Bacterial Urinary Tract Infection Research Articles

Antibiotic efficacy and resistance patterns of urinary tract infection-causing bacteria in dogs and resistome of multidrug-resistant Klebsiella pneumoniae via whole genome sequencing in South Korea

Bacterial urinary tract infections (UTIs) are prevalent in dogs and necessitate antibiotic intervention. However, the emergence of multidrug-resistant (MDR) bacteria poses significant challenges to antibiotic therapy. Although fosfomycin has been demonstrated to achieve and maintain high concentrations in urine, suggesting its potential for treating UTIs in dogs, its efficacy and the resistance profiles of urinary pathogens from canine UTIs remain elusive. Therefore, this study was conducted to investigate the antibiotic susceptibility of bacterial pathogens isolated from companion dogs with UTIs, with a particular focus on their susceptibility and resistance to fosfomycin. A total of 70 isolates from urine samples were analyzed, of which Escherichia coli (n = 18), Proteus mirabilis (n = 9), Klebsiella pneumoniae (n = 5), and Staphylococcus pseudintermedius (n = 5) were predominant. Resistance to erythromycin was most prevalent (94.59%), followed by clindamycin (91.89%) and ampicillin (78.37%), whereas the lowest resistance rate was observed for amikacin (5.40%). Resistance to fosfomycin was observed in 15 out of the 37 predominant isolates (40.54%), including all K. pneumoniae isolates (100%). All isolates, except 4 E. coli strains, were categorized as MDR (33 out of 37; 89.18%). The resistance rates for amoxicillin/clavulanic acid and trimethoprim-sulfamethoxazole, which are common first-line antibiotics for canine UTIs, were 48.64 and 56.75%, respectively. Whole-genome sequencing of K. pneumoniae isolates, which exhibited high resistance to fosfomycin, revealed multiple antibiotic resistance genes, with chromosomal fosA present in all isolates. Among the 27 dogs with recurrent infection included in this study, 2 were administered fosfomycin, resulting in clinical remission, as evidenced by negative urine culture tests. Overall, this study is the first to demonstrate the importance of assessing fosfomycin resistance profile for optimal treatment of canine UTIs, particularly in cases involving MDR strains.

'From women for women': A citizen science approach engaging women in the isolation and application of the vaginal health-associated bacterium Lactobacillus crispatus.

A vaginal microbiome rich in Lactobacillus crispatus is associated with good reproductive and sexual health outcomes. Dysbiosis, indicated by the loss of Lactobacillus crispatus, is a risk factor for urogenital infections, such as the clinical diagnosis of bacterial vaginosis (BV) or urinary tract infections. While many scientists have explored probiotics using a conventional pharmaceutical approach, concerns about accessibility and affordability prompt an investigation into a preventive approach using this naturally occurring bacterium. Our study aimed to explore a potential woman-friendly vaginal probiotic product using the naturally occurring bacterium, Lactobacillus crispatus. Citizen scientists actively participated in a two-day practicum and successfully performed the procedures using self-collected vaginal swabs. The practicum received positive responses from participants who demonstrated notable engagement and enthusiasm. With expert guidance, participants without a laboratory background were able to execute assigned tasks successfully. From the Dutch crispatus Citizen Science Collective of 48 women, 22 succeeded in isolating their own Lactobacillus crispatus strains using a Loop-Mediated Isothermal Amplification (LAMP) protocol for identification. Additionally, 48 metagenomes and 54 whole genomes from 22 individuals were sequenced for comparative analysis. This project effectively engaged a community of women in the isolation of Lactobacillus crispatus strains from their vaginal microbiota, followed by in vitro characterization experiments and a hackathon for the development of a probiotic product. Our citizen science approach opens up collaboration possibilities and new avenues for exploration of vaginal health, facilitating community involvement and the development of targeted interventions to enhance women's well-being.

Performance of UF-5000 in rapidly screening out urinary tract infection, predicting Gram-negative bacteria infection.

