Clean-catch Urine Research Articles

MP74-12 THE URINARY MICROBIOME IN THOSE WITH OVERACTIVE BLADDER IS MORE ABUNDANT IN ESCHERICHIA AND LESS ABUNDANT IN LACTOBACILLUS RELATIVE TO THAT OF HEALTHY CONTROLS

You have accessJournal of UrologyCME1 Apr 2023MP74-12 THE URINARY MICROBIOME IN THOSE WITH OVERACTIVE BLADDER IS MORE ABUNDANT IN ESCHERICHIA AND LESS ABUNDANT IN LACTOBACILLUS RELATIVE TO THAT OF HEALTHY CONTROLS Glenn Werneburg, Daniel Hettel, Madison Lyon, Ava Adler, Peace Orji, Suruchi Ramanujan, Jacqueline Zillioux, Bradley Gill, Howard Goldman, Sandip Vasavada, and Aaron Miller Glenn WerneburgGlenn Werneburg More articles by this author , Daniel HettelDaniel Hettel More articles by this author , Madison LyonMadison Lyon More articles by this author , Ava AdlerAva Adler More articles by this author , Peace OrjiPeace Orji More articles by this author , Suruchi RamanujanSuruchi Ramanujan More articles by this author , Jacqueline ZilliouxJacqueline Zillioux More articles by this author , Bradley GillBradley Gill More articles by this author , Howard GoldmanHoward Goldman More articles by this author , Sandip VasavadaSandip Vasavada More articles by this author , and Aaron MillerAaron Miller More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003348.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The urinary tract harbors its own microbiota. Overactive bladder (OAB) is a common urologic diagnosis, with predominant symptoms being urinary urgency and frequency. We sought to characterize the urinary microbiome of the overactive bladder population and compare that with healthy controls. We hypothesized that the population with OAB would harbor unique patterns of microbiota relative to healthy controls. Understanding the microbiota associated with OAB could open new avenues toward the investigation of alteration of microbiota as a therapeutic strategy for overactive bladder and other urologic conditions. METHODS: Female patients age 18 and over with overactive bladder by AUA/SUFU criteria were included, as were a group of control adult female patients without urologic diagnoses. Participants provided a clean catch urine specimen. Samples were subjected to next-generation sequencing, and microbial diversity was determined. Diversity and taxonomic profiles were compared between groups by two-tailed t-tests and PERMANOVA. RESULTS: 46 patients with OAB and 32 healthy controls were included. The OAB group median age was 65.7 (IQR 14.3), and the healthy control group median age was 60.4 (IQR 38.6) and. Microbiota were detected in all urine samples. Beta diversity and phylum profiles differed significantly between groups (Top, p=0.005). Specifically, Firmicutes were less abundant and Proteobacteria were more abundant in the OAB group than the control group (Bottom, p<0.05). 5 Escherichia/Shigella taxa were more abundant in the OAB group (p<0.001), and 6 Lactobacillus taxa were more abundant in the control group (p<0.05). There were no Escherichia/Shigella taxa more abundant in the control group, and no Lactobacillus taxa more abundant in the OAB group. CONCLUSIONS: The urinary microbiome differed significantly between the selected population with OAB and a healthy control population. Specifically, Lactobacillus genera were more abundant in healthy controls, and Escherichia more abundant in individuals with OAB. Additional study is needed to further delineate the relationship between the microbiome and OAB, whether it may be a cause or effect of the OAB symptom complex, and whether it can be modulated to improve OAB treatment. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1074 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Glenn Werneburg More articles by this author Daniel Hettel More articles by this author Madison Lyon More articles by this author Ava Adler More articles by this author Peace Orji More articles by this author Suruchi Ramanujan More articles by this author Jacqueline Zillioux More articles by this author Bradley Gill More articles by this author Howard Goldman More articles by this author Sandip Vasavada More articles by this author Aaron Miller More articles by this author Expand All Advertisement PDF downloadLoading ...

PD19-08 THE URINARY FUNGAL MICROBIOME IN THOSE WITH OVERACTIVE BLADDER IS LESS ABUNDANT IN MALASSEZIA AND MORE ABUNDANT IN ASPERGILLUS RELATIVE TO HEALTHY CONTROLS

