Clinical Signs Of Urinary Tract Infection Research Articles

Assessments at week 2 and 3 in Term Newborns Diagnoses with Prolonged Jaundice

Introduction: Jaundice is one of the most common problems at neonatal period and seen in 60-70% of all newborns at first days of life. Prolonged jaundice is defined as hyperbilirubinemia persisting at the end of week 2 in term newborns. In this study, we reviewed term newborns diagnosed with prolonged jaundice. It was aimed to demonstrate delaying laboratory evaluations for a week in infants with favorable clinical presentation can prevent unnecessary tests in majority of newborns. Materials and methods: The study included full-term newborns who presented after day 14 of life and diagnosed with prolonged jaundice at neonatology outpatient clinic of Health Sciences University, Keçiören Teaching and Research Hospital in 2016. Overall, 336 infants with prolonged jaundice were screened. The infants with congenital anomaly, those with findings of sepsis or severe infection, those with history of intrauterine infection, those with history of acholic stool and those with no available data were excluded. In 180 patients included, clinical evaluations, bilirubin levels and advanced test results were assessed at baseline and weekly follow-up. Findings: Of the infants included, 51.7% were boys while 48.3% were girls. The most common blood type was A Rh (+). There was ABO incompatibility alone in 24 infants (14.2%), Rh incompatibility alone in 6 infants (3.5%) and ABO plus Rh incompatibility in 3 infants (1.2%). In 130 infants, total bilirubin was studied on both week 2 and 3. At week 3, total bilirubin value was ≥10 mg/dl in only 36 infants (27.7%) while it was decreased below 10 mg/dL in 94 infants (72.3%). Urinary tract infection (UTI) was detected in 7 of 38 infants with available tests at week 2. Two of 6 infants with UTI had other clinical signs of UTI. Mean total bilirubin value was 17.9 mg/dL in 5 infants. A significant correlation was found between UTI and vomiting, breastfeeding and feeding pattern (p

Mitigating antimicrobial resistance, an approach to stewardship in canine urinary tract infection.

Urinary tract infection (UTI) caused by antimicrobial resistant bacteria is common in dogs leading to serious health impact in pet animal as well as on human health. Understanding the prevalent uropathogens and their drug susceptibility is essential for limiting the antimicrobial resistance through implementation of stewardship policies. In view of this, present study was envisaged to determine the prevalent bacterial uropathogens and their antibiogram from clinical cases of canine UTI. Urine samples were collected from 35 dogs presented with clinical signs of UTI and a total of 27 bacterial isolates were recovered. Among that Escherichia coli was the most predominant isolate followed by Klebsiella aerogenes, Staphylococcus aureus, Proteus mirabilis, Enterococcus sp. and Citrobacter freundii. All isolates were found resistant to one or more 1st line antibiotics recommended by consensus guidelines and 70% of total isolates showed multidrug resistance. Additionally, this study evaluated the weightage of empirical therapy as per the consensus guidelines over antimicrobial susceptibility test guided treatment. Dogs with uncomplicated UTI were selected and categorized into three different groups (n = 6). Group 1 was treated with common empirical choice amoxycillin-clavulanic acid and dogs showed susceptible to ciprofloxacin were kept in Group 2 and treated with ciprofloxacin along with urinary alkalizer disodium hydrogen citrate. Nitrofurantoin susceptible cases were kept in Group 3 and treated with a combination of nitrofurantoin and urinary acidifier ammonium chloride. Therapeutic outcome was evaluated and success rate was higher in Group 2 and 3 than Group 1 suggested that selection of antibiotics with the use of local or institutional antibiogram data is more considerate than acknowledged international guidelines in the existing situation.

The prevalence of urinary tract infections (UTIs) in the pediatric hospital of Benghazi city, Libya.

