Rate Of Bacteriuria Research Articles

Implications of Bacteriuria in Myelomeningocele Patients at Time of Urodynamic Testing.

Objective: To identify those myelomeningocele (MMC) patients at risk for post-urodynamic study (UDS) complications. We hypothesized that patients who manage their bladder with clean intermittent catheterization (CIC) would have a greater risk of post-instrumentation complications due to higher rates of bacteriuria compared to those who freely void (FV). Design/Methods: Urine was collected from patients with MMC without augmentation cystoplasty undergoing routine renal ultrasound or urodynamic study (UDS). Samples were divided into those with bacteriuria (urine culture ≥10,000 colony-forming units) and those without. Post-UDS complications were evaluated and compared between CIC and FV patients. Results: A total of 91 urine samples from 82 total MMC patients were included for evaluation. Significantly more patients on CIC than those who FV had bacteriuria (67% vs 33%, p = .0457). From these urine samples, 54 were obtained at time of UDS of which 45 were from patients on CIC and 9 from FV patients. More patients on CIC had bacteriuria at the time of UDS than those who FV (60% vs 33%, respectively), but this did not reach significance (p = .1416). No patient with bacteriuria on CIC had a complication after UDS while one FV patient with bacteriuria developed post-UDS pyelonephritis. Conclusion: MMC patients with bacteriuria on CIC did not have post-UDS complications. Patients with bacteriuria who FV may be at particular risk for post-instrumentation UTI, providing guidance as to which MMC patients should undergo urine testing prior to UDS in order to prevent post-instrumentation pyelonephritis.

Ureteric implantation into the bowel portion of augmented bladders during kidney transplantation: a review of urological complications and outcomes.

In patients with bladder augmentation undergoing kidney transplantation, conventional technique recommends anastomosing the transplanted ureter to the bladder. We report our technique of ureteric implantation into the bowel portion of the enterocystoplasty, and review the urological outcomes of transplantation in these patients. Seven patients (mean age: 26 years (range 24-54 years), two females, five deceased donors) with augmented cystoplasty and subsequent kidney transplantation by a single surgeon from 2011 to 2015 were reviewed. Following standard vascular anastomosis and reperfusion of the transplanted kidney, ureteric implantation involved continuous 5/0 polydiaoxanone anastomosis between the spatulated ureter and full thickness bowel portion of the cystoplasty over a 6-Fr double J stent. A second peri-anastomosis layer of bowel plication was performed to prevent reflux using interrupted 3/0 vicryl sutures. Short-term urological and kidney function outcomes were evaluated. Causes of renal failure included: posterior urethral valve with reflux nephropathy (two patients), bilateral vesicoureteric reflux (two patients), lumbosacral agenesis with neurogenic bladder (one patient), tuberculosis of the urinary tract with post-infective ureteric stricture (one patient), and lupus nephritis (one patient). Bladder reconstruction was performed at median duration of 103 months (35-171 months) before transplantation. Gastrocystoplasty was performed in two patients while colon and/or ileum were used in the remaining six. After transplantation, all reconstructed bladders except one had a Mitrofanoff for clean intermittent self-catheterization, 5-8 times per day. There were no post-operative ureteric/surgical complications. Delayed graft function occurred in three of seven patients. 30-day asymptomatic bacteriuria rate was three out of seven after stent removal. 1-year post-transplantation, patient and graft survival were 100%. Mean serum creatinine was 142.7 (standard deviation: 51.48). Median number of hospital admissions for urinary tract infections was 0.225 (range 0-0.40). Over a median follow-up period of 4 years (2-7 years), one graft failed from acute T-cell-mediated rejection. This patient passed away from cardio-respiratory collapse after a seizure, 35 months post-transplantation. As of June 2018, the other six kidney grafts were functioning. No complications including calculi formation and/or malignancy were reported. In patients with previously augmented bladders now undergoing kidney transplantation, ureteric implantation into the bowel portion of the cystoplasty appears to be safe.

