Cause Of Urinary Infections Research Articles

DIAGNOSIS AND ANTIBIOTIC RESISTANCE OF ENTEROCOCCUS SPP. CAUSING URINARY TRACT INFECTIONS IN CHILDREN

Introduction: Among Gram-positive bacteria, enterococci are considered the most frequent pathogens in the case of urinary tract infections (UTIs) in children. It is known that enterococci have intrinsic resistance and acquired resistance is achieved by different mechanisms for: beta-lactams, aminoglycosides, quinolones, glycopeptides and linezolid. Objectives: The purpose of this review is to demonstrate that Enterococcus spp. is a frequent cause of urinary infections in children and to analyze antibiotic resistance. Materials and methods: The research was conducted using specific keywords such as “antibiotic resistance”, “children”, “UTI”, “Enterococcus spp.”, and “biofilm”, in specialty books, Google Scholar, PubMed, ScienceDirect and PubMed Central (PMC). Results: Antibiotic resistance of Enterococcus spp. is an issue in the choice of treatment for urinary tract infections. According to certain research, resistance to vancomycin has increased in some countries while decreasing in others. Another concerning problem is the observed gentamicin resistance, notably in Enterococcus faecium. Discussion: Virulence factors, particularly Esp, which is involved in biofilm formation, play a key role in the processes of antibiotic resistance development. The presence of vanA and vanB genes modifies the structure of the bacteria and leads to the emergence of antibiotic resistance. Enterococcal resistance to vancomycin (VRE) represents a major public health problem and is the main mechanism that occurs in nosocomial infections. Conclusions: Enterococcus spp. is one of the most prevalent etiological agents in urinary pathology and a common source of nosocomial infections. Because of the presence of virulence factors and genes, these bacteria can easily acquire resistance to specific antibiotics. Keywords: antibiotic resistance, children, UTI, Enterococcus spp., biofilm

Frequency and antimicrobial susceptibility pattern of hospital isolates of Escherichia coli and Klebsiella pneumoniae in urine samples

Objectives/Aim: Urinary tract infections (UTI) are a serious public health problem and caused by many pathogens, most often by Escherichia coli and Klebsiella pneumoniae.Aim of this study was to show the frequency and antimicrobial susceptibility pattern of E. coli and K. pneumoniae in hospital isolates, following the GLASS methodology.Methods: This is a retrospective study that was conducted in the Laboratory for Urinary Infections OU Clinical Microbiology CCUS in the period from January till December 2018.A total of 13760 urine samples were processed, using standard laboratory methods, in which significant bacteriuria was detected in 3218 (23.4%) of specimens.Results: Out of the total number of positive samples, E. coli was isolated in 1166 (36.2%) and K. pneumoniae at 341 (10.6%) patients. The presence of E. coli and K. pneumoniae isolates is dominant in females (1103/73.2%) and age group 60 and older (812/54.7%). Out of the total E. coli isolates, the ESBL strain was presented with 79 (6.8%) and K. pneumoniae with 145 (42.5%). The proportion of carbapenemase (CPE) produced by K. pneumoniae isolates was 8 (2.4%). The ESBL strain distribution analysis on clinics showed the highest prevalence of both isolates at the Clinic for Nephrology: K. pneumoniae 26/17,9%; E. coli: 12/15.4%. Isolated E. coli showed the highest resistance to ampicillin 673/1166 (57,7%), trimethoprim-sulfamethoxazole 454/1166 (38.9%) and ciprofloxacin 253/970 (26.1%), while K. pneumoniae to ciprofloxacin and trimethoprim-sulfamethoxazole with 151/285 (53.0%) and 164/341 (48.1%), respectively.Conclusions: Our study has shown that the most common cause of urinary infections in hospital settings are E. coli and K. pneumoniae. Data analysis showed that the presence of ESBL isolates was significantly higher in K. pneumoniae than E. coli. CPE isolates of K. pneumoniae were also detected.

Clean, Intermittent Self-Catheterization in the Treatment of Urinary Tract Disease.