Urinary tract infections (UTIs) are a frequent clinical problem and may have adverse clinicalconsequences especially for infants and young children. There have been no studies conducted todetermine the incidence rate of UTIs among children in Benghazi and the guidelines for the laboratorydiagnosis and antimicrobial susceptibility testing remained largely unmanaged. Accordingly, weinvestigated the prevalence of pediatric UTIs during the first six months of the year 2015 in the pediatrichospital of Benghazi city. About 2100 urine samples were collected from patients presented with clinicalsigns of UTIs. In both hospitalized patients admitted to different hospital units and from the outpatientdepartment (OPD), the overall bacterial UTIs rate was 15.43% (324 UTI-positive samples). In OPD, therate of UTIs in boys was 61.83% compared to 45.33% in girls. However, UTIs were more frequent in girlsthan boys as indicated from samples received from the other hospital internal units. The most commoncause of UTIs was Escherichia coli (64.32%). Other responsible agents have included Klebseilla, Proteus,Enterobacter, Pseudomonas, Aeromonas and Streptococcus. The rate of resistance to amoxicillin andnorfloxacin was about 40%. Similarly, the other antibacterial drugs routinely used for UTI susceptibilitytesting revealed less than 30% resistance. Therefore, important factors such as incidence rate of UTIs,standard laboratory diagnosis, and antimicrobial susceptibility testing require a special consideration inchildren for optimal UTIs treatment.

Urinary Cytology: Potential Role in Canine Urinary Tract Infections.

The diagnosis of urinary tract infections (UTIs) requires a concomitant evaluation of clinical signs and urine culture, which is of fundamental to start an appropriate antibiotic treatment. Several factors, such as subclinical bacteriuria or pre-analytical errors, may make the interpretation of urine culture difficult. The aim of the study was to evaluate the association between the finding of neutrophils and bacteria in unstained and stained canine urine sediment and the presence of clinical signs and positive urine culture. Urine samples from 35 dogs with clinical signs of UTI and 55 asymptomatic dogs with risk factors for UTI were prospectively collected by cystocentesis, divided into three aliquots, and submitted for: (1) physical and chemical Dipstick analysis and unstained urinary sediment (casts, crystals, bacteria, leucocytes, cells, parasites); (2) stained urinary sediment (extra/intracellular bacteria, degenerated and non-degenerated neutrophils); (3) qualitative and quantitative urine culture and antimicrobial sensitivity-test. The association between unstained and stained findings of urinary sediment and urine culture was tested. Sensibility, specificity, and positive/negative predictive values in diagnosing positive urine cultures of bacteria at unstained and stained evaluation were compared. Both wet-mount bacteriuria and the cytological presence of intracellular and extracellular bacteria, neutrophils, and degenerated neutrophils were successively associated with positive urine culture (p < 0.001). The presence of intracellular bacteria was the only independent predictor of positive urine culture. Total bacterial count did not differ significantly between symptomatic and asymptomatic dogs. Detection of extracellular and intracellular bacteriuria at stained urinary sediment significantly improved the sensibility of predicting positive urine culture. Cytologic evaluation of urinary sediment may be helpful in detecting signs of active inflammation, thus enhancing the clinical relevance of a positive urine culture.

ANTIMICROBIAL RESISTANCE OF COMMON UROPATHOGENS FROM CATS WITH URINARY TRACT INFECTIONS IN A VETERINARY TEACHING HOSPITAL IN TAIWAN

Urinary tract infection (UTI) is frequently diagnosed in dogs and cats. To realize common regional uropathogens and their antimicrobial resistance plays an important role in both human and veterinary medicine. An empirical antibiotic was administrated while waiting for the results of bacterial culture and antimicrobial susceptibility testing. Eighty-five bacterial isolates were obtained from 74 cats with clinical signs of UTI. Escherichia coli, Enterococcus species, Staphylococcus species and Klebsiella species were the most common bacterial isolates in our hospital. Compared to the previous researches, the susceptibilities of recommended empirical antibiotics exhibited higher resistant rate in our study. Lincomycin was the most resistant antibiotic within the test panel to that almost 98% uropathogens were resistant. The resistant rates of cephalexin, cephalothin, penicillin and amoxicillin were about 90%. Therefore, the selection of empirical antibiotics should be re-evaluated with time in Taiwan.

