Consequences Of Urinary Tract Infections Research Articles

Pulmonary Injury as a Complication of Urinary Tract Infection in Pregnancy.

Pulmonary injuries resulting from urinary tract infections (UTIs) during pregnancy are rare. Prompt detection of pulmonary complications in pregnant patients with UTIs is crucial to prevent adverse outcomes in both the mother and the fetus. These complications may include respiratory issues, pulmonary edema, and exacerbation of preexisting conditions, such as asthma. We aimed to detect reported cases of pulmonary injury after UTIs among pregnancies. We retrospectively reviewed the reported cases and articles in the PubMed database up to September 2023 on pulmonary injury after UTIs among pregnancies through a detailed search strategy. The titles and abstracts of the selected 15 articles were assessed, and ultimately, 7 articles were chosen based on adherence to our inclusion and exclusion criteria. Approximately 1-2% of women may develop acute pyelonephritis due to persistent UTIs, which has been associated with an increased risk of pulmonary edema in certain cases. UTIs can affect pulmonary health. Uremia, a consequence of UTIs, can lead to alterations in the respiratory drive, mechanics, muscle function, and gas exchange. Furthermore, urinary infection-induced inflammation activates neutrophils and promotes their recruitment to the lungs, compromising lung function and damaging the surrounding tissue. Although systematic research on this topic is limited, there may be a link between UTIs and pulmonary damage. However, it remains unclear whether pregnancy exacerbates this association. For maternal health, child health, and the whole public health, it is important to raise awareness of physicians and gynecologists, as well as the different specialties like emergency and intensive care units, with more information about pulmonary injury after UTI in pregnancy; it is important to note that UTIs may not directly cause pulmonary complications, but physiological changes associated with pregnancy can increase this risk, so more care, observation, early detection, and treatment are critical for treating these complications and achieving best outcome in pregnant women with UTIs. More research is needed in this area, as the mechanism underlying the existence of pulmonary damage post-UTI in pregnancy is unclear.

Long-term consequences of urinary tract infection in childhood: an electronic population-based cohort study in Welsh primary and secondary care.

Childhood urinary tract infection (UTI) can cause renal scarring, and possibly hypertension, chronic kidney disease (CKD), and end-stage renal failure (ESRF). Previous studies have focused on selected populations, with severe illness or underlying risk factors. The risk for most children with UTI is unclear. To examine the association between childhood UTI and outcomes in an unselected population of children. A retrospective population-based cohort study using linked GP, hospital, and microbiology records in Wales, UK. Participants were all children born in 2005-2009, with follow-up until 31 December 2017. The exposure was microbiologically confirmed UTI before the age of 5 years. The key outcome measures were renal scarring, hypertension, CKD, and ESRF. In total, 159 201 children were included; 77 524 (48.7%) were female and 7% (n = 11 099) had UTI before the age of 5 years. A total of 0.16% (n = 245) were diagnosed with renal scarring by the age of 7 years. Odds of renal scarring were higher in children by age 7 years with UTI (1.24%; adjusted odds ratio 4.60 [95% confidence interval [CI] = 3.33 to 6.35]). Mean follow-up was 9.53 years. Adjusted hazard ratios were: 1.44 (95% CI = 0.84 to 2.46) for hypertension; 1.67 (95% CI = 0.85 to 3.31) for CKD; and 1.16 (95% CI = 0.56 to 2.37) for ESRF. The prevalence of renal scarring in an unselected population of children with UTI is low. Without underlying risk factors, UTI is not associated with CKD, hypertension, or ESRF by the age of 10 years. Further research with systematic scanning of children's kidneys, including those with less severe UTI and without UTI, is needed to increase the certainty of these results, as most children are not scanned. Longer follow-up is needed to establish if UTI, without additional risk factors, is associated with hypertension, CKD, or ESRF later in life.

Genotypic characterization of extended-spectrum β-lactamase producing urinary isolates among pregnant women in Ho municipality, Ghana

