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Sample records for tract infection diagnosis

  1. Diagnosis of pediatric urinary tract infections

    Directory of Open Access Journals (Sweden)

    Jeng-Daw Tsai

    2016-09-01

    Full Text Available Urinary tract infection (UTI is the second common infection in children. The diagnosis of UTI in infants and children can be difficult. Good history taking and physical examination are corner stones of good care of UTI. In addition, this article reviewed current evident on the methods of urine specimen collection and various diagnostic criteria to reach the diagnosis of UTI. Asian Guideline for UTI in children is highlighted to increase consensus of the diagnosis of UTI.

  2. Diagnosis of pediatric urinary tract infections

    OpenAIRE

    Jeng-Daw Tsai; Chun-Chen Lin; Stephan S. Yang

    2016-01-01

    Urinary tract infection (UTI) is the second common infection in children. The diagnosis of UTI in infants and children can be difficult. Good history taking and physical examination are corner stones of good care of UTI. In addition, this article reviewed current evident on the methods of urine specimen collection and various diagnostic criteria to reach the diagnosis of UTI. Asian Guideline for UTI in children is highlighted to increase consensus of the diagnosis of UTI.

  3. Diagnosis of Urinary Tract Infections in Children

    Science.gov (United States)

    2016-01-01

    Urinary tract infections (UTIs) are a common occurrence in children. The management and laboratory diagnosis of these infections pose unique challenges that are not encountered in adults. Important factors, such as specimen collection, urinalysis interpretation, culture thresholds, and antimicrobial susceptibility testing, require special consideration in children and will be discussed in detail in the following review. PMID:27053673

  4. Pediatric urinary tract infections: diagnosis and treatment.

    Science.gov (United States)

    Bitsori, Maria; Galanakis, Emmanouil

    2012-10-01

    Urinary tract infection (UTI) is the most common serious bacterial infection in childhood. Prompt diagnosis and treatment are required for the optimal clinical outcome and the prevention of long-term morbidity and sequelae. Diagnosis and treatment of UTI may seem to be easy tasks, but they remain among the most controversial issues in pediatrics. Consequently, children suspected for UTIs are investigated and treated differently in different settings. The absence of typical clinical presentation and the uncertainties in setting the index of suspicion, collecting appropriate urine samples and interpreting results, combined with different antibiotic policies in the face of increasing resistance of uropathogens, contribute to the controversy. Recently issued guidelines have attempted to settle several thorny aspects in diagnosis and treatment, but quite a few issues still remain controversial. In this review, the authors explore the current situation on diagnosis and treatment of childhood UTI in better understanding their pathogenesis and prevalence in different child populations, discuss recently evaluated diagnostic tests and the new management guidelines.

  5. Diagnosis and treatment of urinary tract infections across age groups.

    Science.gov (United States)

    Chu, Christine M; Lowder, Jerry L

    2018-01-02

    increasing to fluoroquinolones, beta-lactams, and trimethoprim-sulfamethoxazole. Most uropathogens still display good sensitivity to nitrofurantoin. First-line treatments for urinary tract infection include nitrofurantoin, fosfomycin, and trimethoprim-sulfamethoxazole (when resistance levels are urinary tract infection based on symptoms and testing allows for greater accuracy in diagnosis of urinary tract infection, decreasing overtreatment and encouraging antimicrobial stewardship. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. Diagnosis and clinical management of urinary tract infection

    OpenAIRE

    Heilberg, Ita Pfeferman; Schor, Nestor

    2003-01-01

    A review about recent aspects on diagnosis and clinical management of urinary tract infection (UTI) is presented. There is a wide variation in clinical presentation of UTI which include different forms as cystitis, pyelonephritis, urethral syndrome and the clinical relevance of asymptomatic bacteriuria and low-count bacteriuria that must be distinguished from contamination. Pathogenetic aspects concerning bacterial virulence as well as host factors in susceptibility to UTI as urinary tract ob...

  7. Comparative Study on Diagnosis of Urinary Tract Infection among ...

    African Journals Online (AJOL)

    Urinary tract infection (UTI) is associated with clinical conditions such as hypertension, anaemia, kidney failure and even death. Diagnosis and early detection of UTI are critical measures in the management of the disease. The classical microbiological culture method is hindered by long diagnostic time and characteristic ...

  8. Urinary Tract Infections in Pregnancy - Diagnosis, Treatment and Prevention

    OpenAIRE

    Figueiredo, A; Gomes, G; Campos, A

    2012-01-01

    Objectives: Literature review of classification, epidemiology, pathophysiology, microbiology, clinical presentation, diagnosis, complications, treatment and prevention of urinary tract infections (UTI) in pregnancy. Data Sources and Review Methods: Bibliographic research in Medline, through PubMed and Medscape, of systematic reviews, observational studies, clinical guidelines, meta-analyses and randomized controlled trials published between January 1992 and December 2010. Results: Asymp...

  9. [Diagnosis and clinical management of urinary tract infection].

    Science.gov (United States)

    Heilberg, Ita Pfeferman; Schor, Nestor

    2003-01-01

    A review about recent aspects on diagnosis and clinical management of urinary tract infection (UTI) is presented. There is a wide variation in clinical presentation of UTI which include different forms as cystitis, pyelonephritis, urethral syndrome and the clinical relevance of asymptomatic bacteriuria and low-count bacteriuria that must be distinguished from contamination. Pathogenetic aspects concerning bacterial virulence as well as host factors in susceptibility to UTI as urinary tract obstruction, vesicoureteral reflux, indwelling bladder catheters, pregnancy, diabetes mellitus, sexual activity, contraceptive methods, prostatism, menopause, advanced age and renal transplantation are discussed. Diagnostic criteria and the most common tests utilized for differentiation between lower and upper UTI have been reviewed. The authors conclude that a careful evaluation of the underlying factors is required for the correct diagnosis of UTI and to prevent recurrence and that appropriate strategies and specific therapeutic regimens may maximize the benefit while reducing costs and adverse reactions.

  10. The Diagnosis, Evaluation and Treatment of Acute and Recurrent Pediatric Urinary Tract Infections

    Science.gov (United States)

    Becknell, Brian; Schober, Megan; Korbel, Lindsey; Spencer, John David

    2015-01-01

    Urinary tract infection is one of the most common bacterial infections encountered by pediatricians. Currently, the diagnosis and management of acute urinary tract infection and recurrent urinary tract infection in children remains controversial. Recently published guidelines and large clinical trials have attempted to clarify UTI diagnostic and management strategies. In this manuscript, we review the diagnosis and management of acute and recurrent urinary tract infection in the pediatric population. PMID:25421102

  11. Pathogenesis and Laboratory Diagnosis of Childhood Urinary Tract Infection

    Directory of Open Access Journals (Sweden)

    Jharna Mandal

    2016-04-01

    Full Text Available Urinary tract infection (UTI is one of the most common infections of childhood. The clinical presentations are mostly non-specific or mild. As any episode of UTI can potentially damage the kidneys, timely diagnosis and treatment are necessary to prevent renal damage. Incidence of UTI varies depending on the age, gender, and race of the child. UTIs in children are commonly caused by bacteria, though viruses, fungi, and parasites are also occasionally involved. The pathogenesis of UTI is complex where several host and pathogen factors influence the course of the disease and its outcome. Urine culture is still considered the gold standard method for the diagnosis of UTI. The means of obtaining urine samples from children for culture involves urethral catheterisation and suprapubic aspiration. The conventional methods of antibiotic susceptibility testing are labour intensive and time exhaustive. With the advent of technology, many automated platforms are available which are rapid, involve less volume of the culture or the sample, and have high accuracy.

  12. Urinary tract infections in infants and children: Diagnosis and management.

    Science.gov (United States)

    Robinson, Joan L; Finlay, Jane C; Lang, Mia Eileen; Bortolussi, Robert

    2014-06-01

    Recent studies have resulted in major changes in the management of urinary tract infections (UTIs) in children. The present statement focuses on the diagnosis and management of infants and children >2 months of age with an acute UTI and no known underlying urinary tract pathology or risk factors for a neurogenic bladder. UTI should be ruled out in preverbal children with unexplained fever and in older children with symptoms suggestive of UTI (dysuria, urinary frequency, hematuria, abdominal pain, back pain or new daytime incontinence). A midstream urine sample should be collected for urinalysis and culture in toilet-trained children; others should have urine collected by catheter or by suprapubic aspirate. UTI is unlikely if the urinalysis is completely normal. A bagged urine sample may be used for urinalysis but should not be used for urine culture. Antibiotic treatment for seven to 10 days is recommended for febrile UTI. Oral antibiotics may be offered as initial treatment when the child is not seriously ill and is likely to receive and tolerate every dose. Children UTI with a renal/bladder ultrasound to identify any significant renal abnormalities. A voiding cystourethrogram is not required for children with a first UTI unless the renal/bladder ultrasound reveals findings suggestive of vesicoureteral reflux, selected renal anomalies or obstructive uropathy.

  13. Diagnosis and management of bacteremic urinary tract infection in infants.

    Science.gov (United States)

    Roman, Heidi K; Chang, Pearl W; Schroeder, Alan R

    2015-01-01

    To report the prevalence of bacteremia by age in a sample of infantsurinary tract infections (UTIs), to compare characteristics of infants with UTIs with and without bacteremia, and to describe treatment courses and 30-day outcomes in infants with UTIs with and without bacteremia. We used a retrospective cross-sectional design to determine the prevalence of bacteremia in infants with UTIs at our institution. A double cohort design matching for age and gender was used to compare clinical characteristics and outcomes between infants with bacteremic versus nonbacteremic UTIs. We identified 1379 UTIs, with blood cultures obtained in 52% of cases. The prevalence of bacteremia was 4.1% (95% confidence interval 3.1%-5.3%) for all UTIs and 8% (95% confidence interval 6.1%-10.2%) for UTIs in which blood culture was obtained. Fifty-five infants with bacteremic UTIs were compared with 110 infants with nonbacteremic UTIs. Except for minor differences in the urinalysis and serum band count, there were no significant differences in clinical presentation between the 2 groups. Bacteremic infants received longer parenteral treatment courses than nonbacteremic infants (mean 6.7 vs 2.4 days, PPediatrics.

  14. Urinary Tract Infection (UTI)

    Science.gov (United States)

    ... Home A-Z Health Topics Urinary tract infections Urinary tract infections > A-Z Health Topics Urinary tract infections (PDF, ... Embed Subscribe To receive Publications email updates Submit Urinary tract infections Urinary tract infections (UTIs) are most often caused ...

  15. Quality indicators for the diagnosis and antibiotic treatment of acute respiratory tract infections in general practice

    DEFF Research Database (Denmark)

    Saust, Laura Trolle; Bjerrum, Lars; Arpi, Magnus

    2017-01-01

    Objective: To develop quality indicators for the diagnosis and antibiotic treatment of acute respiratory tract infections, tailored to the Danish general practice setting. Design: A RAND/UCLA Appropriateness Method was used. Setting: General practice. Subjects: A panel of nine experts, mainly...... general practitioners, was asked to rate the relevance of 64 quality indicators for the diagnosis and antibiotic treatment of acute respiratory tract infections based on guidelines. Subsequently, a face-to-face meeting was held to resolve misinterpretations and to achieve consensus. Main outcome measures...

  16. Quality indicators for diagnosis and treatment of respiratory tract infections in general practice:

    DEFF Research Database (Denmark)

    Plejdrup, Malene; Bjerrum, Lars; Gahrn-Hansen, Bente

    Objective: To develop a set of quality indicators focusing on the diagnosis and treatment of respiratory tract infections in general practice.  Material and methods: A modified 2-round Delphi study was conducted from April to July 2008. A panel of 27 experts (13 countries) comprising mainly general...

  17. Diagnosis of aetiology and complications of relapsing urinary tract infections via imaging methods

    International Nuclear Information System (INIS)

    Rieden, K.; Mende, U.

    1985-01-01

    The indication and efficiency of various radiological examination methods in relapsing infections of the urinary tract, as well as the complications of such infections, are described, and characteristic and pathognomical findings are demonstrated. The diagnostic accuracy of the individual imaging methods depends on the site, size, and density of the pathological process. Accurate diagnosis also requires the incorporation of clinical findings including those established by means of clinical pathology setups. (orig.) [de

  18. Surface enhanced Raman spectroscopy for urinary tract infection diagnosis and antibiogram

    Science.gov (United States)

    Kastanos, Evdokia; Hadjigeorgiou, Katerina; Kyriakides, Alexandros; Pitris, Constantinos

    2010-02-01

    Urinary tract infection diagnosis and antibiogram require a minimum of 48 hours using standard laboratory practice. This long waiting period contributes to an increase in recurrent infections, rising health care costs, and a growing number of bacterial strains developing resistance to antibiotics. In this work, Surface Enhanced Raman Spectroscopy (SERS) was used as a novel method for classifying bacteria and determining their antibiogram. Five species of bacteria were classified with > 90% accuracy using their SERS spectra and a classification algorithm involving novel feature extraction and discriminant analysis. Antibiotic resistance or sensitivity was determined after just a two-hour exposure of bacteria to ciprofloxacin (sensitive) and amoxicillin (resistant) and analysis of their SERS spectra. These results can become the basis for the development of a novel method that would provide same day diagnosis and selection of the most appropriate antibiotic for most effective treatment of a urinary tract infection.

  19. Quality indicators for the diagnosis and antibiotic treatment of acute respiratory tract infections in general practice

    DEFF Research Database (Denmark)

    Saust, Laura Trolle; Bjerrum, Lars; Arpi, Magnus

    2017-01-01

    Objective: To develop quality indicators for the diagnosis and antibiotic treatment of acute respiratory tract infections, tailored to the Danish general practice setting. Design: A RAND/UCLA Appropriateness Method was used. Setting: General practice. Subjects: A panel of nine experts, mainly...... general practitioners, was asked to rate the relevance of 64 quality indicators for the diagnosis and antibiotic treatment of acute respiratory tract infections based on guidelines. Subsequently, a face-to-face meeting was held to resolve misinterpretations and to achieve consensus. Main outcome measures...... indicators focusing on the diagnostic process and 19 indicators focusing on the decision about antibiotic treatment and choice of antibiotics, respectively. Conclusion: These newly developed quality indicators may be used to strengthen Danish general practitioners’ focus on their management of patients...

  20. RECOMMENDATIONS ON DIAGNOSIS AND TREATMENT OF URINARY TRACT INFECTIONS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    T. V. Margiyeva

    2016-01-01

    Full Text Available Given very high prevalence of urinary tract infection (UTI in the setting of renal pathology in children, timely disease identification, adequate antibacterial treatment and, if necessary, anti relapse therapy are of extreme importance. It is known that recurrent UTI is a risk factor of renal damage progression and development of renal failure. The given clinical recommendations on UTI diagnosis and management are based on the evidence-based approach. This helps to optimize work of pediatricians and pediatric nephrologists.

  1. Antibiotic treatment and the diagnosis of Streptococcus pneumoniae in lower respiratory tract infections in adults

    DEFF Research Database (Denmark)

    Korsgaard, Jens; Møller, Jens Kjølseth; Kilian, Mogens

    2005-01-01

    OBJECTIVE: To analyze the possible influence of antibiotic treatment on the results of different diagnostic tests for the diagnosis of lower respiratory tract infections with Streptococcus pneumoniae. MATERIAL AND METHODS: A prospective cohort of 159 unselected adult immunocompetent patients...... admitted to Silkeborg County Hospital in Denmark with community-acquired lower respiratory tract infections underwent microbiological investigations with fiber-optic bronchoscopy with bronchoalveolar lavage, blood and sputum culture and urine antigen test for type-specific polysaccharide capsular antigens...... was positive in both systems, making a total of 22 patients with documented pneumococcal infection. As a positive culture test was dependent on the absence of antibiotic treatment, whereas a positive urine antigen test depended on antibiotic treatment within 48 hours, the two tests were complementary...

  2. Comparison of PCR, culture, and serological tests for diagnosis of Mycoplasma pneumoniae respiratory tract infection in children

    NARCIS (Netherlands)

    Dorigo-Zetsma, J. W.; Zaat, S. A.; Wertheim-van Dillen, P. M.; Spanjaard, L.; Rijntjes, J.; van Waveren, G.; Jensen, J. S.; Angulo, A. F.; Dankert, J.

    1999-01-01

    For diagnosis of Mycoplasma pneumoniae infection we compared two rapid tests, PCR and the immunoglobulin M immunofluorescence assay (IgM IFA), with culture and the complement fixation test (CFT), in a prospective study among 92 children with respiratory tract infection and 74 controls. Based on

  3. Urinary tract infection in children: Diagnosis, treatment, imaging - Comparison of current guidelines.

    Science.gov (United States)

    Okarska-Napierała, M; Wasilewska, A; Kuchar, E

    2017-12-01

    Urinary tract infection (UTI) is a frequent disorder of childhood, yet the proper approach for a child with UTI is still a matter of controversy. The objective of this study was to critically compare current guidelines for the diagnosis and management of UTI in children, in light of new scientific data. An analysis was performed of the guidelines from: American Academy of Pediatrics (AAP), National Institute for Health and Care Excellence (NICE), Italian Society of Pediatric Nephrology, Canadian Paediatric Society (CPS), Polish Society of Pediatric Nephrology, and European Association of Urology (EAU)/European Society for Pediatric Urology (ESPU). Separate aspects of the approach for a child with UTI, including diagnosis, treatment and further imaging studies, were compared, with allowance for recent research in each field. The analyzed guidelines tried to reconcile recent reports about diagnosis, treatment, and further diagnostics in pediatric UTI with prior practices and opinions, and economic capabilities. There was still a lack of sufficient data to formulate coherent, unequivocal guidelines on UTI management in children, with imaging tests remaining the main area of controversy. As a result, the authors formulated their own proposal for UTI management in children. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  4. Cost-effectiveness of different strategies for diagnosis of uncomplicated urinary tract infections in women presenting in primary care

    NARCIS (Netherlands)

    Bosmans, Judith E; Coupé, Veerle M H; Knottnerus, Bart J; Geerlings, Suzanne E; Moll van Charante, Eric P; Ter Riet, Gerben

    2017-01-01

    BACKGROUND: Uncomplicated Urinary Tract Infections (UTIs) are common in primary care resulting in substantial costs. Since antimicrobial resistance against antibiotics for UTIs is rising, accurate diagnosis is needed in settings with low rates of multidrug-resistant bacteria. OBJECTIVE: To compare

  5. Cost-effectiveness of different strategies for diagnosis of uncomplicated urinary tract infections in women presenting in primary care

    NARCIS (Netherlands)

    Bosmans, Judith E.; Coupé, Veerle M. H.; Knottnerus, Bart J.; Geerlings, Suzanne E.; Moll van Charante, Eric P.; ter Riet, Gerben

    2017-01-01

    Uncomplicated Urinary Tract Infections (UTIs) are common in primary care resulting in substantial costs. Since antimicrobial resistance against antibiotics for UTIs is rising, accurate diagnosis is needed in settings with low rates of multidrug-resistant bacteria. To compare the cost-effectiveness

  6. Procalcitonin and C-reactive protein in urinary tract infection diagnosis.

    Science.gov (United States)

    Xu, Rui-Ying; Liu, Hua-Wei; Liu, Ji-Ling; Dong, Jun-Hua

    2014-05-30

    Urinary infections are a common type of pediatric disease, and their treatment and prognosis are closely correlated with infection location. Common clinical manifestations and laboratory tests are insufficient to differentiate between acute pyelonephritis and lower urinary tract infection. This study was conducted to explore a diagnostic method for upper and lower urinary tract infection differentiation. The diagnostic values of procalcitonin (PCT) and C-reactive protein (CRP) were analyzed using the receiver operating characteristic curve method for upper and lower urinary tract infection differentiation. PCT was determined using chemiluminescent immunoassay. The PCT and CRP values in children with acute pyelonephritis were significantly higher than those in children with lower urinary tract infection (3.90 ± 3.51 ng/ml and 68.17 ± 39.42 mg/l vs. 0.48 ± 0.39 ng/ml and 21.39 ± 14.92 mg/l). The PCT values were correlated with the degree of renal involvement, whereas the CRP values failed to show such a significant correlation. PCT had a sensitivity of 90.47% and a specificity of 88% in predicting nephropathia, whereas CRP had sensitivity of 85.71% and a specificity of 48%. Both PCT and CRP can be used for upper and lower urinary tract infection differentiation, but PCT has higher sensitivity and specificity in predicting pyelonephritis than CRP. PCT showed better results than CRP. PCT values were also correlated with the degree of renal involvement.

  7. Unexplained extra visits to general practitioners before the diagnosis of first urinary tract infection: a case-control study

    OpenAIRE

    van der Voort, J H; Edwards, A; Roberts, R; Newcombe, R; Jones, K

    2002-01-01

    Aims: To determine: (1) whether children diagnosed with a urinary tract infection (UTI) visited their general practitioner (GP) more frequently before the diagnosis of UTI was established compared to children never diagnosed with a UTI; and (2) whether those children with evidence of renal scarring at their first diagnosed UTI visited their GPs more frequently before diagnosis compared to children who did not have evidence of renal scarring when their first UTI was investigated.

  8. [Urinary tract infections in adults].

    Science.gov (United States)

    Michno, Mikolaj; Sydor, Antoni

    Review of urinary tract infections in adults including etiology, pathogenesis, classification and the most important therapeutic recommendations. Urinary tract infections are still a common clinical problem occurring more often in sexually active women, pregnancy, elderly , after catherization of a urinary bladder and urological surgery as well as in the co-existence of diabetes or nephrolithiasis. Due to the anatomical differences, women suffer more often than men. The main etiological factor is Escherichia coli, even though it plays a lesser role in the complicated infections, than in non-complicated ones. Apart from that, the infections may also be caused by atypical microbes, viruses and fungi. Relapses as well as reinfections are typical features of urinary tract infections and in some cases prolonged infections can spread from lower to upper urinary tract contributing to pyelonephritis, urosepsis or even death. These long-term infections can progress in a hidden, insidious, oligosymptomatic or asymptomatic manner leading to irreversible, progressive deterioration of renal function. They can also mask other diseases such as tuberculosis or neoplasms of the urinary tract, which leads to the delayed diagnosis and treatment. Diagnosis and treatment of urinary tract infections is a complex problem, often requiring specialized procedures as well as hospitalization. The choice of a therapy is determined by the type of infection, general condition, age and coexisting diseases. Rapid diagnosis and implementation of proper pharmacotherapy may shorten the time of treatment and hospitalization, preventing serious complications and reinfections.

  9. Enhancing quality practice for prevention and diagnosis of urinary tract infection during inpatient spinal cord rehabilitation.

    Science.gov (United States)

    Alavinia, Seyed Mohammad; Omidvar, Maryam; Farahani, Farnoosh; Bayley, Mark; Zee, Joana; Craven, Beverley Catharine

    2017-11-01

    To reduce the incidence of Urinary Tract Infection (UTI) in subacute SCI individuals admitted for tertiary inpatient rehabilitation. A quality improvement team was assembled to improve UTI prevention/diagnosis. To plan data collection, UTI-related factors were mapped in an Ishikawa (fishbone) driver diagram. Data including patient demographics, presence and frequency of signs and/or symptoms of UTI and antibiotic initiation from August to December 2015 were recorded. Sensitivity, Specificity, Positive and Negative Predictive Values (PPV, NPV), and Likelihood Ratios (LR) were calculated for each sign and symptom. Tertiary SCI Rehabilitation Results: Among 55 inpatients with subacute SCI who had signs/symptoms prompting urine culture and sensitivity (C&S), 32 (58.18%) were diagnosed with a UTI. The most frequent symptoms were foul smelling urine (41%), change in urine color (31%), and incontinence (25%), and the most common sign was fever (34%). Most UTIs (81%) occurred among individuals using Clean Intermittent Catheterization (CIC), with 46% of catheterizations performed by nurses. Foul smelling urine had the highest sensitivity (0.50, 95% CI: 0.31-0.69), and new incontinence had the highest specificity (0.88, 95% CI: 0.69-0.97) for UTI diagnosis. The highest PPV belonged to the cloudy urine (0.71, 95% CI: 0.42-0.92). The combination of cloudy and foul smelling urine increased the PPV to 78% (95% CI: (0.40-0.97). The concurrent presence of cloudy and foul smelling urine is predicted of UTI diagnosis inpatients tertiary setting. SCI inpatients are susceptible to UTI when learning CIC technique from nurses.

  10. DIAGNOSIS OF CULTURE POSITIVE URINARY TRACT INFECTIONS AND THEIR ANTIMICROBIAL SENSITIVITY PROFILE IN TERTIARY CARE CENTRE

    Directory of Open Access Journals (Sweden)

    Prince Sreekumar Pius

    2016-12-01

    Full Text Available BACKGROUND Urinary tract infection is very common all over the world and in India more than 10 million cases are reported per year. It is one of the common infections diagnosed in the outpatients as well as the hospitalised patients. Empirical treatment of community acquired urinary tract infections are determined by the antibiotic sensitivity in a population. This study was conducted to determine the antimicrobial sensitivity amongst the uropathogens to help establish local guidelines on treatment of urinary tract infection. MATERIALS AND METHODS In this study, we collected 1306 samples from patients in whom we suspected to have urinary tract infection based on clinical signs and symptoms (e.g. with fever (greater than 38°C without another explanation or from a patient who had at least one urinary symptom (dysuria, urgency, frequency, or suprapubic pain or tenderness in our hospital during January 2016-June 2016. RESULTS Urine cultures were positive for 18% of the patients. Among these cultures, Klebsiella pneumonia (41%, Escherichia coli (35% and Pseudomonas aeruginosa (7% were the common organisms found. Highest antimicrobial sensitivity amongst these pathogens was found with cefoperazone/sulbactam and amikacin. CONCLUSION Cefoperazone/sulbactam and amikacin were the highly sensitive systemic antibiotics while ciprofloxacin and norfloxacin were the sensitive oral antibiotics in our locality.

  11. Relationship between conventional culture and flow cytometry for the diagnosis of urinary tract infection.

    Science.gov (United States)

    García-Coca, Marta; Gadea, Ignacio; Esteban, Jaime

    2017-06-01

    Urine culture is the gold standard for the diagnosis of urinary tract infections (UTI). The use of flow cytometry analyzers (FCA) prior to culture allows for the quantification and recognition of cell components in urine to be automated and makes it possible to relate these data to the urine pathogens subsequently identified in cultures. Urine samples were assessed with the Sysmex UF-1000i analyzer. Those that met the criteria for culture (> 25 leukocytes/μL or > 385 bacteria/μL) were subjected to quantitative urine culture on chromogenic agar. Counts of red blood cells (RBC), white blood cells (WBC), epithelial cells (EC), and the kind of microorganisms identified in cultures were evaluated. A total of 17,483 samples were processed by FCA. Of these, 9057 met the criteria for culture. Urine cultures were reduced by 48.2%. The most common urine pathogen was Escherichia coli (60.3%). Negative urine cultures were significantly (p flow cytometer for screening urine samples allows for a reduction in the number of urine cultures. WBC values correlate well with the main urine pathogens related to UTI. The results observed for Enterococcus spp. suggest a low impact of these pathogens as a cause of UTI.

  12. Urinary tract infection - children

    Science.gov (United States)

    UTI - children; Cystitis - children; Bladder infection - children; Kidney infection - children; Pyelonephritis - children ... Craig JC. Long-term antibiotics for preventing recurrent urinary tract infection in children. Cochrane Database Syst Rev . 2011;(3):CD001534. PMID: ...

  13. Accuracy of ultrasonography and plain-film abdominal radiography in the diagnosis of urologic abnormalities in men with urinary tract infection: critically appraised topic

    International Nuclear Information System (INIS)

    Daunt, S.W.

    2004-01-01

    An adult male patient presented with dysuria and urinary frequency. A subsequent urine culture confirmed the presence of a urinary tract infection. How accurate is the combination of ultrasonography and plain-film abdominal radiography in the diagnosis of urologic abnormalities in men with confirmed urinary tract infection? (author)

  14. Accuracy of simple urine tests for diagnosis of urinary tract infections in low-risk pregnant women

    OpenAIRE

    Feitosa,Danielle Cristina Alves; Silva,Márcia Guimarães da; Parada,Cristina Maria Garcia de Lima

    2009-01-01

    Anatomic and physiological alterations during pregnancy predispose pregnant women to urinary tract infections (UTI). This study aimed to identify the accuracy of the simple urine test for UTI diagnosis in low-risk pregnant women. Diagnostic test performance was conducted in Botucatu, SP, involving 230 pregnant women, between 2006 and 2008. Results showed 10% UTI prevalence. Sensitivity, specificity and accuracy of the simple urine test were 95.6%, 63.3% and 66.5%, respectively, in relation to...

  15. Emerging nanotechnology based strategies for diagnosis and therapeutics of urinary tract infections: A review.

    Science.gov (United States)

    Kumar, M S; Das, A P

    2017-11-01

    At present, various diagnostic and therapeutic approaches are available for urinary tract infections. But, still the quest for development of more rapid, accurate and reliable approach is an unending process. The pathogens, especially uropathogens are adapting to new environments and antibiotics day by day rapidly. Therefore, urinary tract infections are evolving as hectic and difficult to eradicate, increasing the economic burden to the society. The technological advances should be able to compete the adaptability characteristics of microorganisms to combat their growth in new environments and thereby preventing their infections. Nanotechnology is at present an extensively developing area of immense scientific interest since it has diverse potential applications in biomedical field. Nanotechnology may be combined with cellular therapy approaches to overcome the limitations caused by conventional therapeutics. Nanoantibiotics and drug delivery using nanotechnology are currently growing areas of research in biomedical field. Recently, various categories of antibacterial nanoparticles and nanocarriers for drug delivery have shown their potential in the treatment of infectious diseases. Nanoparticles, compared to conventional antibiotics, are more beneficial in terms of decreasing toxicity, prevailing over resistance and lessening costs. Nanoparticles present long term therapeutic effects since they are retained in body for relatively longer periods. This review focuses on recent advances in the field of nanotechnology, principally emphasizing diagnostics and therapeutics of urinary tract infections. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. The Diagnosis of Urinary Tract Infection in Young Children (DUTY) Study Clinical Rule: Economic Evaluation.

    Science.gov (United States)

    Hollingworth, William; Busby, John; Butler, Christopher C; O'Brien, Kathryn; Sterne, Jonathan A C; Hood, Kerenza; Little, Paul; Lawton, Michael; Birnie, Kate; Thomas-Jones, Emma; Harman, Kim; Hay, Alastair D

    2017-04-01

    To estimate the cost-effectiveness of a two-step clinical rule using symptoms, signs and dipstick testing to guide the diagnosis and antibiotic treatment of urinary tract infection (UTI) in acutely unwell young children presenting to primary care. Decision analytic model synthesising data from a multicentre, prospective cohort study (DUTY) and the wider literature to estimate the short-term and lifetime costs and healthcare outcomes (symptomatic days, recurrent UTI, quality adjusted life years) of eight diagnostic strategies. We compared GP clinical judgement with three strategies based on a 'coefficient score' combining seven symptoms and signs independently associated with UTI and four strategies based on weighted scores according to the presence/absence of five symptoms and signs. We compared dipstick testing versus laboratory culture in children at intermediate risk of UTI. Sampling, culture and antibiotic costs were lowest in high-specificity DUTY strategies (£1.22 and £1.08) compared to clinical judgement (£1.99). These strategies also approximately halved urine sampling (4.8% versus 9.1% in clinical judgement) without reducing sensitivity (58.2% versus 56.4%). Outcomes were very similar across all diagnostic strategies. High-specificity DUTY strategies were more cost-effective than clinical judgement in the short- (iNMB = £0.78 and £0.84) and long-term (iNMB =£2.31 and £2.50). Dipstick tests had poorer cost-effectiveness than laboratory culture in children at intermediate risk of UTI (iNMB = £-1.41). Compared to GPs' clinical judgement, high specificity clinical rules from the DUTY study could substantially reduce urine sampling, achieving lower costs and equivalent patient outcomes. Dipstick testing children for UTI is not cost-effective. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  17. [Recurrent urinary tract infections should not be treated cavalierly. First verify the diagnosis!].

    Science.gov (United States)

    Wagenlehner, F M E; Naber, K G

    2003-10-23

    Acute uncomplicated cystitis (AUC) and acute uncomplicated pyelonephritis (AUP) are two common urinary tract infections (UTI) in otherwise healthy young women. Both weaknesses of the mucosal barrier and specific factors of uropathogenic bacteria must be present before the bacteria can adhere to the urothelium and give rise to an infection. These circumstances are also of relevance in recurrent UTI. Antibiotic treatment of AUC and AUP is based on the guidelines of the Infectious Diseases Society of America (IDSA). For the prevention of recurrent UTI, antibiotics, functional foods, injections, probiotic agents and other measures are recommended with varying potential for success.

  18. Quality indicators for diagnosis and treatment of respiratory tract infections in general practice: a modified Delphi study

    DEFF Research Database (Denmark)

    Hansen, Malene Plejdrup; Bjerrum, Lars; Gahrn-Hansen, Bente

    2010-01-01

    was achieved in both Delphi rounds. A total of 41 of the proposed 59 quality indicators attained consensus. None of the quality indicators focusing on the diagnostic process achieved consensus. Consensus was attained for 14 quality indicators focusing on the decision regarding antibiotic treatment and for 27...... quality indicators focusing on the choice of antibiotics. CONCLUSION: This study resulted in a final set of 41 quality indicators concerning respiratory tract infections in general practice. These quality indicators may be used to strengthen general practitioners' focus on their management of patients......OBJECTIVE: To develop a set of quality indicators focusing on the diagnosis and treatment of respiratory tract infections in general practice. DESIGN: A modified 2-round Delphi study. SETTING: General practice. SUBJECTS: A panel of 27 experts (13 countries) comprising mainly general practitioners...

  19. Choice of urine collection methods for the diagnosis of urinary tract infection in young, febrile infants.

    Science.gov (United States)

    Schroeder, Alan R; Newman, Thomas B; Wasserman, Richard C; Finch, Stacia A; Pantell, Robert H

    2005-10-01

    The optimal method of urine collection in febrile infants is debatable; catheterization, considered more accurate, is technically difficult and invasive. To determine predictors of urethral catheterization in febrile infants and to compare bag and catheterized urine test performance characteristics. Prospective analysis of infants enrolled in the Pediatric Research in Office Settings' Febrile Infant Study. A total of 219 practices from within the Pediatric Research in Office Settings' network, including 44 states, the District of Columbia, and Puerto Rico. A total of 3066 infants aged 0 to 3 months with temperatures of 38 degrees C or higher. We calculated adjusted odds ratios for predictors of catheterization. Diagnostic test characteristics were compared between bag and catheterization. Urinary tract infection was defined as pure growth of 100 000 CFU/mL or more (bag) and 20 000 CFU/mL or more (catheterization). Seventy percent of urine samples were obtained by catheterization. Predictors of catheterization included female sex, practitioner older than 40 years, Medicaid, Hispanic ethnicity, nighttime evaluation, and severe dehydration. For leukocyte esterase levels, bag specimens demonstrated no difference in sensitivity but somewhat lower specificity (84% [bag] vs 94% [catheterization], PInfection rates were similar in bag and catheterized specimens (8.5% vs 10.8%). Ambiguous cultures were more common in bag specimens (7.4% vs 2.7%, Purinary tract infection. Although both urine cultures and urinalyses are more accurate in catheterized specimens, the magnitude of difference is small but should be factored into clinical decision making.

  20. Children's UTIs in the new millennium. Diagnosis, investigation, and treatment of childhood urinary tract infections in the year 2001.

    Science.gov (United States)

    White, C. T.; Matsell, D. G.

    2001-01-01

    OBJECTIVE: To provide an effective approach for family physicians treating children presenting with urinary tract infections (UTIs). QUALITY OF EVIDENCE: The information presented, and articles quoted, are drawn from both review of the literature and recent consensus guidelines. Data and recommendations come from prospective multicentre trials; retrospective reviews; expert consensus statements; and some smaller trials, commentaries, and editorials. MAIN MESSAGE: Urinary tract infections are often seen in family practice. Diagnosis requires suspicion and a realization that children, especially those younger than 2 years, often have very few, nonspecific signs of infection. Obtaining a proper urine sample is vital, because true infections require radiographic studies. Antibiotic prophylaxis is promoted because of the link between vesicoureteral reflux, recurrent UTIs, and renal scarring and hypertension. We generally provide prophylaxis until children are 3 or 4 years, when risk of damage from reflux is lessened and timely urine samples are easier to obtain for prompt therapy. Surgical opinion is sought only when medical management has failed. Failure is defined as either recurrent infections and pyelonephritis or poor renal growth. CONCLUSION: To diagnose UTIs in children, physicians must suspect them, obtain proper urine samples, order appropriate investigations to rule out underlying anatomic abnormalities, and treat with appropriate antibiotics considering both organism sensitivities and length of therapy. PMID:11561337

  1. Diagnosis and Antibiotic Resistance Distribution in Children with Urinary Tract Infection: A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Rahime Renda

    2018-01-01

    Full Text Available Background: Urinary tract infection is a common disease in childhood. The aim of this study was to determine the diagnostic performance of urinary analysis, assess the role of urine culture in determining its necessity and evaluate etiologic agents and antimicrobial resistance patterns in children with urinary tract infection.Methods: Our study was made by evaluating the patients who applied to the Antalya Research and Training Hospital- Turkey, between 2015 and 2017. A total 237 urine analysis and urine culture were retrospectively analyzed. Culture results were taken a reference for microscopic and chemical examination of urine and diagnostic accuracy of the test parameters, and the performance of urine analysis were calculated. The culture and antibiogram results were examined and antibiotic resistance with infectious agents frequency was evaluated.Results: The 42.4% of culture negative samples showed leukocyte esterase, nitrite, bacterial and leukocyte counts, which are indicative of infection in urine analysis, were found in normal range. The highest sensitivity (90% was in the presence of leucocyte esterase and bacteria, while the highest specificity (99.4% was in the presence of nitrite alone or with other components (leucocyte or leucocyte esterase. The highest antibiotic resistance was found in beta lactam antibiotics. The lowest antibiotic resistance was detected in the carbapenem followed by fluoroquinolone group antibiotics.Conclusion: Microscopic and chemical examination of urine analysis can give us information about urine culture requirement. The observation of increasing overall resistance to antibiotics authorize further studies that lead to new recommendations to antibiotic use in children and adolescents.

  2. Pediatric Urinary Tract Infection

    Science.gov (United States)

    SBA National Resource Center: 800-621-3141 Pediatric Urinary Tract Infections and Catheterization in Children with Neurogenic Bladder and Bowel Why is it important to begin urologic care in infancy and ...

  3. Urinary Tract Infections (For Kids)

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    Full Text Available ... Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & Hospitals ... Kids / Urinary Tract Infections (UTIs) What's in this article? What Exactly Is a Urinary Tract? Urinary Tract ...

  4. Urinary Tract Infections (For Kids)

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    Full Text Available ... Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & ... Kids / Urinary Tract Infections (UTIs) What's in this article? What Exactly Is a Urinary Tract? Urinary Tract ...

  5. Urinary Tract Infections (For Teens)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Urinary Tract Infections KidsHealth / For Teens / Urinary Tract Infections What's ... especially girls — visit a doctor. What Is a Urinary Tract Infection? A bacterial urinary tract infection (UTI) is ...

  6. Complete urinary tract infection (UTI) diagnosis and antibiogram using surface enhanced Raman spectroscopy (SERS)

    Science.gov (United States)

    Hadjigeorgiou, Katerina; Kastanos, Evdokia; Kyriakides, Alexandros; Pitris, Costas

    2012-03-01

    There are three stages to a complete UTI diagnosis: (1) identification of a urine sample as positive/negative for an infection, (2) identification of the responsible bacterium, (3) antibiogram to determine the antibiotic to which the bacteria are most sensitive to. Using conventional methods, all three stages require bacterial cultures in order to provide results. This long delay in diagnosis causes a rise in ineffective treatments, chronic infections, health care costs and antibiotic resistance. In this work, SERS is used to identify a sample as positive/negative for a UTI as well as to obtain an antibiogram against different antibiotics. SERS spectra of serial dilutions of E. coli bacteria mixed with silver nanoparticles, showed a linear correlation between spectral intensity and concentration. For antibiotic sensitivity testing, SERS spectra of three species of gram negative bacteria were collected four hours after exposure to the antibiotics ciprofloxacin and amoxicillin. Spectral analysis revealed clear separation between bacterial samples exposed to antibiotics to which they were sensitive and samples exposed to antibiotics to which they were resistant. With the enhancement provided by SERS, the technique can be applied directly to urine samples leading to the development of a new, rapid method for UTI diagnosis and antibiogram.

  7. Artificial Urine for Teaching Urinalysis Concepts and Diagnosis of Urinary Tract Infection in the Medical Microbiology Laboratory.

    Science.gov (United States)

    Khan, Latifa B; Read, Hannah M; Ritchie, Stephen R; Proft, Thomas

    2017-01-01

    Dipstick urinalysis is an informative, quick, cost-effective and non-invasive diagnostic tool that is useful in clinical practice for the diagnosis of urinary tract infections (UTIs), kidney diseases, and diabetes. We used dipstick urinalysis as a hands-on microbiology laboratory exercise to reinforce student learning about UTIs with a particular focus on cystitis, which is a common bacterial infection. To avoid exposure to potentially contaminated human urine samples, we prepared artificial urine using easily acquired and affordable ingredients, which allowed less-experienced students to perform urinalysis without the risk of exposure to pathogenic organisms and ensured reliable availability of the urine samples. This practical class taught medical students how to use urinalysis data in conjunction with medical history to diagnose diseases from urine samples and to determine a treatment plan for clinical scenarios.

  8. Clinical validation of integrated nucleic acid and protein detection on an electrochemical biosensor array for urinary tract infection diagnosis.

    Directory of Open Access Journals (Sweden)

    Ruchika Mohan

    Full Text Available BACKGROUND: Urinary tract infection (UTI is a common infection that poses a substantial healthcare burden, yet its definitive diagnosis can be challenging. There is a need for a rapid, sensitive and reliable analytical method that could allow early detection of UTI and reduce unnecessary antibiotics. Pathogen identification along with quantitative detection of lactoferrin, a measure of pyuria, may provide useful information towards the overall diagnosis of UTI. Here, we report an integrated biosensor platform capable of simultaneous pathogen identification and detection of urinary biomarker that could aid the effectiveness of the treatment and clinical management. METHODOLOGY/PRINCIPAL FINDINGS: The integrated pathogen 16S rRNA and host lactoferrin detection using the biosensor array was performed on 113 clinical urine samples collected from patients at risk for complicated UTI. For pathogen detection, the biosensor used sandwich hybridization of capture and detector oligonucleotides to the target analyte, bacterial 16S rRNA. For detection of the protein biomarker, the biosensor used an analogous electrochemical sandwich assay based on capture and detector antibodies. For this assay, a set of oligonucleotide probes optimized for hybridization at 37°C to facilitate integration with the immunoassay was developed. This probe set targeted common uropathogens including E. coli, P. mirabilis, P. aeruginosa and Enterococcus spp. as well as less common uropathogens including Serratia, Providencia, Morganella and Staphylococcus spp. The biosensor assay for pathogen detection had a specificity of 97% and a sensitivity of 89%. A significant correlation was found between LTF concentration measured by the biosensor and WBC and leukocyte esterase (p<0.001 for both. CONCLUSION/SIGNIFICANCE: We successfully demonstrate simultaneous detection of nucleic acid and host immune marker on a single biosensor array in clinical samples. This platform can be used for

  9. Urinary Tract Infections (For Kids)

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    Full Text Available ... urinary tract infection, or UTI, you're probably thinking about peeing quite a lot. Why? Because it ... Urinary Tract? Your urinary tract is actually a system made up of these main parts: two kidneys ...

  10. Urinary Tract Infections.

    Science.gov (United States)

    Plummer, Nancy; Michael, Nancy, Ed.

    This module on urinary tract infections is intended for use in inservice or continuing education programs for persons who administer medications in long-term care facilities. Instructor information, including teaching suggestions, and a listing of recommended audiovisual materials and their sources appear first. The module goal and objectives are…

  11. Urinary Tract Infections (For Kids)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Urinary Tract Infections (UTIs) KidsHealth / For Kids / Urinary Tract Infections ( ... Let's find out more. What Exactly Is a Urinary Tract? Your urinary tract is actually a system made ...

  12. Urinary Tract Infections (For Kids)

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    Full Text Available ... Staying Safe Videos for Educators Search English Español Urinary Tract Infections (UTIs) KidsHealth / For Kids / Urinary Tract Infections ( ... Let's find out more. What Exactly Is a Urinary Tract? Your urinary tract is actually a system made ...

  13. Urinary Tract Infections (For Kids)

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    Full Text Available ... Staying Safe Videos for Educators Search English Español Urinary Tract Infections (UTIs) KidsHealth / For Kids / Urinary Tract Infections (UTIs) What's in this article? What Exactly Is ...

  14. The role of procalcitonin as a guide for the diagnosis, prognosis, and decision of antibiotic therapy for lower respiratory tract infections

    Directory of Open Access Journals (Sweden)

    Amal Abd El-Azeem

    2013-10-01

    Conclusion: Serum PCT level could be used as a novel marker of lower respiratory tract bacterial infections for diagnosis, prognosis and follow up of therapy. This reduces side-effects of an unnecessary antibiotic use, lowers costs, and in the long-term, leads to diminishing drug resistance.

  15. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America

    NARCIS (Netherlands)

    Hooton, Thomas M.; Bradley, Suzanne F.; Cardenas, Diana D.; Colgan, Richard; Geerlings, Suzanne E.; Rice, James C.; Saint, Sanjay; Schaeffer, Anthony J.; Tambayh, Paul A.; Tenke, Peter; Nicolle, Lindsay E.

    2010-01-01

    Guidelines for the diagnosis, prevention, and management of persons with catheter-associated urinary tract infection (CA-UTI), both symptomatic and asymptomatic, were prepared by an Expert Panel of the Infectious Diseases Society of America. The evidence-based guidelines encompass diagnostic

  16. URINARY TRACT INFECTION IN CHILDREN

    Directory of Open Access Journals (Sweden)

    T. V. Margieva

    2014-01-01

    Full Text Available The issues of diagnosing and treating urinary tract infections and their role in development of renal injury are being actively discussed by scientists and practicing pediatricians. The article presents the most recent data on etiological factors, pathogenesis and clinical manifestations of this disease. It provides recommendations on diagnosis and management of patients depending on their age. The article presents a discussion of antibacterial therapy course duration and indications for anti-relapse treatment. The study demonstrates that intravenous antibacterial therapy must be launched immediately in neonates in the event of pyretic fever; empirical antibacterial therapy must be launched immediately in older children after diagnosis of the urinary tract infection has been confirmed; subsequently, treatment ought to be corrected depending on the results of a bacteriological trial, sensitivity to antibiotics and effectiveness of the prescribed antibiotic. Along with normalization of urination rhythm and water intake schedule, antibacterial preventive therapy might be considered, if effective, in the event of recurrent nature of the urinary tract infection

  17. Pediatric urinary tract infection

    Energy Technology Data Exchange (ETDEWEB)

    Blickman, J.G.

    1991-02-06

    Acute urinary tract infection (UTI) is an important cause of morbidity in children and may be complicated by congenital urinary tract abnormalities of a functional or anatomic nature which, predispose to recurrent UTI's that in turn may lead to renal failure and hypertension. Early radiologic and ultrasonographic investigations may reveal these anatomic anomalies in particular because the urinary tract, specifically in children, is not readily accessible to adequate clinical examinations Excretory urography (EU) has been considered as the 'gold standard' of upper urinary tract visualization, while the voiding cystourethrogram (VCUG) was thought to be the preferential method of imaging of the lower urinary tract. Recently, major technical advances have altered this commonly accepted diagnostic workup. Although ultrasonography, radio-nuclide scanning and urodynamics have become important contributors to the understanding of pathophysiology of UTI's their value and place in assessment of the sequence of imaging has not been comprehensively studied. This thesis deals about the optimization of the choice and the order of the different imaging techniques used in the evaluation of children, younger than six year with UTI. (author). 243 refs.; 23 figs.; 8 tabs.

  18. Pediatric urinary tract infection

    International Nuclear Information System (INIS)

    Blickman, J.G.

    1991-01-01

    Acute urinary tract infection (UTI) is an important cause of morbidity in children and may be complicated by congenital urinary tract abnormalities of a functional or anatomic nature which, predispose to recurrent UTI's that in turn may lead to renal failure and hypertension. Early radiologic and ultrasonographic investigations may reveal these anatomic anomalies in particular because the urinary tract, specifically in children, is not readily accessible to adequate clinical examinations Excretory urography (EU) has been considered as the 'gold standard' of upper urinary tract visualization, while the voiding cystourethrogram (VCUG) was thought to be the preferential method of imaging of the lower urinary tract. Recently, major technical advances have altered this commonly accepted diagnostic workup. Although ultrasonography, radio-nuclide scanning and urodynamics have become important contributors to the understanding of pathophysiology of UTI's their value and place in assessment of the sequence of imaging has not been comprehensively studied. This thesis deals about the optimization of the choice and the order of the different imaging techniques used in the evaluation of children, younger than six year with UTI. (author). 243 refs.; 23 figs.; 8 tabs

  19. Managing urinary tract infections

    OpenAIRE

    Saadeh, Sermin A.; Mattoo, Tej K.

    2011-01-01

    Urinary tract infections (UTI) are common in childhood. Presence of pyuria and bacteriuria in an appropriately collected urine sample are diagnostic of UTI. The risk of UTI is increased with an underlying urological abnormality such as vesicoureteral reflux, constipation, and voiding dysfunction. Patients with acute pyelonephritis are at risk of renal scarring and subsequent complications such as hypertension, proteinuria with and without FSGS, pregnancy-related complications and even end-sta...

  20. Accuracy of simple urine tests for diagnosis of urinary tract infections in low-risk pregnant women.

    Science.gov (United States)

    Feitosa, Danielle Cristina Alves; da Silva, Márcia Guimarães; de Lima Parada, Cristina Maria Garcia

    2009-01-01

    Anatomic and physiological alterations during pregnancy predispose pregnant women to urinary tract infections (UTI). This study aimed to identify the accuracy of the simple urine test for UTI diagnosis in low-risk pregnant women. Diagnostic test performance was conducted in Botucatu, SP, involving 230 pregnant women, between 2006 and 2008. Results showed 10% UTI prevalence. Sensitivity, specificity and accuracy of the simple urine test were 95.6%, 63.3% and 66.5%, respectively, in relation to UTI diagnoses. The analysis of positive (PPV) and negative (NPV) predictive values showed that, when a regular simple urine test was performed, the chance of UTI occurrence was small (NPV 99.2%). In view of an altered result for such a test, the possibility of UTI existence was small (PPV 22.4%). It was concluded that the accuracy of the simple urine test as a diagnostic means for UTI was low, and that performing a urine culture is essential for appropriate diagnosis.

  1. Left ventricular outflow tract to left atrial communication secondary to rupture of mitral-aortic intervalvular fibrosa in infective endocarditis: diagnosis by transesophageal echocardiography and color flow imaging.

    Science.gov (United States)

    Bansal, R C; Graham, B M; Jutzy, K R; Shakudo, M; Shah, P M

    1990-02-01

    Infection of the mitral-aortic intervalvular fibrosa occurs most commonly in association with infective endocarditis of the aortic valve. Infection of the aortic valve results in a regurgitant jet that presumably strikes this subaortic interannular zone of fibrous tissue and produces a secondary site of infection. Infection of this interannular zone then leads to the formation of subaortic abscess or pseudoaneurysm of the left ventricular outflow tract. This infected zone of mitral-aortic intervalvular fibrosa or subaortic aneurysm can subsequently rupture into the left atrium with systolic ejection of blood from the left ventricular outflow tract to the left atrium. This report describes the echocardiographic findings in three patients with pathologically proved left ventricular outflow tract to left atrial communication. Precise preoperative diagnosis is important, and this lesion should be differentiated from ruptured aneurysm of the sinus of Valsalva and perforation of the anterior mitral leaflet. Transthoracic echocardiography using color flow imaging and conventional Doppler techniques may show an eccentric mitral regurgitation type of signal in the left atrium originating from the region of the left ventricular outflow tract. However, transesophageal echocardiography provides an accurate preoperative diagnosis and should be used intraoperatively during repair of such lesions.

  2. Urinary tract infections during pregnancy.

    Science.gov (United States)

    Le, Jennifer; Briggs, Gerald G; McKeown, Anna; Bustillo, Gerardo

    2004-10-01

    To provide a comprehensive review of urinary tract infections (UTIs) during pregnancy. All aspects of UTIs, including epidemiology, pathogenesis, resistance, clinical features, diagnosis, treatment, and prevention, were reviewed. MEDLINE (1966-August 2003) and Cochrane Library searches were performed using the key search terms urinary tract infection, pyelonephritis, cystitis, asymptomatic bacteriuria, and resistance. All article abstracts were evaluated for relevance. Only articles pertaining to pregnancy were included. The majority of published literature were review articles; the number of original clinical studies was limited. UTIs are the most common bacterial infections during pregnancy. They are characterized by the presence of significant bacteria anywhere along the urinary tract. Pyelonephritis is the most common severe bacterial infection that can lead to perinatal and maternal complications including premature delivery, infants with low birth weight, fetal mortality, preeclampsia, pregnancy-induced hypertension, anemia, thrombocytopenia, and transient renal insufficiency. Enterobacteriaceae account for 90% of UTIs. The common antibiotics used are nitrofurantoin, cefazolin, cephalexin, ceftriaxone, and gentamicin. Therapeutic management of UTIs in pregnancy requires proper diagnostic workup and thorough understanding of antimicrobial agents to optimize maternal outcome, ensure safety to the fetus, and prevent complications that lead to significant morbidity and mortality in both the fetus and the mother.

  3. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Staying Safe Videos for Educators Search English Español Urinary Tract Infections (UTIs) KidsHealth / For Kids / Urinary Tract Infections (UTIs) ... How Do I Know if I Have a UTI? You may notice signs of a urinary tract ...

  4. Clinician practice and the National Healthcare Safety Network definition for the diagnosis of catheter-associated urinary tract infection.

    Science.gov (United States)

    Al-Qas Hanna, Fadi; Sambirska, Oksana; Iyer, Sugantha; Szpunar, Susanna; Fakih, Mohamad G

    2013-12-01

    The National Healthcare Safety Network (NHSN) definition for catheter-associated urinary tract infection (CAUTI) is used to evaluate improvements in CAUTI prevention efforts. We assessed whether clinician practice was reflective of the NHSN definition. We evaluated all adult inpatients hospitalized between July 2010 and June 2011, with a first positive urine culture > 48 hours of admission obtained while catheterized or within 48 hours of catheter discontinuation. Data comprised patients' signs, symptoms, and diagnostic tests; clinician's diagnosis; and the impression of the infectious diseases (ID) consultant. The clinician's practice was compared with the NHSN definition and the ID consultant's impression. Antibiotics were initiated by clinicians to treat CAUTI in 216 of 387 (55.8%) cases, with 119 of 387 (30.7%) fitting the NHSN CAUTI definition, and 63 of 211 (29.9%) considered by ID to have a CAUTI. The sensitivity, specificity, and positive and negative predictive values of a clinician diagnosis of CAUTI were 62.2%, 47%, 34.3%, and 73.7% when compared with NHSN CAUTI definition (n = 387) and 100%, 57.4%, 50%, and 100% when compared with the ID consultant evaluation (n = 211), respectively. The positive predictive value of the NHSN CAUTI definition was 35.1% when compared with the ID consultant's impression (n = 211). NHSN CAUTI definition did not reflect clinician or ID consultant practices. Our findings reflect the differences between surveillance definitions and clinical practice. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  5. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... an infection somewhere in your urinary tract. Let's find out more. What Exactly Is a Urinary Tract? ... bladder, your brain tells you it's time to find a bathroom. Once you're ready to pee, ...

  6. Evaluation of the nitrite and leukocyte esterase activity tests for the diagnosis of acute symptomatic urinary tract infection in men.

    NARCIS (Netherlands)

    Koeijers, J.J.; Kessels, A.G.H.; Nys, S.; Bartelds, A.; Donker, G.; Stobberingh, E.; Verbon, A.

    2007-01-01

    For 422 male patients with symptoms indicative of a urinary tract infection, nitrite and leukocyte esterase activity dipstick test results were compared with results of culture of urine samples. The positive predictive value of a positive nitrite test result was 96%. Addition of results of the

  7. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... urinary tract infection, or UTI, you're probably thinking about peeing quite a lot. Why? Because it ... you have a bladder infection, your doctor will order some medicine for you to take to kill ...

  8. Early effect of American Academy of Pediatrics Urinary Tract Infection Guidelines on radiographic imaging and diagnosis of vesicoureteral reflux in the emergency room setting.

    Science.gov (United States)

    Arlen, Angela M; Merriman, Laura S; Kirsch, Jared M; Leong, Traci; Scherz, Hal C; Smith, Edwin A; Broecker, Bruce H; Kirsch, Andrew J

    2015-05-01

    In 2011 the AAP revised practice parameters on febrile urinary tract infection in infants and children 2 to 24 months old. New imaging recommendations invigorated the ongoing debate regarding the diagnosis and management of vesicoureteral reflux. We compared evaluations in these patients with febrile urinary tract infection before and after guideline publication. During 2 separate 6-month periods 350 patients 2 to 24 months old were evaluated in the emergency room setting. Demographics, urine culture, renal-bladder ultrasound, voiding cystourethrogram and admission status were assessed. A total of 172 patients presented with initial febrile urinary tract infection in 2011, of whom 47 (27.3%) required hospitalization, while 42 of 178 (23.6%) were admitted in 2012. Admission by year did not significantly differ (p = 0.423). After guideline revision 41.2% fewer voiding cystourethrograms were done (72.1% of cases in 2011 vs 30.9% in 2012, p urinary tract infection. We found no relationship between renal-bladder ultrasound and abnormal voiding cystourethrogram, consistent with previous findings that call ultrasound into question as the determinant for additional imaging. Whether forgoing routine voiding cystourethrogram results in increased morbidity is the subject of ongoing study. Copyright © 2015. Published by Elsevier Inc.

  9. Performance of a veterinary urine dipstick paddle system for diagnosis and identification of urinary tract infections in dogs and cats.

    Science.gov (United States)

    Ybarra, Winnie L; Sykes, Jane E; Wang, Yenlie; Byrne, Barbara A; Westropp, Jodi L

    2014-04-01

    To evaluate the performance of a veterinary urine dipstick paddle (UDP) for diagnosis and identification of urinary tract infection (UTI) in dogs and cats. Prospective, randomized, blinded study. 207 urine specimens. UDPs were inoculated by 2 investigators and incubated according to manufacturer's instructions. Results, including presence or absence of bacterial growth, organism counts, and identification of uropathogens, were compared between investigators and with microbiology laboratory results. A subset of UDPs with bacterial growth was submitted to the laboratory for confirmation. The laboratory reported 64 (30.9%) specimens had growth of bacteria. Bacterial growth was reported for 63 (30.4%) and 58 (28.0%) of the UDPs by investigators 1 and 2, respectively. Sensitivity and specificity of the UDP for detection of bacterial growth were 97.3% and 98.6%, respectively, for investigator 1 and 89.1% and 99.3%, respectively, for investigator 2. For UPDs with ≥ 10(5) colony-forming units/mL, organism counts correlated well between the laboratory and investigators 1 (r = 0.95) and 2 (r = 0.89). Pathogen identification was not always accurate. Only 25 of 33 (75.8%) UDPs submitted for confirmation yielded bacteria consistent with those isolated from the original bacterial culture of urine. The veterinary UDP system was a sensitive test for screening patients for bacterial UTI, but uropathogen identification was not always accurate. When UDPs have bacterial growth, a fresh urine specimen should be submitted to the laboratory to confirm the identity of the organisms and to permit antimicrobial susceptibility testing.

  10. Urinary Tract Infections (For Kids)

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    Full Text Available ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... English Español Urinary Tract Infections (UTIs) KidsHealth / For Kids / Urinary Tract Infections (UTIs) What's in this article? ...

  11. The Diagnosis of Urinary Tract infection in Young children (DUTY): a diagnostic prospective observational study to derive and validate a clinical algorithm for the diagnosis of urinary tract infection in children presenting to primary care with an acute illness.

