Assessment Of Urinary Tract Infection Research Articles

Assessment of Urinary Tract Infections Among Female Patients Attending Ruhengeri Referral Hospital

Background: Urinary tract infections (UTIs) are the inflammatory disorders of the urinary tract caused by the abnormal growth of pathogens. UTI is known to cause short-term morbidity in terms of fever, dysuria, and lower abdominal pain (LAP) and may result in permanent scarring of the kidney. The presence of bacteria in the urine, known as bacteriuria, may be indicative of infection or colonization of the urinary tract, but it may also be due to bacterial contamination occurring during collection of a specimen. Aim: The present study was done in order to identify the bacteria causing UTI from female patients. Methodology: A cross sectional study was conducted on female patients who were attending Ruhengeri Referral Hospital in a period of two months from October to November 2021. Urine samples were collected from patients who were requested to urinary test with respect to standard procedures. Samples were processed and analyzed at INES-Ruhengeri microbiology laboratory where gram stain and culture as well as biochemical test were performed in order to make microbial identification. From the results patients who were found with UTI, their structured questionnaire was taken into consideration in order to determine the associated risk factors. Results: The outcomes of the study indicated that E.coli, K. pneumonia, P. aeruginosa, Enterobacter ssp and S. saprophyticus were isolated from patients urine sample where E. coli is more present in patients sample where it has been found at 60%(18) samples. The least isolated bacteria in patient’s samples are Enterrobacter spp and S. saprophyticus at frequency of 2(6.7) per each bacterium. The risk factor associated with urinary tract infection in female patients attended Ruhengeri-referral-hospital in a period of study, the results indicated that douching in secret parts twice a day is associated with UTI with P-value equivalent to 0.001. Conclusion: This study was intended to assess the UTI among female patients. The study findings indicated that E.coli, K. pneumonia, P. aeruginosa, Enterobacter ssp and S. saprophyticus are more likely to be found in urinary tract of female. The study finding has indicated also that poor hygienic life style increases the risk of being infected by UTIs.

Assessment of Urinary Tract Infection in Symptomatic Geriatric Patients in Port Harcourt Metropolis, Nigeria.

Urinary tract infections are one of the most prevalent infectious diseases presented in medical care facilities as well as community settings. The elderly have increased risk of developing urinary tract infection (UTI) with attendant morbidities and complications.This study was aimed at investigating the UTI prevalence of geriatric (≥65years) patients, their aetiological agents andantimicrobial susceptibility pattern. The study was conducted on urine samplesfrom150geriatric patients in PortHarcourt metropolis, Nigeria. The samples were inoculated onto MacConkey Agar and Cysteine Lactose Electrolyte Deficient (CLED) agar. Isolates were identified based on colonial morphology, Gram staining and Biochemical characterization and antimicrobial susceptibility test was performed on the bacterial isolates using Mueller-Hinton agar (Oxiod, United Kingdom) according to standard techniques. This study revealed that fifty 50 (33.3%) had UTI. The age group (80-89years) had the highest prevalence of UTI (12.6%) followed by (70years to 79years) which had (10.7%) and the lowest was (65years to 69years) with UTI prevalence of (10%). The bacterial isolates were poorly susceptible to all the antimicrobial agents used. Escherichia coli (38%) was the predominant bacterial uropathogen, followed by Staphylococcus aureus (32%), Klebsiella pnuemoniae (20%) and Protues mirabilis (10%) which had the lowest. In addition, this study revealed that the females had a higher prevalence of UTI (19.3%) than the males (14%). This study revealed that UTI in the geriatrics is a serious challenge in our locality. Extensive use of antibiotics in the geriatric have been implicated as likely reason for harboring resistant flora. Therefore, the rational use of antibiotics to is advocated to curtail the fast-rising increase of antimicrobial resistance and improve outcome.

