptomatic UTI by the absence of signs and symptoms compatible with UTI or by clinical determination that a nonurinary etiology accounts for the patient's symptoms. ABU is a very common condition that is often treated unnecessarily with antibiotics. Pregnant women and perso...

  1. 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...

  2. 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...

  3. Amoxicillin-clavulanic acid in treatment of urinary tract infection due to gram-negative bacteria resistant to penicillin.

    OpenAIRE

    Martinelli, R; A.A. Lopes; Oliveira, M.M.; Rocha, H

    1981-01-01

    Twenty-two adult patients with urinary tract infections caused by penicillin-resistant bacteria completed treatment with amoxicillin alone or amoxicillin plus clavulanic acid in a randomized double-blind clinical trial. Of the 13 patients treated with amoxicillin plus clavulanic acid, the absence of bacteriuria within 7 days of therapy was observed in 85%, as compared with only 25% of the 8 patients receiving amoxicillin only. There were no significant side effects nor any clinical, biochemic...

  4. 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...

  5. 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...

  6. PREVALENCE OF URINARY TRACT INFECTION IN PREGNANT W OMEN

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    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 ...

  7. Cytotoxicity of the HpmA hemolysin and urease of Proteus mirabilis and Proteus vulgaris against cultured human renal proximal tubular epithelial cells.

    OpenAIRE

    Mobley, H L; Chippendale, G R; Swihart, K G; Welch, R A

    1991-01-01

    Proteus mirabilis, a common agent of nosocomially acquired and catheter-associated bacteriuria, can cause acute pyelonephritis. In ascending infections, bacteria colonize the bladder and ascend the ureters to the proximal tubules of the kidney. We postulate that Proteus species uses the HpmA hemolysin and urease to elicit tissue damage that allows entry of these bacteria into the kidney. To study this interaction, strains of Proteus mirabilis and P. vulgaris and their isogenic hemolysin-negat...

  8. Internalization of Proteus mirabilis by human renal epithelial cells.

    OpenAIRE

    Chippendale, G R; Warren, J W; Trifillis, A. L.; Mobley, H L

    1994-01-01

    Proteus mirabilis, a common agent of bacteriuria in humans, causes acute pyelonephritis and bacteremia. Renal epithelium provides a barrier between luminal organisms and the renal interstitium. We have hypothesized that P. mirabilis may be internalized into renal epithelium. To test this hypothesis, we added suspensions of three P. mirabilis strains (10(8) CFU) to confluent monolayers of primary cultures of human renal proximal tubular epithelial cells (HRPTEC) and, after 3 h, found the bacte...

  9. 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 ...

  10. Bacterial Biofilms and Catheters: A Key to Understanding Bacterial Strategies in Catheter-Associated Urinary Tract Infection

    OpenAIRE

    Nickel, J. Curtis; Costerton, J. William

    1992-01-01

    Despite major technological improvements in catheter drainage systems, the indwelling Foley catheter remains the most common cause of nosocomial infection in medical practice. By approaching this common complicated urinary tract infection from the perspective of the biofilm strategy bacteria appear to use to overcome obstacles to produce bacteriuria, one appreciates a new understanding of these infections. An adherent biofilm of bacteria in their secretory products ascends the luminal and ext...

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

    OpenAIRE

    Haldia Priyanka, Sharma Taruna, Nautiyal Ruchira

    2015-01-01

    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 uti...

  12. 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

  13. 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...

  14. Epidemiology of urinary tract infections and antibiotics sensitivity among pregnant women at Khartoum North Hospital

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    Ali Salah K

    2011-01-01

    Full Text Available Abstract Background Urinary tract infections (UTI can lead to poor maternal and perinatal outcomes. Investigating epidemiology of UTI and antibiotics sensitivity among pregnant women is fundamental for care-givers and health planners. Methods A cross sectional study has been conducted at Khartoum north teaching hospital Antenatal Care Clinic between February-June 2010, to investigate epidemiology of UTI and antibiotics resistance among pregnant women. Structured questionnaires were used to gather data from pregnant women. UTI was diagnosed using mid stream urine culture on standard culture media Results Out of 235 pregnant women included, 66 (28.0% were symptomatic and 169 (71.9% asymptomatic. the prevalence of bacteriuria among symptomatic and asymptomatic pregnant women were (12.1%, and (14.7% respectively, with no significant difference between the two groups (P = 0.596, and the overall prevalence of UTI was (14.0%. In multivariate analyses, age, gestational age, parity, and history of UTI in index pregnancy were not associated with bacteriuria. Escherichia coli (42.4% and S. aureus (39.3% were the commonest isolated bacteria. Four, 2, 2, 3, 4, 2 and 0 out of 14 E. coli isolates, showed resistance to amoxicillin, naladixic acid, nitrofurantoin, ciprofloxacin, co-trimoxazole, amoxicillin/clavulanate and norfloxacin, respectively Conclusion Escherichia coli were the most prevalent causative organisms and showing multi drug resistance pattern, asymptomatic bacteriuria is more prevalent than symptomatic among pregnant women. Urine culture for screening and diagnosis purpose for all pregnant is recommended.

  15. GLIMPSE INTO THE HIDDEN ASPECTS OF URINARY TRACT INFECTION IN PATIENTS WITH DIABETES MELLITUS AND PROSTATOMEGALY

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    Dwijen

    2016-02-01

    Full Text Available BACKGROUND The worldwide prevalence of diabetes has risen dramatically over the past two decades from 30 million cases in 1985 to 382 million in 2013. Infections are of particular concern in diabetics. Benign prostatic hyperplasia and benign prostatic enlargement are the most common diseases in aging men which can lead to lower urinary tract symptoms. AIMS AND OBJECTIVE The objective of this study. 1. To study various risk factors associated with Urinary tract infections in Diabetes with prostatomegaly. 2. To study causative microorganisms and their drug susceptibility in diabetics with Urinary tract infections having prostatomegaly. MATERIALS & METHODS: STUDY SETTING A hospital based prospective observational study conducted for a period of 1 year. 50 indoor cases meeting inclusion criteria were selected. INCLUSION CRITERIA Diabetics having prostatomegaly presenting with urinary tract infection or positive urine culture were included. RESULTS Out of 50 patients 46% had bacteriuria, 82% were above 50 years. Longer duration of diabetes >6years were associated with bacteriuria in 59.37% in contrast to 150 ml in contrast to those with 40cc in comparison with volume 50 years, longer duration of diabetes, non-adherence to treatment, insulin therapy and prostate volume >40cc could be considered as significant risk for bacteriuric urinary infection. Uncontrolled blood glucose with HbA1 C>7%, post void residue >150 ml and prostate volume >40 cc are associated with bacteriuria. E. coli is the commonest organism and imipenem, cefepime, aminoglycosides, fluoroquinolones and nitrofurantoin showed favourable response.

  16. Prevalence of urinary tract infection among pregnant women at Bugando Medical Centre, Mwanza, Tanzania.

    Science.gov (United States)

    Masinde, A; Gumodoka, B; Kilonzo, A; Mshana, S E

    2009-07-01

    Urinary tract infections (UTI) are the most common bacterial infections during pregnancy and these infections. Untreated UTI can be associated with serious obstetric complications. This cross-sectional study was carried out to determine the prevalence of UTI among symptomatic and asymptomatic pregnant women attending Bugando Medical centre (BMC) in Mwanza, Tanzania. A total of 247 pregnant women were enrolled, of these 78 (31.5%) were symptomatic and 169 (68.4%) asymptomatic. UTI was diagnosed using mid stream urine (MSU) culture on standard culture media and urinalysis was done using rapid dip stick. The prevalence of bacteriuria among symptomatic and asymptomatic pregnant women were 17.9% and 13.0% respectively, with no significant difference between the two groups (p = 0.307). Using univariate analysis there was no association of parity (p = 0.825), gestational age (p = 0.173), education (p = 0.615), age (p = 0.211) and marital status (p = 0.949) with bacteriuria. The sensitivity and specificity of urine dipstick was 38.9% and 86.7% respectively. Escherichia coli (47.2%) and Enterococcus spp (22.2%) were the most commonly recovered pathogens. The rate of resistance of Escherichia coli to ampicillin, tetracycline, sulfamethaxazole/trimethoprim, gentamicin, ciprofloxacin, nitrofurantoin, ceftriaxone, and imipenem were 53%, 58.8%, 64.7%, 5.9%, 11.8%, 5.9%, 29.4% and 0%, respectively. In conclusion, asymptomatic bacteriuria among pregnant women is prevalent in our setting and majority of Escherichia coli are resistant to ampicillin, tetracycline, SXT and ceftriaxone. Due to low sensitivity of rapid dip stick, routine urine culture and susceptibility testing is recommended to all pregnant women at booking. PMID:20734713

  17. Uropathogenic Escherichia coli superinfection enhances the severity of mouse bladder infection.

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    Drew J Schwartz

    2015-01-01

    Full Text Available Urinary tract infections (UTIs afflict over 9 million women in America every year, often necessitating long-term prophylactic antibiotics. One risk factor for UTI is frequent sexual intercourse, which dramatically increases the risk of UTI. The mechanism behind this increased risk is unknown; however, bacteriuria increases immediately after sexual intercourse episodes, suggesting that physical manipulation introduces periurethral flora into the urinary tract. In this paper, we investigated whether superinfection (repeat introduction of bacteria resulted in increased risk of severe UTI, manifesting as persistent bacteriuria, high titer bladder bacterial burdens and chronic inflammation, an outcome referred to as chronic cystitis. Chronic cystitis represents unchecked luminal bacterial replication and is defined histologically by urothelial hyperplasia and submucosal lymphoid aggregates, a histological pattern similar to that seen in humans suffering chronic UTI. C57BL/6J mice are resistant to chronic cystitis after a single infection; however, they developed persistent bacteriuria and chronic cystitis when superinfected 24 hours apart. Elevated levels of interleukin-6 (IL-6, keratinocyte cytokine (KC/CXCL1, and granulocyte colony-stimulating factor (G-CSF in the serum of C57BL/6J mice prior to the second infection predicted the development of chronic cystitis. These same cytokines have been found to precede chronic cystitis in singly infected C3H/HeN mice. Furthermore, inoculating C3H/HeN mice twice within a six-hour period doubled the proportion of mice that developed chronic cystitis. Intracellular bacterial replication, regulated hemolysin (HlyA expression, and caspase 1/11 activation were essential for this increase. Microarrays conducted at four weeks post inoculation in both mouse strains revealed upregulation of IL-1 and antimicrobial peptides during chronic cystitis. These data suggest a mechanism by which caspase-1/11 activation and IL-1

  18. 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.