Urine culture is the gold standard for identifying microorganisms in urine. However, the process is time-consuming and usually takes days to get the results, which impedes timely treatment. This study aimed to evaluate the performance of UF-5000 in excluding bacterial urinary tract infection (UTI) and detecting the presence of Gram-negative bacteria. A total of 1,522 urine specimens were subjected to routine urine analysis and culture. Bacteria, white blood cell counts, and UF-5000 bacteria information flags were compared with urine culture. Bacteria forward scatter (B_FSC), and bacteria fluorescent light intensity (B_FLH) parameters were assessed to determine the optimal angle for discriminating bacterial growth patterns, which was verified in the validation cohort. The optimal cut-off values were 42.2/µL and 100.2/µL to rule out UTI for bacteria at ≥104 CFU/mL and ≥105 CFU/mL, respectively. The agreement of UF-5000 bacterial classification and urine culture was fair (Kappa = 0.227). Regarding the discrimination of bacterial groups, "Gram Neg?" was associated with a specificity of 94.0% and a positive predictive value of 87.2% in the detection of Gram-negative bacteria. By estimating the B_FSC and B_FLH parameters, the best angle was 28° for distinguishing Gram-negative and Gram-positive bacteria. Among the 136 urine specimens with the low angle pattern (<28°) in the validation cohort, 127 specimens were confirmed to contain Gram-negative bacteria. The UF-5000 analyzer is a suitable and rapid tool to exclude negative urine specimens, and bacterial information flags for Gram-negative bacteria could be trusted by clinicians.IMPORTANCEThe strength of our study relied on being the first study assessing the bacteria forward scatter (B_FSC) and bacteria fluorescent light intensity (B_FLH) research parameters with a UF-5000 urine analyzer and establishing the best angle for distinguishing Gram-negative and Gram-positive bacteria. When the bacterial scatter plot angle is less than 28°, the possibility of Gram-negative bacterial infection is more than 80%. Meanwhile, we find that UF-5000 bacterial information flags have a significant advantage in detecting Gram-negative bacteria with a specificity of over 90% and a positive predictive value of over 80%.

Photonic sensor based on surface imprinted polymers for enhanced point-of-care diagnosis of bacterial urinary tract infections

Effective bacterial detection is crucial for health diagnostics, particularly for the detection of pathogenic species like Escherichia coli (E. coli), which is responsible for up to 90% of urinary tract infections (UTIs), is especially crucial. Current detection methods are time-consuming, often delaying diagnosis and treatment. This study introduces an innovative approach for rapid E. coli detection using porous silicon (PSi) substrates combined with Surface Imprinted Polymers (SIPs) for photoluminescence-based (PL-based) E. coli detection. The PSi/SIP substrates offer high sensitivity, selectivity, and a low limit of detection (LOD) without the need for natural recognition elements. These substrates, fabricated via metal-assisted chemical etching (MACE) and PDMS-based E. coli imprinting, demonstrate reliable repeatability and a fast detection. Real-time detection experiments in phosphate-buffered saline (PBS) and urine showed consistent stair-like quenching of the PL signal with increasing E. coli concentrations, achieving theoretical LODs of approximately 13 ± 2 CFU/mL in PBS and 17 ± 3 CFU/mL in urine. The substrates exhibited excellent selectivity, differentiating E. coli from other species such as Cronobacter sakazakii (C. sakazakii) and Listeria monocytogenes. The high sensitivity and reproducibility of PSi/SIP substrates, along with the ease of use and rapid detection capabilities of the resulting sensor, highlight the potential of this novel platform for point-of-care (PoC) applications in clinical diagnostics.

Presence of Enterococci in Cats with Urinary Tract Infections and Antibiotic Resistance Profiles