ObjectiveThe case of antibiotic resistance has become a major global concern and Extended Spectrum β-lactamase (ESBL) producing organisms have so far remained the biggest culprit. The consequences of urinary tract infection (UTI) and antibiotic resistance among pregnant women cannot be underestimated. We investigated UTI and ESBL production among urinary pathogens isolated from pregnant women. MethodWe obtained non-repeat, clean catch midstream urine samples from 1345 pregnant women suspected of having UTI for bacterial identification at the Ho Teaching Hospital Laboratory between June 2013 and March 2015. The isolates were taken through relevant biochemical testing for identification and then subjected to antimicrobial agents for susceptibility testing using the disc diffusion method. We tested for ESBL production by the combined disc method and ESBL positive (+ESBL) phenotype isolates were genotyped for BlaTEM, BlaSHV, and BlaCTX-M using polymerase chain reaction (PCR). Data were analyzed using SPSS v24 and p-values < 0.05 were considered statistically significant. ResultsOf the 1345 urine samples tested, 230 (17.1%, 95% CI: 15.1%–19.1%) yielded significant bacteriuria. The most common bacterium isolated was Staphylococcus aureus (29.6%) followed closely by Escherichia coli (28.7%) both of which were highest during the second trimester of gestation. We isolated 152 gram-negative isolates with 41.4% (63/230) being + ESBL. Of the 63 + ESBL, 45 (71.4%) possessed blaTEM, 42 (66.7%) had blaCTX-M and 2 (3.2%) possessed blaSHV genes; 38 possessed multiple ESBL genes comprising 2 with both SHV and TEM genes and 36 with both CTX-M and TEM genes. ConclusionHigh prevalence of UTI and persistent transmission of ESBLs among pregnant women in the Ho Municipality is worrying and a course for public health concern. We recommend urine culture during pregnancy as a routine laboratory investigation to avoid birth-related complications.

Bacterial Urinary Tract Infection and Early Asymptomatic Bacteriuria in Kidney Transplantation Still Negatively Affect Kidney Transplant Outcomes in the Era of Modern Immunosuppression and Cotrimoxazole Prophylaxis.

Risk factors and consequences of urinary tract infection (UTI) post-kidney transplant have been variously reported by studies that were heterogenous in immunosuppressants and prophylactic protocols. We aimed to clarify the risks and consequences of UTI in kidney transplant recipients with post-transplantation cotrimoxazole prophylaxis in the context of modern immunosuppression. This retrospective cohort included kidney transplant recipients receiving tacrolimus, mycophenolate, prednisolone, and cotrimoxazole for bacterial UTI prophylaxis. Recipients were categorized into non-UTI and UTI groups. Asymptomatic bacteriuria (ASB) was screened in the first 3 months and was evaluated for association with UTI. Of 348 kidney transplant recipients, 129 were in the UTI group and 219 in the non-UTI group. UTI risk factors were female sex, body mass index ≥ 25 kg/m2, human leukocyte antigen mismatch, and panel reactive antibody ≥ 50%. Recipients with recurrent UTI had inferior allograft function compared with non-UTI recipients. Patient survival was significantly lower in recipients with UTI in the first post-transplant month. Higher degree of immunosuppressions was associated with recurrent UTI and drug-resistant organisms. In conclusion, UTI continues to negatively affect graft function and survival of kidney transplant recipients. Treating ASB in the first 3 months did not reduce the UTI incidence in the first transplantation year.

Retrospective analysis of urine culture results in our clinic: determination of pathogen types and antibiotic resistance in our region

Aim: Untreated urinary tract infections and increasing resistance to antibiotics are important health problems in pregnant and non-pregnant women. The aim of this study is to determine "Escherichia coli" (E. coli) strains and other growing microorganisms isolated from urine samples sent from pregnant and non-pregnant patients in the Gynecology and Obstetrics outpatient clinic in Mardin State Hospital, and evaluate the antimicrobial susceptibility profile. Materials and Methods: The results of reproduction in midstream urine samples obtained from pregnant and non-pregnant women who were sent to Mardin State Hospital Microbiology Laboratory with the suspicion of urinary system infection from the Gynecology and Obstetrics Outpatient Clinic between January 1, 2018 and June 17, 2020 were retrospectively evaluated. Results: The mean age of pregnant patients was significantly lower than that of the non-pregnant group. While E. Coli and Klebsiella were prominent in the pregnant group, the incidence of E. Coli and Enterococcus sp. had increased in the non-pregnant group. Conclusion: Urinary tract infection remains an important public health problem. To prevent the adverse obstetric consequences of urinary tract infection during pregnancy, it is important to investigate local susceptibility of microorganisms, especially common factors such as E. coli, at certain periods.