  19. 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

  20. Evaluation of Granada Agar Plate for Detection of Streptococcus agalactiae in Urine Specimens from Pregnant Women

    OpenAIRE

    Tamayo, Javier; Gómez-Garcés, José-Luis; Alós, Juan-Ignacio

    2004-01-01

    The Granada agar plate (GAP; Biomedics SL, Madrid, Spain) was evaluated for the detection of group B streptococci (GBS) in urine specimens from pregnant women submitted for testing for asymptomatic bacteriuria and was compared with blood agar (BA [Columbia agar with 5% sheep blood]; bioMérieux, Marcy l'Etoile, France). The GAP detected 103 out of 105 GBS, whereas BA detected only 50. Use of the GAP could be a good method for the detection of GBS in urine specimens from pregnant women.

  1. [Catheter-associated urinary tract infections].

    Science.gov (United States)

    Liedl, B

    2015-09-01

    In patients with indwelling urethral catheters significant bacteriuria develops within 4 weeks of indwelling time in practically 100% of the cases. Catheter encrustation and obstruction can occur in approximately 40% of patients. Symptomatic ascending urinary tract infections, urethral complications and urolithiasis can occur in significant numbers in the long term. Regular educational and surveillance programs in nursing homes, hospitals and in home care are important to instruct personnel in hygiene procedures, to learn the indications for catheterization, to keep the indwelling time of catheters as short as possible, to detect any complications early and to initiate appropriate diagnostics and therapy by the urologist. PMID:26275988

  2. 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...

  3. 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

  4. 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.

  5. Efficacy of pivmecillinam for treatment of lower urinary tract infection caused by extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae.

    Science.gov (United States)

    Titelman, Emilia; Iversen, Aina; Kalin, Mats; Giske, Christian G

    2012-04-01

    To evaluate the clinical and bacteriological efficacy of pivmecillinam against lower urinary tract infection (UTI) caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae, patients treated for lower UTI with pivmecillinam (n=8) were studied. Patients treated with nitrofurantoin (n=3) and trimethoprim (n=3) or a combination of these agents with pivmecillinam (n=3) were included as a control group. Antimicrobial susceptibility was determined with EUCAST methodology. Bacteriologic cure was defined as pivmecillinam had good clinical response (8/8), but bacteriological cure rates were low (2/8). However, none of the patients with persisting bacteriuria had a relapse of UTI symptoms within 6 months. All isolates were susceptible to the given antimicrobial. Most isolates belonged to the CTX-M-1 group (n=11, 65%) or CTX-M-9-group (n=4, 24%). Four E. coli isolates belonged to the international clone O25b-ST131 (25%). In conclusion, pivmecillinam had good clinical activity against lower UTI caused by ESBL-producing Enterobacteriaceae, but bacteriological cure rates were low. The persistent bacteriuria appears to be of little clinical importance, but larger clinical studies are needed to determine the usefulness of pivmecillinam in infections caused by ESBL-producing bacteria. PMID:22204597

  6. Laboratory evaluation of urinary tract infections in an ambulatory clinic.

    Science.gov (United States)

    Carroll, K C; Hale, D C; Von Boerum, D H; Reich, G C; Hamilton, L T; Matsen, J M

    1994-01-01

    A 4-month evaluation of ambulatory patients with a suspicion of a urinary tract infection was performed. Specific objectives included assessment of five urinary screening methods, reevaluation of the necessity of the phenylethyl alcohol plate (PEA), and cost-effectiveness of screening for low colony count bacteriuria. Urine samples were collected as midstream, clean-caught specimens. A total of 142 samples, 87 from 79 symptomatic patients and 55 negative controls, were evaluated. All urine specimens were cultured using a 0.01 mL loop and a 0.001 mL loop onto Columbia sheep blood agar, MacConkey agar, and PEA agar. Twenty-four specimens (17%) were sterile, 64 (45%) were contaminated, and 54 (38%) were infected. Five urine screening methods were performed. These tests and their associated sensitivity and specificity are as follows. The Chemstrip 9 (Behring, Inc., Somerville, NJ) for leukocyte esterase and nitrate, 67%, 98%; microscopic analysis on spun urine, 79%, 93%; methylene blue stain for pyuria, 60%, 99%; Gram stain for pyuria, 45%, 93%; Gram stain for bacteriuria, 65%, 75%; and the URISCREEN (Analytab Products, Plainview, NY), 92%, 89%. Inclusion of a PEA plate for isolation of gram-positive organisms provided no additional information. Routine culture of urine samples at 10(-2) mL increased the contamination rate by 19%. PMID:7506476

  7. Urinary infection before and after prostatectomy

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    Pourmand Gholamreza

    2010-01-01

    Full Text Available To determine the prevalence of pre and post prostatectomy related urinary tract in-fection and its correlation with peri-operative events, we studied 120 patients who underwent pros-tatectomy due to benign prostatic hypertrophy from September 2005 to September 2006. Urine cultures were performed before the operations, after a week, and three months later. Data including prostate volume, prostatic specific antigen (PSA, post voiding residue (PVR and histopathological reports as well as the duration of urinary leak, bladder irrigation, hospitalization, and catheterization were studied. The mean age of the studied patients was 70.5 ± 8 years. Significant preoperative bac-teriuria was revealed in 18 (15% patients of whom 14(77% patients developed negative cultures following the operation. Postoperative bacteriuria was detected in 9(7.5% patients who negative urine cultures preoperatively. Pre and post operative micro-organisms were different in the majority of the cases. The mean PSA was higher in patients with a positive history of infection. Following prostatectomy, patients with positive urine cultures had significantly longer urinary leakage, cathe-terization, and hospital stays compared with those who remained culture negative. We conclude that the incidence of positive urine culture pri-prostatectomy for BPH can be improved by appropriate antibiotic therapy, and the risk factors for postoperative urinary infection include preoperative infec-tion, prolonged urinary leakage, catheterization, and hospital stay. The elevated PSA may be a risk factor.

  8. 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.

  9. Rising prevalence of antimicrobial resistance in urinary tract infections during pregnancy: Necessity for exploring newer treatment options

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    Meher Rizvi

    2011-01-01

    Full Text Available Background: Urinary tract infections (UTI are one of the most common medical complications of pregnancy. The emergence of drug resistance and particularly the Extended-spectrum beta-lactamase production by Escherichia coli and methicillin resistance in Staphylococci, limits the choice of antimicrobials. Materials and Methods: Patients in different stages of pregnancy with or without symptoms of urinary tract infection attending the antenatal clinic of obstetrics and gynaecology were screened for significant bacteriuria, by standard loop method on 5% sheep blood agar and teepol lactose agar. Isolates were identified by using standard biochemical tests and antimicrobial susceptibility testing was done using Kirby Bauer disc diffusion method. Results: A total of 4290 (51.2% urine samples from pregnant females showed growth on culture. Prevalence of asymptomatic bacteriuria 3210 (74.8% was higher than symptomatic UTI 1080 (25.2%. Escherichia coli was the most common pathogen accounting for 1800 (41.9% of the urinary isolates. Among the gram-positive cocci, coagulase negative species of Staphylococci 270 (6.4% were the most common pathogen. Significantly high resistance was shown by the gram negative bacilli as well as gram positive cocci to the β-lactam group of antimicrobials, flouroquinolones and aminoglycosides. Most alarming was the presence of ESBL in 846 (47% isolates of Escherichia coli and 344 (36.9% isolates of Klebsiella pneumoniae, along with the presence of methicillin resistance in 41% of Staphylococcus species and high-level aminoglycoside resistance in 45(30% isolates of Enterococcus species. Glycopeptides and carbepenems were the only group of drugs to which all the strains of gram positive cocci and gram negative bacilli were uniformly sensitive, respectively. Conclusions: Regular screening should be done for the presence of symptomatic or asymptomatic bacteriuria in pregnancy and specific guidelines should be issued for testing

  10. Automazione dell’urinocoltura in campioni da catetere vescicale: criticità applicative ed interpretative dell’uso in routine del laser-nefelometro

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    Marcello Meledandri

    2006-12-01

    Full Text Available Automated urine culture methods have spread throughout Italian clinical laboratories in the last decade.Among available systems, Uro-Quick™ (a laser nephelometric instrument evaluates the microbial growth in liquid medium, shortening the overall time of laboratory processing. The performances of the instrument have been estimated in patients with indwelling urinary catheter. Urine of patients with CAUTI (Catheter Associated Urinary Tract Infection, because of high dilution and anti-bacterial load, frequently produce working difficulties and misleading interpretation. In 2003-2004 urine specimens coming from patients of S.Filippo Neri Hospital, in Rome (Italy were examined. Patients with closed-circuit urinary catheter, mainly hospitalized in ICUs, and requesting urine cultures for clinical reasons were enrolled. A total of 100 properly collected specimens, from different patients,were considered. For each, several clinical information (especially antibiotic therapy were also collected. Urine specimens were examined as follows: 1 microbial count and evaluation of antibacterial load by means of Uro-Quick™ ; 2 microscope (HPF observation for pyuria in the sediment; direct plate culturing of urine, with 10 μl calibrated loop.A bacteriuria was defined as the growth of 1-2 species, with a count > = 103 CFU/mL; the same value, together with the finding of pyuria (at two degrees: >1 WBC, >5 WBC, respectively, was used for a presumptive definition of CAUTI. A considerable rate of specimens (62% showed anti-bacterial load (while the reported antibiotic therapy was 54%.The instrumentation revealed a sensibility of 74% and specificity of 98% in finding bacteriuria. However, when negative specimens which had antibacterials were re-classified as positive (for possible presence of inhibited microorganisms, sensibility increased to 95%. On the contrary, considering the presence of >5 WBC in the sediment, sensibility and specificity declined, respectively

  11. 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

  12. CT appearance of acute inflammatory disease of the renal interstitium

    International Nuclear Information System (INIS)

    Today, infection remains the most common disease of the urinary tract and constitutes almost 75% of patient problems requiring urologic evaluation. There have been several major factors responsible for our better understanding of the nature and pathophysiology of urinary tract infection. One has been quantitated urine bacteriology and another, the discovery that a significant part of the apparently healthy adult female population has asymptomatic bacteriuria. Abnormal conditions such as neurogenic bladder, bladder malignancy, prolonged catheter drainage and reflux, altered host resistance, diabetes mellitus, and urinary tract obstruction, as well as pregnancy, may either predispose to or be implicated in the pathogenesis of urinary tract infection. There is a wide range of conditions that result in acute renal inflammation and those under discussion affect primarily the interstitium. This term refers to the connective tissue elements separating the tubules in the cortex and medulla. Hence, the interstitial nephritides are to be distinguished from the glomerulonephritides and fall into two general etiologic categories: infectious and noninfectious

  13. ENDOCARDITIS WITH AN UNCOMMON GERM

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    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.