Background: Bacterial urinary tract infection (UTI) is one of the most common diseases in cats caused by an imbalance between the natural host defence mechanisms of the urinary tract and virulent bacteria. This study investigated the prevalence and antimicrobial susceptibility of enterococci isolated from cats presenting urinary tract problems to veterinary clinics in Istanbul. Methods: 100 urine samples were collected from cats by cystocentesis and plated on blood agar. Isolates found catalase and oxidase negative plated on Enterococcocel agar. After incubation, the isolates formed black colonies were tested by PCR using E. faecium and E. faecalis-specific primers. Then the antibiotic susceptibility of the isolates was determined. Result: Eight of the 100 isolates that formed black colonies on Enterococcosel agar were identified as Enterococcus spp. After PCR tests, six isolates were classified as E. faecalis, one isolate was classified as E. faecium and one isolate that did not form a band was classified as Enterococcus spp. As a result of the Kirby-Bauer disc diffusion method used to determine the antibiotic susceptibility of the isolates, most resistance was found to cephalothin (100%) and penicillin, erythromycin, clindamycin and tetracycline (87.5%). While vancomycin resistance was not observed in any isolate, the lowest resistance was to enrofloxacin and ciprofloxacin (33.3%). Multiple antibiotic resistance was observed in all (100%) isolates. The presence of multi-resistant enterococci in cats represents a significant health threat. Bacterial identification and antimicrobial susceptibility testing should always be performed in urinary tract infections to guide definitive diagnosis and treatment.

Acute necrotizing encephalopathy caused by bacterial infection

PurposeAcute necrotizing encephalopathy (ANE), a rare and severe brain disorder, is typically linked to prior infections. ANE predominantly affects children, with most reported cases attributed to viral infections. However, instances of bacterial-induced ANE are infrequent. Here, we present a case of adult-onset ANE associated with bacterial infection.Case descriptionsThe patient exhibited a hyperinflammatory state following a urinary tract bacterial infection, with neurological function rapidly declining into a coma as the illness progressed. Gram culture of blood suggested Escherichia coli infection. A magnetic resonance imaging (MRI) scan of the brain showed symmetrical hyperintense lesions involving bilateral thalami and pons in T2-weighted and fluid-attenuated inversion recovery images. These lesions also presented with diffuse cerebral edema and diffusion restriction and subacute hemorrhage. Based on clinical symptoms and typical brain MRI, ANE was diagnosed, and the patient underwent immunotherapy.ConclusionsThis case underscores the occurrence of ANE triggered by bacterial infection, expanding our understanding of the pathogens associated with this condition. It suggests that ANE may be an immune-mediated disorder rather than solely an infectious disease.

Antibiotic susceptibility of uropathogens: a 3-year retrospective study at Ho Teaching Hospital of Ghana

BackgroundUrinary tract infection (UTI) remains one of the most treated infections in primary healthcare over the last two decades. The infection is treated with antibiotics. However, there have been reported cases of increasing antibiotic resistance globally, limiting the available antibiotics for the treatment of the infection. The study aimed to determine the frequency of bacterial urinary tract infections and their antibiotic resistance pattern in Ho Teaching Hospital of Ghana from 2019–2021.MethodologyData on urine culture and susceptibility testing and patient demographics from 2019–2021 were collected from the microbiology unit archives with a designed Microsoft Excel 2019 form and later exported to IBM SPSS (v26) for statistical analysis on the uropathogens and their antibiotic resistance pattern. P-value < 0.05 was considered statistically significant.ResultsOut of 4806 records, 1005 bacterial isolates were found, with a total prevalence of 20.91%. The most prevalent group of organisms was the Enterobacteriaceae, with E. coli 409 (40.70%) being the most frequent isolate. Of the 772 isolates subjected to amikacin, 48(6.22%) and 6(0.78%) of the Gram-negative and Gram-positive bacterial organisms showed resistance to the antibiotic respectively. 58.96% (148/251) and 3.59% (9/251) of Gram-negatives and Gram-positives were resistant to cotrimoxazole. Out of the 1005 bacterial isolates, 165(16.42%), 161(16.02%) and 2(0.20%) showed multidrug resistance (MDR), extensively-drug resistance (XDR), and pandrug resistance (PDR) respectively.ConclusionThere was a high antibiotic-resistant pattern among the uropathogens reported in this current study, hence, the Standard Treatment Guidelines may need to be updated to reflect the high rates of antibiotic resistance exhibited by most prevalent isolates.