P8.094: Assessment of Urinary Tract Infections Microbiologically in Kidney Transplant Recipients

P8.094: Assessment of Urinary Tract Infections Microbiologically in Kidney Transplant Recipients

A Cross-Sectional Assessment of Urinary Tract Infections Among Geriatric Patients: Prevalence, Medication Regimen Complexity, and Factors Associated With Treatment Outcomes.

Background: Urinary tract infections (UTIs) are the second most prevalent infection among the elderly population. Hence, the current study aimed to evaluate the prevalence of UTIs among older adults, medication regimen complexity, and the factors associated with the treatment outcomes of elderly patients infected with UTIs.Methods: A retrospective cross-sectional study was conducted at the Department of Urology, Hospital Pulau Pinang, Malaysia. The patients ≥65 years of age were included in the present study with a confirmed diagnosis of UTIs from 2014 to 2018 (5 years).Results: A total of 460 patients met the inclusion criteria and were included in the present study. Cystitis (37.6%) was the most prevalent UTI among the study population followed by asymptomatic bacteriuria (ASB) (31.9%), pyelonephritis (13.9%), urosepsis (10.2%), and prostatitis (6.4%). Unasyn (ampicillin and sulbactam) was used to treat the UTIs followed by Bactrim (trimethoprim/sulfamethoxazole), and ciprofloxacin. The factors associated with the treatment outcomes of UTIs were gender (odd ratio [OR] = 1.628; p = 0.018), polypharmacy (OR = 0.647; p = 0.033), and presence of other comorbidities (OR = 2.004; p = 0.002) among the study population.Conclusion: Cystitis is the most common UTI observed in older adults. Gender, the burden of polypharmacy, and the presence of comorbidities are the factors that directly affect the treatment outcomes of UTIs among the study population.

Prevalence, Antimicrobial Susceptibility Pattern, and Associated Factors of Urinary Tract Infections among Pregnant and Nonpregnant Women at Public Health Facilities, Harar, Eastern Ethiopia: A Comparative Cross-Sectional Study.

Background Urinary tract infection is one of the most common health problems worldwide, afflicting many women in reproductive age, especially in developing countries. Increased risk of infection has been attributed to pregnancy and antimicrobial resistance. Objective To compare the prevalence, antimicrobial susceptibility pattern of the bacteria and associated factors of urinary tract infections among pregnant and nonpregnant women attending public health facilities, Harar, Eastern Ethiopia. Methods A health facility-based comparative cross-sectional study was conducted among 651 randomly selected women from public health facilities, Harar, Eastern Ethiopia, between February 2017 and December 2017. Pertinent data were collected through a face-to-face interview using a structured questionnaire. The midstream urine specimen was collected and cultured on cysteine-lactose-electrolyte-deficient agar and blood agar. Pure isolates were tested against the ten most prescribed antimicrobials using the Kirby-Bauer disk diffusion method. Data were entered and analysed using Statistical Program for Social Sciences version 21. A p value <0.05 was considered statistically significant. Results The overall prevalence of significant bacteriuria was 23% (95% CI: 13.6, 26.8). The higher proportion of bacteria were isolated from pregnant women (14.1%) compared to nonpregnant women (8.9%). Escherichia coli (28.8%) and Streptococcus aureus (14.3%) were the most common isolates. E. coli was resistant to amoxicillin (83.3%), trimethoprim-sulfamethoxazole (78.6%), and ciprofloxacin (81%), whereas S. aureus was resistant to chloramphenicol (81%), erythromycin (81%), and amoxicillin (76.2%). Current symptoms, and history of catheterization increase the likelihood of urinary tract infections.Conclusion Pregnant women were more likely infected with bacterial pathogens than nonpregnant women. Current symptoms, and catheterization increase the odds of urinary tract infections. More than half of the isolates were resistant to the commonly prescribed antimicrobials. Regular assessment of urinary tract infections and antimicrobial resistance are recommended to provide effective therapy and thereby prevent urinary tract complications.