Diagnosis of hospital acquired urinary tract infections in Gonesse PRM ward

To assess the benefit of systematic urine cyto-bacteriological exam (UCB) screening within the 48 hours of patients’ admission in a conventional PRM ward and on day 7, to attribute the occurrence of an hospital acquired infection to the ward. A retrospective analysis of UCB results performed on entrance and on Day 7, systematically from 01/01/2013 to 12/31/2016. A questioning to look for clinical signs of urinary tract infection (UTI) was conducted. In total, 2338 UCB were performed in 1064 patients. One hundred and twenty four UCB had positive bacteriuria. Fifty-two patients have initially sterile UCB and 76 had contamination. Of 52 patients with initially sterile UCB, 3 had no control at Day 7, 19 remained sterile and 30 had positive bacteriuria. Twenty-one of the 30 patients had clinical signs of UTI (44%) and 4 of them were infected with ESBL germs (1 in 2013 and 2016, 2 in 2014). Of 76 patients with initially contamination, 17 had no control at Day 7, 45 were sterile or remained contaminated on day 7, and 14 had positive bacteriuria (24%) of which 2 had clinical signs of UTI and one of them was infected with ESBL germ (2013). Finally, 23 patients had a UTI that is to say 1% of the UCB. The systematic UCB on Day 0 and Day 7 was established to diagnose hospital acquired UTI and to determine ward accountability. This exam does not take into account the clinic although UTI diagnosis is based on clinical signs. If there is no clinical suspicion of UTI within the first 48 hours, and if the patient develops a UTI within these first 48 hours, the UTI is a hospital acquired infection and is accountable for the PRM ward, regardless of the bacterium. UCB interest dwells in germ and antibiogram analysis both for patient's treatment and for bacterial ecology monitoring of the ward and/or the establishment. The cost/benefit ratio of systematic UCB is negative: 1% of patients have an UTI associated with clinical care (clinical signs confirmed by a positive UCB). Therefore, there is no need for routine urinary screening. Clinical watchfulness must be ever-present.

Ceftolozane/tazobactam for febrile UTI due to multidrug-resistant Pseudomonas aeruginosa in a patient with neurogenic bladder.

Urinary tract infections (UTI) are a major public health problem among spinal cord injury (SCI) patients. They frequently involve multidrug-resistant (MDR) bacteria. Ceftolozane/tazobactam (C/T) is a novel antibiotic combination approved for complicated intra-abdominal and UTI caused by Gram-positive and Gram-negative organisms, including some MDR strains. Little is known about the use of this agent for complicated febrile UTI occurring among SCI patients with neurogenic bladder due to MDR Pseudomonas aeruginosa (PSA). We describe the case of a 35-year-old man with SCI due to multiple sclerosis, with a neurogenic bladder necessitating a bilateral nephrostomy and double J catheter, who developed a febrile UTI due to a MDR PSA, which was susceptible only to amikacin and colistin. Because of this MDR phenotype and the underlying kidney disease, a 1000 mg (1000 mg per 500 mg) dose of C/T was given as monotherapy every 8 h for 7 days, after 3 days of colistin and amikacin. Thanks to this treatment, the patient had a favorable outcome with no clinical signs of UTI or positive urine culture up to 1 month after diagnosis. C/T seems to be an effective and safe therapeutic option for febrile UTI due to MDR PSA in SCI patients with neurogenic bladder, even when administered in monotherapy for 10 days.