    Science.gov (United States)

    Hay, Alastair D; Birnie, Kate; Busby, John; Delaney, Brendan; Downing, Harriet; Dudley, Jan; Durbaba, Stevo; Fletcher, Margaret; Harman, Kim; Hollingworth, William; Hood, Kerenza; Howe, Robin; Lawton, Michael; Lisles, Catherine; Little, Paul; MacGowan, Alasdair; O'Brien, Kathryn; Pickles, Timothy; Rumsby, Kate; Sterne, Jonathan Ac; Thomas-Jones, Emma; van der Voort, Judith; Waldron, Cherry-Ann; Whiting, Penny; Wootton, Mandy; Butler, Christopher C

    2016-07-01

    It is not clear which young children presenting acutely unwell to primary care should be investigated for urinary tract infection (UTI) and whether or not dipstick testing should be used to inform antibiotic treatment. To develop algorithms to accurately identify pre-school children in whom urine should be obtained; assess whether or not dipstick urinalysis provides additional diagnostic information; and model algorithm cost-effectiveness. Multicentre, prospective diagnostic cohort study. Children UTI likelihood ('clinical diagnosis') and urine sampling and treatment intentions ('clinical judgement') were recorded. All index tests were measured blind to the reference standard, defined as a pure or predominant uropathogen cultured at ≥ 10(5) colony-forming units (CFU)/ml in a single research laboratory. Urine was collected by clean catch (preferred) or nappy pad. Index tests were sequentially evaluated in two groups, stratified by urine collection method: parent-reported symptoms with clinician-reported signs, and urine dipstick results. Diagnostic accuracy was quantified using area under receiver operating characteristic curve (AUROC) with 95% confidence interval (CI) and bootstrap-validated AUROC, and compared with the 'clinician diagnosis' AUROC. Decision-analytic models were used to identify optimal urine sampling strategy compared with 'clinical judgement'. A total of 7163 children were recruited, of whom 50% were female and 49% were children provided clean-catch samples, 94% of whom were ≥ 2 years old, with 2.2% meeting the UTI definition. Among these, 'clinical diagnosis' correctly identified 46.6% of positive cultures, with 94.7% specificity and an AUROC of 0.77 (95% CI 0.71 to 0.83). Four symptoms, three signs and three dipstick results were independently associated with UTI with an AUROC (95% CI; bootstrap-validated AUROC) of 0.89 (0.85 to 0.95; validated 0.88) for symptoms and signs, increasing to 0.93 (0.90 to 0.97; validated 0.90) with dipstick

  12. Cost-effectiveness of different strategies for diagnosis of uncomplicated urinary tract infections in women presenting in primary care

    Science.gov (United States)

    Coupé, Veerle M. H.; Knottnerus, Bart J.; Geerlings, Suzanne E.; Moll van Charante, Eric P.; ter Riet, Gerben

    2017-01-01

    Background Uncomplicated Urinary Tract Infections (UTIs) are common in primary care resulting in substantial costs. Since antimicrobial resistance against antibiotics for UTIs is rising, accurate diagnosis is needed in settings with low rates of multidrug-resistant bacteria. Objective To compare the cost-effectiveness of different strategies to diagnose UTIs in women who contacted their general practitioner (GP) with painful and/or frequent micturition between 2006 and 2008 in and around Amsterdam, The Netherlands. Methods This is a model-based cost-effectiveness analysis using data from 196 women who underwent four tests: history, urine stick, sediment, dipslide, and the gold standard, a urine culture. Decision trees were constructed reflecting 15 diagnostic strategies comprising different parallel and sequential combinations of the four tests. Using the decision trees, for each strategy the costs and the proportion of women with a correct positive or negative diagnosis were estimated. Probabilistic sensitivity analysis was used to estimate uncertainty surrounding costs and effects. Uncertainty was presented using cost-effectiveness planes and acceptability curves. Results Most sequential testing strategies resulted in higher proportions of correctly classified women and lower costs than parallel testing strategies. For different willingness to pay thresholds, the most cost-effective strategies were: 1) performing a dipstick after a positive history for thresholds below €10 per additional correctly classified patient, 2) performing both a history and dipstick for thresholds between €10 and €17 per additional correctly classified patient, 3) performing a dipstick if history was negative, followed by a sediment if the dipstick was negative for thresholds between €17 and €118 per additional correctly classified patient, 4) performing a dipstick if history was negative, followed by a dipslide if the dipstick was negative for thresholds above €118 per

  13. Cost-effectiveness of different strategies for diagnosis of uncomplicated urinary tract infections in women presenting in primary care.

    Directory of Open Access Journals (Sweden)

    Judith E Bosmans

    Full Text Available Uncomplicated Urinary Tract Infections (UTIs are common in primary care resulting in substantial costs. Since antimicrobial resistance against antibiotics for UTIs is rising, accurate diagnosis is needed in settings with low rates of multidrug-resistant bacteria.To compare the cost-effectiveness of different strategies to diagnose UTIs in women who contacted their general practitioner (GP with painful and/or frequent micturition between 2006 and 2008 in and around Amsterdam, The Netherlands.This is a model-based cost-effectiveness analysis using data from 196 women who underwent four tests: history, urine stick, sediment, dipslide, and the gold standard, a urine culture. Decision trees were constructed reflecting 15 diagnostic strategies comprising different parallel and sequential combinations of the four tests. Using the decision trees, for each strategy the costs and the proportion of women with a correct positive or negative diagnosis were estimated. Probabilistic sensitivity analysis was used to estimate uncertainty surrounding costs and effects. Uncertainty was presented using cost-effectiveness planes and acceptability curves.Most sequential testing strategies resulted in higher proportions of correctly classified women and lower costs than parallel testing strategies. For different willingness to pay thresholds, the most cost-effective strategies were: 1 performing a dipstick after a positive history for thresholds below €10 per additional correctly classified patient, 2 performing both a history and dipstick for thresholds between €10 and €17 per additional correctly classified patient, 3 performing a dipstick if history was negative, followed by a sediment if the dipstick was negative for thresholds between €17 and €118 per additional correctly classified patient, 4 performing a dipstick if history was negative, followed by a dipslide if the dipstick was negative for thresholds above €118 per additional correctly classified

  14. Cost-effectiveness of different strategies for diagnosis of uncomplicated urinary tract infections in women presenting in primary care.

    Science.gov (United States)

    Bosmans, Judith E; Coupé, Veerle M H; Knottnerus, Bart J; Geerlings, Suzanne E; Moll van Charante, Eric P; Ter Riet, Gerben

    2017-01-01

    Uncomplicated Urinary Tract Infections (UTIs) are common in primary care resulting in substantial costs. Since antimicrobial resistance against antibiotics for UTIs is rising, accurate diagnosis is needed in settings with low rates of multidrug-resistant bacteria. To compare the cost-effectiveness of different strategies to diagnose UTIs in women who contacted their general practitioner (GP) with painful and/or frequent micturition between 2006 and 2008 in and around Amsterdam, The Netherlands. This is a model-based cost-effectiveness analysis using data from 196 women who underwent four tests: history, urine stick, sediment, dipslide, and the gold standard, a urine culture. Decision trees were constructed reflecting 15 diagnostic strategies comprising different parallel and sequential combinations of the four tests. Using the decision trees, for each strategy the costs and the proportion of women with a correct positive or negative diagnosis were estimated. Probabilistic sensitivity analysis was used to estimate uncertainty surrounding costs and effects. Uncertainty was presented using cost-effectiveness planes and acceptability curves. Most sequential testing strategies resulted in higher proportions of correctly classified women and lower costs than parallel testing strategies. For different willingness to pay thresholds, the most cost-effective strategies were: 1) performing a dipstick after a positive history for thresholds below €10 per additional correctly classified patient, 2) performing both a history and dipstick for thresholds between €10 and €17 per additional correctly classified patient, 3) performing a dipstick if history was negative, followed by a sediment if the dipstick was negative for thresholds between €17 and €118 per additional correctly classified patient, 4) performing a dipstick if history was negative, followed by a dipslide if the dipstick was negative for thresholds above €118 per additional correctly classified patient

  15. Neonatal Staphylococcus lugdunensis urinary tract infection.

    Science.gov (United States)

    Hayakawa, Itaru; Hataya, Hiroshi; Yamanouchi, Hanako; Sakakibara, Hiroshi; Terakawa, Toshiro

    2015-08-01

    Staphylococcus lugdunensis is a known pathogen of infective endocarditis, but not of urinary tract infection. We report a previously healthy neonate without congenital anomalies of the kidney and urinary tract who developed urinary tract infection due to Staphylococcus lugdunensis, illustrating that Staphylococcus lugdunensis can cause urinary tract infection even in those with no urinary tract complications. © 2015 Japan Pediatric Society.

  16. Urinary tract infections in women

    African Journals Online (AJOL)

    Urinary tract infections (UTIs) are common bacterial infections in women, with ... Acute cystitis refers to symptomatic infection of the bladder in the lower ... lungs in a patient with pneumonia.4. Risk factors ... use of antimicrobial agents for community-acquired UTIs has resulted in the emergence of antimicrobial resistance.

  17. URINARY TRACT INFECTION IN ADULTS

    African Journals Online (AJOL)

    Enrique

    Infection of the urinary tract (UTI) is frequently encountered in clinical practice — in the USA these ... Asymptomatic UTI is identified when organisms can be isolated in appropriate numbers .... Pregnancy ... men, so pre-treatment urine culture is.

  18. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... when you do, phew! Your pee smells bad. These things happen because bacteria have caused an infection ... tract is actually a system made up of these main parts: two kidneys two ureters (say: YUR- ...

  19. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... site Sitio para adolescentes Body Mind Sexual Health Food & Fitness Diseases & ... KidsHealth / For Kids / Urinary Tract Infections (UTIs) What's in this article? What Exactly Is a Urinary ...

  20. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... five to six times a day but never think twice about? Answer: Pee! But if you have ... urinary tract infection, or UTI, you're probably thinking about peeing quite a lot. Why? Because it ...

  1. Urinary Tract Infections in Children

    Directory of Open Access Journals (Sweden)

    Mustafa Taskesen

    2009-04-01

    Full Text Available Urinary tract infections (UTI are frequent conditions in children. Untreated urinary tract infections can lead to serious kidney problems that could threaten the life of the child. Therefore, early detection and treatment of urinary tract infection is important. In older children, urinary tract infections may cause obvious symptoms such as stomach ache and disuria. In infants and young children, UTIs may be harder to detect because of less specific symptoms. Recurrences are common in children with urinary abnormalities such as neurogenic bladder, vesicourethral reflux or those with very poor toilet and hygiene habits. This article reviews the diagnostic approach and presents the current data related to the roles of radiologic imaging, surgical correction and antibiotic prophylaxis of UTIs in children. [Archives Medical Review Journal 2009; 18(2.000: 57-69

  2. Urinary Tract Infections in the Older Adult.

    Science.gov (United States)

    Nicolle, Lindsay E

    2016-08-01

    Urinary infection is the most common bacterial infection in elderly populations. The high prevalence of asymptomatic bacteriuria in both men and women is benign and should not be treated. A diagnosis of symptomatic infection for elderly residents of long-term care facilities without catheters requires localizing genitourinary findings. Symptomatic urinary infection is overdiagnosed in elderly bacteriuric persons with nonlocalizing clinical presentations, with substantial inappropriate antimicrobial use. Residents with chronic indwelling catheters experience increased morbidity from urinary tract infection. Antimicrobial therapy is selected based on clinical presentation, patient tolerance, and urine culture results. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Urinary tract infections in children.

    Science.gov (United States)

    Sedberry-Ross, Sherry; Pohl, Hans G

    2008-03-01

    Urinary tract infections can be a significant source of morbidity in the pediatric population. The mainstay of evaluating urinary tract infections in children has been physical examination, urinalysis and culture, and renal and bladder sonography and contrast cystography. However, novel clinical paradigms now consider the importance of various risk factors, such as bacterial virulence and antibiotic-resistance patterns, elimination disorders, and the role of innate immunity and inflammation in determining the likelihood of renal cortical scarring.

  4. The Diagnosis of Urinary Tract infection in Young children (DUTY): a diagnostic prospective observational study to derive and validate a clinical algorithm for the diagnosis of urinary tract infection in children presenting to primary care with an acute illness.

    Science.gov (United States)

    Hay, Alastair D; Birnie, Kate; Busby, John; Delaney, Brendan; Downing, Harriet; Dudley, Jan; Durbaba, Stevo; Fletcher, Margaret; Harman, Kim; Hollingworth, William; Hood, Kerenza; Howe, Robin; Lawton, Michael; Lisles, Catherine; Little, Paul; MacGowan, Alasdair; O'Brien, Kathryn; Pickles, Timothy; Rumsby, Kate; Sterne, Jonathan Ac; Thomas-Jones, Emma; van der Voort, Judith; Waldron, Cherry-Ann; Whiting, Penny; Wootton, Mandy; Butler, Christopher C

    2016-01-01

    BACKGROUND It is not clear which young children presenting acutely unwell to primary care should be investigated for urinary tract infection (UTI) and whether or not dipstick testing should be used to inform antibiotic treatment. OBJECTIVES To develop algorithms to accurately identify pre-school children in whom urine should be obtained; assess whether or not dipstick urinalysis provides additional diagnostic information; and model algorithm cost-effectiveness. DESIGN Multicentre, prospective diagnostic cohort study. SETTING AND PARTICIPANTS Children < 5 years old presenting to primary care with an acute illness and/or new urinary symptoms. METHODS One hundred and seven clinical characteristics (index tests) were recorded from the child's past medical history, symptoms, physical examination signs and urine dipstick test. Prior to dipstick results clinician opinion of UTI likelihood ('clinical diagnosis') and urine sampling and treatment intentions ('clinical judgement') were recorded. All index tests were measured blind to the reference standard, defined as a pure or predominant uropathogen cultured at ≥ 10(5) colony-forming units (CFU)/ml in a single research laboratory. Urine was collected by clean catch (preferred) or nappy pad. Index tests were sequentially evaluated in two groups, stratified by urine collection method: parent-reported symptoms with clinician-reported signs, and urine dipstick results. Diagnostic accuracy was quantified using area under receiver operating characteristic curve (AUROC) with 95% confidence interval (CI) and bootstrap-validated AUROC, and compared with the 'clinician diagnosis' AUROC. Decision-analytic models were used to identify optimal urine sampling strategy compared with 'clinical judgement'. RESULTS A total of 7163 children were recruited, of whom 50% were female and 49% were < 2 years old. Culture results were available for 5017 (70%); 2740 children provided clean-catch samples, 94% of whom were ≥ 2 years old

  5. Respiratory tract infection during Hajj

    Directory of Open Access Journals (Sweden)

    Alzeer Abdulaziz

    2009-01-01

    Full Text Available Respiratory tract infection during Hajj (pilgrimage to Mecca is a common illness, and it is responsible for most of the hospital admissions. Influenza virus is the leading cause of upper respiratory tract infection during Hajj, and pneumonia can be serious. Taking into account the close contacts among the pilgrims, as well as the crowding, the potential for transmission of M. tuberculosis is expected to be high. These pilgrims can be a source for spreading infection on their return home. Although vaccination program for influenza is implemented, its efficacy is uncertain in this religious season. Future studies should concentrate on prevention and mitigation of these infections.

  6. Urinary Tract Infections in Children : EAU/ESPU Guidelines

    NARCIS (Netherlands)

    Stein, Raimund; Dogan, Hasan S.; Hoebeke, Piet; Kocvara, Radim; Nijman, Rien J. M.; Radmayr, Christian; Tekgul, Serdar

    Context: In 30% of children with urinary tract anomalies, urinary tract infection (UTI) can be the first sign. Failure to identify patients at risk can result in damage to the upper urinary tract. Objective: To provide recommendations for the diagnosis, treatment, and imaging of children presenting

  7. Bladder Infection (Urinary Tract Infection - UTI) in Adults

    Science.gov (United States)

    ... The Urinary Tract & How It Works Bladder Infection (Urinary Tract Infection—UTI) in Adults View or Print All ... Bladder infections are the most common type of urinary tract infection (UTI), but any part of your urinary ...

  8. Survey of risk factors urinary tract infection

    OpenAIRE

    A Dehghani; M zahedi; M moezzi; M dafei; H Falahzadeh

    2016-01-01

    Introduction: Women are very susceptible to urinary tract infections and pregnancy raises the risk of urinary tract infection. In general, little information on the risk factors of urinary tract infection in pregnancy is underway. Urinary tract infection in pregnancy is an important risk factor for pregnancy dire consequences. The purpose of this study is to find risk factors associated with urinary tract infection in pregnant women. Methods: The study was observational and retrospective ...

  9. 1H NMR spectroscopy-based metabolomics analysis for the diagnosis of symptomatic E. coli-associated urinary tract infection (UTI).

    Science.gov (United States)

    Lussu, Milena; Camboni, Tania; Piras, Cristina; Serra, Corrado; Del Carratore, Francesco; Griffin, Julian; Atzori, Luigi; Manzin, Aldo

    2017-09-21

    Urinary tract infection (UTI) is one of the most common diagnoses in girls and women, and to a lesser extent in boys and men younger than 50 years. Escherichia coli, followed by Klebsiella spp. and Proteus spp., cause 75-90% of all infections. Infection of the urinary tract is identified by growth of a significant number of a single species in the urine, in the presence of symptoms. Urinary culture is an accurate diagnostic method but takes several hours or days to be carried out. Metabolomics analysis aims to identify biomarkers that are capable of speeding up diagnosis. Urine samples from 51 patients with a prior diagnosis of Escherichia coli-associated UTI, from 21 patients with UTI caused by other pathogens (bacteria and fungi), and from 61 healthy controls were analyzed. The 1 H-NMR spectra were acquired and processed. Multivariate statistical models were applied and their performance was validated using permutation test and ROC curve. Orthogonal Partial Least Squares-discriminant Analysis (OPLS-DA) showed good separation (R 2 Y = 0.76, Q2=0.45, p UTI caused by Escherichia coli and healthy controls. Acetate and trimethylamine were identified as discriminant metabolites. The concentrations of both metabolites were calculated and used to build the ROC curves. The discriminant metabolites identified were also evaluated in urine samples from patients with other pathogens infections to test their specificity. Acetate and trimethylamine were identified as optimal candidates for biomarkers for UTI diagnosis. The conclusions support the possibility of a fast diagnostic test for Escherichia coli-associated UTI using acetate and trimethylamine concentrations.

  10. Urinary tract infection - adults

    Science.gov (United States)

    Bladder infection - adults; UTI - adults; Cystitis - bacterial - adults; Pyelonephritis - adults; Kidney infection - adults ... control. Menopause also increases the risk of a UTI. The following also increase your chances of developing ...

  11. Urinary tract infections in pregnancy.

    Science.gov (United States)

    Ovalle, A; Levancini, M

    2001-01-01

    Urinary tract infections are very common during pregnancy. Escherichia coli is the most common pathogen isolated from pregnant women. Ampicillin should not be used because of its high resistance to Escherichia coli. Pyelonephritis can cause morbidity and can be life-threatening to both mother and fetus. Second and third-generation cephalosporins are recommended for treatment, administered initially intravenously during hospitalization. Cultures and the study of virulence factors of uropathogenic Escherichia coli are recommended for the adequate management of pyelonephritis. The lower genital tract infection associated with pyelonephritis is responsible for the failure of antibiotic treatment. Asymptomatic bacteriuria can evolve into cystitis or pyelonephritis. All pregnant women should be routinely screened for bacteriuria using urine culture, and should be treated with nitrofurantoin, sulfixosazole or first-generation cephalosporins. Recurrent urinary infection should be treated with prophylactic antibiotics. Pregnant women who develop urinary tract infections with group B streptococcal infection should be treated with prophylactic antibiotics during labour to prevent neonatal sepsis. Preterm delivery is frequent. Evidence suggests that infection plays a role in the pathogenesis of preterm labour. Experimental models in pregnant mice support the theory that Escherichia coli propagated by the transplacental route, involving bacterial adhesins, induces preterm delivery, but this has not been demonstrated in humans. Ascending lower genital tract infections are the most probable cause of preterm delivery, but this remains to be proved.

  12. Urinary Tract Infection and Neurogenic Bladder.

    Science.gov (United States)

    McKibben, Maxim J; Seed, Patrick; Ross, Sherry S; Borawski, Kristy M

    2015-11-01

    Urinary tract infections (UTIs) are frequent, recurrent, and lifelong for patients with neurogenic bladder and present challenges in diagnosis and treatment. Patients often present without classic symptoms of UTI but with abdominal or back pain, increased spasticity, and urinary incontinence. Failure to recognize and treat infections can quickly lead to life-threatening autonomic dysreflexia or sepsis, whereas overtreatment contributes to antibiotic resistance, thus limiting future treatment options. Multiple prevention methods are used but evidence-based practices are few. Prevention and treatment of symptomatic UTI requires a multimodal approach that focuses on bladder management as well as accurate diagnosis and appropriate antibiotic treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Multi-bacteria multi-antibiotic testing using surface enhanced Raman spectroscopy (SERS) for urinary tract infection (UTI) diagnosis

    Science.gov (United States)

    Hadjigeorgiou, Katerina; Kastanos, Evdokia; Pitris, Costas

    2013-06-01

    The inappropriate use of antibiotics leads to antibiotic resistance, which is a major health care problem. The current method for determination of bacterial susceptibility to antibiotics requires overnight cultures. However most of the infections cannot wait for the results to receive treatment, so physicians administer general spectrum antibiotics. This results in ineffective treatments and aggravates the rising problem of antibiotic resistance. In this work, a rapid method for diagnosis and antibiogram for a bacterial infection was developed using Surface Enhanced Raman Spectroscopy (SERS) with silver nanoparticles. The advantages of this novel method include its rapidness and efficiency which will potentially allow doctors to prescribe the most appropriate antibiotic for an infection. SERS spectra of three species of gram negative bacteria, Escherichia coli, Proteus spp., and Klebsiella spp. were obtained after 0 and 4 hour exposure to the seven different antibiotics. Bacterial strains were diluted in order to reach the concentration of (2x105 cfu/ml), cells/ml which is equivalent to the minimum concentration found in urine samples from UTIs. Even though the concentration of bacteria was low, species classification was achieved with 94% accuracy using spectra obtained at 0 hours. Sensitivity or resistance to antibiotics was predicted with 81%-100% accuracy from spectra obtained after 4 hours of exposure to the different antibiotics. This technique can be applied directly to urine samples, and with the enhancement provided by SERS, this method has the potential to be developed into a rapid method for same day UTI diagnosis and antibiogram.

  14. Postpartum urinary tract infection by mode of delivery

    DEFF Research Database (Denmark)

    Gundersen, Tina Djernis; Krebs, Lone; Loekkegaard, Ellen Christine Leth

    2018-01-01

    OBJECTIVES: To examine the association between postpartum urinary tract infection and intended mode of delivery as well as actual mode of delivery. DESIGN: Retrospective cohort study. SETTING AND PARTICIPANTS: All live births in Denmark between 2004 and 2010 (n=450 856). Births were classified...... was postpartum urinary tract infection (n=16 295) within 30 days post partum, defined as either a diagnosis of urinary tract infection in the National Patient Registry or redemption of urinary tract infection-specific antibiotics recorded in the Register of Medicinal Product Statistics. RESULTS: We found that 4.......6% of women with intended caesarean delivery and 3.5% of women with intended vaginal delivery were treated for postpartum urinary tract infection.Women with intended caesarean delivery had a significantly increased risk of postpartum urinary tract infection compared with women with intended vaginal delivery...

  15. Urinary Tract Infection in Children: A Review

    Directory of Open Access Journals (Sweden)

    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.

  16. New markers of urinary tract infection.

    Science.gov (United States)

    Masajtis-Zagajewska, Anna; Nowicki, Michal

    2017-08-01

    Urinary tract infection (UTI) is the most common bacterial infection independent of age. It is also one of the most common causes of hospitalizations for infections among elderly people and the most common indication for antibiotic prescriptions in primary care. Both diagnostics and management of lower and upper urinary tract infections provide challenges in clinical practice due to their high prevalence and recurrence, and worldwide increase of antibiotic resistance. The clinical symptoms of UTI are often uncharacteristic or asymptomatic. The accurate diagnosis and early treatment are crucial due to risk of septicaemia and long-term consequences. Currently the diagnosis of urinary tract infection is based on the presence of clinical symptoms in combination with the results of nitrite strip test indicating the presence of bacteria in urine and semi-quantitative measurement of white blood cells count in urine. Although urine culture is the gold standard in UTI diagnostics it is both time-consuming and costly. Searching for novel biomarkers of UTI has attracted much attention in recent years. The article reviews several promising serum and urine biomarkers of UTI such as leukocyte esterase, C-reactive protein, procalcitonin, interleukins, elastase alpha (1)-proteinase inhibitor, lactofferin, secretory immunoglobulin A, heparin-binding protein, xanthine oxidase, myeloperoxidase, soluble triggering receptor expressed on myeloid cells-1, α-1 microglobulin (α1Mg) and tetrazolium nitroblue test (TNB). Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Renal scintigraphy in children with first febrile urinary tract infection

    International Nuclear Information System (INIS)

    Duarte Perez, Maria Caridad; Guillen Dosal, Ana; Martinez Silva, Magaly; Hernandez Robledo, Ernesto

    2012-01-01

    The urinary tract infection is one of the most frequent bacterial infections in the childhood. Two hundred eleven children diagnosed as first febrile urinary tract infection patients were studied and performed Tc-DMSA renal scintigraphy in the acute phase of infection. The results were correlated to the duration and intensity of the fever before the diagnosis, to the acute phase reactants (hemogram, erythrosedimentation and reactive-C protein) and to the results of imaging studies (renal ultrasound and mictional uretrocystography)

  18. Urinary Tract Infection

    Science.gov (United States)

    ... discomfort Frequent, painful urination Blood in urine Urethra (urethritis) Burning with urination Discharge When to see a ... opening to the bladder. Infection of the urethra (urethritis). This type of UTI can occur when GI ...

  19. Treatment ofurinary tract infection inchildren

    Directory of Open Access Journals (Sweden)

    Danuta Zwolińska

    2016-09-01

    Full Text Available Urinary tract infection is the most frequent bacterial infection in children. Its prevalence in the population younger than 14 years of age has been estimated at 5–10%. Its high recurrence, especially in patients with risk factors, poses a significant problem. The risk factors most common in the group of children ≤3 years are congenital defects blocking the flow of urine to the bladder, whereas in older children they most typically include a tendency for constipation and dysfunction of the lower urinary tract. The clinical picture is variable and depends on the child’s age, immunity status, pathogen virulence and localisation of infection. The mildest form of urinary tract infection is asymptomatic bacteriuria, whereas more severe presentations include acute pyelonephritis, acute focal bacterial nephritis and urosepsis. Prognosis is usually good, but under certain circumstances hypertension, proteinuria and chronic kidney disease may develop. Therefore, early introduced appropriate treatment is essential. According to the Polish Society for Paediatric Nephrology guidelines, asymptomatic bacteriuria does not warrant treatment, whereas febrile patients (>38°C under 24 months old with a suspicion for urinary tract infection must be promptly administered antibiotic therapy, after a urine specimen has been obtained for culture. For many years, urinary tract infection has remained a topic of controversy in terms of therapy duration and administration route. Inpatient treatment of children under 3 months of age is an accepted rule. Acute pyelonephritis necessitates a longer therapy, lasting from 7 to 10 days, whereas the duration of treatment of lower urinary tract infection has been cut down to 3 up to 5 days. Routine prophylactic antimicrobial therapy is not recommended following the initial urinary tract infection episode, yet should be considered in special circumstances. Alternative

  20. Management of urinary tract infections in pregnancy.

    Science.gov (United States)

    Hodgman, D E

    1994-06-01

    Urinary tract infections (UTIs) are one of the most frequent complications of pregnancy. When the lower UTIs of asymptomatic bacteriuria and cystitis are not eradicated, the subsequent risk of the development of pyelonephritis is increased. The associated decreased maternal morbidity and fetal prematurity are the goals of a screening and treatment program for pregnant women. This clinical article presents information on the etiology, incidence, diagnosis, and management of asymptomatic bacteriuria and cystitis. Nursing implications regarding teaching are included.

  1. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Answers (Q&A) Staying Safe Videos for Educators Search English Español Urinary Tract Infections (UTIs) KidsHealth / For ... Nondiscrimination Visit the Nemours Web site. Note: All information on KidsHealth® is for educational purposes only. For ...

  2. Executive summary of the diagnosis and treatment of urinary tract infection: Guidelines of the Spanish Society of Clinical Microbiology and Infectious Diseases (SEIMC).

    Science.gov (United States)

    de Cueto, Marina; Aliaga, Luis; Alós, Juan-Ignacio; Canut, Andres; Los-Arcos, Ibai; Martínez, Jose Antonio; Mensa, Jose; Pintado, Vicente; Rodriguez-Pardo, Dolors; Yuste, Jose Ramon; Pigrau, Carles

    2017-05-01

    Most urinary tract infections (UTI) are uncomplicated infections occurring in young women. An extensive evaluation is not required in the majority of cases, and they can be safely managed as outpatients with oral antibiotics. Escherichia coli is by far the most common uropathogen, accounting for >80% of all cases. Other major clinical problems associated with UTI include asymptomatic bacteriuria, and patients with complicated UTI. Complicated UTIs are a heterogeneous group associated with conditions that increase the risk of acquiring infection or treatment failure. Distinguishing between complicated and uncomplicated UTI is important, as it influences the initial evaluation, choice, and duration of antimicrobial therapy. Diagnosis is especially challenging in the elderly and in patients with in-dwelling catheters. The increasing prevalence of resistant uropathogens, including extended-spectrum β-lactamases and carbapenemase-producing Enterobacteriaceae, and other multidrug-resistant Gram-negative organisms further compromises treatment of both complicated and uncomplicated UTIs. The aim of these Clinical Guidelines is to provide a set of recommendations for improving the diagnosis and treatment of UTI. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  3. Value of comprehensive renal ultrasound in children with acute urinary tract infection for assessment of renal involvement: comparison with DMSA scintigraphy and final diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Brader, Peter; Riccabona, Michael [Medical University Graz, Division of Pediatric Radiology, Department of Radiology, Graz (Austria); Schwarz, Thomas [Medical University Graz, Division of Nuclear Medicine, Department of Radiology, Graz (Austria); Seebacher, Ursula [Medical University Graz, Department of Pediatric Surgery, Graz (Austria); Ring, Ekkehard [Medical University Graz, Department of Pediatrics, Graz (Austria)

    2008-12-15

    The aim of this study was to evaluate the value of comprehensive renal ultrasound (US), i.e., combining greyscale US and amplitude-coded color Doppler sonography (aCDS), for assessment of urinary tract infection (UTI) in infants and children, compared to (1) {sup 99m}Tc DMSA scintigraphy and (2) final diagnosis. Two hundred eighty-seven children with UTI underwent renal comprehensive US and DMSA scintigraphy. The results were compared with regard to their reliability to diagnose renal involvement, using (1) DMSA scintigraphy and (2) final diagnosis as the gold standard. Sixty-seven children clinically had renal involvement. Sensitivity increased from 84.1% using only aCDS to 92.1% for the combined US approach, using DMSA scintigraphy as the reference standard. When correlated with the final diagnosis, sensitivity for DMSA scintigraphy was 92.5%; sensitivity for comprehensive US was 94.0%. Our data demonstrate an increasing sensitivity using the combination of renal greyscale US supplemented by aCDS for differentiation of upper from lower UTI. Sensitivity for DMSA and comprehensive US was similar for both methods compared to the final diagnosis. Comprehensive US should gain a more important role in the imaging algorithm of children with acute UTI, thereby reducing the radiation burden. (orig.)

  4. Value of comprehensive renal ultrasound in children with acute urinary tract infection for assessment of renal involvement: comparison with DMSA scintigraphy and final diagnosis

    International Nuclear Information System (INIS)

    Brader, Peter; Riccabona, Michael; Schwarz, Thomas; Seebacher, Ursula; Ring, Ekkehard

    2008-01-01

    The aim of this study was to evaluate the value of comprehensive renal ultrasound (US), i.e., combining greyscale US and amplitude-coded color Doppler sonography (aCDS), for assessment of urinary tract infection (UTI) in infants and children, compared to (1) 99m Tc DMSA scintigraphy and (2) final diagnosis. Two hundred eighty-seven children with UTI underwent renal comprehensive US and DMSA scintigraphy. The results were compared with regard to their reliability to diagnose renal involvement, using (1) DMSA scintigraphy and (2) final diagnosis as the gold standard. Sixty-seven children clinically had renal involvement. Sensitivity increased from 84.1% using only aCDS to 92.1% for the combined US approach, using DMSA scintigraphy as the reference standard. When correlated with the final diagnosis, sensitivity for DMSA scintigraphy was 92.5%; sensitivity for comprehensive US was 94.0%. Our data demonstrate an increasing sensitivity using the combination of renal greyscale US supplemented by aCDS for differentiation of upper from lower UTI. Sensitivity for DMSA and comprehensive US was similar for both methods compared to the final diagnosis. Comprehensive US should gain a more important role in the imaging algorithm of children with acute UTI, thereby reducing the radiation burden. (orig.)

  5. Diagnosis of liver, biliary tract and gastrointestine

    International Nuclear Information System (INIS)

    Aburano, Tamio

    1981-01-01

    The role of RI imaging in the diagnosis of lesions of the liver, biliary tracts and gastrointestinal tracts are reviewed, and representative cases are shown. Liver scintigraphy was of value for the diagnosis of lesions limitted to the liver such as primary and metastatic liver cancer and inflammatory liver diseases. However, RI methods were less useful in the diagnosis of lesions of the biliary tracts and stomach. RI scintigraphy was more sensitive than angiography in the detection of Meckel's deverticulum, Ballet's esophagus, and gastrointestinal hemorrhage. (Tsunoda, M.)

  6. Childhood urinary tract infection in primary care: a prospective observational study of prevalence, diagnosis, treatment, and recovery

    Science.gov (United States)

    Butler, Christopher C; O’Brien, Kathryn; Pickles, Timothy; Hood, Kerenza; Wootton, Mandy; Howe, Robin; Waldron, Cherry-Ann; Thomas-Jones, Emma; Hollingworth, William; Little, Paul; Van Der Voort, Judith; Dudley, Jan; Rumsby, Kate; Downing, Harriet; Harman, Kim; Hay, Alastair D

    2015-01-01

    Background The prevalence of targeted and serendipitous treatment for, and associated recovery from, urinary tract infection (UTI) in pre-school children is unknown. Aim To determine the frequency and suspicion of UTI in children who are acutely ill, along with details of antibiotic prescribing, its appropriateness, and whether that appropriateness impacted on symptom improvement and recovery. Design and setting Prospective observational cohort study in primary care sites in urban and rural areas in England and Wales. Method Systematic urine sampling from children aged children’s urine samples, 339 (5.6%) met laboratory criteria for UTI and 162 (47.9%) were prescribed antibiotics at the initial consultation. In total, 576/7101 (8.1%) children were suspected of having a UTI prior to urine sampling, including 107 of the 338 with a UTI (clinician sensitivity 31.7%). Children with a laboratory-diagnosed UTI were more likely to be prescribed antibiotics when UTI was clinically suspected than when it was not (86.0% versus 30.3%, Pchildren with unsuspected UTI, 70 (30.3%) received serendipitous antibiotics (that is, antibiotics prescribed for a different reason). Overall, 176 (52.1%) children with confirmed UTI did not receive any initial antibiotic. Organism sensitivity to the prescribed antibiotic was higher when UTI was suspected than when treated serendipitously (77.1% versus 26.0%; PChildren with UTI prescribed appropriate antibiotics at the initial consultation improved a little sooner than those with a UTI who were not prescribed appropriate antibiotics initially (3.5 days versus 4.0 days; P = 0.005). Conclusion Over half of children with UTI on culture were not prescribed antibiotics at first presentation. Serendipitous UTI treatment was relatively common, but often inappropriate to the organism’s sensitivity. Methods for improved targeting of antibiotic treatment in children who are acutely unwell are urgently needed. PMID:25824181

  7. A study of the validity of urinary tract infection diagnosis in children younger than two years of age at Hvidovre Hospital

    DEFF Research Database (Denmark)

    Roed-Petersen, Casper; Møller, Alice Friis; Høgh, Birthe

    2008-01-01

    INTRODUCTION: The aim of this study is to validate the diagnosis of urinary tract infection (UTI) concerning false-positive diagnoses in children younger than two years of age at Hvidovre Hospital. MATERIALS AND METHODS: The material consists of 89 children (50 girls and 39 boys) diagnosed...... with acute pyelonephritis from September 2002 until October 2004. Two patients dropped out as they were diagnosed in other countries. The patient records were investigated to identify the children who fulfilled the UTI criteria used in the department: 1) Two mid-stream urine samples with bacterial growth...... of = 10.000 cfu (colony forming units)/cc, 2) growth of = 100 cfu/cc in urine obtained by a suprapubic puncture of the bladder or 3) a mid-stream urine sample with bacterial growth of = 10.000 cfu/cc and a clinical picture of UTI together with elevated inflammatory laboratory parameters. RESULTS: 70 out...

  8. [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

  9. Antimicrobial Stewardship and Urinary Tract Infections

    Directory of Open Access Journals (Sweden)

    Lilian M. Abbo

    2014-05-01

    Full Text Available Urinary tract infections are the most common bacterial infections encountered in ambulatory and long-term care settings in the United States. Urine samples are the largest single category of specimens received by most microbiology laboratories and many such cultures are collected from patients who have no or questionable urinary symptoms. Unfortunately, antimicrobials are often prescribed inappropriately in such patients. Antimicrobial use, whether appropriate or inappropriate, is associated with the selection for antimicrobial-resistant organisms colonizing or infecting the urinary tract. Infections caused by antimicrobial-resistant organisms are associated with higher rates of treatment failures, prolonged hospitalizations, increased costs and mortality. Antimicrobial stewardship consists of avoidance of antimicrobials when appropriate and, when antimicrobials are indicated, use of strategies to optimize the selection, dosing, route of administration, duration and timing of antimicrobial therapy to maximize clinical cure while limiting the unintended consequences of antimicrobial use, including toxicity and selection of resistant microorganisms. This article reviews successful antimicrobial stewardship strategies in the diagnosis and treatment of urinary tract infections.

  10. Recurrent urinary tract infections in females

    International Nuclear Information System (INIS)

    Mohsin, R.; Siddiqui, K.M.

    2010-01-01

    Uncomplicated Urinary tract infections are common in adult women across the entire age spectrum, with mean annual incidence of 15% and 10% in those aged 15-39 and 40-79 years, respectively. Urinary tract infection (UTI), with its diverse clinical syndromes and affected host groups, remains one of the most common but widely misunderstood and challenging infectious diseases encountered in clinical practice. Recurrent urinary tract infections (UTIs) present a significant problem for women and a challenge for the doctors who care for them. The diagnosis of uncomplicated UTI can be achieved best by a thorough assessment of patient symptoms with or without the addition of a urine dipstick test. Treatment should be based on the most recent guidelines, taking into account resistance patterns in the local community. The patient who suffers from recurrent UTIs can be treated safely and effectively with continuous antibiotic prophylaxis, post-coital therapy, or self-initiated treatment. This review article covers the latest trends in the management of recurrent UTI among women. Further research is needed regarding rapid diagnosis of UTI, accurate presumptive identification of patients with resistant pathogens, and development of new antimicrobials for drug-resistant UTI. (author)

  11. Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months.

    Science.gov (United States)

    Roberts, Kenneth B

    2011-09-01

    To revise the American Academy of Pediatrics practice parameter regarding the diagnosis and management of initial urinary tract infections (UTIs) in febrile infants and young children. Analysis of the medical literature published since the last version of the guideline was supplemented by analysis of data provided by authors of recent publications. The strength of evidence supporting each recommendation and the strength of the recommendation were assessed and graded. Diagnosis is made on the basis of the presence of both pyuria and at least 50,000 colonies per mL of a single uropathogenic organism in an appropriately collected specimen of urine. After 7 to 14 days of antimicrobial treatment, close clinical follow-up monitoring should be maintained to permit prompt diagnosis and treatment of recurrent infections. Ultrasonography of the kidneys and bladder should be performed to detect anatomic abnormalities. Data from the most recent 6 studies do not support the use of antimicrobial prophylaxis to prevent febrile recurrent UTI in infants without vesicoureteral reflux (VUR) or with grade I to IV VUR. Therefore, a voiding cystourethrography (VCUG) is not recommended routinely after the first UTI; VCUG is indicated if renal and bladder ultrasonography reveals hydronephrosis, scarring, or other findings that would suggest either high-grade VUR or obstructive uropathy and in other atypical or complex clinical circumstances. VCUG should also be performed if there is a recurrence of a febrile UTI. The recommendations in this guideline do not indicate an exclusive course of treatment or serve as a standard of care; variations may be appropriate. Recommendations about antimicrobial prophylaxis and implications for performance of VCUG are based on currently available evidence. As with all American Academy of Pediatrics clinical guidelines, the recommendations will be reviewed routinely and incorporate new evidence, such as data from the Randomized Intervention for Children

  12. [Urinary tract infection in pregnancy].

    Science.gov (United States)

    Herráiz, Miguel Angel; Hernández, Antonio; Asenjo, Eloy; Herráiz, Ignacio

    2005-12-01

    Urinary tract infections, asymptomatic bacteriuria (AB), acute cystitis (AC) and acute pyelonephritis (AP), are favored by the morphological and functional changes involved in pregnancy. AB increases the risk of preterm labor, low birth weight and AP. AB should be detected by uroculture (other methods are not sufficiently effective) and treated early. Approximately 80% of cases are caused by Escherichia coli. The risks and effectiveness of the distinct antibiotic regimens should be evaluated: fosfomycin trometamol in monotherapy or as short course therapy is safe and effective for the treatment of AB and AC. AP is the most frequent cause of hospital admission for medical reasons in pregnant women and can lead to complications in 10% of cases, putting the lives of the mother and fetus at risk. Currently outpatient treatment of AP is recommended in selected cases. Adequate follow-up of pregnant women with urinary tract infections is required due to frequent recurrence.

  13. Role of Tc99m-dimercaptosuccinic acid (DMSA) in diagnosis of acute urinary tract infection (UTI) in Sudanese children patients

    International Nuclear Information System (INIS)

    Abu baker, S. E. E.

    2003-01-01

    Pediatric nuclear medicine, in order to survive, must be innovative in finding ways of competing with other pediatric imaging studies for better health care. In this study a group of thirty-one patients with urinary tract infection confirmed by clinical investigation, (fever, pain, ....ect), laboratory investigation (RBC and pus cell)and urine culture, were evaluate by nuclear medicine study. The aim of the study was to compare the diagnostic value of cortical scintigraphy using Tc 99m dimercaptosuccinic acid (Tc 99m -DMSA), with two other routine investigations; the intravenous urographic (IVU), and ultrasonography (US), for diagnosis of renal parenchymal abnormality in children. The Tc 99m -DMSA renal scan was utilized as the gold standard test for renal involvement. All patients had Tc 99m -DMSA renal scan, and US, and only 22 patients had contrast IVU. The Tc 99m -DMSA renal scan showed abnormality renal scanning in about 94% of patients, US abnormalities were detected in about 81% of patient, while the IVU detected defects in about 87%. Because the prevalence of upper UTI in children is high, Tc 99m -DMSA renal scan is undoubtedly the available tool for pediatriacicians as a guide in giving appropriate antibiotic therapy and to prevent further renal damage. The study concludes that, the renal cortical scintigraphy with Tc 99m -DMSA has been reported to be a useful children diagnostic study of acute parenchymal renal infections, moreover, is presently the method of choice to detect acute parenchymal infection. (Author)

  14. Improving the Diagnosis and Treatment of Urinary Tract Infection in Young Children in Primary Care: Results from the DUTY Prospective Diagnostic Cohort Study

    Science.gov (United States)

    Hay, Alastair D.; Sterne, Jonathan A. C.; Hood, Kerenza; Little, Paul; Delaney, Brendan; Hollingworth, William; Wootton, Mandy; Howe, Robin; MacGowan, Alasdair; Lawton, Michael; Busby, John; Pickles, Timothy; Birnie, Kate; O’Brien, Kathryn; Waldron, Cherry-Ann; Dudley, Jan; Van Der Voort, Judith; Downing, Harriet; Thomas-Jones, Emma; Harman, Kim; Lisles, Catherine; Rumsby, Kate; Durbaba, Stevo; Whiting, Penny; Butler, Christopher C.

    2016-01-01

    PURPOSE Up to 50% of urinary tract infections (UTIs) in young children are missed in primary care. Urine culture is essential for diagnosis, but urine collection is often difficult. Our aim was to derive and internally validate a 2-step clinical rule using (1) symptoms and signs to select children for urine collection; and (2) symptoms, signs, and dipstick testing to guide antibiotic treatment. METHODS We recruited acutely unwell children aged under 5 years from 233 primary care sites across England and Wales. Index tests were parent-reported symptoms, clinician-reported signs, urine dipstick results, and clinician opinion of UTI likelihood (clinical diagnosis before dipstick and culture). The reference standard was microbiologically confirmed UTI cultured from a clean-catch urine sample. We calculated sensitivity, specificity, and area under the receiver operator characteristic (AUROC) curve of coefficient-based (graded severity) and points-based (dichotomized) symptom/sign logistic regression models, and we then internally validated the AUROC using bootstrapping. RESULTS Three thousand thirty-six children provided urine samples, and culture results were available for 2,740 (90%). Of these results, 60 (2.2%) were positive: the clinical diagnosis was 46.6% sensitive, with an AUROC of 0.77. Previous UTI, increasing pain/crying on passing urine, increasingly smelly urine, absence of severe cough, increasing clinician impression of severe illness, abdominal tenderness on examination, and normal findings on ear examination were associated with UTI. The validated coefficient- and points-based model AUROCs were 0.87 and 0.86, respectively, increasing to 0.90 and 0.90, respectively, by adding dipstick nitrites, leukocytes, and blood. CONCLUSIONS A clinical rule based on symptoms and signs is superior to clinician diagnosis and performs well for identifying young children for noninvasive urine sampling. Dipstick results add further diagnostic value for empiric antibiotic

  15. Improving the Diagnosis and Treatment of Urinary Tract Infection in Young Children in Primary Care: Results from the DUTY Prospective Diagnostic Cohort Study.

    Science.gov (United States)

    Hay, Alastair D; Sterne, Jonathan A C; Hood, Kerenza; Little, Paul; Delaney, Brendan; Hollingworth, William; Wootton, Mandy; Howe, Robin; MacGowan, Alasdair; Lawton, Michael; Busby, John; Pickles, Timothy; Birnie, Kate; O'Brien, Kathryn; Waldron, Cherry-Ann; Dudley, Jan; Van Der Voort, Judith; Downing, Harriet; Thomas-Jones, Emma; Harman, Kim; Lisles, Catherine; Rumsby, Kate; Durbaba, Stevo; Whiting, Penny; Butler, Christopher C

    2016-07-01

    Up to 50% of urinary tract infections (UTIs) in young children are missed in primary care. Urine culture is essential for diagnosis, but urine collection is often difficult. Our aim was to derive and internally validate a 2-step clinical rule using (1) symptoms and signs to select children for urine collection; and (2) symptoms, signs, and dipstick testing to guide antibiotic treatment. We recruited acutely unwell children aged under 5 years from 233 primary care sites across England and Wales. Index tests were parent-reported symptoms, clinician-reported signs, urine dipstick results, and clinician opinion of UTI likelihood (clinical diagnosis before dipstick and culture). The reference standard was microbiologically confirmed UTI cultured from a clean-catch urine sample. We calculated sensitivity, specificity, and area under the receiver operator characteristic (AUROC) curve of coefficient-based (graded severity) and points-based (dichotomized) symptom/sign logistic regression models, and we then internally validated the AUROC using bootstrapping. Three thousand thirty-six children provided urine samples, and culture results were available for 2,740 (90%). Of these results, 60 (2.2%) were positive: the clinical diagnosis was 46.6% sensitive, with an AUROC of 0.77. Previous UTI, increasing pain/crying on passing urine, increasingly smelly urine, absence of severe cough, increasing clinician impression of severe illness, abdominal tenderness on examination, and normal findings on ear examination were associated with UTI. The validated coefficient- and points-based model AUROCs were 0.87 and 0.86, respectively, increasing to 0.90 and 0.90, respectively, by adding dipstick nitrites, leukocytes, and blood. A clinical rule based on symptoms and signs is superior to clinician diagnosis and performs well for identifying young children for noninvasive urine sampling. Dipstick results add further diagnostic value for empiric antibiotic treatment. © 2016 Annals of Family

  16. Urinary tract infection in children

    International Nuclear Information System (INIS)

    Kovacs, L.; Janko, V.

    2014-01-01

    Urinary tract infections (UTIs) are among the most common bacterial infections in children which can be a source of significant morbidity. For as yet unknown reasons a minority of UTIs in children progress to renal scarring, hypertension and renal insufficiency. Clinical presentation of UTI in children may be nonspecific, and the appropriateness of certain diagnostic tests remains controversial. The diagnostic work-up should be tailored to uncover functional and structural abnormalities such as dysfunctional voiding, vesicoureteral reflux and obstructive uropathy. A more aggressive work-up is recommended for patients at greater risk for pyelonephritis and renal scarring, including infants less than one year of age. Early sequential (intravenous treatment followed by oral antibiotics) antibacterial therapy is recommended to prevent renal scarring. Routine antibiotic prophylaxis is not recommended, it may be used in patients with higher grade reflux, obstructive uropathy or recurring UTI who are at greater risk for subsequent infections and complications. (author)

  17. Upper respiratory tract infections in athletes.

    Science.gov (United States)

    Page, Clifton L; Diehl, Jason J

    2007-07-01

    Upper respiratory tract infections (URTIs) represent the most common acute illnesses in the general population and account for the leading acute diagnoses in the outpatient setting. Given the athlete's expectation to return to activity as soon as possible, the sports medicine physician should be able to accurately diagnose and aggressively treat these illnesses. This article discusses the common pathogens, diagnosis, treatment options, and return-to-play decisions for URTIs, with a focus on the common cold, sinusitis, pharyngitis, and infectious mononucleosis in the athlete.

  18. URINARY TRACT INFECTIONS IN PREGNANCY

    Directory of Open Access Journals (Sweden)

    N Sivalingam

    2007-01-01

    Full Text Available 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 diagnosing UTIs. Without treatment, asymptomatic bacteriuria in pregnancy is associated with preterm delivery, intrauterine growth retardation, low birth weight, maternal hypertension, pre-eclampsia and anaemia. Acute pyelonephritis can lead to maternal sepsis. Recurrent UTIs in pregnancy require prophylactic antibiotic treatment.

  19. Epidemiology of urinary tract infections in Hiroshima

    Energy Technology Data Exchange (ETDEWEB)

    Freedman, L R; Phair, J P; Seki, Masafumi; Hamilton, H B; Nefzger, M D

    1964-08-19

    The present study was conducted at ABCC on a sample of Hiroshima residents systematically seleced for determining the influence on general health status of exposure to the atomic bomb of 1945. A survey for urinary infections was taken on persons in the sample examined in the ABCC clinic over a 1-year period: approximately 3000 women and 2000 men. The purpose of the study was to determine the prevalence of urinary infection and to study the relation between bacteriuria and various aspects of the general examination, particularly blood pressure. In addition, the rates of urinary tract infection in the clinic were compared with the rates of chronic pyelonephritis at autopsy. Results showed that infections were much more common in women than in men and rose with age in both sexes. The greatest increase in the prevalence was found in women age 60 years and over was due to coliform bacteria in all but a few instances. There was no difference in hematuria, glycosuria, diabetes, serum cholesterol, blood groups, electrocardiograms, audiometry, vibrometry, hemoglobin levels or height-weight ratios. Blood pressure is higher in infected women as compared with noninfected women and the finding of higher rates for cardiac enlargement suggests that this small difference in blood pressures may have biological significance. However, the data do not permit a conclusion as to whether the urinary infections were responsible for the higher blood pressure levels, or whether the higher blood pressure levels increased the frequency of detectable infection. The difference between the clinical rates of urinary infection in men and women, and the pathological diagnosis of pyelonephritis in the same population, supports a previous suggestion that much of what is called pyelonephritis at autopsy is not due to urinary tract infection. 27 references, 2 figures, 10 tables.

  20. Rapid tests and urine sampling techniques for the diagnosis of urinary tract infection (UTI) in children under five years: a systematic review.

    Science.gov (United States)

    Whiting, Penny; Westwood, Marie; Watt, Ian; Cooper, Julie; Kleijnen, Jos

    2005-04-05

    Urinary tract infection (UTI) is one of the most common sources of infection in children under five. Prompt diagnosis and treatment is important to reduce the risk of renal scarring. Rapid, cost-effective, methods of UTI diagnosis are required as an alternative to culture. We conducted a systematic review to determine the diagnostic accuracy of rapid tests for detecting UTI in children under five years of age. The evidence supports the use of dipstick positive for both leukocyte esterase and nitrite (pooled LR+ = 28.2, 95% CI: 17.3, 46.0) or microscopy positive for both pyuria and bacteriuria (pooled LR+ = 37.0, 95% CI: 11.0, 125.9) to rule in UTI. Similarly dipstick negative for both LE and nitrite (Pooled LR- = 0.20, 95% CI: 0.16, 0.26) or microscopy negative for both pyuria and bacteriuria (Pooled LR- = 0.11, 95% CI: 0.05, 0.23) can be used to rule out UTI. A test for glucose showed promise in potty-trained children. However, all studies were over 30 years old. Further evaluation of this test may be useful. Dipstick negative for both LE and nitrite or microscopic analysis negative for both pyuria and bacteriuria of a clean voided urine, bag, or nappy/pad specimen may reasonably be used to rule out UTI. These patients can then reasonably be excluded from further investigation, without the need for confirmatory culture. Similarly, combinations of positive tests could be used to rule in UTI, and trigger further investigation.

  1. Therapeutic management of Urinary Tract Infections (UTI): A ...

    African Journals Online (AJOL)

    Urinary Tract Infection (UTI) is one of the most common diseases and a significant cause of morbidity in all age groups. There are large differences in the management of UTI with respect to definition, diagnosis and treatment. This retrospective study reviewed the diagnosis and drug treatment of UTI at the Teaching ...

  2. Diagnosis of vesicoureteral reflux according to the 1999 and 2011 guidelines of the Subcommittee on Urinary Tract Infection of the American Academy of Pediatrics.

    Science.gov (United States)

    Capone, Marina A; Balestracci, Alejandro; Toledo, Ismael; Martin, Sandra M

    2016-04-01

    In 1999, the American Academy of Pediatrics (AAP) recommended perform a renal ultrasonography and avoiding cystourethrography to all infants between 2 and 24 months of age after their first urinary tract infection (UTI). In 2011, the AAP restricted voiding cystourethrography to children with a pathological ultrasonography, recurrent and/ or atypical infections. Our objective was to compare, in patients with vesicoureteral reflux (VUR) and normal renal ultrasonography, the prevalence of a relevant pathology as if patients had been studied as per the 1999 guidelines (for first UTI) or the 2011 guidelines (for recurrent and/or atypical UTI). We conducted a retrospective analysis of patients with UTI, aged between 2 and 24 months old, seen at our department between January 2010 and August 2014 and who had a normal renal ultrasonography and VUR. A relevant pathology was defined as a finding of grade III VUR or higher and/or pathological renal scintigraphy. Forty-five patients (31 girls) were included and were grouped as if they had been treated as per the 1999 or 2011 guidelines. The prevalence of a relevant pathology among patients studied as per the 1999 guidelines (9 out of 24 cases, 3 with atypical UTI) or as per the 2011 guidelines (11 out of 21 cases) was similar (37.5% versus 52%, respectively; p= 0.31). Six patients (25%) with a relevant pathology diagnosed as per the 1999 guidelines would not have been identified in a timely manner with the 2011 version. The prevalence of a relevant pathology identified in children with VUR and normal renal ultrasonography was similar with both guidelines. However, considering the present guidelines, one out of four patients would have been exposed to a delayed or potentially missed diagnosis if recurrence would have been expected to complete the assessment. Sociedad Argentina de Pediatría.

  3. [Fungal infections of the gastrointestinal tract].

    Science.gov (United States)

    Maragkoudakis, Emmanouil; Realdi, Giuseppe; Dore, Maria Pina

    2005-06-01

    In immunocompetent subjects fungal infections of the gastrointestinal tract are uncommon. Candida esophagitis remains the single most common fungal infection in immunocompromised hosts or in H. pylori- infected patients who receive antibiotic therapy. Enteric fungal infections are uncommon even in HIV-infected patients. Antifungal agents such as amphotericin B, ketoconazole, fluconazole, and the various formulations of itraconazole are effective for most cases.

  4. Survey of risk factors urinary tract infection

    Directory of Open Access Journals (Sweden)

    A Dehghani

    2016-09-01

    Full Text Available Introduction: Women are very susceptible to urinary tract infections and pregnancy raises the risk of urinary tract infection. In general, little information on the risk factors of urinary tract infection in pregnancy is underway. Urinary tract infection in pregnancy is an important risk factor for pregnancy dire consequences. The purpose of this study is to find risk factors associated with urinary tract infection in pregnant women. Methods: The study was observational and retrospective analysis was carried on in the winter of which 310 pregnant women participated in 11 health centers in Shahrekord. Of these 155 cases (patients and 155 controls (healthy that were matched for age Information required from the health records of pregnant women and complete Czech list of researcher whose validity was confirmed by experts were gathered. Information needed by pregnant women health records and complete list researcher was collected. Czech list contains a number of possible risk factors for illness and demographic characteristics of the study participants was Statistical analysis software spss version 16 by using chi square tests and logistic regression and t analysis was performed. Results: Among the variables vomiting (p = 0/00 a history of urinary tract infection in a previous pregnancy (P =.001, CI = 1.508-4.408, OR = 2.578 abortion own history (P =.014, CI = 1.165 -3.847, OR = 2.117, respectively, the most important risk factors for urinary tract infection in pregnant women were determined. Conclusion: Prevention and treatment of vomiting in pregnancy prevention of urinary tract infections during pregnancy. Prevention of abortion can play an important role in the prevention of urinary tract infection and its complications in pregnancy. The study also revealed a number of factors can have an impact on urinary tract infection in pregnancy that has not been enough attention and it is necessary that more attention be placed on health programs and

  5. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Urinary Tract? Your urinary tract is actually a system made up of these main parts: two kidneys ... topic for: Kids Chronic Kidney Diseases Movie: Urinary System Your Urinary System Bedwetting View more Partner Message ...

  6. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Urinary Tract? Your urinary tract is actually a system made up of these main parts: two kidneys ... topic for: Kids Chronic Kidney Diseases Movie: Urinary System Your Urinary System Bedwetting View more About Us ...

  7. Recurrent uncomplicated urinary tract infections in women: a review.

    Science.gov (United States)

    Nosseir, Sandy B; Lind, Lawrence R; Winkler, Harvey A

    2012-03-01

    Recurrent urinary tract infections most often present with symptoms of irritative voiding. In most cases, they are caused by reinfection with a previously isolated organism. Patients with one or more symptoms of uncomplicated recurrent urinary tract infection should undergo thorough examination and screening for underlying comorbidities that increase susceptibility. When frequent reinfections, empiric treatment relapse, persistent infections, or risk factors for complicated infections are encountered, patients may benefit from urodynamics, cystoscopy, renal ultrasound, intravenous urogram, or voiding cystourethrogram to evaluate for anatomic, functional, or metabolic abnormalities affecting the urinary tract (e.g., stones, stricture, obstruction, vesicoureteral reflux, lesions, detrusor underactivity). These patients may benefit from culture-guided empiric treatment and further evaluation by urology, nephrology, or infectious disease specialists. In patients with a history of uncomplicated urinary tract infections, empiric treatment guided by local antimicrobial resistance may efficiently treat a suspected recurrence. After successful treatment of the acute infection, postcoital prophylaxis, continuous prophylaxis, or self-start empiric treatment may be selected based on frequency of recurrent infections, temporal relation to intercourse, and patient characteristics. Ancillary measures such as probiotics, cranberry products, or local estrogen replacement may also be considered. This article will review the current definition, epidemiology, pathogenesis, diagnosis, work-up, treatment, treatment side effects, and prevention of recurrent urinary tract infections in women. A suggested algorithm for evaluation and treatment based on current literature is provided.

  8. [Urinary tract infection in pregnancy and menopause].

    Science.gov (United States)

    Broseta Rico, Enrique; Jiménez Cruz, Juan Fernando

    2002-11-01

    To review the topic of urinary tract infections (UTI) during pregnancy and menopause. UTI during pregnancy and menopause have great relevance in the field of urologic infections; during pregnancy because of the particularities involved in its diagnosis and treatment and potential consequences to the fetus and mother; menopausal UTI because this group of women is numerous and represents a growing section of the general population pyramid, due to the aging of population in developed countries associated with longer life expectancies and grater demand for quality of life. We performed a bibliographic review combined with our personal experience. During pregnancy there are several functional and anatomical changes that condition not only a higher risk of UTI, but also an additional treatment difficulty due to antimicrobial pharmacokinetics alterations and potential damage to the fetus. Despite efforts to find an easy, fast and reliable test for bacteriuria detection, urine culture continues to be the first diagnostic test for its detection and follow up during pregnancy. Penicillin derivates and cephalosporins continue to be the first choice because their lack of adverse effects on either fetus or mother. Alternative options like phosphomicin and aztreonam although they show low toxicity there is need for more studies supporting their suitability for the treatment of pregnancy UTIs. Menopausal female UTI have their different features from those in younger women. Hormonal alterations derived from gonadal atrophy associate functional changes in the vaginal ecosystem, making it prone to enterobacteriaceae colonization as a first step up to the urinary tract. This associated with genitourinary tract anatomical alterations inherent t aging make UTI extraordinary prevalent in this growing segment of population. Treatment lines focus on hormonal alteration correction and proper antimicrobial prophylaxis and vaccines in a close future. UTIs during pregnancy and menopause have

  9. Comparison of microbiological diagnosis of urinary tract infection in young children by routine health service laboratories and a research laboratory: Diagnostic cohort study

    Science.gov (United States)

    Birnie, Kate; Hay, Alastair D.; Wootton, Mandy; Howe, Robin; MacGowan, Alasdair; Whiting, Penny; Lawton, Michael; Delaney, Brendan; Downing, Harriet; Dudley, Jan; Hollingworth, William; Lisles, Catherine; Little, Paul; O’Brien, Kathryn; Pickles, Timothy; Rumsby, Kate; Thomas-Jones, Emma; Van der Voort, Judith; Waldron, Cherry-Ann; Harman, Kim; Hood, Kerenza; Butler, Christopher C.; Sterne, Jonathan A. C.