Prevalence of symptomatic urinary tract infections and asymptomatic bacteriuria in Iraqi pregnant women of Babylon Governorate

Background: Urinary tract infections (UTIs) are the most common infections among pregnant women. It can be lead to poor maternal and perinatal outcomes. Objective: The objective of the study is to determine the prevalence rate of symptomatic UTIs and asymptomatic bacteriuria of pregnant women in the Babylon Governorate and to determine its association with sociodemographic, obstetrical, and other factors. Materials and Methods: Cross-sectional study between March 2018 and June 2018 involves examining 300 pregnant women at primary health centers; Maternity and Pediatrics Hospital of Hilla city, with and without symptoms of UTI were employed for this study. Midstream urine samples were taken, and general urine examination was performed. Results: The results of this study revealed that the overall prevalence of UTI among pregnant was 64.6% which include (symptomatic bacteriuria 8.0%, asymptomatic bacteriuria 6.3%, and UTI 50.3%). The higher rate of UTI was found in lower age, multiparous women, and during the second trimester. Factors such as socioeconomic status, history of UTI, dysuria, and positive laboratory results were found to be significantly associated with UTI. Conclusion: UTI is still the common health problem in pregnant women especially during their second trimester. Urinalyses are essential for all pregnant women during the antenatal period. The screening will be assisted to early detection and treatment of asymptomatic bacteriuria which prevent complication for mother and baby.

Инфекционные осложнения в отдаленном посттрансплантационном периоде у реципиентов почечного трансплантата в сочетании с фотофорезом

to evaluate the influence of prophylactic use of photopheresis on the risk of long-term infective complications after kidney transplantation. The open cohort randomized study was conducted. A total of 60 recipients after cadaveric kidney allotransplantation from 30 donors were assessed. The patients were randomized into two groups (n=30). All transplants were paired, and one kidney was transplanted to patient in intervention group and the another one was transplanted to patient in control group. In the intervention group all patients received standard immunosuppression therapy (tacrolimus, mycophenolate, prednisone) and 10-15 sessions of photopheresis during first 6 months after the transplantation. In the control group only the immunosuppression therapy was given. The follow-up period ranged from 2 to 7 years, an average 4.5+/-2.0 years. The rate infective complications in the both groups gradually decreased as the postoperative period increased exponentially, but it was lower in the intervention group than in the control group. The rate of respiratory infection, asymptomatic bacteriuria and viremia, verified by the genetic amplification was 4, 2 and 1.5 times lower in the intervention group. The risk of clinically meaningful infection was significantly lower in the intervention group than in the control group: IRR 0.3888 (95% CI 0.2754; 0.5445; <0.0001). 6-year survival in the intervention group was 100% in comparison to 82.8% in the control group (95% CI 51.6; 93.16). The prophylactic use of the photopheresis allows to decrease the risk of infective complications after the kidney transplantation.

Real-World Retention Rates After Intravesical OnabotulinumtoxinA for Idiopathic Overactive Bladder.

The risk of incomplete bladder evacuation requiring catheterization after intravesical onabotulinumtoxinA (BoNT-A) is well established. However, the rates reported in the literature are highly variable and low overall in clinical trials. We attempt to evaluate the rate of symptomatic acute urinary retention requiring catheterization after initial BoNT-A in a private practice setting of patients with idiopathic overactive bladder. We performed a retrospective study from 2010 to 2014 for patients with idiopathic overactive bladder undergoing their first BoNT-A. Demographic information recorded included age, sex, presence of diabetes, baseline postvoid residual (PVR), presence of urodynamic detrusor overactivity, bladder capacity, peak flow rate (Qmax), BoNT-A unit dose, and carrier volume. Urinary retention was defined as those patients who were symptomatic and required catheterization for a PVR of 200 mL or greater. Of 103 patients who received BoNT-A, 21 (20.3%) developed symptomatic retention requiring catheterization. There was no difference in baseline characteristics, preoperative PVR, and units injected (all P > 0.05). The retention group had a higher rate of bacteriuria and symptomatic urinary tract infection (all P < 0.05). Despite developing symptomatic retention requiring performance of catheterization, 47% of these patients continued with a subsequent injection of BoNT-A. The need for catheterization after initial delivery of intravescial BoNT-A is an adverse event that seems to be higher in our clinical practice than seen in clinical trials. This information will be critical in order to properly counsel our future patients about the risks and benefits of this therapy.