You have accessJournal of UrologyCME1 Apr 2023PD19-08 THE URINARY FUNGAL MICROBIOME IN THOSE WITH OVERACTIVE BLADDER IS LESS ABUNDANT IN MALASSEZIA AND MORE ABUNDANT IN ASPERGILLUS RELATIVE TO HEALTHY CONTROLS Glenn Werneburg, Daniel Hettel, Madison Lyon, Ava Adler, Peace Orji, Suruchi Ramanujan, Jacqueline Zillioux, Bradley Gill, Howard Goldman, Sandip Vasavada, and Aaron Miller Glenn WerneburgGlenn Werneburg More articles by this author , Daniel HettelDaniel Hettel More articles by this author , Madison LyonMadison Lyon More articles by this author , Ava AdlerAva Adler More articles by this author , Peace OrjiPeace Orji More articles by this author , Suruchi RamanujanSuruchi Ramanujan More articles by this author , Jacqueline ZilliouxJacqueline Zillioux More articles by this author , Bradley GillBradley Gill More articles by this author , Howard GoldmanHoward Goldman More articles by this author , Sandip VasavadaSandip Vasavada More articles by this author , and Aaron MillerAaron Miller More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003285.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The urinary tract harbors its own microbiota, but fungi composition remains poorly characterized. Overactive bladder (OAB) is a common urologic diagnosis, with predominant symptoms being urinary urgency and frequency. We sought to investigate the urinary fungal microbiome of the overactive bladder population and compare that with healthy controls. We hypothesized that the population with OAB would harbor unique patterns of fungi relative to healthy controls. Understanding the fungi associated with OAB could open new avenues toward the investigation of fungi in disease manifestation and treatment response. METHODS: Female patients age 18 and over with overactive bladder by AUA/SUFU criteria were included, as were a group of control adult female patients without urologic diagnoses. Participants provided a clean catch urine specimen. Samples were subjected to next-generation sequencing using ITS primers to capture fungii, and fungal diversity was determined. Diversity and taxonomic profiles were compared between groups by two-tailed t-tests and PERMANOVA. RESULTS: 46 patients with OAB and 32 healthy controls were included. The OAB group median age was 65.7 (IQR 14.3), and the healthy control group median age was 60.4 (IQR 38.6) and. Fungi were detected in all urine samples. The predominant phylum was Ascomycota in overactive bladder patients and Basidiomycota in healthy controls. Malassezia taxa was less (12% OAB, 18% other, p<0.05) abundant in the overactive bladder group and Aspergillus was more abundant in the OAB group (14% OAB versus 7% healthy, p<0.05). CONCLUSIONS: The urinary fungal microbiome, or “mycobiome” differed significantly between the selected population with OAB and a healthy control population. Ascomycota was the predominant phylum. Malassezia was less abundant in those with OAB and Aspergillus more abundant. Additional study is needed to further delineate the relationship between the fungal microbiome and OAB, whether it may be a cause or effect of the OAB symptom complex, and whether it can be modulated to improve OAB treatment. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e580 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Glenn Werneburg More articles by this author Daniel Hettel More articles by this author Madison Lyon More articles by this author Ava Adler More articles by this author Peace Orji More articles by this author Suruchi Ramanujan More articles by this author Jacqueline Zillioux More articles by this author Bradley Gill More articles by this author Howard Goldman More articles by this author Sandip Vasavada More articles by this author Aaron Miller More articles by this author Expand All Advertisement PDF downloadLoading ...

Urine collection techniques in non-toilet trained children: Switzerland's paediatric office practices in 2022.

Urine collection techniques in non-toilet trained children: Switzerland's paediatric office practices in 2022.

PREVALENCE, ANTIMICROBIAL SUSCEPTIBILITY BACTERIURIA AMONG PREGNANT WOMEN AT SOS HOSPITAL, MUQDISHO SOMALIA

&#x0D; &#x0D; &#x0D; Objective: the aim of this study is to isolate the prevalence, of antimicrobial susceptibility bacteriuria among pregnant women at SOS hospital.Methods: Descriptive cross-sectional study during the time frame between Dec 2020 at SOS hospital in Hilawa distract Muqdisho.The urine sample was collected using the midstream clean-catch urine method and tested bacteriologically following standard procedure. An antimicrobial susceptibility test was also performed for the isolated organism using the Kirby disk diffusion method according to the clinical laboratory standard institute (CLSI). &#x0D; For data analysis and interpretation we used the SPSS tool and interpretation was presented in frequencies and percentages in tables.Result: of the 102 samples collected 34 showed no growth 68 was growth. of the 68 demonstration organisms Staphylococcus aureus 46 (41.1%). E.coli were 8 (7.8%) and pseudomonads aeruginosa 8(7.8% ) Proteus mirabiliss 3(2.9%), K.Pneumonia 3(2.9%). the most sensitive drug was Levofloxacin 51(75%). while Nitrofurantoin was the highest resistant pattern 58(85.29%) followed by Ceftriaxone 48(70.6%) amoxicillin 38(55.9%) ciprofloxacin 24 ( 35.29%) respectively. &#x0D; &#x0D; &#x0D;

Evaluation of Sorghum bicolor (L.) Moench on the Reduction of Creatinine Levels and Its Antioxidant Properties In vitro

The study investigated the effect of Sorghum bicolor (L.) Moench extract on the renal activity of both normal and ailing patients. Phytochemical analysis, antioxidant activity, vacuum liquid chromatography and TLC were carried out. The creatinine reduction ability was analyzed using Jaffe’s method for clean-catch spot urine samples of normal, diabetic and hypertensive patients. S. bicolor showed strong antioxidant activity with an IC50 value of 52.17 μg/ml, compared to the standard vitamin C with an IC50 value of 40.59 μg/ml. Statistical analysis (ANOVA) result showed a significant difference between the patients’ urine (rows) (p-value = 2.77×10–08) and a significant difference between the dose treatments (columns) (p-value = 8.38×10–14). Whilst different fractions of S. bicolor at different concentrations showed varying effects on the creatinine concentration, it reduced creatinine level in low doses and has antioxidant properties. Dhaka Univ. J. Pharm. Sci. 21(2): 165-172, 2022 (December)

ASYMPTOMATIC BACTERIURIA IN REPRODUCTIVE AGE GROUP FEMALES.