  14. 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...

  15. [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

  16. Urinary catheter related nosocomial infections in paediatric intensive care unit.

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    Tullu M

    1998-04-01

    Full Text Available The present prospective study was carried out in the Paediatric Intensive Care Unit (PICU of a tertiary care teaching hospital in Mumbai. The objective was to determine the incidence, risk factors, mortality and organisms responsible for urinary catheter related infections (UCRI. Colonization and/or bacteriuria was labelled as urinary catheter related infection (UCRI. Forty-four patients with 51 urinary catheters were studied. Incidence of UCRI was 47.06%. Age, female sex and immunocompromised status did not increase the risk of UCRI. Duration of catheter in-situ and duration of stay in the PICU were associated with higher risk of UCRI. The mortality was not increased by UCRI. Commonest organism isolated in UCRI was E. coli, which had maximum susceptibility to nitrofurantoin and amikacin.

  17. Causative agents of urinary tracts infection in children with obstructive uropathy

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    P.V.Glybochko

    2010-06-01

    Full Text Available 167 children with different variants of congenital obstructions of urinary tracts were examined; the causative agents of urinary tracts infections were analyzed in all the cases. The changes of the cytokines levels were determined in those patients which had the more often found causative agents in the analyses. It was mentioned that of the total patients with obstructive uropathy (OU the fifth part in the absence of bacteriuria had a pathogen in biopsy material (BM of urinary tracts. In fourth part of cases microorganisms that were detected in BM and urine did not matched. The changes of cytokines levels in urine did not have any species-specific dependence on causative agent

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

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    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.

  19. Robot-Assisted Laparoscopic Repair of Spontaneous Appendicovesical Fistula

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    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.

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

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    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.

  1. Update on prenatal care.

    Science.gov (United States)

    Zolotor, Adam J; Carlough, Martha C

    2014-02-01

    Many elements of routine prenatal care are based on tradition and lack a firm evidence base; however, some elements are supported by more rigorous studies. Correct dating of the pregnancy is critical to prevent unnecessary inductions and to allow for accurate treatment of preterm labor. Physicians should recommend folic acid supplementation to all women as early as possible, preferably before conception, to reduce the risk of neural tube defects. Administration of Rho(D) immune globulin markedly decreases the risk of alloimmunization in an RhD-negative woman carrying an RhD-positive fetus. Screening and treatment for iron deficiency anemia can reduce the risks of preterm labor, intrauterine growth retardation, and perinatal depression. Testing for aneuploidy and neural tube defects should be offered to all pregnant women with a discussion of the risks and benefits. Specific genetic testing should be based on the family histories of the patient and her partner. Physicians should recommend that pregnant women receive a vaccination for influenza, be screened for asymptomatic bacteriuria, and be tested for sexually transmitted infections. Testing for group B streptococcus should be performed between 35 and 37 weeks' gestation. If test results are positive or the patient has a history of group B streptococcus bacteriuria during pregnancy, intrapartum antibiotic prophylaxis should be administered to reduce the risk of infection in the infant. Intramuscular or vaginal progesterone should be considered in women with a history of spontaneous preterm labor, preterm premature rupture of membranes, or shortened cervical length (less than 2.5 cm). Screening for diabetes should be offered using a universal or a risk-based approach. Women at risk of preeclampsia should be offered low-dose aspirin prophylaxis, as well as calcium supplementation if dietary calcium intake is low. Induction of labor may be considered between 41 and 42 weeks' gestation. PMID:24506122

  2. Asymptomatic bacteriurea among pregnant women visiting Nepal Medical College Teaching Hospital, Kathmandu, Nepal.

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    Marahatta, R; Dhungel, B Acharya; Pradhan, P; Rai, S K; Choudhury, D Roy

    2011-06-01

    Urinary tract infection is the commonest bacterial infection in pregnancy. The overall incidence is 5.0-10.0% of all pregnancy. During pregnancy bacterial growth is favoured by increased urinary content of glucose, aminoacids and other nutrients. Other factors responsible for infection are basically related to hormonal effect and mechanical factors. Prolonged stasis of urine in urinary bladder favours growth of micro organism, relaxation of vesico-ureteric junction leads to reflux of urine from bladder to ureter and later up to renal pelvis and later can affect the renal parenchyma affecting the function of kidneys. In addition, some maternal defense mechanism are less effective during pregnancy. Bacteriuria either asymptomatic (5.0%) or symptomatic is common in pregnancy, if left untreated, asymptomatic bacteriuria will lead to acute pyelonephritis in 20.0-30.0%. This may result in abortion, premature delivery, low birth baby and even still birth. About 12.0% of antenatal admission are sepsis due to pyelonephritis. Keeping in mind that UTI in pregnancy leads to increase in maternal morbidity as well as neonatal morbidity and mortality. In this prospective study all asymptomatic consecutive antenatal women were included 200 from each trimester with total of 600 in number to see the incidence in different trimester, most prevalent organisms and it's sensitivity. They were followed up till delivery to see the incidence of asymptomatic bacteriurea in different trimester and its outcome in terms of type of delivery, baby weight, apgar score given at the time of birth and hospital admission for morbidity. PMID:22364093

  3. 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.

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

    KAUST Repository

    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.

  5. 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)

  6. Epidemiological and clinical aspects of urinary tract infection in community-dwelling elderly women

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    Luiz Paulo José Marques

    2012-10-01

    Full Text Available BACKGROUND: Urinary tract infections (UTIs in elderly patients can be a complex problem in terms of approach to diagnosis, treatment, and prevention, because the patients often present nonspecific symptoms. The epidemiological and clinical characteristics of UTI in elderly women were studied, in order to make early diagnosis and prevent serious clinical complications secondary to UTI. METHODS: This was a prospective population-based study, with elderly women, during their first medical office visit. Medical records were obtained by clinical history and physical examination in order to detect signs and symptoms of UTI and the presence of comorbidities. Clean-catch midstream urine specimens for urinary dipstick test, sediment, and culture were collected; cervical samples for conventional Pap smears were also collected. RESULTS: UTI was found in 16.55% of elderly women. The most frequent urinary symptom was foul smelling urine, in 60.6%. E. coli was responsible for 98 (76.56% cases of significant bacteriuria; 34 (34.69% were resistant to trimethoprim-sulfamethoxazole, and 21 (21.42% to fluoroquinolones. Asymptomatic bacteriuria (AB was not treated. The presence of predisposing factors demonstrated that the history of previous UTI (p < 0.001, vaginitis (p < 0.001, and diabetes (p = 0.042 increased the risk for UTI. CONCLUSION: This study confirmed the high prevalence of UTI among elderly women and its unusual clinical presentation. Diabetes, history of previous UTI, and vaginitis were shown to be predisposing factors for UTI; it is not necessary to treat AB in elderly women, even among diabetics.

  7. 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

  8. Contribution of Proteus mirabilis urease to persistence, urolithiasis, and acute pyelonephritis in a mouse model of ascending urinary tract infection.

    Science.gov (United States)

    Johnson, D E; Russell, R G; Lockatell, C V; Zulty, J C; Warren, J W; Mobley, H L

    1993-07-01

    Proteus mirabilis, a significant cause of bacteriuria and acute pyelonephritis in humans, produces urease. This high-molecular-weight, multimeric, cytoplasmic enzyme hydrolyzes urea to ammonia and carbon dioxide. To assess the role of urease in colonization, urolithiasis, and acute pyelonephritis in an animal model of ascending urinary tract infection, we compared a uropathogenic strain of P. mirabilis with its isogenic urease-negative mutant, containing an insertion mutation within ureC, the gene encoding the large subunit of the enzyme. Mice challenged transurethrally with the parent strain developed significant bacteriuria and urinary stones. The urease-negative mutant had a 50% infective dose of 2.7 x 10(9) CFU, a value more than 1,000-fold greater than that of the parent strain (2.2 x 10(6) CFU). The urease-positive parent strain reached significantly higher concentrations and persisted significantly longer in the bladder and kidney than did the mutant. Indeed, in the kidney, the parent strain increased in concentration while the mutant concentration fell so that, by 1 week, the parent strain concentration was 10(6) times that of the mutant. Similarly, the urease-positive parent produced significantly more severe renal pathology than the mutant. The initial abnormalities were in and around the pelvis and consisted of acute inflammation and epithelial necrosis. By 1 week, pyelitis was more severe, crystals were seen in the pelvis, and acute pyelonephritis, with acute interstitial inflammation, tubular epithelial cell necrosis, and in some cases abscesses, had developed. By 2 weeks, more animals had renal abscesses and radial bands of fibrosis. We conclude that the urease of P. mirabilis is a critical virulence determinant for colonization, urolithiasis, and severe acute pyelonephritis. PMID:8514376

  9. [Staghorn renal lithiasis treated with shock waves. Bacteriologic aspects].