Quality of the diagnostic process in patients presenting with symptoms suggestive of bladder or kidney cancer: a systematic review

ObjectivesIn urological cancers, sex disparity exists for survival, with women doing worse than men. Suboptimal evaluation of presenting symptoms may contribute.DesignWe performed a systematic review examining factors affecting the quality...

Risk assessment of urinary tract infections for patients receiving dapagliflozin

Risk assessment of urinary tract infections for patients receiving dapagliflozin

Clinicomicrobial assessment of urinary tract infections in a tertiary care hospital

BACKGROUND AND OBJECTIVES: Urinary tract infections (UTIs) encompass a wide array of infections, accounting for a vast number of community as well as hospital-acquired infections. This study was undertaken to evaluate the changing clinical presentations and risk factors of UTIs and the etiological agents in complicated and uncomplicated UTIs. METHODOLOGY: This 1-year cross-sectional study was comprised of 500 patients with signs and symptoms of UTI and/or with UTI confirmed by urine culture in the admitted in the Department of Medicine and Nephrology, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi. RESULTS: Most of the patients (59.00%) of the patients were males and the male-female ratio was 1.43:1. The most common age group was 51–60 years comprised of 25.40% of the patients and the mean age was 53.60 ± 17.55 years. Majority of the patients (76.80%) had complicated type of UTI. Most of the patients had fever with chills (65.60%), followed by pain abdomen (47.00%). Majority of the patients (88.20%) had community-acquired infection while 8.40% and 3.40% of the patients had catheter-related nosocomial infection and noncatheter nosocomial infection, respectively. Overall, Escherichia coli was the most common organism (56.40%) isolated and it was the most common organism isolated in patients with nosocomial catheter-related infections as well as noncatheter-related nosocomial infections. Furthermore, E. coli was the most common organism isolated in patients with complicated (57.03%) and uncomplicated UTI (55.17%). The most common risk factor was type 2 diabetes mellitus (T2DM) (40%) followed by chronic kidney disease (19.2%). CONCLUSION: The most common clinical presentations of UTI are fever with chills. T2DM is the important risk factors of UTI. E. coli is the predominant causative agent in all the UTIs.

Biomarker-based Assessment of Urinary Tract Infection in Persons with Spinal Cord Injury

BackgroundUrinary tract infection (UTI) is the most common infection and the second leading cause of death in spinal cord injury (SCI) patients. However, there is currently no consensus about the clinical criteria for UTI in SCI patients and the lack of a universal definition of asymptomatic bacteriuria (ABU) make the diagnosis even more complex and the treatment recommendations problematic. Prompt diagnosis and timely treatment of UTI are important to prevent possible progression to sepsis. Elevated concentrations of some biomarkers may be correlated with infection and their serial measurements may be helpful to assess the effectiveness of antibiotic therapy.MethodsFifteen SCI participants were enrolled for either lower UTI, upper UTI (pyelonephritis), ABU, or control. Patients suspected of having any inflammation or infection other than UTI were excluded. Participants were monitored for their serum procalcitonin (PCT) and c-reactive protein (CRP) levels initially and every 3 days once the UTI was confirmed and antibiotics prescribed. In addition, the urine was cultured initially and every three days in patients with UTI for correlation with biomarkers. UTI/ABU was assessed by patient’s physician.ResultsBoth mean initial PCT and CRP were significantly higher in patients with lower UTI (P = 0.027 and P = 0.001, respectively) and those with upper UTI (P = 0.044 and P < 0.0001, respectively) compared with control and ABU participants. PCT and CRP were generally reduced to the normal levels gradually during the course of antibiotic therapy for those patients with UTI that were placed on antibiotic therapy. Mean bacterial colonies grown from initial urine cultures in patients with upper or lower UTI were >100,000 CFU/mL. Control participants had urine cultures of ≤1,000 CFU/mL). Generally, cultures from UTI patients placed on antibiotics were negative for the organism(s) treated for during or after the completion of antibiotic therapy.ConclusionSerum concentrations of CRP and PCT may be used to aid in the early assessment of UTI in SCI patients in the absence of other sources of inflammation and/or infection. In general, CRP measurements are more pronounced than PCT measurements in patients with ABU or lower UTI. However, PCT levels elevate conspicuously in patient with pyelonephritis.Disclosures All authors: No reported disclosures.