Background: Asymptomatic bacteriuria is one of the important causative factors for premature or low-birth infants, postpartum urinary tract infections and higher fetal mortality rates in pregnant women Methods: Thirty-two asymptomatic females from the antenatal clinic, twenty-five females admitted to the post-natal ward and ten nonpregnant females were randomly selected. Clean-catch midstream urine sample was collected and processed for culture and sensitivity as per standard guidelines.Results: Overall incidence of asymptomatic bacteriuria was 11.9%. The incidence of asymptomatic bacteriuria in pregnant females was 3.1% whereas the incidence in post-natal females was 40%. None of the non-pregnant females had asymptomatic bacteriuria. Conclusion: Screening of antenatal and post-partum females is required to avoid adverse outcomes.

Abstract 13157: Workplace Culture and Biomarkers of Sympathetic Activation

Workplace environment can impact health, but most research has focused on toxic chemicals. Recently, workplace culture—experiences, values, and behaviors unique to a workplace—is studied for its impact on overall health risk; however, connections with robust biologic markers of health remain to be established. Therefore, we examine associations between work environment and urinary levels of catecholamines and their metabolites as biomarkers of sympathetic activation. In 2018-19, we recruited participants (n=219) from an ongoing CV risk cohort to investigate workplace culture, overall well-being, and stress. Participants completed 7 questionnaires. Clean catch urine samples were used to measure catecholamines and their metabolites. To estimate associations between work and health scales and log or logit-transformed outcomes we used Pearson correlation and linear regression models adjusting for demographics and creatinine. Participants reporting higher well-being had lower levels of dopamine (DA) ( r = -0.28), serotonin (5HT) ( r = -0.17), and 3-methoxytyramine (3MT) ( r = -0.31), a product of dopamine breakdown. Participants reporting a more engaged workplace had lower levels of DA ( r = -0.20) and 3MT ( r = -0.22). Those reporting more positive workplace culture had lower levels of DA ( r = -0.17) and 3MT ( r = -0.26) and higher levels of norepinephrine ( r = 0.19) and 5-hydroxyindole-3-acetic acid (HIAA) ( r = 0.22). When participants identified more workplace isolation, they had higher levels of DA ( r = 0.19) and 3MT ( r = 0.19). Positive workplace culture was correlated with lower levels of DA ( r = -0.22) and 3MT ( r = -0.28) and higher levels of HIAA ( r = 0.22) and homovanillic acid ( r = 0.20). Given high correlations between catecholamines, we used 3MT for linear regression. In fully adjusted models we found in more positive work cultures, levels of 3MT remained significantly lower (β = -0.065 ±0.025, p = 0.01), accounting for 23% of the variance, and a significant positive association between workplace isolation and 3MT (β= 0.064 ±0.030, p = 0.04), accounting for 22% of the variance with 3MT, which may reflect greater dopamine degradation. These findings suggest an important relationship between how we work and sympathetic nervous system activity.

Prevalence and antimicrobial sensitivity of asymptomatic bacteriuria among sickle cell anaemia patients in Aminu Kano Teaching Hospital, Nigeria

Introduction: Urinary tract infection (UTI) is a common cause of morbidity in children with sickle cell anaemia (SCA) and may present as asymptomatic bacteriuria. Asymptomatic bacteriuria is often under-diagnosed and may lead to long term renal complications.&#x0D; Aim: This study compared the prevalence of asymptomatic bacteriuria, bacterial isolates and their antimicrobial sensitivity in children with and without SCA seen at Aminu Kano Teaching Hospital.&#x0D; Subjects and Methods: This cross-sectional study recruited 139 children with SCA in stable state and 139 children without SCA aged 1- 15 years. All children were tested for asymptomatic bacteriuria using clean catch or mid-stream urine samples. Children whose samples yielded significant bacteriuria (≥105cfu/ml) had a repeat urine culture within a week to confirm asymptomatic bacteriuria.&#x0D; Results: Both study groups had a mean age of 4.25 years ± 3.04, and a male: female ratio of 1.4:1. The prevalence of asymptomatic bacteriuria was higher in children with SCA(5.8%) compared to children without SCA (1.4%). Asymptomatic bacteriuria was more common among females in both study groups. The most common isolate in both groups was E. coli. Majority of the isolates were sensitive to quinolones, gentamycin and nitrofurantoin but resistant to commonly used antibiotics like amoxicillin and cotrimoxazole.&#x0D; Conclusion: Asymptomatic bacteriuria is more common in children with SCA than those without SCA. Majority of isolated pathogens showed low susceptibility to ampicillin, amoxicillin, cotrimoxazole and nalidixic acid, this implies that the use of these drugs for empirical or first line treatment for UTI in children with SCA should be avoided.