Prevalence of Bacterial Urinary Tract Infection among Pregnant Women in Wasit Province in Iraq

Background: Urinary tract infections (UTIs) are the most common type of infection during pregnancy. UTI include a spectrum of disorders, ranging from those affecting the lower urinary tract, like asymptomatic bacteriuria and cystitis, to those affecting the kidney, such as pyelonephritis. In pregnancy UTI can lead to preterm labor, anemia and septicemia. Escherichia coli is the most common pathogenic microorganisms associated with UTI and counting up to 60–80% of all UTIs. Objective: The aim of this study is to determine the prevalence of urinary tract infection (UTI) among pregnant women in wasit province. Materials and Methods: Mid-stream urine samples from 100 pregnant women who attending to Al- Shaheed Fairuz hospital and private clinics in wasit province between the periods of March 2024 to July 2024 with the age range of (16-35) years. The urine samples were cultured on MacConkey and blood agars then examined by Macroscopic and Microscopic examination by Gram's stain. The colonies were examined by biochemical tests (Oxidase, catalase, manitol salt agar, novobiocin tests, IMViC) and confirmatory tests (API 20E and API Staph) for isolates. Results: The results showed that the percentage of bacterial growth culture among the pregnant women was 33%. Gram negative bacteria were the higher percentage with (73%). Eschirishia coli bacteria were the most frequently isolated organism (40%) while, the lower percentage for Streptococcus spp. (3%). UTI in pregnant women was commonest in the age group 20-24 years (42%). According to trimesters of pregnancy, the highest percentage of UTI was in third trimester (43%) followed by second trimester (39%), while the the first trimest was the the lowest percentage with (18%). Conclusions: Urinary tract infections (UTIs) are common during pregnancy. Untreated UTIs can lead to complications such as preterm labor, low birth weight and sepsis. E.coli is the predominant pathogen presently causing urinary tract infections at all stages of pregnancy. Urine culture and sensitivity tests are mandatory for all pregnant women during the different trimesters.

Assessment of the Antimicrobial Activity of (Copper Sulphate Pentahydrate and Potash Alum) Nanoparticles on Bacteria (Pseudomonas Aeruginosa) Isolated with Bacterial Urinary Tract Infections (UTIs)

Assessment of the Antimicrobial Activity of (Copper Sulphate Pentahydrate and Potash Alum) Nanoparticles on Bacteria (Pseudomonas Aeruginosa) Isolated with Bacterial Urinary Tract Infections (UTIs)

Honey Enhances Antibiotic Effectiveness Against Urinary Tract Infections

Background: Urinary tract infections (UTIs) are prevalent across all ages and genders and pose significant treatment challenges, often requiring alternative therapeutic approaches due to increasing antibiotic resistance. Specific Background: The study examines the impact of antibiotics and honey on bacterial UTIs, revealing 17 cases, primarily caused by Staphylococcus aureus and Klebsiella pneumoniae. Knowledge Gap: The study evaluates the effectiveness of honey in combining antibiotics with anise and spring flower honey, focusing on its potential to enhance antimicrobial effects in UTIs. Results: Biochemical analysis and VITEK diagnostics revealed significant bacterial growth. Antibiotic susceptibility tests showed varied effectiveness, with spring flower honey enhancing the activity of nitrofurantoin (35%), trimethoprim (17.6%), trimethoprim-sulfamethoxazole (23.5%), tetracycline, and norfloxacin (35.2%). Anise honey also demonstrated notable synergistic effects, particularly with norfloxacin (47%) and tetracycline (41%). Novelty: This study highlights the potential of combining honey with antibiotics to combat UTIs, offering new insights into alternative treatment strategies and demonstrating significant synergy with specific antibiotics. Implications: The findings suggest that incorporating honey into UTI treatments could improve therapeutic outcomes and help mitigate the growing issue of antibiotic resistance. Further research is needed to identify active compounds in honey and optimize their use with antibiotics. Highlights: Enhanced Efficacy: Honey boosts antibiotic effectiveness against UTIs. Resistance Solution: Combines honey to counteract antibiotic resistance. Honey Variability: Different honeys show varied synergistic effects. Keywords: Urinary Tract Infection, Antibiotics, Honey, Synergistic Effect, Antibiotic Resistance

Evaluation of antibacterial susceptibility profile in pregnant women with asymptomatic bacteriuria in Kadapa