Awareness of Students On Environmental Hygiene and Health Consequences of Urinary Tract Infection (UTI) At Islamic University in Uganda

Awareness of Students On Environmental Hygiene and Health Consequences of Urinary Tract Infection (UTI) At Islamic University in Uganda

Incidence, Risk Factors and Consequences of Urinary Tract Infection following Renal Transplantation

Incidence, Risk Factors and Consequences of Urinary Tract Infection following Renal Transplantation

Which Children Develop Renal Scarring After One UTI

Renal scarring can be a permanent consequence of urinary tract infection (UTI), and is associated with long-term conditions such as decreased renal

Long‐term clinical consequences of urinary tract infections during childhood: a review

Kidney scarring related to urinary tract infection in childhood has been considered the cause of serious long-term clinical consequences. This assumption is now debated, as the advent of routine antenatal ultrasound in the 1980s has shown that a consistent part of the changes previously attributed to postinfectious scarring is mainly due to congenital malformations. With the aim of determining what is presently known on the long-term clinical consequences of urinary tract infections (UTIs) in childhood, we performed a review of the literature on the relation between UTIs and blood pressure, renal function, growth and pregnancy-related complications. By searching Medline/PubMed and Embase from 1980 to 2011, we identified 20 cohorts of children from 23 papers. Renal function: there are no clear data to establish long-term consequences following UTIs during childhood. Most data seem to show that the outcome of renal function can already be delineated at first presentation or in the initial years of follow-up; only 0.4% of children with normal renal function at start presented a decrease during follow-up. Hypertension: there is a low risk, associated with renal damage. Growth and pregnancy-related complications: the few available data seem to exclude a major influence of UTIs.

Fetal Supraventricular Tachycardia with Hydrops and 1:1 Atrioventricular Block in a Pregnant Patient with a Sinus Arrhythmia

respiratory distress in pregnancy. Nonetheless, we seem to be encountering this problem more frequently. The association of pyelonephritis and respiratory distress in pregnancy was first described in 1984. Pyelonephritis alone is estimated to occur in 1 to 2% of all pregnancies. Some studies suggest that one out of every 50 women admitted for pyelonephritis will develop some respiratory distress. Unfortunately, the etiology for the mechanism of the syndrome remains unknown. Respiratory distress in pregnancy is associated with a high rate of perinatal morbidity and mortality. It is fortunate that this patient had access to an institution where she could have maternal fetal medicine and pulmonology consults. Her management prevented artificial ventilation, which would have increased her statistical risk. Providing care for this patient and others like her has increased our awareness of the possible consequences of urinary tract infections in pregnancy.

Bloodstream Infection After Kidney Transplantation: Epidemiology, Microbiology, Associated Risk Factors, and Outcome

Bloodstream infection (BSI) is associated with both relevant morbidity and mortality rates after kidney transplantation. From January 1, 2000 to January 31, 2006, all episodes of BSI were retrospectively assessed through the review of medical records in two tertiary teaching Hospitals in Sao Paulo, Brazil, where 3308 transplant procedures were performed during this period. Contaminants and polymicrobial infections were excluded. The main objectives of the study were to describe clinical and microbiologic aspects of BSI, as well as risk factors for both BSI and mortality from these infections in kidney transplant patients. BSI was detected in 185 patients, with onset after a median of 235 days after transplantation; 62% occurred after 6 months. The primary source of infection was the urinary tract in 37.8%. The most prevalent pathogen overall was Escherichia coli (30.3%). Risk factors for early acquired BSI (first 6 months after transplantation) were acute rejection, ureteric stent placement, and receiving an organ from a deceased donor. For late BSI (after 6 months), associated risk factors were acute rejection, Charlson Comorbidity Score more than or equal to 3, and receiving an organ from a deceased donor. Risk factors related to 30-day mortality were Acute Physiology and Chronic Health Evaluation II Score more than or equal to 20, shock, and respiratory failure. BSI is most frequently a consequence of urinary tract infection, with a high prevalence of gram-negative bacilli. Severity of disease was the main determinant of 30-day mortality after BSI, and based on the knowledge of risk factors, some interventions are suggested for reducing the rate of BSI after transplantation.

Urinary Tract Infections Complicating Stroke

Hospital-acquired urinary tract infection (UTI) is a common complication in hospitalized patients. Recently, catheter-associated UTI has been identified by the Centers for Medicare and Medicaid Services as a preventable condition, and additional payments to hospitals for its treatment are now declined, increasing the need for prevention of this important complication. This article explores in-depth the pathophysiology, risk factors for, and consequences of UTI after stroke and possible methods to reduce its incidence in the stroke population. Patients with stroke are particularly vulnerable to UTI due to increased risk from immunosuppression, bladder dysfunction, and increased Foley catheter use; and the fever and systemic inflammatory response associated with UTI may impair stroke recovery. UTI is associated with poorer neurological outcomes, longer hospital stays, and increased cost of care after stroke. Intervention strategies previously attempted in this and other populations include prophylactic antibiotics, antiseptic-impregnated catheters, and quality improvement interventions to reduce inappropriate catheterization. Patients with stroke have different risks for, consequences of, and barriers to reducing UTI than other hospitalized patients. Further research is needed to develop an effective approach to decreasing this important complication in the stroke population.