The incidence of urinary tract infection of different routes of catheterization following gynecologic surgery: a systematic review and meta-analysis of randomized controlled trials

We performed a systematic review of randomized controlled trials to assess the incidence of urinary tract infection (UTI) and complications of different urinary drainage methods (indwelling urinary catheterization, suprapubic catheterization, and intermittent catheterization.). PubMed, EMBASE, and Cochrane Library were systematically searched from their inception to March 2018. We selected randomized controlled trials (RCTs) comparing at least two of the three possible urinary drainage routes after gynecologic surgery. A meta-analysis was performed using the RevMan software, and a random-effects model was used to pool the effect size. The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach was used to rate the quality of evidence. Fifteen RCTs met eligibility criteria (N = 1607), the meta-analysis indicated that suprapubic drainage was associated with a reduction in the rate of asymptomatic bacteriuria compared with indwelling urinary catheterization [risk ratios (RR) = 0.39, 95% confidence interval (CI): 0.24-0.65, P = 0.0003) but was associated with a higher rate of hematuria (RR = 4.49, 95% CI: 1.16-17.41, P = 0.03). Indwelling urinary catheterization increased the rate of recatheterization compared with suprapubic drainage (RR = 2.95, 95% CI: 1.22-7.11, P = 0.02) and was associated with higher rate of symptomatic UTI compared with intermittent catheterization (RR = 2.79, 95% CI: 1.09-7.14, P = 0.03). No difference was found in other aspects (complication rate and catheter-related pain) among the three drainage routes. This meta-analysis suggested that suprapubic drainage was superior to indwelling urethral catheterization in reduction of asymptomatic bacteriuria and rate of recatheterization but was associated with higher rate of hematuria. Intermittent catheterization was associated with a reduction in symptomatic UTI compared with indwelling urinary catheterization. More high-quality randomized trials are needed to determine which route is most appropriate for catheterization in patients after gynecologic surgery.

ASYMPTOMATIC BACTERIURIA

Objectives: To record the rate of asymptomatic bacteriuria in pregnant females.Period: November 2015 to February 2016. Settings: Holy Family Hospital, Rawalpindi.Material &amp; Methods: 200 pregnant females for regular pre-natal visits during 2nd and 3rdtrimester of pregnancy between 18-50 years of age were included. Sterile bottles were used tocollect the urine sample from the patients and sent to the hospital laboratory for the evaluationof asymptomatic bacteriuria in pregnant females. Results: We recorded most of the casesbetween 18-30 years of age i.e. 56%(n=112) whereas 44%(n=88) were between 31-50 yearsof age, mean+sd: 28.76+5.42 years. Frequency of asymptomatic bacteriuria was recordedin 22%(n=44). We found 21(23.86%) out of 88 cases had lower class, 15(23.44%) out of 64cases had middle class, 7(17.95%) out of 39 cases had upper middle class while 1(11.11%)out of 9 cases had higher class. Conclusion: Asymptomatic bacteriuria is not an uncommoncomplication during pregnancy, however, regular screening may help to prevent and reducethis morbidity at early stage.

Rate and association of lower urinary tract infection with recurrence after transurethral resection of bladder tumor.

PurposeTo evaluate the rate of pyuria and bacteriuria after transurethral resection of bladder tumor (TURBT).Materials and MethodsWe retrospectively evaluated data obtained from 363 patients who underwent TURBT between October 2012 and December 2013 at Seoul National University Hospital. Urinalysis and urine culture were assessed at 3, 6, 12, and 24 months postoperatively. Primary endpoint was the rate of bacteriuria (≥105/mL in a midstream) and pyuria (white blood cells ≥5/high-power field).ResultsWe analyzed 306 patients who were eligible for the study. Pyuria was present in 23.5% of patients in the 3rd postoperative month and in 31.7% of patients in the 24th postoperative month. Bacteriuria was present in 1.3% of patients in the 3rd postoperative month and in 2.6% of patients in the 24th postoperative month. Among urothelial carcinoma patients (n=220), 24.1% showed pyuria and 1.8% showed bacteriuria at the 3rd postoperative month. We found that 31.8% showed pyuria and 3.2% showed bacteriuria at the 24th postoperative month. There was no significant difference in the rate of pyuria and bacteriuria between the intravesical treatment group and the no-treatment group. Multivariate analysis demonstrated that pyuria in the 3rd postoperative month (odd ratio [OR], 2.254; p=0.039), tumor multiplicity (OR, 3.331; p=0.001), and the absence of intravesical treatment (OR, 4.927; p=0.001) increases the risk of tumor recurrence.ConclusionsA significant proportion of patients showed pyuria after TURBT during the follow-up period. Additionally, presence of pyuria in the short-term follow-up period after TURBT constitutes a risk factor for recurrence of bladder cancer.