Long-term Risk of Urinary Adverse Events in Curatively Treated Patients With Rectal Cancer: A Population-Based Analysis.

Treatment modalities for rectal cancer, including radiation, are associated with urinary adverse effects. The purpose of this study was to determine the influence of surgery and radiation therapy for rectal cancer on long-term urinary complications. Using the Surveillance Epidemiology and End Results-Medicare data set from the United States, patients with rectal cancer older than 66 years of age who underwent rectal resection between 1992 and 2007 were stratified into treatment groups that accounted for surgical resection and the timing of radiation therapy, if used. A control group of patients who did not have rectal cancer were matched by age, sex, demographics, and comorbidities. The primary outcome was a urinary adverse event defined as a relevant urinary diagnosis with an associated procedure. Patients with rectal cancer in different treatment groups were compared with control patients using a propensity-adjusted, multivariable Cox regression analysis. The study was conducted with the Surveillance Epidemiology and End Results-Medicare data set from the United States at our institution. Of the 11,068 patients with rectal cancer, 56.2% had surgical resection alone, 21.7% received preoperative radiation, and 22.1% received postoperative radiation. The median follow-up for all of the groups of patients was >2 years. All of the groups of patients with rectal cancer were more likely to develop a urinary adverse event compared with control subjects. Adjusted HRs were 2.28 (95% CI, 2.02-2.57) for abdominoperineal resection alone, 2.24 (95% CI, 1.79-2.80) for preoperative radiation and surgical resection, 2.04 (95% CI, 1.70-2.44) for surgical resection and postoperative radiation, and 1.69 (95% CI, 1.52-1.89) for low anterior resection alone. Treatment patterns are somewhat outdated, with a large proportion of patients receiving postoperative radiation. The data did not allow for accurate assessment of urinary tract infections or mild urinary retention that is not managed with a procedure. Rectal cancer surgery with or without radiation is associated with a higher risk of urinary complications requiring procedures. Patients who undergo low anterior resection without radiation tend toward the lowest risk for a urinary adverse event.

Developing Mobile Clinical Decision Support for Nursing Home Staff Assessment of Urinary Tract Infection using Goal-Directed Design.

Unique characteristics of nursing homes (NHs) contribute to high rates of inappropriate antibiotic use for asymptomatic bacteriuria (ASB), a benign condition. A mobile clinical decision support system (CDSS) may support NH staff in differentiating urinary tract infections (UTI) from ASB and reducing antibiotic days. We used Goal-Directed Design to: 1) Characterize information needs for UTI identification and management in NHs; 2) Develop UTI Decide, a mobile CDSS prototype informed by personas and scenarios of use constructed from Aim 1 findings; 3) Evaluate the UTI Decide prototype with NH staff. Focus groups were conducted with providers and nurses in NHs in Denver, Colorado (n= 24). Qualitative descriptive analysis was applied to focus group transcripts to identify information needs and themes related to mobile clinical decision support for UTI identification and management. Personas representing typical end users were developed; typical clinical context scenarios were constructed using information needs as goals. Usability testing was performed using cognitive walk-throughs and a think-aloud protocol. Four information needs were identified including guidance regarding resident assessment; communication with providers; care planning; and urine culture interpretation. Design of a web-based application incorporating a published decision support algorithm for evidence-based UTI diagnoses proceeded with a focus on nursing information needs during resident assessment and communication with providers. Certified nursing assistant (CNA) and registered nurse (RN) personas were constructed in 4 context scenarios with associated key path scenarios. After field testing, a high fidelity prototype of UTI Decide was completed and evaluated by potential end users. Design recommendations and content recommendations were elicited. Goal-Directed Design informed the development of a mobile CDSS supporting participant-identified information needs for UTI assessment and communication in NHs. Future work will include iterative deployment and evaluation of UTI Decide in NHs to decrease inappropriate use of antibiotics for suspected UTI.