    Science.gov (United States)

    Durlach, R A; Toblli, J E; Gigler, C; Domecq, P; Vázquez, R; Cucci, V; Ramas, H; Ghirlanda, J M

    1994-01-01

    Struvite renal stones are caused by infection of the urine with bacteria that synthesize the enzyme urease. Ammonium is released by the breakdown of urea by urease, the urine becomes highly alkaline, and magnesium ammonium phosphate (struvite) and carbonate apatite crystallize. Incorporation of the infecting bacteria within the developing stone, results in a focus of infection that is resistant to conventional antimicrobial therapy, and which is manifested clinically by repeated urinary tract infection caused by persistent bacteriuria. Extracorporeal shock wave lithotripsy (ESWL) currently is accepted as the election treatment for most renal calculi. This trial examines the bacteriologic aspects pre and post-ESWL. Eighty adult patients, 47 females and 33 males, without clinical signs of urinary tract infections (UTI) were submitted to urine cultures pre and post-ESWL. The first 50 patients underwent during and post-ESWL, 150 blood cultures, which all proved to be negative, confirming very low risk of generalized sepsis. No patient presented fever, chills or rigors pre or postprocedures. With respect to urine cultures 43 patients (52.5%) had a pre-ESWL UTI, in comparison to 49 (60%) who had a UTI post-ESWL. The distribution of organisms pre and post-ESWL was as follows: Proteus mirabilis (22/22), Escherichia coli (11/11), Pseudomonas aeruginosa (4/5), Klebsiella pneumoniae (2/2), Enterobacter cloacae (0/1), Alcaligenes odorans (1/2) Enterococcus faecalis (1/3), Staphylococcus saprophyticus (1/2) and Candida albicans (1/1). In this study 6 patients presented bacteriuria post-ESWL probably due to bacteria from inside the calculi. According to these results, the risk of bacteremia seems to be very low. In 60% of staghorn renal stones we could demonstrate a bacterial infection. PMID:7658975

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

    Science.gov (United States)

    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

  11. 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

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

    Science.gov (United States)

    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

  13. 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

  14. Interactions among urogenital, intestinal, skin, and oral infections in pregnant and lactating Panamanian Ngäbe women: a neglected public health challenge.

    Science.gov (United States)

    González-Fernández, Doris; Koski, Kristine G; Sinisterra, Odalis Teresa; Del Carmen Pons, Emérita; Murillo, Enrique; Scott, Marilyn E

    2015-06-01

    Interrelationships among bacteria, protozoa, helminths, and ectoparasites were explored in a cross-sectional survey of 213 pregnant and 99 lactating indigenous women. Prevalences in pregnancy and lactation, respectively, were: vaginitis (89.2%; 46.8%), vaginal trichomoniasis (75.3%; 91.1%), bacterial vaginosis (BV; 60.6%; 63.3%), hookworm (56.6%; 47.8%), asymptomatic bacteriuria/urinary tract infection (AB/UTI; 56.2%; 36.2%), cervicitis (33.3%; 6.3%), vaginal yeast (24.9%; 11.4%), Ascaris (32.5%; 17.4%), vaginal diplococci (20.4%; 31.6%), caries (19.7%; 18.2%), scabies (17.4%; 8.1%), and Trichuris (12.5%; 8.7%). Multiple regressions revealed positive associations during pregnancy (trichomoniasis and AB/UTI; diplococci and Ascaris) and lactation (yeast and scabies). Negative associations were detected in pregnancy (BV and trichomoniasis; hookworm and diplococci) and lactation (BV and yeast). Vaginal Lactobacillus reduced odds of diplococci in pregnancy and lactation, but increased Ascaris eggs per gram (epg) and odds of trichomoniasis in pregnancy and yeast in lactation. These associations raised a concern that treatment of one condition may increase the risk of another. PMID:25825387

  15. 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.)

  16. 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.

  17. 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.

  18. 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.

  19. Identification of gram positive cocci isolated from urine.

    Science.gov (United States)

    Mathai, E; Margaret, A; George, V; Brahmadathan, K N

    1994-07-01

    A total of 195 strains of Gram positive cocci isolated from urine, in pure culture and in counts of > 10(3) colony forming units/ml, during January-September 1992, were speciated using schema recently described by Facklam and Washington, and Kloos and Lambe. Seventy three (85%) of the 86 enterococci were identified as Enterococcus faecalis while 11 (13%) were E. faecium. Eighteen (29%) of the 62 staphylococcal isolates were Staphylococcus aureus; 20 (45%) of the 44 coagulase negative staphylococci were speciated as Staph. haemolyticus. Of the 47 strains of beta haemolytic streptococci isolated, 45 (96%) were group B; one was group G and the other group F. Our results show the diverse species of Gram positive cocci associated with bacteriuria and the need to speciate them in a diagnostic laboratory. In the context of a larger number of tests required for the speciation of Gram positive cocci, we recommend a simplified scheme which we found feasible on a routine basis. PMID:7927545

  20. 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

  1. 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.

  2. Immediate versus delayed hysterectomy for endometrial carcinoma: surgical morbidity and hospital stay

    International Nuclear Information System (INIS)

    A retrospective review presented is of the intraoperative complications, postoperative morbidity, and length of hospitalization in 138 patients with stage I endometrial carcinoma treated at Yale-New Haven Hospital from January 1, 1977 to December 31, 1981. One group (stage IA, grade 1) was treated with surgery alone; two groups were treated with preoperative intracavitary radium, followed with either an immediate or a delayed hysterectomy. The three groups were comparable in age, weight, and major preoperative medical problems. The mean estimated blood loss during surgery and transfusion requirements during hospitalization were similar for all three groups. The duration of the surgery in the immediate group was longer than the other two groups. The occurrence of febrile morbidity and major postoperative complications in the three groups was similar, except for bacteriuria, which was significantly more common in the immediate group. The length of the postoperative hospitalization was the same for each group; however, the delayed group as compared with the immediate group had a total hospitalization of two days longer. Hence, in the current study, immediate hysterectomy did not significantly increase the surgical or postoperative morbidity rate, compared with delayed hysterectomy. The single hospital stay in the former treatment group represented cost containment

  3. Review of genitourinary tuberculosis with focus on end-stage renal disease

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    Neiberg A. Lima

    2012-02-01

    Full Text Available Tuberculosis (TB is a current public health problem, remaining the most common worldwide cause of mortality from infectious disease. Recent studies indicate that genitourinary TB is the third most common form of extra-pulmonary disease. The diagnosis of renal TB can be hypothesized in a non-specific bacterial cystitis associated with a therapeutic failure or a urinalysis with a persistent leukocyturia in the absence of bacteriuria. We report on the case of a 33-year-old man who presented on admission end stage renal disease (ESRD secondary to renal TB and a past history of pulmonary TB with important radiologic findings. The diagnosis was based on clinical findings despite all cultures being negative. Empiric treatment with tuberculostatic drugs was started and the patient became stable. He was discharged with no symptom, but without renal function recovery. He is on maintenance hemodialysis three times a week. TB is an important cause of kidney disease and can lead to irreversible renal function loss.

  4. 'How to deal with this, that and the other?' An orthopaedic surgeon's unexpected encounter with a trio of problems in an elderly man.

    Science.gov (United States)

    Chen, Yongsheng; Singh, Amritpal; Long, Yiling Angeline; Chee, Yu Han

    2014-01-01

    This is the first clinical report of a psoas abscess encountered during a routine hemiarthroplasty surgery for a femoral neck fracture in a man with a recent urinary tract infection. There were no prior symptoms to suggest a psoas abscess, which was present on the same side as the hip fracture, apart from a history of recurrent urinary tract infection. The surgery had to be altered intraoperatively to that of an excision arthroplasty of the displaced non-viable femoral head along with insertion of an antibiotic-impregnated cement spacer into the hip joint. Relevant microbiological studies confirmed a methicillin-sensitive Staphylococcus aureus psoas abscess with bacteraemia in addition to Staphylococcus bacteriuria, so 6 weeks of intravenous antibiotics were started. A planned second-stage hemiarthroplasty was undertaken and the patient recovered fully without complications. Primary infection of the urinary tract by S. aureus is rare. This case serves to remind clinicians that caution must be exercised in patients with recurrent infections, especially when such infections affect organs or areas close to the intended surgery site. This warrants thorough evaluation for an occult source of infection. A psoas abscess is an unusual cause of hip pain and accurate diagnosis relies on a high index of suspicion. The antibiotic-impregnated articulating cement spacer is a useful surgical adjunct after excision arthroplasty, it not only elutes a high concentration of antibiotics in the infected field, but also facilitates second-stage arthroplasty surgery by preventing muscle and soft tissue contractures from developing. PMID:25385563

  5. 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.

  6. [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

  7. 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

  8. 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,

  9. Host-pathogen interactions in urinary tract infection.

    Science.gov (United States)

    Nielubowicz, Greta R; Mobley, Harry L T

    2010-08-01

    The urinary tract is a common site of bacterial infections; nearly half of all women experience at least one urinary tract infection (UTI) during their lifetime. These infections are classified based on the condition of the host. Uncomplicated infections affect otherwise healthy individuals and are most commonly caused by uropathogenic Escherichia coli, whereas complicated infections affect patients with underlying difficulties, such as a urinary tract abnormality or catheterization, and are commonly caused by species such as Proteus mirabilis. Virulence and fitness factors produced by both pathogens include fimbriae, toxins, flagella, iron acquisition systems, and proteins that function in immune evasion. Additional factors that contribute to infection include the formation of intracellular bacterial communities by E. coli and the production of urease by P. mirabilis, which can result in urinary stone formation. Innate immune responses are induced or mediated by pattern recognition receptors, antimicrobial peptides, and neutrophils. The adaptive immune response to UTI is less well understood. Host factors TLR4 and CXCR1 are implicated in disease outcome and susceptibility, respectively. Low levels of TLR4 are associated with asymptomatic bacteriuria while low levels of CXCR1 are associated with increased incidence of acute pyelonephritis. Current research is focused on the identification of additional virulence factors and therapeutic or prophylactic targets that might be used in the generation of vaccines against both uropathogens. PMID:20647992

  10. 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.

  11. A rare complication of ESWL: Focal metastatic multiple organ abscesses in a horseshoe kidney

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    Ugur Kuyumcuoglu

    2014-06-01

    Full Text Available Extracorporeal shock wave lithotripsy (ESWL is an effective treatment modality in the minimal invasive management of urinary system stone disease. Although the majority of the complications occuring after ESWL are minor (most common ones are gross haematuria, pain, perinephritic hematoma; bacteriuria may also occur in some cases which sometimes can lead to sepsis and even metastatic abscess formation in a very rare part of the cases treated. In this rare situation infection agent spreads quickly via hematogenous route and causes abscess formation in different parts of the body. Majority of such cases usually have an underlying systemic disease like diabetes mellitus (DM, malignancy, HIV or steroid use which lead to disruption of immune system functions. Abscess formation following ESWL is extremely rare and usually limited with some case reports published in the literature. Herein, we present a diabetic case with formation of multiple abscess foci in kidney, as well as in lungs and liver following ESWL. The patient was first admitted to our emergency department with high fever and respiratory distress and misdiagnosed as metastatic tumor foci based on radiologic findings. To the best of our knowledge, our case is the first one in the literature in whom simultanous abscess formation in multiple organ systems has been documented following an otherwise uneventful ESWL.