Bacteriology and Antibiogram of Urinary Tract Infection Among Female Patients in a Tertiary Health Facility in South Eastern Nigeria.

Background:Urinary Tract Infection (UTI) is a common contagion among men and women with the incidence relatively higher among women due to their differing anatomy. An understanding of the kind of pathogens implicated in urinary tract infections as well as antibiotic susceptibility profiling may help the clinician make rationally correct empirical choice in their treatment.Objective:This study is aimed at determining the type and antibiotic susceptibility pattern of bacterial uropathogens isolated from female patients attending Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Awka, Nigeria.Method:Two hundred and forty patients with clinically diagnosed UTI and who were on at least 5 days’ antibiotic holiday were recruited into the study. Their demographic characteristics were captured using pre-tested questionnaire. Their clean catch mid-stream urine samples were collected using sterile universal container and sent to the Microbiology Department for processing. Within 30 minutes of samples collection, the specimens were cultured and the isolates were identified, after 24 h of incubation, using standard microbiological techniques. Antibiotic susceptibility tests were done with standard antibiotic discs using the Kirby–bauer disc diffusion method.Results:Out of the 240 urine samples, 89.17% yielded significant bacteriuria. The pathogens implicated were Escherichia coli (28.5%), Staphylococcus aureus (28.0%), Salmonella spp (22.8%) and Pseudomonas aeruginosa (20.5%). HIV status, patients age, pregnancy status and marital status all significantly affected bacteriuria rate (p value < 0.05), while patients’ location (sub-urban/rural dwelling), and level of education did not (p value > 0.05). The pattern of microbial resistance to antibiotics suggests that ceftazidime, fosfomycin and cefoxitin may not be used as first-line agents in the empirical treatment of UTIs rather; levofloxacin, meropenem or aztreonam should be considered. Levofloxacin was significantly effective against all the isolates and may be administered empirically while waiting for the culture result (Mean % susceptibility was 79.85).Conclusion: E. coli and S. aureus were the predominant pathogens in the study and many were resistant to the commonly prescribed antibiotics and so leave the clinicians with only few alternative drugs for UTIs treatment. Routine surveillance and monitoring studies need to be constantly conducted to update clinicians on the prevalent pathogens and the rational and empirical treatment of UTIs. Aggressive and consistent health education using every possible media is also recommended to combat the menace of drug resistance occasioned by inappropriate antibiotic use.

Is bacteriological testing of bladder urine informative in acute obstructive pyelo- nephritis?

The study comprised 72 sequentially selected patients (12 men and 60 women) with OOP associated with ureteral stones. Mean age of patients was 53.7+/-0.5 years. All patients underwent bacteriological examination of the bladder urine collected by a transurethral catheter and pelvic urine obtained after relieving stone-related ureteral obstruction. Urinary diversion was performed using j-j stent and PCN in 64 and 8 patients, respectively. Preoperative prophylactic antibiotics were administered routinely. Bacteriological testing of urine was carried out using an extended set (9-10) of culture media. Empirical antibiotic therapy was initiated only after the restoration of urine outflow from the kidney and continued for 5-6 days until the availability of bacteriological testing results. Levels of bacteriuria with Enterobacteria, gram-positive pathogens and NAB in two urine samples did not differ significantly (p>0.05). There was a wide range of bacteriuria from 101 to 106 CFU/ml of most microorganisms except @Proteus spp., S. aureus. In bladder urine, the rates of bacteriuria of more or equal 104 CFU/ml for E. coli, Klebsiella spp. and Proteus spp. were 90.9%, 72.7% and 100.0%, respectively. For the remaining microorganisms, predominant bacteriuria was less or equal 103 CFU/ml. In pelvic urine, the rates of bacteriuria of more or equal 104 CFU/ml for E. coli, Klebsiella spp. and Proteus spp. was 71.8%, 40.0% and 66.7%, respectively. Other uropathogens in the pelvic urine mainly had a bacterial count of less or equal 103 CFU/ml. Only the concentration of Corynebacterium spp. in the pelvic urine significantly (p=0.023) differed from that of the bladder urine. There were no significant differences between microbiota of bladder and pelvic urine depending on duration of OOP except higher rates of Corynebacterium spp. in the bladder urine.