Polybacteria in Urinary Tract Infection among Antenatal Patients Attending University Teaching Hospital Ado-Ekiti, Ekiti State, Nigeria

A study of the polybacteria in UTI among antenatal patients attending clinics at the Ekiti State University Teaching Hospital, Ado-Ekiti, southwest, Nigeria was conducted between October, 2009 and July, 2011. Two hundred consenting symptomatic and asymptomatic pregnant women were recruited into the study and clean-catch midstream urine samples were collected from them. Structured questionnaires were also administered to the subjects to obtain relevant socio-demographic data from them. The results showed that 98(49%) out of the 200 samples had significant bacteria growth, 22 (11%) yielded growth of Candida albicans, 30 (15%) yielded no significant growth, 14 (7%) yielded mixed growth of contaminants, while 44 (22%) yielded no bacteria growth. Microscopically, the presence of Trichomonas vaginalis was detected in 8 (4%) of the samples. Thirty (28.8%) of the samples yielded growth of Escherichia coli, Klebsiella spp 28 (26.9%), Staphylococcus spp 22 (21.2%), Pseudomonas spp 10 (9.6%), Proteus spp 6 (5.8%) and Streptococcus spp 2 (1.9%). Statistical analysis of the result reveal that there’s an association between polybacteria UTI and subjects’ socio-economic status. It was more prevalent in subjects with low socio-economic status, was highest in subjects’ in first trimester and lowest in the third trimester. Antibiotic susceptibility testing shows that the isolates had high sensitivity to peflacine, gentamicin, nitrofurantoin, rocephin and cloxacillin. They had fairly good sensitivity to ciprofloxacin and nalidixic acid, whereas they had moderate sensitivity to chloramphenicol and zinacef. They were however resistant to tetracycline, cotrimoxazole, colisitn, streptomycin, ampicillin and penicillin.

Magnitude of Multidrug-resistant Bacterial Uropathogens and Associated Factors in Urinary Tract Infection Suspected Adult HIV-Positive Patients in Southern Ethiopia

Background: Due to the reduction of their immunity, people living with the human immunodeficiency virus (HIV) are more susceptible to acquiring urinary tract infections (UTI). Moreover, the emergence of drug-resistant bacterial uropathogens has grown widely and now constitutes a severe clinical problem among HIV-positive patients. Methods: An institution-based cross-sectional study was conducted at the ART clinic of Arba Minch General Hospital from 1st January to 30th May, 2021. A total of 251 adult HIV-positive patients clinically suspected of having UTIs were systematically recruited. Socio-demographic and other factors were collected by a pre-tested structured questionnaire. A clean-catch mid-stream urine sample was collected and inoculated onto blood agar, MacConkey agar, and cysteine lactose electrolyte deficient agar (CLED). The inoculated culture media were incubated aerobically at 37°C for 24 hrs. After overnight incubation, significant bacteriuria, 105 CFU/ml, was considered. Bacterial identification was made by standard protocols. Antimicrobial susceptibility testing was done by Kirby Bauer’s disk diffusion method. The data was analyzed using SPSS version 25. A P-value less than 0.05 was used as statistical significance. Results: The overall magnitude of multidrug-resistant (MDR) uropathogens was found to be 14.3%, with a 95% CI (10-19.1). Gram-negative bacteria (83.3%) were the predominant MDR isolates, with E. coli (41.7%) followed by K. pneumoniae (22.2%). All isolates of S. aureus and two-thirds of the isolated CoNS were MDR. A total of 30% and 16.7% of Gram-negative isolates were ESBL and carbapenemase producers, respectively, whereas 50% and 33.3% of isolated S. aureus and CoNS were methicillin-resistant, respectively. Antibiotic use in the previous 6 months [AOR = 6.7, 95% CI: (2.53-17.6)], presence of chronic underlying disease [AOR = 7.03, 95% CI: (1.72-28.73)], antibiotic use without a prescription [AOR = 9.7, 95% CI: (3.53-26.675)], CD4+ counts less than 250 cells/mm3 [AOR = 8.05, 95% CI: (2.078–31.154)], and CD4+ count in between 250-500 cells/mm3 [AOR = 2.49, 95% CI: (1.05-5.923)] were found to be statistically significant associated with MDR uropathogens. Conclusion: This study found a significant number of multidrug-resistant uropathogens, indicating that healthcare providers should be aware of this and take urgent action to minimize resistance spread, as well as consider current empirical antibiotic therapy for UTI in HIV-positive patients.