  12. Antibiotics for Causative Microorganisms of Urinary Tract Infections

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    M Esmaeili

    2005-09-01

    Full Text Available Background: Urinary tract infection is a common bacterial disease in children which may cause chronic renal failure and hypertention. Many reports suggest that the rate of antibiotic resistance to infectious organisms is increasing. Therefore periodic surveillance of resistance rates is needed to ensure that appropriate recommendations can be made for better management & preventing of late sequelae. Methods In this cross sectional descriptive study we investigate the results of urinalysis, urine culture and antibiotic sensitivity of the isolated organisms in the urine of 1556 children aged under 10 years in Mashhad city between April 2001 and June 2002. Described parameters are age, sex, incidence of significant bacteriuria, leucocyturia, causative bacterial agents, and antibiotic sensitivity pattern. Findings: The most common age group in both sexes was infantile period. Median age was 20.3 months in boys and 47.5 months in girls. E.coli, klebsiella and proteus were the causative organisms in 87.3%. They were sensitive to cefotaxime, cefixime, cephalotin, amikacin, ciprofloxacin, nitrofurantoin and gentamicin in more than 96% while resistant to trimetoprim-sultamethoxazol in about 75%. Conclusion: We recommend, with regard to continuous changing in causative microorganisms isolated from patients with urinary tract infection and antibiotic sensitivity pattern, as a guideline for physicians, to determine bacterial sensitivity in populations yearly.

  13. 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.

  14. Urinary Tract Infection: How It Happens?

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    Silvio Altarac

    2015-01-01

    Full Text Available Urinary tract infections (UTIs, including cystitis and pyelonephritis, affect a large proportion of the world population and account for substantial morbidity and medical costs. Classification of the UTIs is based on the anatomical level of infection, the grade of severity of infection, the underlying risk factors, and the microbiological findings. Uropathogenic Escherichia coli is the causative agent in 70-95% of community-acquired uroinfections and about 50% of all cases of nosocomial uroinfections. Virulence factors associated with uropathogenic strains of E. coli contain toxins such as haemolysin and cytotoxic necrotising factor, capsules, lipopolysaccharide, the siderophore aerobactin, and adhesive organelles. The ability to attach to urothelial cells is the most important determinant of pathogenicity. An adherence is followed by inflammation involving the urothelial cells’ cytokine response. Whereas interleukin (IL-6 can cause the fever and systemic response of the UTIs, IL-8 can function as a neutrophil chemoattractant. Cytokines released by T cells and monocytes modify initiative urothelial cells’ cytokine response to bacteria. Nevertheless, antibiotic treatments can effectively sterilise the urine, but bacteria can survive and persist in the bladder tissue, serving as a reservoir for the recurrent UTIs. The severity of 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 is low. It should be reasonable to ‘individualise’ diagnosis and therapy by interconnecting information on uropathogenic bacterial virulence and the host response.

  15. Ronda clínica y epidemiológica: Club de revistas

    Directory of Open Access Journals (Sweden)

    Estrada, Carolina

    2013-04-01

    Full Text Available En esta sección de Ronda Clínica se harán reflexiones y comentarios sobre algunos artículos recientes que han sido considerados por la comunidad médica como investigaciones de gran relevancia para la práctica clínica y la salud pública: la revisión sistemática de Dinicolantonio y colaboradores (1 que cuestiona el paradigma de la dieta baja en sodio frente a la dieta normal en pacientes con falla cardíaca sistólica; la verificación de la importancia de la intuición médica en la detección de infecciones graves en niños según el estudio de Van den Bruel y colaboradores (2; decidir si tratar o no la bacteriuria asintomática en mujeres jóvenes con infecciones recurrentes del tracto urinario, de acuerdo con el ensayo clínico aleatorio de Cai y colaboradores (3; y por último, el descubrimiento de que los usuarios persistentes de cannabis muestran una disminución progresiva e irreversible de sus funciones neuropsicológicas desde la niñez hasta la mitad de la vida, en una gran cohorte prospectiva de neozelandeses seguida desde su nacimiento por Meier y colaboradores (4.

  16. [Uncomplicated urinary tract infection and treatment].

    Science.gov (United States)

    Wagenlehner, F M E; Vahlensieck, W; Watermann, D; Weidner, W; Naber, K G

    2011-01-01

    Urinary tract infections (UTI) are frequent infections in the outpatient and hospital setting. With respect to treatment options, UTI can generally be stratified into uncomplicated and complicated / nosocomial infections. Uncomplicated UTI are represented by the acute uncomplicated cystitis and the uncomplicated pyelonephritis. They are mainly caused by E. coli. There are, however, also increasing resistance rates found in uncomplicated UTI, e. g., against aminopenicillins, cotrimoxazole and increasingly also fluoroquinolones. This development has called for a new evaluation of the treatment recommendations in uncomplicated UTI. As an empirical therapy for uncomplicated cystitis fosfomycin trometamol, nitrofurantoin or pivmecillinam are recommended as first-line agents. As the oral first line therapy for uncomplicated pyelonephritis fluroquinolones in high dosages are recommended. The frequent asymptomatic bacteriuria does not need to be treated, with only a few exceptions. Due to the increasing antibiotic resistance and the emergence of multiresistant uropathogens, empirical antibiotic treatment becomes more difficult. Therefore the results of susceptibility testing should be awaited whenever possible. PMID:21267803

  17. [Are there alternatives to antimicrobial therapy and prophylaxis of uncomplicated urinary tract infections?].

    Science.gov (United States)

    Naber, K G; Alidzhanov, Zh F

    2014-01-01

    The acute uncomplicated cystitis in women is one of the most frequently diagnosed bacterial infection. A clinically symptomatic urinary tract infection must be differentiated from the asymptomatic bacteriuria, which is not considered an infectionbut rather a colonization which should not be treated. For the antimicrobial therapy according to the European guidelines the old oral antibiotics (fosfomycin trometamol, nitrofurantoin, pivmecillinam) should be prescribed, against which E. coli is still susceptible in over 90%. With new therapeutic concepts not mainly the elimination of bacteria but rather the treatment of the inflammatory (over)reaction of the host is highlighted. To establish the significance of these therapeutic options as compared to the standard antibiotic therapy, the results of the ongoing and planned phase 3 studies need to be awaited. Thus reliable clinical measuring parameters for diagnostics and outcome are needed. The acute cystitis symptom score (ACSS) was developed and validated in Russian and Uzbec languages. Because of its high reliability, validity and predictive value it can be used not only in daily practice but also for clinical studies for the diagnosis of an acute uncomplicated cystitis in women. PMID:25799720

  18. Best pharmacological practice: urinary tract infections.

    Science.gov (United States)

    Nicolle, Lindsay

    2003-05-01

    Urinary tract infection is the most frequent bacterial infection. Acute uncomplicated urinary infection and acute non-obstructive pyelonephritis occur in young women with normal genitourinary tracts. Empirical short-course therapy is preferred for the management of acute cystitis, but evolving resistance requires continuing reassessment of optimal antimicrobial selection. Empirical trimethoprim or trimethoprim/sulfamethoxazole has been recommended, but increasing resistance to these agents suggests that pivmecillinam, nitrofurantoin and perhaps fosfomycin trometamol should be considered. Although flouroquinolones are effective as short-course therapy, widespread empirical use of these agents should be discouraged because of potential promotion of resistance. For acute non-obstructive pyelonephritis, flouroquinolones are the empirical oral treatment of choice, although urine culture results should direct continuing therapy. Complicated urinary tract infection occurs in men or women of all ages with underlying abnormalities of the genitourinary tract. Treatment of complicated urinary infection is individualised, taking into consideration the underlying abnormality and susceptibilities of the infecting organism. Asymptomatic bacteriuria should not be treated except in pregnant women, in patients prior to undergoing an invasive surgical procedure, or renal transplant recipients in the early postrenal transplant period. PMID:12739995

  19. Clinical evaluation of pivmecillinam in intractable urinary-tract infections with complications. A comparative study with amoxicillin by a randomized double-blind technique.

    Science.gov (United States)

    Ishigami, J; Tanikaze, S; Miyazaki, S; Ono, S; Kuroda, M; Hirooka, K; Mita, T; Sugimoto, M; Kuroda, K; Nakatsuka, E; Suemitsu, H; Tomioka, S; Takahashi, Y; Hara, S; Terasoma, K; Tanaka, K; Ueharaguchi, H; Hikosaka, K; Yasumuro, T; Kaneda, K; Akita, Y; Okano, H; Kobayashi, M; Kataoka, N

    1977-11-01

    A comparative study was made by the double-blind technique in order to make clear the usefulness of pivmecillinam in the treatment of intractable complicated urinary-tract infections using amoxicillin as a reference drug. Pivmecillinam was given in dosage of 400 mg (potency) per day which was one-fifth the dose of amoxicillin 2,000 mg (potency) per day. In global judgement, pivmecillinam was found superior to amoxicillin. It showed a "significant" superiority over amoxicillin for the treatment of, among others, the urinary-tract infections after prostatectomy, which are intractable diseases. When evaluated by symptoms, pivmecillinam improved bacteriuria "significantly" better than amoxicillin. When seen by causative organisms, the pivmecillinam treatment was "significantly" superior to the amoxicillin treatment against E. coli infections. Pivmecillinam was active against amoxicillin-resistant E. coli. Incidence of adverse reactions was less frequent with pivmecillinam than with amoxicillin. These results indicate that pivmecillinam is a drug of high usefulness for the treatment of intractable complicated urinary-tract infections when evaluated using amoxicillin as a reference drug. PMID:201786

  20. 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

  1. 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

  2. Epidemiology of urinary infections in renal transplant recipients.

    Science.gov (United States)