The effect of periuretral care and follow-up on bacteriuria in patients with urinary catheter: A comparison of three solutions

Objective: The aim of this study was to compare urinary colonization rates in subjects whose periurethral area was cleaned with sterile water or tap water versus povidone-iodine before and after urinary catheter insertion. Patients and Methods: The study was conducted in intensive care, surgery and medical wards of a university hospital. The study assessed a total of 207 adult patients requiring urinary catheterization for bacteriuria. They were screened for eligibility by the supervising physician. 110 patients were excluded from the study. The study sample included a total of 97 patients. The only difference among the three groups was that sterile, tap water and povidone-iodine were used to clean the periurethral area. A urine specimen was collected immediately before and 72 hours after catheter insertion. Results: The povidone-iodine group patients had a mean age of 67.9±12 years, the mean of the sterile group patients was 66.3±14 years, and the mean of the tap water group patients was 63.5±12 years. The Chi-Square test revealed no inter-group difference for age groups (P=0.483). Urinary tract infections occurred in 18% of the total sample. The percentage of infection for povidone-iodine, sterile water and tap water groups was 22.2%, 38.9%, and 38.9% respectively. Conclusion: There were no significant differences in the rate of bacteriuria or urinary tract infections in the sterile water, tap water and povidone-iodine groups. Traditionally, povidone-iodine solutions have been used to clean the periurethral area is probably not useful than water solutions.

Asymptomatic urinary tract infection with multidrug resistant pathogens in retro positive patients on ART

Introduction: Asymptomatic urinary tract infection refers to occurrence of bacteria in urine without causing symptoms. UTI is more prevalent among retro positive patients compared to people without HIV. Objectives – The study was done to determine prevalence of UTI, common etiologies and antibiotic susceptibility pattern of urinary isolates among HIV seropositive patients attending ART centre for CD4 counts. Materials & Methods: –A total of 109 patients without any symptoms of UTI were included in the study. AST was done using Kirby Bauer disk diffusion method.CD4 count was done using FACS counter. Results: Out of the 109 cases tested, 55 were males, and 54 cases were females. No growth was seen in 60 (55.04%) samples, insignificant bacteriuria in 9(8.26%) samples. Significant growth was seen in 40 samples (36.7%). Among the 54 females, 44% had significant growth. Among 55 males, significant growth was seen in 29.1%. The isolated organisms included Escherichia coli - 9(22.5%), Staphylococcus aureus - 7(17.5%), Candida albicans - 7(17.5%). Bacterial isolates showing resistance to three or more categories of antibiotics were considered Multidrug resistant (MDR). Multidrug resistance was seen among 16 bacterial isolates (48.5%). HIV positive patients with CD4 counts of <200 had higher rates of asymptomatic bacteriuria. Conclusion: Screening of HIV seropositive patients with lower CD4 counts for asymptomatic UTI helps in early diagnosis and appropriate, early management of MDR will reduce morbidity.

MP11-18 EFFECTIVENESS OF SINGLE DOSE OF AMIKACIN COMPARED WITH LEVOFLOXACIN FOR PROPHYLACTIC USE IN TRANSRECTAL PROSTATE BIOPSY.