Diagnostic test accuracy of dipstick urinalysis for diagnosing urinary tract infection in febrile infants attending the emergency department

ObjectiveTo report the diagnostic test accuracy of dipstick urinalysis for the detection of urinary tract infections (UTIs) in febrile infants aged 90 days or less attending the emergency department (ED).DesignRetrospective...

Association between Preoperative Urine Culture and Urinary Tract Infection after Spinal Surgery.

This is a retrospective study. This study assessed risk factors accounting for urinary tract infections (UTIs) to determine whether preoperative asymptomatic UTI (aUTI) could be used to predict UTIs in patients after spinal surgery. UTI is a spinal surgery complication that increases the incidence of surgical site infections. However, the risk factors for UTIs after spinal surgery remain unclear. This study included 509 (mean age, 54.5 years; 239 males and 270 females) patients who underwent posterior spine surgery at the department of the current study. First, clean catch urine was collected, after which a urine culture was performed for all patients before surgery. Preoperative detection of the aUTI (>105 colony-forming units/mL) rate was then determined. Subsequently, risk factors for postoperative UTI were evaluated using logistic regression analysis with the following as independent variables: age, sex, obesity, diabetes, spinal cord tumor, the preoperative Japanese Orthopedic Association (JOA) score, JOA-bladder function, preoperative urine culture positivity, aUTI, preoperative Escherichia coli detection, the postoperative catheter placement period, instrumentation, number of surgical levels, surgery duration, and blood loss. The preoperative aUTI and postoperative UTI incidences were 8.1% and 4.1%, respectively. Furthermore, multivariate logistic analysis showed that the risk factor for postoperative UTI was preoperative aUTI (odds ratio, 4.234; 95% confidence interval, 1.532-11.702; p=0.005). Preoperative aUTI is a risk factor for UTI in patients after spinal surgery.

Evaluation of Diagnostic Methods for Asymptomatic Bacteriuria (ASB) During Pregnancy

Asymptomatic bacteriuria (ASB) is the existence of bacteria in a patient's properly gathered urine who has no obvious symptoms of a urinary tract infection, which is common in females, with the prevalence rate of 2-11%, ASB during pregnancy is influenced by a range of factors including; mechanical compression, changes in the immune and renal systems, if ASB untreated, it can lead to cystitis and pyelonephritis. Our aim is to evaluate the sensitivity and specificity of the screening tests compared with the culture method for detection of ASB during pregnancy, and to identify the most common etiologic agents of ASB in pregnant women. An analytical cross- sectional study was carried out on 110 pregnant women, selected using nonprobability sampling methods their age between 18-45year- old with no signs and symptoms of urinary tract infections (UTIs). Clean-catch Midstream urine specimen from each participant was collected and submitted for routine analysis by dipstick to detect leukocyte esterase, nitrite reductase tests and microscopic examination to detect pyuria (pus cells), as well as urine culture, and biochemical test. About 14.5% of pregnant women were positive for ASB, the most prevalent bacterium Escherichia coli (37.5%) followed by Klebsiella pneumoniae (18.7%). There was no significant association between age, parity, gestation, recurrent urinary tract infections, Diabetes mellitus, hypertension and ASB. For screening tests; the nitrite test was more specific (98.9%) than leukocyte esterase and pus cells, on the other hand, pus cell detection was more sensitive (81.2%) than the other tests for detection of ASB. The prevalence of ASB was relatively high, no one used routine screening tests revealed both high sensitivity and specificity. So, urine culture remains the gold standard method for detection of ASB in pregnant women.

Current Antibiotic Resistance Pattern of Prevalent Uropathogens in Urinary Tract Infection of Diabetic Patients in Comparison with non-Diabetics

Introduction: Urinary tract infections (UTIs) are a common infectious disease worldwide. Bacterial resistance to antibiotics is one of the most challenging global health problems. Regional surveillance programs are necessary to update knowledge on antimicrobial resistance patterns for empirical antibiotic treatment of the patients. This study aimed to explore the bacteriology and antibiotic resistance pattern of urological pathogens in diabetic patients compared to that in non-diabetics. Materials and Methods: A prospective study during the period from June 2021 to November 2021 in Khulna City Medical College Hospital was carried out including 347 diabetic and non-diabetic patients. Midstream clean-catch urine samples were collected from suspected UTI patients of age more than 14 years and inoculated in Mac Conkey &amp; Blood agar media for semi-quantitative urine culture and sensitivity test. Antibiotic susceptibility test was done by Kirby-Bauer disc diffusion method following clinical laboratory science (CLS) program. Results: Among the 347 inoculated samples, Culture positive were in 286 cases. Gram-negative E. coli was isolated from 119 (overall 41.6%, 51% in diabetics and 36.5% in non-diabetic patients) samples which were the most predominant bacteria, followed by Enterococcus, Pseudomonas and Klebsiella. UTI with E. coli was significantly at a higher rate in diabetic patients and Exhibits 100% resistance to Ceftriaxone, Nalidixic acid, Cefuroxime and Cefixime. Bacteria offered a high degree of resistance against commonly used antibiotics-Amoxycillin, Ciprofloxacin, Amikacin, Gentamycin, Levofloxacin, Nalidixic acid and Nitrofurantoin ranging from 7% to 93%. Conclusion: E. coli infection is significantly predominant in UTI cases in this study and exhibits a higher rate of resistance to all antibiotics in diabetic patients than that in non-diabetics. None of the antibiotics is 100% sensitive in diabetic patients. Imipenem, meropenem and Piperacillin remain .......