Agentes causadores de infecções urinárias em cães em Rio Verde–GO: ocorrência e determinação da sensibilidade a antimicrobianos

The urinary tract infections (UTI) occur usually when there is a temporary or permanent failure in the mechanisms of host defense and sufficient number of mainly bacteria that multiply and persist in a portion of the urinary tract. We collected 26 urine samples obtained by cystocentesis in dogs with clinical signs of UTI, in 2010, the Center for Animal Control and the Veterinary Hospital at Fesurv, located in Rio Verde-GO, with the objective to establish the rate of UTI, the etiologic agents and antibiotic susceptibility. All samples were subjected to urinalysis and urine culture to also. There were bacteriuria in 16 urinalysis and only four samples with positive culture. The identification of the bacteria was performed by traditional biochemical methods and antibiotic susceptibility by disk diffusion method. There was a higher incidence of UTI in females. Gram-negative isolates were Citrobacter sp and Klebsiella sp. And among the Gram-positive Staphylococcus aureus, S. saprophyticus and S. epidermis were most prevalent. The antibiotic nitrofurantoin, tetracycline, cephalothin, chloramphenicol, norfloxacin, erythromycin and enrofloxacin were effective in the treatment of Gram-positive and only cephalothin and enrofloxacin in the treatment of Gram-negative bacteria. The results reinforce the need for knowledge of antimicrobial susceptibility of bacteria causing UTI, to prevent the misuse of antibiotics.

Antimicrobial resistance of urinary Escherichia coli isolates

BackgroundEscherichia coli is the most common bacteria involved in the aetiology of the urinary tract infections (UTI).PurposeThe aim of the study is to compare the susceptibility to antibacterial agents of...

Complicated urinary tract infections: practical solutions for the treatment of multiresistant Gram-negative bacteria

Resistance in Gram-negative bacteria has been increasing, particularly over the last 6 years. This is mainly due to the spread of strains producing extended-spectrum β-lactamases (ESBLs) such as CTX-M enzymes or AmpC β-lactamases. Many of the isolates producing these enzymes are also resistant to trimethoprim, quinolones and aminoglycosides, often due to plasmid co-expression of other resistance mechanisms. CTX-M-producing Escherichia coli often occurs in the community and as E. coli is one of the commonest organisms causing urinary tract infections (UTIs) the choice of agents to treat these infections is diminishing. Novel combinations of antibiotics are being used in the community and broad-spectrum agents such as carbapenems are being used increasingly as empirical treatment for severe infections. Of particular concern therefore are reports in the UK of organisms that produce carbapenemases. As resistance is becoming more widespread, prudent use of antimicrobials is imperative and, as asymptomatic bacteriuria is typically benign in the elderly, antibiotics should not be prescribed without clinical signs of UTI. The use of antibiotics as suppressive therapy or long-term prophylaxis may no longer be defensible.

Frequency of urinary tract infection among dogs with pruritic disorders receiving long-term glucocorticoid treatment

To determine frequency of urinary tract infection (UTI) among dogs with pruritic disorders that were or were not receiving long-term glucocorticoid treatment. Observational study. 127 dogs receiving glucocorticoids for > 6 months and 94 dogs not receiving glucocorticoids. Bacterial culture of urine samples was performed in dogs receiving long-term glucocorticoid treatment, and information was collected on drug administered, dosage, frequency of administration, duration of glucocorticoid treatment, and clinical signs of UTI. For dogs not receiving glucocorticoids, a single urine sample was submitted for bacterial culture. Multiple (2 to 6) urine samples were submitted for 70 of the 127 (55%) dogs receiving glucocorticoids; thus, 240 urine samples were analyzed. For 23 of the 127 (18.1%) dogs, results of bacterial culture were positive at least once, but none of the dogs had clinical signs of UTI. Pyuria and bacteriuria (present vs absent) were found to correctly predict results of bacterial culture for 89.9% and 95.8% of the samples, respectively. Type of glycocorticoid, dosage, frequency of administration, and duration of treatment were not associated with frequency of UTI. None of the urine samples from dogs not receiving glucocorticoids yielded bacterial growth. The frequency of UTI was significantly higher for dogs treated with glucocorticoids than for dogs that had not received glucocorticoids. Results suggest that dogs receiving long-term glucocorticoid treatment have an increased risk of developing a UTI. On this basis, we recommend that urine samples be submitted for bacterial culture at least yearly for such dogs.