    2017-01-01

    Objectives To compare the validity of diagnosis of urinary tract infection (UTI) through urine culture between samples processed in routine health service laboratories and those processed in a research laboratory. Population and methods We conducted a prospective diagnostic cohort study in 4808 acutely ill children aged <5 years attending UK primary health care. UTI, defined as pure/predominant growth ≥105 CFU/mL of a uropathogen (the reference standard), was diagnosed at routine health service laboratories and a central research laboratory by culture of urine samples. We calculated areas under the receiver-operator curve (AUC) for UTI predicted by pre-specified symptoms, signs and dipstick test results (the “index test”), separately according to whether samples were obtained by clean catch or nappy (diaper) pads. Results 251 (5.2%) and 88 (1.8%) children were classified as UTI positive by health service and research laboratories respectively. Agreement between laboratories was moderate (kappa = 0.36; 95% confidence interval [CI] 0.29, 0.43), and better for clean catch (0.54; 0.45, 0.63) than nappy pad samples (0.20; 0.12, 0.28). In clean catch samples, the AUC was lower for health service laboratories (AUC = 0.75; 95% CI 0.69, 0.80) than the research laboratory (0.86; 0.79, 0.92). Values of AUC were lower in nappy pad samples (0.65 [0.61, 0.70] and 0.79 [0.70, 0.88] for health service and research laboratory positivity, respectively) than clean catch samples. Conclusions The agreement of microbiological diagnosis of UTI comparing routine health service laboratories with a research laboratory was moderate for clean catch samples and poor for nappy pad samples and reliability is lower for nappy pad than for clean catch samples. Positive results from the research laboratory appear more likely to reflect real UTIs than those from routine health service laboratories, many of which (particularly from nappy pad samples) could be due to contamination. Health service

  10. Comparison of microbiological diagnosis of urinary tract infection in young children by routine health service laboratories and a research laboratory: Diagnostic cohort study.

    Directory of Open Access Journals (Sweden)

    Kate Birnie

    Full Text Available To compare the validity of diagnosis of urinary tract infection (UTI through urine culture between samples processed in routine health service laboratories and those processed in a research laboratory.We conducted a prospective diagnostic cohort study in 4808 acutely ill children aged <5 years attending UK primary health care. UTI, defined as pure/predominant growth ≥105 CFU/mL of a uropathogen (the reference standard, was diagnosed at routine health service laboratories and a central research laboratory by culture of urine samples. We calculated areas under the receiver-operator curve (AUC for UTI predicted by pre-specified symptoms, signs and dipstick test results (the "index test", separately according to whether samples were obtained by clean catch or nappy (diaper pads.251 (5.2% and 88 (1.8% children were classified as UTI positive by health service and research laboratories respectively. Agreement between laboratories was moderate (kappa = 0.36; 95% confidence interval [CI] 0.29, 0.43, and better for clean catch (0.54; 0.45, 0.63 than nappy pad samples (0.20; 0.12, 0.28. In clean catch samples, the AUC was lower for health service laboratories (AUC = 0.75; 95% CI 0.69, 0.80 than the research laboratory (0.86; 0.79, 0.92. Values of AUC were lower in nappy pad samples (0.65 [0.61, 0.70] and 0.79 [0.70, 0.88] for health service and research laboratory positivity, respectively than clean catch samples.The agreement of microbiological diagnosis of UTI comparing routine health service laboratories with a research laboratory was moderate for clean catch samples and poor for nappy pad samples and reliability is lower for nappy pad than for clean catch samples. Positive results from the research laboratory appear more likely to reflect real UTIs than those from routine health service laboratories, many of which (particularly from nappy pad samples could be due to contamination. Health service laboratories should consider adopting procedures used

  11. Urinary tract infection in the neurogenic bladder

    Science.gov (United States)

    Vigil, Humberto R.

    2016-01-01

    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 ≥103 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

  12. [Antibiotic prescribing in acute respiratory tract infections in general practice].

    Science.gov (United States)

    Malo, S; Bjerrum, L; Feja, C; Lallana, M J; Poncel, A; Rabanaque, M J

    2015-06-01

    Antimicrobial resistance is a worldwide threat to public health. Acute respiratory tract infections are the main reason for antibiotic prescribing in the Spanish paediatric population. The aim of the study was to describe the frequency of antibiotic prescription and their pattern of use in acute respiratory tract infections diagnosed in children in Primary Care in Aragón (Spain). A study was conducted over a 1-year period on children between 0 and 14 years-old, recording all episodes of acute otitis, acute pharyngotonsillitis, non-specific upper respiratory infection, and acute bronchitis. The proportion of episodes within each diagnosis receiving an antibiotic prescription was calculated, and the prescribing pattern was determined. Half (50%) of the children in Aragón were diagnosed with a respiratory tract infection during the study period. Non-specific upper respiratory infection was the most frequent diagnosis. An antibiotic was prescribed in 75% of pharyngotonsillitis episodes, 72% of otitis, 27% of bronchitis, and 16% of non-specific upper respiratory infections. Broad spectrum antibiotics, mainly amoxicillin and amoxicillin-clavulanic, were predominantly prescribed. Antibiotic prescribing in respiratory tract infections in children was generally high, and the choice of antibiotics was probably inappropriate in a high percentage of cases. Therefore an improvement in antibiotic prescribing in children appears to be needed. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  13. How do Dutch general practitioners diagnose children's urinary tract infections?

    NARCIS (Netherlands)

    Harmsen, M.; Wolters, R.J.; Wouden, J.C. van der; Grol, R.P.T.M.; Wensing, M.J.P.

    2009-01-01

    OBJECTIVE: To study which tests general practitioners used to diagnose a urinary tract infection (UTI) in children and which patient characteristics were associated with test choice. DESIGN: Retrospective chart review on the diagnosis of UTIs in children in Dutch general practices who were diagnosed

  14. Work up of Pediatric Urinary Tract Infection

    Science.gov (United States)

    Copp, Hillary L.; Schmidt, Bogdana

    2016-01-01

    Pediatric UTI costs the healthcare system upwards of 180 million dollars annually, and accounts for over 1.5 million clinician visits per year. Accurate and timely diagnosis of these infections is important for determining appropriate treatment and preventing long-term complications such as renal scarring, hypertension, and end-stage renal disease. Outside of the first 12 months, girls are more likely to be diagnosed with a UTI. About half of boys with UTI will be diagnosed within the first 12 months of life. The prevalence and incidence of pediatric UTI varies by age, race/ethnicity, sex and circumcision status. Diagnosis of UTI is made based on history and exam findings and confirmed with appropriately collected urine. If a bag specimen is negative, this can be used to rule out UTI without the need for confirmatory culture; however positive urinalysis tests from bag specimen warrant further investigation with a catheterized specimen or suprapubic aspiration. Urine culture is the gold standard for diagnosing UTI: Greater than 50,000 CFU on a catheterized specimen or suprapubic aspiration indicate presence of a UTI. Greater than 100,000 CFU on a voided specimen is considered a positive culture. There is no consensus on the need and optimal strategy for imaging in the setting of urinary tract infection in the pediatric population. Prompt recognition of UTI and antibiogram-based, empiric treatment or culture-based, targeted treatment should be initiated within 72 of presentation. PMID:26475948

  15. Urinary Tract Infections (For Kids)

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    Full Text Available ... Urinary Tract? Your urinary tract is actually a system made up of these main parts: two kidneys two ureters (say: ... Chronic Kidney Diseases Movie: Urinary System Your Urinary System Bedwetting View more ... & Terms of Use Notice of Nondiscrimination Visit the Nemours Web ...

  16. urinary tract infections amongst pregnant women attending

    African Journals Online (AJOL)

    boaz

    Urinary tract infection (UTI) constitutes a major health problem in pregnant women due to their relatively short urethra, which ... the urine samples of pregnant women prior to treatment. ... Of 500 asymptomatic pregnant women screened, 433.

  17. Management of Urinary Tract Infections in Children

    African Journals Online (AJOL)

    Abstract. Urinary Tract Infections (UTIs) are a common occurrence in paediatrics. ... Ceftriaxone, ampicillin, cefotaxime and gentamycin are the recommended parenteral antibiotics, ... and/or oral medication) and hydration status (in the case of.

  18. The diagnosis of urinary tract infections in young children (DUTY: protocol for a diagnostic and prospective observational study to derive and validate a clinical algorithm for the diagnosis of UTI in children presenting to primary care with an acute illness

    Directory of Open Access Journals (Sweden)

    Downing Harriet

    2012-07-01

    Full Text Available Abstract Background Urinary tract infection (UTI is common in children, and may cause serious illness and recurrent symptoms. However, obtaining a urine sample from young children in primary care is challenging and not feasible for large numbers. Evidence regarding the predictive value of symptoms, signs and urinalysis for UTI in young children is urgently needed to help primary care clinicians better identify children who should be investigated for UTI. This paper describes the protocol for the Diagnosis of Urinary Tract infection in Young children (DUTY study. The overall study aim is to derive and validate a cost-effective clinical algorithm for the diagnosis of UTI in children presenting to primary care acutely unwell. Methods/design DUTY is a multicentre, diagnostic and prospective observational study aiming to recruit at least 7,000 children aged before their fifth birthday, being assessed in primary care for any acute, non-traumatic, illness of ≤ 28 days duration. Urine samples will be obtained from eligible consented children, and data collected on medical history and presenting symptoms and signs. Urine samples will be dipstick tested in general practice and sent for microbiological analysis. All children with culture positive urines and a random sample of children with urine culture results in other, non-positive categories will be followed up to record symptom duration and healthcare resource use. A diagnostic algorithm will be constructed and validated and an economic evaluation conducted. The primary outcome will be a validated diagnostic algorithm using a reference standard of a pure/predominant growth of at least >103, but usually >105 CFU/mL of one, but no more than two uropathogens. We will use logistic regression to identify the clinical predictors (i.e. demographic, medical history, presenting signs and symptoms and urine dipstick analysis results most strongly associated with a positive urine culture result. We will

  19. The diagnosis of urinary tract infections in young children (DUTY): protocol for a diagnostic and prospective observational study to derive and validate a clinical algorithm for the diagnosis of UTI in children presenting to primary care with an acute illness.

    Science.gov (United States)

    Downing, Harriet; Thomas-Jones, Emma; Gal, Micaela; Waldron, Cherry-Ann; Sterne, Jonathan; Hollingworth, William; Hood, Kerenza; Delaney, Brendan; Little, Paul; Howe, Robin; Wootton, Mandy; Macgowan, Alastair; Butler, Christopher C; Hay, Alastair D

    2012-07-19

    Urinary tract infection (UTI) is common in children, and may cause serious illness and recurrent symptoms. However, obtaining a urine sample from young children in primary care is challenging and not feasible for large numbers. Evidence regarding the predictive value of symptoms, signs and urinalysis for UTI in young children is urgently needed to help primary care clinicians better identify children who should be investigated for UTI. This paper describes the protocol for the Diagnosis of Urinary Tract infection in Young children (DUTY) study. The overall study aim is to derive and validate a cost-effective clinical algorithm for the diagnosis of UTI in children presenting to primary care acutely unwell. DUTY is a multicentre, diagnostic and prospective observational study aiming to recruit at least 7,000 children aged before their fifth birthday, being assessed in primary care for any acute, non-traumatic, illness of ≤ 28 days duration. Urine samples will be obtained from eligible consented children, and data collected on medical history and presenting symptoms and signs. Urine samples will be dipstick tested in general practice and sent for microbiological analysis. All children with culture positive urines and a random sample of children with urine culture results in other, non-positive categories will be followed up to record symptom duration and healthcare resource use. A diagnostic algorithm will be constructed and validated and an economic evaluation conducted.The primary outcome will be a validated diagnostic algorithm using a reference standard of a pure/predominant growth of at least >103, but usually >105 CFU/mL of one, but no more than two uropathogens.We will use logistic regression to identify the clinical predictors (i.e. demographic, medical history, presenting signs and symptoms and urine dipstick analysis results) most strongly associated with a positive urine culture result. We will then use economic evaluation to compare the cost

  20. Two-picture urography in urinary tract infections

    International Nuclear Information System (INIS)

    Laehde, S.; Standertskjoeld-Nordenstam, C.G.; Suoranta, H.; Pyhtinen, J.

    1981-01-01

    Researchers analyzed separately from a urographic series 1 radiograph of the kidneys, ureters and bladder after releasing compression. The diagnosis was compared to that of the complete series in 230 consecutive urographic studies performed for recurrent urinary tract infections. The findings were in agreement in 88 per cent of the cases and no therapeutically significant change was overlooked owing to the decrease in the number of exposures. A urographic series with 2 films is described and recommended for the screening of recurrent urinary tract infections in young patients

  1. 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. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Gram-stain plus MALDI-TOF MS (Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry for a rapid diagnosis of urinary tract infection.

    Directory of Open Access Journals (Sweden)

    Almudena Burillo

    Full Text Available Microbiological confirmation of a urinary tract infection (UTI takes 24-48 h. In the meantime, patients are usually given empirical antibiotics, sometimes inappropriately. We assessed the feasibility of sequentially performing a Gram stain and MALDI-TOF MS mass spectrometry (MS on urine samples to anticipate clinically useful information. In May-June 2012, we randomly selected 1000 urine samples from patients with suspected UTI. All were Gram stained and those yielding bacteria of a single morphotype were processed for MALDI-TOF MS. Our sequential algorithm was correlated with the standard semiquantitative urine culture result as follows: Match, the information provided was anticipative of culture result; Minor error, the information provided was partially anticipative of culture result; Major error, the information provided was incorrect, potentially leading to inappropriate changes in antimicrobial therapy. A positive culture was obtained in 242/1000 samples. The Gram stain revealed a single morphotype in 207 samples, which were subjected to MALDI-TOF MS. The diagnostic performance of the Gram stain was: sensitivity (Se 81.3%, specificity (Sp 93.2%, positive predictive value (PPV 81.3%, negative predictive value (NPV 93.2%, positive likelihood ratio (+LR 11.91, negative likelihood ratio (-LR 0.20 and accuracy 90.0% while that of MALDI-TOF MS was: Se 79.2%, Sp 73.5, +LR 2.99, -LR 0.28 and accuracy 78.3%. The use of both techniques provided information anticipative of the culture result in 82.7% of cases, information with minor errors in 13.4% and information with major errors in 3.9%. Results were available within 1 h. Our serial algorithm provided information that was consistent or showed minor errors for 96.1% of urine samples from patients with suspected UTI. The clinical impacts of this rapid UTI diagnosis strategy need to be assessed through indicators of adequacy of treatment such as a reduced time to appropriate empirical treatment or

  3. Urinary Tract Infections (For Kids)

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    Full Text Available ... Illnesses & Injuries Relax & Unwind People, Places & Things That Help Feelings Expert Answers Q&A Movies & More for ... ll never want to have one again! To help keep those bacteria out of your urinary tract, ...

  4. Urinary Tract Infections (For Kids)

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    Full Text Available ... Urinary Tract Troubles Girls are more likely than boys to get a UTI. That's because their urethras are much shorter than boys' urethras. The shorter urethra means bacteria can get ...

  5. Urinary Tract Infections (For Kids)

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    Full Text Available ... body. Ahhh! That feels better. Urinary Tract Troubles Girls are more likely than boys to get a ... away properly, they stay on your skin. In girls, this means they can grow near the opening ...

  6. Streptococcus pneumoniae urinary tract infection in pedeatrics.

    Science.gov (United States)

    Pougnet, Richard; Sapin, Jeanne; De Parscau, Loïc; Pougnet, Laurence

    2017-06-01

    Streptococcus pneumoniae infections in children are most often lung infections or meningitis. Urinary tract infections are much rarer. We present the case of a urinary tract infection with Streptococcus pneumoniae. The clinical picture was classical. The urine culture showed the presence of Streptococcus pneumoniae in urine (10 4 UFC/mL; with 2 × 10 4 leucocytes/mL). The literature mentions a few cases of such infections. In some studies, the prevalence of Streptococcus pneumoniae in urine of children is less than 1%. Those children mostly present abnormalities of urinary tract. In our case, urinary ultrasound scan have shown the presence of an ectopic kidney in this child. The discussion between the clinician and the biologist has contributed to the discovery of this renal anomaly.

  7. Urinary Tract Infections (For Kids)

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    Full Text Available ... Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & ... & Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert ...

  8. Histopathologic diagnosis of eosinophilic conditions in the gastrointestinal tract.

    Science.gov (United States)

    Hurrell, Jennifer M; Genta, Robert M; Melton, Shelby D

    2011-09-01

    Eosinophils, a constitutive component of the columnar-lined gastrointestinal tract, play an essential role in allergic responses and parasitic infections. The tissue density of these cells also increases in a variety of conditions of uncertain etiology. With the exception of the esophageal squamous epithelium, in which no eosinophils are normally present, the population of normal eosinophils in the remainder of the luminal gut is poorly defined. Therefore, histopathologists must rely on their subjective judgment to determine when a diagnosis of eosinophilic gastritis, enteritis, or colitis should be rendered. Eosinophilic esophagitis is currently the best defined and most studied eosinophilic condition of the digestive tract; therefore, the confidence in accurate diagnosis is increasing. In contrast, the characteristic clinicopathologic features of eosinophilic conditions affecting other parts of the digestive tract remain somewhat elusive. This review was designed to present pathologists with simple and practical information for the biopsy-based histopathologic diagnosis of eosinophilic esophagitis, gastritis, enteritis, and colitis. It was prepared by critically reviewing more than 200 articles on the topic, along with incorporating evidence accumulated through our own collective experience. We anticipate that by increasing pathologists' confidence in reporting these abnormal but often nameless eosinophilic infiltrates, we can help better define and characterize their significance.

  9. Current concepts in urinary tract infections.

    Science.gov (United States)

    Williams, D H; Schaeffer, A J

    2004-03-01

    Urinary tract infections (UTIs) are common infectious diseases that can be associated with substantial morbidity and significant expenditures. This review highlights the current concepts and recent advances in our understanding and management of this condition. Specific topics include pathogenesis, host factors, antimicrobial resistance, recurrent UTIs in women, diagnosis, treatment of uncomplicated and complicated UTIs, prophylaxis, catheter associated bacteriuria, pregnancy, diabetes, UTIs in men, prostatitis, and the chronic pelvic pain syndrome. UTIs can be viewed as an interaction between specific bacterial virulence factors and the patient. A new model explaining the pathogenesis of recurrent UTIs has been presented. There is a need to reconsider traditional treatment recommendations in the face of local resistance patterns, as well as the need to make better use of drugs that are currently available. Prospects for prevention of recurrent UTI include natural compounds, bacterial interference and immunization. With regard to UTI risk in women, patients can be classified based on age, and functional and hormonal status. Appropriate treatment approaches must be based on this classification. In contrast to uncomplicated UTIs, management of most complicated infections depends on clinical experience and resources at individual institutions rather than on evidence based guidelines. Asymptomatic bacteriuria generally should not be treated except in high-risk catheterized patients and in pregnancy. UTIs in men generally require formal urologic evaluation. Our understanding of the etiologies, diagnostic strategies, and treatment options for prostatitis and the chronic pelvic pain syndrome in men continues to evolve.

  10. Urinary tract infections in children: EAU/ESPU guidelines.

    Science.gov (United States)

    Stein, Raimund; Dogan, Hasan S; Hoebeke, Piet; Kočvara, Radim; Nijman, Rien J M; Radmayr, Christian; Tekgül, Serdar

    2015-03-01

    In 30% of children with urinary tract anomalies, urinary tract infection (UTI) can be the first sign. Failure to identify patients at risk can result in damage to the upper urinary tract. To provide recommendations for the diagnosis, treatment, and imaging of children presenting with UTI. The recommendations were developed after a review of the literature and a search of PubMed and Embase. A consensus decision was adopted when evidence was low. UTIs are classified according to site, episode, symptoms, and complicating factors. For acute treatment, site and severity are the most important. Urine sampling by suprapubic aspiration or catheterisation has a low contamination rate and confirms UTI. Using a plastic bag to collect urine, a UTI can only be excluded if the dipstick is negative for both leukocyte esterase and nitrite or microscopic analysis is negative for both pyuria and bacteriuria. A clean voided midstream urine sample after cleaning the external genitalia has good diagnostic accuracy in toilet-trained children. In children with febrile UTI, antibiotic treatment should be initiated as soon as possible to eradicate infection, prevent bacteraemia, improve outcome, and reduce the likelihood of renal involvement. Ultrasound of the urinary tract is advised to exclude obstructive uropathy. Depending on sex, age, and clinical presentation, vesicoureteral reflux should be excluded. Antibacterial prophylaxis is beneficial. In toilet-trained children, bladder and bowel dysfunction needs to be excluded. The level of evidence is high for the diagnosis of UTI and treatment in children but not for imaging to identify patients at risk for upper urinary tract damage. In these guidelines, we looked at the diagnosis, treatment, and imaging of children with urinary tract infection. There are strong recommendations on diagnosis and treatment; we also advise exclusion of obstructive uropathy within 24h and later vesicoureteral reflux, if indicated. Copyright © 2014 European

  11. Urinary Tract Infections (For Kids)

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    Full Text Available ... Mind Sexual Health Food & Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) ... a bladder infection, your doctor will order some medicine for you to take to kill the bacteria. ...

  12. Urinary Tract Infections (For Kids)

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  13. Urinary Tract Infections (For Kids)

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    Full Text Available ... padres General Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life ... get up into the bladder more easily and cause an infection there. Some of the bacteria that ...

  14. Urinary Tract Infections (For Kids)

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    Full Text Available ... Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for ... can cause a bladder infection, which is a type of UTI. You may also hear a bladder ...

  15. Urinary Tract Infections (For Kids)

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    Full Text Available ... infection before anyone else can see there's anything wrong with you. That's why it's important to talk ... kidney infection and you should see a doctor right away. What Will the Doctor Do? First, your ...

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  18. Urinary tract infection in women - self-care

    Science.gov (United States)

    Most urinary tract infections (UTIs) are caused by bacteria that enter the urethra and travel to the bladder. ... BATHING AND HYGIENE To prevent future urinary tract infections, ... believe make infections more likely. Change your pad each time ...

  19. Work-up of Pediatric Urinary Tract Infection.

    Science.gov (United States)

    Schmidt, Bogdana; Copp, Hillary L

    2015-11-01

    Pediatric urinary tract infection (UTI) costs the health care system more than $180 million annually, and accounts for more than 1.5 million clinician visits per year. Accurate and timely diagnosis of these infections is important for determining appropriate treatment and preventing long-term complications such as renal scarring, hypertension, and end-stage renal disease. After the first 12 months, girls are more likely to be diagnosed with a UTI. About half of boys with UTI are diagnosed within the first 12 months of life. Diagnosis of UTI is made based on history and examination findings and confirmed by urine testing. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    NARCIS (Netherlands)

    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

  1. Urinary Tract Infections in Older Women

    Science.gov (United States)

    Mody, Lona; Juthani-Mehta, Manisha

    2014-01-01

    IMPORTANCE Asymptomatic bacteriuria and symptomatic urinary tract infections (UTIs) in older women are commonly encountered in outpatient practice. OBJECTIVE To review management of asymptomatic bacteriuria and symptomatic UTI and review prevention of recurrent UTIs in older community-dwelling women. EVIDENCE REVIEW A search of Ovid (Medline, PsycINFO, Embase) for English-language human studies conducted among adults aged 65 years and older and published in peer-reviewed journals from 1946 to November 20, 2013. RESULTS The clinical spectrum of UTIs ranges from asymptomatic bacteriuria, to symptomatic and recurrent UTIs, to sepsis associated with UTI requiring hospitalization. Recent evidence helps differentiate asymptomatic bacteriuria from symptomatic UTI. Asymptomatic bacteriuria is transient in older women, often resolves without any treatment, and is not associated with morbidity or mortality. The diagnosis of symptomatic UTI is made when a patient has both clinical features and laboratory evidence of a urinary infection. Absent other causes, patients presenting with any 2 of the following meet the clinical diagnostic criteria for symptomatic UTI: fever, worsened urinary urgency or frequency, acute dysuria, suprapubic tenderness, or costovertebral angle pain or tenderness. A positive urine culture (≥105 CFU/mL) with no more than 2 uropathogens and pyuria confirms the diagnosis of UTI. Risk factors for recurrent symptomatic UTI include diabetes, functional disability, recent sexual intercourse, prior history of urogynecologic surgery, urinary retention, and urinary incontinence. Testing for UTI is easily performed in the clinic using dipstick tests. When there is a low pretest probability of UTI, a negative dipstick result for leukocyte esterase and nitrites excludes infection. Antibiotics are selected by identifying the uropathogen, knowing local resistance rates, and considering adverse effect profiles. Chronic suppressive antibiotics for 6 to 12 months and

  2. Urinary Tract Infections (For Kids)

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  11. Infective endocarditis following urinary tract infection caused by Globicatella sanguinis

    OpenAIRE

    Takahashi, Saeko; Xu, Chieko; Sakai, Tetsuya; Fujii, Kotaro; Nakamura, Morio

    2017-01-01

    We report the first case of infective endocarditis following urinary tract infection (UTI) caused by Globicatella sanguinis in an 87-year-old Japanese woman with recurrent episodes of UTI. We identified the pathogen using the Rapid ID32 Strep system. Accurate identification of this infection is important and essential for the effective antimicrobial coverage to this pathogen.

  12. Imaging strategies in pediatric urinary tract infection

    Energy Technology Data Exchange (ETDEWEB)

    Dacher, Jean-Nicolas [University of Rouen, Quant-IF Laboratory, School of Medicine and Pharmacy, Rouen (France); Rouen University Hospital Charles Nicolle, Department of Radiology, Rouen (France); UFR Medecine Pharmacie de Rouen, Laboratoire Quant-If, Rouen (France); Hitzel, Anne; Vera, Pierre [University of Rouen, Quant-IF Laboratory, School of Medicine and Pharmacy, Rouen (France); CRLCC Henri Becquerel, Department of Nuclear Medicine, Rouen (France); Avni, Fred E. [Free University of Brussels, Department of Radiology, Erasmus Hospital, Brussels (Belgium)

    2005-07-01

    This article is focused on the controversial topic of imaging strategies in pediatric urinary tract infection. A review of the recent literature illustrates the complementary roles of ultrasound, diagnostic radiology and nuclear medicine. The authors stress the key role of ultrasound which has recently been debated. The commonly associated vesicoureteric reflux has to be classified as congenital or secondary due to voiding dysfunction. A series of frequently asked questions are addressed in a second section. The proposed answers are not the product of a consensus but should rather be considered as proposals to enrich the ongoing debate concerning the evaluation of urinary tract infection in children. (orig.)

  13. Imaging strategies in pediatric urinary tract infection

    International Nuclear Information System (INIS)

    Dacher, Jean-Nicolas; Hitzel, Anne; Vera, Pierre; Avni, Fred E.

    2005-01-01

    This article is focused on the controversial topic of imaging strategies in pediatric urinary tract infection. A review of the recent literature illustrates the complementary roles of ultrasound, diagnostic radiology and nuclear medicine. The authors stress the key role of ultrasound which has recently been debated. The commonly associated vesicoureteric reflux has to be classified as congenital or secondary due to voiding dysfunction. A series of frequently asked questions are addressed in a second section. The proposed answers are not the product of a consensus but should rather be considered as proposals to enrich the ongoing debate concerning the evaluation of urinary tract infection in children. (orig.)

  14. VIRAL ETIOLOGY OF RECURRENT URINARY TRACT INFECTIONS

    Directory of Open Access Journals (Sweden)

    H. S. Ibishev

    2017-01-01

    Full Text Available Introduction. Recurrent urinary tract infection is an actual problem of modern urology.Objective. Complex investigation of urinary tract infections including viral etiology for chronic recurrent cystitis in womenMaterials and methods. The study included 31 women with recurrent infection of urinary tract. Inclusion criteria were the presence of lower urinary tract symptoms caused by infection, severe recurrent course, the lack of anatomical and functional disorders of the urinary tract, the absence of bacterial pathogens during the study, taking into account the culture of aerobic and anaerobic culturing techniques.Results. The analysis of the clinical manifestations, the dominant in the study group were pain and urgency to urinate at 100% and 90% of women surveyed, respectively, and less frequent urination were recorded in 16.1% of patients. In general clinical examination of urine in all cases identified leukocyturia and 90% of the hematuria. By using a polymerase chain reaction (PCR in midstream urine of all examined was verified 10 types of human papilloma virus (HPV with the predominance of 16 and 18 types . Considering the presence of recurrent infectious and inflammatory processes of the urinary tract, cystoscopy with bladder biopsy was performed for all patients. When histomorphological biopsies of all patients surveyed noted the presence of the specific characteristics of HPV: papillary hyperplasia with squamous koilocytosis, pale cytoplasm and shrunken kernels. When analyzing the results of PCR biopsy data corresponded with the results of PCR in midstream urine in all biopsies was detected HPV.Conclusions. Human papillomavirus infection may be involved in the development of viral cystitis. In the etiological structure of viral cystitis, both highly oncogenic and low oncogenic HPV types can act.

  15. Urinary tract infection after voiding cystourethrogram.

    Science.gov (United States)

    Johnson, E K; Malhotra, N R; Shannon, R; Jacobson, D L; Green, J; Rigsby, C K; Holl, J L; Cheng, E Y

    2017-08-01

    Reported rates of post-procedural urinary tract infection (ppUTI) after voiding cystourethrogram (VCUG) are highly variable (0-42%). This study aimed to determine the risk of ppUTI after cystogram, and evaluate predictors of ppUTI. A retrospective cohort study of children undergoing VCUG or radionuclide cystogram (henceforth 'cystogram') was conducted. Children with neurogenic bladder who underwent cystogram in the operating room and without follow-up at the study institution were excluded. Incidence of symptomatic ppUTI within 7 days after cystogram was recorded. Predictors of ppUTI were evaluated using univariate statistics. A total of 1108 children (54% female, median age 1.1 years) underwent 1203 cystograms: 51% were on periprocedural antibiotics, 75% had a pre-existing urologic diagnosis (i.e., vesicoureteral reflux (VUR) or hydronephrosis; not UTI alone), and 18% had a clinical UTI within 30 days before cystogram. Of the cystograms, 41% had an abnormal cystogram and findings included VUR (82%), ureterocele (6%), and diverticula (6%). Twelve children had a ppUTI (1.0%; four girls, five uncircumcised boys, three circumcised boys; median age 0.9 years). Factors significantly associated with diagnosis of a ppUTI (Summary fig.) included: pre-existing urologic diagnosis prior to cystogram (12/12, 100% of patients with ppUTI), abnormal cystogram results (11/12, 92%), and use of periprocedural antibiotics (11/12, 92%). All 11 children with an abnormal cystogram had VUR ≥ Grade III. However, among all children with VUR ≥ Grade III, 4% (11/254) had a ppUTI. This is the largest study to date that has examined incidence and risk factors for ppUTI after cystogram. The retrospective nature of the study limited capture of some clinical details. This study demonstrated that the risk of ppUTI after a cystogram is very low (1.0% in this cohort). Having a pre-existing urologic diagnosis such as VUR or hydronephrosis was associated with ppUTI; therefore, children with

  16. Diabetes and Risk of Community-Acquired Respiratory Tract Infections, Urinary Tract Infections, and Bacteremia

    DEFF Research Database (Denmark)

    Thomsen, Reimar W.; Mor, Anil

    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...... increase for hospitalization with pneumonia associated with diabetes. The increase of risk for tuberculosis is of similar magnitude in highly developed countries, and possibly higher in low-income countries. Poor glycemic control and long diabetes duration predict higher risk for both pneumonia...... and 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...

  17. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... signs that you might have a bladder infection, so based on your answers, your mom or dad ... off before you collect the pee. This is so your urine sample won't contain germs from ...

  18. Urinary Tract Infections (For Kids)

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    Full Text Available ... Your pee smells bad. These things happen because bacteria have caused an infection somewhere in your urinary ... shorter than boys' urethras. The shorter urethra means bacteria can get up into the bladder more easily ...

  19. Urinary Tract Infections (For Kids)

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  1. Urinary Tract Infections (For Kids)

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    Full Text Available ... Teens Teens site Sitio para adolescentes Body Mind Sexual Health Food & Fitness Diseases & Conditions Infections Drugs & Alcohol ... stick into your cup of urine. The stick has specially treated paper on it and if it ...

  2. Urinary Tract Infections (For Kids)

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    Full Text Available ... a bladder infection, your doctor will order some medicine for you to take to kill the bacteria. ... the hospital. At the hospital, the germ-fighting medicine can be delivered more effectively through a tiny ...

  3. Urinary Tract Infections (For Kids)

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  5. Urinary Tract Infections (For Kids)

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    Full Text Available ... of your body. If they aren't wiped away properly, they stay on your skin. In girls, ... infection and you should see a doctor right away. What Will the Doctor Do? First, your doctor ...

  6. Urinary Tract Infections (For Kids)

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    Full Text Available ... Kids Kids site Sitio para niños How the Body Works Puberty & Growing Up Staying Healthy Staying Safe ... More for Teens Teens site Sitio para adolescentes Body Mind Sexual Health Food & Fitness Diseases & Conditions Infections ...

  7. Urinary Tract Infections (For Kids)

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    Full Text Available ... Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & Hospitals ... 237 milliliters) of urine in your bladder, your brain tells you it's time to find a bathroom. ...

  8. Urinary Tract Infections (For Kids)

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    Full Text Available ... Parents site Sitio para padres General Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & ... of Use Notice of Nondiscrimination Visit the Nemours Web site. Note: All information on KidsHealth® is for ...

  9. Urinary Tract Infections (For Kids)

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    Full Text Available ... site Sitio para adolescentes Body Mind Sexual Health Food & Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs ... You'll also want to stay away from foods and drinks that contain caffeine , such as cola ...

  10. Urinary Tract Infections (For Kids)

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    Full Text Available ... You also might have the feeling that you need to go to the bathroom all the time. ... infection — with chills and a high fever — may need to spend a couple of days in the ...

  11. Urinary Tract Infections (For Kids)

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    Full Text Available ... kidney infection and you should see a doctor right away. What Will the Doctor Do? First, your ... consult your doctor. © 1995- The Nemours Foundation. All rights reserved. Images provided by The Nemours Foundation, iStock, ...

  12. Urinary Tract Infections (For Kids)

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    Full Text Available ... the night to pee? Do you feel pain, pressure, or a tickle in your lower belly? Is ... has a kidney infection — with chills and a high fever — may need to spend a couple of ...

  13. Triggered Urine Interleukin-6 Correlates to Severity of Symptoms in Nonfebrile Lower Urinary Tract Infections.

    Science.gov (United States)

    Sundén, Fredrik; Butler, Daniel; Wullt, Björn

    2017-07-01

    Objective diagnosis of symptomatic urinary tract infections in patients prone to asymptomatic bacteriuria is compromised by local host responses that are already present and the positive urine culture. We investigated interleukin-6 as a biomarker for nonfebrile urinary tract infection severity and diagnostic thresholds for interleukin-6 and 8, and neutrophils to differentiate between asymptomatic bacteriuria and urinary tract infection. Patients with residual urine and neurogenic bladders due to spinal lesions included in a long-term Escherichia coli 83972 asymptomatic bacteriuria inoculation trial were monitored for 2 years. Symptom scoring and urine sampling to estimate interleukin-6 and 8, and neutrophils were performed regularly monthly and at urinary tract infection episodes. Patients were followed in the complete study for a mean of 19 months (range 10 to 27) and those with asymptomatic bacteriuria with E. coli 83972 were followed a mean of 11 months (range 4 to 19). A total of 37 nonfebrile urinary tract infection episodes with complete data on interleukin-6 and 8, neutrophils and symptom scoring were documented. Interleukin-6 was the only marker that persistently increased during urinary tract infection compared to asymptomatic bacteriuria in pooled and paired intra-individual comparisons (p urinary tract infection symptoms (p urinary tract infection episodes. However, in urinary tract infections with worse symptoms interleukin-6 and neutrophils demonstrated equal good/excellent outcomes. Triggered interleukin-6 correlated to urinary tract infection symptom severity and demonstrated a promising differential diagnostic capacity to discriminate urinary tract infection from asymptomatic bacteriuria. Future studies should explore interleukin-6 as a biomarker of urinary tract infection severity and assess the treatment indication in nonfebrile urinary tract infections. Copyright © 2017 American Urological Association Education and Research, Inc. Published by

  14. The nature of immune responses to urinary tract infections

    Science.gov (United States)

    Abraham, Soman N.; Miao, Yuxuan

    2016-01-01

    The urinary tract is constantly exposed to microorganisms that inhabit the gastrointestinal tract, but generally the urinary tract resists infection by gut microorganisms. This resistance to infection is mainly ascribed to the versatility of the innate immune defences in the urinary tract as the adaptive immune responses are limited, particularly when only the lower urinary tract is infected. In recent years, as the strengths and weaknesses of the immune system of the urinary tract have emerged and as the virulence attributes of uropathogens are recognized, several potentially effective and unconventional strategies to contain or prevent urinary tract infections have emerged. PMID:26388331

  15. Asymptomatic urinary tract infection among pregnant women ...

    African Journals Online (AJOL)

    Background: A good proportion of pregnant women patronize traditional birth homes in Nigeria for ante-natal care. This study aimed at determining the prevalence, risk factors, and susceptibility profile of etiologic agents of urinary tract infection among ante-natal attendees in a traditional birth home in Benin City, Nigeria.

  16. Febrile urinary tract infections: pyelonephritis and urosepsis

    NARCIS (Netherlands)

    Schneeberger, Caroline; Holleman, Frits; Geerlings, Suzanne E.

    2016-01-01

    Complicated infections of the urinary tract (UTI) including pyelonephritis and urosepsis are also called febrile UTI. This review describes insights from the literature on this topic since July 2014. Recent studies regarding risk factors and consequences of febrile UTI confirmed existing knowledge.

  17. [Characteristic features of urinary tract infection in malnourished children].

    Science.gov (United States)

    Stârcea, Magdalena; Munteanu, Mihaela; Brumariu, O

    2010-01-01

    The aim of this study is to prove a relationship between urinary tract infection and malnutrition in children 0-3 years old, hospitalized in the IVI Pediatric Clinic, Hospital St. Mary Iaşi, between January 2000 and December 2004. We have made a retrospective study for 298 infant and young children with urinary tract infection, 237 eutrophic and 61 malnourished. We studied comparatively the both groups with urinary tract infection (UTI), and we applied statistic methods for results. The statistic methods prove that relative risk for UTI increases in malnutrition, predictive positive value is 72.5%. The clinical manifestation is similar in malnourished and eutrophic, but many co morbidities were associated with dystrophic status. Malformation of urinary tract was associate two times more in malnourished child. The etiology of infection was dominated by Escherichia coli, Proteus and Klebsiella pneumoniae. In malnourished children 5% of UTI was determinate by opportunist etiological agents like: Enterobacter, Enterococcus, Acinetobacter. More frequently, bacterium develops resistance of antibiotics like amino-penicilina, Trimethoprim and Cephalosporin. Accurate and fast diagnosis and treatment of UTI in infant and child with malnutrition is the best way for nutritional rehabilitation and prevention of serious consequence.

  18. Urinary Tract Infections (For Kids)

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  19. Urinary Tract Infections (For Kids)

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    Full Text Available ... Teens Teens site Sitio para adolescentes Body Mind Sexual Health Food & Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert ... More on this topic for: Kids Chronic Kidney ... purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor. © 1995- The Nemours Foundation. All ...

  20. Urinary Tract Infections (For Kids)

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    Full Text Available ... Injuries Relax & Unwind People, Places & Things That Help Feelings Expert Answers Q&A Movies & More for Teens Teens site Sitio para adolescentes Body Mind Sexual Health Food & Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert ...

  1. Antibiotic resistance in community-acquired urinary tract infections

    African Journals Online (AJOL)

    of community-acquired UTI organisms to amoxycillin and co-trimoxazole was .... Treatment of uncomplicated urinary tract infection in non-pregnant women. Postgrad ... Single-dose antibiotic treatment for symptomatic uri- nary tract infections in ...

  2. urinary tract infections in symptomatic pregnant women attending

    African Journals Online (AJOL)

    Administrator

    bacterial infections in the elderly but also the most common and ... For pregnant women, urinary tract infection is the most common ... causing arthropathy in children. Urinary tract ... resistance in our environment, resistance such as β-. Urinary ...

  3. Childhood urinary tract infection in Benin City: pathogens and ...

    African Journals Online (AJOL)

    Childhood urinary tract infection in Benin City: pathogens and antimicrobial ... of bacterial isolates implicated in urinary tract infection (UTI) amongst children was ... There is also an emerging resistance of common pathogens to azithromycin ...

  4. Recurrent Urinary Tract Infections and Related Conditions (For Parents)

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Recurrent Urinary Tract Infections and Related Conditions KidsHealth / For Parents / Recurrent Urinary Tract Infections and Related Conditions What's in this article? ...

  5. Urinary Tract Infection in Febrile Children with Sickle Cell Anaemia ...

    African Journals Online (AJOL)

    Eastern Nigeria. Children with this disease have increased tendency to develop frequent and severe infections especially of the urinary tract, bones and lungs. The prevalence of urinary tract infection (UTI) has however not been reported in this part ...

  6. Urinary tract infections in patients with spinal cord injuries.

    Science.gov (United States)

    D'Hondt, Frederiek; Everaert, Karel

    2011-12-01

    Spinal cord injuries (SCI) result in different lower urinary tract dysfunctions. Because of both the disease and the bladder drainage method, urinary tract infections (UTIs) are one of the most frequent conditions seen in SCI patients. Diagnosis is not always easy due to lack of symptoms. Asymptomatic bacteriuria needs no treatment. If symptoms occur, antibiotherapy is indicated. Duration depends mainly on severity of illness and upper urinary tract or prostatic involvement. Choice of antibiotherapy should be based on local resistance profiles, but fluoroquinolones seems to be an adequate empirical treatment. Prevention of UTI is important, as lots of complications can be foreseen. Catheter care, permanent low bladder pressure and clean intermittent catheterization (CIC) with hydrophilic catheters are interventions that can prevent UTI. Probiotics might be useful, but data are limited.

  7. The laboratory diagnosis of Chlamydia trachomatis infections

    Directory of Open Access Journals (Sweden)

    Max A Chernesky

    2005-01-01

    Full Text Available Lower genital tract infections with Chlamydia trachomatis are predominantly asymptomatic in men and women. Diagnostic technology has provided several approaches to the diagnosis of C trachomatis. Outside of cells, Chlamydia can die or degrade without optimal storage and transportation. Because some of the other assays perform better on certain specimen types, it is important for laboratories to recognize these differences and provide advice to physicians and nurses collecting patient specimens, with the objective of diagnosing lower genital tract infections to prevent transmission and upper tract damage. Most invasive specimens, such as cervical or urethral swabs, may be collected for culture, antigen or nucleic acid detection. Noninvasive samples such as first-void urine and vaginal swabs can be easily collected by the patient; these samples must be tested by more sensitive nucleic acid amplification tests. These newer investigative strategies should enable implementation of screening programs to identify and treat partners. Serology has not been particularly useful for the diagnosis of acute C trachomatis infections in adults. Presently, it appears that antibiotic-resistant C trachomatis is not a clinical problem. Laboratories providing C trachomatis diagnosis require participation in continuous quality improvement programs.

  8. Urinary tract infections in symptomatic pregnant women attending ...

    African Journals Online (AJOL)

    Background: Several notable human pathogens cause urinary tract infections. Several factors are known to predispose an individual to developing urinary tract infections; one of the factors is pregnancy. Therefore, this research set out to determine the bacteriologic profile of urinary tract infection and the susceptibility pattern ...

  9. Fungal Urinary Tract Infection in Burn Patients‎

    Directory of Open Access Journals (Sweden)

    Suad Yousuf Aldorkee

    2017-11-01

    Full Text Available Background: Urinary tract infection is the most common hospital-acquired infection. Fungal species are unusual causes of urinary tract infection in healthy individuals, but common in the hospital setting or among patients with predisposing diseases and structural abnormalities of the kidney and collecting system. Burn patients are susceptible to nosocomial infections owing to the immunocompromising effects of burn injury, cutaneous and respiratory tract injury, prolonged intensive care unit stays and broad-spectrum antibiotic therapy. Objective: The study population includes adult patients of both genders who presented with different percentages of body burns. Urine sample was collected from each patient at the time of admission and weekly thereafter for 6 weeks and sent for general urine examination and urine culture to test for the possibility of fungal growth. Those who found to develop fungal UTI by urine culture during their hospitalization and had no infection at the time of admission were selected as subjects for our study. Results: 28 (18.6% patients had positive fungal culture during their hospitalization, 11 of them were males and 17 were females, the most common age of presentation was 41-50 years and the mean age ± SD was (44.4 ± 10.7 years. The most common isolated fungi were Candida albicans (64.3%, followed by Candida glabrata (21.4% and Candida tropicalis (7.1%. The majority of patients developed infection within the 2nd and 3rd weeks of hospitalization, however, those who presented with total body surface area burned > 40% developed an earlier infection within the 1st week. Female gender, urethral catheterization and diabetes mellitus were significantly associated with higher risk of infection as the P values were 0.03, 0.005 and 0.004 respectively. Conclusion: Fungal urinary tract infection occurred in 18.6% of burn patients. The most common causative fungi are candida species. Advanced age, female gender, high percentage of

  10. 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...

  11. Diagnostic value of radioisotopic cystography in evaluation of VUR in children with urinary tract infection

    International Nuclear Information System (INIS)

    Amiri, M.; Shabestani- Monfared, A.; Derazgisoo, M.

    2002-01-01

    Radioisotope scanning is very important in evaluation, diagnosis and proper treatment of urinary tract infection and vesico ureteral reflux because of high sensitivity of this technique and less radiation dose delivered to the patients. This is a descriptive cross-sectional study to determine the frequency vesico ureteral reflux in a group of children aged 28 days to 14 years referred to our department with diagnosis of urinary tract infection .The radioisotope scanning was conducted for all of patients (30 patients) and the results were analyzed. The results showed that urinary tract infection is seen in wide age group and is usually associated with vesico ureteral reflux . The above findings revealed the important role of radioisotope scanning in early diagnosis and subsequent treatment of urinary tract infection to detect vesico ureteral reflux and prevent subsequent side effects in these patients

  12. Urinary tract infection in kidney transplant recipients.

    Science.gov (United States)

    Chacón-Mora, Natalia; Pachón Díaz, Jerónimo; Cordero Matía, Elisa

    2017-04-01

    Infectious complications remain a major cause of morbidity and mortality among transplant recipients. Urinary tract infection (UTI) is the most common infectious complication in kidney transplant recipients with a reported incidence from 25% to 75%, varies widely likely due to differences in definition, diagnostic criteria, study design, and length of observation. We sought reviews the incidence and importance of urinary tract infection on graft survival, the microbiology with special emphasis on multidrug resistant microorganisms, the therapeutic management of UTI and the prophylaxis of recurrent UTI among solid organ transplant recipients, highlighting the need for prospective clinical trials to unify the clinical management in this population. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  13. [Clinical evaluations of flomoxef in respiratory tract infections].

    Science.gov (United States)

    Mikasa, K; Sawaki, M; Ako, H; Narita, N

    1987-10-01

    Flomoxef (FMOX, 6315-S), a new antibacterial drug, was administered to 9 cases with respiratory tract infections for a duration of 8 approximately 16 days at a daily dose of 2 g. Diagnosis of these patients were bronchopneumonia 5 cases, chronic bronchitis 3 cases and acute bronchitis 1 case. From transtracheal aspiration several organisms were isolated; Haemophilus influenzae was isolated in 3 cases, Streptococcus pneumoniae in 3 cases, H. influenzae plus Branhamella catarrhalis in 1 case, Streptococcus dysgalactiae plus Neisseria meningitidis in 1 case and Corynebacterium pseudodiphtheriticum in 1 case. The clinical efficacy was good in all 9 cases, the efficacy rate was 100%. All the bacteria were eliminated. Side effects were not observed. From these results, it appears that FMOX is a valuable drug in the treatment of respiratory tract infections.

  14. No. 250-Recurrent Urinary Tract Infection.

    Science.gov (United States)

    Epp, Annette; Larochelle, Annick

    2017-10-01

    To provide an update of the definition, epidemiology, clinical presentation, investigation, treatment, and prevention of recurrent urinary tract infections in women. Continuous antibiotic prophylaxis, post-coital antibiotic prophylaxis, and acute self-treatment are all efficient alternatives to prevent recurrent urinary tract infection. Vaginal estrogen and cranberry juice can also be effective prophylaxis alternatives. A search of PubMed and The Cochrane Library for articles published in English identified the most relevant literature. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date restrictions. This update is the consensus of the Sub-Committee on Urogynaecology of the Society of Obstetricians and Gynaecologists of Canada. Recommendations were made according to the guidelines developed by the Canadian Task Force on Preventive Health Care (Table 1). Recurrent urinary tract infections need careful investigation and can be efficiently treated and prevented. Different prophylaxis options can be selected according to each patient's characteristics. Copyright © 2017. Published by Elsevier Inc.

  15. The Vaginal Microbiota and Urinary Tract Infection.

    Science.gov (United States)

    Stapleton, Ann E

    2016-12-01

    The vagina is a key anatomical site in the pathogenesis of urinary tract infection (UTI) in women, serving as a potential reservoir for infecting bacteria and a site at which interventions may decrease the risk of UTI. The vaginal microbiota is a dynamic and often critical factor in this pathogenic interplay, because changes in the characteristics of the vaginal microbiota resulting in the loss of normally protective Lactobacillus spp. increase the risk of UTI. These alterations may result from the influence of estrogen deficiency, antimicrobial therapy, contraceptives, or other causes. Interventions to reduce adverse effects on the vaginal microbiota and/or to restore protective lactobacilli may reduce the risks of UTI.

  16. Catheter Associated Urinary Tract Infection Prevention bundle

    Directory of Open Access Journals (Sweden)

    O. Zarkotou

    2017-01-01

    Full Text Available Catheter-associated urinary tract infections (CAUTI are among the most common healthcare-associated infections, and potentially lead to significant morbidity and mortality. Multifaceted infection control strategies implemented as bundles can prevent nosocomial infections associated with invasive devices such as CAUTIs. The components of the CAUTI bundle proposed herein, include appropriate indications for catheterization and recommendations for the procedures of catheter insertion and catheter maintenance and care. Avoiding unnecessary urinary catheter use is the most effective measure for their prevention. To minimize the risk of CAUTI, urinary catheters should be placed only when a clinical valid indication is documented and they should be removed as soon as possible; alternatives to catheterization should also be considered. Aseptic insertion technique, maintenance of closed drainage system and strict adherence to hand hygiene are essential for preventing CAUTI. The successful implementation of the bundle requires education and training for all healthcare professionals and evaluation of surveillance data.

  17. Enterobiasis (Pinworm Infection): Diagnosis

    Science.gov (United States)

    ... The CDC Cancel Submit Search The CDC Parasites - Enterobiasis (also known as Pinworm Infection) Note: Javascript is disabled or is not ... message, please visit this page: About CDC.gov . Pinworm Infection General Information Pinworm Infection FAQs Epidemiology & Risk ...

  18. Laboratory Diagnosis of Parasites from the Gastrointestinal Tract.

    Science.gov (United States)

    Garcia, Lynne S; Arrowood, Michael; Kokoskin, Evelyne; Paltridge, Graeme P; Pillai, Dylan R; Procop, Gary W; Ryan, Norbert; Shimizu, Robyn Y; Visvesvara, Govinda

    2018-01-01

    This Practical Guidance for Clinical Microbiology document on the laboratory diagnosis of parasites from the gastrointestinal tract provides practical information for the recovery and identification of relevant human parasites. The document is based on a comprehensive literature review and expert consensus on relevant diagnostic methods. However, it does not include didactic information on human parasite life cycles, organism morphology, clinical disease, pathogenesis, treatment, or epidemiology and prevention. As greater emphasis is placed on neglected tropical diseases, it becomes highly probable that patients with gastrointestinal parasitic infections will become more widely recognized in areas where parasites are endemic and not endemic. Generally, these methods are nonautomated and require extensive bench experience for accurate performance and interpretation. Copyright © 2017 American Society for Microbiology.

  19. Etiologic study of urinary tract infection in dogs

    Directory of Open Access Journals (Sweden)

    Marcia Mery Kogika

    1995-03-01

    Full Text Available Urinary tract infections were documented in 51 dogs. Several factors such as etiologic agents, localization of the infection, predisposing factors, sex, age, and breed were considered. The diagnosis of urinary tract infection (UTI was based on bacteriological investigation and it was considered positive when urine sample collected by catheterization contained more than 105 bacteria/ml. Mixed infection was found in 4 of the infected dogs, totallizing 55 isolates. Among them, Escherichia coli (35.3% was the most frequently isolated, followed by Staphylococcus sp. (23.5%, Proteus mirabilis (15.7%, Streptococcus sp. (13.7%, Klebsiella sp. (9.8%. Pseudomonas aeruginosa (3.9%, Enterobacter cloacae (2.0%, Citrobacter freundii (2.0% and Providencia rettgeri (2.0%. As to antimicrobial susceptibility, norfloxacin and gentamicin were successful for the treatment of gram-negative microorganisms, while the most effective drugs for gram-positive bacteria were cephalothin and nitrofurantoin. UTI was observed more frequently in Cocker Spaniel and German Shepherd; male dogs were more involved, and pyelonephritis was the predominant disease observed. Infection was seen in all ages, but the frequency was higher in middle aged dogs. Urolithiasis were observed as common predisposing or underlying factors to UTI being, cither Staphylococcus sp. or Proteus mirabilis isolated in those cases which alkaline urine pH was observed.

  20. Assessment of infective urinary tract disorders

    International Nuclear Information System (INIS)

    Sixt, R.; Stokland, E.

    1998-01-01

    Urinary tracts infection (UTI) is common in children, particularly in the youngest age groups. There is a risk for progressive deterioration of renal function in these children if aggravating factors such as gross reflux and/or outflow obstruction of the urinary tract are present. In this review the pros and cons of available scintigrafic and radiological imaging techniques for the work-up of these children are presented. Ultrasound can be used in the acute phase to exclude obstruction but can not reliably show transient or permanent parenchymal lesions. The presence of reflux can be established with X-ray or direct nuclide cystography. The X-ray technique gives good morphological information and has a grading system with prognostic relevance. Both techniques are invasive and great care must be taken to keep the radiation burden down with the X-ray technique. Indirect nuclide cystography following a renographic study is non-invasive but has a lower sensitivity than direct techniques. More experience is needed with the indirect technique to evaluate the consequences of its apparently low sensitivity. Urography has a limited place in the acute work-up of urinary tract infection but can be used to look for renal scarring 1-2 years after an acute pyelonephritis. The 99m Tc dimercaptosuccinic acid (DMSA) scan can be used during the acute UTI to show pyelonephritic lesions with good accuracy and/or during the follow-up after six months to show permanent lesions. The acute DMSA scan can be omitted

  1. [COMPLICATED URINARY TRACT INFECTIONS IN THE ELDERLY].

    Science.gov (United States)

    Ćosić, I; Ćosić, V

    2016-12-01

    Urinary tract infections (UTI) are the most common bacterial infections involving lower (cystitis, prostatitis) or upper (pyelonephritis, renal abscess, perinephric abscess) urinary tract. Differentiation of complicated and uncomplicated UTI is usually based on the presence of structural or functional urinary tract abnormalities, which can increase the risk of treatment failure and development of serious complications. Factors that increase the risk are foreign bodies, stones, obstruction, neurogenic bladder, kidney transplantation, immunosuppression, and pregnancy. Complicated UTI includes a spectrum of conditions that increase the risk of treatment failure, as well as of serious complications such as bacteremia and sepsis, perinephric abscess, renal impairment and emphysematous pyelonephritis. To avoid the potentially devastating outcomes, appropriate diagnostic procedures, antibiotic and surgical treatment, and appropriate follow-up are required. The incidence of complicated UTI will grow in the future due to general aging of the population, increasing incidence of diabetes, and ever growing number of immunocompromised and immunosuppressed patients. It is of key importance to recognize complicated UTI on time, and treat it wisely and aggressively to reduce duration of the disease and the risk of antibiotic resistance.

  2. Imaging in childhood urinary tract infection.

    Science.gov (United States)

    Riccabona, Michael

    2016-05-01

    Urinary tract infection (UTI) is a common query in pediatric radiology. Imaging for and after UTI is still a heavily debated topic with different approaches, as thorough evidence to decide upon a definite algorithm is scarce. This review article tries to address the clinical rational of the various approaches (general imaging, top-down or bottom-up, selected and individualized imaging concepts…), describes the available imaging modalities and the respective findings in imaging children with UTI, and proposes an imaging algorithm for the work-up of children during and after UTI discussing the "pros and cons" of the different attitudes. In summary, imaging by US is generally considered for all infants and children with a febrile or complicated (upper) UTI, particularly without previously known urinary tract anatomy. The further work-up (searching for renal scarring and assessment of vesico-ureteric reflux) is then decided according to these initial findings as well as the clinical presentation, course, and scenario.

  3. Risk factors for lower respiratory tract infections in children

    International Nuclear Information System (INIS)

    Silfeler, I.; Tanidir, I.C.

    2012-01-01

    Objectives: Acute respiratory tract infections are divided into two groups as upper and lower respiratory tract infections. These are very common diseases in childhood. In this study, we aimed to determine risk factors for lower respiratory tract in this region. Methodology: Hospital were included in our study. Their examinations, backgrounds, family histories and information about environmental factors were recorded in questionnaire forms. Results: Lack of vaccination, duration of breast feeding, onset age of cow's milk, family history for asthma and food allergy, number of hospitalized people in the same room, number of people who live in same house and smoking around the children were evaluated for the presence of LRTI, and LRTI risks of these factors were respectively observed as 1.69, 1.71, 1.61, 1.69, 1.20, 1.47, 1.56 and 2.63 fold increased. Conclusion: Standardization of clinical diagnosis, accurate and realistic use of antibiotics, correction of nutrition, improvement of socio-economic situation and the elimination of Respiratory Infections. (author)

  4. Prevalence of urinary tract infection and vesicoureteral reflux in children with lower urinary tract dysfunction.

    Science.gov (United States)

    Van Batavia, Jason P; Ahn, Jennifer J; Fast, Angela M; Combs, Andrew J; Glassberg, Kenneth I

    2013-10-01

    Lower urinary tract dysfunction is a common pediatric urological problem that is often associated with urinary tract infection. We determined the prevalence of a urinary tract infection history in children with lower urinary tract dysfunction and its association, if any, with gender, bowel dysfunction, vesicoureteral reflux and specific lower urinary tract conditions. We retrospectively reviewed the charts of children diagnosed with and treated for lower urinary tract dysfunction, noting a history of urinary tract infection with or without fever, gender, bowel dysfunction and vesicoureteral reflux in association with specific lower urinary tract conditions. Of the 257 boys and 366 girls with a mean age of 9.1 years 207 (33%) had a urinary tract infection history, including 88 with at least 1 febrile infection. A total of 64 patients underwent voiding cystourethrogram/videourodynamics, which revealed reflux in 44 (69%). In 119 of the 207 patients all infections were afebrile and 18 underwent voiding cystourethrogram/videourodynamics, which revealed reflux in 5 (28%). A urinary tract infection history was noted in 53% of girls but only 5% of boys (p infection history than patients with idiopathic detrusor overactivity disorder or primary bladder neck dysfunction (each p urinary tract dysfunction have a much higher urinary tract infection incidence than males. This association was most often noted for lower urinary tract conditions in which urinary stasis occurs, including detrusor underutilization disorder and dysfunctional voiding. Reflux was found in most girls with a history of febrile infections. Since reflux was identified in more than a quarter of girls with only afebrile infections who were evaluated for reflux, it may be reasonable to perform voiding cystourethrogram or videourodynamics in some of them to identify reflux. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  5. A prospective study of urinary tract infection during pelvic radiotherapy

    International Nuclear Information System (INIS)

    Bialas, I.; Bessell, E.M.; Sokal, M.

