Early Urinary Tract Infection Research Articles

Effectiveness of a Combination of Nasturtium Herb and Horseradish Root (Angocin®Anti-Infekt N) Compared to Antibiotics in Managing Acute and Recurrent Urinary Tract Infections: A Retrospective Real-world Cohort Study.

The goal of this study was to evaluate whether the medical recommendation of Angocin®Anti-Infekt N, compared to standard antibiotic treatment shortly after the diagnosis of a urinary tract infection (UTI) or cystitis, is negatively associated with an early, sporadic, or recurrent UTI, subsequent antibiotic prescriptions, pyelonephritis as a renal complication, or UTI-associated sick leave. This retrospective cohort study was based on data from the IQVIATM Disease Analyzer database and included patients diagnosed with acute UTI or cystitis by physicians in Germany between 2005 and 2021, who were prescribed either Angocin® or standard antibiotics within 4 days after diagnosis. Patients prescribed antibiotics were matched to those prescribed Angocin® (5:1) using propensity scores. Univariable logistic and Cox regression models were used to investigate the association between Angocin® prescription and the defined study outcomes. The effects of Angocin® were adjusted for age, sex, insurance status, index diagnosis, and physician specialty. A total of 2277 Angocin® patients and 11,385 antibiotic patients were available for analysis. Compared to antibiotic prescriptions, Angocin® prescription was associated with significantly lower odds of an early relapse within 1-30 days after the index date (odds ratio (OR): 0.74; 95% confidence interval (CI): 0.62-0.87; p < 0.001), further sporadic UTI within 31-365 days after the index date (OR: 0.68; 95% CI: 0.58-0.78; p < 0.001), and recurrent UTI (OR: 0.63; 95% CI: 0.48-0.82; p < 0.001). This was also accompanied by reduced antibiotic prescriptions (1-30 days: OR: 0.63; 95% CI: 0.53-0.74, p < 0.001; 31-365 days: OR: 0.56; 95% CI: 0.49-0.64, p < 0.001). A strong, but due to the low incidence, not significant, negative association was observed between Angocin® prescription and the occurrence of pyelonephritis (hazard ratio (HR): 0.67; 95% CI: 0.43-1.06; p = 0.073). The results of this real-world data study demonstrate that Angocin® can be an effective therapeutic option for managing acute and recurrent UTIs and serves as an alternative therapy to antibiotics.

Cumulative rabbit anti-human thymocyte globulin dose to recipient weight during the peri-operative period is an independent risk factor for early postoperative urinary tract infection after kidney transplantation

Anti-human thymocyte globulin-Fresenius (ATG-F) is frequently utilized to achieve successful induction for kidney transplantation recipients. This study aimed to examine the association between the ATG-F dose-to-recipient-weight ratio (ADR) and the risk of developing urinary tract infections (UTIs) following kidney transplantation. Data of kidney transplant recipients who underwent ATG-F-induction peri-operatively in a medical center were retrospectively collected, and the incidence of UTIs during the first postoperative year was also recorded. The risk of UTI associated with ADR was analyzed, and receiver operating characteristic curves were drawn to determine the optimal ADR, followed by Cox regression models. In total, 131 recipients were included, with an UTI incidence of 19.08% and a mean interval of 3.08 months. The optimal ADR was 6.34, involving 41 and 90 patients in the low ADR and high ADR groups, respectively. The UTI-free rate in the low ADR group was significantly higher than that in the high ADR group (p = 0.007). Cox regression analysis indicated that a high ADR independently increased the risk of UTI following kidney transplantation (hazard ratio: 5.306, 95% confidence interval: 1.243–22.660, p = 0.024). There was no significant difference in rejection rate between the high ADR and low ADR groups. In conclusion, a high ADR increased the incidence of early postoperative UTI among kidney transplant recipients.

Chromogenic versus Conventional: A Comparative Analysis for Uropathogen Detection in Paediatrics at a Tertiary Centre