Assessment of urinary tract infection and their resistance to antibiotics in diabetic and non-diabetic patients

Diabetic patients are more susceptible to urinary tract infections (UTIs) than non-diabetic patients and due to the development of multidrug resistant uropathogenic strains, the choice of antibacterial agents is being limited. The study was undertaken to determine the influence of diabetes mellitus on the uropathogens and antibiotic sensitivity pattern among patients with UTIs. A cross-sectional study was conducted in which total of 400 patients were studied out of which 150 were diabetics and 250 were non-diabetics. Patients with negative urine culture (n = 240) were excluded from the study and 160 patients with positive culture of UTIs of which 80 were diabetics and 80 were non-diabetics, included in this study. Clinical data were obtained from individual study participant with informed written consent using pre-tested questionnaire. According to the clean-catch procedure, midstream urine samples were collected and cultured for the diagnosis and susceptibility of bacteriuria. Out of 160 uropathogenic isolates, E. coli was found as a leading pathogen i.e. 46.25% followed by Candida spp. 30.62%, S. Faecalis 15.62%, P. aeruginosa 3.13%, Pneumococcus. 1.25%, MSSA 1.25%, MRSA 0.63%, Proteus spp. 0.63% and Vancomycin resistant enterococcus spp. 0.63%. The results indicated that prevalence of UTIs was significantly higher in diabetic patients than in non-diabetic subjects. E. coli was found to be the most common isolate. It was observed that UTIs in diabetic patients was more in female diabetic patients than in male patients. Investigation of bacteriuria in diabetic patients for UTIs is an important tool for the treatment and prevention of renal complications.

Assessment of Urinary Tract Infection and Anti Lactoferrin Antibodies Levels in Iraqi Patients with Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune disease that may be triggered by urinary tract infection (UTI) especially if they are investigated in the presence of lactoferrin antibodies. The objective is to determine anti lactoferrin antibodies in RA and its association with urinary tract infection. Out of 162 autoimmunity Iraqi patients, UTI and levels of anti lactoferrin antibodies were assessed in 98 (60.49 %) with rheumatoid arthritis (RA), compared with 30 apparently healthy control and 74.48 % were observed to have UTI, the predominant bacteria identified as a cause of UTI; Proteus spp. was present as a single causative pathogen in 58.90 %, while E. coli was observed in 17.80 %. Anti lactoferrin antibodies were significantly higher in RA patients was observed in UTI+ve versus UTI-ve cases in total patients compared with healthy control that P value (≤0.05).

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

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.

A Protocol for the Urine/Dipstick Pad Method

The urinary tract accounts for nearly one third of all infections in the long-term care setting. This article reviews factors that influence nitrite and leukocyte esterase results obtained from traditional urine dipstick analysis for assessment of urinary tract infections in elderly long-term care residents. This article also proposes a protocol for a urine dipstick pressed into an incontinence pad as an alternative to dipstick analysis of a clean-catch or catheterized urine specimen.

A Protocol for the Urine Dipstick/Pad Method

The urinary tract accounts for nearly one third of all infections in the long-term care setting. This article reviews factors that influence nitrite and leukocyte esterase results obtained from traditional urine dipstick analysis for assessment of urinary tract infections in elderly long-term care residents. This article also proposes a protocol for a urine dipstick pressed into an incontinence pad as an alternative to dipstick analysis of a clean-catch or catheterized urine specimen.