    Valera, B; Gentil, M A; Cabello, V; Fijo, J; Cordero, E; Cisneros, J M

    2006-10-01

    Urinary tract infection (UTI) remains a significant cause of infectious complications in renal transplant recipients. We evaluated prospectively all the UTIs in 161 kidney recipients transplanted between July 2003 and July 2005. All patients received prophylaxis with sulfadoxine-pyrimethamine. We excluded asymptomatic bacteriuria. Forty-one patients (25%) suffered at least one UTI episode. Ninety-two episodes of infection were confirmed with an incidence rate of 97 UTI episodes per 100 patient-years. The most common clinical features were uncomplicated acute bacterial cystitis, 71 episodes (77%), and acute pyelonephritis, 21 episodes (23%). Microbiological isolation was confirmed in 58 episodes (63%). Bacterial infections were the most frequent etiologies: gram-negative bacilli in 52 (90%), gram-positive cocci in 4 (7%), fungal in 2 (3%), and one viral BK virus (2%) infection. The causative microorganisms were E. coli as the principal isolated agent in 41 cases (71%), including 10 (24%) that were extended-spectrum betalactamases (ESBLEC). All episodes showed a favorable course. The survival rate of the graft at the end of the study period was 90.7%, and the survival rate of the transplant recipients was 97.5%. The incidence of UTI in transplant patients who received antibiotic prophylaxis was high. E. coli (ESBLEC) was the main agent isolated. Uncomplicated UTI, the most frequent post transplantation infection, showed a good prognosis. PMID:17097953

  3. Reflujo vesicoureteral: conceptos actuales

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    Sandalio Durán Álvarez

    2000-06-01

    Full Text Available Se hace una revisión de la literatura y se extraen las siguientes conclusiones: Las cicatrices renales pueden presentarse sin reflujo vesicoureteral (RVU y pueden no existir en presencia de reflujo severo. Aunque tienen más riesgos los lactantes, los niños mayores también son vulnerables. La respiración quirúrgica del RVU no disminuye la incidencia de infección urinaria recurrente, por lo que la cirugía no es el tratamiento de elección y probablemente sea una indicación excepcional. El RVU tiende a resolverse espontáneamente. No deben indicarse antibióticos en los niños con bacteriuria asintomática por ser potencialmente peligrosos. Se deberá descartar RVU mediante uretrocistografía miccional en todo paciente menor de 5 años que padezca infección urinaria aguda febril y especialmente si es menor de 3, independientemente del sexo y del resultado del estudio ultrasonográfico, y a cualquier edad si el ultrasonido detecta cicatriz, dilatación pélvica, mala delimitación corticomedular o signos de displasia; a toda hidronefrosis prenatal que se confirme después del nacimiento y a todo niño con agenesia renal o displasia renal multiquística unilaterales. Los hermanos e hijos de pacientes con RVU necesitan una valoración especial. No está demostrado que la profilaxis antibacteriana prevenga el daño renal en los pacientes con RVU. Se necesitan estudios controlados para poder precisar bien su utilidad o ineficiencia. Se recomienda no utilizarla después de los 3 años de edad.A literature review was made from which the following conclusions were drawn: Renal scars may occur without vesico-ureteral reflux and may not be present when there is severe reflux. Although infants are at more risk, older children are also vulnerable. Surgical repair of vesico-ureteral reflux does not reduce incidence of recurrent urinary infection, so surgery is not a treatment of choice but probably an exceptional measure. Vesico-ureteral reflux tends

  4. Prevention and treatment strategy in pregnant women with group B streptococcal infection.

    Science.gov (United States)

    Tevdorashvili, G; Tevdorashvili, D; Andghuladze, M; Tevdorashvili, M

    2015-04-01

    Group B streptococcus (GBS; Streptococcus agalactiae) are encapsulated gram-positive cocci belonging to Lancefield group B, that frequently colonizes the human genital and gastrointestinal tracts. It is an important cause of illness in three categories of population: infants, pregnant women, and adults with underlying medical conditions. In pregnant women and postpartum women, GBS is a frequent cause of asymptomatic bacteriuria, urinary tract infection, upper genital tract infection (i.e. intraamniotic infection or chorioamnionitis), postpartum endometritis (8%), pneumonia (2%), puerperal sepsis (2%), and bacteremia without a focal site (31%). It also can cause focal infections such as pneumonia, meningitis, and endocarditis, albeit rarely. Invasive maternal infection with GBS is associated with pregnancy loss and preterm delivery. Prior to the widespread use of maternal intrapartum chemoprophylaxis, maternal colonization with GBS conferred an increased risk of chorioamnionitis, and early postpartum infection. The serotype distribution of invasive GBS infection in pregnant women is similar to that of early-onset neonatal disease. The most common GBS serotypes causing invasive disease in adults and neonates are Ia, Ib, III, and V. Vaccination of adolescent women is considered an ideal solution. However, recent reports (April 2015) have shown that serotype IV GBS is emerging in pregnant carriers and causing infections in neonates and adults. This emergence is of concern because GBS conjugate vaccines that are being developed to prevent invasive disease may protect only against serotypes Ia, Ib, II, III, and V, or combinations thereof. Though research for the development of such a vaccine is underway, a good candidate vaccine has yet to surface. PMID:25953932

  5. [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. PMID:22658283

  6. Purple urine bag syndrome in nursing homes: Ten elderly case reports and a literature review

    Directory of Open Access Journals (Sweden)

    Chi-Hung Lin

    2008-08-01

    Full Text Available Chi-Hung Lin1, Hsien-Te Huang1, Chia-Chang Chien1, Dong-Sheng Tzeng1,2, For-Wey Lung1,3–51Department of Psychiatry, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan; 2Graduate Institute of Occupational Safety and Health; 3Graduate Institute of Behavioral Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan; 4Department of Psychiatry, National Defense Medical Center, Taipei, Taiwan; 5Calo Psychiatric Center, Pingtung County, TaiwanAbstract: Purple urine bag syndrome (PUBS is a rare occurrence, in which the patient has a purple-colored urine bag following urinary catheterization for hours to days. Most of authors believe it is a mixture of indigo (blue and indirubin (red that becomes purple. Previous study showed that PUBS occurred predominantly in chronically catheterized, constipated women. We collected 10 elderly patients with PUBS in two nursing homes. The first two cases were identified by chart review in 1987 and 2003, and then later eight cases (42.1% were collected among 19 urinary catheterized elderly in the period between January 2007 and June 2007. In the present report, PUBS probably can occur in any patients with the right elements, namely urinary tract infection (UTI with bacteria possessing these enzymes, diet with enough tryptophan, and being catheterized. Associations with bed-bound state, Alzheimer’s, or dementia from other causes are reflections of the state of such patients who are at higher risk for UTI, and hence PUBS occurred. Although we presented PUBS as a harmless problem, prevention and control of the nosocomial catheter-associated UTIs (CAUTIs has become very important in the new patient-centered medical era. Thus, we should decrease the duration of catheterization, improve catheter care, and deploy technological advances designed for prevention, especially in the elderly cared for in nursing homes.Keyword: purple urine bag syndrome, indigo, indirubin, nursing home, bacteriuria, indoxyl sulphatase

  7. 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.

  8. 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.

  9. Clinical and bacteriological profile of UTI patients attending a North Indian tertiary care center

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    Saif Quaiser

    2015-01-01

    Full Text Available Introduction: Urinary tract infection (UTI is a common cause of morbidity in patients attending our hospital. Recently UTI has become more complicated and difficult to treat because of appearance of pathogens with increasing resistance to the commonly used antimicrobial agents. Objectives: The main aim of the study was to determine the bacteriological profile and antibiotic susceptibility pattern of UTI patients attending our hospital. Materials and Methods: 1843 patients complaining of fever with or without urinary symptoms attending medicine and nephrology clinics of Jawaharlal Nehru Medical College Hospital, Aligarh from June 2012 to July 2014 were analysed. Clean catch mid-stream urine specimens collected from each subject were subjected to urine culture and sensitivity tests. Patients with age 15 to 85 years were included. Results: Significant bacteriuria was detected in 33.4% patients. Diabetes, obstructive uropathy, and previous instrumentation were the major risk factors identified. The most common pathogens isolated were Escherichia coli (52.4%, Klebsiella pneumoniae (12.3% and Citrobacter spp. (9.1%. Most susceptible antibiotic was Amikacin, Cefoperazone-sulbactum, Piperacillin-tazobactum and Nitrofurantoin for most of the isolates. E. coli which was the main isolate was found to be most susceptible to Amikacin (78.3%, Cefoperazone-sulbactum (72.8%, Piperacillin-tazobactum (70.5%, Gentamicin (69.3%, Nitrofurantoin (67.3%, Cefoperazone (64.1% and Ceftriaxone (61.6%. Conclusion: This study highlights the common pathogens causing UTI in our area and their antibiotic sensitivity patterns which could help clinicians in starting rational empirical antibiotic therapy for such patients while awaiting urine culture reports. This would significantly decrease the incidence of drug resistance and be more cost effective to the patients.

  10. 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.

  11. 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.

  12. 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.

  13. Complete genome sequence of uropathogenic Proteus mirabilis, a master of both adherence and motility.

    Science.gov (United States)

    Pearson, Melanie M; Sebaihia, Mohammed; Churcher, Carol; Quail, Michael A; Seshasayee, Aswin S; Luscombe, Nicholas M; Abdellah, Zahra; Arrosmith, Claire; Atkin, Becky; Chillingworth, Tracey; Hauser, Heidi; Jagels, Kay; Moule, Sharon; Mungall, Karen; Norbertczak, Halina; Rabbinowitsch, Ester; Walker, Danielle; Whithead, Sally; Thomson, Nicholas R; Rather, Philip N; Parkhill, Julian; Mobley, Harry L T

    2008-06-01

    The gram-negative enteric bacterium Proteus mirabilis is a frequent cause of urinary tract infections in individuals with long-term indwelling catheters or with complicated urinary tracts (e.g., due to spinal cord injury or anatomic abnormality). P. mirabilis bacteriuria may lead to acute pyelonephritis, fever, and bacteremia. Most notoriously, this pathogen uses urease to catalyze the formation of kidney and bladder stones or to encrust or obstruct indwelling urinary catheters. Here we report the complete genome sequence of P. mirabilis HI4320, a representative strain cultured in our laboratory from the urine of a nursing home patient with a long-term (> or =30 days) indwelling urinary catheter. The genome is 4.063 Mb long and has a G+C content of 38.88%. There is a single plasmid consisting of 36,289 nucleotides. Annotation of the genome identified 3,685 coding sequences and seven rRNA loci. Analysis of the sequence confirmed the presence of previously identified virulence determinants, as well as a contiguous 54-kb flagellar regulon and 17 types of fimbriae. Genes encoding a potential type III secretion system were identified on a low-G+C-content genomic island containing 24 intact genes that appear to encode all components necessary to assemble a type III secretion system needle complex. In addition, the P. mirabilis HI4320 genome possesses four tandem copies of the zapE metalloprotease gene, genes encoding six putative autotransporters, an extension of the atf fimbrial operon to six genes, including an mrpJ homolog, and genes encoding at least five iron uptake mechanisms, two potential type IV secretion systems, and 16 two-component regulators. PMID:18375554

  14. 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.