Abstract Background: Urinary tract infections (UTIs) are a common bacterial infection in children, often presenting with non-specific symptoms such as undiagnosed fever and gastrointestinal issues. Early detection and treatment are essential to reduce morbidity and mortality. Aims: This study aimed to compare conventional culture media with chromogenic culture methods for detecting uropathogens and to identify the causative pathogens in pediatric patients at a tertiary care hospital. Patients and Methods: The study was conducted over 18 months in the department of microbiology at a tertiary care hospital, involving 400 pediatric patients who met the inclusion and exclusion criteria. Urine samples were collected and promptly processed, then inoculated on various media, including blood agar, MacConkey agar, cysteine lactose electrolyte deficient agar, and UTI chromogenic agar. Bacterial isolates were identified using standard bacteriological techniques, and their antimicrobial susceptibility was determined using the Kirby–Bauer disk diffusion method. Results: Escherichia coli was the most prevalent Gram-negative organism detected on both conventional and UTI chromogenic agar. UTI chromogenic agar showed greater efficiency in isolating and presumptively identifying uropathogens. E. coli isolates demonstrated high susceptibility to key antimicrobial agents. Enterococcus spp. were completely sensitive to vancomycin and linezolid, while nitrofurantoin was effective in 57.14% of cases. Conclusion: UTI chromogenic agar is an effective alternative to conventional media, offering advantages in isolating and presumptively identifying uropathogens. Its enhanced sensitivity, particularly for Gram-positive cocci like Enterococcus spp. in mixed cultures, provides valuable support to clinicians for early UTI diagnosis and treatment decisions.

FIRE Stones: impact of forced diuresis on the residual fragment rate after flexible ureteroscopy for destruction of kidney stones with laser—protocol for a randomized controlled two-parallel group multicenter trial with blinding evaluation

BackgroundLithiasis is a common and recurrent disease. Flexible ureteroscopy (fURS) is the cornerstone of laser treatment of kidney stones. Kidney stones destruction requires its laser pulverization into small fragments in order to remove them through the ureter or improve their spontaneous expulsion along the urinary tract. However, most of the time, all the micro-fragments and dust created cannot be extracted using our surgical tools and may stay intra-renally at the end of the procedure. Adjuvant treatments (such as forced diuresis, inversion or mechanical pressure) were previously described to improve the expulsion of stone fragments after extra-corporeal shock wave lithotripsy. Nevertheless, the impact of adjuvant treatment after fURS remains unclear and mainly theoretical.ObjectiveThe primary objective is to show that the injection of 40 mg of furosemide in slow intravenous during 10 min, after the procedure, increases the stone-free rate 3 months after a fURS for destruction of kidney stones with laser.Methods/designThe study will be a two-parallel group randomized, controlled, multicentric trial with a blinding evaluation. Nine French departments of urology will participate. Patients will be randomized in 2 groups: the experimental group (injection of 40 mg of furosemide at the end of the surgery) and a control one (usual care). Patients will be followed up for 3 months (± 2 weeks) after the surgery. Then, we will perform a low dose abdomino-pelvic CT scan. The primary outcome is the stone-free rate at 3 months. A centralized review of the images will be performed by two specialized radiologists, in a blind and crossed way to allow a homogenization of the results. The secondary outcomes will include the rate of early post-operative urinary tract infection (UTI), the evaluation of post-operative pain, and the safety of the use of furosemide in patients treated by fURS for renal stone laser destruction. As secondary objectives, it is also planned to look at the effect of the prescription of an alpha-blocker as usual treatment on stone-free rate and to assess the agreement between the imaging analysis of the urologist and the specialized radiologist.DiscussionLithiasis is a public health problem. It affects about 10% of the general population. This prevalence is increasing (multiplied by 3 in 40 years), partly due to changes in the population’s eating habits over the years. The lithiasis patient is a patient with a chronic disease requiring annual follow-up and who may suffer from multiple recurrences, with a recurrence rate at 5 years of 50%.Recurrences are partly due to residual fragments left in the kidneys at the end of the operation. Other risk factors for recurrence include dietary hygiene and the presence of an associated metabolic disease. The metabolic blood and urine tests recommended by the Association Française d’Urologie (AFU) can be used to manage these last two problems.As far as residual fragments are concerned, their presence leads to an early recurrence of stones because they form the bed for a new aggregation of crystals in the kidneys. Being able to reduce the rate of residual fragments in patients with the use of furosemide at the end of the intervention therefore seems essential in the management of recurrences in our patients. This will also improve our patients’ quality of life.Indeed, lithiasis disease leads to chronic pain associated with acute pain that motivates consultations to the emergency for specialized management. This study is the first to evaluate the impact of forced diuresis with the use of furosemide on the stone-free rate after a fURS for destruction of kidney stone with laser.Trial registrationClinicalTrials.gov Identifier: NCT05916963, first received: 22 June 2023.EU Clinical Trials Register EudraCT Number: 2022-502890-40-00.

Clinical and Economic Burden of Early Urinary Tract Infection in Kidney Transplant Recipients

Clinical and Economic Burden of Early Urinary Tract Infection in Kidney Transplant Recipients

Optimizing practices to prevent urinary tractinfection after cystoscopy and urodynamics in women: A quality improvement study.