    1989-01-01

    The frequency of urinary tract infection before and during pelvic radiotherapy was studied prospectively in 172 patients who were not catherised and had not had instrumentation for at least 4 weeks prior to radiotherapy. The incidence of urinary tract infection prior to radiotherapy was 17% and a further 17% of patients develped a urinary tract infection during radiotherapy. Mid-stream specimens of urine (MSU) should be examined for infection on a weekly basis during pelvic radiotherapy not only to identify this additional 17% of patients but also to detect those patients who have persistent urinary tract infection in spite of treatment with appropriate antibiotics. (author). 6 refs.; 1 fig.; 4 tabs

  6. Urinary Tract Infection: Pathogenesis and Outlook.

    Science.gov (United States)

    McLellan, Lisa K; Hunstad, David A

    2016-11-01

    The clinical syndromes comprising urinary tract infection (UTI) continue to exert significant impact on millions of patients worldwide, most of whom are otherwise healthy women. Antibiotic therapy for acute cystitis does not prevent recurrences, which plague up to one fourth of women after an initial UTI. Rising antimicrobial resistance among uropathogenic bacteria further complicates therapeutic decisions, necessitating new approaches based on fundamental biological investigation. In this review, we highlight contemporary advances in the field of UTI pathogenesis and how these might inform both our clinical perspective and future scientific priorities. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Urinary Tract Infection: Pathogenesis and Outlook

    Science.gov (United States)

    McLellan, Lisa K.; Hunstad, David A.

    2016-01-01

    The clinical syndromes comprising urinary tract infection (UTI) continue to exert significant impact on millions of patients worldwide, most of whom are otherwise healthy women. Antibiotic therapy for acute cystitis does not prevent recurrences, which plague up to one fourth of women after an initial UTI. Rising antimicrobial resistance among uropathogenic bacteria further complicates therapeutic decisions, necessitating new approaches based on fundamental biological investigation. In this review, we highlight contemporary advances in the field of UTI pathogenesis and how these might inform both our clinical perspective and future scientific priorities. PMID:27692880

  8. Proteus mirabilis and Urinary Tract Infections

    Science.gov (United States)

    Schaffer, Jessica N.; Pearson, Melanie M.

    2015-01-01

    Proteus mirabilis is a Gram-negative bacterium which is well-known for its ability to robustly swarm across surfaces in a striking bulls’-eye pattern. Clinically, this organism is most frequently a pathogen of the urinary tract, particularly in patients undergoing long-term catheterization. This review covers P. mirabilis with a focus on urinary tract infections (UTI), including disease models, vaccine development efforts, and clinical perspectives. Flagella-mediated motility, both swimming and swarming, is a central facet of this organism. The regulation of this complex process and its contribution to virulence is discussed, along with the type VI-secretion system-dependent intra-strain competition which occurs during swarming. P. mirabilis uses a diverse set of virulence factors to access and colonize the host urinary tract, including urease and stone formation, fimbriae and other adhesins, iron and zinc acquisition, proteases and toxins, biofilm formation, and regulation of pathogenesis. While significant advances in this field have been made, challenges remain to combatting complicated UTI and deciphering P. mirabilis pathogenesis. PMID:26542036

  9. Proteus mirabilis and Urinary Tract Infections.

    Science.gov (United States)

    Schaffer, Jessica N; Pearson, Melanie M

    2015-10-01

    Proteus mirabilis is a Gram-negative bacterium and is well known for its ability to robustly swarm across surfaces in a striking bulls'-eye pattern. Clinically, this organism is most frequently a pathogen of the urinary tract, particularly in patients undergoing long-term catheterization. This review covers P. mirabilis with a focus on urinary tract infections (UTI), including disease models, vaccine development efforts, and clinical perspectives. Flagella-mediated motility, both swimming and swarming, is a central facet of this organism. The regulation of this complex process and its contribution to virulence is discussed, along with the type VI-secretion system-dependent intra-strain competition, which occurs during swarming. P. mirabilis uses a diverse set of virulence factors to access and colonize the host urinary tract, including urease and stone formation, fimbriae and other adhesins, iron and zinc acquisition, proteases and toxins, biofilm formation, and regulation of pathogenesis. While significant advances in this field have been made, challenges remain to combatting complicated UTI and deciphering P. mirabilis pathogenesis.

  10. 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.

  11. Bacterial Uropathogens in Urinary Tract Infection and Antibiotic ...

    African Journals Online (AJOL)

    BACKGROUND: Urinary tract infection (UTI) is one of the most common bacterial infections encountered by clinicians in developing countries. Area-specific monitoring studies aimed to gain knowledge about the type of pathogens responsible for urinary tract infections and their resistance patterns may help the clinician to ...

  12. Adenovirus respiratory tract infections in Peru.

    Directory of Open Access Journals (Sweden)

    Julia S Ampuero

    Full Text Available BACKGROUND: Currently, there is a paucity of data regarding human adenovirus (HAdv circulation in Andean regions of South America. To address this shortcoming, we report the clinical, phylogenetic, and epidemiologic characteristics of HAdv respiratory tract infection from a large sentinel surveillance study conducted among adults and children in Peru. METHODS/PRINCIPAL FINDINGS: Oropharyngeal swabs were collected from participants visiting any of 38 participating health centers, and viral pathogens were identified by immunofluorescence assay in cell culture. In addition, molecular characterization was performed on 226 randomly selected HAdv samples. Between 2000 and 2010, a total of 26,375 participants with influenza-like illness (ILI or severe acute respiratory infection (SARI were enrolled in the study. HAdv infection was identified in 2.5% of cases and represented 6.2% of all viral pathogens. Co-infection with a heterologous virus was found in 15.5% of HAdv cases. HAdv infection was largely confined to children under the age of 15, representing 88.6% of HAdv cases identified. No clinical characteristics were found to significantly distinguish HAdv infection from other respiratory viruses. Geographically, HAdv infections were more common in sites from the arid coastal regions than in the jungle or highland regions. Co-circulation of subgroups B and C was observed each year between 2006 and 2010, but no clear seasonal patterns of transmission were detected. CONCLUSIONS/SIGNIFICANCE: HAdv accounted for a significant fraction of those presenting with ILI and SARI in Peru and tended to affect the younger population disproportionately. Longitudinal studies will help better characterize the clinical course of patients with HAdv in Peru, as well as determine the role of co-infections in the evolution of illness.

  13. Adenovirus respiratory tract infections in Peru.

    Science.gov (United States)

    Ampuero, Julia S; Ocaña, Víctor; Gómez, Jorge; Gamero, María E; Garcia, Josefina; Halsey, Eric S; Laguna-Torres, V Alberto

    2012-01-01

    Currently, there is a paucity of data regarding human adenovirus (HAdv) circulation in Andean regions of South America. To address this shortcoming, we report the clinical, phylogenetic, and epidemiologic characteristics of HAdv respiratory tract infection from a large sentinel surveillance study conducted among adults and children in Peru. Oropharyngeal swabs were collected from participants visiting any of 38 participating health centers, and viral pathogens were identified by immunofluorescence assay in cell culture. In addition, molecular characterization was performed on 226 randomly selected HAdv samples. Between 2000 and 2010, a total of 26,375 participants with influenza-like illness (ILI) or severe acute respiratory infection (SARI) were enrolled in the study. HAdv infection was identified in 2.5% of cases and represented 6.2% of all viral pathogens. Co-infection with a heterologous virus was found in 15.5% of HAdv cases. HAdv infection was largely confined to children under the age of 15, representing 88.6% of HAdv cases identified. No clinical characteristics were found to significantly distinguish HAdv infection from other respiratory viruses. Geographically, HAdv infections were more common in sites from the arid coastal regions than in the jungle or highland regions. Co-circulation of subgroups B and C was observed each year between 2006 and 2010, but no clear seasonal patterns of transmission were detected. HAdv accounted for a significant fraction of those presenting with ILI and SARI in Peru and tended to affect the younger population disproportionately. Longitudinal studies will help better characterize the clinical course of patients with HAdv in Peru, as well as determine the role of co-infections in the evolution of illness.

  14. Adenovirus Respiratory Tract Infections in Peru

    Science.gov (United States)

    Ampuero, Julia S.; Ocaña, Víctor; Gómez, Jorge; Gamero, María E.; Garcia, Josefina; Halsey, Eric S.; Laguna-Torres, V. Alberto

    2012-01-01

    Background Currently, there is a paucity of data regarding human adenovirus (HAdv) circulation in Andean regions of South America. To address this shortcoming, we report the clinical, phylogenetic, and epidemiologic characteristics of HAdv respiratory tract infection from a large sentinel surveillance study conducted among adults and children in Peru. Methods/Principal Findings Oropharyngeal swabs were collected from participants visiting any of 38 participating health centers, and viral pathogens were identified by immunofluorescence assay in cell culture. In addition, molecular characterization was performed on 226 randomly selected HAdv samples. Between 2000 and 2010, a total of 26,375 participants with influenza-like illness (ILI) or severe acute respiratory infection (SARI) were enrolled in the study. HAdv infection was identified in 2.5% of cases and represented 6.2% of all viral pathogens. Co-infection with a heterologous virus was found in 15.5% of HAdv cases. HAdv infection was largely confined to children under the age of 15, representing 88.6% of HAdv cases identified. No clinical characteristics were found to significantly distinguish HAdv infection from other respiratory viruses. Geographically, HAdv infections were more common in sites from the arid coastal regions than in the jungle or highland regions. Co-circulation of subgroups B and C was observed each year between 2006 and 2010, but no clear seasonal patterns of transmission were detected. Conclusions/Significance HAdv accounted for a significant fraction of those presenting with ILI and SARI in Peru and tended to affect the younger population disproportionately. Longitudinal studies will help better characterize the clinical course of patients with HAdv in Peru, as well as determine the role of co-infections in the evolution of illness. PMID:23056519

  15. Common bacterial urinary tract infections in women.

    Science.gov (United States)

    Cimino, J E

    1976-09-01

    Unfortunately, there is no general consensus as to how long patients with bacteriuria or urinary tract infections should be monitored and certainly there is no agreement on how long recurrent episodes should be treated beyond ten days to two weeks. The most important points to remember are: 1. Culture the urine both at the time of therapy and during follow-up. The patient should be examined periodically for the presence of bacteruria. If bacteria cannot be eradicated, at least the physician is aware of the organism most likely causing the patient's symptoms. 2. Do not subject the patient with frequent recurrent (chronic) and complicated infections to continual antibacterial therapy, but rather, manage the acute episodes. 3. Use prophylaxis, particularly single bed-time doses for dysuria and frequency symptoms. 4. Screen for bacteriuria during pregnancy. 5. Avoid the use of catheters except where absolutely necessary. 6. Avoid systemic prophylaxis of infection in patients with catheters; rather, use closed-system drainage with antibacteri-irrigation. It is to be hoped within the next few years, studies now underway will allow specific recommendations regarding the management of asymptomatic bacteruria, the duration of therapy for recurrent infections, the prevention and treatment of L-form bacterial infections, and indications for urologic procedures.

  16. [Upper respiratory tract infections and sports].

    Science.gov (United States)

    Boffi El Amari, Emmanuelle

    2010-08-11

    Upper respiratory tract infections are frequent in athletes. Mainly of viral origin, they are treated symptomatically. Infectious mononucleosis is associated with an estimated 2% per hundred risk of splenic rupture, which occurs between day four and twenty one of the illness. Therefore return to play guidelines recommend avoiding, exercice during the first twenty one days. Physical exercise seems to influence the immune system, depending on the intensity and length of it. But the relationship between physical exercise and risk of infections remains controversial: some articles showing an increase in risk, whereas others suggesting a certain degree of protection, in athletes. The actual generally accepted working theory is the J-curve proposed by Nieman. This model remains to be formally proven.

  17. Cranberry in prevention of urinary tract Infections in pregnancy

    OpenAIRE

    Miranda-Machado Pablo Andrés

    2011-01-01

    The urinary infection tract is the most common infectious complication in pregnancy.The aim was to conduct a literature review of the evidence on effectiveness, safetyand cost effectiveness of cranberry products in preventing urinary tract infection inpregnancy. Studies suggest a potential protective effect of cranberry products againsturinary tract infection in pregnancy and there is no documented evidence of danger orcontraindication in pregnancy or lactation. The cost effectiveness of cran...

  18. Assessment of infective urinary tract disorders

    Energy Technology Data Exchange (ETDEWEB)

    Sixt, R.; Stokland, E. [Goteborg, Sahlgrenska Univ. Hospital/Ostra (Sweden). Dept. of Pediatric Clinical Physiology and Dept. of Pediatric Radiology

    1998-06-01

    Urinary tracts infection (UTI) is common in children, particularly in the youngest age groups. There is a risk for progressive deterioration of renal function in these children if aggravating factors such as gross reflux and/or outflow obstruction of the urinary tract are present. In this review the pros and cons of available scintigrafic and radiological imaging techniques for the work-up of these children are presented. Ultrasound can be used in the acute phase to exclude obstruction but can not reliably show transient or permanent parenchymal lesions. The presence of reflux can be established with X-ray or direct nuclide cystography. The X-ray technique gives good morphological information and has a grading system with prognostic relevance. Both techniques are invasive and great care must be taken to keep the radiation burden down with the X-ray technique. Indirect nuclide cystography following a renographic study is non-invasive but has a lower sensitivity than direct techniques. More experience is needed with the indirect technique to evaluate the consequences of its apparently low sensitivity. Urography has a limited place in the acute work-up of urinary tract infection but can be used to look for renal scarring 1-2 years after an acute pyelonephritis. The {sup 99m}Tc dimercaptosuccinic acid (DMSA) scan can be used during the acute UTI to show pyelonephritic lesions with good accuracy and/or during the follow-up after six months to show permanent lesions. The acute DMSA scan can be omitted.

  19. Study of the pattern of lower respiratory tract infection within the first year in renal transplant patients

    Directory of Open Access Journals (Sweden)

    Nasr Affara

    2015-07-01

    Conclusion: Lower respiratory tract infection is a serious complication after renal transplantation. Bacterial and mixed bacterial infections are the most common etiologies, proper diagnosis using all tools of diagnosis especially bronchoscopy and quantitative culture can help in diagnosis and prevent the overuse of antibiotics.

  20. Role of scintigraphy in urinary tract infection

    International Nuclear Information System (INIS)

    Conway, J.J.

    1988-01-01

    There is controversy regarding the role of radiological imaging for urinary tract infection (UTI). The gold standard has been the intravenous pyelogram (IVP). Yet, the IVP has a very limited value with only about 25% of children with pyelonephritis demonstrating abnormalities. Ultrasound (US) has recently been advocated as a replacement for the poorly sensitive and poorly specific IVP. However, comparative studies between US and IVP indicate only an equivalent sensitivity and specificity. Cortical scintigraphy with Technetium-99m glucoheptonate (99mTc GH) or 99mTc dimercaptosuccinic acid (99mTc DMSA) has also been advocated as a means of differentiating parenchymal (pyelonephritis) from nonparenchymal (lower UTI) involvement in UTI. The clinical presentation may be misleading especially in the infant and child in whom an elevated temperature, flank pain, shaking chills, or an elevated sedimentation rate are often lacking. The clinician attempts to localize the site of infection for it has a direct bearing upon the therapy. A collecting system infection can often be eradicated with a single oral dose of an appropriate antibiotic, whereas renal parenchymal involvement requires IV therapy for an extended interval. Cortical scintigraphy can localize the site of infection with a high degree of accuracy. Recent studies report a sensitivity of 86% and specificity of 81% of pyelonephritis. This is in contrast to the IVP with a sensitivity of only 24% and US with a sensitivity of only 42%. The scintigraphic appearance of parenchymal infection of the kidney is a spectrum of minimal to gross defects reflecting the degree of histologic involvement that spans from a mild infection to frank abscess. Cortical scintigraphy can be used to monitor the evolution of scarring following infection. Cortical scintigraphy with 99mTc DMSA or 99mTc GH is the method of choice for the initial evaluation of UTI. 37 references

  1. Diagnosis and Management of Lower Urinary Tract Dysfunction.

    Science.gov (United States)

    McDonough, Robert C; Ryan, Stephen T

    2016-06-01

    Lower urinary tract dysfunction is an umbrella diagnosis that covers difficulty evacuating urine from the bladder. In its most simple form, it is either an inability to store urine or an inability to empty the bladder of urine appropriately. The normal and the abnormal bladder, the role of urodynamics in evaluation of lower urinary tract dysfunction, and the medical and behavioral management of some of these disorders are reviewed. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Urinary tract infections: epidemiology, mechanisms of infection and treatment options

    Science.gov (United States)

    Flores-Mireles, Ana L.; Walker, Jennifer N.; Caparon, Michael; Hultgren, Scott J.

    2015-01-01

    Urinary tract infections (UTIs) are a severe public health problem and are caused by a range of pathogens, but most commonly by Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis and Staphylococcus saprophyticus. High recurrence rates and increasing antimicrobial resistance among uropathogens threaten to greatly increase the economic burden of these infections. In this Review, we discuss how basic science studies are elucidating the molecular details of the crosstalk that occurs at the host–pathogen interface, as well as the consequences of these interactions for the pathophysiology of UTIs. We also describe current efforts to translate this knowledge into new clinical treatments for UTIs. PMID:25853778

  3. Prevention of recurrent urinary tract infections.

    Science.gov (United States)

    Wagenlehner, F M E; Vahlensieck, W; Bauer, H W; Weidner, W; Piechota, H J; Naber, K G

    2013-03-01

    Urinary tract infections (UTI) are among the most frequent bacterial infections in the community and health care setting. Mostly young and, to some extent, postmenopausal women are affected by recurrent UTI (rUTI) defined as ≥3 UTI/year or ≥2 UTI/half year. In contrast, rUTI is rare in healthy men. On the other hand, rUTI are frequently found in female and male patients with complicating urological factors, e.g. urinary catheters, infection stones. Remediable predisposing factors in uncomplicated rUTI in women are rare. In complicated rUTI the success depends mainly on the possibility to eliminate or at leastimprove the complicating risk factors. Continuous antibiotic prophylaxis or postcoital prophylaxis, if there is close correlation with sexual intercourse, are most effective to prevent rUTI. Nitrofurantoin, trimethoprim (or cotrimoxazole), and fosfomycin trometamol are available as first-line drugs. Oral cephalosporins and quinolones should be restricted to specific indications. Antibiotic prophylaxis reduces the number of uropathogens in the gut and/or vaginal flora and reduces bacterial "fitness". Given the correct indication, the recurrence rate of rUTI can be reduced by about 90%. Due to possible adverse events and the concern of selecting resistant pathogens, according to the guidelines of the European Association of Urology antimicrobial prophylaxis should be considered only after counselling, behavioural modification and non-antimicrobial measures have been attempted. In postmenopausal patients vaginal substitution of oestriol should be started first. Oral or parenteral immunoprophylaxis is another option in patients with rUTI. Other possibilities with varying scientific evidence are prophylaxis with cranberry products, specific plant combinations or probiotics. The prophylaxis of catheter-associated UTI should employ strategies which result in a reduction of frequency and duration of catheter drainage of the urinary tract. The currently available

  4. Value of Ultrasound in Detecting Urinary Tract Anomalies After First Febrile Urinary Tract Infection in Children.

    Science.gov (United States)

    Ghobrial, Emad E; Abdelaziz, Doaa M; Sheba, Maha F; Abdel-Azeem, Yasser S

    2016-05-01

    Background Urinary tract infection (UTI) is an infection that affects part of the urinary tract. Ultrasound is a noninvasive test that can demonstrate the size and shape of kidneys, presence of dilatation of the ureters, and the existence of anatomic abnormalities. The aim of the study is to estimate the value of ultrasound in detecting urinary tract anomalies after first attack of UTI. Methods This study was conducted at the Nephrology Clinic, New Children's Hospital, Faculty of Medicine, Cairo University, from August 2012 to March 2013, and included 30 children who presented with first attack of acute febrile UTI. All patients were subjected to urine analysis, urine culture and sensitivity, serum creatinine, complete blood count, and imaging in the form of renal ultrasound, voiding cysto-urethrography, and renal scan. Results All the patients had fever with a mean of 38.96°C ± 0.44°C and the mean duration of illness was 6.23 ± 5.64 days. Nineteen patients (63.3%) had an ultrasound abnormality. The commonest abnormalities were kidney stones (15.8%). Only 2 patients who had abnormal ultrasound had also vesicoureteric reflux on cystourethrography. Sensitivity of ultrasound was 66.7%, specificity was 37.5%, positive predictive value was 21.1%, negative predictive value was 81.8%, and total accuracy was 43.33%. Conclusion We concluded that ultrasound alone was not of much value in diagnosing and putting a plan of first attack of febrile UTI. It is recommended that combined investigations are the best way to confirm diagnosis of urinary tract anomalies. © The Author(s) 2015.

  5. [Microbiological diagnosis of HIV infection].

    Science.gov (United States)

    López-Bernaldo de Quirós, Juan Carlos; Delgado, Rafael; García, Federico; Eiros, José M; Ortiz de Lejarazu, Raúl

    2007-12-01

    Currently, there are around 150,000 HIV-infected patients in Spain. This number, together with the fact that this disease is now a chronic condition since the introduction of antiretroviral therapy, has generated an increasing demand on the clinical microbiology laboratories in our hospitals. This increase has occurred not only in the diagnosis and treatment of opportunistic diseases, but also in tests related to the diagnosis and therapeutic management of HIV infection. To meet this demand, the Sociedad de Enfermedades Infecciosas y Microbiología Clinica (Spanish Society of Infectious Diseases and Clinical Microbiology) has updated its standard Procedure for the microbiological diagnosis of HIV infection. The main advances related to serological diagnosis, plasma viral load, and detection of resistance to antiretroviral drugs are reviewed in this version of the Procedure.

  6. Laboratory Diagnosis of Infective Endocarditis

    Science.gov (United States)

    Liesman, Rachael M.; Pritt, Bobbi S.; Maleszewski, Joseph J.

    2017-01-01

    ABSTRACT Infective endocarditis is life-threatening; identification of the underlying etiology informs optimized individual patient management. Changing epidemiology, advances in blood culture techniques, and new diagnostics guide the application of laboratory testing for diagnosis of endocarditis. Blood cultures remain the standard test for microbial diagnosis, with directed serological testing (i.e., Q fever serology, Bartonella serology) in culture-negative cases. Histopathology and molecular diagnostics (e.g., 16S rRNA gene PCR/sequencing, Tropheryma whipplei PCR) may be applied to resected valves to aid in diagnosis. Herein, we summarize recent knowledge in this area and propose a microbiologic and pathological algorithm for endocarditis diagnosis. PMID:28659319

  7. Bacteraemia, urinary tract infection and malaria in hospitalised ...

    African Journals Online (AJOL)

    . However, it remains unclear whether such infections are attributable to the malaria, other risk factors, or are coincidental. Objective: To determine the prevalence of bacteraemia and urinary tract infections (UTI) in febrile hospitalised children ...

  8. Urinary tract infections in the infant.

    Science.gov (United States)

    Arshad, Mehreen; Seed, Patrick C

    2015-03-01

    Urinary tract infection (UTI) in an infant may be the first indication of an underlying renal disorder. Early recognition and initiation of adequate therapy for UTI is important to reduce the risk of long-term renal scarring. Ampicillin and gentamicin are traditionally the empiric treatment of choice; however, local antibiotic resistance patterns should be considered. Maternal antibiotics during pregnancy also increase the risk of resistant pathogens during neonatal UTI. Long-term management after the first UTI in infants remains controversial because of lack of specific studies in this age group and the risk-benefit issues for antibiotic prophylaxis between reduced recurrent disease and emergent antibiotic resistance. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Antibiotic Resistance in Pediatric Urinary Tract Infections.

    Science.gov (United States)

    Stultz, Jeremy S; Doern, Christopher D; Godbout, Emily

    2016-12-01

    Urinary tract infections (UTIs) are a common problem in pediatric patients. Resistance to common antibiotic agents appears to be increasing over time, although resistance rates may vary based on geographic region or country. Prior antibiotic exposure is a pertinent risk factor for acquiring resistant organisms during a first UTI and recurrent UTI. Judicious prescribing of antibiotics for common pediatric conditions is needed to prevent additional resistance from occurring. Complex pediatric patients with histories of hospitalizations, prior antibiotic exposure, and recurrent UTIs are also at high risk for acquiring UTIs due to extended spectrum beta-lactamase-producing organisms. Data regarding the impact of in vitro antibiotic susceptibility testing interpretation on UTI treatment outcomes is lacking.

  10. Novel management of urinary tract infections.

    Science.gov (United States)

    Storm, Douglas W; Patel, Ashay S; Koff, Stephen A; Justice, Sheryl S

    2011-07-01

    To highlight observations that have suggested the need for changing the conventional approach to the evaluation and management of urinary tract infections (UTIs) and vesicoureteral reflux in children and examine new alternative approaches to prevention of UTI and renal scarring based on research into host-pathogen interaction. Recent studies have questioned the traditional approach of using prophylactic antibiotics to prevent recurrence of UTI and development of renal scarring in children with vesicoureteral reflux. Ongoing research on host-pathogen interactions reveals a promising capability to analyze virulence factors in bacteria causing UTIs in children, identify highly virulent bacteria capable of causing pyelonephritis and renal injury, and to selectively target the gastrointestinal reservoirs of these bacteria for elimination using probiotics. Promising experimental studies correlating bacterial virulence with pattern of UTI and identification and characterization of a newly available probiotic capable of eradicating uropathogenic bacteria make targeted probiotic prevention of renal injury-inducing UTIs a potential therapeutic reality.

  11. Urinary tract infections in women with urogynaecological symptoms

    NARCIS (Netherlands)

    Lakeman, Marielle M. E.; Roovers, Jan-Paul W. R.

    2016-01-01

    Urinary tract infections are common in the field of urogynaecology. Women with persistent urinary symptoms seem more likely to have bacteriuria despite negative cultures. In this review, we will give an overview of the recent insights on the relationship between urinary tract infection and

  12. Early diagnosis and empiric therapy for cirrhosis associated with infection

    Directory of Open Access Journals (Sweden)

    NAN Yuemin

    2015-03-01

    Full Text Available Infection is a frequent complication of cirrhosis, which often occurs in the lungs, chest, abdomen, biliary tract, urinary tract, soft tissue, and skin, and occasionally causes spontaneous bacteremia in patients. This paper reviews the risk factors and common types of infection in cirrhosis associated with infection, and the early diagnosis and symptomatic treatment of different types of infection. Moreover, this paper points out that cirrhosis associated with infection is a key factor for disease progression and the early diagnosis and treatment are essential for successful treatment. The third-generation cephalosporins are the first-line antibiotic agents. Drug-resistant bacteria should be treated with antibiotic compound containing β-lactamase inhibitors or carbapenems. Methicillin-resistant Staphylococcus aureus should be treated with glycopeptide antibiotics or combination therapies. Pulmonary mycoses are mainly treated with caspofungin or voriconazole. Antibiotics combined with supportive therapies including the administration of albumin can improve the treatment outcome and prognosis.

  13. Cranberry for Urinary Tract Infection: From Bench to Bedside.

    Science.gov (United States)

    Nabavi, Seyed Fazel; Sureda, Antoni; Daglia, Maria; Izadi, Morteza; Nabavi, Seyed Mohammad

    2017-01-01

    Urinary tract infections are common infectious diseases which can occur in any part of the urinary tract such as bladder, kidney, ureters, and urethra. They are commonly caused by bacteria that enter through the urethra. Urinary tract infections commonly develop in the bladder and spread to renal tissues. Up to now, there are different antimicrobial agents which have beneficial role on urinary tract infections. However, most of them cause different adverse effects and therefore, much attention has been paid to the search for effective therapeutic agents with negligible adverse effects. Cranberry is known as one of the most important edible plants, which possesses potent antimicrobial effects against the bacteria responsible for urinary tract infections. Growing evidence has shown that cranberry suppresses urinary tract infections and eradicates the bacteria. Therefore, the aim of this study is to critically review the available literature regarding the antimicrobial activities of cranberry against urinary tract infection microorganisms. In addition, we discuss etiology, epidemiology, risk factors, and current drugs of urinary tract infections to provide a more complete picture of this disease.

  14. Urinary tract infections in women: etiology and treatment options

    Directory of Open Access Journals (Sweden)

    Minardi D

    2011-04-01

    Full Text Available Daniele Minardi, Gianluca d'Anzeo, Daniele Cantoro, Alessandro Conti, Giovanni MuzzonigroDepartment of Clinical and Specialist Sciences, Urology, Polytechnic University of the Marche Medical School and United Hospitals, Ancona, ItalyAbstract: Urinary tract infections (UTI are common among the female population. It has been calculated that about one-third of adult women have experienced an episode of symptomatic cystitis at least once. It is also common for these episodes to recur. If predisposing factors are not identified and removed, UTI can lead to more serious consequences, in particular kidney damage and renal failure. The aim of this review was to analyze the factors more commonly correlated with UTI in women, and to see what possible solutions are currently used in general practice and specialized areas, as well as those still under investigation. A good understanding of the possible pathogenic factors contributing to the development of UTI and its recurrence will help the general practitioner to interview the patient, search for causes that would otherwise remain undiscovered, and to identify the correct therapeutic strategy.Keywords: urinary tract infection, women, etiology, diagnosis, treatment

  15. Preventing urinary tract infections in early childhood.

    Science.gov (United States)

    Williams, Gabrielle J; Craig, Jonathan C; Carapetis, Jonathan R

    2013-01-01

    Urinary tract infection (UTI) is common in children, causes them considerable discomfort, as well as distress to parents and has a tendency to recur. Approximately 20% of those children who experience one infection will have a repeat episode. Since 1975, 11 trials of long-term antibiotics compared with placebo or no treatment in 1,550 children have been published. Results have been heterogeneous, but the largest trial demonstrated a small reduction (6% absolute risk reduction, risk ratio 0.65) in the risk of repeat symptomatic UTI over 12 months of treatment. This effect was consistent across sub groups of children based upon age, gender, vesicoureteric reflux status and number of prior infections. Trials involving re-implantation surgery (and antibiotics compared with antibiotics alone) for the sub-group of children with vesicoureteric reflux have not shown a reduction in repeat UTI, with the possible exception of a very small benefit for febrile UTI. Systematic reviews have shown that circumcision reduces the risk of repeat infection but 111 circumcisions would need to be performed to prevent one UTI in unpredisposed boys. Given the need for anaesthesia and the risk of surgical complication, net clinical benefit is probably restricted to those who are predisposed (such as those with recurrent infection). Many small trials in complementary therapies have been published and many suggest some benefit, however inclusion of children is limited. Only three trials involving 394 children for cranberry products, two trials with a total of 252 children for probiotics and one trial with 24 children for vitamin A are published. Estimates of efficacy vary widely and imprecision is evident. Multiple interventions to prevent UTI in children exist. Of those, long-term low dose antibiotics has the strongest evidence base, but the benefit is small. Circumcision in boys reduces the risk substantially, but should be restricted to those at risk. There is little evidence of benefit of

  16. Urinary NGAL deficiency in recurrent urinary tract infections.

    Science.gov (United States)

    Forster, Catherine S; Johnson, Kathryn; Patel, Viral; Wax, Rebecca; Rodig, Nancy; Barasch, Jonathan; Bachur, Richard; Lee, Richard S

    2017-06-01

    Children with recurrent urinary tract infections (rUTI) often show no identifiable cause of their infections. Neutrophil gelatinase-associated lipocalin (NGAL) is known to be upregulated within the uroepithelium and kidney of patients with UTI and exhibits a localized bacteriostatic effect through iron chelation. We hypothesize that some patients with rUTI without an identifiable cause of their recurrent infections have locally deficient NGAL production. We therefore explored whether a lack of NGAL production may be a factor in the pathogenesis of rUTI. Patients seen in the urology clinic for rUTI who were tract, or other reasons that predispose to UTI, such as neurogenic bladder, the need for intermittent catheterization, or unrepaired posterior urethral valves. Control patients were healthy children enrolled from the emergency department with no history of UTI or renal dysfunction, normal urinalysis at the time of enrollment, and presenting no diagnosis associated with increased NGAL levels, such as acute kidney injury or infection. NGAL was measured by immunoblot. Fifteen cases and controls were enrolled. Median urinary NGAL levels were significantly decreased in rUTI patients compared with controls [15 (14-29) ng/ml vs 30 (27-61) ng/ml; p = 0.002)] Although comparatively diminished, measurable NGAL levels were present in all patients with rUTI. Urinary NGAL is significantly decreased in patients with compared with patients without rUTI. These data suggest that some patients with rUTI may be predisposed to UTI because of a relative local deficiency in urinary NGAL production.

  17. Urinary tract infection in postmenopausal women.

    Science.gov (United States)

    Raz, Raul

    2011-12-01

    Urinary tract infection (UTI) is the most common bacterial infection in women in general and in postmenopausal women in particular. Two groups of elderly women with recurrent UTI should be differentiated regarding age and general status: healthy, young postmenopausal women aged 50 to 70 years who are neither institutionalized or catheterized and elderly institutionalized women with or without a catheter. Bacteriuria occurs more often in elderly functionally impaired women, but in general it is asymptomatic. However, the risk factors associated with recurrent UTI in elderly women are not widely described. In a multivariate analysis it was found that urinary incontinence, a history of UTI before menopause, and nonsecretor status were strongly associated with recurrent UTI in young postmenopausal women. Another study described the incidence and risk factors of acute cystitis among nondiabetic and diabetic postmenopausal women. Independent predictors of infection included insulin-treated patients and a lifetime history of urinary infection. Borderline associations included a history of vaginal estrogen cream use in the past month, kidney stones, and asymptomatic bacteriuria at baseline. Another important factor in postmenopausal women is the potential role that estrogen deficiency plays in the development of bacteriuria. There are at least two studies showing a beneficial effect of estrogen in the management of recurrent bacteriuria in elderly women. One of these studies showed that vaginal estrogen cream reduced vaginal pH from 5.5±0.7 to 3.6±1.0, restored lactobacillus, and decreased new episodes of UTI. Another study reported similar results using an estriol vaginal ring. However, contradictory results are found in the literature. For example, additional studies found that the use of estriol-containing vaginal pessaries was less effective than oral nitrofurantoin macrocrystals in preventing UTI in postmenopausal women. Two other studies also did not find any

  18. Multidrug resistance in pediatric urinary tract infections.

    Science.gov (United States)

    Gaspari, Romolo J; Dickson, Eric; Karlowsky, James; Doern, Gary

    2006-01-01

    Urinary tract infections (UTIs) represent a common infection in the pediatric population. Escherichia coli is the most common uropathogen in children, and antimicrobial resistance in this species complicates the treatment of pediatric UTIs. Despite the impact of resistance on empiric antibiotic choice, there is little data on multidrug resistance in pediatric patients. In this paper, we describe characteristics of multidrug-resistant E. coli in pediatric patients using a large national database of uropathogens antimicrobial sensitivities. Antimicrobial susceptibility patterns to commonly prescribed antibiotics were performed on uropathogens isolated from children presenting to participating hospitals between 1999 and 2001. Data were analyzed separately for four pediatric age groups. Single and multidrug resistance to ampicillin, amoxicillin-clavulanate, cefazolin, ciprofloxacin, nitrofurantoin, and trimethoprim-sulfamethoxazole (TMP-SMX) were performed on all specimens. There were a total of 11,341 E. coli urine cultures from 343 infants (0-4 weeks), 1,801 toddlers (5 weeks-24 months), 6,742 preteens (2-12 years), and 2,455 teens (13-17 years). E. coli resistance to ampicillin peaked in toddlers (52.8%) but was high in preteens (52.1%), infants (50.4%), and teens (40.6%). Resistance to two or more antibiotics varied across age groups, with toddlers (27%) leading preteens (23.1%), infants (21%), and teens (15.9%). Resistance to three or more antibiotics was low in all age groups (range 3.1-5.2%). The most common co-resistance in all age groups was ampicillin/TMP-SMZ. In conclusion, less than half of all pediatric UTIs are susceptible to all commonly used antibiotics. In some age groups, there is a significant percentage of co-resistance between the two most commonly used antibiotics (ampicillin and TMP-SMZ).

  19. Recurrent urinary tract infections in women.

    Science.gov (United States)

    Aydin, Abdullatif; Ahmed, Kamran; Zaman, Iftikhar; Khan, Muhammad Shamim; Dasgupta, Prokar

    2015-06-01

    Recurrent urinary tract infections (UTIs) are more common in women and are frequently defined as ≥2 episodes in the last 6 months or ≥3 episodes in the last 12 months. In a primary care setting, 53 % of women above the age of 55 years and 36 % of younger women report a recurrence within 1 year. Thus, management and prevention of recurrent UTI is of utmost significance. This review aims to highlight the latest research in prevention strategies and suggest a management pathway. A search was conducted on MEDLINE, Embase and the Cochrane Database of Systematic Reviews databases for the latest systematic reviews and high-quality randomized controlled trials. Special emphasis was placed on the remit "recurrent" and strongly adhered to. Furthermore, a Google search was conducted for current guidelines on the management of UTIs. Current prevention strategies include eliminating risk factors that increase the risk of acquiring recurrent UTI and continuous, post-coital and self-initiated antimicrobial prophylaxis. Other prospective preventative strategies, currently under trial, include use of vaccinations, D-mannose and lactobacillus (probiotics). Although risk factors should be identified and addressed accordingly, individualized antibiotic prophylaxis remains the most effective method of management. Non-antibiotic prevention strategies such as cranberry, vitamin C and methenamine salts lack strong evidence to be introduced as routine management options and as alternatives to antibiotics. Based on current evidence and guidelines, a management pathway is recommended. Emerging therapies require further evaluation before they can be recommended.

  20. Asymptomatic bacteriuria and symptomatic urinary tract infections during pregnancy.

    Science.gov (United States)

    Macejko, Amanda M; Schaeffer, Anthony J

    2007-02-01

    Urinary tract infections are common complications of pregnancy; upper tract infections in particular may lead to significant morbidity for both the mother and fetus. Bacteriuria is a significant risk factor for developing pyelonephritis in pregnant women. Therefore, proper screening and treatment of bacteriuria during pregnancy is necessary to prevent complications. All women should be screened for bacteriuria in the first trimester, and women with a history of recurrent urinary tract infections or anomalies should have repeat bacteriuria screening throughout pregnancy. Treatment of bacteriuria should include 3-day therapy with appropriate antimicrobials, and women should be followed closely after treatment because recurrence may occur in up to one third of patients.

  1. Antibiotic Resistance of Urinary Tract Infection of Children Under 14 Years Admitted To The Pediatric Clinic of Imam Sajjad Hospital, 2012

    OpenAIRE

    F Asadi Manesh F; A Sharifi; Z Mohammad Hosini; H Nasrolahi; N Hosseini; A Kalantari; SAM Khosravani

    2014-01-01

    Background & aim: Urinary tract infection is the most common childhood infections after upper respiratory tract infection. Early diagnosis, proper treatment and appropriate patient follow-up can lead to a significant reduction in symptoms. The purpose of this study was to determine the antimicrobial resistance of urinary tract infection in children under 14 years admitted to the pediatric clinic of Imam Sajjad (AS) Yasooj. Methods: Methods: In this cross-sectional study antibiotic sensiti...

  2. Screening for urinary tract infection with the Sysmex UF-1000i urine flow cytometer

    NARCIS (Netherlands)

    Broeren, M.A.C.; Bahceci, C.; Vader, H.; Arents, N.L.A.

    2011-01-01

    The diagnosis of urinary tract infection (UTI) by urine culture is time-consuming and can produce up to 60 to 80% negative results. Fast screening methods that can reduce the necessity for urine cultures will have a large impact on overall turnaround time and laboratory economics. We have evaluated

  3. Routine tests and automated urinalysis in patients with suspected urinary tract infection at the ED

    NARCIS (Netherlands)

    Middelkoop, S. J. M.; van Pelt, L. J.; Kampinga, G. A.; ter Maaten, J. C.; Stegeman, C. A.

    Background: Urinary tract infections (UTIs) are frequently encountered. Diagnostics of UTI (urine dipstick, Gram stain, urine culture) lack proven accuracy and precision in the emergency department. Utility of automated urinalysis shows promise for UTI diagnosis but has not been validated. Methods:

  4. Update on the approach of urinary tract infection in childhood.

    Science.gov (United States)

    Simões e Silva, Ana Cristina; Oliveira, Eduardo Araújo

    2015-01-01

    Urinary tract infection (UTI) is the most common bacterial infection in childhood. UTI may be the sentinel event for underlying renal abnormality. There are still many controversies regarding proper management of UTI. In this review article, the authors discuss recent recommendations for the diagnosis, treatment, prophylaxis, and imaging of UTI in childhood based on evidence, and when this is lacking, based on expert consensus. Data were obtained after a review of the literature and a search of Pubmed, Embase, Scopus, and Scielo. In the first year of life, UTIs are more common in boys (3.7%) than in girls (2%). Signs and symptoms of UTI are very nonspecific, especially in neonates and during childhood; in many cases, fever is the only symptom. Clinical history and physical examination may suggest UTI, but confirmation should be made by urine culture, which must be performed before any antimicrobial agent is given. During childhood, the proper collection of urine is essential to avoid false-positive results. Prompt diagnosis and initiation of treatment is important to prevent long-term renal scarring. Febrile infants with UTIs should undergo renal and bladder ultrasonography. Intravenous antibacterial agents are recommended for neonates and young infants. The authors also advise exclusion of obstructive uropathies as soon as possible and later vesicoureteral reflux, if indicated. Prophylaxis should be considered for cases of high susceptibility to UTI and high risk of renal damage. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  5. Pin Tract Infection after Uniplanar External Fixation of Open ...

    African Journals Online (AJOL)

    ADMIN

    Regionally, a study by Jellis et al in Lusaka, Zambia, compared the rate of severe pin tract infection in HIV negative and positive ... likelihood of infection such as human immunodeficiency virus infection, diabetes mellitus, liver failure, renal failure, tumours ... Combined Open Tibia-Fibular. And Femur Fractures. 2. 2.7. Totals.

  6. Antibiogram of nosocomial urinary tract infections in Felege Hiwot ...

    African Journals Online (AJOL)

    Background: Nosocomial infections increase the cost of medical care, extend hospital stay and reflect on the morbidity and mortality of the admitted patients. Urinary tract infections (UTIs) are one of the most common nosocomial infections in humans. Objectives: To determine the prevalence and antibiogram of nosocomial ...

  7. Prevalence of urinary tract infection among pregnant women at ...

    African Journals Online (AJOL)

    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 ...

  8. Management of upper respiratory tract infections in children

    African Journals Online (AJOL)

    Upper respiratory tract infection (URTI) occurs commonly in both children and adults and is a major ... by a watery nasal discharge, which after one to three days becomes .... iron supplementation is remarkably effective in areas where iron.

  9. a seven months retrospective study on urinary tract infection among

    African Journals Online (AJOL)

    DR. AMINU

    Urinary Tract Infection (UTI) is a significant health problem world wide, ... responsible for a high rate of morbidity in neonates and children. ... predominant bacterial pathogens and their sensitivity to antibiotics so as to guide ... resistant strains.

  10. Emphysematous cystitis: An unusual lower urinary tract infection ...

    African Journals Online (AJOL)

    Emphysematous cystitis: An unusual lower urinary tract infection. MA Lakmichi, M Boukhar, F Barjani, O Saghir, T Hanich, B Wakrim, M Gabsi, A Elhauos, N Charif Idrissi Genouni, N Ousehal, Z Dahami, SM Moudouni, I Sarf ...

  11. Pediatric recurrent respiratory tract infections: when and how to ...

    African Journals Online (AJOL)

    Pediatric recurrent respiratory tract infections: when and how to explore the immune system? (About 53 cases). Mohammed El-Azami-El-Idrissi, Mounia Lakhdar-Idrissi, Sanae Chaouki, Samir Atmani, Abdelhak Bouharrou, Moustapha Hida ...

  12. International Spinal Cord Injury Urinary Tract Infection Basic Data Set

    DEFF Research Database (Denmark)

    Goetz, L L; Cardenas, D D; Kennelly, M

    2013-01-01

    To develop an International Spinal Cord Injury (SCI) Urinary Tract Infection (UTI) Basic Data Set presenting a standardized format for the collection and reporting of a minimal amount of information on UTIs in daily practice or research.......To develop an International Spinal Cord Injury (SCI) Urinary Tract Infection (UTI) Basic Data Set presenting a standardized format for the collection and reporting of a minimal amount of information on UTIs in daily practice or research....

  13. Concomitant Bacterial Meningitis in Infants With Urinary Tract Infection.

    Science.gov (United States)

    Thomson, Joanna; Cruz, Andrea T; Nigrovic, Lise E; Freedman, Stephen B; Garro, Aris C; Ishimine, Paul T; Kulik, Dina M; Uspal, Neil G; Grether-Jones, Kendra L; Miller, Aaron S; Schnadower, David; Shah, Samir S; Aronson, Paul L; Balamuth, Fran

    2017-09-01

    To determine age-stratified prevalence of concomitant bacterial meningitis in infants ≤60 days with a urinary tract infection, we performed a 23-center, retrospective study of 1737 infants with urinary tract infection. Concomitant bacterial meningitis was rare, but more common in infants 0-28 days of age [0.9%; 95% confidence interval (CI): 0.4%-1.9%) compared with infants 29-60 days of age (0.2%; 95% CI: 0%-0.8%).

  14. "Urinary Tract Infection"-Requiem for a Heavyweight.

    Science.gov (United States)

    Finucane, Thomas E

    2017-08-01

    "Urinary tract infection" ("UTI") is an ambiguous, expansive, overused diagnosis that can lead to marked, harmful antibiotic overtreatment. "Significant bacteriuria," central to most definitions of "UTI," has little significance in identifying individuals who will benefit from treatment. "Urinary symptoms" are similarly uninformative. Neither criterion is well defined. Bacteriuria and symptoms remit and recur spontaneously. Treatment is standard for acute uncomplicated cystitis and common for asymptomatic bacteriuria, but definite benefits are few. Treatment for "UTI" in older adults with delirium and bacteriuria is widespread but no evidence supports the practice, and expert opinion opposes it. Sensitive diagnostic tests now demonstrate that healthy urinary tracts host a ubiquitous, complex microbial community. Recognition of this microbiome, largely undetectable using standard agar-based cultures, offers a new perspective on "UTI." Everyone is bacteriuric. From this perspective, most people who are treated for a "UTI" would probably be better off without treatment. Elderly adults, little studied in this regard, face particular risk. Invasive bacterial diseases such as pyelonephritis and bacteremic bacteriuria are also "UTIs." Mindful decisions about antibiotic use will require a far better understanding of how pathogenicity arises within microbial communities. It is likely that public education and meaningful informed-consent discussions about antibiotic treatment of bacteriuria, emphasizing potential harms and uncertain benefits, would reduce overtreatment. Emphasizing the microbiome's significance and using the term "urinary tract dysbiosis" instead of "UTI" might also help and might encourage mindful study of the relationships among host, aging, microbiome, disease, and antibiotic treatment. © 2017, Copyright the Author Journal compilation © 2017, The American Geriatrics Society.

  15. The role of imaging in adult acute urinary tract infection

    International Nuclear Information System (INIS)

    Webb, J.A.W.

    1997-01-01

    Imaging is required in only a minority of patients with urinary tract infection. Some patients who present with severe loin pain are imaged because ureteric colic is suspected. If urinary tract infection does not respond normally to antibiotics, imaging is undertaken to check for evidence of renal obstuction or sepsis. Finally, after the acute infection has been treated, imaging is required in some patients to check for factors pre-disposing to renal damage or to relapsing or recurrent infection. This review discusses the appropriate choice of imaging technique to use in each clinical situation and summarises the expected findings. (orig.). With 15 figs., 1 tab

  16. [The features in preventing recurrent lower urinary tract infection].

    Science.gov (United States)

    Gadzhieva, Z K; Kazilov, Yu B

    2016-08-01

    This review outlines characteristics of medications most commonly used for preventing recurrent lower urinary tract infection (UTI). It shows that the treatment and prophylaxis of UTI should be comprehensive and include the restoration of the normal urogenital tract anatomy and use in addition to antibacterial and anti-inflammatory drugs, agents, normalizing the function of the lower urinary tract, as well as drugs for local and systemic immunoprophylaxis, protection of the urothelium from recurrent infection, local hormone replacement therapy in menopause, and dietary supplements to acidify the urine.

  17. Reproductive tract infections in northern Vietnam: health providers' diagnostic dilemmas

    DEFF Research Database (Denmark)

    Nguyen, My Hu'o'ng; Gammeltoft, Tine; Christoffersen, Sarah Vigh

    2010-01-01

    Research was conducted on reproductive tract infections among women obtaining induced abortions at Ph[image omitted]-[image omitted] hospital in Haiphong City, a major maternity hospital in northern Vietnam. The research aimed to explore how clinicians and lab-technicians diagnose reproductive...... tract infections and the difficulties they experience in establishing exact diagnoses. A combination of both quantitative and qualitative research methodologies was employed. The quantitative research involved 748 abortion-seeking women; the qualitative research was conducted with 10 doctors and 10 lab......-technicians providing reproductive health services. A marked tendency was observed among both clinicians and lab-technicians to overdiagnose reproductive tract infections and to prescribe antibiotics routinely. Social, cultural, and clinical factors associated with the tendency to overdiagnose reproductive tract...

  18. Evaluation of maternal urinary tract infection as a potential risk factor for neonatal urinary tract infection.

    OpenAIRE

    Nasrin Khalesi; Nastaran Khosravi; Ali Jalali; Leila Amini

    2014-01-01

    Objective To assess the relationship between maternal UTI during pregnancy and neonatal UTI. Materials and methods This cross-sectional study included eighty neonates referred to Ali-e-Asghar Hospital, Tehran, Iran, in 2011. The participants were divided into the study (with diagnosis of UTI; n = 40) and the control (without this type of infection; n = 40) groups. The mothers were asked about the history of UTI during pregnancy, and if the response was positive, the trimester in which UTI had...

  19. [Diagnosis of upper urinary tract tumors. A pending challenge].

    Science.gov (United States)

    Westendarp, M; Laguna, M P; de la Rosette, J J M C

    2014-07-01

    Early diagnosis of upper urinary tract tumors is not easy. The development of endoscopic equipment has expanded the group of patients candidates for minimally invasive treatment. Only by providing accurate tumor staging and grading can clinicians decide which patients should be offered conservative therapies. We need diagnostic methods that allow us to make an early and accurate diagnosis for these lesions, as well as safe follow-up. Our proposal is to present a review of the most used diagnostic method, their features, and future diagnostic tools. The diagnostic arsenal requires further improvement. Only through accurate diagnosis, we will be able to safely provide conservative treatment. Developing new diagnostic techniques seem to move us closer to this goal even more. We propose a working algorithm on the management of these lesions.

  20. Urinary tract infections in pregnancy: evaluation of diagnostic framework.

    Science.gov (United States)

    Jido, Tukur Ado

    2014-01-01

    This study was performed with the objective to examine the diagnostic framework for urinary tract infection (UTI) in pregnancy and physician response to the clinical diagnosis and to correlate responses to the results of urine culture and sensitivity. Over a 6-month period, 81 consecutive patients attending the labor ward admission of a district general hospital with the diagnosis of UTI during pregnancy were analyzed. Relevant information on symptom complex, result of dipstick urinalysis and culture and sensitivity were recorded. Data were analyzed using descriptive statistics. Of the 78 patients analyzed, 79% had increased urinary frequency, 73.1% had suprapubic pains and 53.1% had dysuria. All the patients had urinalysis with dipsticks, 41 (52.6%) were positive for nitrites and 64 (82.1%) were positive for leukocyte esterase. All 78 patients had urine culture and sensitivity, 21 (26.8%) of who were positive, and coliforms were the most commonly isolated pathogens. The sensitivity for nitrite was 80.9%, specificity 57.9% and positive predictive value 41.4%. The corresponding figures for leukocyte esterase were sensitivity 100%, specificity 24.6% and positive predictive value 32.8%. Sixty-six (84.6%) patients had treatment started on the basis of the clinical diagnosis, mostly with co-amoxyclavullinic acid or amoxicillin alone. A high resistance rate to these empirically chosen antibiotics was seen in the sensitivity pattern of isolated pathogens. Current clinical diagnostic algorithms for the diagnosis of UTI when applied in the context of pregnancy have low specificity and positive predictive values; yet, empirical antibiotics are frequently employed on this basis. These are often not in keeping with the sensitivity pattern of isolated organisms. There is need for a continuing research for more specific bedside tests.

  1. Urinary tract infections in pregnancy: Evaluation of diagnostic framework

    Directory of Open Access Journals (Sweden)

    Tukur Ado Jido

    2014-01-01

    Full Text Available This study was performed with the objective to examine the diagnostic framework for urinary tract infection (UTI in pregnancy and physician response to the clinical diagnosis and to correlate responses to the results of urine culture and sensitivity. Over a 6-month period, 81 consecutive patients attending the labor ward admission of a district general hospital with the diagnosis of UTI during pregnancy were analyzed. Relevant information on symptom complex, result of dipstick urinalysis and culture and sensitivity were recorded. Data were analyzed using descriptive statistics. Of the 78 patients analyzed, 79% had increased urinary frequency, 73.1% had suprapubic pains and 53.1% had dysuria. All the patients had urinalysis with dipsticks, 41 (52.6% were positive for nitrites and 64 (82.1% were positive for leukocyte esterase. All 78 patients had urine culture and sensitivity, 21 (26.8% of who were positive, and coliforms were the most commonly isolated pathogens. The sensitivity for nitrite was 80.9%, specificity 57.9% and positive predictive value 41.4%. The corresponding figures for leukocyte esterase were sensi-tivity 100%, specificity 24.6% and positive predictive value 32.8%. Sixty-six (84.6% patients had treatment started on the basis of the clinical diagnosis, mostly with co-amoxyclavullinic acid or amoxicillin alone. A high resistance rate to these empirically chosen antibiotics was seen in the sensitivity pattern of isolated pathogens. Current clinical diagnostic algorithms for the diagnosis of UTI when applied in the context of pregnancy have low specificity and positive predictive values; yet, empirical antibiotics are frequently employed on this basis. These are often not in keeping with the sensitivity pattern of isolated organisms. There is need for a continuing research for more specific bedside tests.

  2. Zinc Supplementation in Treatment of Children With Urinary Tract Infection.

    Science.gov (United States)

    Yousefichaijan, Parsa; Naziri, Mahdyieh; Taherahmadi, Hassan; Kahbazi, Manijeh; Tabaei, Aram

    2016-07-01

    Urinary tract infection (UTI) is very common in children. Precocious diagnosis and appropriate treatment are important because of the permanent disease complications. Zinc increases the response to treatment in many infections. In this study, we explored the effect of zinc in treating UTI. Two hundred children with UTI were divided into 2 groups of 100 who were comparable in terms of age, sex, urine laboratory profiles, and clinical signs and symptoms. The control group received a standard treatment protocol for UTI and the intervention group received oral zinc sulfate syrup plus routine treatment of UTI. A faster recovery was observed in the patients receiving zinc, but abdominal pain was exacerbated by zinc and lasted longer. Three months after the treatment, there was no significant difference between the two groups in the time of fever stop and negative urine culture. In children with UTI, zinc supplementation has a positive effect in ameliorating severe dysuria and urinary frequency while the use of this medication is not recommended in the presence of abdominal pain.

  3. bacterial uropathogens in urinary tract infection and antibiotic

    African Journals Online (AJOL)

    User

    2011-07-02

    Jul 2, 2011 ... BACKGROUND: Urinary tract infection (UTI) is one of the most common bacterial infections ... leaves the clinicians with very few alternative options of drugs for the treatment of UTIs. As drug resistance ... can be asymptomatic or symptomatic, UTIs that .... pregnancy and stage of pregnancy, age groups and.

  4. Urinary tract infection among pregnant women at Bobo-Dioulasso ...

    African Journals Online (AJOL)

    Urinary tract infections are the first infections in pregnant women and can cause serious complications during pregnancy. In order to improve its management in low income country like Burkina Faso, we conducted a prospect cross-sectional study, to describe its epidemiological and biological aspects in pregnant women at ...

  5. Incidence of urinary tract infection (UTI) among pregnant women in ...

    African Journals Online (AJOL)

    This study reports the incidence of urinary tract infections (UTIs) among 80 pregnant women attending antenatal clinics at Oluyoro Catholic Hospital (OCH), Ibadan, Nigeria, as well as the isolation and identification of the pathogens responsible for the infection. A total of 80 clean voided mid-stream urine samples were ...

  6. Urinary tract infection in renal transplant recipients | Elkehili | Arab ...

    African Journals Online (AJOL)

    Introduction: Urinary tract infection (UTI) is the commonest bacterial infection occurring in renal transplant recipients, and it is associated with significant morbidity. This study aimed to assess the characteristics of all UTI episodes diagnosed in renal transplant patients who attended regularly for follow up in the nephrology ...

  7. The innate immune response during urinary tract infection and pyelonephritis.

    Science.gov (United States)

    Spencer, John David; Schwaderer, Andrew L; Becknell, Brian; Watson, Joshua; Hains, David S

    2014-07-01

    Despite its proximity to the fecal flora, the urinary tract is considered sterile. The precise mechanisms by which the urinary tract maintains sterility are not well understood. Host immune responses are critically important in the antimicrobial defense of the urinary tract. During recent years, considerable advances have been made in our understanding of the mechanisms underlying immune homeostasis of the kidney and urinary tract. Dysfunctions in these immune mechanisms may result in acute disease, tissue destruction and overwhelming infection. The objective of this review is to provide an overview of the innate immune response in the urinary tract in response to microbial assault. In doing so, we focus on the role of antimicrobial peptides-a ubiquitous component of the innate immune response.

  8. Infection diagnosis in nuclear medicine

    International Nuclear Information System (INIS)

    Martin-Comin, J.

    1997-01-01

    Full text. The clinical applicability of agents like 67 Ga and 111 In-labelled leukocytes began the era of infection imaging diagnosis in Nuclear Medicine, more than two decades ago. In this period other agents have appeared in the field. 99 m Tc-HMPAQ-leukocytes and 99 m Tc-anti granulocyte monoclonal antibodies (able to label white blood cells) and 111 In and 99 mTc-polyclonal immuno globulins (in cold kit presentation). These agents had widespread the use of Nuclear Medicine procedures in clinical practice. Nevertheless, there is not, up to now, an specific agent to diagnose infection and is some cases a second or third agent (i.e.: 99 mTc-colloid) is used to obtain an accurate diagnosis. Actually, research is orientated to the development of agents with low antigenic power (peptides or fragments of monoclonal antibodies), or other non immunogenic agents involved in the inflammation process (selectin, antibiotic). Some experiences have also been done with PET agents. The clinical usefulness of commercially available agents and the future possibilities of the new ones will be presented

  9. Sonographic diagnosis of intramural hematoma of gastrointestinal tract

    International Nuclear Information System (INIS)

    Woo, Seong Ku; Cheon, S. K.; Seong, N. G.

    1989-01-01

    Sonographic findings of nine cases of intramural hematoma of the gastrointestinal tract are presented. The duodenum was the most common site, followed by the ascending colon and the stomach. Intramural hematomas present as centrally or eccentrically located bowel mass of variable echogenicity: heter-ogeneously echogenic in six cases; hypoechoic in two case; anechoic in one case. In five cases of duodenal hematoma, the stomach and/or duodenal bulb were distended and filled with fluid. It is concluded that ultrasonography is a simple and useful tool in the diagnosis of intramural hematoma of the intestine

  10. Scintigraphy findings in children presenting the first febrile infection of urinary tract

    International Nuclear Information System (INIS)

    Duarte Perez, Maria Caridad; Piedra Bello, Misleidys; Guillen Dosal, Ana

    2010-01-01

    Urinary tract infection (UTI) is one of the more frequent bacterial infections in childhood. The aim of present research was to know the acute phase renal alterations of the first febrile infection of urinary tract

  11. Urinary glicosaminoglycans levels in women with urinary tract infection and non urinary tract infection

    Science.gov (United States)

    Pasaribu, H. P.; Hanifa, A.; Tala, R. Z.; Ardiansyah, E.; Simanjuntak, R. Y.; Effendy, I. H.

    2018-03-01

    UTI is an infection that occurs in the urinary tract due to the proliferation of a microorganism. Female is fourteen times more vulnerable to UTI than male, because their urethra is shorter. Bladder epithelium is coated with a thin layer of glycosaminoglycans which act as a non-specific anti-adherence factor and nonspecific defense mechanisms against infection and can be found in the urine. An analytic study with cross sectional approach was conducted in 46 patients (23 with UTI and 23 non UTI) from June 2016 to determine differences in levels of urinary glycosaminoglycans between two groups. Urine samples were taken and tested for UTI and non UTI strips test. Laboratory examination of urine GAGs levels using ELISA kit for Human Glycosaminoglycans, then tabulated and analyzed using SPSS. The result showed no significant differences in the characteristics of women between two groups. There are significant differences in the mean levels of urinary GAGs in women with UTI compared with Non-UTI (69.74 ± 21.34; 21.39 ± 2.61 mg/l; p UTI incidence, with low odds ratio values and no significant difference in the mean of urinary glicosaminoglycans level based on sexual status.