  15. 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.

  16. Activity of fosfomycin and comparison of several susceptibility testing methods against contemporary urine isolates.

    Science.gov (United States)

    Hirsch, Elizabeth B; Raux, Brian R; Zucchi, Paola C; Kim, Yisu; McCoy, Christopher; Kirby, James E; Wright, Sharon B; Eliopoulos, George M

    2015-12-01

    Fosfomycin is recommended as first-line treatment for acute uncomplicated cystitis in women. It has demonstrated in vitro activity against a variety of pathogens; however, a paucity of data are available from the USA. We determined the susceptibility of a collection of urine isolates to fosfomycin and compared multiple methods of susceptibility testing. Consecutive non-duplicate Enterobacteriaceae, enterococci and Pseudomonas aeruginosa isolates were collected from the clinical microbiology laboratory between August 2013 and January 2014. Isolates represented hospitalised or emergency department patients with monomicrobial bacteriuria. Fosfomycin MICs were determined in duplicate, on separate days, by Etest and disk diffusion and results were compared with agar dilution. Nitrofurantoin and ciprofloxacin were used as comparators. MIC results were categorised using Clinical and Laboratory Standards Institute interpretive criteria for Escherichia coli and Enterococcus faecalis. Correlation between the three testing methods was evaluated. Overall susceptibility to fosfomycin was 94.4%, 93.5% and 87.9% by agar dilution, disk diffusion and Etest, respectively. Five fosfomycin-resistant isolates were identified, including two Morganella morganii, one P. aeruginosa, one Proteus mirabilis and one Enterobacter aerogenes. Across all organisms, rates of essential agreement, categorical agreement, minor errors, major errors and very major errors for Etest/disk diffusion compared with agar dilution were 77.3%/NA, 89.5/93.8%, 7.1/5.0%, 3.6/1.3% and 0/0%, respectively. Fosfomycin displayed fairly consistent activity against a majority of isolates collected when using the susceptibility breakpoint of 64 μg/mL. MICs for E. coli were particularly low (≤2 μg/mL). These data lend support to current guidelines that recommend fosfomycin as empirical first-line therapy for uncomplicated UTI. PMID:26498988

  17. Imaging findings of xanthogranulomatous pyelonephritis

    International Nuclear Information System (INIS)

    To define the imaging patterns of xanthogranulomatous pyelonephritis (XGP). The demographic, clinical, and imaging findings of 21 cases of pathologically proven XGP in 20 patients (bilateral in one) were evaluated. The findings of ultrasonography and CT were retrospectively evaluated with regard to distribution and extent of the disease, kidney size, the presence of calculi, hydronephrosis, and renal function. The findings were assessed by two radiologists, who established a consensus. Imaging and pathologic findings were compared. Sixteen of the 20 patients were female, and 19 were adults. Their age ranged from 3 to 16 (mean, 45) years. In all patients except one, the disease was unilateral (right: left =3D 13 :16). In one patient, XGP was bilateral, and there were thus 21 cases. Seventeen (81%) of these were diffuse, and four (19%) were focal; extrarenal extension occurred in 13 cases (62%), among which ipsilateral pleural effusion was noted in two. The kidney was enlarged diffusely in 12 cases (57%), and focally in three (14%); urinary calculi were present in 16 cases (76%), with staghorn calculi in four of these; and hydronephrosis occurred in 17 (81%). Impairment of ipsilateral renal function was noted in 13 cases (62%). Clinical findings of inflammation such as fever, pyuria, bacteriuria, or leucocytosis were noted in all patients. In addition to nephromegaly, renal function impairment, and urinary obstruction due to calculi, which are typical features of XGP, the condition may also show variable imaging findings. If the images obtained in the case of a middle-aged woman with clinical findings of urinary infection are atypical, we believe that XGP should be included in the differential diagnosis. (author)

  18. 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

  19. [Clinical evaluation of pivmecillinam in the maintenance therapy of chronic urinary tract infection (author's transl)].

    Science.gov (United States)

    Tamaya, T; Tsurusaki, T; Kusanishi, H; Okada, H; Yamamoto, H; Ahara, M; Murakami, A; Takano, N; Obata, T; Shimura, T; Iwasaki, T; Nakata, Y; Futaoka, S; Ohshima, K; Furuta, N; Murakami, T; Ohtani, I; Sugihara, Y; Yuasa, M; Mizunoya, F; Ota, S; Fujita, H; Ueha, I; Katoh, K

    1981-09-01

    In order to evaluate the efficacy and safety of pivmecillinam (melysin tablet, PMPC), PMPC was administered to 78 chronic UTI cases in the field of obstetrics and gynecology (posthysterectomy infection, chronic cystitis, chronic pyelonephritis and etc.). In principle, daily 400 mg of PMPC was administered for 2 weeks. (1) Overall clinical efficacy judged by doctor was evaluated in 78 cases and the result was; excellent in 17, good in 37, fair in 10, poor in 13 and unknown in 1 case with the effectiveness rate of 69.2%. (2) Overall clinical efficacy judged by 'criteria for clinical evaluation in complicated UTI' recommended by UTI study member was evaluated in 54 cases and the result was; excellent in 15, good in 20 and poor in 19 cases with the overall efficacy rate of 64.8%, the result of which was similar to that of doctor's judgement. (3) Efficacy on pyuria was evaluated in 72 cases and it was cleared in 27, decreased in 25, unchanged in 20 and unknown in 6 cases. Efficacy on bacteriuria was evaluated in 72 cases and it was eliminated in 44, decreased in 9, replaced in 8, unchanged in 8 and unknown in 9 cases. (4) Side effect, considered by doctors to be caused by PMPC administration, was noticed in 3 out of 78 cases (3.8%), all of which was mild gastrointestinal disturbance and the administration of PMPC was continued. Abnormal change of laboratory finding considered by doctors to be caused by PMPC administration was noticed in 1 out of 78 cases, which was slight elevation of GOT and GPT values. It is therefore considered that PMPC appear to be useful drug for the maintenance therapy of chronic UTI in the field of obstetrics and gynecology. PMID:6276586

  20. 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

  1. 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.

  2. Urinary tract infection in the neurogenic bladder.

    Science.gov (United States)

    Vigil, Humberto R; Hickling, Duane R

    2016-02-01

    There is a high incidence of urinary tract infection (UTI) in patients with neurogenic lower urinary tract function. This results in significant morbidity and health care utilization. Multiple well-established risk factors unique to a neurogenic bladder (NB) exist while others require ongoing investigation. It is important for care providers to have a good understanding of the different structural, physiological, immunological and catheter-related risk factors so that they may be modified when possible. Diagnosis remains complicated. Appropriate specimen collection is of paramount importance and a UTI cannot be diagnosed based on urinalysis or clinical presentation alone. A culture result with a bacterial concentration of ≥10(3) CFU/mL in combination with symptoms represents an acceptable definition for UTI diagnosis in NB patients. Cystoscopy, ultrasound and urodynamics should be utilized for the evaluation of recurrent infections in NB patients. An acute, symptomatic UTI should be treated with antibiotics for 5-14 days depending on the severity of the presentation. Antibiotic selection should be based on local and patient-based resistance patterns and the spectrum should be as narrow as possible if there are no concerns regarding urosepsis. Asymptomatic bacteriuria (AB) should not be treated because of rising resistance patterns and lack of clinical efficacy. The most important preventative measures include closed catheter drainage in patients with an indwelling catheter and the use of clean intermittent catheterization (CIC) over other methods of bladder management if possible. The use of hydrophilic or impregnated catheters is not recommended. Intravesical Botox, bacterial interference and sacral neuromodulation show significant promise for the prevention of UTIs in higher risk NB patients and future, multi-center, randomized controlled trials are required. PMID:26904414

  3. [Urinary tract infection in pregnancy].

    Science.gov (United States)

    Duarte, Geraldo; Marcolin, Alessandra Cristina; Quintana, Silvana Maria; Cavalli, Ricardo Carvalho

    2008-02-01

    Several factors cause urinary tract infection (UTI) to be a relevant complication of the gestational period, aggravating both the maternal and perinatal prognosis. For many years, pregnancy has been considered to be a factor predisposing to all forms of UTI. Today, it is known that pregnancy, as an isolated event, is not responsible for a higher incidence of UTI, but that the anatomical and physiological changes imposed on the urinary tract by pregnancy predispose women with asymptomatic bacteriuria (AB) to become pregnant women with symptomatic UTI. AB affects 2 to 10% of all pregnant women and approximately 30% of these will develop pyelonephritis if not properly treated. However, a difficult-to-understand resistance against the identification of AB during this period is observed among prenatalists. The diagnosis of UTI is microbiological and it is based on two urine cultures presenting more than 10(5) colonies/mL urine of the same germ. Treatment is facilitated by the fact that it is based on an antibiogram, with no scientific foundation for the notion that a pre-established therapeutic scheme is an adequate measure. For the treatment of pyelonephritis, it is not possible to wait for the result of culture and previous knowledge of the resistance profile of the antibacterial agents available for the treatment of pregnant women would be the best measure. Another important variable is the use of an intravenous bactericidal antibiotic during the acute phase, with the possibility of oral administration at home after clinical improvement of the patient. At our hospital, the drug that best satisfies all of these requirements is cefuroxime, administered for 10-14 days. Third-generation cephalosporins do not exist in the oral form, all of them involving the inconvenience of parenteral administration. In view of their side effects, aminoglycosides are considered to be inadequate for administration to pregnant women. The inconsistent insinuation of contraindication of

  4. Approach to urinary tract infections.

    Science.gov (United States)