Post catheterization urine analysis in lower?segment caesarean section patients

To assess the effect of duration of catherization on urine analysis and on first voiding time after removal of catheter in postoperative period after caesarean section.Patients who have undergone caesarean section from June 2020 to June 2021. The catheter was in-situ post operatively. Urine sample from each patient was analyzed for routine microscopy before catheterization as well as after removal of catheter. Midstream clean catch urine was collected in sterile container and sent for urine routine analysis. As per duration of catheter in situ we divided the patients in four groupsPatients with catheter in situ- up to 24 hours, 24 to 48 hours, 48 to 72 hours, &amp;#62; 72 hours.Factors like urgency, frequency, dysuria and time required to void first time after removal of catheter were taken into consideration. &amp;#62; 4 pus cells in microscopy were taken as UTI.Urinary urgency and frequency were 91% in patient with catheter in situ for &amp;#62;24 hours. Out of 50 with duration of 1 to 3 hours catheter in situ, 48 had moderate dysuria, 10 with duration &amp;#62; 3 hours catheter in situ had dysuria in post- operatively. Of 35 with &amp;#62; 2 days of catheter in situ, 31 had UTI in postoperatively. Time taken to void the bladder initially was increased after removal of catheter in postoperatively.We have concluded that use of catheter for &amp;#62;24 hours is associated with increased incidence of urinary infection and more discomfort at first voiding.

MP38-05 TARGETED LIQUID CHROMATOGRAPHY MASS SPECTROMETRY QUANTIFICATION OF EXCRETED URINARY ESTROGENS AMONG POSTMENOPAUSAL WOMEN USING DIFFERENT ESTROGEN HORMONE THERAPY MODALITIES

You have accessJournal of UrologyCME1 May 2022MP38-05 TARGETED LIQUID CHROMATOGRAPHY MASS SPECTROMETRY QUANTIFICATION OF EXCRETED URINARY ESTROGENS AMONG POSTMENOPAUSAL WOMEN USING DIFFERENT ESTROGEN HORMONE THERAPY MODALITIES Michael L. Neugent, Neha Hulyalkar, Vladimir Shulaev, Philippe E. Zimmern, and Nicole J. De Nisco Michael L. NeugentMichael L. Neugent More articles by this author , Neha HulyalkarNeha Hulyalkar More articles by this author , Vladimir ShulaevVladimir Shulaev More articles by this author , Philippe E. ZimmernPhilippe E. Zimmern More articles by this author , and Nicole J. De NiscoNicole J. De Nisco More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002592.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Estrogen hormone therapy (EHT) is commonly used among postmenopausal women to treat symptoms of menopause. EHT can be administered via multiple modalities including oral (oEHT), transdermal patch (pEHT), and vaginal (vEHT). To date, there is little quantitative literature comparing the modalities of EHT and their respective excreted metabolites. Quantifying excreted estrogens to assess EHT dosage, compliance, or metabolism can be challenging due to the chemical nature of estrogens and their metabolites. The goal of this work was to develop and implement a robust, sensitive liquid chromatography mass spectrometry (LC-MS)-based targeted assay for the detection of excreted urinary estrogen conjugates at the picomolar range using a minimal volume of urine. METHODS: We used a strictly curated, controlled cohort of postmenopausal women (n=50) who passed a set of exclusion criteria for an ongoing study of recurrent UTI (rUTI) but were not currently experiencing infection at the time of urine donation. Clean-catch mid-stream urine was collected, estrogens were extracted from urine via solid phase extraction, and analyzed by a sensitive, targeted LC-MS. RESULTS: In this study we generated a sensitive, targeted LC-MS assay for the quantification of urinary estrogen conjugates, included the sulfates and glucuronides of Estrone (E1) and 17β-Estradiol (E2). Implementation of this assay on urine samples from a clinical cohort of postmenopausal women found that oEHT and pEHT modalities exhibited the highest levels of excreted urinary estrogen conjugates. Interestingly, we found that women using vEHT exhibited urinary estrogen concentrations that were not distinguishable from women who were not using EHT. CONCLUSIONS: These data suggest that oEHT and pEHT modalities exhibit higher concentrations of excreted urinary estrogen conjugates, which may be a proxy biomarker for systemic estrogen concentration during EHT. Source of Funding: The Welch Foundation, The Foundation for Women’s Wellness, NIH grant 1R01DK131267-01, and The University of Texas at Dallas Startup funds to NJD, The Felicia and John Cain Distinguished Chair in Women’s Health to PZ © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e619 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael L. Neugent More articles by this author Neha Hulyalkar More articles by this author Vladimir Shulaev More articles by this author Philippe E. Zimmern More articles by this author Nicole J. De Nisco More articles by this author Expand All Advertisement PDF DownloadLoading ...