Effect of Urinary Tract Infection on Reservoir Function in Patients With Ileal Bladder Substitute

We determined the functional consequences of urinary tract infection in patients with an ileal bladder substitute in terms of urinary continence, post-void residual and urinary retention. A total of 48 patients with culture documented urinary tract infection (single organism, 10(5) or greater cfu) were retrospectively evaluated before, during and after the infection for changes in continence, post-void residual and urinary retention as well as for resolution of symptomatology after appropriate antibiotic therapy. Of the 48 patients 40 had a single infection while the remaining 8 had multiple urinary tract infection episodes. During daytime 27 of the 44 patients with previously good daytime continence experienced deterioration in their baseline voiding status while infected. Of the 40 patients who were previously continent at night 20 had incontinence while infected. There were 15 patients with documented post-void residual and urinary retention developed in 4 during the urinary tract infection. All patients returned to baseline continence status and reservoir function after appropriate antibiotic treatment based on objective and subjective assessments. Urinary tract infection may cause urinary incontinence in patients with ileal bladder substitutes. Therefore, when there are complaints of de novo urinary incontinence, a finding of post-void residual or an acute presentation of urinary retention, a urinary tract infection should be excluded. When the urinary tract infection is appropriately treated urinary continence and reservoir function return to their baseline status.

Can MRI replace DMSA in the detection of renal parenchymal defects in children with urinary tract infections?

Renal parenchymal defects may be a consequence of urinary tract infections (UTI) in childhood. MRI is a non-radiation imaging modality compared with DMSA scanning. To compare DMSA with MRI for the detection of renal parenchymal defects in children presenting for radiological investigation after a first UTI. Both DMSA and MRI were performed at the same appointment in 37 children (aged 4 months-13 years; mean 4.5 years) with a history of UTI. Both planar and SPECT DMSA were performed. MRI of the kidneys employed axial and coronal T1-, T2- and fat-saturated T1-weighted (T1-W) sequences. Some children had imaging after IV contrast medium. The coronal fat-saturated T1-W sequence was the best sequence and it detected all the findings on MRI. MRI had a sensitivity of 77% and a specificity of 87% for the detection of a scarred kidney using DMSA as the gold standard. MRI diagnosed pyelonephritis in two children that had been interpreted as scarring on DMSA. Renal MRI using a single, coronal, fat-saturated T1-W sequence is a rapid, accurate and minimally invasive technique for the detection of renal scarring that does not employ ionizing radiation.

Long-term consequences of urinary tract infections.

The past several years have brought marked changes in our understanding of the consequences of urinary tract infections (UTIs). Studies of infants with intrauterine dilatation of the urinary tract show that many children previously thought to have incurred kidney damage after an infection actually have congenital renal damage. The importance of vesicoureteric reflux (VUR) in the pathogenesis of acute pyelonephritis has been downgraded with the recognition of the frequency with which kidney infection occurs in the absence of VUR. Some infants with intrauterine VUR and no history of UTI have impaired kidney function or hypertension secondary to renal hypoplasia or dysplasia.

The long-term consequences of urinary tract infections: a historic and contemporary perspective.

The long-term adverse consequences of UTI in childhood are hypertension, impaired renal function, end-stage renal disease, and complications during pregnancy. These adverse effects of UTIs are a result of renal parenchymal damage. Currently, these complications are unusual among patients in industrialized countries, unless kidney damage is present at birth. VUR, the most common abnormality encountered in infants and young children with UTIs, is not a diagnostic entity, but reflects a spectrum of underlying conditions. There may be nonobstructive VUR with no other urinary tract abnormality. VUR may be associated with voiding dysfunction and frequent UTIs. It may be present with bladder outlet obstruction, hydronephrosis, and intrauterine renal damage. Children with intrauterine renal damage are those most likely to develop hypertension and those at greatest risk for progression to end-stage renal disease. Acquired renal injury as a cause of adverse long-term consequences due to UTI is much less common than it was early in this century, probably as a result of improved health care.