  12. 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.

    2015-01-01

    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

  13. Urinary tract infection-like symptom is associated with worse bladder cancer outcomes in the Medicare population: Implications for sex disparities.

    Science.gov (United States)

    Richards, Kyle A; Ham, Sandra; Cohn, Joshua A; Steinberg, Gary D

    2016-01-01

    To determine the time to bladder cancer diagnosis from initial infection-like symptoms and its impact on cancer outcomes. Using Surveillance, Epidemiology and End Results-Medicare, we designed a retrospective cohort study identifying beneficiaries aged ≥ 66 years diagnosed with bladder cancer from 2007 to 2009. Patients were required to have a hematuria or urinary tract infection claim within 1 year of bladder cancer diagnosis (n = 21 216), and have 2 years of prior Medicare data (n = 18 956) without any precedent hematuria, bladder cancer or urinary tract infection claims (n = 12 195). The number of days to bladder cancer diagnosis was measured, as well as the impact of sex and presenting symptom on time to diagnosis, pathology, and oncological outcomes. The mean time to bladder cancer diagnosis was 72.2 days in women versus 58.9 days in men (P urinary tract infection. Cox proportional hazards analysis identified an increased risk of mortality from bladder cancer and all causes in women presenting with urinary tract infection (hazard ratio 1.37, 95% confidence interval 1.10-1.71, and hazard ratio 1.47, 95% confidence interval 1.28-1.69) compared with women with hematuria. Women have a longer interval from urinary tract infection to diagnosis of bladder cancer. Urinary tract infection presentation can adversely affect time to diagnosis, pathology and survival. Time to diagnosis seems not to be an independent predictor of bladder cancer outcomes. © 2015 The Japanese Urological Association.

  14. Enabling factors for antibiotic prescribing for upper respiratory tract infections

    DEFF Research Database (Denmark)

    Jaruseviciene, Lina; Radzeviciene Jurgute, Ruta; Bjerrum, Lars

    2013-01-01

    . This study aimed to explore experiences of GPs in Lithuania and the Russian Federation with regard to antibiotic prescription for upper respiratory tract infections. By such means it might be possible to reveal external enabling factors that influence antibiotic prescribing in these countries. Method. Five...... for political leadership to encourage clinically grounded antibiotic use; over-the-counter sale of antibiotics; designation of antibiotics as reimbursable medications; supervision by external oversight institutions; lack of guidelines for the treatment of upper respiratory tract infections; and pharmaceutical......Abstract Introduction. General practitioners (GPs) write about 80% of all antibiotic prescriptions, the greatest number of them for patients with respiratory tract infections. However, there is a lack of research targeting the influence of external factors on antibiotic prescribing by physicians...

  15. Consultation expectations among patients with respiratory tract infection symptoms

    DEFF Research Database (Denmark)

    Lauridsen, Gitte Bruun; Sørensen, Mette Sejr; Hansen, Malene Plejdrup

    2017-01-01

    INTRODUCTION: Antibiotic resistance is a growing threat to public health, and antibiotic prescribing increases. About 90% of antibiotics are prescribed in general practice, mostly for acute respiratory tract infections. It is well known that patient expectations and general practitioners......' misinterpretation of patients' expectations are associated with antibiotic overuse. The aim of this study was to explore Danish patients' expectations when consulting a general practitioner with symptoms of acute respiratory tract infection, and to determine predictors for these expectations. METHODS......: A questionnaire survey was conducted in Danish primary care during 2014. Patients aged ≥ 18 years were asked about their expectations to the consultation when consulting with symptoms of acute respiratory tract infections. Associations between socio-demographic characteristics, self-reported antibiotic...

  16. Consultation expectations among patients with respiratory tract infection symptoms

    DEFF Research Database (Denmark)

    Bruun Lauridsen, Gitte; Sejr Sørensen, Mette; Hansen, Malene Plejdrup

    2017-01-01

    Introduction: Antibiotic resistance is a growing threat to public health, and antibiotic prescribing increases. About 90% of antibiotics are prescribed in general practice, mostly for acute respiratory tract infections. It is well known that patient expectations and general practitioners’ misinter......­pretation of patients’ expectations are associated with antibiotic overuse. The aim of this study was to explore Danish patients’ expectations when consulting a general prac­titioner with symptoms of acute respiratory tract infection, and to determine predictors for these expectations. Methods: A questionnaire survey...... was conducted in Danish primary care during 2014. Patients aged ≥ 18 years were asked about their expectations to the consultation when consulting with symptoms of acute respiratory tract infections. Associations between socio-demographic characteristics, self-reported antibiotic prescription and patients...

  17. A Case of Pyriform Sinus Fistula Infection with Double Tracts

    Directory of Open Access Journals (Sweden)

    Masato Shino

    2014-01-01

    Full Text Available Pyriform sinus fistula is a rare clinical entity and the precise origin remains controversial. The fistula is discovered among patients with acute suppurative thyroiditis or deep neck infection of the left side of the neck and is usually located in the left pyriform sinus. To the best of our knowledge, only a single tract has been reported to be responsible for pyriform sinus fistula infection. We present a case of a 13-year-old female patient with a pyriform sinus fistula that caused a deep infection of the left side of the neck and showed double-tract involvement discovered during surgical resection of the entire fistula. Both tracts arose around the pyriform sinus and terminated at the upper portion of the left lobe of the thyroid.

  18. Urinary tract infections in older women: a clinical review.

    Science.gov (United States)

    Mody, Lona; Juthani-Mehta, Manisha

    2014-02-26

    Asymptomatic bacteriuria and symptomatic urinary tract infections (UTIs) in older women are commonly encountered in outpatient practice. To review management of asymptomatic bacteriuria and symptomatic UTI and review prevention of recurrent UTIs in older community-dwelling women. A search of Ovid (Medline, PsycINFO, Embase) for English-language human studies conducted among adults aged 65 years and older and published in peer-reviewed journals from 1946 to November 20, 2013. The clinical spectrum of UTIs ranges from asymptomatic bacteriuria, to symptomatic and recurrent UTIs, to sepsis associated with UTI requiring hospitalization. Recent evidence helps differentiate asymptomatic bacteriuria from symptomatic UTI. Asymptomatic bacteriuria is transient in older women, often resolves without any treatment, and is not associated with morbidity or mortality. The diagnosis of symptomatic UTI is made when a patient has both clinical features and laboratory evidence of a urinary infection. Absent other causes, patients presenting with any 2 of the following meet the clinical diagnostic criteria for symptomatic UTI: fever, worsened urinary urgency or frequency, acute dysuria, suprapubic tenderness, or costovertebral angle pain or tenderness. A positive urine culture (≥105 CFU/mL) with no more than 2 uropathogens and pyuria confirms the diagnosis of UTI. Risk factors for recurrent symptomatic UTI include diabetes, functional disability, recent sexual intercourse, prior history of urogynecologic surgery, urinary retention, and urinary incontinence. Testing for UTI is easily performed in the clinic using dipstick tests. When there is a low pretest probability of UTI, a negative dipstick result for leukocyte esterase and nitrites excludes infection. Antibiotics are selected by identifying the uropathogen, knowing local resistance rates, and considering adverse effect profiles. Chronic suppressive antibiotics for 6 to 12 months and vaginal estrogen therapy effectively reduce

  19. Clinical profile and antibiotics sensitivity in childhood urinary tract infection at Dhulikhel Hospital.

    Science.gov (United States)

    Singh, S D; Madhup, S K

    2013-01-01

    Urinary Tract Infection implies presence of actively multiplying organisms in the urinary tract. Although it is infrequently associated with mortality, it is still a significant cause of morbidity. Early diagnosis is critical to preserve renal function of growing kidney. Our purpose was to determine the clinical, microbiologic profile and antibiotic sensitivity of such infections in pediatric Urinary Tract Infection (UTI) patients at Dhulikhel Hospital. A hospital based prospective descriptive study of 135 children from 2 months to 16 years, with clinical diagnosis of urinary tract infection who visited the pediatric department of Dhulikhel Hospital over the period of 15 months were enrolled in the study. All patients underwent routine urine analysis and culture. Children with recurrent UTI underwent micturating cystourethrogram (MCUG). Children with recurrent UTI of more than two years and with feature of pyelonephritis underwent USG abdomen as well. Complications and response of the treatment was observed in all cases of UTI. All data were entered in Epidata and data analysis was done using spss 16 version. Among 135 children, 32.5% were male and 67.4% were female. Fever was the most common presenting symptom in 74.80% of patients followed by dysuria in 54.1%. Among these children 95.6% had significant pyuria and 45% had culture positive infection. Children who showed positive for bacteriuria, Escherichia coli (78.7%) was the most common organism and are more than 80% sensitive to Amikacin, Gentamicin, Ceftriaxone, Ofloxacin, Nalidixic acid, Imipenem and Vancomycin. Co-trimoxazole was the most common drug used for treatment with a mean drug respond time of (mean+/-S.D) of 2.21+/-.78 days. 2+/-. Children who had recurrent UTI were more prone to develop culture positive UTI (p=0.0001). Urinary Tract Infection in female was almost twice more common than in male. Cotrimoxazole was the most common drug used for treatment, sensitivity of this drug was less than 50% for

  20. Diagnosis of Helicobacter pylori infection

    International Nuclear Information System (INIS)

    Nysaeter, G.; Berstad, K.; Weberg, R.; Berstad, A.; Hardardottir, H.

    1992-01-01

    By employing the 14 C-urea breath test as the reference methods the authors determined the specificity and sensitivity of three bioptic methods for diagnosis of Helicobacter pylori infection in 103 subjects. All biopsy specimens were obtained from the gastric antrum. For culture the specificity was 100%. Its applicability was reduced, however, by a low sensitivity (73.8%) and a delay of several days before the final result was available. Microscopy of Loeffler-stained biopsy smears yielded a specificity of 100% and a sensitivity of 92.9%, but the method was regarded time-consuming. The rapid urease test yielded a specificity of 98.4% and a sensitivity of 85.7%. Being quick, simple and inexpensive, the rapid urease test is well suited for routine use in gastroscopy. 17 refs., 4 tabs

  1. The investigation of urinary tract infections in children

    International Nuclear Information System (INIS)

    Carty, H.; Rangr, P.

    2002-01-01

    This article outlines the role and methods used in the investigation of urinary tract infections in children. Each modality, whether it has been used in the past or begin used currently or in the future, has been discussed, together with its advantages and pitfalls. There are no hard and fast rules in the investigation of urinary tract infections. It really depends on the clinical scenario and the child. This article will hopefully provide a basis of understanding the reasons behind each investigation and their appropriate use in the child depending on their age and clinical history. (author)

  2. Cranberries for preventing urinary tract infections

    Directory of Open Access Journals (Sweden)

    Ruth G. Jepson

    Full Text Available BACKGROUND: Cranberries have been used widely for several decades for the prevention and treatment of urinary tract infections (UTIs. This is the third update of our review first published in 1998 and updated in 2004 and 2008. OBJECTIVES: To assess the effectiveness of cranberry products in preventing UTIs in susceptible populations. METHODS: Search methods: We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL in The Cochrane Library and the Internet. We contacted companies involved with the promotion and distribution of cranberry preparations and checked reference lists of review articles and relevant studies. Date of search: July 2012. Selection criteria: All randomised controlled trials (RCTs or quasi-RCTs of cranberry products for the prevention of UTIs. Data collection and analysis: Two authors independently assessed and extracted data. Information was collected on methods, participants, interventions and outcomes (incidence of symptomatic UTIs, positive culture results, side effects, adherence to therapy. Risk ratios (RR were calculated where appropriate, otherwise a narrative synthesis was undertaken. Quality was assessed using the Cochrane risk of bias assessment tool. MAIN RESULTS: This updated review includes a total of 24 studies (six cross-over studies, 11 parallel group studies with two arms; five with three arms, and two studies with a factorial design with a total of 4473 participants. Ten studies were included in the 2008 update, and 14 studies have been added to this update. Thirteen studies (2380 participants evaluated only cranberry juice/concentrate; nine studies (1032 participants evaluated only cranberry tablets/capsules; one study compared cranberry juice and tablets; and one study compared cranberry capsules and tablets. The comparison/control arms were placebo, no treatment, water, methenamine hippurate, antibiotics, or lactobacillus. Eleven studies were not included in the meta

  3. Postpartum urinary tract infection by mode of delivery: a Danish nationwide cohort study.

    Science.gov (United States)

    Gundersen, Tina Djernis; Krebs, Lone; Loekkegaard, Ellen Christine Leth; Rasmussen, Steen Christian; Glavind, Julie; Clausen, Tine Dalsgaard

    2018-03-14

    To examine the association between postpartum urinary tract infection and intended mode of delivery as well as actual mode of delivery. Retrospective cohort study. All live births in Denmark between 2004 and 2010 (n=450 856). Births were classified by intended caesarean delivery (n=45 053) or intended vaginal delivery (n=405 803), and by actual mode of delivery: spontaneous vaginal delivery, operative vaginal delivery, emergency or planned caesarean delivery in labour or prelabour. The primary outcome measure was postpartum urinary tract infection (n=16 295) within 30 days post partum, defined as either a diagnosis of urinary tract infection in the National Patient Registry or redemption of urinary tract infection-specific antibiotics recorded in the Register of Medicinal Product Statistics. We found that 4.6% of women with intended caesarean delivery and 3.5% of women with intended vaginal delivery were treated for postpartum urinary tract infection.Women with intended caesarean delivery had a significantly increased risk of postpartum urinary tract infection compared with women with intended vaginal delivery (OR 1.33, 95% CI 1.27 to 1.40), after adjustment for age at delivery, smoking, body mass index, educational level, gestational diabetes mellitus, infection during pregnancy, birth weight, preterm delivery, preterm prelabour rupture of membranes, pre-eclampsia, parity and previous caesarean delivery (adjusted OR 1.24, 95% CI 1.17 to 1.46).Using actual mode of delivery as exposure, all types of operative delivery had an equally increased risk of postpartum urinary tract infection compared with spontaneous vaginal delivery. Compared with intended vaginal delivery, intended caesarean delivery was significantly associated with a higher risk of postpartum urinary tract infection. Future studies should focus on reducing routine catheterisation prior to operative vaginal delivery as well as improving procedures related to catheterisation. © Article author

  4. Improving the prescribing of antibiotics for urinary tract infection.

    Science.gov (United States)

    Peterson, G M; Stanton, L A; Bergin, J K; Chapman, G A

    1997-04-01

    In recent years there have been changes in the recommended antibiotic treatment for urinary tract infections (UTIs). In particular, the use of amoxycillin or co-trimoxazole is now discouraged, with amoxycillin-potassium clavulanate, cephalexin and trimethoprim becoming first-line agents for uncomplicated lower UTIs. To examine whether academic detailing, performed by a pharmacist, could modify prescribing practices for antibiotics used in the treatment of UTI in the community setting. The intervention was conducted in Southern Tasmania, using the remainder of the State as a control area. The target group of general practitioners was sent educational material designed to assist in the appropriate prescribing of antibiotics in the treatment of UTI. A pharmacist then visited each general practitioner and discussed the rational use of antibiotics for UTIs directly with him/her. Outcomes were measured using evaluation feedback from the general practitioners and pharmacoepidemiological data, which were not linked to diagnosis. The key variable examined was the total defined daily doses (DDDs) dispensed for the recommended first-line agents (amoxycillin-potassium clavulanate, cephalexin and trimethoprim) compared with amoxycillin (3 g single-dose form) and co-trimoxazole. The educational programme was very well received by the general practitioners. Changes in the prescribing of antibiotics commonly used for UTIs were evident in both study regions over the course of the study, but the improvements were significantly greater in the intervention area. Educational programmes utilizing academic detailing by pharmacists can modify prescribing practices within the community setting.

  5. Reliability of dipstick assay in predicting urinary tract infection

    Directory of Open Access Journals (Sweden)

    Anith Kumar Mambatta

    2015-01-01

    Full Text Available Aims: Urine dipstick analysis is a quick, cheap and a useful test in predicting Urinary Tract Infection (UTI in hospitalized patients. Our aim is to evaluate the reliability (sensitivity of urine dipstick analysis against urine culture in the diagnosis of UTI. Materials and Methods: Patients admitted to our hospital suspected of having UTI, with positive urine cultures were included in this study from a 2-year period (January 2011 to December 2012. Dipstick urinalysis was done using multistix 10 SG (Siemens and clinitek advantus analyzer. The sensitivity of dipstick nitrites, leukocyte esterase and blood in these culture-positive UTI patients was calculated retrospectively. Results: Urine dipstick analysis of 635 urine culture-positive patients was studied. The sensitivity of nitrite alone and leukocyte esterase alone were 23.31% and 48.5%, respectively. The sensitivity of blood alone in positive urine culture was 63.94%, which was the highest sensitivity for a single screening test. The presence of leukocyte esterase and/or blood increased the sensitivity to 72.28%. The sensitivity was found to be the highest when nitrite, leukocyte and blood were considered together. Conclusions: Nitrite test and leukocyte esterase test when used individually is not reliable to rule out UTI. Hence, symptomatic UTI patients with negative dipstick assay should be subjected to urine culture for a proper management.

  6. Importance of sonography in the evaluation of urinary tract infections in children

    International Nuclear Information System (INIS)

    Zocchi, M.; Ferrero, C.G.

    1988-01-01

    One undred and twenty-one children with a clinical diagnosis of urinary tract infection (UTI) were examined with sonography (US), ivp and voiding cystouretrography (VCUG). In 84 patients neither US nor radiography findings were found of pathological findings both US and ivp were negative, whereas VCUG was decisive for a correct diagnosis. VCUG demonstrated vesicouretericreflux in 10 patients, posterior urotheral valves in 1 patient, and small diverticula of the urinary bladder in 5 patients. In 17 of the remaining 21 cases, there was agreementbetween US and urographic findings, whereas in 4 cases US provided us with false positives, with images of apparent renal scarring. the mistake was caused by an incorrect US detection of unilateral duplication of the collecting systems. The authors conclude by stressing the importance of ivp in the evaluetion of urinary tract infections in children, even in case of negative VCUG and US results, and suggest comparing US measurements comparable to body growth

  7. Kidney and Urinary Tract Congenital Malformations. Diagnosis and Evolution. 1999- 2005

    International Nuclear Information System (INIS)

    Aguilera Bauza, Mirna Pilar; Pena Perez, Raul; Ramirez Prieto, Juan Romelio; Martinez Feria, Rafael; Parra Cruz, Mariela; Pena Hernandez, Miguel Antonio

    2008-01-01

    A descriptive study in 351 patients at the Nephrology and Urology Services at 'Octavio de la Concepcion de la Pedraja' Teaching Pediatric Hospital from January 1999 to December 2005, was carried out. 535 kidney and urinary tract congenital malformations of 19 types were diagnosed. Primary vesicoureteral reflux and ureteropyelic stenosis were the most frequently malformations. The majority of these patients were diagnosed during the first year of the life. The most frequently clinic manifestation was urinary tract infection. Ultrasound study and cystouretrography were effective to diagnose these malformations. The majority of patients with prenatal diagnosis had congenital hydronephrosis. Posterior urethral valves were the principal cause of chronic renal failure. The I, II and III grades of Primary Vesicoureteral Reflux disappeared spontaneously with conservative treatment. There was a direct relationship between Reflux Nephropathy and the grade of these malformations

  8. In vitro activity of vaccinium macrocarpon (cranberry) on urinary tract pathogens in uncomplicated urinary tract infection

    International Nuclear Information System (INIS)

    Bukhari, S.; Tariq, S.; Alam, M.A.; Chiragh, S.; Wazir, M.S.; Suleman, M.

    2015-01-01

    Background: Urinary tract infection is the most common bacterial infection in the community, mainly caused by Escherichia coli (E coli). Due to its high incidence and recurrence, problems are faced in the treatment with antibiotics. Cranberry being herbal remedy have long been the focus of interest for their beneficial effects in preventing urinary tract infections. This study was conducted to analyse in vitro activity of cranberry (Vaccinium macrocarpon) on uropathogenic E coli in uncomplicated urinary tract infections. Method: In this laboratory based single group experimental study, anti-bacterial activity of Vaccinium macrocarpon concentrate on urinary tract E coli was investigated, in vitro. Ninety-six culture positive cases of different uropathogens were identified. Vaccinium macrocarpon concentrate at different concentrations was prepared in distilled water and put in wells punched in nutrient agar. E coli isolates were inoculated on the plates and incubated at 37 Degree C for 24 hours. A citric acid solution of the same pH as that of Vaccinium macrocarpon was used and put in a well on the same plate to exclude the effect of pH. Results: A total of 35 isolates of E coli were identified out of 96 culture positive specimens of urine and found sensitive to Vaccinium macrocarpon (p<0.000). Results revealed that Vaccinium macrocarpon has antibacterial effect against E coli. Furthermore the antibacterial activity of Vaccinium macrocarpon has dose response relationship. Acidic nature of Vaccinium macrocarpon due to its pH is not contributory towards its antibacterial effect. Conclusion: Vaccinium macrocarpon concentrate may be used in urinary tract infection caused by E coli. (author)

  9. The effectiveness of systematic perioperative oral hygiene in reduction of postoperative respiratory tract infections after elective thoracic surgery in adults

    DEFF Research Database (Denmark)

    Pedersen, Preben Ulrich; Larsen, Palle; Håkonsen, Sasja Jul

    2016-01-01

    to increase patients' risk for nosocomial respiratory tract infection. OBJECTIVES: To identify, appraise and synthesize the best available evidence on the effectiveness of systematic perioperative oral hygiene in the reduction of postoperative respiratory airway infections in adult patients undergoing...... elective thoracic surgery. INCLUSION CRITERIA: Patients over the age of 18 years who had been admitted for elective thoracic surgery, regardless of gender, ethnicity, diagnosis severity, co-morbidity or previous treatment.Perioperative systematic oral hygiene (such as mechanical removal of dental biofilm......% confidence interval [CI] 0.55-0.78) for respiratory tract infections RR 0.48 (95%CI: 0.36-0.65) and for deep surgical site infections RR 0.48 (95%CI 0.27-0.84). CONCLUSIONS: Systematic perioperative oral hygiene reduces postoperative nosocomial, lower respiratory tract infections and surgical site infections...

  10. Antimicrobial Resistance of Breakthrough-Urinary Tract Infections in Children under Antimicrobial Prophylaxis

    OpenAIRE

    Nomura, Toshihito; Hisata, Ken; Toyama, Yudai; Sakaguchi, Keita; Igarashi, Naru; Nakao, Akihiro; Matsunaga, Nobuaki; Komatsu, Mitsutaka; Obinata, Kaoru; Shimizu, Toshiaki

    2017-01-01

    Antimicrobial prophylaxis using cefaclor or trimethoprim-sulfamethoxazole (co-trimoxazole) is recommended for children with vesicoureteral reflex (VUR) to prevent recurrent urinary tract infection (UTI). This retrospective study was performed by reviewing the data of children ≥5 years of age treated for recurrent UTI in six hospitals from 2010 to 2015. The criteria for UTI diagnosis is fever (≥38°C) and positive results in urine culture (>104 colony-forming units/ml in midstream or withdrawn ...

  11. Urinary tract infection among pregnant women at a secondary level hospital in Northern India

    OpenAIRE

    Shashi Kant; Ayush Lohiya; Arti Kapil; Sanjeev Kumar Gupta

    2017-01-01

    Background: Urinary tract infection (UTI) during pregnancy is frequently associated with complications. Currently, in India, there is no regular screening for UTI, and facility for diagnosis of UTI is not available at peripheral government health centers. Objective: To estimate the proportion of pregnant women with UTI among antenatal clinic attendees in rural Haryana. Methods: Eligible participants were pregnant women attending antenatal clinic of secondary care center of rural Haryana from ...

  12. New paradigms of urinary tract infections: Implications for patient management

    Directory of Open Access Journals (Sweden)

    Dennis J Horvath

    2012-01-01

    Full Text Available Urinary tract infections (UTIs represent one of the most commonly acquired diseases among the general population as well as hospital in-patients, yet remain difficult to effectively and consistently treat. High rates of recurrence, anatomic abnormalities, and functional disturbances of the urinary tract all contribute to the difficulty in management of these infections. However, recent advances reveal important molecular and genetic factors that contribute to bacterial invasion and persistence in the urinary tract, particularly for the most common causative agent, uropathogenic Escherichia coli. Recent studies using animal models of experimental UTIs have recently provided mechanistic insight into the clinical observations that question the effectiveness of antibiotic therapy in treatment. Ultimately, continuing research will be necessary to identify the best targets for effective treatment of this costly and widespread infectious disease.

  13. Distal Ureteral Diameter Ratio is Predictive of Breakthrough Febrile Urinary Tract Infection.

    Science.gov (United States)

    Arlen, Angela M; Leong, Traci; Guidos, P Joseph; Alexander, Siobhan E; Cooper, Christopher S

    2017-12-01

    Distal ureteral diameter ratio is an objective measure that is prognostic of spontaneous resolution of vesicoureteral reflux. Along with likelihood of resolution, improved identification of children at risk for recurrent febrile urinary tract infections may impact management decisions. We evaluated the usefulness of ureteral diameter ratio as a predictive factor for breakthrough febrile urinary tract infections. Children with primary vesicoureteral reflux and detailed voiding cystourethrogram were identified. Ureteral diameter ratio was computed by measuring largest ureteral diameter within the pelvis and dividing by the distance between L1 and L3 vertebral bodies. Demographics, vesicoureteral reflux grade, laterality, presence/absence of bladder-bowel dysfunction, and ureteral diameter ratio were tested in univariate and multivariable analyses. Primary outcome was breakthrough febrile urinary tract infections. We analyzed 112 girls and 28 boys with a mean ± SD age of 2.5 ± 2.3 years at diagnosis. Vesicoureteral reflux was grade 1 to 2 in 64 patients (45.7%), grade 3 in 50 (35.7%), grade 4 in 16 (11.4%) and grade 5 in 10 (7.2%). Mean ± SD followup was 3.2 ± 2.7 years. A total of 40 children (28.6%) experienced breakthrough febrile urinary tract infections. Ureteral diameter ratio was significantly greater in children with (0.36) vs without (0.25) breakthrough febrile infections (p = 0.004). Controlling for vesicoureteral reflux grade, every 0.1 U increase in ureteral diameter ratio resulted in 1.7 times increased odds of breakthrough infection (95% CI 1.24 to 2.26, p urinary tract infections independent of reflux grade. Ureteral diameter ratio provides valuable prognostic information about risk of recurrent pyelonephritis and may assist with clinical decision-making. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  14. Paediatric Urinary Tract Infection: A Hospital Based Experience

    Science.gov (United States)

    Wani, Khursheed Ahmed; Bhat, Javaid Ahmed; Parry, Nazir Ahmed; Shaheen, Lubna; Bhat, Sartaj Ali

    2016-01-01

    Introduction Paediatric Urinary Tract Infection (UTI) is one of the commonly encountered entities by paediatricians. Studies have shown easy vulnerability of paediatric urinary tract in any acute febrile illness and a miss in diagnosis could have long term consequences like renal scaring with its adverse effects. Bearing these evidence based preludes in view we designed our study to know the prevalence of UTI in Kashmir province. Aim Aim of the present study was to know the prevalence of UTI in febrile children and to know the sensitivity of different imaging modalities like Renal and Urinary Bladder Ultrasonography (RUS), Voiding Cystourethrography (VCUG) and Dimercaptosuccinic Acid (DMSA) scan in diagnosing UTI. Materials and Methods A total of 304 patients, between 2 months to 10 years, with axillary temperature of ≥ 100.4oF (38oC), who did not have a definite source for their fever and who were not on antibiotics were included in the study. Detailed history and through clinical examination was done to rule out any potential or definite focus of infection as per the predesigned proforma. Routine urine examination with culture and sensitivity, followed by RUS and VCUG was done in all patients where routine urine examination was suggestive of UTI. DMSA was done in only culture proven cases after 6 months to document the renal scarring. Results Out of 304 children, 140 were males and 164 were females, UTI was present in 40 patients who had fever without any apparent cause giving a prevalence of 13.2%. Escherichia coli (E. coli) were the commonest isolated organism, followed by Klebsiella and Citrobacter species. Renal and Urinary Bladder Ultrasonography (RUS) detected Vesicoureteral Reflux (VUR) in 25% (10/40) while VCUG showed VUR in 55% (22/40) giving a RUS sensitivity of 45% for detecting VUR. DMSA done only after 6 months in UTI diagnosed patients showed a renal scarring in 25% (10/40) patients. Conclusion Missing a febrile paediatric UTI, can prove a future

  15. Novel Approaches to Preventing Urinary Tract Infection in Women

    Science.gov (United States)

    2001-09-01

    vaccines . In: Mobley HLT. 54. Johnson JR. Steil A. Delavari P. Canine feces as a reservoir ofextraintestinal Warren 1W, eds. Urinary tract infections...the material was subjected to analysis by Triple quadrupole ESI-MS/CID-MS experiments were electrospray ionization mass spectrometry in the positive ion...prophylaxis. Characteristic of prophylactic regimens development of vaccines against these infections, containing nitrofurantoin is the frequency of side

  16. Comparative study of reproductive tract infections of female sex ...

    African Journals Online (AJOL)

    Background: Reproductive tract infections (RTIs) have become international public health problem. Aim: We assessed the RTIs. A community-based study was carried out among female sex workers (FSWs), gynecology clinic patients and general population in Suzhou, China to investigate the major pathogens of RTIs and ...

  17. Prophylactic ciprofloxacin for catheter-associated urinary-tract infection

    NARCIS (Netherlands)

    Wall, E. van der; Verkooyen, R.P.; Mintjes-de Groot, J.; Oostinga, J.; Dijk, Arie van; Hustinx, W.N.M.; Verbrugh, H.A.

    1992-01-01

    Patients receiving antibiotics during bladder drainage have a lower incidence of urinary-tract infections compared with similar patients not on antibiotics. However, antibiotic prophylaxis in patients with a urinary catheter is opposed because of the fear of inducing resistant bacterial strains. We

  18. Cranberry juice for urinary tract infection in children

    OpenAIRE

    Goldman, Ran D.

    2012-01-01

    Question Several children in my clinic are recovering from urinary tract infections (UTI). A mother of one of the children asked me if I recommended cranberry juice for children to prevent future episodes of UTI. She was given cranberry juice after she suffered from a UTI several months ago.

  19. Management of childhood urinary tract infections: an economic modeling study.

    NARCIS (Netherlands)

    Harmsen, M.; Adang, E.M.M.; Wolters, R.J.; Wouden, J.C. van der; Grol, R.P.T.M.; Wensing, M.J.P.

    2009-01-01

    Childhood urinary tract infections (UTIs) can lead to renal scarring and ultimately to terminal renal failure, which has a high impact on quality of life, survival, and health-care costs. Variation in the treatment of UTIs between practices is high. OBJECTIVE: To assess the cost-effectiveness of a

  20. Management of Urinary Tract Infections in Children | Schellack ...

    African Journals Online (AJOL)

    Urinary Tract Infections (UTIs) are a common occurrence in paediatrics. UTIs present in children as fever, anorexia, vomiting, lethargy and dysuria. Approximately 80% of the time, Escherichia coli is the causative bacteria in paediatrics, however, fungal UTI caused by Candida species can occur in premature infants. With an ...

  1. Upper respiratory tract infection, heterologous immunisation and meningococcal disease

    NARCIS (Netherlands)

    Scholten, R. J.; Bijlmer, H. A.; Tobi, H.; Dankert, J.; Bouter, L. M.

    1999-01-01

    To test the hypothesis that an episode of upper respiratory tract infection or heterologous immunisation is a predisposing factor for the occurrence of meningococcal disease, data from 377 cases of meningococcal disease and their household contacts (n = 1124) were analysed by conditional logistic

  2. Interventions for preventing recurrent urinary tract infection during pregnancy

    NARCIS (Netherlands)

    Schneeberger, Caroline; Geerlings, Suzanne E.; Middleton, Philippa; Crowther, Caroline A.

    2015-01-01

    Recurrent urinary tract infections (RUTI) are common in women who are pregnant and may cause serious adverse pregnancy outcomes for both mother and child including preterm birth and small-for-gestational-age babies. Interventions used to prevent RUTI in women who are pregnant can be pharmacological

  3. Interventions for preventing recurrent urinary tract infection during pregnancy

    NARCIS (Netherlands)

    Schneeberger, Caroline; Geerlings, Suzanne E.; Middleton, Philippa; Crowther, Caroline A.

    2015-01-01

    Background Recurrent urinary tract infections (RUTI) are common in women who are pregnant and may cause serious adverse pregnancy outcomes for both mother and child including preterm birth and small-for-gestational-age babies. Interventions used to prevent RUTI in women who are pregnant can be

  4. Interventions for preventing recurrent urinary tract infection during pregnancy

    NARCIS (Netherlands)

    Schneeberger, Caroline; Geerlings, Suzanne E.; Middleton, Philippa; Crowther, Caroline A.

    2012-01-01

    Background Recurrent urinary tract infections (RUTI) are common in women who are pregnant and may cause serious adverse pregnancy outcomes for both mother and child including preterm birth and small-for-gestational-age babies. Interventions used to prevent RUTI in women who are pregnant can be

  5. Bacterial aetiology in lower respiratory tract infections : Relevance in outpatients

    NARCIS (Netherlands)

    Teepe, J.

    2017-01-01

    Lower respiratory tract infection (LRTI) is one of the leading reasons for consulting in primary care. Today, a general practitioner faces the challenge of distinguishing between patients with a mild self-limiting disease to whom antibiotics would do more harm than good and those who would benefit

  6. Management of non-catheter-associated complicated urinary tract infection.

    Science.gov (United States)

    Dielubanza, Elodi J; Mazur, Daniel J; Schaeffer, Anthony J

    2014-03-01

    This article presents an overview of non-catheter-associated complicated urinary tract infection (UTI) from a urologic point of view. Discussion includes the evaluation and workup a complicated UTI through history, physical examination, laboratory analysis, and radiographic studies. Specific types of complicated UTI, such as urinary obstruction and renal abscess, are reviewed. Copyright © 2014 Elsevier Inc. All rights reserved.

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    The virulence determinants of uropathogenic Escherichia coli have been studied extensively over the years, but relatively little is known about what differentiates isolates causing various types of urinary tract infections. In this study, we compared the genomic profiles of 45 strains from a range...

  8. Diagnostic strategies for urinary tract infections in French general practice.

    Science.gov (United States)

    Kinouani, S; de Lary de Latour, H; Joseph, J-P; Letrilliart, L

    2017-10-01

    We aimed to describe the diagnostic management procedures for detection of urinary tract infections in general practice and their correlated factors. We analyzed data from the ECOGEN study on urinary tract infections, collected in France between November 2011 and April 2012. This national cross-sectional study was carried out in general practices. Data was coded according to the International Classification of Primary Care. A total of 340 consultations or home visits were held for urinary tract infections. The five most frequent diagnostic procedures were (in descending order) clinical examination (67.6%), urine cytobacteriological examination (UCBE) (47.9%), urine dipstick test (15.6%), blood test (8.5%), and imaging (6.5%). No urine dipstick test or UCBE was performed in 43% of cases. Factors correlated with diagnostic procedures were age and gender of patients, annual number of consultations held by family physicians, and duration of consultation. Family physicians did not comply with guidelines on diagnostic management for detection of urinary tract infections. We hypothesized that this non-compliance could be due to the family physicians' environment and characteristics, and to clinical practice guidelines. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  9. Evaluation of parental perception of childhood urinary tract infection ...

    African Journals Online (AJOL)

    Background: Urinary tract infection (UTI) is common in children with possible severe complications, deserving public health interventions. Aims: To evaluate parental perception of symptoms, causes, complication and treatment of childhood UTI, and proposerelevant interventions. Methods: This is an ethicallyapproved ...

  10. Antimicrobial resistance patterns in outpatient urinary tract infections ...

    African Journals Online (AJOL)

    Background. There is a global emergence of resistance against commonly prescribed antibiotics. Empirical antibiotic prescribing should be guided by local antimicrobial susceptibility patterns. Aim. To identify organisms and determine antibiotic susceptibility in urinary tract infections (UTIs) at 3 Military Hospital, Bloemfontein ...

  11. Resistance of Uropathogens in Asymptomatic Urinary Tract Infection ...

    African Journals Online (AJOL)

    Worldwide the surveillance of antimicrobial resistance among urinary tract pathogens is useful to determine the important trend and geographical variation of uropathogens. The study evaluated the pathogen frequency, resistance rate and pattern among HIV-infected Nigerians. Midstream urine samples taken for culture ...

  12. Evaluation of female residents for urinary tract infections, Onicha ...

    African Journals Online (AJOL)

    Cases of urinary tract infections (UTIs) have been on the increase in our society, posing a threat to health causing economic and social burden on the populace especially among women and girls. This study was therefore carried out to assess the prevalence of UTIs among female residents of Igboeze-Onicha Community in ...

  13. Predictors of Urinary Tract Infections in Nursing Students in India

    African Journals Online (AJOL)

    Dear Sir,. I read with a lot of interest, the original research paper by Vyas et al.[1] This paper tried to find out the clinical, demographic and social causes predisposing nursing students to urinary tract infections (UTI). The study has revealed the prevalence rate of UTI as >19%. The authors have mentioned that the subjects ...

  14. a seven months retrospective study on urinary tract infection among

    African Journals Online (AJOL)

    DR. AMINU

    ABSTRACT. Urinary Tract Infection (UTI) is a significant health problem world wide, affecting all ages and both sexes. It is the most common infectious complication associated with serious risk in pregnancy and responsible for a high rate of morbidity in neonates and children. Most often antibiotics are prescribed in UTI ...

  15. Metabolomics of urinary tract infection : a multiplatform approach

    NARCIS (Netherlands)

    Pacchiarotta, Tiziana

    2014-01-01

    Urinary tract infection is a complex clinical entity a common infectious disease that encompasses a variety of clinical syndromes with a positive bacterial culture as common denominator. This thesis provides an exhaustive exploratory study of the metabolic pattern of patients affected by urinary

  16. Occurrence of Urinary Tract Infection in Adolescent and Adult ...

    African Journals Online (AJOL)

    Background: Urinary tract infection (UTI) is commonly experienced by women of various age groups especially elderly ones. We planned to find out the prevalent microbial strains causing UTI in slum inhabitant adolescent and adult women in Dhaka City, Bangladesh. Methods amd Materials: Urine sample was collected ...

  17. Factors associated with community-acquired urinary tract infections ...

    African Journals Online (AJOL)

    Background: Urinary tract infections (UTI) are a common medical problem affecting the general population and thus commonly encountered in medical practice, with the global burden of UTIs at about 150 million people. Because uropathogens largely originate from colonic flora, they are easy to predict, and this is the ...

  18. Urinary Tract Infection Caused by a Capnophilic Proteus mirabilis Strain

    NARCIS (Netherlands)

    Trapman, M.; Ingen, J. van; Keijman, J.; Swanink, C.M.A.

    2015-01-01

    From a urine sample from a patient with a urinary tract infection, a carbon dioxide-dependent Proteus mirabilis strain was isolated. It is important to perform urine cultures in 5% carbon dioxide and an anaerobic atmosphere if bacteria prominent in Gram stains do not grow on routine media in ambient

  19. Antibiotic Resistance in Urinary Tract Infections in College Students

    Science.gov (United States)

    Olson, Ronald P.; Haith, Karen

    2012-01-01

    Objective: To determine resistance to antibiotics of "Escherichia coli" in uncomplicated urinary tract infections (uUTIs) in female college students. Participants: Symptomatic patients presenting to a student health service from September 2008 to December 2009. Methods: Clean catch midstream urine samples were tested for urinalysis (UA) and…

  20. Improving antibiotic use for complicated urinary tract infections

    NARCIS (Netherlands)

    Spoorenberg, V.

    2014-01-01

    Guidelines for antimicrobial treatment are important in the process of improving antibiotic use, because they describe appropriate antibiotic use. In this thesis, we demonstrated the value of appropriate antibiotic use (i.e. guideline adherence) in patients with a complicated urinary tract infection

  1. Pediatric Urinary Tract Infection as a Cause of Outpatient Clinic ...

    African Journals Online (AJOL)

    2018-03-01

    Mar 1, 2018 ... predictors of Urinary Tract Infection (UTI) as a cause of pediatric outpatient department ... with pediatric UTI (1,4,5). Effective management of patients suffering ..... patients. J of. Resear in Medical and Dental Sci 2014; 2(1). 17.

  2. Effect of pravastatin and fosinopril on recurrent urinary tract infections

    NARCIS (Netherlands)

    Pouwels, K.B.; Visser, Sipke; Hak, E.

    OBJECTIVES: Recurrent urinary tract infections (UTIs) are a problem affecting both women and men. Animal experiments and in vitro studies indicate that statins might prevent recurrent UTIs. We assessed the effects of pravastatin on UTI antibiotic prescribing among adults. METHODS: A post hoc

  3. Urinary Tract Infection in Children: Etiological Structure, Age and Gender Characteristics

    Directory of Open Access Journals (Sweden)

    V.V. Bezruk

    2015-10-01

    Full Text Available Objective. To study the etiological structure of urinary tract infections, dynamics, gender and age dependence in the child population of Chernivtsi region. Patients and methods. During 2009–2013 2432 urine samples of the children treated in health care centers of Chernivtss region were investigated by bacteriological method with purpose of verification of the diagnosis urinary tract infections. Six hundred and fifty five strains of bacteria and fungi were isolated as etiological agents. Results. The patient’s gender was found to correlate with etiological structure of the urinary tract infections and the content of the residential urine microflora. The main etiological role of the Enterobacteriaceae family in general was demonstrated. As a causative agent of the urinary tract infection E.coli has been isolated more frequently in the urine samples of female patients (р < 0.05. In contrary, Proteus spp. has been isolated in male patients (р < 0.01. As a part of the urine resident microflora E.coli strains were more frequently isolated in the female urine samples (р < 0.05. Conclusion. The research will allow to hold the correct and reasoned medical and rehabilitation events on all stages of rendering of specialized medical care for children and to develop the programs directed on the improvement of indicators of health and prevention of disability in children.

  4. Update on the approach of urinary tract infection in childhood

    Directory of Open Access Journals (Sweden)

    Ana Cristina Simões e Silva

    2015-11-01

    Full Text Available Objective: Urinary tract infection (UTI is the most common bacterial infection in childhood. UTI may be the sentinel event for underlying renal abnormality. There are still many controversies regarding proper management of UTI. In this review article, the authors discuss recent recommendations for the diagnosis, treatment, prophylaxis, and imaging of UTI in childhood based on evidence, and when this is lacking, based on expert consensus. Sources: Data were obtained after a review of the literature and a search of Pubmed, Embase, Scopus, and Scielo. Summary of the findings: In the first year of life, UTIs are more common in boys (3.7% than in girls (2%. Signs and symptoms of UTI are very nonspecific, especially in neonates and during childhood; in many cases, fever is the only symptom. Conclusions: Clinical history and physical examination may suggest UTI, but confirmation should be made by urine culture, which must be performed before any antimicrobial agent is given. During childhood, the proper collection of urine is essential to avoid false-positive results. Prompt diagnosis and initiation of treatment is important to prevent long-term renal scarring. Febrile infants with UTIs should undergo renal and bladder ultrasonography. Intravenous antibacterial agents are recommended for neonates and young infants. The authors also advise exclusion of obstructive uropathies as soon as possible and later vesicoureteral reflux, if indicated. Prophylaxis should be considered for cases of high susceptibility to UTI and high risk of renal damage. Resumo: Objetivo: A infecção do trato urinário (ITU é a infecção bacteriana mais comum na infância. A ITU pode ser o evento sentinela para alteração renal subjacente. Ainda há muitas controvérsias com relação ao tratamento adequado da ITU. Neste artigo de revisão, discutimos as últimas recomendações para diagnóstico, tratamento, profilaxia e imagiologia da ITU na infância, com base em comprova

  5. Treatments for symptomatic urinary tract infections during pregnancy.

    Science.gov (United States)

    Vazquez, Juan C; Abalos, Edgardo

    2011-01-19

    Urinary tract infections, including pyelonephritis, are serious complications that may lead to significant maternal and neonatal morbidity and mortality. There is a large number of drugs, and combination of them, available to treat urinary tract infections, most of them tested in non-pregnant women. Attempts to define the optimal antibiotic regimen for pregnancy have, therefore, been problematic. The objective of this review was to determine, from the best available evidence from randomised controlled trials, which agent is the most effective for the treatment of symptomatic urinary tract infections during pregnancy in terms of cure rates, recurrent infection, incidence of preterm delivery and premature rupture of membranes, admission to neonatal intensive care unit, need for change of antibiotic, and incidence of prolonged pyrexia. We searched the Cochrane Pregnancy and Childbirth Group Trials Register (November 2009) and reference lists of articles. We considered all trials where the intention was to allocate participants randomly to one of at least two alternative treatments for any symptomatic urinary tract infection. Both review authors assessed trial quality and extracted data. We included 10 studies, recruiting a total of 1125 pregnant women. In most of the comparisons there were no significant differences between the treatments under study with regard to cure rates, recurrent infection, incidence of preterm delivery, admission to neonatal intensive care unit, need for change of antibiotic and incidence of prolonged pyrexia. When cefuroxime and cephradine were compared, there were better cure rates (29/49 versus 41/52) and fewer recurrences (20/49 versus 11/52) in the cefuroxime group. There was only one other statistically significant difference when comparing outpatient versus inpatient treatment. Gestational age at birth was greater in women from the outpatient group (38.86 versus 37.21), while birthweight was on average greater in the inpatient group

  6. Evaluation of maternal urinary tract infection as a potential risk factor for neonatal urinary tract infection.

    Science.gov (United States)

    Khalesi, Nasrin; Khosravi, Nastaran; Jalali, Ali; Amini, Leila

    2014-06-01

    To assess the relationship between maternal UTI during pregnancy and neonatal UTI. This cross-sectional study included eighty neonates referred to Ali-e-Asghar Hospital, Tehran, Iran, in 2011. The participants were divided into the study (with diagnosis of UTI; n = 40) and the control (without this type of infection; n = 40) groups. The mothers were asked about the history of UTI during pregnancy, and if the response was positive, the trimester in which UTI had occurred. Urinalysis and urine culture were carried out for all neonates. Overall, 14.9% of neonates had mothers with a positive history of UTI during their pregnancy (4.4%, 6.1%, and 4.4% during the 1(st), 2(nd), and 3(rd) trimesters, respectively). A significant relationship was detected between the occurrence of UTI in neonates and maternal UTI, so that the overall prevalence of UTI among neonates of affected mothers was significantly higher than that observed among non-infected mothers (30.0% versus 6.8%; p = 0.001). Maternal UTI resulted in 5.9-fold increased risk of neonatal UTI. In UTI group, the most common bacterial etiologies of UTI were Escherichia coli (65.9%), followed by Klebsiella (14.6%) and Staphylococci (9.8%). Our findings confirmed the association between the history of UTI in mother and occurrence of UTI in neonate, emphasizing to pay more attention for assessing and managing UTI in neonates in order to reduce the related complications.

  7. Significance of Moraxella catarrhalis as a causative organism of lower respiratory tract infections

    Directory of Open Access Journals (Sweden)

    M.O. Ramadan

    2017-07-01

    Conclusion: This study shows that when microbiological and clinical criteria are met, M. catarrhalis when isolated should be considered as a pathogen causing lower respiratory tract infections. M. catarrhalis, lower respiratory tract infections.

  8. Urinary tract infections during pregnancy - an updated overview.

    Science.gov (United States)

    Szweda, Hanna; Jóźwik, Marcin

    Urinary tract infections (UTIs) are the most common type of infection during pregnancy, affecting up to 10% of pregnant women. They are also recognized as the second most common ailment of pregnancy, after anemia. Three clinical types of pregnancy-related UTI are distinguished: asymptomatic bacteriuria (ASB), cystitis, and pyelonephritis. A particular form of ASB is the presence of Group B streptococci in the urinary tract of the pregnant woman. All clinical types of UTI may lead to serious maternal and fetal complications. Therefore, unlike in the nonpregnant female patient, all UTIs during pregnancy, including the asymptomatic infection, require treatment. In some patients, antibiotic prophylaxis should also be introduced. In the present work, we collectively summarize current practical recommendations from a number of international bodies and organizations.

  9. Are probiotics effective in preventing urinary tract infection?

    Science.gov (United States)

    Canales, Juan; Rada, Gabriel

    2018-04-04

    Urinary tract infection is the most common bacterial infection and recurrences are common. Probiotics have been proposed as an alternative to decrease this risk. However, it is not clear if they are really effective. To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. We identified six systematic reviews including nine studies overall, of which seven were randomized trials. We concluded it is not clear whether probiotics decrease the risk of symptomatic urinary tract infection, because the certainty of the evidence is very low.

  10. Intractable urinary tract infection in a renal transplant recipient

    International Nuclear Information System (INIS)

    Gokulnath, Renuka Satish

    2009-01-01

    Urinary tract infections (UTI) are the most common bacterial infections after renal transplantation and are associated with significant morbidity and mortality. Recurrent or relapsing infections are not uncommon in the early post-transplant period and superadded fungal UTI can occur in these patients, posing a difficult therapeutic problem. Literature on recurrent UTI after transplant as well as the ideal approach to such patients is scanty. We present the case of a renal allograft recipient who presented with relapsing bacterial UTI complicated by systemic fungemia; also, a brief review of fungal UTI is attempted. (author)

  11. Urinary tract infections in pregnant women with coeliac disease.

    Science.gov (United States)

    Olén, Ola; Montgomery, Scott M; Ekbom, Anders; Bollgren, Ingela; Ludvigsson, Jonas F

    2007-02-01

    Previous research has indicated a link between coeliac disease (CD) and urinary tract infection (UTI). The objective of this study was to assess the risk of UTI and repeated episodes of UTI before the current pregnancy in women with diagnosed or undiagnosed CD. A national registry-based cohort study restricted to pregnant women was used in this investigation, with linkage between the Swedish National Medical Birth Registry and the National Inpatient Registry. We analysed the risk of UTI during pregnancy from 1973 to 1989 in 212 pregnancies to women who had received a diagnosis of CD prior to giving birth and in 786 pregnancies to women diagnosed after giving birth. We also assessed the risk of repeated episodes of UTI before the current pregnancy according to data in the national birth records of 1990-2001 in 617 women with CD diagnosed prior to giving birth and 109 women diagnosed after giving birth. UTI during pregnancy: UTI occurred during 19,139/1,678,304 pregnancies to women who had never had a diagnosis of CD, compared with in 12/786 pregnancies to women with undiagnosed CD (adjusted odds ratio (AOR)=1.37; 95% CI=0.78-2.43; p=0.276) and in 0/212 pregnancies to women with diagnosed CD (AOR=0.06; 95% CI=0.00-8.94; p=0.277) (ORs adjusted for maternal age, parity, nationality and calendar period). Repeated episodes of UTI before the current pregnancy: among 692,991 women who had never had a diagnosis of CD, 74,776 reported repeated episodes of UTI, compared with 14/101 women with undiagnosed CD (AOR=1.39; 95% CI=0.79-2.45; p=0.255) and 69/566 women with diagnosed CD (AOR=1.02; 95% CI=0.79-1.32; p=0.864) (ORs adjusted for maternal age, parity, nationality, calendar period and civil status). Adjustment for smoking in a subset of patients with available data did not change the risk estimates. It cannot be ruled out that undiagnosed CD in pregnant women is associated with a small, increased risk of UTI. In pregnant women with diagnosed CD, there seems to be no

  12. [Osteosynthesis-associated infections : Epidemiology, definition and diagnosis].

    Science.gov (United States)

    Renz, N; Feihl, S; Dlaska, C E; Schütz, M A; Trampuz, A

    2017-06-01

    Osteosynthesis-associated infections occur in 1-5% after closed and in up to 30% after open fractures. There are three different descriptions of implant-associated infections after fracture fixation, which are crucial for the selection of the adequate treatment strategy; temporal appearance from the index surgery (early versus late), pathogenesis of the infection (exogenous, hematogenous and contiguous from an adjacent focus), duration of infection symptoms (acute versus chronic). Diagnosis of osteosynthesis-associated infection is challenging, as chronic low-grade infections often present only with unspecific and subtle clinical symptoms. History, clinical evaluation, imaging, histopathlogical and microbiological examination build the cornerstones of diagnostics in implant-associated infections. A new onset of rest pain, early loosening of the prosthesis or mechanically unexplained, nonunion should raise suspicion for infection and prompt further evaluation. Percutaneous sinus tracts, purulent wound secretion and skin erosions with visibility of the implant confirm the implant-associated infection. Elevated C‑reactive protein value in blood is a supportive argument for infection, but is neither sensitive nor specific for infection. Imaging plays a key role to detect nonunions, infectious callus, sequester, peri-implant osteolysis and extraosseous and intramedullary involvement. Through microbiological and histopathological examination of intraoperative tissue samples, as well as sonication of explanted implants the causative pathogen is identified in most cases.

  13. Drug utilization study of antibiotics for urinary tract infections in a ...

    African Journals Online (AJOL)

    A drug utilization pattern of antibiotics for urinary tract infections in 200 cases above 18 years of age was done at Katuri Medical College Hospital, Guntur, India. The antibiotic sensitivity profile of the microorganism causing urinary tract infections was studied in cases diagnosed as urinary tract infection. The patients with ...

  14. 77 FR 11133 - Draft Guidance for Industry on Complicated Urinary Tract Infections: Developing Drugs for...

    Science.gov (United States)

    2012-02-24

    ...] Draft Guidance for Industry on Complicated Urinary Tract Infections: Developing Drugs for Treatment... Urinary Tract Infections: Developing Drugs for Treatment.'' The purpose of this guidance is to assist sponsors in the clinical development of drugs for the treatment of complicated urinary tract infections (c...

  15. A case-control study of lower urinary-tract infections, associated antibiotics and the risk of developing prostate cancer using PCBaSe 3.0.

    Science.gov (United States)

    Russell, Beth; Garmo, Hans; Beckmann, Kerri; Stattin, Pär; Adolfsson, Jan; Van Hemelrijck, Mieke

    2018-01-01

    To investigate the association between lower urinary-tract infections, their associated antibiotics and the subsequent risk of developing PCa. Using data from the Swedish PCBaSe 3.0, we performed a matched case-control study (8762 cases and 43806 controls). Conditional logistic regression analysis was used to assess the association between lower urinary-tract infections, related antibiotics and PCa, whilst adjusting for civil status, education, Charlson Comorbidity Index and time between lower urinary-tract infection and PCa diagnosis. It was found that lower urinary-tract infections did not affect PCa risk, however, having a lower urinary-tract infection or a first antibiotic prescription 6-12 months before PCa were both associated with an increased risk of PCa (OR: 1.50, 95% CI: 1.23-1.82 and 1.96, 1.71-2.25, respectively), as compared to men without lower urinary-tract infections. Compared to men with no prescriptions for antibiotics, men who were prescribed ≥10 antibiotics, were 15% less likely to develop PCa (OR: 0.85, 95% CI: 0.78-0.91). PCa was not found to be associated with diagnosis of a urinary-tract infection or frequency, but was positively associated with short time since diagnoses of lower urinary-tract infection or receiving prescriptions for antibiotics. These observations can likely be explained by detection bias, which highlights the importance of data on the diagnostic work-up when studying potential risk factors for PCa.

  16. Imaging after urinary tract infection in older children and adolescents.

    Science.gov (United States)

    Kurtz, Michael P; Chow, Jeanne S; Johnson, Emilie K; Rosoklija, Ilina; Logvinenko, Tanya; Nelson, Caleb P

    2015-05-01

    There are few guidelines and little data on imaging after urinary tract infections in older children. We determined the clinical yield of renal and bladder ultrasound, and voiding cystourethrogram in older children and adolescents after urinary tract infection. We analyzed findings on voiding cystourethrogram, and renal and bladder ultrasound as well as the clinical history of patients who underwent the 2 studies on the same day between January 2006 and December 2010. We selected for study patients 5 to 18 years old who underwent imaging for urinary tract infection. Those with prior postnatal genitourinary imaging or prenatal hydronephrosis were excluded from analysis. We identified a cohort of 153 patients, of whom 74% were 5 to 8 years old, 21% were 8 to 12 years old and 5% were 12 to 18 years old. Of the patients 77% were female, 78% had a febrile urinary tract infection history and 55% had a history of recurrent urinary tract infections. Renal and bladder ultrasound findings revealed hydronephrosis in 7.8% of patients, ureteral dilatation in 3.9%, renal parenchymal findings in 20% and bladder findings in 12%. No patient had moderate or greater hydronephrosis. Voiding cystourethrogram showed vesicoureteral reflux in 34% of cases and bladder or urethral anomalies in 12%. Reflux was grade I, II-III and greater than III in 5.9%, 26% and 2% of patients, respectively. For any voiding cystourethrogram abnormality the sensitivity and specificity of any renal and bladder ultrasound abnormality were 0.49 (95% CI 0.37-0.62) and 0.76 (95% CI 0.66-0.84), respectively. Positive and negative predictive values were 0.58 (95% CI 0.44-0.71) and 0.69 (0.59-0.77), respectively. In older children with a history of urinary tract infection the imaging yield is significant. However, imaging revealed high grade hydronephrosis or high grade vesicoureteral reflux in few patients. Renal ultrasound is not reliable for predicting voiding cystourethrogram findings such as vesicoureteral

  17. PROBLEMATIC ISSUES OF CAUSAL TREATMENT FOR URINARY TRACT INFECTIONS IN CHILDREN

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    V. I. Kirillov

    2016-01-01

    Full Text Available The review gives data on shortcomings in the antimicrobial measures that are associated with the defects in the effective treatment of urinary system infections, such as the high risk of disease relapses and the stable proportion of secondary pyelonephritis among the causes of chronic renal failure. The vulnerability of this approach is to accelerate the rate of acquiring the resistance of uropathogens to the currently available antibiotics that may also have a number of side effects, including those involved in the pathogenesis of urinary tract infections. Difficulties in conducting adequate causal therapy are also associated with some subjective factors that largely hamper the personalized diagnosis of diseases of causative agents.

  18. Distribution of Microorganisms and Antibiotic Resistance in Children with Urinary Tract Infections, Retrospective Case Series.

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    Didem Kaya

    2017-04-01

    Full Text Available Aim Urinary tract infection is one of the most common serious bacterial infections in children. Due to regional differences and past infections, the use of antibiotics has problems such as variability in microorganisms and antibiotic susceptibility. In this study, we aimed to determine the microorganisms detected in urinary tract infections in children and their antibiotic resistance status.Methods A retrospective observational study was planned. Demographic data, urine microscopy and urine culture results of patients who were hospitalized with urinary tract infection diagnosis in our pediatric clinic at hospital were recorded retrospectively through hospital automation system. The first culture results of the patients were used in the evaluation of the data. Results In the study group of 112 patients, Escherichia coli (E. coli and Klebsiella were the most identified microorganisms in patients with urinary culture. Under 2 years old, Klebsiella was more frequent, and at 2 years of age there was a noticeable increase in the frequency of E-coli. The most common resistance of both microorganisms was found to be ampicillin. Conclusions: Regional infectious agents and antibiotic resistance should be revised at regular intervals, appropriate empiric therapy should be considered. Thus, is predicted that the chance of success in treatment will increase and the speed of resistance development will decrease.

  19. Recurrent urinary tract infections in young children: role of DMSA scintigraphy in detecting vesicoureteric reflux

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    Awais, Muhammad; Rehman, Abdul; Nadeem, Naila; Zaman, Maseeh Uz

    2015-01-01

    Performing micturiting cystourethrography (MCUG) in young children with recurrent urinary tract infections is controversial with discrepancy among the major guidelines. Previous studies have shown that a normal dimercaptosuccinic acid (DMSA) scintigraphy may avoid the need of performing MCUG for detecting vesicoureteric reflux in children with first febrile urinary tract infection. However, the role of DMSA for ruling out vesicoureteric reflux in children with recurrent urinary tract infections has not been studied. Approval from institutional ethical review committee was sought and the requirement of informed consent was waived. A total of 50 children under the age of 10 years with recurrent urinary tract infections underwent MCUG scan within 3 months of DMSA scan from January 2011 to September 2012 at our institution. Diagnosis of recurrent urinary tract infections and grading of vesicoureteric reflux was according to previously established standards. Abnormalities on DMSA scan - scarring, hydronephrosis and reduced differential renal function - were compared with presence of vesicoureteric reflux on MCUG. High-grade vesicoureteric reflux was noted on MCUG in 22 (44%) cases. The findings on DMSA included hydronephrosis and scarring in 25 (50%) and 25 (50%) cases, respectively. Abnormalities on DMSA scan for detecting the presence of high-grade vesicoureteric reflux on MCUG examination had sensitivity, specificity, positive and negative predictive values of 95.45%, 35.71%, 53.85% and 90.91%, respectively. The positive and negative likelihood ratios were 1.48 and 0.13 respectively. DMSA scan had high overall sensitivity and negative predictive value with a low negative likelihood ratio for ruling out high-grade vesicoureteric reflux on MCUG, which may obviate the need of invasive MCUG along with its associated drawbacks. (orig.)