: The bacterial urinary tract infection in pregnancy may be symptomatic (cystitis, pyelonephritis) or asymptomatic (bacteriuria without symptoms). Empirical antimicrobial therapy may be affected by resistance of uropathogens due to the irrational use of antibiotics. This prevalence of resistance is rising and varies across the globe due to different treatment recommendations which may be determined by taking into account frequently occurring infections, susceptibility patterns, evidence, physician acceptance, antimicrobial stewardship norms, availability of formularies, and antimicrobial prices. So the current research was carried out. : A cross-sectional study was conducted among pregnant women with UTI attending antenatal care (ANC) by excluding pregnant women who had taken antibiotics within the two weeks prior to their ANC follow-up and symptomatic UTI pregnant women. The antibiotic sensitivity of the uropathogens and their identification were evaluated by conventional culture, microbiological techniques and sensitivity tests. The results were analysed by SPSS software for descriptive statistics. : 377 pregnant women with UTI participated in the present study. The results demonstrated that most of the participants who lived in urban areas (64%) were affected. The results also suggest that 42% of participants who had secondary education as the highest level of education, 45% of participants belonged to an upper middle-class family and, 40% of working professionals in the study were affected. Out of 103 isolates, 79 isolates were gram negative &amp; 24 were Gram positive. Out of seventy-nine gram negative isolates, the major contribution was by (36), . (26). Among 24 gram positive isolates, the major contribution was by Coagulase Negative Staphylococci (CONS) (12). The uropathogens were shown diverse antibiotic sensitivity for the study test drugs. : This study concludes that the antibacterial susceptibility and resistance of uropathogens may vary in different geographical areas based on antibiotic usage and circumstances. This study also demonstrated the imperative prerequisite of periodic assessments.

Genito - Urinary Tuberculosis with Secondary Bacterial Urinary Tract Infection - A Case Report

Genito - Urinary Tuberculosis with Secondary Bacterial Urinary Tract Infection - A Case Report

Diagnostic ultrasonography and antimicrobial resistance of different pathogens associated with canine and feline lower urinary tract disorders

There is a significant issue concerning the dissemination of antimicrobial-resistant bacteria within companion animals. Urinary tract infections (UTIs) are a common problem in veterinary medicine for which empirical antibiotics are utilized. This study aimed to investigate the antimicrobial resistance of different uropathogens associated with UTIs in canine and feline cases. A total of 146 dogs and 162 cats suffered from lower urinary tract disorders were subjected to ultrasonographic and microbiological examination. Cystitis, urinary sediment, and cystic calculi are the most common ultrasonographic abnormalities associated with bacterial UTIs. Bacterial UTIs were obtained in 36.98 % and 25.92 % of cases in dogs and cats, respectively. A low rate of mixed infection was detected in canine cases (3.7 %). E. coli was the most prevalent pathogen isolated from 46.4 % and 66.7 % of canine and feline isolates, respectively followed by Proteus spp. in canine isolates (16.1 %) and Klebsiella spp. in feline isolates (14.3 %). Staphylococcus spp. was isolated from canine cases only with the detection of methicillin-resistant Staphylococcus pseudintermedius (MRSP) strains at 3.6 %. The majority of the isolated strains were resistant to various antibiotic classes, particularly β-lactams. All gram-negative bacteria were susceptible to amikacin, whereas gram-positive strains exhibited 100 % sensitivity to nitrofurantoin and linezolid. Different bacterial species displayed low resistance to carbapenems and fluoroquinolones. Multi-drug resistance was reported in canine and feline strains at 64.3 % and 54.8 %, respectively. These findings prove the crucial necessity to restrict antibiotic consumption depending on urine culture and antibiotic sensitivity tests.

Enhancing clinical decision-making: Sysmex UF-5000 as a screening tool for bacterial urinary tract infection in children.