URINARY TRACT INFECTION IN THE IMMUNOCOMPROMISED HOST: Lessons from Kidney Transplantation and the AIDS Epidemic

The occurrence of urinary tract infection and its clinical impact is determined, as with any infectious disease, by the interaction between the virulence of the infecting organism and the host defense mechanisms that can be mobilized. In the case of urinary tract infections, an anatomically and functionally intact kidney and urinary tract are the primary host defenses, with phagocytic function and immune mechanisms coming into play to limit the consequences of those infections. Of all the categories of immunocompromised hosts, the renal transplant patient is the one most susceptible to the direct and indirect consequences of urinary tract infections. In the first 3 months post transplant, the incidence of urinary tract infection is greater than 30%, and there is a relatively high rate of bacteremia and overt pyelonephritis of the allograft. After this time period, unless anatomic or functional derangement of the urinary tract is present, the direct clinical manifestations are far more benign. In addition to the direct effects of urinary tract infection on these patients, indirect effects are also important. These include the activation of CMV by TNF released as a consequence of a urinary tract infection and the initiation of allograft injury. Fortunately, low-dose trimethoprim-sulfamethoxazole or fluoroquinolones are safe and effective prophylactic strategies for preventing the direct and indirect consequences of urinary tract infections. Although the pathogenetic mechanisms are incompletely understood, data are emerging that AIDS patients have both an increased incidence and severity of urinary tract infection. The risk for urinary tract infections seem to be correlated with the degree of immune compromise and, perhaps, the amount of malnutrition and wasting that are present. The best strategies for preventing urosepsis in AIDS patients remain to be defined.

Feline matrix‐crystalline urethral plugs: A unifying hypothesis of causes

ABSTRACTThe hypothesis is advanced that various combinations of aetiologically different events may lead to three different, but common, clinical manifestations of feline lower urinary tract disease. One manifestation, characterised by nonobstructive haematuria, dysuria, pollakiuria, and increased production of proteinaceous and cellular inflammatory reactions occurs as a consequence of urinary tract infections with viruses and occasionally other infectious agents. A second manifestation is that of classical urolithiasis, which occurs in response to oversaturation of urine with different types of calculogenic substances. Naturally occurring feline uroliths containing magnesium ammonium phosphate, calcium oxalate, ammonium urate, calcium phosphate, cystine and xanthine have been observed. A third manifestation, resulting from the concomitant occurrence of urinary tract infections and various types of urine crystals, is characterised by formation of matrix‐crystalline plugs that may obstruct the urethra, especially of male cats. Preliminary data suggest that urethral plug matrix contains Tamm‐Horsfall mucoprotein, similar to that observed involved in the formation of renal tubular casts.

Use of Antimicrobials for Patients Undergoing Prostatectomy

Our suggestions for the use of antimicrobials in patients undergoing prostatectomy are summarized in Table 2. The use of antimicrobial prophylaxis perioperatively for patients without bacteriuria remains controversial. Some authors recommend and others do not recommend antimicrobial prophylaxis. We do not recommend perioperative prophylaxis for low-risk patients without previous urinary tract infections or an indwelling urethral catheter. We do recommend that patients with risk factors that increase the rate or consequence of urinary tract infection, those with previous urinary tract infections, or those with indwelling urethral catheters, even though the urine shows no growth, receive perioperative antimicrobial prophylaxis. Antimicrobial therapy is mandatory for patients with preoperative bacteriuria. The drug must be selected according to the susceptibility of the pathogen, and the duration of treatment must be guided by the severity of the infection. At the time of catheter removal, antimicrobial prophylaxis is probably beneficial, and antimicrobial therapy is essential if bacteriuria is present prior to catheter removal. All patients must have cultures after catheter removal and antimicrobial therapy if a urinary tract infection is identified.

Host-Parasite Interaction in the Urinary Tract

The term urinary tract infection (UTI) describes a heterogeneous group of disorders localized to the urinary tract [1]. Bacteriuria may be associated with clinical conditions of varying severity and consequence. The analysis of these conditions may be based on several factors. (7) The site of infection: the localization of bacteria to the kidneys can be determined (e.g., by urethral catheterization or bladder wash-out) or implied by a decrease in renal function (e.g., the renal concentrating capacity) [1-3]. (2) The severity of the host response to bacteriuria: the response may be systemic (involving sites distant to the urinary tract, as shown by the elevation of body temperature and circulating acute-phase reactants) and/or local to the urinary tract (as shown by leukocyte excretion) [4, 5]. (3) The consequences of UTI: these include recurrences of UTI and renal scars (which may or may not have consequences for renal function) [6,7] and end-stage renal disease. The link between UTI and renal failure remains, however, undefined. The complexity of UTI has contributed to its usefulness as a model system for studies of pathogenesis. The changes induced in the host by bacteria that enter this normally sterile site may be used to assess determinants of bacterial virulence and host resistance. This approach has provided new insights into the molecular mechanisms that determine the disease process [8].