No AccessJournal of UrologyCatheterization1 Feb 2017Clean, Intermittent Self-Catheterization in the Treatment of Urinary Tract Disease Jack Lapides, Ananias C. Diokno, Sherman J. Silber, and Bette S. Lowe Jack LapidesJack Lapides More articles by this author , Ananias C. DioknoAnanias C. Diokno More articles by this author , Sherman J. SilberSherman J. Silber More articles by this author , and Bette S. LoweBette S. Lowe More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.10.097AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail References 1 Lapides, J.: Role of hydrostatic pressure and distention in urinary tract infection. In: Progress in Pyelonephritis. Edited by E. H. Kass. Philadelphia: F. A. Davis Co., p. 578, 1965. Google Scholar 2 Mehrotra, R. M. L.: An experimental study of the vesical circulation during distension and in cystitis. J Path Bact., 66: 79, 1953. Google Scholar 3 Lapides, J., Costello, R. T., Jr., Zierdt, D. K. and Stone, T. E.: Primary cause and treatment of recurrent urinary infection in women: preliminary report. J Urol., 100: 552, 1968. Google Scholar 4 Lapides, J. and Costello, R. T., Jr.: Uninhibited neurogenic bladder: a common cause for recurrent urinary infection in normal women. J Urol., 101: 539, 1969. Google Scholar 5 Lapides, J. and Diokno, A. C.: Persistence of the infant bladder as a cause for urinary infection in girls. J Urol., 103: 243, 1970. Google Scholar 6 Schwarz, H.: Renal invasion by E. coli via a mucosal lesion of the sigmoid colon: a demonstration utilizing methods of autoradiography and group-specific serologic typing. Invest Urol., 6: 98, 1968. Google Scholar 7 Campbell, M. F.: Urologic complications of anorectal and colon surgery. Amer J Proctol., 12: 43, 1961. Google Scholar 8 Lapides, J.: Urinary diversion. Surgery, 69: 142, 1971. Google Scholar 9 Guttmann, L. and Frankel, H.: The value of intermittent catheterization in the early management of traumatic paraplegic and tetraplegia. Paraplegia, 4: 63, 1966. Google Scholar © 2002 by American Urological Association, Inc.®FiguresReferencesRelatedDetails Volume 197Issue 2SFebruary 2017Page: S122-S124 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.®MetricsAuthor Information Jack Lapides More articles by this author Ananias C. Diokno More articles by this author Sherman J. Silber More articles by this author Bette S. Lowe More articles by this author Expand All Advertisement PDF downloadLoading ...

Molecular typing of uropathogenic E. coli strains by the ERIC-PCR method

IntroductionEscherichia coli (E. coli) is the most common cause of urinary infections in hospitals. The aim of this study was to evaluate the ERIC-PCR method for molecular typing of uropathogenic E. coli strains isolated from hospitalized patients.MethodsIn a cross sectional study, 98 E. coli samples were collected from urine samples taken from patients admitted to Baqiyatallah Hospital from June 2014 to January 2015. The disk agar diffusion method was used to determine antibiotic sensitivity. DNA proliferation based on repetitive intergenic consensus was used to classify the E. coli strains. The products of proliferation were electrophoresed on 1.5% agarose gel, and their dendrograms were drawn. The data were analyzed by online Insillico software.ResultsThe method used in this research proliferated numerous bands (4–17 bands), ranging from 100 to 3000 base pairs. The detected strains were classified into six clusters (E1–E6) with 70% similarity between them.ConclusionIn this study, uropathogenic E. coli strains belonged to different genotypic clusters. It was found that ERIC-PCR had good differentiation power for molecular typing of uropathogenic E. coli strains isolated from the patients in the study.

Poorly Regulated Blood Glucose in Diabetic Patients-predictor of Acute Infections.