MP49-20 UROTYPES IN YOUNG WOMEN WITH PELVIC PAIN: A PILOT ANALYSIS OF CLINICAL URINARY MICROBIOME CLASSIFICATION

You have accessJournal of UrologyCME1 May 2022MP49-20 UROTYPES IN YOUNG WOMEN WITH PELVIC PAIN: A PILOT ANALYSIS OF CLINICAL URINARY MICROBIOME CLASSIFICATION James M. Weinberger, L. Marcella Henao, Crystal Cisneros, James E. Ackerman, and A. Lenore Ackerman James M. WeinbergerJames M. Weinberger More articles by this author , L. Marcella HenaoL. Marcella Henao More articles by this author , Crystal CisnerosCrystal Cisneros More articles by this author , James E. AckermanJames E. Ackerman More articles by this author , and A. Lenore AckermanA. Lenore Ackerman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002624.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There are substantial differences in the urobiomes of women depending on age and menopausal status. Our previous work demonstrated that younger women (age <45) tended to have a more limited set of dominant microbes and could be classified by Next Generation Sequencing into one of 3 “urotypes” based on the composition of Lactobacilli and E. coli. We sought to determine if we could confirm that pattern in an unselected sampling of women seeking urogynecologic care and if these patterns correlated with presenting complaints. METHODS: Women (age 18-45) presenting with LUTS were prospectively enrolled if their clean-catch urine sample was deemed unnecessary for analysis by the provider. Samples were assessed via quantitative PCR (qPCR) for E. coli and Lactobacillus crispatus, gasseri, iners and jensenii and classified into urotypes using unsupervised clustering. The subset of women complaining of painful urogenital conditions were classified into the following categories using ICD-10 codes and primary provider-given diagnosis: bladder-specific pain syndrome (BPS), myofascial pelvic pain (MPP), and unspecified pelvic pain (PP). We performed correlations between bacterial types and pain diagnoses. RESULTS: Using Lactobacillus spp. and E. coli, premenopausal women could be classified into 3 dominant urotypes; the majority of asymptomatic subjects fell into Urotype 1(low Lactobacilli, low E. coli). Of the 186 premenopausal women enrolled, 56 were diagnosed with BPS, MPP, or PP. Examining across urotype, the MPP and BPS groups segregate; patients with MPP were Urotype 1, while BPS exhibited elevated L. iners (Urotype 2) (Figure 1). The majority of PP patients were Lactobacillus-poor, falling into the E.coli-positive urotype (Urotype 3). CONCLUSIONS: Pelvic pain is a common complaint in this age group. While previous studies of pelvic pain have noted differences in diversity and Lactobacilli abundance between controls and pain groups, our qPCR-based urotyping was able to classify young women into three subgroups, demonstrating differential associations with asymptomatic controls and pelvic pain phenotypes. These data suggest that urotype data may be a meaningful mechanism to subclassify pelvic pain patients. Future studies are needed to determine if these groups correlate to treatment responses. Source of Funding: N/a © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e862 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information James M. Weinberger More articles by this author L. Marcella Henao More articles by this author Crystal Cisneros More articles by this author James E. Ackerman More articles by this author A. Lenore Ackerman More articles by this author Expand All Advertisement PDF DownloadLoading ...

Chlorhexidine skin cleaning to reduce clean-catch urine contamination in infants: A pilot study.

Clean-catch urine (CCU) samples are frequently contaminated. Our aim was to determine if cleaning with 0.1% chlorhexidine before CCU is a safe and feasible method to reduce contamination. Prospective interventional pilot study. Children 1-24 months underwent perigenital skin cleaning with 0.1% chlorhexidine. Primary outcome was contamination rate, and secondary outcomes were parent and clinician satisfaction with the procedure. Twelve of 54 urine samples were contaminated (22%, 95% CI 13-35). Over 90% of parents and clinicians were either 'satisfied' or 'very satisfied'. No adverse events were recorded. Cleaning with chlorhexidine solution before CCU is safe and feasible.