Retrospective Evaluation of Urinary Tract Infection in 42 Dogs with Hyperadrenocorticism or Diabetes Mellitus or Both

A retrospective study was performed to determine the proportion of dogs with hyperadrenocorticism or diabetes mellitus or both that had urinary tract infection (UTI) and to describe clinical and laboratory findings. Dogs with these endocrine disorders were included if results of quantitative urine culture were available and dogs were not receiving antimicrobials. Dogs with positive urine cultures were considered to have UTI and dogs with negative urine cultures were used as controls. Information including history, clinical signs, physical examination findings, and results of laboratory tests and urine culture was extracted from all records. Findings in dogs with UTI were compared with control dogs. There were 101 dogs with hyperadrenocorticism or diabetes mellitus or both that met inclusion criteria; 42 (41.6%) had UTI and 59 (58.4%) did not. UTI was present in 46% of dogs with hyperadrenocorticism, 37% of dogs with diabetes mellitus, and 50% of dogs with both endocrine disorders. There was no association between endocrine group and occurrence of UTI. Escherichia coli was the most common bacteria isolated, and cultures from 29 dogs (69%) showed growth of this organism. Of dogs with UTI, &lt;5% had stranguria, pollakiuria, or discolored urine, whereas 60% had pyuria and 69% had bacteriuria. We conclude that UTIs are common in dogs with hyperadrenocorticism, diabetes mellitus, or both diseases. Clinical signs of UTI, however, are uncommon and results of urinalysis may be normal. Therefore, it is appropriate to recommend urine culture as part of the evaluation of dogs with these endocrine disorders.

Retrospective evaluation of urinary tract infection in 42 dogs with hyperadrenocorticism or diabetes mellitus or both.

A retrospective study was performed to determine the proportion of dogs with hyperadrenocorticism or diabetes mellitus or both that had urinary tract infection (UTI) and to describe clinical and laboratory findings. Dogs with these endocrine disorders were included if results of quantitative urine culture were available and dogs were not receiving antimicrobials. Dogs with positive urine cultures were considered to have UTI and dogs with negative urine cultures were used as controls. Information including history, clinical signs, physical examination findings, and results of laboratory tests and urine culture was extracted from all records. Findings in dogs with UTI were compared with control dogs. There were 101 dogs with hyperadrenocorticism or diabetes mellitus or both that met inclusion criteria; 42 (41.6%) had UTI and 59 (58.4%) did not. UTI was present in 46% of dogs with hyperadrenocorticism, 37% of dogs with diabetes mellitus, and 50% of dogs with both endocrine disorders. There was no association between endocrine group and occurrence of UTI. Escherichia coli was the most common bacteria isolated, and cultures from 29 dogs (69%) showed growth of this organism. Of dogs with UTI, <5% had stranguria, pollakiuria, or discolored urine, whereas 60% had pyuria and 69% had bacteriuria. We conclude that UTIs are common in dogs with hyperadrenocorticism, diabetes mellitus, or both diseases. Clinical signs of UTI, however, are uncommon and results of urinalysis may be normal. Therefore, it is appropriate to recommend urine culture as part of the evaluation of dogs with these endocrine disorders.

A Single Dose of Aztreonam in the Prevention of Urinary Tract Infections in Elderly Catheterized Patients

We have compared the effects of aztreonam and placebo in the prevention of urinary tract infections (UTI) in elderly hospitalized patients who needed urethral catheterization. 162 patients (96 males, 66 females; age range 60-91 years) were randomly allocated to receive double-blind a single dose of aztreonam (2 g i.m. 80 patients) or placebo (4 ml lidocaine 2%, 82 patients) three hours before catheterization. All patients were followed-up for 7 days. Urine culture was performed before, at the first, third and seventh day of catheterization. At the end of follow-up 71/80 patients (88.7%) who received a single preventing dose of aztreonam had negative urine culture without clinical signs of UTI. On the contrary, in the group treated with placebo at the end of follow-up only 38/82 patients (46.3%) had negative urine without clinical signs of UTI. In conclusion, our data suggest that a single 2g i.m. dose of aztreonam is effective in preventing UTI in elderly patients needing indwelling urethral catheterization.