Introduction:Diabetes mellitus, the most frequent endocrinology disease is a predisposing factor for infections. Diabetic patients have 4,4 times greater risk of systemic infection than non diabetics. Aim: a) To determine the prevalence and characteristics of acute infectious diseases in hospitalized diabetics; b) To correlate values of blood glucose levels and HbA1c with acute infections in hospitalized diabetics; c) To identify the etiology of infectious diseases.Material and methods:The study included 450 diabetic patients hospitalized in the 24-month period in the Intensive care unit of the Clinic for Endocrinology, Diabetes and Metabolic Disorders CCUS. In 204 patients (45,3%) there was an acute infectious condition and the following data was registered: a) gender and age; b) basic illness; c) laboratory parameters of inflammation (Le, CRP); d) blood glucose upon admission, parameters of glucoregulation (HbA1c, fructosamine); e) type of infection; f) verification of etiological agent; g) late complications of diabetes; and h) outcome.Results:Out of 204 diabetic patients with infection, there was 35,3% men and 64,7% women. More than half of patients (61%) were in the age group 61-80 years. The most common primary disease was Diabetes mellitus type 2. HbA1c and fructosamine were significantly increased in diabetic patients with acute infection compared to diabetics without acute infection. There is a positive correlation between HbA1c levels and CRP, and blood glucose and CRP in diabetic patients with acute infection. Most frequent infections: urinary tract infection (70,0%), followed by respiratory infections (11,8%), soft tissue infections (10,3%), generalized–bacteremia / sepsis (6,9%). The most common cause of urinary infection and generalized infection was Escherichia colli. The most common bacteria causing soft tissue infections was Staphylococcus aureus.Conclusion:Almost half (45,3%) of hospitalized diabetic patients had acute infectious condition. They present most frequently in women, aged 61-80 years, with Type 2 Diabetes mellitus. HbA1c and fructosamine were significantly increased in diabetic patients with acute infection. There is a positive correlation between the parameters of inflammation and glucoregulation in diabetics with acute infection. Most frequent was a urinary tract infection and the most common causative agent was Escherichia coli. The most common cause of soft tissue infections was Staphylococcus aureus. Out of 21 patients with verified soft tissue infections, 18 of them (85,7%) had confirmed diagnosis of diabetic microangiopathy diabetica. A total of 96,1% of patients fully recovered.

Etiology of urinary tract infection in scholar children

To prospectively assess the prevalence of vesicourethral dysfunction in children over 3 years old, comparing it with the occurrence rate for other potential factors that cause urinary infection in this age range. 36 girls and 9 boys were assessed, with mean age of 6.4 years, ranging from 3 to 13.9 years. These children were prospectively assessed regarding the presence of symptoms of lower urinary tract dysfunction. These data were compared with the retrospective assessment of other potential risk factors for urinary infection. Ultrasonography was performed in 28 children and voiding cystourethrogram was performed in 26 patients. Vesicourethral dysfunction was diagnosed in 39 (87%) of the 45 children with urinary infection. Among these 39 patients, all had voiding urgency, 30 (77%) had urinary incontinence, 12 (31%) pollakiuria and 3 (8%) presented infrequent voiding. Vaginal discharge was evidenced in 8 (22%) girls and phimosis in 2 (22%) boys. Obstipation was diagnosed in 10 (22%) cases. Significant post-voiding residue was detected in 4 (13%) of the 28 cases assessed. Vesicoureteral reflux was evidenced in 5 (19%) of the 26 patients who underwent voiding cystourethrogram. In only 2 (4%) cases there was not an apparent cause for the infection. Vesicourethral dysfunction is a major cause of urinary infection in children with ages above 3 years old. In cases where voiding dysfunction in not present, other predisposing factors must be assessed. However, only 4% of the patients did not present an apparent urologic cause for the infection.

Significance of Staph. saprophyticus as a uropathogen in adult Saudi females.

Staphylococcus saprophyticus is a well documented aetiological organism of urinary tract infections in young sexually active females. This report highlights its role as an added cause of urinary infection in Saudi women and its previously unrecognized importance as a uropathogen in this population. The diagnosis is based on laboratory identification of coagulase-negative staphylococci (novobiocin resistance), absence of haemolysis, and production of intense pigmentation.