A rapid screening test for urinary tract infections (UTIs) in children is needed to avoid unnecessary cultures and provide prompt reports to make appropriate clinical decisions. We have evaluated for the first time the performance of the Sysmex UF-5000 flow cytometer as a screening tool for UTIs in children. This study included 4445 pediatric patients, with urinary sediment and urine culture data collected from January 2020 to September 2023. The Sysmex UF-5000 analyzer was utilized to measure urine white blood cell (WBC) and bacteria (BACT), with the findings being compared to the culture results. At ≥ 104 colony-forming unit (CFU)/mL, 513 samples were culture-positive (400 samples presented 104-105 CFU/mL, and 113 demonstrated ≥ 105 CFU/mL bacterial growth). Optimal indicators for positive cultures were BACT counts of 92.2/μL (AUC: 0.944) and WBC counts of 40.8/μL (AUC:0.863). False negative rate were 0.9% when using a 7.8 bacteria/μL cut-off and avoiding unnecessary cultures in 28.1%. The UF-5000 has a higher consistency rate for Gram-negative (GN) bacteria (90.3%) than Gram-positive (GP) bacteria (86.8%). For samples with 105 CFU/mL, UF-5000's Bacteria -Information flags showed superior concordance for samples with 104-105 CFU/mL bacteria. Screening pediatric urine cultures with the UF-5000 showed potential application value in identifying negative cultures and significant bacterial growth, although performance may vary depending on the study population. Furthermore, detecting Gram typing aids in guiding early clinical empirical medication, particularly for UTIs caused by GN bacteria.

Antimicrobial Susceptibility of Canine and Feline Urinary Tract Infection Pathogens Isolated from Animals with Clinical Signs in European Veterinary Practices during the Period 2013-2018.

Bacterial urinary tract infections (UTIs) occur frequently in companion animals and are often treated with antibiotics. However, antimicrobial resistance can severely hamper treatment success. Therefore, antimicrobial susceptibility monitoring is key. UTI isolates were obtained from dogs and cats in two collection periods (ComPath II: 2013-2014 and ComPath III: 2017-2018) as part of CEESA's ComPath programme. Susceptibility testing of the UTI isolates (2021 in total) was carried out at one central laboratory using agar and broth dilution methodology as recommended by the Clinical and Laboratory Standards Institute. Escherichia coli was the most frequently isolated bacterium in UTI in both dogs (46.9%, 43.1%) and cats (61.2%, 48.3%) across ComPath II and ComPath III, respectively. The percentage of resistance in E. coli was low (<10%) across both programmes in both dogs and cats except for trimethoprim-sulfamethoxazole (dogs ComPath III: 12.9%; cats ComPath II: 13.0%) and enrofloxacin (10.5%), marbofloxacin (11.4%), and doxycycline (98.8%) for dogs in ComPath III. Three (7.5%) of the 40 isolated S. aureus bacteria in total were MRSA and harboured mecA. The level of multidrug resistance (MDR) was generally low and ranged from 0.0% for feline coagulase-negative Staphylococcus spp. to 11.7% for canine Proteus spp., except for a peak of MDR observed in canine Klebsiella isolates from ComPath II (36.7%). Overall, antimicrobial resistance for most canine and feline UTI pathogens isolated during the ComPath II and ComPath III programmes was low (1-10%) to moderate (10-20%).

The Prevalence of Bacterial Urinary Tract Infections Among School-age Children

Urinary tract infections (UTIs) are the most common and serious bacterial infection in children. The current study aims at identifying the most prevalent symptoms and pathogenic bacteria linked to urinary tract infections in school-aged children in Al-Muthanna Province. Between October 2023 and April 2024, a urine samples were collected from 685 (417 female and 268 male) students across three age groups: 129 (19%) (6-12 years), 240 (35%) (&gt;12-14 years), and 316 (46%) (&gt;14-18 years) with symptoms of urinary tract infection. Female students (345) were significantly more affected by bacterial infections compared to male students (182), χ² (df=1, N=685) = 20.2, p &lt; .001. In cases of UTI symptom onset, the likelihood of bacterial UTIs is 1.9 times higher for children aged &gt;12-14 and 3.2 times higher for those aged &gt;14-18 compared to children aged 6-12. The prevalence of symptomatic UTIs among schoolchildren increases with age, from 62% to 83.9% across different age groups. Among female students aged 6-18 with UTI symptoms, 82.7% had a bacterial UTI, compared to 67.9% of male students. Over 5% of schoolchildren without bacterial UTI exhibit moderate to marked pyuria. Hematuria percentages were comparable between individuals with and without bacterial UTIs. The average pH tended to be acidic for both groups, with infected individuals having a pH less than six and uninfected individuals having a pH less than seven. Escherichia coli was the predominant infectious followed by Enterococcus faecalis, Enterobacter aerogenes, Klebsiella pneumoniae, Proteus mirabilis and Pseudomonas aeruginosa at rates of 74%, 41%, 33%, 36%, 29% and 19%, respectively. Staphylococcus aureus and Staphylococcus epidermidis occurred at a frequency of 12% and 8%, respectively, while Streptococcus agalactiae occurred at a frequency of 3%.