Risk Factors Associated with Urinary Tract Infection in Children

Introduction: Urinary tract infection is infection leading to an inflammatory response in the epithelium of the urinary tract. Urinary tract infection is defined as the growth of significant number of organisms of a single species in the urine, in the presence of symptoms. Significant bacteriuria is a growth with colony count of &gt;105 / ml of a single species in a mid-stream clean catch urine sample. Aims: To find the prevalence of urinary tract infection in children with fever and its risk factor. Methods: A hospital based cross sectional observational study was performed in Nepalgunj Medical College, Kohalpur from October 2019 to October 2020.Children of age two months to 14 years admitted in Department of Pediatrics and visiting in outdoor fulfilling inclusion criteria were taken for the study. Detailed history and examination was performed. Data related to age, sex, predisposing risk factors of Urinary tract infection, symptoms and relevant investigations was carried out in all patients. Results: Among 135 children, maximum 62(45.92%) children were in the age group 1-5 years. There were 70(51.85) male and 65(48.14) female children. The prevalence of culture positive of urinary tract infection was 19.20%. Pyuria was more significant in females in comparison to male, more common in age group less than 5 years. 26 children were culture positive among which males to female ratio in urine culture positive cases were 1: 2.3 and majority had E.coli positive in urine culture sample. Apart from the female children urinary tract infection was commonly seen in uncircumcised male comprising of 8(11.42%) of total male children. Conclusion: In children presenting with fever, urinary tract infection was one of the common causes. It was most common in children less than 5 years, female gender and uncircumcised male children were two commonly associated risk factors

Lessening Urine Contamination in Children and Adolescents

Source: Hoover AC, Segal RS, Zimmerman MB, et al. Urine trouble: reducing midstream clean catch urine contamination among children 3–17 years old. Pediatrics. 2021;148(2):e2020049787. doi:10.1542/peds.2020-049787Investigators from the University of Iowa, Iowa City, IA, conducted a study to assess the effectiveness of a quality improvement intervention designed to reduce the rate of bacterial contamination in urine specimens collected by a clean catch technique. The intervention was developed by a multidisciplinary team, including representatives from inpatient and outpatient units and the emergency department at the University of Iowa Stead Family Children’s Hospital. A specific process was followed in developing the intervention, which included literature reviews, observations from various stakeholders, and an iterative approach in which different interventions were assessed. The final quality improvement intervention included use of a cleansing towelette with 0.13% benzalkonium chloride for urethral meatus cleansing, a set of instructions for obtaining a clean catch sample provided to the patient or caregiver, emphasis on a mid-stream collection, avoiding the insertion of dipsticks in the urine sample sent for culture, clarification that samples should arrive at the microbiology laboratory within 30 minutes of collection or be refrigerated, and real-time tracking of contamination rates.The primary study outcome was change in urine contamination rates before (April 2016 to September 2017) and after (April 2018 to September 2018) hospital-wide implementation of the quality improvement intervention. Sustainability of the intervention was assessed by assessing contamination rates during consecutive 12-month periods in 2018–2019 and 2019–2020. A standard definition for classifying a urine culture as contaminated was used, and all cultures were processed by a single microbiology laboratory. Chi-square tests were used to compare contamination rates prior to and after implementation of the quality improvement bundle; subgroup analyses, including by age groups (3–9, 10–15 and 16–17 years) and sex also were conducted.During the pre-intervention phase a total of 912 clean-catch urine cultures were obtained, of which 416 (45.6%) were contaminated. In the 6-month period following implementation of the quality improvement intervention, the contamination rate in 233 urine cultures was 30.9% (decrease of 14.7 percentage points; 95% CI, -21.5, -8.0). There were statistically significant decreases in contamination rates in female patients (52.7% to 40.1%, -12.6 percentage points; 95% CI, -21.1, -4.1) and in children 3-9 years old and those 10–15 years old; no significant decreases were observed in male patients or in those 16–17 years old. Although there was a significant decrease (-7.3 percentage points; 95% CI, -11.6, -2.9) in contamination rates throughout the entire follow-up period, rates increased to 38.3% during the 2018–2019 period and to 42.9% in 2019–2020 period.The authors conclude that implementation of a quality improvement intervention reduced the rates of bacterial contamination in clean catch urine cultures.Dr Sanchez-Kazi has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.The diagnosis of urinary tract infection is dependent on the quality of urine specimen collected. To lessen bacterial contamination in febrile infants and children up to 2 years of age, the AAP recommends that urine culture be obtained by urethral catheterization or suprapubic aspiration. (See AAP Grand Rounds. 2018:39[4]:39.)1 In toilet-trained children and adolescents, several clinical guidelines recommend obtaining urine by mid-stream clean catch with adequate cleaning of the urogenital area.2,3 In the current quality improvement study initiated by residents, bacterial contamination rate decreased with the combination of education regarding proper cleaning prior to urine collection and timely processing of the urine specimen. Similar interventions including development of specific digital apps were utilized in previous studies but with conflicting results.4,5Within 2 years of observation, the contamination rate slowly increased, albeit lower than the pre-intervention period. It is extremely helpful that the authors extended the period of observation to determine sustainability and, more importantly, to assess the role of performance bias in clinical intervention studies. The results of the current study reinforce the need for frequent review and constant reinforcement of the protocol with medical personnel and patients or caregivers in order to reduce the need for repeated urine testing, leading to conservation of both time and resources. It is interesting to note that the urine contamination rate obtained by catheterization is higher in the current study than in other reports.6Proper cleaning of the urogenital area and timely processing of collected urine specimens reduce bacterial contamination in toilet-trained children and in adolescents.