Role of bacterial growth rates in the epidemiology and pathogenesis of urinary infections in women

The mean minimum generation time in shake culture in urine of 6 urinary isolates of Escherichia coli (21.7 +/- 0.6 min) was significantly shorter (P = 0.0003) than that of 14 isolates of less common urinary pathogens (46.0 +/- 18.6 min). Mixed populations of approximately equal numbers of E. coli cells paired with other urinary, fecal, and urethral organisms were introduced into a laboratory model of the lower human urinary tract. This model used urine as a medium and reproduced some features of the balance between bacterial growth and the flushing effect of urine. After 24 h E. coli formed greater than or equal to 99% of the bacterial population in the bladder model for 16 our of 18 pairs of isolates examined. Relatively high oxygen tensions in urine sample from 18 healthy women (10.9 +/- 22. kPA) and 18 infected patients (8.0 +/- 4.3 kPa) may explain why anaerobic urinary infections are uncommon. The rapid growth rate of E. coli may be one explanation why it is the commonest cause of urinary infection even though it is relatively uncommon at the urethral meatus.

Urinary infection in kidney transplantation

Urinary tract infection is the most frequent complication following renal transplantation and is important in the etiology of post-transplantation sepsis. The 87 renal homografts done in 1974 at The New York Hospital-Cornell Medical Center were reviewed retrospectively, with at least one year follow-up, in all cases, with particular attention to factors relating urinary tract infection to ultimate success or failure of the renal graft. The over-all incidence of urinary tract infection was 61 per cent. Early infection was associated with a particularly poor prognosis for graft survival. Most patients with urinary infections after successful transplantation experience a combination of both early and late infections. Anatomic factors constitute a remediable cause of urinary infections after transplantation and should be searched for in cases of multiple, recurrent infections, de novo hypertension, or deterioration of previously stable graft function. There were significant differences in the bacteriologic spectrum of urinary tract infections associated with successful transplants as opposed to unsuccessful transplants.

Gram-positive, motile, cluster-forming cocci as a cause of urinary infection.

One hundred and thirteen strains of motile, Gram-positive, catalase-positive, cluster-forming cocci were isolated from patients with urinary infection attending a private surgery. They constituted 1% of the total 11 302 positive cultures. The biochemical characteristics and the drug sensitivities of the strains are described. The significance of motility for organisms which cause urinary infections is pointed out.At the present time the organisms isolated are orphans in the controversial classification of staphylococci and micrococci.

Persistence of the infant bladder as a cause for urinary infection in girls : J. Lapides and A. C. Diokno. J. Urol. 103:243–248 (February), 1970

Persistence of the infant bladder as a cause for urinary infection in girls : J. Lapides and A. C. Diokno. J. Urol. 103:243–248 (February), 1970

Letter to the Editor

"At the evidence of two witnesses . . . shall the matter be established." (Deuteronomy 19:15). Concerning worms as a cause of urinary infections, I certainly do agree that pinworms carry B. Coli with them into the bladder, but I did not want to bring up this subject because my purpose was rather to draw attention to the syndrome of night cries in little girls. I have since observed a 10-year-old girl whose crepuscular crisis was caused by 2 pinworms on her hymen.

Critique on the Concept of Vesical Neck Obstruction in Children

It is doubtful that vesical neck obstruction in children is the common cause of urinary infection, reflux, and enuresis. Routine revision of the bladder neck, in association with ureterovesicoplasty, does not improve the cure rate of the antireflux operation. Most agree that it is difficult, if not impossible, to diagnose such obstruction with endoscopy or cystourethrography. Outlet obstruction, through trigonal hypertrophy, tends to further protect the ureterovesical "valve" from incompetency. Voiding pressure studies reveal no significant gradient on either side of the vesical neck. Recent investigations show that the area of increased resistance in young girls is not at the vesical neck but in the midurethra and is caused by involuntary spasm of the periurethral striated muscle. Treatment of the accompanying distal urethral stenosis usually relieves this spasm.