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia II1 Apr 2017MP11-18 EFFECTIVENESS OF SINGLE DOSE OF AMIKACIN COMPARED WITH LEVOFLOXACIN FOR PROPHYLACTIC USE IN TRANSRECTAL PROSTATE BIOPSY. Marcela Pelayo-Nieto, Edgar Linden-Castro, Iván A. Ramírez-Galindo, Daniel Espinosa-Perez Grovas, Roberto C. Rodriguez-Alvarado, Felipe Guzmán-Hernández, Jesús A. Morales-Covarrubias, Edy D. Rubio-Arellano, and Roberto Cortez-Betancourt Marcela Pelayo-NietoMarcela Pelayo-Nieto More articles by this author , Edgar Linden-CastroEdgar Linden-Castro More articles by this author , Iván A. Ramírez-GalindoIván A. Ramírez-Galindo More articles by this author , Daniel Espinosa-Perez GrovasDaniel Espinosa-Perez Grovas More articles by this author , Roberto C. Rodriguez-AlvaradoRoberto C. Rodriguez-Alvarado More articles by this author , Felipe Guzmán-HernándezFelipe Guzmán-Hernández More articles by this author , Jesús A. Morales-CovarrubiasJesús A. Morales-Covarrubias More articles by this author , Edy D. Rubio-ArellanoEdy D. Rubio-Arellano More articles by this author , and Roberto Cortez-BetancourtRoberto Cortez-Betancourt More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.419AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prophylactic antibiotics are recommended prior to prostate biopsy. The main effect of antibiotic prophylaxis is a lowered incidence of postbiopsy bacteriuria. Although not all patients with bacteriuria are symptomatic, all patients who develop infectious complications following rectal biopsy are bacteriuric. Prostate biopsy performed without antibiotic prophylaxis is associated with increased rates of bacteriuria (8 to 44 percent) and bacteremia (16 to 70 percent) Major infectious complications, such as sepsis, Fournier gangrene, and urinary tract infection requiring hospital admission have been reported in patients who did not receive prophylactic antibiotics. Fluoroquinolones are the most widely used antibiotic for prophylaxis due to their broad spectrum of activity, easy oral administration, good penetration to prostate gland tissue, and long-lasting bactericidal activity. The development of resistant organisms is becoming an increasing problem and may lead to a need to alter the antibiotic régimen. The increase in the incidence of antibiotic-resistant infections following prostate biopsy is felt to be responsible for an increasing need for hospitalization after prostate biopsy. We developed a standard prophylactic regimen, in which security and efficacy are the priority; however the variability in costs is reduced. Aim: To prospectively evaluate the efficacy of amikacin compared with levofloxacin as prophylactic measure in transrectal prostate biopsy. METHODS A prospective, observational, comparative study, which included 393 patients who had standard indication of transrectal prostate biopsy. The study was conducted with a random choice and split into two groups, demographic characteristics were similar in both groups. Group A: 205 patients who were administered a single dose of levofloxacin (500 mg) orally 60-120 minutes before the procedure; and Group B: 188 patients who were given amikacin 15 mg / kg intramuscularly 60-120 min before the procedure. All patients underwent urinalysis and urine culture before and after the procedure. We identified post biopsy complications: bacteriuria, urinary tract infection, orchitis, pyelonephritis, sepsis, all of them were evaluated, all patients with a severe condition were hospitalized. The variables were correlated using Fishers Exact Test. RESULTS In Group A, 4.3% of patients presented a febrile UTI and 0.97% presented sepsis. In Group B, 5.3% presented febrile UTI and .53% presented sepsis. Comparing both groups, we found no relationship between the dose and the risk for complications (p=0.52). In the group analysis considering DM, a significant relationship for complication risks was not found, Group A (p=0.62) and Group B (p=0.58). The same in the analysis of overweight and obesity no significant relationship with complications was found, Group A (p=0.85) and Group B (p=0.65). CONCLUSIONS Given its efficacy and simplicity, a single dose of 500mg of levofloxacin represents an excellent prophylaxis method in transrectal prostate biopsies guided by ultrasound. However, a single dose of amikacin shows similar results as levofloxacin, thus it can significantly reduce the cost of antibacterial therapy and have a similar safety profile. © 2017FiguresReferencesRelatedDetailsCited byPilatz A, Dimitropoulos K, Veeratterapillay R, Yuan Y, Omar M, MacLennan S, Cai T, Bruyère F, Bartoletti R, Köves B, Wagenlehner F, Bonkat G and Pradere B (2020) Antibiotic Prophylaxis for the Prevention of Infectious Complications following Prostate Biopsy: A Systematic Review and Meta-AnalysisJournal of Urology, VOL. 204, NO. 2, (224-230), Online publication date: 1-Aug-2020. Volume 197Issue 4SApril 2017Page: e143-e144 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Marcela Pelayo-Nieto More articles by this author Edgar Linden-Castro More articles by this author Iván A. Ramírez-Galindo More articles by this author Daniel Espinosa-Perez Grovas More articles by this author Roberto C. Rodriguez-Alvarado More articles by this author Felipe Guzmán-Hernández More articles by this author Jesús A. Morales-Covarrubias More articles by this author Edy D. Rubio-Arellano More articles by this author Roberto Cortez-Betancourt More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Cranberry Capsules Don't Prevent Bacteriuria Plus Pyuria in Older Women.