Different profiles of acute graft pyelonephritis among kidney recipients from standard or elderly donors.

Acute graft pyelonephritis (AGPN) is a relatively common complication in kidney transplants (KTs); however, the effects on allograft function, diagnostic criteria, and risk factors are not well established. Retrospective analysis of all consecutive adult KTs was performed between 01 January 2011 and 31 December 2018 (follow-up ended on 31 December 2019) to examine the association between the diagnosis of AGPN (confirmed with magnetic resonance imaging [MRI]) during the first post-transplantation year and graft outcomes. Among the 939 consecutive KTs (≈50% with donors ≥60 years), we identified 130 MRI-confirmed AGPN episodes, with a documented association with recurrent and multidrug-resistant bacterial urinary tract infections (UTIs) (p < 0.005). Ureteral stenosis was the only risk factor associated with AGPN (OR 2.9 [95% CI, 1.6 to 5.2]). KTs with AGPN had a decreased allograft function at the first year (ΔeGFR 6 mL/min/1.73 m2 [-2-15] in non-AGPN vs. -0.2 [-6.5-8.5] in AGPN, p < 0.001), with similar and negative profiles in KTs from standard or elderly donors. However, only KTs with AGPN and a donor <60 years showed reduced death-censored graft survival (p = 0.015); most of this subgroup received anti-thymocyte globulin (ATG) induction (40.4% vs. 17.7%), and their MRI presented either a multifocal AGPN pattern (73.9% vs. 56.7%) or abscedation (28.3% vs. 11.7%). No difference was noted in death-censored graft survival between early (<3 months post-KT) or late (3-12 months) AGPN, solitary/recurrent forms, or types of multidrug-resistant pathogens. Linear regression confirmed the independent role of multifocal pattern, abscedation, ATG induction, and donor age on the eGFR at the first year. AGPN, influenced by multifocal presentation, ATG induction, donor age, and abscedation, affects kidney function and significantly impacts allograft survival in KTs with donors <60 years.

Association Between Sexually Transmitted Infections and the Urine Culture.

Bacterial urinary tract infections (UTI) and some sexually transmitted infections (STI) can have overlapping signs and symptoms or nonspecific findings, such as pyuria on urinalysis. Furthermore, results from the urine culture and the nucleic acid amplification test for an STI may not be available during the clinical encounter. We sought to determine whether gonorrhea, chlamydia, and trichomoniasis are associated with bacteriuria, information that might aid in the differentiation of STIs and UTIs. We used multinomial logistic regression to analyze 9,650 encounters of female patients who were aged ≥18years and who underwent testing for STIs. The ED encounters took place from April 18, 2014-March 7, 2017. We used a multivariable regression analysis to account for patient demographics, urinalysis findings, vaginal wet-mount results, and positive or negative (or no) findings from the urine culture and testing for Neisseria gonorrhoeae, Chlamydia trachomatis, or Trichomonas vaginalis. In multivariable analysis, infection with T vaginalis, N gonorrhoeae, or C trachomatis was not associated with having a urine culture yielding 10,000 or more colony-forming units per mililiter (CFU/mL) of bacteria compared with a urine culture yielding less than 10,000 CFU/mL or no urine culture obtained. The diagnosis of a UTI in the ED was not associated with having a urine culture yielding 10,000 or more CFU/mL compared with a urine culture yielding less than 10,000 CFU/mL. After adjusting for covariates, no association was observed between urine culture results and testing positive for trichomoniasis, gonorrhea, or chlamydia. Our results suggest that having a concurrent STI and bacterial UTI is unlikely.

Correlation of CD4+ count and viral load with urinary tract infection and antimicrobial resistance pattern of bacterial uropathogens among HIV patients in Wolaita Sodo, South Ethiopia.