  20. Recurrent urinary tract infections in young children: role of DMSA scintigraphy in detecting vesicoureteric reflux

    Energy Technology Data Exchange (ETDEWEB)

    Awais, Muhammad; Rehman, Abdul; Nadeem, Naila [Aga Khan University Hospital, Department of Radiology, Karachi (Pakistan); Zaman, Maseeh Uz [Aga Khan University Hospital, Nuclear Medicine, Department of Radiology, Karachi (Pakistan)

    2014-07-04

    Performing micturiting cystourethrography (MCUG) in young children with recurrent urinary tract infections is controversial with discrepancy among the major guidelines. Previous studies have shown that a normal dimercaptosuccinic acid (DMSA) scintigraphy may avoid the need of performing MCUG for detecting vesicoureteric reflux in children with first febrile urinary tract infection. However, the role of DMSA for ruling out vesicoureteric reflux in children with recurrent urinary tract infections has not been studied. Approval from institutional ethical review committee was sought and the requirement of informed consent was waived. A total of 50 children under the age of 10 years with recurrent urinary tract infections underwent MCUG scan within 3 months of DMSA scan from January 2011 to September 2012 at our institution. Diagnosis of recurrent urinary tract infections and grading of vesicoureteric reflux was according to previously established standards. Abnormalities on DMSA scan - scarring, hydronephrosis and reduced differential renal function - were compared with presence of vesicoureteric reflux on MCUG. High-grade vesicoureteric reflux was noted on MCUG in 22 (44%) cases. The findings on DMSA included hydronephrosis and scarring in 25 (50%) and 25 (50%) cases, respectively. Abnormalities on DMSA scan for detecting the presence of high-grade vesicoureteric reflux on MCUG examination had sensitivity, specificity, positive and negative predictive values of 95.45%, 35.71%, 53.85% and 90.91%, respectively. The positive and negative likelihood ratios were 1.48 and 0.13 respectively. DMSA scan had high overall sensitivity and negative predictive value with a low negative likelihood ratio for ruling out high-grade vesicoureteric reflux on MCUG, which may obviate the need of invasive MCUG along with its associated drawbacks. (orig.)

  1. [Recurrent urinary tract infection due to enterovesical fistula secondary to colon diverticular disease: a case report].

    Science.gov (United States)

    Cavalcanti, Natália Silva; da Silva, Lorena Luryann Cartaxo; da Silva, Leonardo Sales; da Fonseca, Luiz Antonio Cavalcante; Alexandre, Cristianne da Silva

    2013-01-01

    Enterovesical fistula are pathological connections between the bladder and pelvic intestinal segments. It consists of a rare complication of neoplastic and inflammatory pelvic disorders, in addition to iatrogenic or traumatic injuries, and correlates with both high morbidity and mortality indexes. Male patient, 61 years old, admitted at the hospital clinics featuring abdominal pain and distension, vomiting and fecal retention. Patient's pathological precedents include high blood pressure, diabetes mellitus, vesical dysfunction and recurrent urinary tract infection on the past three years. Magnetic resonance imaging of abdomen and pelvis revealed enterovesical fistula in association with colon diverticular disease of the sigmoid. Management of choice consisted of partial colectomy with bowel lowering and partial cystectomy with surgical double-J stent insertion. Although consisting of a gastrointestinal primary affection, patients with enterovesical fistula usually search for medical help charging urinary tract features. In this particular case, our patient was admitted with gastrointestinal symptoms, reasoned by diagnostic delay, as the patient had already attended at multiple centers with urinary symptoms. Despite being an unusual affection, recurrent urinary tract infection associated with colon diverticular disease must always be considered at differential diagnosis of recurrent urinary tract infection as it concurs with high morbidity and mortality.

  2. Predictive model of urinary tract infection after surgical treatment for women with endometrial cancer.

    Science.gov (United States)

    Machida, Hiroko; Hom, Marianne S; Shabalova, Anastasiya; Grubbs, Brendan H; Matsuo, Koji

    2017-08-01

    The aim of the study was to identify risk factors associated with postoperative urinary tract infections (UTIs) following hysterectomy-based surgical staging in women with endometrial cancer. This is a retrospective study utilizing an institutional database (2008-2016) of stage I-IV endometrial cancer cases that underwent hysterectomy-based surgery. UTIs occurring within a 30-day time period after surgery were examined and correlated to patient clinico-pathological demographics. UTIs were observed in 44 (6.4%, 95% confidence interval 4.6-8.2) out of 687 cases subsequent to the diagnosis of endometrial cancer. UTI cases were significantly associated with obesity, advanced stage, prolonged operative time, hysterectomy type, pelvic lymphadenectomy, non-β-lactam antibiotics, and intraoperative urinary tract injury (all, p Urinary tract infections are common in women following surgical treatment for women with endometrial cancer with risk factors being a prolonged surgical time, radical hysterectomy, and non-guideline perioperative anti-microbial agent use. Consideration of prophylactic anti-microbial agent use in a high-risk group of postoperative urinary tract infection merits further investigation.

  3. Evaluation of maternal urinary tract infection as a potential risk factor for neonatal urinary tract infection.

    Directory of Open Access Journals (Sweden)

    Nasrin Khalesi

    2014-06-01

    Full Text Available To assess the relationship between maternal UTI during pregnancy and neonatal UTI.This cross-sectional study included eighty neonates referred to Ali-e-Asghar Hospital, Tehran, Iran, in 2011. The participants were divided into the study (with diagnosis of UTI; n = 40 and the control (without this type of infection; n = 40 groups. The mothers were asked about the history of UTI during pregnancy, and if the response was positive, the trimester in which UTI had occurred. Urinalysis and urine culture were carried out for all neonates.Overall, 14.9% of neonates had mothers with a positive history of UTI during their pregnancy (4.4%, 6.1%, and 4.4% during the 1(st, 2(nd, and 3(rd trimesters, respectively. A significant relationship was detected between the occurrence of UTI in neonates and maternal UTI, so that the overall prevalence of UTI among neonates of affected mothers was significantly higher than that observed among non-infected mothers (30.0% versus 6.8%; p = 0.001. Maternal UTI resulted in 5.9-fold increased risk of neonatal UTI. In UTI group, the most common bacterial etiologies of UTI were Escherichia coli (65.9%, followed by Klebsiella (14.6% and Staphylococci (9.8%.Our findings confirmed the association between the history of UTI in mother and occurrence of UTI in neonate, emphasizing to pay more attention for assessing and managing UTI in neonates in order to reduce the related complications.

  4. Adhesion Molecules Associated with Female Genital Tract Infection.

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    Jamal Qualai

    Full Text Available Efforts to develop vaccines that can elicit mucosal immune responses in the female genital tract against sexually transmitted infections have been hampered by an inability to measure immune responses in these tissues. The differential expression of adhesion molecules is known to confer site-dependent homing of circulating effector T cells to mucosal tissues. Specific homing molecules have been defined that can be measured in blood as surrogate markers of local immunity (e.g. α4β7 for gut. Here we analyzed the expression pattern of adhesion molecules by circulating effector T cells following mucosal infection of the female genital tract in mice and during a symptomatic episode of vaginosis in women. While CCR2, CCR5, CXCR6 and CD11c were preferentially expressed in a mouse model of Chlamydia infection, only CCR5 and CD11c were clearly expressed by effector T cells during bacterial vaginosis in women. Other homing molecules previously suggested as required for homing to the genital mucosa such as α4β1 and α4β7 were also differentially expressed in these patients. However, CD11c expression, an integrin chain rarely analyzed in the context of T cell immunity, was the most consistently elevated in all activated effector CD8+ T cell subsets analyzed. This molecule was also induced after systemic infection in mice, suggesting that CD11c is not exclusive of genital tract infection. Still, its increase in response to genital tract disorders may represent a novel surrogate marker of mucosal immunity in women, and warrants further exploration for diagnostic and therapeutic purposes.

  5. Pitfalls of diagnosing urinary tract infection in infants and young children.

    Science.gov (United States)

    Yamasaki, Yasuhito; Uemura, Osamu; Nagai, Takuhito; Yamakawa, Satoshi; Hibi, Yoshiko; Yamamoto, Masaki; Nakano, Masaru; Kasahara, Katsuaki; Bo, Zhang

    2017-07-01

    The aim of this study was to examine the sensitivity and specificity of pyuria-based diagnosis of urinary tract infection (UTI) in urine collected by transurethral catheterization, and the reliability of diagnosis of pyuria in urine collected in a perineal bag. The gold standard for UTI diagnosis is significant colony counts of a single organism in urine obtained in a sterile manner. We enrolled 301 patients who underwent medical examination at the present hospital for possible UTI between January 2005 and December 2009. We collected 438 urine samples by transurethral catheterization. We investigated the accuracy of pyuria-based diagnosis of UTI using transurethral catheterization urine specimens, and the reliability of diagnosis of pyuria using bag-collected urine specimens. The false-negative rate of UTI diagnosis based on pyuria in transurethral catheterization urine sediments was 9.0%; there was no significant difference in the false-negative rate of UTI diagnosis between boys and girls. Approximately 28% of pyuria-positive bag-collected urine specimens were pyuria negative on transurethral catheterization; this rate was significantly higher in girls than in boys (56.7% vs. 8.9%, P UTI. Pyuria in bag-collected urine specimens frequently consists of urine leukocytes from external genitalia as well as from the urinary tract. © 2017 Japan Pediatric Society.

  6. Bacterial infection of the lower respiratory tract in 34 horses.

    Science.gov (United States)

    Racklyeft, D J; Love, D N

    2000-08-01

    To investigate associations between the bacteriology and aspects of history, clinical presentation, outcome and pathology of lower respiratory tract disease of 34 horses. Detailed aerobic and anaerobic bacteriological investigations were performed on clinical specimens from horses with pneumonia, lung abscessation and necrotic pneumonia with or without pleurisy in an attempt to identify those bacteria that might contribute to the initiation and progression of infection. Bacteria were cultured from 33 of the 34 horses. In ten cases, only aerobic/facultatively anaerobic isolates were cultured while aerobic/facultatively anaerobic bacteria and obligately anaerobic bacteria were isolated in the other 23 cases. Moderate to large numbers of anaerobic bacteria were isolated only when the estimated duration of illness was at least five days. Bacteria were not cultured from 12 of the pleural fluid samples but were always cultured from pulmonary samples (either transtracheal aspirates from live horses or pulmonary lesions at necropsy). Streptococcus equi subsp zooepidemicus was isolated in the three cases where only one bacterial species was cultured. In the other 30 cases, multiple species were isolated. These included most often and in greatest numbers, Streptococcus equi subsp zooepidemicus, Pasteurellaceae, Escherichia coli, anaerobic cocci, Eubacterium fossor, Bacteroides tectum, Prevotella heparinolytica, Fusobacterium spp, and pigmented members of the genera Prevotella and Porphyromonas. Aerobic/facultatively anaerobic organisms were isolated from 97% of horses, while obligately anaerobic organisms were cultured from 68% of horses. There was no association between the isolation of any specific bacterium and the outcome of disease. However, obligately anaerobic bacteria (such as anaerobic cocci, Bacteroides tectum, P heparinolytica and Fusobacterium spp) and the facultatively anaerobic species Escherichia coli, were recovered more commonly from horses that died or were

  7. Predominant bacteria and patterns of antibiotic susceptibility in urinary tract infection in children with spina bifida.

    Science.gov (United States)

    Ortiz, Tara K; Velazquez, Nermarie; Ding, Laura; Routh, Jonathan C; Wiener, John S; Seed, Patrick C; Ross, Sherry S

    2018-04-20

    Urinary tract infection is more common in children with spina bifida (SB) than neurologically intact children, and Escherichiacoli is the most common urinary pathogen in the general pediatric population. Less is known of the pathogens responsible for urinary tract infections (UTI) in the pediatric SB population or their evolving antimicrobial resistance patterns. The goal of this study is to determine the epidemiology and antimicrobial resistance patterns of SB-associated urinary pathogens. Between January 1996 and August 2013, 231 patients aged 1 month to 18 years were identified with a diagnosis of SB-NB and at least one symptomatic urinary tract infection (UTI) event (Table). Two-hundred and thirty-one normally voiding children with a single symptomatic UTI were age-matched based on age at diagnosis of UTI at a 1:1 ratio. Chi-square tests and Generalized Estimating Equation analysis, controlling for clinicopathological factors, were performed to compare rates of pathogen-associations with UTI between groups and likelihood of UTI with multi-drug resistant (MDR) organisms. Children in the SB-NB group had a higher rate of non-E. coli UTI compared with controls (64% vs. 41%, p Children with SB-NB are more likely to have non-E. coli UTI, UTIs with MDR organisms, and urosepsis than the general pediatric population. Published by Elsevier Ltd.

  8. Risk of urinary tract infection in infants and children with acute bronchiolitis

    Science.gov (United States)

    Hendaus, Mohamed A; Alhammadi, Ahmed H; Khalifa, Mohamed S; Muneer, Eshan; Chandra, Prem

    2015-01-01

    OBJECTIVES: To estimate the prevalence of urinary tract infection in infants and children with bronchiolitis. METHODS: A retrospective cross-sectional study involving patients zero to 24 months of age who were hospitalized with acute bronchiolitis was conducted. RESULTS: A total of 835 paediatric patients with acute bronchiolitis were admitted to the paediatric ward between January 2010 and December 2012. The mean (± SD) age at diagnosis was 3.47±2.99 months. There were 325 (39%) girls and 510 (61%) boys. For the purpose of data analysis, the patient population was divided into three groups: group 1 included children hospitalized with respiratory syncytial virus (RSV) bronchiolitis; group 2 included children hospitalized with clinical bronchiolitis with no virus detected; and group 3 included children hospitalized with clinical bronchiolitis due to a respiratory virus other than RSV. Results revealed that urinary tract infection was present in 10% of patients, and was most common in group 3 (13.4%) followed by group 2 (9.7%), and was least common in group 1 (6%) (P=0.030). CONCLUSIONS: The possibility of a urinary tract infection should be considered in a febrile child with a diagnosis of bronchiolitis, particularly if the trigger is a respiratory virus other than RSV. PMID:26175566

  9. Urinary tract infection in full-term newborn infants: risk factor analysis

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    Falcão Mário Cícero

    2000-01-01

    Full Text Available OBJECTIVE: To analyze the correlation of risk factors to the occurrence of urinary tract infection in full-term newborn infants. PATIENTS AND METHODS: Retrospective study (1997 including full-term infants having a positive urine culture by bag specimen. Urine collection was based on: fever, weight loss > 10% of birth weight, nonspecific symptoms (feeding intolerance, failure to thrive, hypoactivity, debilitate suction, irritability, or renal and urinary tract malformations. In these cases, another urine culture by suprapubic bladder aspiration was collected to confirm the diagnosis. To compare and validate the risk factors in each group, the selected cases were divided into two groups: Group I - positive urine culture by bag specimen collection and negative urine culture by suprapubic aspiration, and Group II - positive urine culture by bag specimen collection and positive urine culture by suprapubic aspiration . RESULTS: Sixty one infants were studied, Group I, n = 42 (68.9% and Group II, n = 19 (31.1%. The selected risk factors (associated infectious diseases, use of broad-spectrum antibiotics, renal and urinary tract malformations, mechanical ventilation, parenteral nutrition and intravascular catheter were more frequent in Group II (p<0.05. Through relative risk analysis, risk factors were, in decreasing importance: parenteral nutrition, intravascular catheter, associated infectious diseases, use of broad-spectrum antibiotics, mechanical ventilation, and renal and urinary tract malformations. CONCLUSION: The results showed that parenteral nutrition, intravascular catheter, and associated infectious diseases contributed to increase the frequency of neonatal urinary tract infection, and in the presence of more than one risk factor, the occurrence of urinary tract infection rose up to 11 times.

  10. [Clinical studies on flomoxef in respiratory tract infections].

    Science.gov (United States)

    Kanegae, H; Yamada, H; Yamaguchi, T; Kuroki, S; Katoh, O

    1987-10-01

    Flomoxef (FMOX, 6315-S) is a new oxacephem with a broad spectrum of antimicrobial activity. We used FMOX for treatment of 13 patients with respiratory tract infections including 4 cases of pneumonia, 5 of lung abscess and 4 of exacerbation of the chronic airway diseases. FMOX showed excellent in vitro antimicrobial activities against clinical isolates including 4 strains of Streptococcus pneumoniae, 2 strains of Haemophilus influenzae and each one strain of Escherichia coli and Klebsiella pneumoniae. Clinical responses were excellent in 3 cases, good in 7 and fair or poor in 3. No side effect was observed, but abnormal laboratory findings caused by FMOX administration were found in 2 cases; hypertransaminasemia and eosinophilia. However, neither of them was severe. From the above results, it is considered that FMOX will be useful for treatment of patients with respiratory tract infections.

  11. [Clinical trials of flomoxef in complicated urinary tract infections].

    Science.gov (United States)

    Ohta, N; Sudoko, H; Fukuta, K; Nakano, M; Ushiyama, T; Tajima, A; Aso, Y; Masuda, H; Suzuki, A; Suzuki, K

    1987-10-01

    Flomoxef (6315-S, FMOX), a new oxacephem antibiotic was studied clinically in 27 patients with complicated urinary tract infections. FMOX was intravenously administered at a dose of 1.0 g twice daily for 5 days. Clinical effect of FMOX on patients with complicated urinary tract infections were excellent in 11.5%, moderate in 57.7% and overall clinical efficacy rate was 69.2%. During the treatment with FMOX, urticaria was observed in 1 case. In laboratory tests, a decrease of RBC, Hb and Ht in 1 case, a decrease of WBC in 1 case and an elevation of GPT in another case were observed. But these abnormal values were slight and transient.

  12. [Lower urinary tract infections in men. Urethritis, cystitis and prostatitis].

    Science.gov (United States)

    Zanella, Marie-Céline; Schoofs, Fabian; Huttner, Benedikt; Huttner, Angela

    2017-04-12

    Recommendations for the treatment of lower non-catheter-related urinary tract infection (UTI) in men are rarely evidence-based. Their management requires the localization of the site of infection, whether it be the urethra, bladder or prostate, and includes antibiotic therapy and in most cases urological assessment. They are often associated with urinary tract procedures or anatomical or functional abnormalities. Nearly 80 % of male UTIs are caused by Enterobacteriaceae. The prevalence of broad-spectrum beta-lactamase-producing strains (ESBL) and quinolone-resistant strains is increasing. The aim of this article is to define three types of lower, non-catheter-related UTI in men - urethritis, cystitis and prostatitis - their microbiology and management in Switzerland.

  13. 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.

  14. The problems of urinary tract infections with Candida spp. aetiology in women.

    Science.gov (United States)

    Tomczak, Hanna; Szałek, Edyta; Grześkowiak, Edmund

    2014-08-29

    Urinary tract infections (UTIs) in women are a growing clinical concern. The most frequent risk factors of UTIs with fungal aetiology in women are: antibiotic therapy (especially broad-spectrum antibiotics), immunosuppressive therapy, diabetes, malnutrition, pregnancy, and frequent intercourse. The aim of the study was to analyse urinary tract infections with Candida spp. aetiology in women hospitalised at the Clinical Hospital in Poznań, Poland, between 2009 and 2011. The investigations revealed that as many as 71% of positive urine cultures with Candida fungi came from women. The following fungi were most frequently isolated from the patients under analysis: C. albicans (47%), C. glabrata (31%), C. tropicalis (6%), C. krusei (3%). In order to diagnose a UTI the diagnosis cannot be based on a single result of a urine culture. Due to the small number of antifungal drugs and high costs of treatment, antifungal drugs should be applied with due consideration and care.

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

    Science.gov (United States)

    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 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. Clinical Practice Guidelines for the Antibiotic Treatment of Community-Acquired Urinary Tract Infections

    Science.gov (United States)

    Ha, U-Syn; Lee, Seung-Ju; Yeo, Jeong Kyun; Min, Seung Ki; Lee, Heeyoung

    2018-01-01

    Urinary tract infections (UTIs) are infectious diseases that commonly occur in communities. Although several international guidelines for the management of UTIs have been available, clinical characteristics, etiology and antimicrobial susceptibility patterns may differ from country to country. This work represents an update of the 2011 Korean guideline for UTIs. The current guideline was developed by the update and adaptation method. This clinical practice guideline provides recommendations for the diagnosis and management of UTIs, including asymptomatic bacteriuria, acute uncomplicated cystitis, acute uncomplicated pyelonephritis, complicated pyelonephritis related to urinary tract obstruction, and acute bacterial prostatitis. This guideline targets community-acquired UTIs occurring among adult patients. Healthcare-associated UTIs, catheter-associated UTIs, and infections in immunocompromised patients were not included in this guideline. PMID:29637759

  17. Complicated catheter-associated urinary tract infections due to Escherichia coli and Proteus mirabilis.

    Science.gov (United States)

    Jacobsen, S M; Stickler, D J; Mobley, H L T; Shirtliff, M E

    2008-01-01

    Catheter-associated urinary tract infections (CAUTIs) represent the most common type of nosocomial infection and are a major health concern due to the complications and frequent recurrence. These infections are often caused by Escherichia coli and Proteus mirabilis. Gram-negative bacterial species that cause CAUTIs express a number of virulence factors associated with adhesion, motility, biofilm formation, immunoavoidance, and nutrient acquisition as well as factors that cause damage to the host. These infections can be reduced by limiting catheter usage and ensuring that health care professionals correctly use closed-system Foley catheters. A number of novel approaches such as condom and suprapubic catheters, intermittent catheterization, new surfaces, catheters with antimicrobial agents, and probiotics have thus far met with limited success. While the diagnosis of symptomatic versus asymptomatic CAUTIs may be a contentious issue, it is generally agreed that once a catheterized patient is believed to have a symptomatic urinary tract infection, the catheter is removed if possible due to the high rate of relapse. Research focusing on the pathogenesis of CAUTIs will lead to a better understanding of the disease process and will subsequently lead to the development of new diagnosis, prevention, and treatment options.

  18. Predictors Of Non-Escherichia Coli Urinary Tract Infection.

    Science.gov (United States)

    Shaikh, Nader; Wald, Ellen R; Keren, Ron; Gotman, Nathan; Ivanova, Anastasia; Carpenter, Myra A; Moxey-Mims, Marva; Hoberman, Alejandro

    2016-11-01

    We aimed to determine which children are prone to non-Escherichia coli urinary tract infection (UTIs). We included 769 children with UTI. We found that circumcised males, Hispanic children, children without fever and children with grades 3 and 4 vesicoureteral reflux were more likely to have a UTI caused by organisms other than E. coli. This information may guide clinicians in their choice of antimicrobial therapy.

  19. Recurrent urinary tract infection by burkholderia cepacia in a live related renal transplant recipient

    International Nuclear Information System (INIS)

    Zeshan, M.

    2012-01-01

    Burkholderia cepacia is high virulent organism usually causing lower respiratory tract infections especially in Cystic fibrosis (CF) patients and post lung transplant. Urinary tract infections with Burkholderia cepacia have been associated after bladder irrigation or use of contaminated hospital objects. Post renal transplant urinary tract infection (UTI) is the most common infectious complications. Recurrent urinary tract infection with Burkholderia cepacia is a rare finding. Complete anatomical evaluation is essential in case recurrent urinary tract infections (UTI) after renal transplant. Vesico-ureteric reflux (VUR) and neurogenic urinary bladder was found to be important risk factors. (author)

  20. Accurate detection of male subclinical genital tract infection via cervical culture and DNA hybridization assay of the female partner

    NARCIS (Netherlands)

    Trum, J. W.; Pannekoek, Y.; Spanjaard, L.; Bleker, O. P.; van der Veen, F.

    2000-01-01

    The accuracy of the PACE2 DNA hybridization assay of the cervix and cervical culture in female partners for the diagnosis of male subclinical genital tract infection were assessed in a male infertility population. A total of 184 men were screened for the presence of Chlamydia trachomatis, Ureaplasma

  1. Comparative assessment of renal Tc-99m DMSA scan and renal sonography findings in complication of urinary tract infections

    International Nuclear Information System (INIS)

    Alavi, M.; Rasekhi, A.

    2002-01-01

    Urinary tract infection is a common disease in childhood specially in female. In this study 50 patients with established diagnosis of urinary tract infection were evaluated by both renal scan with Tc-99m DMSA and renal sonography. The study revealed that most urinary tract infections are in children, female sex between 5-9 years of age. Therefore the most important complications (renal scarring) are also common in this age-sex distribution. Occurrence of renal scars increase with increasing the number of recurrent infections. Vesicoureteral reflux is one of the most important, common risk factors for renal scarring. Renal Tc-99m Dmsa scan is more sensitive than renal sonography in detecting the renal scars

  2. Urinary tract infection in children: Role of ultrasonography

    International Nuclear Information System (INIS)

    Lee, Hye Won; Lee, Sun Wha; Ko, Young Tae; Lim, Joo Won

    1994-01-01

    To evaluate diagnostic usefulness of ultrasonography(US) in pediatric patient with urinary tract infection. Fifty-five children with urinary tract infection underwent renal ultrasonography and voiding cystourethrography(VCUG). The imaging findings were analyzed retrospectively. Renal sonograms were normal in 34 of 55 children(62%). Five of 34 patients with normal sonogram had vesicoureteral reflux of grade I and III on VCUG. Renal sonograms were abnormal in 21 of 55 children(38%). Sonographic findings included hydronephrosis, hyperechoic kidney, nephromegaly, altrophic kidney, renal abscess, and duplex ureter. Eleven of 21 patient with abnormal sonogram had vesicoureteral reflux of grade I to IV on VCUG. Ultrasonography is an useful and reliable initial screening examination in the investigation of children with UTI. Unfortunately US is neither sufficiently sensitive nor specific for detecting VUR. VCUG provides confirmative and valuable information about vesicoureteral reflux, and VCUG should be considered as a next modality for UTI. The combined use of sonography and VCUG provides more valuable information in urinary tract infection

  3. Human respiratory syncytial virus load normalized by cell quantification as predictor of acute respiratory tract infection.

    Science.gov (United States)

    Gómez-Novo, Miriam; Boga, José A; Álvarez-Argüelles, Marta E; Rojo-Alba, Susana; Fernández, Ana; Menéndez, María J; de Oña, María; Melón, Santiago

    2018-05-01

    Human respiratory syncytial virus (HRSV) is a common cause of respiratory infections. The main objective is to analyze the prediction ability of viral load of HRSV normalized by cell number in respiratory symptoms. A prospective, descriptive, and analytical study was performed. From 7307 respiratory samples processed between December 2014 to April 2016, 1019 HRSV-positive samples, were included in this study. Low respiratory tract infection was present in 729 patients (71.54%). Normalized HRSV load was calculated by quantification of HRSV genome and human β-globin gene and expressed as log10 copies/1000 cells. HRSV mean loads were 4.09 ± 2.08 and 4.82 ± 2.09 log10 copies/1000 cells in the 549 pharyngeal and 470 nasopharyngeal samples, respectively (P respiratory tract infection and 4.22 ± 2.28 log10 copies/1000 cells with upper respiratory tract infection or febrile syndrome (P < 0.05). A possible cut off value to predict LRTI evolution was tentatively established. Normalization of viral load by cell number in the samples is essential to ensure an optimal virological molecular diagnosis avoiding that the quality of samples affects the results. A high viral load can be a useful marker to predict disease progression. © 2018 Wiley Periodicals, Inc.

  4. Clinical requirements in the treatment of today's respiratory tract infections.

    Science.gov (United States)

    Höffken, G

    1993-01-01

    Respiratory tract infections (RTIs) are among the most frequent infections in man and lower tract infections account substantially for the overall mortality in hospitals. Regarding the etiology of pneumonias, one has to consider different pathogenic mechanisms, age of the patients, underlying diseases, concomitant medications, symptomatologies, seasonal influences, and clinical conditions, e.g. intensive care environment and mechanical ventilation. To optimize the rational management of respiratory infections, identification of the etiologic agent would be desirable. The decision of how to treat is often based on epidemiologic, clinical, and radiological assessments. Epidemiologic studies have shown a pronounced difference in the etiologic spectrum between community- and hospital-acquired RTIs. In community-acquired pneumonias, pneumococci, Haemophilus influenzae, Legionella, Mycoplasma and viruses predominate, whereas in nosocomially acquired pneumonias, Enterobacteriaceae, e.g. Klebsiella, Proteus, Enterobacter as well as Pseudomonas and staphylococci comprise the most frequent isolates. Empirical therapy has to cover all possible etiologic pathogens which most likely cause the infection. In addition, an adequate kinetic profile, e.g. once or twice daily dosing, sufficient pulmonary tissue or fluid penetration, and acceptable tolerance and costs are prerequisites for optimal therapy. Drugs of choice for the treatment of community-acquired pneumonia are aminobenzylpenicillins or macrolides. Oral cephalosporins exhibit excellent activity against many bacterial pathogens of typical community-acquired pneumonia, and are active against beta-lactamase-producing H. influenzae.

  5. [Urinary tract infections : What has been confirmed in therapy?

    Science.gov (United States)

    Marcon, J; Stief, C G; Magistro, G

    2017-12-01

    Urinary tract infections (UTIs) affect approximately 150 million people worldwide per year, causing annual health costs of over three billion dollars just in the USA. Every second woman experiences at least one UTI in her lifetime, with every one in four experiencing recurrence. Uncomplicated infections like single or recurrent cystitis and pyelonephritis can be distinguished from complicated disease. UTIs in men can spread to the male glands, causing prostatitis and epididymitis. Antibiotic therapy is the standard procedure for UTIs. However, the extensive and sometimes irrational use of antibiotics for the treatment of infections has led to an increase in the incidence of multiresistant pathogens in recent years. Therefore, preventive nonantibiotic approaches are of great interest. This article provides an overview of the current management of urological infections as well as an outline of nonantibiotic preventive treatment modalities.

  6. Evaluation of Screening Methods for the Detection of Urinary Tract ...

    African Journals Online (AJOL)

    2000-05-30

    screening testsfor urinary tract infection was donefrom March 20 to May 30, 2000. A cross sectional study ... the diagnosis of urinary tract infection on the basis of pyuria alone. The minimum number of ..... infection Complicating. Pregnancy J.

  7. Histopathological Diagnosis of Fungal Infections: Problems and ...

    African Journals Online (AJOL)

    Histopathology is a major diagnostic tool in mycology and has the advantage of rapid diagnosis, cost effectiveness, ability to provide initial identification of the infecting fungus and demonstrates tissue reactions and currently the means of diagnosing the infections caused by the fungi: Lodoa loboi and Rhinosporidium ...

  8. Urinary tract infection as a single presenting sign of multiple vaginal foreign bodies: case report and review of the literature.

    Science.gov (United States)

    Neulander, Endre Z; Tiktinsky, Alex; Romanowsky, Igor; Kaneti, Jacob

    2010-02-01

    Vaginal foreign bodies in children usually present with foul-smelling discharge and/or vaginal bleeding. Rarely, these basic clinical diagnostic signs are not present. We report on a 5(1/2)-year-old girl with recurrent lower urinary tract infection as the sole presentation of multiple vaginal foreign bodies. Ultrasound of the lower urinary tract was inconclusive, and cystography indicated for recurrent urinary tract infections was declined by the patient in an outpatient setting. Cystography under general anesthesia raised the suspicion of foreign vaginal objects, and the definitive diagnosis was made by vaginoscopy. The relevant literature covering this subject is reviewed. High level of suspicion and strict basic diagnostic protocol are the most important steps for a timely diagnosis of this condition. Copyright 2010 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  9. Host-pathogen interactions mediating pain of urinary tract infection.

    Science.gov (United States)

    Rudick, Charles N; Billips, Benjamin K; Pavlov, Vladimir I; Yaggie, Ryan E; Schaeffer, Anthony J; Klumpp, David J

    2010-04-15

    Pelvic pain is a major component of the morbidity associated with urinary tract infection (UTI), yet the molecular mechanisms underlying UTI-induced pain remain unknown. UTI pain mechanisms probably contrast with the clinical condition of asymptomatic bacteriuria (ASB), characterized by significant bacterial loads without lack symptoms. A murine UTI model was used to compare pelvic pain behavior elicited by infection with uropathogenic Escherichia coli strain NU14 and ASB strain 83972. NU14-infected mice exhibited pelvic pain, whereas mice infected with 83972 did not exhibit pain, similar to patients infected with 83972. NU14-induced pain was not dependent on mast cells, not correlated with bacterial colonization or urinary neutrophils. UTI pain was not influenced by expression of type 1 pili, the bacterial adhesive appendages that induce urothelial apoptosis. However, purified NU14 lipopolysaccharide (LPS) induced Toll-like receptor 4 (TLR4)-dependent pain, whereas 83972 LPS induced no pain. Indeed, 83972 LPS attenuated the pain of NU14 infection, suggesting therapeutic potential. These data suggest a novel mechanism of infection-associated pain that is dependent on TLR4 yet independent of inflammation. Clinically, these findings also provide the rational for probiotic therapies that would minimize the symptoms of infection without reliance on empirical therapies that contribute to antimicrobial resistance.

  10. Transient Pseudohypoaldosteronism due to Urinary Tract Infection in Infancy: A Report of 4 Cases

    Directory of Open Access Journals (Sweden)

    Kaplowitz Paul

    2009-05-01

    Full Text Available Hyponatremia with hyperkalemia in infancy is an uncommon but life-threatening occurrence. In the first weeks of life, this scenario is often associated with aldosterone deficiency due to salt-wasting congenital adrenal hyperplasia. However, alternative diagnoses involving inadequate mineralocorticoid secretion or action must be considered, particularly for infants one month of age or older. We report four infants who presented with profound hyponatremia accompanied by urinary tract infection, ultimately leading to the diagnosis of transient pseudohypoaldosteronism. Our cases provide support for the idea that the renal tubular resistance to aldosterone is due to urinary tract infection itself rather than to underlying urinary tract anomalies typically found in these infants. Awareness of this condition is important so that serum aldosterone, urine sodium, and urine cultures may be obtained immediately in any infant presenting with hyponatremia and hyperkalemia in whom a diagnosis of congenital adrenal hyperplasia was not found. Adequate replacement with intravenous saline and antibiotic therapy is sufficient to correct sodium levels over 24–48 hours.

  11. Urologic evaluation of urinary tract infection in pregnancy.

    Science.gov (United States)

    Diokno, A C; Compton, A; Seski, J; Vinson, R

    1986-01-01

    Thirty-three antepartum patients with urinary tract infections underwent urologic evaluation as soon as the infection had been successfully treated. The evaluation included history of voiding habits, cystometry, urethral calibration and cystourethroscopy. A second phase of the urologic evaluation included an excretory urogram and repeat cystometry 10-12 weeks postpartum. Sixty percent had a history of infrequent voiding, and 90% of them had a bladder capacity greater than 450 mL. Forty-one percent of the patients had a normal bladder capacity (less than 450 mL), and 85% of this group did not have any history of infrequent voiding. The radiographic evaluation postpartum in 18 of 33 patients revealed major abnormalities in 50%. These abnormalities were seen as often and were as significant in women with asymptomatic bacteriuria as in those who presented with acute pyelonephritis. The results suggest that the large bladder seen in pregnant women may be secondary to the chronic, unphysiologic habit of infrequent voiding. Furthermore, this study reinforced the fact that most pregnant women with urinary tract infection have preexisting chronic bladder or renal abnormalities that predispose them to infection. Those at risk should be identified early through a careful history and urinalysis to determine which ones need urinary prophylaxis during pregnancy. Postpartum urologic investigation should be carried out to identify any structural or functional problems; understanding them is helpful in present and future management.

  12. Prevalence and bacterial susceptibility of hospital acquired urinary tract infection

    Directory of Open Access Journals (Sweden)

    Dias Neto José Anastácio

    2003-01-01

    Full Text Available PURPOSE: Urinary tract infection is the most common nosocomially acquired infection. It is important to know the etiology and antibiotic susceptibility infectious agents to guide the initial empirical treatment. OBJECTIVE: To determine the prevalence of bacterial strains and their antibiotic susceptibility in nosocomially acquired urinary tract infection in a university hospital between January and June 2003. METHODS: We analyzed the data of 188 patients with positive urine culture (= 10(5 colony-forming units/mL following a period of 48 hours after admission. RESULTS: Half of patients were male. Mean age was 50.26 ± 22.7 (SD, range 3 months to 88 years. Gram-negative bacteria were the agent in approximately 80% of cases. The most common pathogens were E. coli (26%, Klebsiella sp. (15%, P. aeruginosa (15% and Enterococcus sp. (11%. The overall bacteria susceptibility showed that the pathogens were more sensible to imipenem (83%, second or third generation cephalosporin and aminoglycosides; and were highly resistant to ampicillin (27% and cefalothin (30%. It is important to note the low susceptibility to ciprofloxacin (42% and norfloxacin (43%. CONCLUSION: This study suggests that if one can not wait the results of urine culture, the best choices to begin empiric treatment are imipenem, second or third generation cephalosporin and aminoglycosides. Cefalothin and ampicillin are quite ineffective to treat these infections.

  13. Diagnosis and understanding of chronic biofilm infections

    DEFF Research Database (Denmark)

    Thomsen, Trine Rolighed

    2016-01-01

    Title: Diagnosis and understanding of chronic biofilm infections. Name: Trine Rolighed Thomsen Aalborg University and Danish Technological Institute, Denmark Recent evidence suggests that the microbial community, its spatial distribution and activity play an important role in the prolongation......, anaerobic or unculturable bacteria living in biofilms. Thus, diagnosis of chronic infections is challenged by lack of appropriate sampling strategies and by limitations in microbiological testing methods. The purpose of this study was to improve sampling and diagnosis of chronic infections, especially...... considering the biofilm issue. Systematic and optimized sampling of various specimen types was performed. Extended culture, optimized DNA extraction, quantitative PCR, cloning, next generation sequencing and PNA FISH were applied on different types of specimens for optimized diagnosis. For further...

  14. Clinicians' interpretations of point of care urine culture versus laboratory culture results: analysis from the four-country POETIC trial of diagnosis of uncomplicated urinary tract infection in primary care.

    Science.gov (United States)

    Hullegie, Saskia; Wootton, Mandy; Verheij, Theo J M; Thomas-Jones, Emma; Bates, Janine; Hood, Kerenza; Gal, Micaela; Francis, Nick A; Little, Paul; Moore, Michael; Llor, Carl; Pickles, Timothy; Gillespie, David; Kirby, Nigel; Brugman, Curt; Butler, Christopher C

    2017-08-01

    Urine culture at the point of care minimises delay between obtaining the sample and agar inoculation in a microbiology laboratory, and quantification and sensitivity results can be available more rapidly in primary care. To identify the degree to which clinicians' interpretations of a point-of-care-test (POCT) urine culture (Flexicult™ SSI-Urinary Kit) agrees with laboratory culture in women presenting to primary care with symptoms of uncomplicated urinary tract infections (UTI). Primary care clinicians used the Flexicult™-POCT, recorded their findings and took a photograph of the result, which was interpreted by microbiology laboratory technicians. Urine samples were additionally processed in routine care laboratories. Cross tabulations were used to identify important differences in organism identification, quantification and antibiotic susceptibility between these three sources of data. The influence of various laboratory definitions for UTI on culture were assessed. Primary care clinicians identified 202/289 urine samples (69.9%) as positive for UTI using the Flexicult™-POCT, whereas laboratory culture identified 94-190 (32.5-65.7%) as positive, depending on definition thresholds. 82.9% of samples identified positive for E. coli on laboratory culture were also considered positive for E. coli using the Flexicult™ -POCT, and susceptibilities were reasonably concordant. There were major discrepancies between laboratory staff interpretation of Flexicult™ photographs, clinicians' interpretation of the Flexicult™ test, and laboratory culture results. Flexicult™-POCT overestimated the positivity rate of urine samples for UTI when laboratory culture was used as the reference standard. However, it is unclear whether point-of-care or laboratory based urine culture provides the most valid diagnostic information. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. [Nitrofurantoin--clinical relevance in uncomplicated urinary tract infections].

    Science.gov (United States)

    Stock, Ingo

    2014-07-01

    The nitrofuran derivative nitrofurantoin has been used for more than 60 years for the antibacterial therapy of uncomplicated urinary tract infections (UTI). Despite its long application, this antibiotic retained good activity against Escherichia coli and some other pathogens of uncomplicated urinary tract infections such as Staphylococcus saprophyticus and Enterococcus species. Nitrofurantoin therapy has been shown to be accompanied by numerous adverse drug effects. Among these, there are also serious side effects such as pulmonary reactions and polyneuropathy, which mainly occur in long-term use. Recent studies, however, have shown a good efficacy and tolerability of short-term nitrofurantoin therapy comparable to previous established standard therapeutic regimens applying cotrimoxazole or quinolones. Because of these data and the alarming resistance rates of uropathogenic Escherichia coli to cotrimoxazole and quinolones that have been increased markedly in several countries, the clinical significance ofnitrofurantoin has been raised again. In many current treatment guidelines, e. g., the international clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women published by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases, nitrofurantoin has been recommended as one first-line antibiotic of empiric antibacterial treatment of uncomplicated cystitis in otherwise healthy women. In Germany, however, nitrofurantoin should only be applied if more effective and less risky antibiotics cannot be used. Nitrofurantoin is contraindicated in the last three months of pregnancy and in patients suffering from renal impairment of each degree. Despite compatibility concerns, nitrofurantoin has also been recommended for the re-infection prophylaxis of recurrent uncomplicated urinary tract infections in Germany and several other countries.

  16. The DMSA scan in paediatric urinary tract infection

    International Nuclear Information System (INIS)

    Ditchfield, M.R.; Nadel, H.R.

    1998-01-01

    The objective of the present paper was to review the use of the dimercaptosuccinic acid (DMSA) scan in urinary tract infection at British Columbia's Children's Hospital to determine the frequency of cortical defects and the association between vesico-ureteric reflux and the presence of cortical defects in children with urinary tract infection. A total of 129 consecutive children with a urinary tract infection referred for a DMSA scan in a 2-year period (January 1992-January 1994) were retrospectively studied. The results were analysed in terms of kidneys, and the incidence of cortical defects was determined. Eighty-eight patients (68%) had a radiographic micturating cysto-urethrogram within 6 months of the DMSA scan, and in this group the relationship of defects with vesico-ureteric reflux was determined. Overall, 81/258 (31%) of kidneys had a cortical defect on a DMSA scan. Of those who had a micturating cysto-urethrogram, 53/176 (30%) kidneys had vesico-ureteric reflux, and of those that had reflux, 21/53 (40%) had a cortical defect on a DMSA scan. In the group of children without reflux, 38/123 (31%) had a cortical defect. Renal cortical scan defects are common findings in paediatric urinary infection, and frequently occur in the absence of vesico-ureteric reflux. These defects represent either established scars or acute pyelonephritis that can proceed to scarring. The micturating cysto-urethro-gram alone is insufficient as a screening modality to identify those kidneys at risk of renal scarring. Copyright (1998) Blackwell Science Pty Ltd

  17. Detection of PCT and urinary β2 -MG enhances the accuracy for localization diagnosing pediatric urinary tract infection.

    Science.gov (United States)

    Fang, Jian; Luan, Jiangwei; Zhu, Gaohong; Qi, Chang; Wang, Dandan

    2017-09-01

    The purpose of this article was to investigate whether the combination of urinary beta 2 microglobulin (urinary β 2 -MG) and procalcitonin (PCT) diagnosis could enhance the localization diagnostic precision of pediatric urinary tract infection comparing with single diagnosis. A study was conducted in the Nephrology Department of Wuhan women and children's health care centre. This study incorporated 85 participants, including 35 children who were diagnosed as upper urinary tract infection (UUTI) with the symptom of fever and 50 children who conducted lower urinary tract infection (LUTI). Levels of PCT and urinary β 2 -MG in both UUTI and LUTI patients were measured and compared. The level of PCT and β 2 -MG were both significantly higher in UUTI group compared with in LUTI group. AUC of urinary β 2 -MG ROC (sensitivity of 71.4%, specificity of 90.0%) was significantly smaller than that of PCT ROC (sensitivity of 77.1%, specificity of 96.0%) in the single diagnosis. Although in the combined diagnosis, the sensitivity and specificity increased to 88.6% and 98%, respectively. Both PCT and β 2 -MG could be used to localize the UTI. Introducing urinary β 2 -MG into PCT diagnosis could increase the sensitivity and specificity of UTI lesion diagnosis in clinical practice. © 2016 The Authors Journal of Clinical Laboratory Analysis Published by Wiley Periodicals, Inc.

  18. Antibiotic Resistance in Children with Recurrent or Complicated Urinary Tract Infection

    OpenAIRE

    Nidal S Younish; K Qual; T Al-Awaisheh; F Al-Awaisheh; D Al-Kayed

    2009-01-01

    INTRODUCTION: Urinary tract infection is certainly one of the most common childhood infections. Emerging resistance to the antibiotics is not unusual. Current hospitalization for children with urinary tract infection is reserved for severe or complicated cases. The aim of the present study was to determine the antibiotic resistance pattern among children with recurrent or complicated urinary tract infection. METHODS: A retrospective study carried out at Prince Hashem hospital, Zarqa ...

  19. Limited Evidence on the Management of Respiratory Tract Infections in Down's Syndrome : A Systematic Review

    NARCIS (Netherlands)

    Manikam, Logan; Reed, Kate; Venekamp, Roderick P; Hayward, Andrew; Littlejohns, Peter; Schilder, Anne; Lakhanpaul, Monica

    2016-01-01

    AIMS: To systematically review the effectiveness of preventative and therapeutic interventions for respiratory tract infections (RTIs) in people with Down's syndrome. METHODS: Databases were searched for any published and ongoing studies of respiratory tract diseases in children and adults with

  20. Effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections: open randomised controlled trial.

    NARCIS (Netherlands)

    Aardweg, M.T. van den; Boonacker, C.W.; Rovers, M.M.; Hoes, A.W.; Schilder, A.G.M.

    2011-01-01

    OBJECTIVE: To assess the effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections. DESIGN: Open randomised controlled trial. SETTING: 11 general hospitals and two academic centres. PARTICIPANTS: 111 children aged 1-6 with recurrent upper respiratory tract

  1. Prevention of pin tract infection with titanium-copper alloys.

    Science.gov (United States)

    Shirai, Toshiharu; Tsuchiya, Hiroyuki; Shimizu, Tohru; Ohtani, Kaori; Zen, Yo; Tomita, Katsuro

    2009-10-01

    The most frequent complication in external fixation is pin tract infection. To reduce the incidence of implant-associated infection, many published reports have looked at preventing bacterial adhesion by treating the pin surface. This study aimed to evaluate the antibacterial activity of a Titanium-Copper (Ti-Cu) alloy on implant infection, and to determine the potential use of the Ti-Cu alloy as a biomaterial. Two forms of Ti-Cu alloys were synthesized: one with 1% Cu and the other with 5% Cu. For analyzing infectious behavior, the implants were exposed to Staphylococcus aureus and Escherichia coli. The reaction of pathogens to the Ti-Cu alloys was compared with their reaction to stainless steel and pure titanium as controls. Both Ti-Cu alloys evidently inhibited colonization by both bacteria. Conversely, cytocompatibility studies were performed using fibroblasts and colony formation on the metals was assessed by counting the number of colonies. Ti-1% Cu alloy showed no difference in the number of colonies compared with the control. External fixator pins made of Ti-Cu alloys were evaluated in a rabbit model. The tissue-implant interactions were analyzed for the presence of infection, inflammatory changes and osteoid-formation. Ti-1% Cu alloy significantly inhibited inflammation and infection, and had excellent osteoid-formation. Copper blood levels were measured before surgery and at 14 days postoperatively. Preoperative and postoperative blood copper values were not statistically different. Overall, it was concluded that Ti-Cu alloys have antimicrobial activity and substantially reduce the incidence of pin tract infection. Ti-1% Cu alloy shows particular promise as a biomaterial. (c) 2009 Wiley Periodicals, Inc.

  2. Prevalence of upper urinary tract anomalies in hospitalized premature infants with urinary tract infection.

    Science.gov (United States)

    Vachharajani, A; Vricella, G J; Najaf, T; Coplen, D E

    2015-05-01

    The 2011 American Academy of Pediatrics (AAP) guidelines address imaging after initial febrile urinary tract infection (UTI) in infants >2 months of age. We sought to determine the frequency of upper urinary tract anomalies (hydronephrosis and vesicoureteral reflux (VUR)) in hospitalized premature infants with UTI. We retrospectively reviewed the electronic medical records of neonatal intensive care unit (NICU) admissions at a tertiary care children's hospital between 1 January 2006 and 31 December 2010. We queried the records for UTI, renal ultrasound (US) and voiding cystourethrogram (VCUG). We identified 3518 unique admissions. UTI occurred in 118 infants (3%). Sixty-nine (60%) had a normal US. Renal dilation was predominantly renal pelvic dilation (12%) and isolated caliectasis (22%). VUR was identified in 15 (14%) infants evaluated with a VCUG. VUR was identified in nine (12%) infants without and in seven (16%) with an abnormality on US. Reflux was identified in 7% of male and 38% of female infants with a UTI. Anatomic abnormalities of the upper urinary tract are uncommon in premature infants with a UTI that occurs during neonatal hospitalization. In concordance with the AAP guidelines, a VCUG may not be required in all NICU infants under age 2 months after a single UTI.

  3. The significance of ultrasonography in urinary tract infection in children

    International Nuclear Information System (INIS)

    Hwang, Dae Hyun; Lee, Kwang Sul; Jeon, Woo Ki; Kim, Ho Kyun; Lee, Ghi Jai; Kim, Jeong Sook; Jeon, Jong Dong; Han, Chang Yul; Song, Moon Kab

    1990-01-01

    Urinary tract infection(UTI) is one of the major bacterial disease of children that causes morbidity and inconvenience to many patients were related to recurrent vesicoureteral reflux. Radiological examinations of the 72 patients of urinary tract infection(UTI) who were visited to Seoul Paik Hospital from Jan 1st 1986 to Jul 30th 1989, were analysed in this study. US was used as an initial study in all patients who showed acute stage of UTI and followed by IVP, VCUG, 99m Tc-DMSA scan for veslcoureteral reflex or renal scarring. If US showed obstructing lesion, no further study was performed. The resulted were as follows: 1. US is valuable as a screening procedure during the first UTI in congenital abnormalities and in particular obstructive lesions that require surgery. 2. A normal US in a child older than 5 or 6 years is meaningful as an investigation in the group of the first documented UTI uncomplicated. 3. Vesicoureteral reflex, a major factor leading to parenchymal damage in young children can not be detected reliably by US. If the US is suggestive of vesicoureteral reflex, this should be confirmed by VCUG and 99m Tc-DMSA scan for renal scarring. If the US is normal or equivocal in recurrent infection and unexplained persistent clinical findings, this should be followed by VCUG and 9 9mTc-DMSA scan

  4. An update on emerging therapies for urinary tract infections.

    Science.gov (United States)

    Majeed, Aneela; Alarfaj, Sumaiah; Darouiche, Rabih; Mohajer, Mayar

    2017-03-01

    Urinary tract infections (UTIs) are the most common healthcare-acquired infections, and are associated with high morbidity and mortality. Worldwide use of antibiotics has led to a significant rise in resistant uropathogens emanating from both hospitals and communities. The huge concern of multidrug resistance (MDR) has led the Food and Drug Administration (FDA) to encourage drug companies to invest in the development of new antibiotics. Area covered: In this review we summarized data on already approved antibiotics, and selected emerging therapies that are currently in phase II and III trials with emphasis on complicated urinary tract infections (cUTIs). We performed our search using PubMed, ClinicalTrials.gov, Google Scholar and Pharmaprojects. Expert opinion: Efficacious antimicrobials are needed to overcome MDR organisms. There are several dugs in initial and later stages of development, but most of them lack full spectrum of activity against some Gram-negative organisms, particularly against MDR Pseudomonas aeruginosa. Better understanding of the pathogenesis of UTI and genetic engineering of pathogens can provide new drugs to combat resistance in the future.

  5. Grepafloxacin Clinical Program for Lower Respiratory Tract Infections

    Directory of Open Access Journals (Sweden)

    Arne C Rodloff

    1998-01-01

    Full Text Available The present paper evaluates the clinical trial program in lower respiratory tract infections treated with a new fluoroquinolone antibiotic, grepafloxacin. Unlike older quinolones, grepafloxacin has excellent activity against Gram-positive organisms, which include Streptococcus pneumoniae and “atypical” pathogens Legionella species. Mycoplasma pneumoniae and Chlamydia pneumoniae. Grepafloxacin has a long half-life of 12 to 15 h, which allows once daily dosing. Six studies have been conducted regarding community-acquired lower respiratory tract infections (LRTls, four about community-acquired pneumonia (CAP and two about acute bacterial exacerbations of chronic bronchitis (ABECB . In these studies, grepafloxacin demonstrated clinical equivalence with standard therapies. but, in patients with documented infections. grepafloxacin was statistically superior to amoxycillin in both CAP and ABECB. The new fluoroquinolone has a good safety profile, comparable with that of ciprofloxacin. The most common adverse effects of grepafloxacin were nausea and a metallic taste; however, these effects resulted in only a few discontinuations of therapy. With the increasing prevalence of resistance in pathogens isolated from community-acquired LRTIs, grepafloxacin offers a good alternative for monotherapy in these patients.

  6. Antibiotic resistance patterns of outpatient pediatric urinary tract infections.

    Science.gov (United States)

    Edlin, Rachel S; Shapiro, Daniel J; Hersh, Adam L; Copp, Hillary L

    2013-07-01

    We characterize the current national patterns of antibiotic resistance of outpatient pediatric urinary tract infection. We examined outpatient urinary isolates from patients younger than 18 years in 2009 using The Surveillance Network®, a database with antibiotic susceptibility results and patient demographic data from 195 United States hospitals. We determined the prevalence and antibiotic resistance patterns for the 6 most common uropathogens, ie Escherichia coli, Proteus mirabilis, Klebsiella, Enterobacter, Pseudomonas aeruginosa and Enterococcus. We compared differences in uropathogen prevalence between males and females using chi-square analysis. We identified 25,418 outpatient urinary isolates. E. coli was the most common uropathogen overall but the prevalence of E. coli was higher among females (83%) than males (50%, p Resistance among E. coli was highest for trimethoprim-sulfamethoxazole (24%) but lower for nitrofurantoin (less than 1%) and cephalothin (15%). Compared to 2002 Surveillance Network data, E. coli resistance rates increased for trimethoprim-sulfamethoxazole (from 23% to 31% in males and from 20% to 23% in females) and ciprofloxacin (from 1% to 10% and from 0.6% to 4%, respectively). E. coli remains the most common pediatric uropathogen. Although widely used, trimethoprim-sulfamethoxazole is a poor empirical choice for pediatric urinary tract infections in many areas due to high resistance rates. First-generation cephalosporins and nitrofurantoin are appropriate narrow-spectrum alternatives given their low resistance rates. Local antibiograms should be used to assist with empirical urinary tract infection treatment. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  7. Risk Factors for Recurrent Urinary Tract Infection and Renal Scarring.

    Science.gov (United States)

    Keren, Ron; Shaikh, Nader; Pohl, Hans; Gravens-Mueller, Lisa; Ivanova, Anastasia; Zaoutis, Lisa; Patel, Melissa; deBerardinis, Rachel; Parker, Allison; Bhatnagar, Sonika; Haralam, Mary Ann; Pope, Marcia; Kearney, Diana; Sprague, Bruce; Barrera, Raquel; Viteri, Bernarda; Egigueron, Martina; Shah, Neha; Hoberman, Alejandro

    2015-07-01

    To identify risk factors for recurrent urinary tract infection (UTI) and renal scarring in children who have had 1 or 2 febrile or symptomatic UTIs and received no antimicrobial prophylaxis. This 2-year, multisite prospective cohort study included 305 children aged 2 to 71 months with vesicoureteral reflux (VUR) receiving placebo in the RIVUR (Randomized Intervention for Vesicoureteral Reflux) study and 195 children with no VUR observed in the CUTIE (Careful Urinary Tract Infection Evaluation) study. Primary exposure was presence of VUR; secondary exposures included bladder and bowel dysfunction (BBD), age, and race. Outcomes were recurrent febrile or symptomatic urinary tract infection (F/SUTI) and renal scarring. Children with VUR had higher 2-year rates of recurrent F/SUTI (Kaplan-Meier estimate 25.4% compared with 17.3% for VUR and no VUR, respectively). Other factors associated with recurrent F/SUTI included presence of BBD at baseline (adjusted hazard ratio: 2.07 [95% confidence interval (CI): 1.09-3.93]) and presence of renal scarring on the baseline (99m)Tc-labeled dimercaptosuccinic acid scan (adjusted hazard ratio: 2.88 [95% CI: 1.22-6.80]). Children with BBD and any degree of VUR had the highest risk of recurrent F/SUTI (56%). At the end of the 2-year follow-up period, 8 (5.6%) children in the no VUR group and 24 (10.2%) in the VUR group had renal scars, but the difference was not statistically significant (adjusted odds ratio: 2.05 [95% CI: 0.86-4.87]). VUR and BBD are risk factors for recurrent UTI, especially when they appear in combination. Strategies for preventing recurrent UTI include antimicrobial prophylaxis and treatment of BBD. Copyright © 2015 by the American Academy of Pediatrics.

  8. Management of urinary tract infections in children in an era of increasing antimicrobial resistance.

    Science.gov (United States)

    Robinson, Joan L; Le Saux, Nicole

    2016-09-01

    Accurate diagnosis and appropriate use of antimicrobials for treatment and prevention of urinary tract infections (UTIs) is vital in an era of increasing antibiotic resistance. The article reviews indications for and interpretation of urinalysis and urine culture results for diagnosis of UTI, choice of antibiotics for empiric and definitive UTI therapy, the rationale behind and indications for radiographic investigations, and prevention of UTIs including the complex decision as to whether antibiotic prophylaxis will benefit a child. Expert commentary: Over-diagnosis of UTI is a prevalent problem due to the lack of specificity of both urinalysis and urine culture. The most major recent advance in the field has been the recognition that antibiotic prophylaxis for UTI is rarely indicated as in most situations, the number needed to treat to prevent one UTI is too high to justify the risk of adverse events and development of antimicrobial resistance.

  9. Sphingobacterium respiratory tract infection in patients with cystic fibrosis

    Directory of Open Access Journals (Sweden)

    de Gregorio Fabiola

    2009-12-01

    Full Text Available Abstract Background Bacteria that belong to the genus Sphingobacterium are Gram-negative, non-fermentative bacilli, ubiquitous in nature and rarely involved in human infections. The aims of this study were to evaluate the epidemiology of infection by Sphingobacterium in a cohort of patients affected by Cystic Fibrosis (CF, the antibiotic susceptibility and the DNA fingerprinting of the isolated strains and to analyze some clinical outcomes of the infected patients. Findings Between January 2006 and June 2008, patients (n = 332 attending the Regional CF Unit in Naples, Italy, were enrolled. Sputum samples were processed for microscopic, cultural, phenotypic identification and antibiotic susceptibility testing. DNA fingerprinting was performed by pulsed-field gel electrophoresis (PFGE. A total of 21 strains of Sphingobacterium were isolated from 7 patients (13 of S. spiritovorum, 8 of S. multivorum. S. multivorum isolates were more resistant than those of S. spiritovorum. PFGE profiles were in general heterogeneous, which suggested independent circulation. Conclusions This is the first Italian report about respiratory tract infections by Sphingobacterium in CF patients. In our cohort, these infections were not associated with a deterioration of pulmonary function during the follow-up period. Although the exact role of this microorganism in CF lung disease is unknown and the number of infected patients was small, this study could represent an important starting-point for understanding the epidemiology and the possible pathogenic role of Sphingobacterium in CF patients.

  10. Neonatal adrenal hematoma with urinary tract infection: Risk factor or a chance association?

    Directory of Open Access Journals (Sweden)

    Abdelhadi M Habeb

    2014-01-01

    Full Text Available Neonatal adrenal hematoma is a rare finding that can be discovered incidentally or presents with various symptoms. However, urinary tract infection (UTI has not been reported in association with this condition. We report on a 4-week old child with massive unilateral adrenal hematoma discovered incidentally during a routine abdominal ultrasound scan for UTI. The mass resolved spontaneously after several months with no complications. The diagnosis and ma-nagement of infantile suprarenal mass and the possible link between this child′s UTI and the adrenal hematoma are discussed.