According to this study: Rates of bacteriuria plus pyuria after one year were identical in women given cranberry capsules and those given a placebo. Cranberry capsules shouldn't be recommended as an antibacterial treatment for urinary tract infections.

The Rate of Asymptomatic Bacteriuria is Similar in Term and Preterm Delivery

Objectives: To show the prevalence of asymptomatic bacteriuria in pregnant women and to find its correlation with preterm labor.&#x0D; &#x0D; Methods: This research was performed in Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. A total of 78 subjects joined this research. The first group consisted of 39 subjects that were having preterm delivery and the second group consisted of 39 subjects that were having term delivery. Urine analysis and culture were done in&#x0D; both groups. The subject was being considered to have asymptomatic bacteriuria if the urine culture showed a minimum of 100,000 bacteria/ml without any symptoms or signs of urinary tract infection. The number was then analyzed to reveal the correlation of asymptomatic bacteriuria with preterm delivery.&#x0D; &#x0D; Results: There were a significantly higher number of preterm deliveries in subjects whose age ranged between 15-19 year-old (28.20% vs 12.8%; p=0.033). While on the contrary, there was a significantly lower number of preterm delivery in subjects whose age ranged between 30-34 year-old (25.6% vs 5.12%; p=0.020).The incidence&#x0D; number of asymptomatic bacteriuria among all subjects is 21.79%. There was no significant difference of asymptomatic bacteriuria between preterm and a term delivery (23.07% vs 20.51%; p=0.784).&#x0D; &#x0D; Conclusions: There was no significant difference of asymptomatic bacteriuria between the subject with preterm delivery and term delivery, but the incidence of asymptomatic bacteriuria in pregnant women in this study was quite high, reaching eight times higher than those stated in other study. Thus, routine urine culture screening&#x0D; policy in early pregnancy still cannot be omitted, considering that asymptomatic bacteriuria can lead to pyelonephritis which can cause maternal and fetal morbidity.&#x0D; &#x0D; [Indones J Obstet Gynecol; 37-1: 8-11]&#x0D; &#x0D; Keywords: asymptomatic bacteriuria, urine analysis, urine culture, preterm delivery

Postoperative infectious complications in patients undergoing holmium laser enucleation of the prostate: Risk factors and microbiological analysis.

To examine the incidence of postoperative bacteriuria and febrile complications, and to investigate bacterial strains in the urine of patients undergoing holmium laser enucleation of the prostate. We retrospectively analyzed 190 evaluable patients treated with holmium laser enucleation of the prostate at the Gifu University Hospital, Gifu, Japan, between September 2005 and May 2014. All patients presented with lower urinary tract symptoms as a result of benign prostatic hyperplasia. We also evaluated the causative bacteria and compared the findings with the results of preoperative urine cultures. We analyzed the relationship between the emergence of postoperative febrile complications, antibiotic prophylaxis, patient background and surgical procedure. The frequency of bacterial isolation in preoperative and postoperative urine cultures was 41% and 23%, respectively. Preoperatively, Enterococcus faecalis was the most frequently cultured bacteria, second was methicillin-resistant Staphylococcus epidermidis, and third was Escherichia coli. Postoperatively, Enterococcus faecalis was still the most frequently cultured bacteria, whereas the second was Escherichia coli. Risk factors for postoperative bacteriuria were evaluated. Multivariate analysis showed that the rate of postoperative bacteriuria in patients who had taken dutasteride preoperatively was significantly lower than that in the other patients. Risk factors for febrile complications could not be identified. The use of perioperative prophylactic antibacterial agents for holmium laser enucleation of the prostate keeps the rate of postoperative infectious complications low. Dutasteride treatment administered before surgery might reduce the risk of postoperative bacteriuria.

A study of asymptomatic bacteriuria in Egyptian school-going children.

Urinary tract infections (UTI) are a common and important clinical problem in childhood. Upper urinary tract infections (i.e., acute pyelonephritis) may lead to renal scarring, hypertension, and end-stage renal disease. Despite the presence of simple and reliable methods of preliminary screening of children's urine, urinary tract infection continues to be under diagnosed. The aim of this study was to establish prevalence rates of significant bacteriuria in asymptomatic school children by simple urine tests in comparison to standard urine culture techniques in Giza, Egypt. A total of 1000 apparently healthy school going children (6-12) years, 552 boys (55.2%) and 448 girls (44.8%), were enrolled in this cross-sectional prevalence survey. Overall prevalence of significant bacteriuria was 6%. Higher prevalence occurred in girls (11.4%) than boys (1.6%). Escherichia coli was isolated in 35(58%) cases (3 boys and 32 girls), Staph. aureus in 13 (22%) cases (3 boys and 10 girls), Enterobacter in 6 girls (10%), Kelbsiella pneumoniae in 3 boys (5%) and Proteus vulgaris in 3 girls (5%). Asymptomatic bacteriurea could be detected by urine screening program at school age. Overall prevalence of significant bacteriuria was 6%, with predominance in girls than boys.