The permanence of HIV patients in healthcare provision centers exposes their weak immunity to various nosocomial microorganisms that migrate into and out of the hospital environment. The incidence of bacterial infections, including urinary tract infection, was inversely correlated with CD4+ T cells. Urinary tract infection (UTI) is one of the clinical problems among HIV patients. There was scarcity of published data on the relationship between viral load, CD4+ level, and UTI. This study aimed to assess the relationship between viral load and CD4 with bacterial UTI among HIV patients. The cross-sectional study was conducted in the Wolaita Sodo Town Health Center ART clinic. The socio-demographic data were collected using a pre-designed questionnaire. Patients' charts were reviewed to collect the current CD4 and viral load. Urine specimens were inoculated on blood agar, cysteine lactose electrolyte deficient (CLED) agar, and MacConkey agar, and bacterial species were finally identified using various biochemical methods. Antimicrobial sensitivity testing was conducted using standard microbiological tests. Bivariate and multivariate analyses were employed to describe the association between pairs of variables and to examine the relationship between independent variables and dependent variables. In this study, the overall prevalence of urinary tract infection (UTI) was 13.7%. Escherichia coli, Staphylococcus aureus, Pseudomonas aeroginosa, Staphylococcus saprophyticus, Proteus mirabilis, and Klebsiella pneumoniae were bacterial uropathogens detected in this study. E.coli (45.7%) was the predominant isolate followed by S. aureus (14.3%). Positive correlation between CD4+ count and urinary tract infection was detected and found statistically significant (r = 0.288 p > 0.01), whereas the viral load and urinary tract infection negatively correlated and showed statistically significant association (p < 0.01). The resistance rate of E.coli was 94%, 75%, and 69% to ciprofloxacin, norfloxacin, and cefepime, respectively. This study revealed that E.coli exhibited 94% and 75% resistance to amoxicillin-clavulanic acid and tetracycline, respectively. K. pneumoniae demonstrated complete resistance (100%) to amoxicillin-clavulanic acid, tetracycline, and trimethoprim-sulfamethoxazole, while showing 100% susceptibility to ciprofloxacin and nitrofurantoin. In the present study, the magnitude of the multi-drug resistance (MDR) was found to be 80%. CD4+ count, combination of antiretroviral therapy (ART) drugs, and a history of hospitalization were risk factors for urinary tract infection. In the current study, urinary tract infection emerged as a significant health concern among people living with HIV following their ART. The occurrence of urinary tract infection among HIV patients could be influenced by multifactorial factors that require further study. The CD4+ count was positively correlated with the prevalence of UTI, whereas the viral load was negatively correlated. The CD4+ count, combination of ART, and history of hospitalization were independent risk factors for UTI. The prevalence of MDR bacterial pathogens were notably high. Therefore, the treatment of UTI in HIV patients should be prescribed based on antibacterial susceptibility testing results.

Host response during unresolved urinary tract infection alters female mammary tissue homeostasis through collagen deposition and TIMP1.

Exposure to pathogens throughout a lifetime influences immunity and organ function. Here, we explore how the systemic host-response to bacterial urinary tract infection (UTI) induces tissue-specific alterations to the mammary gland. Utilizing a combination of histological tissue analysis, single cell transcriptomics, and flow cytometry, we identify that mammary tissue from UTI-bearing mice displays collagen deposition, enlarged ductal structures, ductal hyperplasia with atypical epithelial transcriptomes and altered immune composition. Bacterial cells are absent in the mammary tissue and blood of UTI-bearing mice, therefore, alterations to the distal mammary tissue are mediated by the systemic host response to local infection. Furthermore, broad spectrum antibiotic treatment resolves the infection and restores mammary cellular and tissue homeostasis. Systemically, unresolved UTI correlates with increased plasma levels of the metalloproteinase inhibitor, TIMP1, which controls extracellular matrix remodeling and neutrophil function. Treatment of nulliparous and post-lactation UTI-bearing female mice with a TIMP1 neutralizing antibody, restores mammary tissue normal homeostasis, thus providing evidence for a link between the systemic host response during UTI and mammary glandalterations.