  11. Persistent renal cortical scintigram defects in children 2 years after urinary tract infection

    International Nuclear Information System (INIS)

    Ditchfield, Michael R.; Cook, David J.; Campo, John F. de; Grimwood, Keith; Powell, Harley R.; Gulati, Sanjeev; Sloane, Robert

    2004-01-01

    Background: Renal cortical scintigraphic studies challenge the role of vesicoureteric reflux in renal scar development, emphasizing instead the part played by acute pyelonephritis. Objective: To determine the prevalence of renal cortical defects in a child cohort 2 years after the child's first diagnosed urinary tract infection and to analyze the relationship of these defects with acute illness variables, primary vesicoureteric reflux and recurrent infections. Materials and methods: In a prospective cohort study, 193 children younger than 5 years with their first proven urinary tract infection underwent renal sonography, voiding cystourethrogram, and renal cortical scintigraphy within 15 days of diagnosis. Two years later, 150 of the 193 children, or 77.7%, had a further renal cortical scintigram, including 75, or 86.2%, of the 87 children who had acute scintigraphic defects. The relationship of cortical defects to age, gender, pre-treatment symptom duration, hospitalization, presence and grade of vesicoureteric reflux, and recurrent urinary tract infections was evaluated. Results: Overall, 20 of the 150 (13.3%; 95% confidence interval (CI) 8.3, 19.8) children had persistent defects 2 years after infection. This included 20 of 75 (26.7%; 95% CI 17.1, 38.1) with initially abnormal scintigrams. No new defects were detected. Although acute defects were more common in the young, those with persistent defects were older (median ages 16.4 vs. 6.8 months, P=0.004) than those with transient abnormalities. After adjustment for age, persistent defects were no longer associated with gender and were not predicted by acute illness variables, primary vesicoureteric reflux or recurrent infections. (orig.)

  12. Treatment failures after antibiotic therapy of uncomplicated urinary tract infections

    DEFF Research Database (Denmark)

    Bjerrum, Lars; Dessau, Ram B; Hallas, Jesper

    2002-01-01

    OBJECTIVES: The efficacy of sulfamethizole and pivmecillinam in the treatment of urinary tract infections (UTI) has been questioned because of an increase in the prevalence of resistant strains. The aim of this study was to describe the risk of treatment failures over the last 10 years. DESIGN......: Retrospective cohort study. MATERIAL: Data were retrieved from Odense Pharmaco Epidemiological Database and consisted of women receiving sulfamethizole (n = 44,716) or pivmecillinam (n = 3093) during the period 1990-99. MAIN OUTCOME MEASURES: Prescription of a new antibiotic drug appropriate for UTI within 4...

  13. Elevated urine levels of heparin-binding protein in children with urinary tract infection.

    Science.gov (United States)

    Kjölvmark, Charlott; Akesson, Per; Linder, Adam

    2012-08-01

    Urinary tract infection (UTI) is a common infection diagnosis in children, and efficient diagnosis and treatment are important to avoid serious complications. In this study we investigated whether urinary levels of neutrophil-derived heparin-binding protein (HBP) can be used as a marker of UTI in children. These results were compared to those of dipstick analysis, interleukin-6 (IL-6) analysis in urine, and bacterial culturing. Seventy-eight children aged 0-18 years with fever and/or symptoms indicating UTI were enrolled in a prospective consecutive study. Urine samples were cultured and analyzed with dipstick, and concentrations of HBP and IL-6 were measured. Fifteen patients were classified as having UTI, 30 patients had fever but were diagnosed with a non-urinary tract infection, and 33 patients had neither UTI nor fever. Using a urine HBP (U-HBP) cut-off level of 32 ng/mL, the sensitivity and specificity for detecting UTI were 93.3 and 90.3 %, respectively. Receiver operating characteristic curves demonstrated that U-HBP levels were a higher specificity indicator of UTI than urine white blood cell counts or urine IL-6 levels; they also showed a higher sensitivity than the results of the urine nitrite test. All patients with significant growth of clinically relevant bacteria had elevated U-HBP levels. The results indicate that rapid analysis of U-HBP can provide helpful guidance in the management of children with suspected UTI.

  14. Gram-Positive Uropathogens, Polymicrobial Urinary Tract Infection, and the Emerging Microbiota of the Urinary Tract.

    Science.gov (United States)

    Kline, Kimberly A; Lewis, Amanda L

    2016-04-01

    Gram-positive bacteria are a common cause of urinary-tract infection (UTI), particularly among individuals who are elderly, pregnant, or who have other risk factors for UTI. Here we review the epidemiology, virulence mechanisms, and host response to the most frequently isolated Gram-positive uropathogens: Staphylococcus saprophyticus, Enterococcus faecalis, and Streptococcus agalactiae. We also review several emerging, rare, misclassified, and otherwise underreported Gram-positive pathogens of the urinary tract including Aerococcus, Corynebacterium, Actinobaculum, and Gardnerella. The literature strongly suggests that urologic diseases involving Gram-positive bacteria may be easily overlooked due to limited culture-based assays typically utilized for urine in hospital microbiology laboratories. Some UTIs are polymicrobial in nature, often involving one or more Gram-positive bacteria. We herein review the risk factors and recent evidence for mechanisms of bacterial synergy in experimental models of polymicrobial UTI. Recent experimental data has demonstrated that, despite being cleared quickly from the bladder, some Gram-positive bacteria can impact pathogenic outcomes of co-infecting organisms. When taken together, the available evidence argues that Gram-positive bacteria are important uropathogens in their own right, but that some can be easily overlooked because they are missed by routine diagnostic methods. Finally, a growing body of evidence demonstrates that a surprising variety of fastidious Gram-positive bacteria may either reside in or be regularly exposed to the urinary tract and further suggests that their presence is widespread among women, as well as men. Experimental studies in this area are needed; however, there is a growing appreciation that the composition of bacteria found in the bladder could be a potentially important determinant in urologic disease, including susceptibility to UTI.

  15. [Prevalence and clinical characteristics of coronavirus NL63 infection in children hospitalized for acute lower respiratory tract infections in Changsha].

    Science.gov (United States)

    Zhang, Fei; Zhang, Bing; Xie, Zhi-Ping; Gao, Han-Chun; Zhao, Xin; Zhong, Li-Li; Zhou, Qiong-Hua; Hou, Yun-De; Duan, Zhao-Jun

    2012-04-01

    The main objective of this study was to explore the prevalence and clinical characteristics of human coronavirus NL63 infection in hospitalized children with acute lower respiratory tract infection (ALRTI) in Changsha. Nasopharyngeal aspirates (NPA) samples were collected from 1185 hospitalized children with ALRTI at the People's Hospital of Hunan province, between September 2008 and October 2010. Reverse transcriptase polymerase chain reaction (RT-PCR) was employed to screen for coronavirus NL63, which is a 255 bp fragment of a part of N gene. All positive amplification products were confirmed by sequencing and compared with those in GenBank. The overall frequency of coronavirus NL63 infection was 0.8%, 6 (60%) out of the coronavirus NL63 positive patients were detected in summer, 2 in autumn, 1 in spring and winter, respectively. The patients were from 2 months to two and a half years old. The clinical diagnosis was bronchopneumonia (60%), bronchiolitis (30%), and acute laryngotracheal bronchitis (10%). Four of the 10 cases had critical illness, 4 cases had underlying diseases, and 7 cases had mixed infection with other viruses. The homogeneity of coronavirus NL63 with those published in the GenBank at nucleotide levels was 97%-100%. Coronavirus NL63 infection exists in hospitalized children with acute lower respiratory tract infection in Changsha. Coronavirus NL63 infections are common in children under 3 years of age. There is significant difference in the infection rate between the boys and the girls: the boys had higher rate than the girls. The peak of prevalence of the coronavirus NL63 was in summer. A single genetic lineage of coronavirus NL63 was revealed in human subjects in Changsha. Coronavirus NL63 may also be one of the lower respiratory pathogen in China.

  16. Evaluation of CD4+/CD8+ status and urinary tract infections ...

    African Journals Online (AJOL)

    Evaluation of CD4+/CD8+ status and urinary tract infections associated with urinary schistosomiasis ... African Health Sciences ... by <50 ova /10ml of urine had a mean CD4+:CD8+ ratio of 1.57 while those with heavy infections as ... Key words: CD4+, CD8+, urinary tract infections, urinary schistosomiasis, rural Nigerians

  17. Prevention of recurrent urinary tract infections in women.

    Science.gov (United States)

    2013-06-01

    Around 40-50% of women experience at least one urinary tract infection (UTI) during their lifetime and 20-30% of these have a recurrence within 3-4 months of the initial infection.¹ Recurrent UTI (usually defined as three episodes in the last 12 months or two episodes in the last 6 months) can have a considerable impact on a woman's quality of life. Each episode of acute UTI in young women is typically associated with about 6 days of symptoms, 2.4 days of restricted activities and 0.4 days of bed rest.¹ Antibacterial prophylaxis is effective in preventing recurrent episodes, but at the expense of unwanted effects and a risk of promoting bacterial resistance. Here we assess the efficacy of different antibacterial regimens and non-antibacterial alternatives (cranberry, probiotics, oestrogens, immunostimulation, hyaluronic acid and chondroitin, acupuncture and herbs) in the prevention of recurrent uncomplicated UTIs in women.

  18. Changes in Bacterial Resistance Patterns of Pediatric Urinary Tract Infections and Rationale for Empirical Antibiotic Therapy

    OpenAIRE

    İbrahim Gökçe; Neslihan Çiçek; Serçin Güven; Ülger Altuntaş; Neşe Bıyıklı; Nurdan Yıldız; Harika Alpay

    2017-01-01

    Background: The causative agent spectrum and resistance patterns of urinary tract infections in children are affected by many factors. Aims: To demonstrate antibiotic resistance in urinary tract infections and changing ratio in antibiotic resistance by years. Study Design: Retrospective cross-sectional study. Methods: We analysed antibiotic resistance patterns of isolated Gram (-) bacteria during the years 2011-2014 (study period 2) in children with urinary tract infections. We...

  19. Recommended treatment for urinary tract infection in pregnancy.

    Science.gov (United States)

    Vercaigne, L M; Zhanel, G G

    1994-02-01

    To establish and recommend a therapeutic regimen for the treatment of urinary tract infection (UTI) in pregnancy based on the published studies. An English-language literature search employing MEDLINE, Index Medicus, and bibliographic reviews of the references obtained were searched (key terms: urinary tract infection, UTI, pregnancy, bacteriuria). All identified human studies dealing with bacteriuria or UTI in pregnancy were analyzed. Limited data are available regarding the appropriate antibiotic management of UTI in pregnancy. Single-dose cure rates with amoxicillin are approximately 80 percent. Trimethoprim/sulfamethoxazole provides cure rates of greater than 80 percent. Cephalosporins and nitrofurantoin produce variable results. We recommend separating pregnant subjects with UTI into two groups. Those with asymptomatic bacteriuria can be treated with a single dose of an antimicrobial to which the organism is susceptible. For those with symptomatic UTI, we recommend amoxicillin 500 mg tid for three days. Urine cultures should be repeated seven days following therapy to assess cure or failure. Well-designed studies need to be performed, comparing single-dose and three-day therapy for UTI in pregnancy.

  20. Urinary tract infections in women with urogynaecological symptoms.

    Science.gov (United States)

    Lakeman, Marielle M E; Roovers, Jan-Paul W R

    2016-02-01

    Urinary tract infections are common in the field of urogynaecology. Women with persistent urinary symptoms seem more likely to have bacteriuria despite negative cultures. In this review, we will give an overview of the recent insights on the relationship between urinary tract infection and persistent urinary symptoms and possible new therapeutic options. Recently published articles evaluated the prevalence of low-count bacteriuria (≥10 CFU/ml) or intracellular bacterial communities in women with overactive bladder symptoms (OAB). Differences in urinary microbioma observed in women with and without OAB symptoms were evaluated. In the light of these findings, current screening strategies were discussed and alternative screening methods for bacteriuria developed. Low-count bacteriuria (≥10 CFU/ml) seems to be more prevalent in women with OAB. Also intracellular bacterial communities are more commonly detected in these women. The microbioma found in women with urinary symptoms appeared to differ from healthy controls. The current screening methods might be insufficient as they are targeted at detecting uropathogenic Escherichia coli, mostly using a detection threshold of at least 10 CFU/ml and failing to detect intracellular bacterial communities. Studies evaluating the efficacy of treating women with low-count bacteriuria are limited but promising.

  1. The Effects of Oxidative Stress in Urinary Tract Infection

    Directory of Open Access Journals (Sweden)

    Ergul Belge Kurutas

    2005-01-01

    Full Text Available We aimed to determine the effects of oxidative stress in urinary tract infection (UTI. One hundred sixty-four urine samples obtained from patients with the prediagnosis of acute UTI admitted to the Faculty of Medicine, Kahramanmaras Sutcu Imam University, were included in this study. Urine cultures were performed according to standard techniques. Urinary isolates were identified by using API ID 32E. The catalase and superoxide dismutase activity and the lipid peroxidation levels known as oxidative stress markers were measured in all urine samples. Thirty-six pathogen microorganisms were identified in positive urine cultures. These microorganisms were as follows: 23 (63.8% E coli, 5 (13.8% P mirabilis, 4 (11.1% K pneumoniae, 2 (5.5% Candida spp, 1 (2.7% S saprophyticus, and 1 (2.7% P aeruginosa. It was observed that lipid peroxidation levels were increased while catalase and superoxide dismutase activities were decreased in positive urine cultures, compared to negative cultures. We conclude that urinary tract infection causes oxidative stress, increases lipid peroxidation level, and leads to insufficiency of antioxidant enzymes.

  2. [Primary and secondary prevention of urinary tract infections].

    Science.gov (United States)

    Wagenlehner, F M E; Vahlensieck, W; Bauer, H W; Weidner, W; Naber, K G; Piechota, H J

    2011-10-01

    Urinary tract infections (UTI) are among the most frequent bacterial infections in the community and health care setting. Mostly young and, to some extent, postmenopausal women are affected by recurrent UTI (rUTI) defined as ≥3 UTI/year. On the other hand rUTI are frequently found in patients with complicating urological factors, e.g. urinary catheters. Modifiable predisposing factors in uncomplicated rUTI in women are rare. Continuous antibiotic prophylaxis or postcoital prophylaxis, if there is close correlation with sexual intercourse, are most effective to prevent rUTI. Nitrofurantoin, trimethoprim (or cotrimoxazole), and fosfomycin trometamol are available as first-line drugs. Oral cephalosporins and quinolones should be restricted to specific indications. Antibiotic prophylaxis reduces the number of uropathogens in the gut and/or vaginal flora and reduces bacterial"fitness". Given the correct indication, the recurrence rate of rUTI can be reduced by about 90%. In postmenopausal patients vaginal substitution of oestriol should be started first. Oral or parenteral immunoprophylaxis is another option in patients with rUTI. Other possibilities with varying scientific evidence are prophylaxis with cranberries or probiotics. The prophylaxis of catheter-associated UTI or asymptomatic bacteriuria should employ strategies which result in a reduction of frequency and duration of catheter drainage of the urinary tract. The currently available catheter materials have only little influence on reducing catheter-associated rUTI.

  3. Association Between Early Idiopathic Neonatal Jaundice and Urinary Tract Infections

    Science.gov (United States)

    Özcan, Murat; Sarici, S Ümit; Yurdugül, Yüksel; Akpinar, Melis; Altun, Demet; Özcan, Begüm; Serdar, Muhittin A; Sarici, Dilek

    2017-01-01

    Background and purpose: Etiologic role, incidence, demographic, and response-to-treatment characteristics of urinary tract infection (UTI) among neonates, its relationship with significant neonatal hyperbilirubinemia, and abnormalities of the urinary system were studied in a prospective investigation in early (≤10 days) idiopathic neonatal jaundice in which all other etiologic factors of neonatal hyperbilirubinemia were ruled out. Patients and methods: Urine samples for microscopic and bacteriologic examination were obtained with bladder catheterization from 155 newborns with early neonatal jaundice. Newborns with a negative urine culture and with a positive urine culture were defined as group I and group II, respectively, and the 2 groups were compared with each other. Results: The incidence of UTI in whole of the study group was 16.7%. Serum total and direct bilirubin levels were statistically significantly higher in group II when compared with group I (P = .005 and P = .001, respectively). Decrease in serum total bilirubin level at the 24th hour of phototherapy was statistically significantly higher in group I compared with group II (P = .022). Conclusions: Urinary tract infection should be investigated in the etiologic evaluation of newborns with significant hyperbilirubinemia. The possibility of UTI should be considered in jaundiced newborns who do not respond to phototherapy well or have a prolonged duration of phototherapy treatment. PMID:28469520

  4. Automated surveillance system for hospital-acquired urinary tract infections in Denmark

    DEFF Research Database (Denmark)

    Condell, Orla; Gubbels, Sophie; Nielsen, J

    2016-01-01

    BACKGROUND: The Danish Hospital-Acquired Infections Database (HAIBA) is an automated surveillance system using hospital administrative, microbiological, and antibiotic medication data. AIM: To define and evaluate the case definition for hospital-acquired urinary tract infection (HA-UTI) and to de......BACKGROUND: The Danish Hospital-Acquired Infections Database (HAIBA) is an automated surveillance system using hospital administrative, microbiological, and antibiotic medication data. AIM: To define and evaluate the case definition for hospital-acquired urinary tract infection (HA-UTI......) and to describe surveillance data from 2010 to 2014. METHODS: The HA-UTI algorithm defined a laboratory-diagnosed UTI as a urine culture positive for no more than two micro-organisms with at least one at ≥10(4)cfu/mL, and a probable UTI as a negative urine culture and a relevant diagnosis code or antibiotic...... treatment. UTI was considered hospital-acquired if a urine sample was collected ≥48h after admission and UTI was calculated per 10,000 risk-days. For validation, prevalence was calculated for each day and compared to point prevalence survey (PPS) data. FINDINGS: HAIBA...

  5. Uncomplicated duplex kidney and DMSA scintigraphy in children with urinary tract infection

    Energy Technology Data Exchange (ETDEWEB)

    Stokland, Eira [The Sahlgrenska Academy at Goeteborg University, Department of Paediatric Radiology, Goeteborg (Sweden); The Queen Silvia Children' s Hospital, Department of Paediatric Radiology, Goeteborg (Sweden); Jodal, Ulf; Swerkersson, Svante; Hansson, Sverker [The Sahlgrenska Academy at Goeteborg University, Department of Paediatrics, Goeteborg (Sweden); Sixt, Rune [The Sahlgrenska Academy at Goeteborg University, Department of Paediatric Clinical Physiology, Goeteborg (Sweden)

    2007-08-15

    Renal duplication is the most common malformation of the urinary tract and is frequently seen among children with urinary tract infection (UTI). To evaluate problems in the interpretation of dimercaptosuccinic acid (DMSA) scintigraphy and to establish the range of relative function in uncomplicated unilateral duplication. Retrospective analysis of 303 children less than 2 years of age with first time non-obstructive urinary tract infection investigated by both urography and DMSA scintigraphy. At DMSA scintigraphy, renal lesions and/or relative function below 45% was considered abnormal. Urography was used as reference for the diagnosis of duplication. Duplex kidneys were found in 22 of 303 patients (7%). Of the 16 children with unilateral duplication, 10 had bilaterally undamaged kidneys with a range of relative function varying between 51% and 57% in the duplex kidney. In two of the children with unilateral duplication the imaging results were discordant. There was risk of underdiagnosis as well as overdiagnosis of renal damage at scintigraphy. Although it is important to be aware of this risk, the rate of misinterpretation was low. A range of 51% to 57% can be used as the limit for normality of the relative function of a unilateral duplex kidney. (orig.)

  6. Uncomplicated duplex kidney and DMSA scintigraphy in children with urinary tract infection

    International Nuclear Information System (INIS)

    Stokland, Eira; Jodal, Ulf; Swerkersson, Svante; Hansson, Sverker; Sixt, Rune

    2007-01-01

    Renal duplication is the most common malformation of the urinary tract and is frequently seen among children with urinary tract infection (UTI). To evaluate problems in the interpretation of dimercaptosuccinic acid (DMSA) scintigraphy and to establish the range of relative function in uncomplicated unilateral duplication. Retrospective analysis of 303 children less than 2 years of age with first time non-obstructive urinary tract infection investigated by both urography and DMSA scintigraphy. At DMSA scintigraphy, renal lesions and/or relative function below 45% was considered abnormal. Urography was used as reference for the diagnosis of duplication. Duplex kidneys were found in 22 of 303 patients (7%). Of the 16 children with unilateral duplication, 10 had bilaterally undamaged kidneys with a range of relative function varying between 51% and 57% in the duplex kidney. In two of the children with unilateral duplication the imaging results were discordant. There was risk of underdiagnosis as well as overdiagnosis of renal damage at scintigraphy. Although it is important to be aware of this risk, the rate of misinterpretation was low. A range of 51% to 57% can be used as the limit for normality of the relative function of a unilateral duplex kidney. (orig.)

  7. [Genotypes of rhinoviruses in children and adults patients with acute respiratory tract infections].

    Science.gov (United States)

    Demirkan, Eda; Kırdar, Sevin; Ceylan, Emel; Yenigün, Ayşe; Kurt Ömürlü, İmran

    2017-10-01

    Rhinovirus (RV) is one of the most frequent causative agent of acute respiratory tract infections in the world. The virus may cause a mild cold, as well as more serious clinical symptoms in patients with immune system deficiency or comorbidities. Rhinoviruses have been identified by molecular methods under three types: RV-A, RV-B and RV-C. In most of the cases, it was reported that RV-A and RV-C were related with lower respiratory tract infections and asthma exacerbations, while RV-B was rarely reported in lower respiratory tract infections. The main objective of this study was to investigate RV species by sequence analysis in nasopharyngeal samples in pediatric and adult patients who were admitted to hospital with acute respiratory tract infections and to establish the relationship between species and age, gender and clinical diagnosis of the patients. Secondly, it was planned to emphasize the efficiency of the sequence analysis method in the determination of RV species. One hundred twenty seven patients (children and adults) who were followed up with acute respiratory tract infections in our university hospital were evaluated between January 2014 and January 2016. Viral loads were determined by quantitative real-time PCR in RV positive patients detected by a commercial kit in nasopharyngeal swab specimens. Thirty-one samples whose viral loads could not be determined were excluded from the study. The remaining 96 samples (50 children and 46 adults) were retested by conventional PCR using the target of VP4/VP2 gene region. A total of 65 samples (32 adults and 33 children) with the bands (549 bp) corresponding to the VP4/VP2 gene regions after the conventional PCR were analyzed by DNA sequencing. A phylogenetic tree was constructed using the neighbour-joining method. After sequence analysis it was determined that 28 (43.07%) were RV-A, 7 (10.76%) were RV-B and 28 (43.07%) were RV-C; and moreover one of each enterovirus (EV) species EV-D68 (1.53%) and EV-C (1

  8. Probiotic therapy: immunomodulating approach toward urinary tract infection.

    Science.gov (United States)

    Amdekar, Sarika; Singh, Vinod; Singh, Desh Deepak

    2011-11-01

    Urinary tract infection (UTI) is an extremely common health problem, with an unpredictable history. Members of enterobacteriaceae family such as Escherichia coli, which are normal inhabitants of human intestines, account for the majority of these uncomplicated infections. Rarely, UTI can result from virus or fungus. There is a close correlation between loss of the normal genital microbiota, particularly Lactobacillus species, and an increased incidence of genital and bladder infections. Although antimicrobial agents are generally effective in eradicating these infections, there is a high incidence of recurrence. Use of Lactobacillus species to combat UTI is now giving modern concept of modern genitourinary vaccine with the facts that it not only maintains low pH of the genital area, produces hydrogen peroxide and hinders the growth of E. coli but also activates Toll-like receptor-2 (TLR2), which produces interleukin-10 (IL-10) and myeloid differentiation factor 88 (MyD88). E. coli activates TLR4, which is responsible for the activation of IL-12, extracellular signal-regulated kinase (ERK) and c-Jun N-terminal kinase (JNK). This process downregulates inflammatory reactions caused due to pathogens. Current review covers the probiotics-based TLR therapy and shed some knowledge for the use of Lactobacillus species as probiotics.

  9. Labeling of antibiotics for infection diagnosis

    International Nuclear Information System (INIS)

    Benitez, A.; Roca, M.; Martin-Comin, J.

    2006-01-01

    The high impact of infection on daily clinical practice has promoted research into better and more accurate diagnostic and therapeutic methods. Localizing inflammation/infection with nuclear medicine techniques began over 40 years ago. Today, 6 7G a-scintigraphy, 9 9mT c-nanocolloid, 1 11I n and 9 9mT c in vitro labeled leukocytes, and monoclonal anti granulocyte antibodies are widely available for this purpose. While these methods are useful for localizing inflammation, they cannot always differentiate septic from aseptic processes. The ideal properties of an agent for diagnosing infection include: high specificity, early diagnosis, rapid blood clearance, ease of preparation, low toxicity, biodistribution appropriate for the disease under study, absence of immunologic response and low cost. A novel approach to infection diagnosis is the use of radiolabelled antibiotics. Antibiotics localize in the infectious focus, where they are frequently taken up and metabolized by microorganisms. The majority of the various antibiotics studied so far are those of the quinolones group (ciprofloxacin, sparfloxacin, enrofloxacin, levofloxacin, norfloxacin and ofloxacin). More recently, the labeling of ceftizoxime, a semisynthetic third generation cephalosporin, has been reported. The relevant features of labeled antibiotics in research and/or clinical infection diagnosis are the focus of this article

  10. Resistance of catheter-associated urinary tract infections to antibacterials

    Directory of Open Access Journals (Sweden)

    Verhaz Antonija

    2005-01-01

    Full Text Available Introduction. Catheter-associated urinary tract infections (CAUTI are the most common nosocomial infections. The worldwide data show the increasing resistance to conventional antibiotics among urinary tract pathogens. Aim. To evaluate the adequacy of initial antimicrobial therapy in relation to the antimicrobial resistance of pathogens responsible for CAUTI in Clinical Center of Banja Luka. Methods. A retrospective study on major causes of CAUTI, antibiotic resistance and treatment principles was conducted at four departments of the Clinical Center of Banja Luka from January 1st, 2000 to April 1st, 2003. Results. The results showed that 265 patients had developed CAUTI. The seven most commonly isolated microorganisms were, in descending order: E. coli (31.0%, Pseudomonas aeruginosa (13.8%, Proteus mirabilis (12.9%, Gr. Klebsiella-Enterobacter (12.3%, Enterococcus spp. (5.2%, Pseudomonas spp. (4.3%, Serratia spp. (4.0%. The most common pathogens were highly resistant to ampicillin (64−100%, gentamycin (63−100%, and trimethoprim-sulfamethoxazole (68−100%, while some bacterias, like Pseudomonas aeruginosa and Serratia spp. showed rates of ciprofloxacin resistance as high as 42.8% and 72.7%, respectively. In 55.5% of the cases, the initial antibiotic therapy was inadequate, and was corrected latter on. There were no standard therapeutic protocols for this type of nosocomial infections. Conclusion. The results of this study emphasized an urgency of the prevention and introduction of clinical protocols for better management of CAUTI. Treatment principles should better correspond to the antibiotic sensitivity of uropathogens.

  11. Urinary Tract Infection Antibiotic Trial Study Design: A Systematic Review.

    Science.gov (United States)

    Basmaci, Romain; Vazouras, Konstantinos; Bielicki, Julia; Folgori, Laura; Hsia, Yingfen; Zaoutis, Theoklis; Sharland, Mike

    2017-12-01

    Urinary tract infections (UTIs) represent common bacterial infections in children. No guidance on the conduct of pediatric febrile UTI clinical trials (CTs) exist. To assess the criteria used for patient selection and the efficacy end points in febrile pediatric UTI CTs. Medline, Embase, Cochrane central databases, and clinicaltrials.gov were searched between January 1, 1990, and November 24, 2016. We combined Medical Subject Headings terms and free-text terms for "urinary tract infections" and "therapeutics" and "clinical trials" in children (0-18 years), identifying 3086 articles. Two independent reviewers assessed study quality and performed data extraction. We included 40 CTs in which a total of 4381 cases of pediatric UTIs were investigated. Positive urine culture results and fever were the most common inclusion criteria (93% and 78%, respectively). Urine sampling method, pyuria, and colony thresholds were highly variable. Clinical and microbiological end points were assessed in 88% and 93% of the studies, respectively. Timing for end point assessment was highly variable, and only 3 studies (17%) out of the 18 performed after the Food and Drug Administration 1998 guidance publication assessed primary and secondary end points consistently with this guidance. Our limitations included a mixed population of healthy children and children with an underlying condition. In 6 trials, researchers studied a subgroup of patients with afebrile UTI. We observed a wide variability in the microbiological inclusion criteria and the timing for end point assessment. The available guidance for adults appear not to be used by pediatricians and do not seem applicable to the childhood UTI. A harmonized design for pediatric UTIs CT is necessary. Copyright © 2017 by the American Academy of Pediatrics.

  12. Factors associated with urinary tract infections among HIV-1 infected patients.

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    Agata Skrzat-Klapaczyńska

    Full Text Available Urinary tract infections remain an important yet underinvestigated clinical problem among HIV infected patients. Here we analyze factors associated with its occurrence and the spectrum of bacterial pathogens identified in the group of patients followed at the HIV Out-Patient Clinic in Warsaw.Clinic database collected all medical information on patients routinely followed since 1994 to 2015. All patients with available urine culture were included into analyses, only the first culture was included. In statistical analyses logistic regression models were used to identify factors associated with positive culture.In total 608 patients had urine culture performed, 176 (28.9% were females and 432 (71,1% were males, 378 (62.2% registered in care before/in 2007, 258 (42.4% infected through homosexual contact. Median baseline lymphocyte CD4+ count was 385 (IQR:204-565 cells/μl and median nadir lymphocyte CD4+ count 197 (86-306 cells/μl. One hundred and eighteen patients were actively infected with HCV, as defined by positive real-time PCR. In total 141 (23.2% patients had positive urine culture, the most common bacterial pathogen was E.coli (58.2% and E. faecalis (12.8%. Patients with urinary tract infection were more likely to be female (51.8% vs. 22.1%, p<0.0001, infected through other than homosexual mode (80.1% vs. 50.7%, p<0.0001, with lower nadir CD4 count (139 vs. 221 cells/μl, p<0.0001 and lower baseline HIV RNA (4.02 vs. 4.35 log copies/ml, p = 0.01 and less likely to be HCV RNA positive (26.9% vs. 49.2%, p = 0.01. In multivariate regression model being registered before/in 2007 (OR = 2.10; [95%CI: 1.24-3.56], infected through other than homosexual mode (2.05;[1.18-3.56] and female gender (2.14;[1.33-3.44] were increasing and higher nadir CD4+ count decreasing (0.92;[0.85-0.99] the odds of urinary tract infection.We have identified that almost one third of patients had urinary tract infections with non-typical bacterial pathogens. Population

  13. Development of a Vaccine against Escherichia coli Urinary Tract Infections

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    Harry L. T. Mobley

    2015-12-01

    Full Text Available Urinary tract infection (UTI is the second most common infection in humans after those involving the respiratory tract. This results not only in huge annual economic costs, but in decreased workforce productivity and high patient morbidity. Most infections are caused by uropathogenic Escherichia coli (UPEC. Antibiotic treatment is generally effective for eradication of the infecting strain; however, documentation of increasing antibiotic resistance, allergic reaction to certain pharmaceuticals, alteration of normal gut flora, and failure to prevent recurrent infections represent significant barriers to treatment. As a result, approaches to prevent UTI such as vaccination represent a gap that must be addressed. Our laboratory has made progress toward development of a preventive vaccine against UPEC. The long-term research goal is to prevent UTIs in women with recurrent UTIs. Our objective has been to identify the optimal combination of protective antigens for inclusion in an effective UTI vaccine, optimal adjuvant, optimal dose, and optimal route of delivery. We hypothesized that a multi-subunit vaccine elicits antibody that protects against experimental challenge with UPEC strains. We have systematically identified four antigens that can individually protect experimentally infected mice from colonization of the bladder and/or kidneys by UPEC when administered intranasally with cholera toxin (CT as an adjuvant. To advance the vaccine for utility in humans, we will group the individual antigens, all associated with iron acquisition (IreA, Hma, IutA, FyuA, into an effective combination to establish a multi-subunit vaccine. We demonstrated for all four vaccine antigens that antigen-specific serum IgG represents a strong correlate of protection in vaccinated mice. High antibody titers correlate with low colony forming units (CFUs of UPEC following transurethral challenge of vaccinated mice. However, the contribution of cell-mediated immunity cannot

  14. Etiology of urinary tract infection in scholar children

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    Barroso Jr. Ubirajara

    2003-01-01

    Full Text Available OBJECTIVE: To prospectively assess the prevalence of vesicourethral dysfunction in children over 3 years old, comparing it with the occurrence rate for other potential factors that cause urinary infection in this age range. MATERIALS AND METHODS: 36 girls and 9 boys were assessed, with mean age of 6.4 years, ranging from 3 to 13.9 years. These children were prospectively assessed regarding the presence of symptoms of lower urinary tract dysfunction. These data were compared with the retrospective assessment of other potential risk factors for urinary infection. Ultrasonography was performed in 28 children and voiding cystourethrogram was performed in 26 patients. RESULTS: Vesicourethral dysfunction was diagnosed in 39 (87% of the 45 children with urinary infection. Among these 39 patients, all had voiding urgency, 30 (77% had urinary incontinence, 12 (31% pollakiuria and 3 (8% presented infrequent voiding. Vaginal discharge was evidenced in 8 (22% girls and phimosis in 2 (22% boys. Obstipation was diagnosed in 10 (22% cases. Significant post-voiding residue was detected in 4 (13% of the 28 cases assessed. Vesicoureteral reflux was evidenced in 5 (19% of the 26 patients who underwent voiding cystourethrogram. In only 2 (4% cases there was not an apparent cause for the infection. CONCLUSION: Vesicourethral dysfunction is a major cause of urinary infection in children with ages above 3 years old. In cases where voiding dysfunction in not present, other predisposing factors must be assessed. However, only 4% of the patients did not present an apparent urologic cause for the infection.

  15. Chlamydia trachomatis infection of the male genital tract: an update.

    Science.gov (United States)

    Mackern-Oberti, Juan Pablo; Motrich, Rubén Darío; Breser, María Laura; Sánchez, Leonardo Rodolfo; Cuffini, Cecilia; Rivero, Virginia Elena

    2013-11-01

    Chlamydia trachomatis (CT) is the most prevalent cause of sexually transmitted diseases. Although the prevalence of chlamydial infection is similar in men and women, current research and screening are still focused on women, who develop the most severe complications, leaving the study of male genital tract (MGT) infection underrated. Herein, we reviewed the literature on genital CT infection with special focus on the MGT. Data indicate that CT certainly infects different parts of the MGT such as the urethra, seminal vesicles, prostate, epididymis and testis. However, whether or not CT infection has detrimental effects on male fertility is still controversial. The most important features of CT infection are its chronic nature and the presence of a mild inflammation that remains subclinical in most individuals. Chlamydia antigens and pathogen recognition receptors (PRR), expressed on epithelial cells and immune cells from the MGT, have been studied in the last years. Toll-like receptor (TLR) expression has been observed in the testis, epididymis, prostate and vas deferens. It has been demonstrated that recognition of chlamydial antigens is associated with TLR2, TLR4, and possibly, other PRRs. CT recognition by PRRs induces a local production of cytokines/chemokines, which, in turn, provoke chronic inflammation that might evolve in the onset of an autoimmune process in genetically susceptible individuals. Understanding local immune response along the MGT, as well as the crosstalk between resident leukocytes, epithelial, and stromal cells, would be crucial in inducing a protective immunity, thus adding to the design of new therapeutic approaches to a Chlamydia vaccine. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  16. Laboratory diagnosis of persistent human chlamydial infection

    Directory of Open Access Journals (Sweden)

    Mirja ePuolakkainen

    2013-12-01

    Full Text Available Diagnostic assays for persistent chlamydial infection are much needed to conduct high-quality, large-scale studies investigating the persistent state in vivo, its disease associations and the response to therapy. Yet in most studies the distinction between acute and persistent infection is based on the interpretation of the data obtained by the assays developed to diagnose acute infections or on complex assays available for research only and/or difficult to establish for clinical use. Novel biomarkers for detection of persistent chlamydial infection are urgently needed. Chlamydial whole genome proteome arrays are now available and they can identify chlamydial antigens that are differentially expressed between acute infection and persistent infection. Utilizing these data will lead to the development of novel diagnostic assays. Carefully selected specimens from well-studied patient populations are clearly needed in the process of translating the proteomic data into assays useful for clinical practice. Before such antigens are identified and validated assays become available, we face a challenge of deciding whether the persistent infection truly induced appearance of the proposed marker or do we just base our diagnosis of persistent infection on the presence of the suggested markers. Consequently, we must bear this in mind when interpreting the available data.

  17. Modern imaging technology for childhood urinary tract infection

    International Nuclear Information System (INIS)

    Riccabona, M.; Fotter, R.

    2005-01-01

    Imaging in childhood urinary tract infection (UTI) is still a matter of debate. There are established guidelines, however new knowledge and the changed medical environment have enhanced this ongoing discussion. These new insights have impacted therapy and consequently the imaging algorithm. Modern imaging methods - particularly MRI and modern ultrasound (US) - are less invasive with a lower radiation burden. Additionally, it has been shown that VUR is a poor predictor for renal scarring out, which affects long-term results. Furthermore, the majority of UT malformations is depicted by prenatal US. The most crucial aspect of improving long-term outcome appears to be the early and reliable depiction of UTI and effective treatment to prevent renal scarring. This review tries to present this new knowledge and to discuss the potential of modern imaging. Recent changes in imaging algorithms are highlighted and an outcome-oriented algorithm that addresses these recent developments is proposed, without lightly abandoning established standards. It consists of an orienting US and - for depiction of renal involvement - amplitude coded color Doppler sonography or renal static scintigraphy (considered the gold standard, particularly for evaluating scars); in future MRI may play a role. Based on this concept, only patients with renal damage as well as patients with complex urinary tract malformations or intractable recurrent UTI may have to undergo VCUG. (orig.) [de

  18. [Treatment of fungal infections of upper respiratory tract and ear].

    Science.gov (United States)

    Kurnatowski, Piotr; Kurnatowska, Agnieszka K

    2007-01-01

    Fungi, in comparison with other pathogenic factors, have high pathogenicity. The number of fungal species which are able to infect people is over 500. The upper respiratory tract and ear have permanent contact with external environment which makes their ontocenoses open to continuous exchange of microorganisms of which they consist. In etiology of inflammatory processes 21 species which belonging to 3 genera (Zygomycota, Ascomycota, Basidiomycota) of fungi play important role. Administration of antifungal drugs can be: prophylactic, empiric preemptive and therapeutic. Physicians may prescribe antibiotics (mainly pollens: amphotericin B, natamycin and nystatin) and chemiotherapeutics (mainly azoles and fluorpirymidins, pigments, chlorhexidine and chlorquinaldol). In ENT practice topical and systemic drugs can be administrated. Topical lozenges include amphotericin B, clotrimazole, chlorhexidine or chlorquinaldol and oral gels: nystatin and miconazole. Some of drugs are in the form of suspension/solution, which can be used for inhalation, into the sinus, for swabbing or for lavage: amphotericin B, natamycin, nystatin, clotrimazol, flucytosine, miconazole, fluconazole, vorykonazole, caspofungin. It should be underlined that only a few of dugs can be absorbed from the digestive tract: flucytosine, fluconazole, itraconazole, ketoconazole, miconazole, vorykonazole.

  19. Antibiotic resistance in children with complicated urinary tract infection

    International Nuclear Information System (INIS)

    Yildiz, B.; Kural, N.; Yarar, C.; Ak, I.; Akcar, N.

    2007-01-01

    Objective was to determine the resistance of antibiotics for complicated urinary tract infection (UTI), including urinary tract anomaly (UTA), for empirical antibiotic therapy of complicated UTI. Four hundred and twenty two urine isolates were obtained from 113 patients with recurrent UTI, who used prophylactic antibiotics between February 1999 and November 2004 in the Eskisehir Osmangazi University, Eskisehir, Turkey. Reflux was found to be most important predisposing factor for recurrent UTI (31.9%). Renal scar was detected more in patients with UTA than without UTA (59.2% versus 12.4%, p<0.05). Gram-negative organisms were dominant in patients with and without UTA (91.5% and 79.2%). Enterococci and Candida spp. were more prevalent in children with UTA than without UTA (p<0.001). Isolates were significantly more resistant to ampicillin, trimethoprim-sulfamethoxazole, amikacin, co-amoxiclav, ticarcillin-clvalanate and piperacillin-tazobactam in patients with UTA than without UTA. We found low resistance to ciprofloxacin and nitrofurantoin in UTI with and without UTA. Enterococci spp. was highly resistance to ampicillin and amikacin in patients with UTA. Aztreonam, meropenem and ciprofloxacin seemed to be the best choice for treatment of UTI with UTA due to Escherichia coli and Klebsiella spp. Nitrofurantoin and nalidixic acid may be first choice antibiotics for prophylaxis in UTI with and without UTA. The UTI with UTA caused by Enterococci spp. might not benefit from a combination of amikacin and ampicillin, it could be treated with glycopeptides. (author)

  20. Urinary tract infections in general practice patients: diagnostic tests versus bacteriological culture.

    NARCIS (Netherlands)

    Nys, S.; Merode, T. van; Bartelds, A.I.M.; Stobberingh, E.E.

    2006-01-01

    Objectives: Urinary tract infections (UTIs) are common bacterial infections encountered in general practice. For the optimal treatment the general practitioner (GP) should rely on the results of diagnostic tests and recent antimicrobial susceptibility of uropathogens. Patients and methods: In total

  1. Anti-inflammatory therapy for urinary tract infection in children

    Directory of Open Access Journals (Sweden)

    A. A. Vyalkova

    2015-01-01

    Full Text Available Objective: to substantiate the importance of an etiological approach to diagnosing urinary tract infection in children in terms of the species and biological properties of an infectious agent and to evaluate the efficiency of anti-inflammatory therapy. The study included 116 patients aged 3-15 years with chronic pyelonephritis (Group 1 and isolated bacteriuria (Group 2. After 10-14-day antibiotic therapy, Group 1 patients were allocated to two subgroups: Subgroup la («=30 took furamag 5 mg/kg/day; Subgroup lb («=30 received furamag at the same dose in combination with canephron. The treatment cycle lasted 10-14 days. Subgroup 2a («=26 children had furamag 5 mgДg/day and Subgroup 2b (« =30 took furamag in combination with canephron. The duration of treatment was 14 days. The investigators established the high efficiency of therapy with furamag for renal infection in the children with the active and decrement phases and that of the drug of choice for its monotherapy of isolated highly virulent bacteriuria. Therapeutic efficiency was proven to be related to the species and biological characteristics of an infectious agent. Anti-inflammatory therapy for pyelonephritis in terms of the species of pathogenic bacteria was ascertained to improve the efficiency of treatment. A rationale was provided for the individual choice of antibiotics, followed by the use of furamag, eubiotics, and drugs aimed at inhibiting virulence factors and persistence of the pathogen to sanitize the primary focus of infection.

  2. Considering Respiratory Tract Infections and Antimicrobial Sensitivity: An Exploratory Analysis

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    Amin, R.

    2009-01-01

    Full Text Available This study was conducted to observe the sensitivity and resistance of status of antibiotics for respiratory tract infection (RTI. Throat swab culture and sensitivity report of 383 patients revealed sensitivity profiles were observed with amoxycillin (7.9%, penicillin (33.7%, ampicillin (36.6%, co-trimoxazole (46.5%, azithromycin (53.5%, erythromycin (57.4%, cephalexin (69.3%, gentamycin (78.2%, ciprofloxacin (80.2%, cephradine (81.2%, ceftazidime (93.1%, ceftriaxone (93.1%. Sensitivity to cefuroxime was reported 93.1% cases. Resistance was found with amoxycillin (90.1%, ampicillin (64.1%, penicillin (61.4%, co-trimoxazole (43.6%, erythromycin (39.6%, and azithromycin (34.7%. Cefuroxime demonstrates high level of sensitivity than other antibiotics and supports its consideration with patients with upper RTI.

  3. Do pollution and climate influence respiratory tract infections in children?

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    Saulo Duarte Passos

    2014-06-01

    Full Text Available To review if pollution and climate changes can influence respiratory tract infections in children. Data source: articles published on the subject in PubMed, SciELO, Bireme, EBSCO and UpTodate were reviewed. The following inclusion criteria were considered: scientific papers between 2002 and 2012, study design, the pediatric population, reference documents such as the CETESB and World Health Organization Summary of the data: We analyzed research that correlated respiratory viruses and climate and/or pollution changes. Respiratory syncytial virus has been the virus related most to changes in climate and humidity. Other "old and new" respiratory viruses such as Human Bocavirus, Metapneumovirus, Parechovirus and Parainfuenza would need to be investigated owing to their clinical importance. Although much has been studied with regard to the relationship between climate change and public health, specific studies about its influence on children's health remain scarce.

  4. Is Escherichia coli urinary tract infection a zoonosis?

    DEFF Research Database (Denmark)

    Jacobsen, L.; Garneau, P.; Bruant, G.

    2012-01-01

    Recently, it has been suggested that the Escherichia coli causing urinary tract infection (UTI) may come from meat and animals. The purpose was to investigate if a clonal link existed between E. coli from animals, meat and UTI patients. Twenty-two geographically and temporally matched B2 E. coli...... from UTI patients, community-dwelling humans, broiler chicken meat, pork, and broiler chicken, previously identified to exhibit eight virulence genotypes by microarraydetection of approximately 300 genes, were investigated for clonal relatedness by PFGE. Nine isolates were selected and tested...... for in vivo virulence in the mouse model of ascending UTI. UTI and community-dwelling human strains were closely clonally related to meat strains. Several human derived strains were also clonally interrelated. All nine isolates regardless of origin were virulent in the UTI model with positive urine, bladder...

  5. Community acquired urinary tract infection: etiology and bacterial susceptibility

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    Dias Neto José Anastácio

    2003-01-01

    Full Text Available PURPOSE: Urinary tract infections (UTI are one of the most common infectious diseases diagnosed. UTI account for a large proportion of antibacterial drug consumption and have large socio-economic impacts. Since the majority of the treatments begins or is done completely empirically, the knowledge of the organisms, their epidemiological characteristics and their antibacterial susceptibility that may vary with time is mandatory. OBJECTIVE: The aim of this study was to report the prevalence of uropathogens and their antibiotic susceptibility of the community acquired UTI diagnosed in our institution and to provide a national data. METHODS: We analyzed retrospectively the results of urine cultures of 402 patients that had community acquired urinary tract infection in the year of 2003. RESULTS: The mean age of the patients in this study was 45.34 ± 23.56 (SD years. There were 242 (60.2% females and 160 (39.8% males. The most commonly isolated organism was Escherichia coli (58%. Klebsiella sp. (8.4% and Enterococcus sp.(7.9% were reported as the next most common organisms. Of all bacteria isolated from community acquired UTI, only 37% were sensitive to ampicillin, 51% to cefalothin and 52% to trimethoprim/sulfamethoxazole. The highest levels of susceptibility were to imipenem (96%, ceftriaxone (90%, amikacin (90%, gentamicin (88%, levofloxacin (86%, ciprofloxacin (73%, nitrofurantoin (77% and norfloxacin (75%. CONCLUSION: Gram-negative agents are the most common cause of UTI. Fluoroquinolones remains the choice among the orally administered antibiotics, followed by nitrofurantoin, second and third generation cephalosporins. For severe disease that require parenteral antibiotics the choice should be aminoglycosides, third generation cephalosporins, fluoroquinolones or imipenem, which were the most effective.

  6. Urinary tract infections in extended care facilities: preventive management strategies.

    Science.gov (United States)

    Regal, Randolph E; Pham, Co Q D; Bostwick, Thomas R

    2006-05-01

    To provide health care professionals with an overview of interventions that may be done to reduce the incidence of urinary tract infections (UTIs) in elderly patients, especially those residing in extended care facilities. A Medline search of the English literature was performed from 1980 to January 2006 to find literature relevant to urinary tract prophylaxis. Further references were hand-searched from relevant sources. When assessing the effectiveness of various clinical interventions for reducing the incidence of UTIs in the elderly, preference was given to more recent, double-blind, placebo-controlled randomized studies, but studies of less robust design also were included in the discussions when the former were lacking. Where possible, recent publications were favored over older studies. References were all reviewed by the authors and chosen to present key citations. Data selection was prioritized to address specific subtopics. Though still frequent in occurrence and quite costly in terms of morbidity, mortality, and cost to the health care system, numerous measures may be taken to ameliorate the incidence of UTIs in elderly, institutionalized residents. First and foremost, establishing and adhering to good infection-control practices by health care givers and minimizing the use of indwelling catheters are essential. Adequate staffing and training are germane to this effort. Reasonably well-designed clinical studies also give credence to the use of topical estrogens and lactobacillus "probiotics" for female subgroups and cranberry juice for a wider array of patients. Vitamin C is of no proven benefit. With regard to antibiotics, with the relative paucity of data available for this patient population, concerns for resistance proliferation must be balanced against perceived gains in UTI reduction.

  7. CLINICAL EFFICACY OF IBUPROFEN IN THERAPY FOR VIRAL UPPER RESPIRATORY TRACT INFECTIONS IN INFANTS

    Directory of Open Access Journals (Sweden)

    I.O. Skugarevskaya

    2006-01-01

    Full Text Available A study of use of ibuprofen in cases of viral upper respiratory tract infections (Vuri in children of early childhood has proved its' safety and efficacy. This medical agent has not only terminate fever but also diminished some other symptoms of Vuri.Key words: ibuprofen, viral upper respiratory tract infections, children.

  8. Coxsackievirus A21, Enterovirus 68, and Acute Respiratory Tract Infection, China

    OpenAIRE

    Xiang, Zichun; Gonzalez, Richard; Wang, Zhong; Ren, Lili; Xiao, Yan; Li, Jianguo; Li, Yongjun; Vernet, Guy; Paranhos-Baccalà, Gláucia; Jin, Qi; Wang, Jianwei

    2012-01-01

    During August 2006–April 2010, in Beijing, China, 2 rare human enterovirus serotypes, coxsackievirus A21 and enterovirus 68, were detected most frequently in human enterovirus–positive adults with acute respiratory tract infections. Thus, during some years, these 2 viruses cause a substantial proportion of enterovirus-associated adult acute respiratory tract infections.

  9. Urinary tract infections in patients with diabetes mellitus: epidemiology, pathogenesis and treatment

    NARCIS (Netherlands)

    Geerlings, Suzanne E.

    2008-01-01

    Patients with diabetes mellitus (DM) have a higher prevalence of asymptomatic bacteriuria (ASB) and incidence of urinary tract infections (UTIs) compared with patients without DM. They also more often have bacteraemia, with the urinary tract as the most common focus for these infections, as well as

  10. Incidence and risk factors for pin tract infection in external fixation of ...

    African Journals Online (AJOL)

    Incidence and risk factors for pin tract infection in external fixation of fractures ... for pin tract infection, there were 93 pins scored grade 1, 32 pins grade 2, 15 ... The incidence increased from 20.5% in closed fractures to 75.9% in open fractures.

  11. Plasma soluble urokinase plasminogen activator receptor in children with urinary tract infection

    DEFF Research Database (Denmark)

    Wittenhagen, Per; Andersen, Jesper Brandt; Hansen, Anita

    2011-01-01

    In this prospective study we investigated the role of plasma levels of soluble urokinase plasminogen activator receptor (suPAR) in children with urinary tract infection.......In this prospective study we investigated the role of plasma levels of soluble urokinase plasminogen activator receptor (suPAR) in children with urinary tract infection....

  12. Pediatric urinary tract infection as a cause of outpatient clinic visits in ...

    African Journals Online (AJOL)

    Background: Failure to timely diagnose and treat urinary tract infections is associated with grave long term consequences. The objectives of this study included assessing the proportion and predictors of Urinary Tract Infection (UTI) as a cause of pediatric outpatient department (OPD) visits and determining common ...

  13. Clinical analysis of urinary tract infection in patients undergoing transurethral resection of the prostate.

    Science.gov (United States)

    Li, Y-H; Li, G-Q; Guo, S-M; Che, Y-N; Wang, X; Cheng, F-T

    2017-10-01

    To analyze the related influencing factors of urinary tract infection in patients undergoing transurethral resection of the prostate (TURP). A total of 343 patients with benign prostatic hyperplasia admitted to this hospital from January 2013 to December 2016, were selected and treated by TURP. Patients were divided into infection group and non-infection group according to the occurrence of urinary tract infection after operation. The possible influencing factors were collected to perform univariate and multivariate logistic regression analysis. There were 53 cases with urinary tract infection after operation among 343 patients with benign prostatic hyperplasia, accounting for 15.5%. The univariate analysis displayed that the occurrence of urinary tract infection in patients undergoing TURP was closely associated with patient's age ≥ 65 years old, complicated diabetes, catheterization for urinary retention before operation, no use of antibiotics before operation and postoperative indwelling catheter duration ≥ 5 d (p urinary tract infection in patients receiving TURP (p urinary tract infection after TURP, while preoperative prophylactic utilization of anti-infective drugs can reduce the occurrence of postoperative urinary tract infection.

  14. Urinary tract infection and adverse outcome of pregnancy.

    Science.gov (United States)

    Dimetry, Shaira R; El-Tokhy, Hanan M; Abdo, Nagla M; Ebrahim, Moustafa A; Eissa, Mohammed

    2007-01-01

    Urinary tract infections (UTIs) during pregnancy are among the commonest health problems world wide, specially in developing countries, including Egypt. It has several adverse outcomes not only on the mother but also on the fetus as well.. The aim of this study is to determine the incidence of UTIs during pregnancy, study the main risk factors associated with such infections and find the impact of these infections on some pregnancy outcomes namely the gestational age and birth weight. A follow-up study on 249 pregnant women attending the ante natal care clinic at Zagazig university hospital. They were recruited over a period from 1st of September to 30th of or November, 2005. The outcome could be recorded for 201 of them. Data were collected through a pretested questionnaire, repeated urine analyses and recording of outcome of pregnancy. The study revealed that the incidence of UTIs during pregnancy was 31.3%. The commonest organisms were Klebsiella and E-coli. Several socio-demographic characteristics were found significantly associated with UTIs, age being 30 years and more, illiterates and low educational level, low socio-economic level and those with unsatisfactory personal hygiene and those using underwear clothes other than cotton. Significant associations with UTIs were also found in multigravidae 4th and more, those having more than one child and those who previously suffered UTIs. The only predicting variable with UTIs was low socio-economic level. The study revealed that the probability of delivering premature infants and low birth weights was significantly higher among those who experienced UTIs during pregnancy. Multivariate analysis revealed that UTI was one of the main contributors to pre-mature deliveries. Urinary tract infections with pregnancy still constitute a big problem with high incidence. It has a great impact on pregnancy outcome mainly pre-mature labor. So, the study recommends health education about personal hygiene, repeated urine

  15. Maternal urinary tract infection as a risk factor for neonatal urinary tract infection.

    Science.gov (United States)

    Emamghorashi, Fatemeh; Mahmoodi, Nasrin; Tagarod, Zahra; Heydari, Seyed Taghi

    2012-05-01

    The aim of the present study was to evaluate the association of maternal UTI during pregnancy with neonatal UTI. One hundred and fourteen neonates admitted to hospital were enrolled in the present study, of whom 40 were admitted for management of UTI and 74 for management of jaundice. Urinalysis and urine culture were carried out for all of the neonates. Data regarding gestational age, history of UTI in the mother during pregnancy, and urinary symptoms of neonates were collected. The mean gestational age of the neonates was 38.4 ± 1.4 weeks (range, 30 to 40 weeks) and their mean age at admission was 6.2 ± 3.8 days old (range, 1 to 25 days). The mean gestational age and birth weight of the two groups with and without UTI were 38.38 ± 1.32 weeks versus 38.41 ± 1.62 weeks and 2930.43 ± 492.15 g versus 2930 ± 447.33 g, respectively. No abnormal findings were detected on physical examinations, and none of the neonate had abnormal renal ultrasonography findings. There was a significant relationship between maternal prenatal UTI and neonatal infection; 30.0% of the neonates with UTI versus 6.8% of those without UTI had mothers with a history of UTI (odds ratio, 5.9; 95% confidence interval, 1.9 to 18.3; P = .001). Our study showed an association between maternal and neonatal UTI. This indicates a possible benefit of evaluation of neonates of mothers who had UTI during pregnancy.

  16. Characterisation of antibiotic prescriptions for acute respiratory tract infections in Danish general practice

    DEFF Research Database (Denmark)

    Aabenhus, Rune; Hansen, Malene Plejdrup; Saust, Laura Trolle

    2017-01-01

    Inappropriate use of antibiotics is contributing to the increasing rates of antimicrobial resistance. Several Danish guidelines on antibiotic prescribing for acute respiratory tract infections in general practice have been issued to promote rational prescribing of antibiotics, however it is unclear...... if these recommendations are followed. We aimed to characterise the pattern of antibiotic prescriptions for patients diagnosed with acute respiratory tract infections, by means of electronic prescriptions, labeled with clinical indications, from Danish general practice. Acute respiratory tract infections accounted for 456...... prescription patterns for acute respiratory tract infections by data linkage of clinical indications. The findings confirm that penicillin V is the most commonly prescribed antibiotic agent for treatment of patients with an acute respiratory tract infection in Danish general practice. However, second...

  17. Novel Strategies in the Prevention and Treatment of Urinary Tract Infections

    Science.gov (United States)

    Lüthje, Petra; Brauner, Annelie

    2016-01-01

    Urinary tract infections are one of the most common bacterial infections, especially in women and children, frequently treated with antibiotics. The alarming increase in antibiotic resistance is a global threat to future treatment of infections. Therefore, alternative strategies are urgently needed. The innate immune system plays a fundamental role in protecting the urinary tract from infections. Antimicrobial peptides form an important part of the innate immunity. They are produced by epithelial cells and neutrophils and defend the urinary tract against invading bacteria. Since efficient resistance mechanisms have not evolved among bacterial pathogens, much effort has been put into exploring the role of antimicrobial peptides and possibilities to utilize them in clinical practice. Here, we describe the impact of antimicrobial peptides in the urinary tract and ways to enhance the production by hormones like vitamin D and estrogen. We also discuss the potential of medicinal herbs to be used in the prophylaxis and the treatment of urinary tract infections. PMID:26828523

  18. Triple valve infective endocarditis - a late diagnosis

    Directory of Open Access Journals (Sweden)

    Edme R. Mustafa

    2018-04-01

    Full Text Available Behcet's disease is a systemic vasculitis of unknown aetiology with cardiac involvement as well as damage to other organs. Whether the sterile valvular inflammation which occurs in this autoimmune disease predisposes to bacterial adhesion and infective endocarditis is not yet established. We present the case of a patient with Behcet disease in which transthoracic echocardiography showed mobile masses on the aortic, tricuspid, and mitral valves, leading to multivalvular infective endocarditis diagnosis, possibly in the context of valvular inflammation. The case presented in this article confirms observation of other studies, namely that ultrasonography plays an important role in the diagnosis and evaluation of rheumatic diseases and permits optimal management in daily practice.

  19. Metagenomic analysis of viral diversity in respiratory samples from patients with respiratory tract infections in Kuwait.

    Science.gov (United States)

    Madi, Nada; Al-Nakib, Widad; Mustafa, Abu Salim; Habibi, Nazima

    2018-03-01

    A metagenomic approach based on target independent next-generation sequencing has become a known method for the detection of both known and novel viruses in clinical samples. This study aimed to use the metagenomic sequencing approach to characterize the viral diversity in respiratory samples from patients with respiratory tract infections. We have investigated 86 respiratory samples received from various hospitals in Kuwait between 2015 and 2016 for the diagnosis of respiratory tract infections. A metagenomic approach using the next-generation sequencer to characterize viruses was used. According to the metagenomic analysis, an average of 145, 019 reads were identified, and 2% of these reads were of viral origin. Also, metagenomic analysis of the viral sequences revealed many known respiratory viruses, which were detected in 30.2% of the clinical samples. Also, sequences of non-respiratory viruses were detected in 14% of the clinical samples, while sequences of non-human viruses were detected in 55.8% of the clinical samples. The average genome coverage of the viruses was 12% with the highest genome coverage of 99.2% for respiratory syncytial virus, and the lowest was 1% for torque teno midi virus 2. Our results showed 47.7% agreement between multiplex Real-Time PCR and metagenomics sequencing in the detection of respiratory viruses in the clinical samples. Though there are some difficulties in using this method to clinical samples such as specimen quality, these observations are indicative of the promising utility of the metagenomic sequencing approach for the identification of respiratory viruses in patients with respiratory tract infections. © 2017 Wiley Periodicals, Inc.