The Effectiveness of Prophylactic Antibiotics with Oral Levofloxacin against Post-Shock Wave Lithotripsy Infectious Complications: A Randomized Controlled Trial.

To evaluate the efficacy of prophylactic antibiotics in reduction of infections after shock wave lithotripsy (SWL) in patients undergoing shock wave lithotripsy (SWL). The study was a randomized control trial. Between 2012 and 2014, patients with pre-operative sterile urine undergoing SWL were randomly assigned by the randomization ratio of 1:1 to receive prophylactic antibiotics with single-dose oral levofloxacin (500 mg) or no treatment (control group), respectively. Urinalysis and urine cultures were obtained between post-operative day five and seven, respectively. Pyuria was defined as ≥10 white blood cells per high power field (WBC/hpf). Significant bacteriuria was defined as ≥10(5) colony forming units per milliliter (CFU/mL) uropathogens. Febrile urinary tract infection (fUTI) was defined as body temperature higher than 38.0°C with pyuria or significant bacteriuria within seven days after SWL treatment. Initially, 274 patents underwent randomization with 135 and 139 patients in the levofloxacin and control group, respectively. A total of 206 patients (106 with placebo and 100 with levofloxacin) with complete follow-up of urinalysis were eligible for analysis. The rates of post-operative pyuria were not significantly different in patients with and without prophylaxis (8% versus 4.7%, p = 0.33). Moreover, there was also no significant difference in rates of bacteriuria in patients with and without prophylaxis (1% versus 0%, p = 0.49). Patients without follow-up urinalysis and urine culture received telephone survey. Among them, there was only one patient reporting post-SWL fever in the levofloxacin group (0.7%) compared with none (0%) in the control group (p = 0.49). As the results of the interim analysis revealed no benefit of levofloxacin in preventing post-SWL pyuria, bacteriuria, and fUTI, we terminated the study early before the pre-planned sample size was achieved. The incidence of asymptomatic and fUTI is low in patients with pre-SWL sterile urine undergoing SWL. Therefore, prophylactic antibiotics may be unnecessary in this cohort of patients.

Clinical Data of Urine Culture and Antimicrobial Sensitivity Tests according to the Voiding Method over 15 Years in Patients with Spinal Cord Injury

Purpose To analyze the results of urine cultures and antimicrobial sensitivity tests according to the voiding methods in patients with spinal cord injury (SCI) over a 15-year period. Materials and Methods A total of 1,579 urine culture samples, obtained from January 2000 to December 2014, for 73 SCI patients were analyzed according to the voiding method. We analyzed the following: positive urine culture rate, colony counts, isolated number of organism, major organisms, and antimicrobial sensitivity tests. The voiding methods were categorized into four methods: clean intermittent catheterization (CIC), suprapubic catheterization (SPC), urethral Foley catheter, and spontaneous voiding (SV). Results Among the 1,579 urine samples, 1,250 (79.2%) were positive. The CIC group showed the lowest rate of bacteriuria (p＜0.001), colony counts (p＜0.001), and polymicrobial infection (p＜0.001). Causative organisms were mostly gram-negative bacteria (86.7%). Pseudomonas aeruginosa (22.7%) was most common pathogen followed by Escherichia coli (22.3%), Klebsiella species (9.5%), Providencia species (4.4%), and Serratia marcescens (4.2%). Major pathogens and antimicrobial sensitivity tests were different according to the voiding method. Conclusions CIC is the best voiding method to reduce urinary tract infection (UTI) in SCI patients. To treat UTI in in SCI patients, empirical antibiotics can be chosen according to the voiding method based on the reference of our study prior to the availability of antimicrobial sensitivity results.

Association between Asymptomatic Bacteriuria and Pre-Eclampsia.

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