    Najar, M S; Saldanha, C L; Banday, K A

    2009-10-01

    Urinary tract infection (UTI) is the most common infection experienced by humans after respiratory and gastro-intestinal infections, and also the most common cause of both community-acquired and nosocomial infections for patients admitted to hospitals. For better management and prognosis, it is mandatory to know the possible site of infection, whether the infection is uncomplicated or complicated, re-infection or relapse, or treatment failure and its pathogenesis and risk factors. Asymptomatic bacteriuria is common in certain age groups and has different connotations. It needs to be treated and completely cured in pregnant women and preschool children. Reflux nephropathy in children could result in chronic kidney disease; otherwise, urinary tract infections do not play a major role in the pathogenesis of end-stage renal disease. Symptomatic urinary tract infections occur most commonly in women of child-bearing age. Cystitis predominates, but needs to be distinguished from acute urethral syndrome that affects both sexes and has a different management plan than UTIs. The prostatitis symptoms are much more common than bacterial prostatic infections. The treatment needs to be prolonged in bacterial prostatitis and as cure rates are not very high and relapses are common, the classification of prostatitis needs to be understood. The consensus conference convened by National Institute of Health added two more groups of patients, namely, chronic prostatitis/chronic pelvic pain syndrome and asymptomatic inflammatory prostatitis, in addition to acute and chronic bacterial prostatitis. Although white blood cells in urine signify inflammation, they do not always signify UTI. Quantitative cultures of urine provide definitive evidence of UTI. Imaging studies should be done 3-6 weeks after cure of acute infection to identify abnormalities predisposing to infection or renal damage or which may affect management. Treatment of cystitis in women should be a three-day course and if

  5. 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.

  6. 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

  7. 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

  8. 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

  9. Burden of invasive group B Streptococcus disease and early neurological sequelae in South African infants.

    Directory of Open Access Journals (Sweden)

    Ziyaad Dangor

    Full Text Available Group B Streptococcus (GBS is a leading cause of neonatal sepsis and meningitis. We aimed to evaluate the burden of invasive early-onset (0-6 days of life, EOD and late-onset (7-89 days, LOD GBS disease and subsequent neurological sequelae in infants from a setting with a high prevalence (29.5% of HIV among pregnant women.A case-control study was undertaken at three secondary-tertiary care public hospitals in Johannesburg. Invasive cases in infants <3 months age were identified by surveillance of laboratories from November 2012 to February 2014. Neurodevelopmental screening was done in surviving cases and controls at 3 and 6 months of age.We identified 122 cases of invasive GBS disease over a 12 month period. Although the incidence (per 1,000 live births of EOD was similar between HIV-exposed and HIV-unexposed infants (1.13 vs. 1.46; p = 0.487, there was a 4.67-fold (95%CI: 2.24-9.74 greater risk for LOD in HIV-exposed infants (2.27 vs. 0.49; p<0.001. Overall, serotypes Ia, Ib and III constituted 75.8% and 92.5% of EOD and LOD, respectively. Risk factors for EOD included offensive draining liquor (adjusted Odds Ratio: 27.37; 95%CI: 1.94-386.50 and maternal GBS bacteriuria (aOR: 8.41; 95%CI: 1.44-49.15, which was also a risk-factor for LOD (aOR: 3.49; 95%CI: 1.17-10.40. The overall case fatality rate among cases was 18.0%. The adjusted odds for neurological sequelae at 6 months age was 13.18-fold (95%CI: 1.44-120.95 greater in cases (13.2% than controls (0.4%.The high burden of invasive GBS disease in South Africa, which is also associated with high case fatality rates and significant neurological sequelae among survivors, is partly due to the heightened risk for LOD in infants born to HIV-infected women. An effective trivalent GBS conjugate vaccine targeted at pregnant women could prevent invasive GBS disease in this setting.

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

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    Iris de Castaño

    2009-11-01

    Full Text Available Introduction: Urinary tract infection (UTI is the most common renal disease in childhood. To find the etiologic microorganism and an early adequate antibiotic therapy are essential to avoid permanent kidney injuries. Objectives: To know the etiologic bacteria and their antibiotic sensibility in urine cultures of children with UTI consulting University Hospital and Club Noel Hospital in Cali, Colombia. Methodology: A total of 123 children under 14 years of age that came into Emergency Service or outpatient clinics at University Hospital or Club Noel Hospital with clinical suspicion of UTI from August 2004 to February 2005 were included in a descriptive transversal study. Urine cultures were taken by supra-pubic aspiration, urine catheterization or mid strain urine. UTI definition was based on colony counts according to recollection method. Positive urine cultures, type of bacteria and antibiotic sensibility were considered for the analysis. Children having either urine cultures with colony counts inferior to recollection method, asymptomatic bacteriuria, occasional catheterization, immunosuppression, vesicostomy or previous admission to intensive care unit, were excluded. Results: Among 123 children entering to the study, 31 were eliminated for colony counts inferior to the recollection method. A total of 123 urine cultures were left for the analysis: 50% of urine cultures were obtained by catheterization, 33% via mid void stream and 17% by supra-pubic aspiration; 58% of patients were females. Escherichia coli was cultured in 72% of the cases, Klebsiella in 16.4%, Proteus 2.5% and other type of bacteria account for 9%. Antibiotics and antibacterials with sensibility over 80% were: cefixime, norfloxocin, cefuroxime, cefprozil, nalidixic acid, ceftriaxone, amikacin, and gentamicin. Intermediate sensibility from 61 to 70%: amoxicillin-clavulinic, cefaclor, ciprofloxacin, and nitrofurantoin. Sensibility under 60% was found for amoxicillin, ampicillin

  11. Characteristics and predictors of death among hospitalized HIV-infected patients in a low HIV prevalence country: Bangladesh.

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    Lubaba Shahrin

    Full Text Available BACKGROUND: Predictors of death in hospitalized HIV-infected patients have not been previously reported in Bangladesh. OBJECTIVE: The primary aim of this study was to determine predictors of death among hospitalized HIV-infected patients at a large urban hospital in Bangladesh. METHODS: A study was conducted in the HIV in-patient unit (Jagori Ward of icddr,b's Dhaka Hospital. Characteristics of patients who died during hospitalization were compared to those of patients discharged from the ward. Bivariate analysis was performed to determine associations between potential risk factors and death. Multivariable logistic regression was used to identify factors independently associated with death. RESULTS: Of 293 patients admitted to the Jagori Ward, 57 died during hospitalization. Most hospitalized patients (67% were male and the median age was 35 (interquartile range: 2-65 years. Overall, 153 (52% patients were diagnosed with HIV within 6 months of hospitalization. The most common presumptive opportunistic infections (OIs identified were tuberculosis (32%, oesophageal candidiasis (9%, Pneumocystis jirovecii pneumonia (PJP (8%, and histoplasmosis (7%. On multivariable analysis, independent predictors of mortality were CD4 count ≤200 cells/mm3 (adjusted odds ratio [aOR]: 16.6, 95% confidence interval [CI]: 3.7-74.4, PJP (aOR: 18.5, 95% CI: 4.68-73.3, oesophageal candidiasis (aOR: 27.5, 95% CI: 5.5-136.9, malignancy (aOR:15.2, 95% CI: 2.3-99.4, and bacteriuria (aOR:7.9, 95% CI: 1.2-50.5. Being on antiretroviral therapy prior to hospitalization (aOR: 0.2, 95% CI: 0.06-0.5 was associated with decreased mortality. CONCLUSION: This study showed that most patients who died during hospitalization on the Jagori Ward had HIV-related illnesses which could have been averted with earlier diagnosis of HIV and proper management of OIs. It is prudent to develop a national HIV screening programme to facilitate early identification of HIV.

  12. A Clinical and Radiological Observation on Urolithiasis

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    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. Risk factors and treatment of urinary tract infections in elderly people

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    Doder Radoslava

    2014-01-01

    Gerontology Center, were reported by 9 (22.5%, 25 (62.5% and 16 (40% users, respectively. The most frequent associated diseases were diabetes mellitus and therapeutic procedures on the prostate and bladder in 7 (17.5% and stroke in 5 (12.5% participants. Conclusion. Urinary infections in the elderly remain a highly challenging issue from both diagnostics and treatment standpoint. An update of guidelines to the relevant antimicrobial therapy is a prerequisite in order to decrease the uncritical administration of antibiotics in asymptomatic bacteriuria and to prevent the spreading of multiresistant organisms.

  14. 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

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

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    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

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

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    Atsushi Wada

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

  17. 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

  18. 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

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    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

  19. 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.

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

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    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

  1. 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

  2. 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

  3. 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.

  4. Infecção urinária na gravidez Urinary tract infection in pregnancy

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    Geraldo Duarte

    2008-02-01

    inconsistentes insinuações de contra-indicações das quinolonas monofluoradas, havendo indicação, acredita-se que a norfloxacina possa ser uma boa opção à cefuroxima. Para os casos em que a profilaxia da ITU está indicada, preferem-se os quimioterápicos, entre eles a nitrofurantoína, com o cuidado de evitar seu uso no final da gravidez pelo risco de kernicterus no neonato.Several factors cause urinary tract infection (UTI to be a relevant complication of the gestational period, aggravating both the maternal and perinatal prognosis. For many years, pregnancy has been considered to be a factor predisposing to all forms of UTI. Today, it is known that pregnancy, as an isolated event, is not responsible for a higher incidence of UTI, but that the anatomical and physiological changes imposed on the urinary tract by pregnancy predispose women with asymptomatic bacteriuria (AB to become pregnant women with symptomatic UTI. AB affects 2 to 10% of all pregnant women and approximately 30% of these will develop pyelonephritis if not properly treated. However, a difficult to understand resistance against the identification of AB during this period is observed among prenatalists. The diagnosis of UTI is microbiological and it is based on two urine cultures presenting more than 10(5 colonies/mL urine of the same germ. Treatment is facilitated by the fact that it is based on an antibiogram, with no scientific foundation for the notion that a pre-established therapeutic scheme is an adequate measure. For the treatment of pyelonephritis, it is not possible to wait for the result of culture and previous knowledge of the resistance profile of the antibacterial agents available for the treatment of pregnant women would be the best measure. Another important variable is the use of an intravenous bactericidal antibiotic during the acute phase, with the possibility of oral administration at home after clinical improvement of the patient. At our hospital, the drug that best satisfies all of

  5. 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