  20. Variation in definitions of urinary tract infections in spina bifida patients: a systematic review.

    Science.gov (United States)

    Madden-Fuentes, Ramiro Jose; McNamara, Erin Rebekah; Lloyd, Jessica Catherine; Wiener, John Samuel; Routh, Jonathan Charles; Seed, Patrick Casey; Ross, Sherry Sedberry

    2013-07-01

    Urinary tract infections (UTIs) are a common source of morbidity among children with spina bifida (SB) and are a frequently reported outcome in studies of this patient population. However, the criteria for a diagnosis of UTI are often not stated. We evaluated the literature on SB patients for the criteria that authors use to define parameters in reporting UTI outcomes. Embase and Medline were queried with the medical subject heading terms “spinal dysraphism,” “myelomeningocele,” “infection,”and “urinary tract infection.” A second search with the exploded term“spina bifida” and “urinary tract infection” was performed. Original research studies reporting a UTI outcome in SB patients were included and evaluated by 2 independent reviewers for the presence of a UTI definition and diagnostic criteria. We identified 872 publications, of which 124 met inclusion criteria. Forty-five of 124 (36.3%) studies reporting UTI as an outcome provided a definition of UTI. Of 124 studies, 28 (22.6%) were published in pediatric journals and 69 (55.6%) in urology journals. A definition of UTI was provided in 11 (39.3%) and 26 (37.7%) studies, respectively. “Fever,culture, and symptoms” defined a UTI in 17 of 45 studies. Journal category and presence of UTI definitions did not correlate (P = .71). Explicit definitions for UTI are heterogeneous and infrequently applied in studies of SB patients, limiting study reliability and estimates of true UTI rates in this population. Future studies will benefit from the development and application of a standard definition for UTI in this population.

  1. Laboratory Diagnosis of Zika Virus Infection.

    Science.gov (United States)

    Landry, Marie Louise; St George, Kirsten

    2017-01-01

    -The rapid and accurate diagnosis of Zika virus infection is an international priority. -To review current recommendations, methods, limitations, and priorities for Zika virus testing. -Sources include published literature, public health recommendations, laboratory procedures, and testing experience. -Until recently, the laboratory diagnosis of Zika infection was confined to public health or research laboratories that prepared their own reagents, and test capacity has been limited. Furthermore, Zika cross-reacts serologically with other flaviviruses, such as dengue, West Nile, and yellow fever. Current or past infection, or even vaccination with another flavivirus, will often cause false-positive or uninterpretable Zika serology results. Detection of viral RNA during acute infection using nucleic acid amplification tests provides more specific results, and a number of commercial nucleic acid amplification tests have received emergency use authorization. In addition to serum, testing of whole blood and urine is recommended because of the higher vial loads and longer duration of shedding. However, nucleic acid amplification testing has limited utility because many patients are asymptomatic or present for testing after the brief period of Zika shedding has passed. Thus, the greatest need and most difficult challenge is development of accurate antibody tests for the diagnosis of recent Zika infection. Research is urgently needed to identify Zika virus epitopes that do not cross-react with other flavivirus antigens. New information is emerging at a rapid pace and, with ongoing public-private and international collaborations and government support, it is hoped that rapid progress will be made in developing robust and widely applicable diagnostic tools.

  2. Pediatric febrile urinary tract infections: the current state of play

    Directory of Open Access Journals (Sweden)

    Hewitt Ian K

    2011-11-01

    Full Text Available Abstract Studies undertaken in recent years have improved our understanding regarding the consequences and management of febrile urinary tract infections (UTIs, which are amongst the most common serious bacterial infections in childhood, with renal scarring a frequent outcome. In the past pyelonephritic scarring of the kidney, often associated with vesico-ureteral reflux (reflux nephropathy was considered a frequent cause of chronic renal insufficiency in children. Increasing recognition as a consequence of improved antenatal ultrasound, that the majority of these children had congenital renal hypo-dysplasia, has resulted in a number of studies examining treatment strategies and outcomes following UTI. In recent years there is a developing consensus regarding the need for a less aggressive therapeutic approach with oral as opposed to intravenous antibiotics, and less invasive investigations, cystourethrography in particular, following an uncomplicated first febrile UTI. There does remain a concern that with this newer approach we may be missing a small subgroup of children more prone to develop severe kidney damage as a consequence of pyelonephritis, and in whom some form of intervention may prove beneficial. These concerns have meant that development of a universally accepted diagnostic protocol remains elusive.

  3. Evaluation of Urinary Tract Infections Due to Candida Species

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    Yeser Karaca Derici

    2016-02-01

    Full Text Available Aim: Although urinary tract infections often caused by bacteria, fungal etiology is detected in a significant number of infections in which Candida is the leading cause. In this study we aimed to evaluate the distribution of Candida strains isolated from urine samples in our hospital. Material and Method: Candida species were identified based on germ tube test, colony morphology on chrom agar Candida (Biomerieux, France and API ID32C AUX (Biomerieux, France commercial kit. Data were analyzed with SPSS 15.0 software for data analysis. Results: During March 2011-March 2014 a total of 109662 urine cultures were evaluated and 24364 samples revealed significant growth. Of the significant growth detected 24364 (22% samples 1096 (4.5% were defined as yeasts. The isolates most frequently detected in this study were C. albicans (50.5%, C. tropicalis (15.9%, C. glabrata (12.7%, C. parapsilosis (7.2%, C. kefyr (5.8%, C. krusei (5.5%. The highest yeast growth was observed in anesthesia intensive care unit. Discussion: In our study, the most frequently isolated species of yeast in the urine was C. albicans. Determination of Candida species and their clinical distributions in hospitals is very important in terms of giving direction to the treatment and measures to be taken.

  4. HIV-1 infection: the role of the gastrointestinal tract.

    Science.gov (United States)

    Cavarelli, Mariangela; Scarlatti, Gabriella

    2014-06-01

    The intestinal mucosa has an important role as portal of entry during mother-to-child transmission of HIV-1 and during sexual transmission. Tissue morphology and integrity, as well as distribution of relevant cell types within the mucosa, spanning from the oropharynx to the rectum, can greatly influence viral infection, replication, presentation, and persistence. The relative contribution to transmission by cell-associated or cell-free virus is still not defined for the different routes of transmission. Although the main target cells for HIV-1 replication are the CD4+ T lymphocytes, which are rapidly depleted both in the periphery and in the mucosal tissues, dendritic cells, Langerhans' cells, and macrophages are players in each of these processes. The predominant cells involved may differ according to the tract of the gut and the route of transmission. The microenvironment of the intestinal mucosa, including mucus, antibodies, or chemo-cytokines, can as well influence infection and replication of the virus: their role is still under investigation. The understanding of these processes may help in developing efficient prevention strategies. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Renal inflammatory response to urinary tract infection in rat neonates.

    Science.gov (United States)

    Zarepour, M; Moradpoor, H; Emamghorashi, F; Owji, S M; Roodaki, M; Khamoushi, M

    2015-09-01

    Urinary tract infection (UTI) is one of the most common bacterial infections. Maternal UTI is a risk factor for neonatal UTI. The aim of the present study was to determine the severity of renal inflammation in neonate rats born from mothers with induced UTI. Twelve pregnant rats (Sprague-Dawley) were included in study. The rats were divided into two groups (six rats in each group). In the first group, pyelonephritis was induced in the third trimester of pregnancy and the second group was used as a control group. After delivery, the neonates were divided into three groups based on days after birth (the 1 st, 3 rd and 7 th days after birth). In each group, two neonates of each mother were killed and a midline abdominal incision was made and both kidneys were aseptically removed. On the 7 th day, rat mothers were killed and their kidneys were removed. The preparations were evaluated with a bright field microscope for inflammatory response. Renal pathology showed inflammation in all UTI-induced mothers, but only two cases of neonates (2.1%) showed inflammation in the renal parenchyma. There was no relation between the positive renal culture and the pathological changes. We conclude that neonates with UTI born to UTI-induced mothers showed a lesser inflammatory response.

  6. Symptomatic Shigella sonnei urinary tract infection in pregnancy.

    Science.gov (United States)

    Baka, S; Spathi, A; Tsouma, I; Kouskouni, E

    2013-01-01

    This report describes a case of urinary tract infection (UTI) due to Shigella sonnei during pregnancy. A 31-year-old pregnant woman was admitted complaining of left-flank tenderness, dysuria, and fever. Following examination, significant laboratory data were collected including increased leukocyte count (10,800/ul with 86% neutrophils) and C-reactive protein (9.6 mg/dl). Urinalysis revealed 30 to 50 leukocytes per high power field while from the quantitative urine culture Shigella sonnei was recovered after 24 h incubation at 37 degrees C. After a two-week course with 750 mg cefuroxime every 8 h, the patient experienced gradual resolution of all symptoms and urinary cultures were negative two weeks and one month, respectively, after completing the therapy. The gestational course was uneventful and the patient delivered a healthy baby girl at term. Shigella sonnei can be responsible for UTI during pregnancy even when no predisposing factors or an apparent source of infection can be identified.

  7. Renal scar formation after urinary tract infection in children

    Directory of Open Access Journals (Sweden)

    Young Seo Park

    2012-10-01

    Full Text Available Urinary tract infection (UTI is a common bacterial illness in children. Acute pyelonephritis in children may lead to renal scarring with the risk of later hypertension, preeclampsia during pregnancy, proteinuria, and renal insufficiency. Until now, vesicoureteral reflux (VUR has been considered the most important risk factor for post-UTI renal scar formation in children. VUR predisposes children with UTI to pyelonephritis, and both are associated with renal scarring. However, reflux nephropathy is not always acquired; rather, it reflects refluxassociated congenital dysplastic kidneys. The viewpoint that chronic kidney disease results from renal maldevelopment-associated VUR has led to questioning the utility of any regimen directed at identifying or treating VUR. Despite the recognition that underlying renal anomalies may be the cause of renal scarring that was previously attributed to infection, the prevention of renal scarring remains the goal of all therapies for childhood UTI. Therefore, children at high risk of renal scar formation after UTI should be treated and investigated until a large clinical study and basic research give us more information.

  8. Renal inflammatory response to urinary tract infection in rat neonates

    Directory of Open Access Journals (Sweden)

    M Zarepour

    2015-01-01

    Full Text Available Urinary tract infection (UTI is one of the most common bacterial infections. Maternal UTI is a risk factor for neonatal UTI. The aim of the present study was to determine the severity of renal inflammation in neonate rats born from mothers with induced UTI. Twelve pregnant rats (Sprague-Dawley were included in study. The rats were divided into two groups (six rats in each group. In the first group, pyelonephritis was induced in the third trimester of pregnancy and the second group was used as a control group. After delivery, the neonates were divided into three groups based on days after birth (the 1 st, 3 rd and 7 th days after birth. In each group, two neonates of each mother were killed and a midline abdominal incision was made and both kidneys were aseptically removed. On the 7 th day, rat mothers were killed and their kidneys were removed. The preparations were evaluated with a bright field microscope for inflammatory response. Renal pathology showed inflammation in all UTI-induced mothers, but only two cases of neonates (2.1% showed inflammation in the renal parenchyma. There was no relation between the positive renal culture and the pathological changes. We conclude that neonates with UTI born to UTI-induced mothers showed a lesser inflammatory response.

  9. Etiology and antimicrobial resistance patterns in pediatric urinary tract infection.

    Science.gov (United States)

    Wang, Jun; He, Lijiao; Sha, Jintong; Zhu, Haobo; Huang, Liqu; Zhu, Xiaojiang; Dong, Jun; Li, Guogen; Ge, Zheng; Lu, Rugang; Ma, Geng; Shi, Yaqi; Guo, Yunfei

    2018-02-02

    Urinary tract infection (UTI) is one of most common pediatric infections. The aim of this study was to investigate the etiology and antimicrobial resistance patterns in children hospitalized at Children's Hospital of Nanjing Medical University. We conducted a retrospective, descriptive study of all UTI from 1 January 2013 to 30 November 2016 in children discharged from Nanjing Children's Hospital. The isolated pathogens and their resistance patterns were examined using midstream urine culture. A total of 2,316 children with UTI were included in the study. The occurrence rates of isolated pathogens were as follows: Enterococcus spp., 35.15%; Escherichia coli, 22.32%; Staphylococcus aureus spp., 7.73%; Streptococcus spp., 7.51%; and Klebsiella spp., 6.95%. Uropathogens had a low susceptibility to linezolid (3.47%), vancomycin (0.92%), imipenem (5.74%), and amikacin (3.17%), but they had a high susceptibility to erythromycin (90.52%), penicillin G (74.01%), cefotaxime (71.41%), cefazolin (73.41%), cefuroxime (72.52%), and aztreonam (70.11%). There is high antibiotic resistance in hospitalized children with UTI. Susceptibility testing should be carried out on all clinical isolates, and the empirical antibiotic treatment should be altered accordingly. © 2018 Japan Pediatric Society.

  10. Preventing urinary tract infections after menopause without antibiotics.

    Science.gov (United States)

    Caretto, Marta; Giannini, Andrea; Russo, Eleonora; Simoncini, Tommaso

    2017-05-01

    Urinary tract infections (UTIs) are the most common bacterial infections in women, and increase in incidence after the menopause. It is important to uncover underlying abnormalities or modifiable risk factors. Several risk factors for recurrent UTIs have been identified, including the frequency of sexual intercourse, spermicide use and abnormal pelvic anatomy. In postmenopausal women UTIs often accompany the symptoms and signs of the genitourinary syndrome of menopause (GSM). Antimicrobial prophylaxis has been demonstrated to be effective in reducing the risk of recurrent UTIs in women, but this may lead to drug resistance of both the causative microorganisms and the indigenous flora. The increasing prevalence of Escherichia coli (the most prevalent uropathogen) that is resistant to antimicrobial agents has stimulated interest in novel non-antibiotic methods for the prevention of UTIs. Evidence shows that topical estrogens normalize vaginal flora and greatly reduce the risk of UTIs. The use of intravaginal estrogens may be reasonable in postmenopausal women not taking oral estrogens. A number of other strategies have been used to prevent recurrent UTIs: probiotics, cranberry juice and d-mannose have been studied. Oral immunostimulants, vaginal vaccines and bladder instillations with hyaluronic acid and chondroitin sulfate are newer strategies proposed to improve urinary symptoms and quality of life. This review provides an overview of UTIs' prophylaxis without antibiotics, focusing on a practical clinical approach to women with UTIs. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Prevention of recurrent urinary tract infection in children.

    Science.gov (United States)

    Williams, Gabrielle; Craig, Jonathan C

    2009-02-01

    Urinary tract infection (UTI) in children is common (5-10%) and recurs in 10-30%. UTI causes an unpleasant, usually febrile illness in children. This review focuses on studies evaluating interventions to prevent UTI in children and published between January 2007 and June 2008. Three relevant updated Cochrane reviews, six randomized trials and an evidence-based guideline were published in the study period. Five of the six trials and one of the three Cochrane updates included data on the effects of relevant interventions in children. Three of the six trials investigated the efficacy of long-term, low-dose antibiotics as prophylaxis, and the other trials and both Cochrane updates evaluated complementary therapies such as vitamin A, probiotics and herbal supplements. The benefit of prophylactic antibiotics for the prevention of recurrent UTI in children remains unclear because of underpowered and suboptimally designed trials, but these studies suggest that any benefit is likely to be small, and clinical significance may be limited. The trials of complementary interventions (vitamin A, probiotics, cranberry, nasturtium and horseradish) generally gave favourable results but were not conclusive. Children and families who use these products should be aware that further infections are possible despite their use.

  12. Utility of Ultrasonography for Urinary Tract Infections of Infants

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Chul Ho; Kim, Yun Jeong [Dongnam Health Univ., Seoul (Korea, Republic of)

    2009-06-15

    In this study, we investigated utility of ultrasonography for urinary tract infections of infants. The results of the research is as follows : 1. The number of infants under one year old was 100 out of 122 infants who were diagnosed as a unitary infection. The ratio of males to females was 1.7 : 1. Seventy-seven infants who underwent three kinds of radiologic examinations such as kidney sonography (51%), {sup 99m}TC DMSA-scan (42%), and VCUG (22%). 2. In comparison of correlation between kidney sonography and VCUG, the sensitivity of kidney sonography was 82% while the specificity of kidney sonography was 58%. In comparison of correlation between kidney sonography and {sup 99m}TC DMSA-scan, the sensitivity of kidney sonography was 66% while the specificity of kidney sonography was 67%. 3. Utility of kidney sonography showed the highest efficiency when we considered pain, discomfort, a sense of shame, psychological stress when infants may undergo at the examination, side-effect of a contrast agent after the examination, and complication of exposure to radiation.

  13. Utility of Ultrasonography for Urinary Tract Infections of Infants

    International Nuclear Information System (INIS)

    Yoon, Chul Ho; Kim, Yun Jeong

    2009-01-01

    In this study, we investigated utility of ultrasonography for urinary tract infections of infants. The results of the research is as follows : 1. The number of infants under one year old was 100 out of 122 infants who were diagnosed as a unitary infection. The ratio of males to females was 1.7 : 1. Seventy-seven infants who underwent three kinds of radiologic examinations such as kidney sonography (51%), 99m TC DMSA-scan (42%), and VCUG (22%). 2. In comparison of correlation between kidney sonography and VCUG, the sensitivity of kidney sonography was 82% while the specificity of kidney sonography was 58%. In comparison of correlation between kidney sonography and 99m TC DMSA-scan, the sensitivity of kidney sonography was 66% while the specificity of kidney sonography was 67%. 3. Utility of kidney sonography showed the highest efficiency when we considered pain, discomfort, a sense of shame, psychological stress when infants may undergo at the examination, side-effect of a contrast agent after the examination, and complication of exposure to radiation.

  14. Epidemiology of Urinary Tract Infections in Hospitolized Children in Fatemi-Sahamieh Hospital (2005-2006

    Directory of Open Access Journals (Sweden)

    M.R Shokrollahei

    2008-04-01

    Full Text Available Background and ObjectivesMorbidity and mortality of urinary tract infection is common in spite of prescription of effective new antibiotics. Chronic pyelonphritis is one of the important reasons of end stage renal failure. Our study is carried out on 167 children admitted in Fatemi koodacan Hospital due to urinary tract infection. Major goal of this study was determination of epidemiology of urinary tract infection.Methods This study was cross sectional descriptive and sampling method was census. Various Factors such as age, gender, causative pathogen, used antibiotics and required time for getting negative urine culture test were studied. data were collected by means questionnaire.ResultsAccording to the study urinary tract infection was more common in females (74.2% of all cases while in male neonates it is more common than females. Incidence peak of urinary tract infection is seen in children between 1-6 years old. The most common pathogens responsible to urinary tract infection was E. coli and Klebsiella. The most common background disease was vesicoureteral reflux. The most common prescribed antibiotic was ceftriaxone (65%. After 2 days of taking antibiotic the majority of patients (87.7% had negative urine culture.ConclusionIn our study E. coli and Klebsiella are the most common pathogen responsible to urinary tract infection. In our study the frequency of urinary tract infection with Proteus was low (only 1.1% in comparison with other studies. Other epidemiological indices in this study were comparable to previous studies.Keywords: Urinary Tract, Urinary Tract Infections, Children

  15. Management of urinary tract infections in patients with neurogenic bladder: challenges and solutions.

    Science.gov (United States)

    Pannek, Jürgen; Wöllner, Jens

    2017-01-01

    Urinary tract infections (UTIs) are one of the most common morbidities in persons with neurogenic lower urinary tract dysfunction (NLUTD). They are associated with a significant morbidity and mortality, and they affect the quality of life of the affected patients. Diagnosis and treatment of UTI in this group of patients are challenging. In this review, the current strategies regarding diagnosis, treatment, and prevention are summarized. it is important to correctly diagnose a UTI, as treatment of bacteriuria should strictly be avoided. A UTI is defined as a combination of laboratory findings (leukocyturia and bacteriuria) and symptoms. Laboratory findings without symptoms are classified as asymptomatic bacteriuria. Routine urine screening is not advised. Only UTI should be treated; treatment of asymptomatic bacteriuria is not indicated. Prior to treatment, urine for a urine culture should be obtained. Antibiotic treatment for ~7 days is advised. In recurrent UTI, bladder management should be optimized and morphologic causes for UTI should be excluded. If UTIs persist, medical prophylaxis should be considered. Currently, no prophylactic measure with evidence-based efficacy exists. Long-term antibiotic prophylaxis should be used merely as an ultimate measure. Among the various mentioned innovative approaches for UTI prevention, bacteriophages, intravesical instillations, complementary and alternative medicine techniques, and probiotics seem to be most promising. Recently, several promising innovative options for UTI prophylaxis have been developed which may help overcome the current therapeutic dilemma. However, further well designed studies are necessary to evaluate the safety and efficacy of these approaches.

  16. Human bocavirus infection as a cause of severe acute respiratory tract infection in children.

    Science.gov (United States)

    Moesker, F M; van Kampen, J J A; van der Eijk, A A; van Rossum, A M C; de Hoog, M; Schutten, M; Smits, S L; Bodewes, R; Osterhaus, A D M E; Fraaij, P L A

    2015-10-01

    In 2005 human bocavirus (HBoV) was discovered in respiratory tract samples of children. The role of HBoV as the single causative agent for respiratory tract infections remains unclear. Detection of HBoV in children with respiratory disease is frequently in combination with other viruses or bacteria. We set up an algorithm to study whether HBoV alone can cause severe acute respiratory tract infection (SARI) in children. The algorithm was developed to exclude cases with no other likely cause than HBoV for the need for admission to the paediatric intensive care unit (PICU) with SARI. We searched for other viruses by next-generation sequencing (NGS) in these cases and studied their HBoV viral loads. To benchmark our algorithm, the same was applied to respiratory syncytial virus (RSV)-positive patients. From our total group of 990 patients who tested positive for a respiratory virus by means of RT-PCR, HBoV and RSV were detected in 178 and 366 children admitted to our hospital. Forty-nine HBoV-positive patients and 72 RSV-positive patients were admitted to the PICU. We found seven single HBoV-infected cases with SARI admitted to PICU (7/49, 14%). They had no other detectable virus by NGS. They had much higher HBoV loads than other patients positive for HBoV. We identified 14 RSV-infected SARI patients with a single RSV infection (14/72, 19%). We conclude that our study provides strong support that HBoV can cause SARI in children in the absence of viral and bacterial co-infections. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  17. Hypercalciuria, a promoting factor to urinary tract infection in children

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    Gheissari Alaleh

    2009-01-01

    Full Text Available Aim: Urinary tract infection (UTI is one of the most common diseases of urogenital tract in children. Detecting predisposing factors for UTI takes an important place in managing patients with UTI. Recently, a few studies emphasized on idiopathic hypercalciuria (IH as a predisposing factor for UTI and dysfunctional voiding. Therefore, we carried out a survey to find out whether non-calculus IH is a contributing factor in children with the first attack of pyelonephritis. Materials and Methods: This is a case-control study carried out on 60 children aged 2-11 years admitted at St Al-Zahra hospital, Isfahan, Iran, with the first episode of upper UTI and 200 age- and gender-matched normal healthy children between September 2003 and February 2005. We used second fasting spot urine sample to measure calcium and creatinine. Two urine samples were obtained one week apart to increase the accuracy of measurement. All samples were collected after at least 6 weeks of completing the treatment course of pyelonephritis. Ultrasound examination and VCUG were performed in all patients before entering the survey as case group to rule out obstruction and VUR. Results: Mean age of case and control group were 4.86 ± 3.08 years and 4.22 ± 2.9 years, respectively. The mean calcium to creatinine ratio (Ca/Cr in case and control group were 0.308 ± 0.21 and 0.208 ± 0.12 mg/mg, respectively, P < 0.001. The difference between the mean values of these two groups was significant only in age group ≤6 years, P < 0.0001 and odds ratio was 2.1 (95% CI 1.03-7.8. After determining the mean values of urine Ca/Cr ration according to both age groups and gender, it was cleared that only significant difference was related to male < 6 years. Conclusion: The likelihood of hypercalciuria should be assessed especially in male children with UTI and without any urinary tract obstruction.

  18. Urinary tract infection pattern in adult women followed from childhood.

    Science.gov (United States)

    Gebäck, Carin; Hansson, Sverker; Martinell, Jeanette; Sandberg, Torsten; Jodal, Ulf

    2016-07-01

    The aim of this study was to describe the pattern of urinary tract infection (UTI) and bladder function in women who had experienced recurrent UTI in childhood, with and without consequent renal damage, and followed for three to four decades. A population-based cohort of women who had been followed from the first UTI in childhood and previously studied at a median age of 27 years was studied at a median age of 41 years. Renal damage was evaluated by (99m)Tc-dimercaptosuccinic acid scan. Clinical data were collected on the pattern of recurrent UTIs and bladder function. A total of 86 women were investigated, of whom 58 had suffered renal damage and 28 were without. Febrile UTI in adulthood had occurred in 22 patients, once in 15 women and twice or more in seven women. There was a change in the infection pattern over time, evident already in childhood, that was characterized by a decrease in UTI frequency and a shift from febrile to non-febrile infections. A significant association was found between renal damage and febrile UTI (p = 0.046), and between abnormal bladder function and recurrent non-febrile UTI (p = 0.002). There was no relationship between persisting vesicoureteral reflux (VUR) and proneness to either symptomatic UTI (p = 0.99) or febrile UTI in adulthood (p = 0.14). Among this study cohort there was a continuously decreasing rate of febrile UTI in adulthood. Persisting VUR was not related to UTI in adulthood. Abnormal bladder function was related to non-febrile UTI but not to febrile UTI.

  19. Infected abdominal sacrocolpopexies: diagnosis and treatment.

    Science.gov (United States)

    Mattox, T Fleming; Stanford, Edward J; Varner, E

    2004-01-01

    The abdominal sacrocolpopexy is an excellent procedure to surgically treat vaginal vault prolapse. A synthetic graft is often used to support the vaginal apex, but has the potential to become infected or erode, requiring its removal or revision. The purpose of this paper is to report our experience in the management of patients with infected synthetic grafts after abdominal sacrocolpopexy. A review of the patient databases from three specialty gynecology centers was performed from March 1996 to June 2002. Only patients with an infected graft after an abdominal sacrocolpopexy were included in the study; patients with either suture or graft erosion responding to conservative treatment were excluded. Twenty-two women, ages 37-73 years, developed infection of the synthetic graft after an abdominal sacrocolpopexy (1-60 months after their initial surgery, mean 8.8 months). The infected materials included polytetrafluoroethylene (PTFE, Goretex, n =15) and polypropylene (n=7). Nine of the 15 PTFE meshes and four of the seven polypropylene meshes were placed at the time of a contaminated case (abdominal hysterectomy [n=12], colon resection [n=1]). Eighteen (82%) of the infected grafts involved braided permanent suture to attach the graft to the vaginal wall, monofilament/non-braided permanent suture was used in three patients, and suture type could not be determined in one. All graft removals were attempted vaginally, and this was successful in 16 cases (73%). Two patients experienced significant bleeding: the first patient required an emergency laparotomy and the second patient's bleeding was controlled with packing. A rectovaginal fistula occurred 3 weeks postoperatively in one patient. Synthetic graft infection should be considered as the differential diagnosis in a patient who has undergone an abdominal sacrocolpopexy. Transvaginal removal is preferred, but is fraught with potentially serious complications. The use of braided permanent sutures to affix the graft to the

  20. Recurrent Urinary Tract Infection Among Renal Transplant Recipients: Risk Factors and Long-Term Outcome.

    Science.gov (United States)

    Tawab, Khaled Abdel; Gheith, Osama; Al Otaibi, Torki; Nampoory, Naryanam; Mansour, Hany; Halim, Medhat A; Nair, Prasad; Said, Tarek; Abdelmonem, Mohamed; El-Sayed, Ayman; Awadain, Waleed

    2017-04-01

    Urinary tract infection is the most common type of bacterial infection in kidney transplant procedures, with adverse effects on graft and patient survival. We aimed to evaluate the risk factors of recurrent urinary tract infection in renal transplant recipients and its impact on patient and graft survival. In a cohort of 1019 patients who were transplanted between 2000 and 2010 at Hamed Al-Essa Organ Transplant Center in Kuwait, 86% developed at least 1 episode of urinary tract infection, with only 6.2% of patients having recurrent infections. We compared patients with recurrent urinary tract infections (group 1) with those who had no recurrence (group 2) regarding their risk factors. Patients in group 1 were significantly younger than those in group 2 (34.9 ± 23 vs 42.8 ± 16 y; P urinary tract infections (P infections were significantly more prevalent among group 1 (10.8% vs 3.8%; P = .008). Long-term graft outcome (functioning and failed) were 78.5% and 21.5% in group 1 versus 85.1% and 13.9% in group 2 (P = .18). Patient outcomes (living and deceased donors) were 98.4% and 1.6% in group 1 versus 95.7% and 4.3% in group 2 (P = .187). Adult females, thymoglobulin induction, pretransplant urologic problems, and hepatitis C infection were the risk factors of recurrent urinary tract infection among our renal transplant patients. However, recurrence did not adversely affect graft or patient survival.

  1. [Imaging and follow-up of children with first febrile Urinary Tract Infection (UTI)].

    Science.gov (United States)

    Grossman, Zachi; Miron, Dan

    2009-10-01

    Urinary tract infection (UTI) in children might, in a minority of cases, cause renal scarring and permanent damage. Known risk factors for renal damage are: obstruction to urinary flow, vesicoureteric reflux and recurrent infections. The current recommendations for imaging and follow-up of children with first febrile UTI include renal ultrasound to rule out anatomic abnormalities, particularly obstruction, cystography for possible diagnosis of vesicoureteric reflux, and prophylactic antibiotic therapy to prevent recurrent infections in children with detected reflux. DMSA renal scanning for the detection of renal scars is recommended as part of the imaging protocol by some institutions. Recently, published data doubts the importance of the various imaging techniques, as well as the effectiveness of prophylactic antibiotic therapy. In the current review, the role of renal ultrasound is examined, especially with regards to familiar data from fetal ultrasound. The complex relationship between vesicoureteric reflux and renal scarring is presented, with the possible implications on the importance of performing routine cystography and DMSA scanning after UTI. Studies questioning the effectiveness of prophylactic antibiotic therapy emphasize the importance of rapid diagnosis and therapy of suspected recurrent UTI as the preferred approach to prevent renal damage. Imaging studies are only recommended for high risk groups and not as a routine following UTI.

  2. [Molecular diagnostic methods of respiratory infections. Has the scheme diagnosis changed?].

    Science.gov (United States)

    Vila Estapé, Jordi; Zboromyrska, Yuliya; Vergara Gómez, Andrea; Alejo Cancho, Izaskun; Rubio García, Elisa; Álvarez-Martínez, Miriam José; la Bellacasa Brugada, Jorge Puig de; Marcos Maeso, M Ángeles

    2016-07-01

    Lower respiratory tract infections remain one of the most common causes of mortality worldwide, which is why early diagnosis is crucial. Traditionally the microbiological diagnosis of these infections has been based on conventional methods including culture on artificial media for isolation of bacteria and fungi and cell cultures for virus and antibody or antigen detection using antigen-antibody reactions. The main drawback of the above mentioned methods is the time needed for an etiological diagnosis of the infection. The techniques based on molecular biology have drawn much attention in recent decades as tools for rapid diagnosis of infections. Some techniques are very expensive, especially those that can detect various microorganisms in the same reaction, therefore the question that arises is whether the cost of such testing is justified by the information obtained and by the clinical impact that its implementation will determine. In this article we make a review of the various techniques of molecular biology applied to the diagnosis of pneumonia and focus primarily on analysing the impact they may have on the management of patients with acute respiratory tract infections. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  3. THE ROLE OF CEPHALOSPORINS IN URINARY TRACT INFECTIONS TREATMENT IN CHILDREN

    Directory of Open Access Journals (Sweden)

    I. L. Chashchina

    2012-01-01

    Full Text Available The problem of effective diagnosis and treatment of acute urinary tract infection (UTI remains relevant in connection with a high prevalence of this nosology and the growth of antibiotic resistance. The need to use of antibiotics in the treatment of acute UTI in children has no doubt. At the same time there are different opinions on duration, and route of administration of the antibiotics. It is not always possible to achieve the desirable effect after a long courses of antibiotic therapy, and duration of fever as a clinical marker of inflammation, was not significantly different in the appointment of oral and parenteral antibiotics. The effectiveness of treatment of acute urinary tract infections in young children depends not on the way of administration but on the dose that ensures the achievement of the minimum inhibitory concentration of the drug. Drugs of choice in patients with acute UTI are: inhibitor-protected aminopenicillins and cephalosporins of II and III generation. However, in children with acute UTI who received antibiotic therapy previously, as well as in suspected obstructive uropathy, the most likely causative agent is toxin-producing E. coli, which has a high degree of resistance to aminopenicillins, including protected. Therefore, the drugs of choice in this category of children should be the antibiotics of the cephalosporin group II–III generation.

  4. Prevalence of multidrug resistant pathogens in children with urinary tract infection: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Srinivasan S, Madhusudhan NS

    2014-11-01

    Full Text Available Urinary tract infection (UTI is one of the commonest medical problems in children. It can distress the child and may cause kidney damage. Prompt diagnosis and effective treatment can prevent complications in the child. But treatment of UTI in children has now become a challenge due to the emergence of multidrug resistant bacteria. Aims & Objectives: To know the bacteriological profile and susceptibility pattern of urinary tract infections in children and to know the prevalence of multidrug resistant uropathogens. Materials & Methods: A retrospective analysis was done on all paediatric urine samples for a period of one year. A total of 1581 samples were included in the study. Antimicrobial susceptibility testing was done on samples showing significant growth by Kirby-Bauer disc diffusion method. Statistical analysis: Prevalence and pattern were analyzed using proportions and percentages. Results: E.coli was the most predominant organism (56% causing UTI in children followed by Klebsiella sp (17%. Fifty three percent of gram negative organisms isolated from children were found to be multidrug resistant. Majority of E. coli isolates were found to be highly resistant to Ampicillin (91% and Cotrimoxazole (82% and highly sensitive to Imipenem (99% and Amikacin (93%. Conclusion: Paediatric UTI was common in children less than 5 years of age. Gram negative bacteria (E. coli and Klebsiella sp were more common than gram positive bacteria. Our study revealed that multidrug resistance was higher in E.coli.

  5. Technical report: urinary tract infections in febrile infants and young children. The Urinary Tract Subcommittee of the American Academy of Pediatrics Committee on Quality Improvement.

    Science.gov (United States)

    Downs, S M

    1999-04-01

    The Urinary Tract Subcommittee of the American Academy of Pediatrics Committee on Quality Improvement has analyzed alternative strategies for the diagnosis and management of urinary tract infection (UTI) in children. The target population is limited to children between 2 months and 2 years of age who are examined because of fever without an obvious cause. Diagnosis and management of UTI in this group are especially challenging for these three reasons: 1) the manifestation of UTI tends to be nonspecific, and cases may be missed easily; 2) clean voided midstream urine specimens rarely can be obtained, leaving only urine collection methods that are invasive (transurethral catheterization or bladder tap) or result in nonspecific test results (bag urine); and 3) a substantial number of infants with UTI also may have structural or functional abnormalities of the urinary tract that put them at risk for ongoing renal damage, hypertension, and end-stage renal disease (ESRD). To examine alternative management strategies for UTI in infants, a conceptual model of the steps in diagnosis and management of UTI was developed. The model was expanded into a decision tree. Probabilities for branch points in the decision tree were obtained by review of the literature on childhood UTI. Data were extracted on standardized forms. Cost data were obtained by literature review and from hospital billing data. The data were collated into evidence tables. Analysis of the decision tree was used to produce risk tables and incremental cost-effectiveness ratios for alternative strategies. Based on the results of this analysis and, when necessary, consensus opinion, the Committee developed recommendations for the management of UTI in this population. This document provides the evidence the Subcommittee used in the development of its recommendations. The Subcommittee agreed that the objective of the practice parameter would be to minimize the risk of chronic renal damage within reasonable economic

  6. Interventions for preventing recurrent urinary tract infection during pregnancy.

    Science.gov (United States)

    Schneeberger, Caroline; Geerlings, Suzanne E; Middleton, Philippa; Crowther, Caroline A

    2012-11-14

    Recurrent urinary tract infections (RUTI) are common in women who are pregnant and may cause serious adverse pregnancy outcomes for both mother and child including preterm birth and small-for-gestational-age babies. Interventions used to prevent RUTI in women who are pregnant can be pharmacological (antibiotics) or non-pharmacological (cranberry products, acupuncture, probiotics and behavioural modifications). So far little is known about the best way to prevent RUTI in pregnant women. To assess the effects of interventions for preventing recurrent urinary tract infections in pregnant women.The primary maternal outcomes were RUTI before birth (variously defined) and preterm birth (before 37 weeks). The primary infant outcomes were small-for-gestational age and total mortality. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (8 June 2012) and reference lists of retrieved articles. Published, unpublished and ongoing randomised controlled trials (RCTs), quasi-RCTs, clustered-randomised trials and abstracts of any intervention (pharmacological and non-pharmacological) for preventing RUTI during pregnancy (compared with another intervention, placebo or with usual care). Two review authors independently evaluated the one identified trial for inclusion and assessed trial quality. Two review authors extracted data. Data were checked for accuracy. The review included one trial involving 200 women. The trial compared a daily dose of nitrofurantoin and close surveillance (regular clinic visit, urine cultures and antibiotics when a positive culture was found) with close surveillance only. No significant differences were found for the primary outcomes: recurrent pyelonephritis (risk ratio (RR) 0.89, 95% confidence interval (CI) 0.31 to 2.53, one study, 167 women), recurrent urinary tract infection before birth (RR 0.30, 95% CI 0.06 to 1.38; one study 167 women) and preterm birth (before 37 weeks) (RR 1.18, 95% CI 0.42 to 3.35; one study 147 women). The

  7. Roultella ornithinolytica infection in infancy: a case of febrile urinary tract infection.

    Science.gov (United States)

    De Petris, Laura; Ruffini, Ermanno

    2018-05-02

    Raoultella ornithinolytica is a Gram-negative, non-motile, encapsulated, aerobic bacillus belonging to the Enterobacteriaceae family. R. ornithinolytica is a not very common, but emergent causal agent of human infection, and its expression of beta-lactamase provides resistance to commonly used antibiotics. The pathogenetic potential of R. ornithinolytica isolates in human disease has become increasingly important. Several cases of hospital-acquired infection, mostly associated with invasive procedures, or in patients with co-morbidity caused by R. ornithinolytica, have been previously reported in the adult population. In pediatric population, two cases in immunocompromised children, one case in an infant with visceral heterotaxy and one case of catheter-related bacteraemia are described. Here, we present the first case of febrile urinary tract infection due to R. ornithinolytica in an 8-month-old infant, recovered from a previous febrile UTI caused by E. coli and without co-morbidity. The empiric therapy with ceftriaxone, followed by cefpodoxime proxetil, resolved symptoms: the clinical condition of the infant improved rapidly and the treatment eradicated urine from the R. ornithinolytica infection. Since other pathogens rather than R. ornithinolytica are usually identified in children with urinary tract infections, including Escherichia coli, Proteus, Klebsiella and Pseudomonas, the identification of this microorganism in our patient's urine was also unexpected.

  8. Bladder volume at onset of vesicoureteral reflux is an independent risk factor for breakthrough febrile urinary tract infection.

    Science.gov (United States)

    Alexander, Siobhan E; Arlen, Angela M; Storm, Douglas W; Kieran, Kathleen; Cooper, Christopher S

    2015-04-01

    Improved identification of children with vesicoureteral reflux at risk for recurrent febrile urinary tract infection may impact management decisions. We hypothesized that reflux occurring earlier during bladder filling increases the duration of exposure of the kidneys to bacteria, and, therefore, increases the risk of pyelonephritis. Children with vesicoureteral reflux and detailed voiding cystourethrogram data were identified. Bladder volume at onset of reflux was normalized for age. Demographics, reflux grade, laterality, presence/absence of bladder-bowel dysfunction and breakthrough febrile urinary tract infections were assessed. Median followup was 24 months (IQR 12 to 52). A total of 208 girls and 47 boys were analyzed with a mean ± SD age at diagnosis of 3.1 ± 2.6 years. On univariate analysis history of febrile urinary tract infection (HR 2.17, 95% CI 1.33-2.85, p = 0.01), dilating vesicoureteral reflux (HR 1.6, 95% CI 1.05-2.42, p = 0.03) and bladder-bowel dysfunction (HR 1.66, 95% CI 0.99-2.75, p = 0.05) were associated with an increased risk of breakthrough febrile urinary tract infection. Median bladder volume at onset of reflux in children with breakthrough febrile urinary tract infection was significantly less (33.1%) than in those without infection (49.5%, p = 0.003). Reflux onset at 35% predicted bladder capacity or less was associated with a significantly increased risk of breakthrough febrile urinary tract infection on multivariate analysis (HR 1.58, 95% CI 1.05-2.38, p = 0.03). Children with early filling vesicoureteral reflux are at increased risk for breakthrough febrile urinary tract infection independent of reflux grade. Bladder volume at onset of reflux should be recorded during cystograms since it provides additional prognostic information about the risk of pyelonephritis and resolution, and may assist with counseling and clinical decision making. Copyright © 2015 American Urological Association Education and Research, Inc. Published by

  9. Longer Duration of Urinary Catheterization Increases Catheter-Associated Urinary Tract Infection in PICU.

    Science.gov (United States)

    Fukuoka, Kahoru; Furuichi, Mihoko; Ito, Kenta; Morikawa, Yoshihiko; Watanabe, Ichiro; Shimizu, Naoki; Horikoshi, Yuho

    2018-06-13

    Catheter-associated urinary tract infections account for 30% of healthcare-associated infections. To date, few studies have addressed pediatric catheter-associated urinary tract infection in PICUs. The aim of our study was to assess the risk of catheter-associated urinary tract infection in relation to the duration of catheterization in the PICU. Retrospective cohort study. PICU at a tertiary children's hospital. Our study was conducted between April 2012 and June 2015 at Tokyo Metropolitan Children's Medical Center in Japan. Children in the PICU with an urethral catheter were included. Catheter-associated urinary tract infection cases were defined according to the National Healthcare Safety Network criteria. The patients' demographic data and isolated organisms were reviewed. Duration of catheterization and the catheter-associated urinary tract infection occurrence rate were analyzed. None. Among 1,890 catheterizations, 23 catheter-associated urinary tract infection cases were identified. The overall occurrence rate was 2.35/1,000 catheter-days. Among the patients with catheter-associated urinary tract infection, 13 were boys. The median age was 11 months (interquartile range, 7-35 mo), and the median duration of catheterization was 7 days (interquartile range, 5-12 d). The isolated bacteria were Escherichia coli (26.5%), Enterococcus faecalis (17.6%), and Klebsiella pneumoniae (11.8%). Two species were isolated in each of 11 cases (47.8%). Each additional day of catheterization increased the risk of catheter-associated urinary tract infection (odds ratio, 1.06; 95% CI, 1.02-1.10, and odds ratio adjusted for contact precaution status and surgical procedures was 1.05; 95% CI, 1.01-1.09). Longer duration of catheterization increased the risk of catheter-associated urinary tract infection by 5% each day at the PICU. Prompt removal of the urethral catheter is strongly recommended whenever feasible.

  10. Anatomy and Physiology of the Urinary Tract: Relation to Host Defense and Microbial Infection.

    Science.gov (United States)

    Hickling, Duane R; Sun, Tung-Tien; Wu, Xue-Ru

    2015-08-01

    The urinary tract exits to a body surface area that is densely populated by a wide range of microbes. Yet, under most normal circumstances, it is typically considered sterile, i.e., devoid of microbes, a stark contrast to the gastrointestinal and upper respiratory tracts where many commensal and pathogenic microbes call home. Not surprisingly, infection of the urinary tract over a healthy person's lifetime is relatively infrequent, occurring once or twice or not at all for most people. For those who do experience an initial infection, the great majority (70% to 80%) thankfully do not go on to suffer from multiple episodes. This is a far cry from the upper respiratory tract infections, which can afflict an otherwise healthy individual countless times. The fact that urinary tract infections are hard to elicit in experimental animals except with inoculum 3-5 orders of magnitude greater than the colony counts that define an acute urinary infection in humans (105 cfu/ml), also speaks to the robustness of the urinary tract defense. How can the urinary tract be so effective in fending off harmful microbes despite its orifice in a close vicinity to that of the microbe-laden gastrointestinal tract? While a complete picture is still evolving, the general consensus is that the anatomical and physiological integrity of the urinary tract is of paramount importance in maintaining a healthy urinary tract. When this integrity is breached, however, the urinary tract can be at a heightened risk or even recurrent episodes of microbial infections. In fact, recurrent urinary tract infections are a significant cause of morbidity and time lost from work and a major challenge to manage clinically. Additionally, infections of the upper urinary tract often require hospitalization and prolonged antibiotic therapy. In this chapter, we provide an overview of the basic anatomy and physiology of the urinary tract with an emphasis on their specific roles in host defense. We also highlight the

  11. Prenatal Diagnosis of Congenital Cytomegalovirus Infection

    Science.gov (United States)

    Lazzarotto, T.; Guerra, B.; Spezzacatena, P.; Varani, S.; Gabrielli, L.; Pradelli, P.; Rumpianesi, F.; Banzi, C.; Bovicelli, L.; Landini, M. P.

    1998-01-01

    We report here the results of a study on the prenatal diagnosis of congenital cytomegalovirus (CMV) infection. The study was carried out by both PCR and virus isolation from amniotic fluid (AF) for 82 pregnant women at risk of transmitting CMV for the detection of (i) seroconversion to CMV immunoglobulin G (IgG) positivity during the first trimester of pregnancy, (ii) symptomatic CMV infection in the mother during the first trimester of pregnancy or intrauterine growth retardation detected by ultrasound or abnormal ultrasonographic findings suggestive of fetal infections, and (iii) seropositivity for CMV-specific IgM. For 50 women, fetal blood (FB) was also obtained and tests for antigenemia and PCR were performed. The results indicate that AF is better than FB for the prenatal diagnosis of CMV infection. PCR with AF has a sensitivity (SNS) of 100%, a specificity (SPE) of 83.3%, a positive predictive value (PPV) of 40%, and a negative predictive value (NPV) of 100%; rapid virus isolation with the same material has an SNS of 50%, an SPE of 100%, a PPV of 100%, and an NPV of 94.7%. Fewer than 10% of the women positive for IgM by enzyme immunoassay (EIA) had a congenitally infected fetus or newborn infant. When EIA IgM positivity was confirmed by Western blotting (WB) and the WB profile was considered, the percent transmission detected among women with an “at-risk” profile was higher than that observed among IgM-positive women and was the same as that among women who seroconverted during the first trimester of pregnancy (transmission rates of 29 and 25%, respectively). PMID:9817869

  12. Adenovirus infection in children with acute lower respiratory tract infections in Beijing, China, 2007 to 2012.

    Science.gov (United States)

    Liu, Chunyan; Xiao, Yan; Zhang, Jing; Ren, Lili; Li, Jianguo; Xie, Zhengde; Xu, Baoping; Yang, Yan; Qian, Suyun; Wang, Jianwei; Shen, Kunling

    2015-10-01

    Human adenoviruses (HAdV) play a significant role in pediatric respiratory tract infections. To date, over 60 types of HAdV have been identified. Here, HAdV types are characterized in children in the Beijing area with acute lower respiratory tract infections (ALRTIs) and the clinical features and laboratory findings of hospitalized HAdV-infected cases are described. Respiratory specimens were collected from pediatric patients with ALRTIs in the emergency department or from those admitted to Beijing Children's Hospital between March 2007 and December 2012. Infections with common respiratory viruses were determined by PCR or RT-PCR. HAdV positive samples were further typed by PCR and sequencing. Among 3356 patients with ALRTIs, 194 (5.8 %) were found to have HAdV infection. HAdV infection was primarily confined to children (88.35 %) less than 5 years of age. A total of 11 different types of HAdV were detected throughout the study period, with HAdV-B7 (49.0 %) and HAdV-B3 (26.3 %) as the most prevalent types, followed by HAdV-C2 (7.7 %) and HAdVC1 (4.6 %). Newly emerging and re-emergent types or variants, HAdV-B55 (n = 5), HAdV-C57 (n = 3), and HAdV-B14p1 (n = 1), were identified. Results also included the reported first case of co-infection with HAdV-C2 and HAdV-C57. Clinical entities of patients with single HAdV infection (n = 49) were similar to those with mixed HAdV/respiratory syncytial virus (RSV) infections (n = 41). Patients with HAdV-B7 infection had longer duration of fever and higher serum levels of muscle enzymes than HAdV-B3-infected patients. During the study period, HAdV-B7 and HAdV-B3 were the predominant types identified in pediatric ALRTIs. HAdV-B7 infection tends to have more severe clinical consequences. The presence of newly emerging types or variants and co-infection with different types of HAdV highlights the need for constant and close surveillance of HAdV infection.

  13. [Different species of human rhinovirus infection in children with acute respiratory tract infections in Beijing].

    Science.gov (United States)

    Song, Ming-hui; Zhao, Lin-qing; Qian, Yuan; Zhu, Ru-nan; Deng, Jie; Wang, Fang; Sun, Yu; Tian, Run

    2013-12-01

    To understand the clinical characteristics of different groups human rhinovirus (HRV)-A, B and C infection in children with acute respiratory tract infections (ARI) in Beijing. Respiratory tract specimens (n = 1412) collected from children with ARI during Jan. 2011 to Dec. 2012 were tested for HRV by using semi-nested PCR. Gene fragments of VP4/VP2 capsid protein amplified from HRV positive specimens were sequenced for HRV genotype confirmation. Then epidemiological characteristics of these HRV-positive cases were analyzed. Among these 1412 specimens tested, 103 (7.3%) were HRV positive, including 54 (52.4%) positive for HRV-A, 14 (13.6%) for HRV-B, 35 (34.0%) for HRV-C determined by sequence analysis. The positive rates of HRV-A, B and C (2.5%, 16/638; 0.3%, 2/638 and 1.3%, 8/638) in children with acute upper respiratory tract infections (URI) were lower than those (5.8%, 36/623; 1.8%, 11/623 and 3.9%, 24/623) in children with acute lower respiratory tract infections (LRI) (P = 0.003, 0.011, 0.003). In children with LRI, the positive rates of HRV-A, C were similar to each other (P = 0.112), and both were higher than that of HRV-B (P = 0.000, P = 0.026). The severity of ARI among children positive for different groups HRV showed no significant difference evaluated by Kruskal-Wallis H test (Hc = 0.044, P > 0.05), as well as that between children co-infected with HRV and other viruses and those infected with HRV only evaluated by Wilcoxon rank sum test (Zc = 0.872, P > 0.05). HRV is one of important pathogens for children with ARI, especially LRI in Beijing. The positive rates of HRV-A and HRV-C are similar to each other, and both are higher than that of HRV-B. No significant difference was shown among children with different HRV genotypes by evaluation of the severity of ARI, and co-infections of HRV with other viruses do not significantly increase the severity of ARI.

  14. Antibiotic resistance in children with recurrent or complicated urinary tract infection.

    Science.gov (United States)

    Younis, N; Quol, K; Al-Momani, T; Al-Awaisheh, F; Al-Kayed, D

    2009-01-01

    Urinary tract infection is certainly one of the most common childhood infections. Emerging resistance to the antibiotics is not unusual. Current hospitalization for children with urinary tract infection is reserved for severe or complicated cases. The aim of the present study was to determine the antibiotic resistance pattern among children with recurrent or complicated urinary tract infection. A retrospective study carried out at Prince Hashem hospital, Zarqa city, eastern Jordan and involved 336 episodes of culture proved urinary tract infection obtained from 121 patients with recurrent UTI, who used prophylactic antibiotics during the period from April 1, 2004 to December 31, 2006. The isolated microorganisms and there antibiotics susceptibility were studied. Seventy three patients (60.3%) were found to have some forms of urinary tract anomaly, significantly more prevalent among male children Purinary tract infection (64.3% vs. 16.6%, Purinary tract infection. Proteus, Pseudomonas and Candida spp. were more prevalent in patients with complicated (Presistant to most antibiotics tested. Pediatric urine culture isolates are becoming increasingly resistant to commonly used antibiotics. Empirical treatment with Trimethoprim-Sulfamethoxazole (TMP-SMX) or Cephalexin as the initial drug is ineffective. Nitrofurantoin and Nalidixic acid can be considered as the first line antibiotics for prophylaxis and or treatment of patients with recurrent UTI, while Meropenam and Ciprofloxacin can be used empirically in treating patients with complicated UTI.

  15. Leishmania infections: Molecular targets and diagnosis.

    Science.gov (United States)

    Akhoundi, Mohammad; Downing, Tim; Votýpka, Jan; Kuhls, Katrin; Lukeš, Julius; Cannet, Arnaud; Ravel, Christophe; Marty, Pierre; Delaunay, Pascal; Kasbari, Mohamed; Granouillac, Bruno; Gradoni, Luigi; Sereno, Denis

    2017-10-01

    Progress in the diagnosis of leishmaniases depends on the development of effective methods and the discovery of suitable biomarkers. We propose firstly an update classification of Leishmania species and their synonymies. We demonstrate a global map highlighting the geography of known endemic Leishmania species pathogenic to humans. We summarize a complete list of techniques currently in use and discuss their advantages and limitations. The available data highlights the benefits of molecular markers in terms of their sensitivity and specificity to quantify variation from the subgeneric level to species complexes, (sub) species within complexes, and individual populations and infection foci. Each DNA-based detection method is supplied with a comprehensive description of markers and primers and proposal for a classification based on the role of each target and primer in the detection, identification and quantification of leishmaniasis infection. We outline a genome-wide map of genes informative for diagnosis that have been used for Leishmania genotyping. Furthermore, we propose a classification method based on the suitability of well-studied molecular markers for typing the 21 known Leishmania species pathogenic to humans. This can be applied to newly discovered species and to hybrid strains originating from inter-species crosses. Developing more effective and sensitive diagnostic methods and biomarkers is vital for enhancing Leishmania infection control programs. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. [The role of the uretral catheter in the development of catheter- related urinary tract infection].

    Science.gov (United States)

    Vasilyev, A O; Govorov, A V; Shiryaev, A A; Pushkar, D Yu

    2017-12-01

    The most common source of nosocomial infection is the urinary tract, especially if they it is drained with a urethral catheter. Catheter-associated urinary tract infections account for at least 80% of all complicated urinary tract infections and are the most common type of hospital-acquired infection. Intestinal microflora plays the leading role in the pathogenesis of catheter-associated urinary tract infections, whereas the most important risk factor for their development is the long duration of urinary catheter drainage. In the case of short-term and intermittent catheterization, routine antibiotic prophylaxis is not required, but if a patient develops clinically significant infection, antibiotic therapy is required followed by definitive therapy based on culture. Urethral catheters coated with antimicrobial substances and anti-inflammatory agents can significantly reduce the adhesion and migration of bacteria, thereby reducing the incidence of urinary tract infections. Despite this, the incidence of catheter-associated infection remains high. We have reviewed recent literature related to catheter-associated urinary tract infections and the best means of preventing this condition.

  17. Effective the ultrasonography in the diagnosis of the affections of the digestive tract

    International Nuclear Information System (INIS)

    Rodriguez Allende, Miguel A.; Nunnez Guerrero, Carlos; Parrilla Delgado, Maria; De Leon Rubio, Nancy

    2003-01-01

    A prospective work was made to highlight the value of the ultrasonido in the diagnosis of the affections of the digestive tract. In total 282 patients were explored constituted in 2 groups integrated by 82 and 200 sick persons, respectively. In the first group they were included patient to those that were detected a lesion of the digestive tract during an exploration ultrasonografica in a casual way. In the second group there are 100 patients that have previous diagnosis of lesion of the digestive tract and that they were studied later on with ultrasonido and 100 healthy to those that equally were carried out a study ultrasonografico. The results were: sensibility of 100%, specificity of 97%, value positive predictivos of 98,7%

  18. Risk factors for postoperative urinary tract infection following midurethral sling procedures.

    Science.gov (United States)

    Doganay, Melike; Cavkaytar, Sabri; Kokanali, Mahmut Kuntay; Ozer, Irfan; Aksakal, Orhan Seyfi; Erkaya, Salim

    2017-04-01

    To identify the potential risk factors for urinary tract infections following midurethral sling procedures. 556 women who underwent midurethral sling procedure due to stress urinary incontinence over a four-year period were reviewed in this retrospective study. Of the study population, 280 women underwent TVT procedures and 276 women underwent TOT procedures. Patients were evaluated at 4-8 weeks postoperatively and were investigated for the occurrence of a urinary tract infection. Patients who experienced urinary tract infection were defined as cases, and patients who didn't were defined as controls. All data were collected from medical records. Multivariate logistic regression model was used to identify the risk factors for urinary tract infection. Of 556 women, 58 (10.4%) were defined as cases while 498 (89.6%) were controls. The mean age of women in cases (57.8±12.9years) was significantly greater than in controls (51.8±11.2years) (purinary tract infection, concomitant vaginal hysterectomy and cystocele repair, TVT procedure and postoperative postvoiding residual bladder volume ≥100ml were more common in cases than in controls. However, in multivariate regression analysis model presence of preoperative urinary tract infection [OR (95% CI)=0.1 (0.1-0.7); p=0.013], TVT procedure [OR (95% CI)=8.4 (3.1-22.3); p=0.000] and postoperative postvoiding residual bladder volume ≥100ml [OR (95% CI)=4.6 (1.1-19.2); p=0.036] were significant independent risk factors for urinary tract infection following midurethral slings CONCLUSION: Urinary tract infection after midurethral sling procedures is a relatively common complication. The presence of preoperative urinary tract infection, TVT procedure and postoperative postvoiding residual bladder volume ≥100ml may increase the risk of this complication. Identification of these factors could help surgeons to minimize this complicationby developing effective strategies. Copyright © 2017. Published by Elsevier B.V.

  19. Predicting the Risk of Breakthrough Urinary Tract Infections: Primary Vesicoureteral Reflux.

    Science.gov (United States)

    Hidas, Guy; Billimek, John; Nam, Alexander; Soltani, Tandis; Kelly, Maryellen S; Selby, Blake; Dorgalli, Crystal; Wehbi, Elias; McAleer, Irene; McLorie, Gordon; Greenfield, Sheldon; Kaplan, Sherrie H; Khoury, Antoine E

    2015-11-01

    We constructed a risk prediction instrument stratifying patients with primary vesicoureteral reflux into groups according to their 2-year probability of breakthrough urinary tract infection. Demographic and clinical information was retrospectively collected in children diagnosed with primary vesicoureteral reflux and followed for 2 years. Bivariate and binary logistic regression analyses were performed to identify factors associated with breakthrough urinary tract infection. The final regression model was used to compute an estimation of the 2-year probability of breakthrough urinary tract infection for each subject. Accuracy of the binary classifier for breakthrough urinary tract infection was evaluated using receiver operator curve analysis. Three distinct risk groups were identified. The model was then validated in a prospective cohort. A total of 252 bivariate analyses showed that high grade (IV or V) vesicoureteral reflux (OR 9.4, 95% CI 3.8-23.5, p urinary tract infection (OR 5.3, 95% CI 1.1-24.7, p = 0.034) and female gender (OR 2.6, 95% CI 0.097-7.11, p urinary tract infection. Subgroup analysis revealed bladder and bowel dysfunction was a significant risk factor more pronounced in low grade (I to III) vesicoureteral reflux (OR 2.8, p = 0.018). The estimation model was applied for prospective validation, which demonstrated predicted vs actual 2-year breakthrough urinary tract infection rates of 19% vs 21%. Stratifying the patients into 3 risk groups based on parameters in the risk model showed 2-year risk for breakthrough urinary tract infection was 8.6%, 26.0% and 62.5% in the low, intermediate and high risk groups, respectively. This proposed risk stratification and probability model allows prediction of 2-year risk of patient breakthrough urinary tract infection to better inform parents of possible outcomes and treatment strategies. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights

  20. Antibiotics for treating lower urinary tract infection in children.

    Science.gov (United States)

    Fitzgerald, Anita; Mori, Rintaro; Lakhanpaul, Monica; Tullus, Kjell

    2012-08-15

    Urinary tract infection (UTI) is one of the most common bacterial infections in infants and children. Lower UTI is the most commonly presenting and in the majority of cases can be easily treated with a course of antibiotic therapy with no further complications. A number of antimicrobials have been used to treat children with lower UTIs; however is it unclear what are the specific benefits and harms of such treatments. This review aims to summarise the benefits and harms of antibiotics for treating lower UTI in children. We searched the Renal Group's Specialised Register (April 2012), CENTRAL (The Cochrane Library 2012, Issue 5), MEDLINE OVID SP (from 1966), and EMBASE OVID SP (from 1988) without language restriction. Date of last search: May 2012. Randomised controlled trials (RCTs) and quasi-RCTs in which antibiotic therapy was used to treat bacteriologically proven, symptomatic, lower UTI in children aged zero to 18 years in primary and community healthcare settings were included. Two authors independently assessed study quality and extracted data. Statistical analyses were performed using the random effects model and the results expressed as risk ratios (RR) with 95% confidence intervals (CI). Sixteen RCTs, analysing 1,116 children were included. Conventional 10-day antibiotic treatment significantly increased the number of children free of persistent bacteriuria compared to single-dose therapy (6 studies, 228 children: RR 2.01, 95%CI 1.06 to 3.80). No heterogeneity was observed. Persistent bacteriuria at the end of treatment was reported in 24% of children receiving single-dose therapy compared to 10% of children who were randomised to 10-day therapy. There were no significant differences between groups for persistent symptoms, recurrence following treatment, or re-infection following treatment. There was insufficient data to analyse the effect of antibiotics on renal parenchymal damage, compliance, development of resistant organisms or adverse events. Despite