The objective of this study was to reduce the incidence of urinary tract infection (UTI) in women undergoing outpatient cystoscopy and/or urodynamic studies (UDS) at our centre by identifying and then altering modifiable risk factors through an analysis of incidence variability among physicians. This was a quality improvement study involving adult women undergoing outpatient cystoscopy and/or UDS at an academic tertiary urogynecology practice. Prophylactic practices for cystoscopy/UDS were surveyed and division and physician-specific UTI rates following cystoscopy/UDS were established. In consultation with key stakeholders, this delineated change concepts based on associations between prophylactic practices and UTI incidence, which were then implemented while monitoring counterbalance measures. Two "Plan-Do-Study-Act-Cycles" were conducted whereby 212 and 210 women were recruited, respectively. Change concepts developed and implemented were: (1) to perform routine urine cultures at the time of these outpatient procedures, and (2) to withhold routine prophylactic antibiotics for outpatient cystoscopy/UDS, except in patients with signs of cystitis. There was no change in the incidence of early presenting UTI (9.0% vs. 9.2%, p = 0.680), but there were significantly fewer antibiotic-related adverse events reported (8.5% vs. 1.5%, p = 0.001). There was no significant change in the total incidence of UTI rates between cycles (7.8% vs. 5.6%, p = 0.649). No specific strategies to decrease the incidence of UTI following outpatient cystoscopy/UDS were identified, however, risk factor-specific antibiotic prophylaxis, as opposed to universal antibiotic prophylaxis, did not increase UTI incidence.

Prevalence and Predictive Factors of Urinary Tract Infection in Kidney Transplant Recipients: A 10-Year Study.

Urinary tract infections are the main infectious complications among kidney transplant recipients and are considered as a potential risk factor for poor graft outcomes. However, the risk factors of urinary tract infections are controversial. The purpose of our study was to estimate the incidence and predisposing factors of urinary tract infections in patients undergoing kidney transplant in our teaching hospital of Sahloul, Tunisia. We retrospectively analyzed the charts of 141 consecutive adult kidney transplants that were performed at the Department of Nephrology, University Hospital of Sahloul, Tunisia, between January 2007 and April 2016. Of 141 patients, 72 (51.1%) had urinary tract infections after kidney transplant. Mean age was 32.54 ± 12.1 years; 47.6% were male patients, and 52.4% were female patients. The average time between transplant and early urinary tract infections was 11 days (range, 1-30 days). Among our patient group, 87.8% of urinary tract infections occurred within the first 6 months posttransplant. We collected 205 episodes of urinary tract infections: 66.3% were asymptomatic bacteriuria, 10.2% acute cystitis, and 23.4% pyelonephritis. The estimated risk factors for urinary tract infection included only female sex (P < .05); older age (P = .32), longer duration of catheter (P = .34), and high body mass index (P = .46) were not correlated with urinary tract infection. Despite preventive measures, urinary tract infections remain an important cause of morbidity among kidney transplant recipients. In fact, more than half of kidney transplant recipients had at least 1 urinary tract infection after surgery. Female sex was statistically associated with higher risk of urinary tract infection.

Validation of quantitative loop-mediated isothermal amplification assay using a fluorescent distance-based paper device for detection of Escherichia coli in urine

Uropathogenic Escherichia coli (UPEC) causes up to 90% of urinary tract infections (UTI) which is more prevalent among females than males. In urine, patients with symptomatic UTI usually have a high concentration of bacterial infection, ≥ 105 colony-forming units (CFU) per mL, in which the culture method is regularly the gold standard diagnosis. In this study, a simple and inexpensive distance-based paper device (dPAD) combined with the fluorescent closed tube LAMP assay was validated for simultaneously screening and semi-quantifying the infection level of E. coli in 440 urine samples of patients with UTI. The dPAD could measure the LAMP amplicons and semi-quantify the levels of E. coli infection in heavy (≥ 104 CFU/mL), light (≤ 103 CFU/mL) and no infection. The sensitivity and specificity had reliable performances, achieving as high as 100 and 92.7%, respectively. The one step LAMP assay could be performed within 3 h, which was 7.5 times faster than the culture method. To empower early UTI diagnosis and fast treatment, this inexpensive dPAD tool combined with the fluorescent closed tube LAMP assay is simple, reliably fast and practically portable for point-of-care settings, particularly in resource-limited areas, which can be set up in all levels of healthcare facilities.

Predictors of postoperative urinary tract infection following holmium laser enucleation of the prostate.

Storage urinary symptoms and urinary tract infection (UTI) are among the most common complications following holmium laser enucleation of the prostate (HoLEP). We aimed to study the incidence and risk factors for storage urinary symptoms and early UTI following HoLEP. A prospectively maintained database was reviewed for patients who underwent HoLEP over a five-year period at a single tertiary center. Patient demographics, preoperative, operative, and postoperative characteristics, as well as infection rates, were obtained and analyzed using the appropriate statistical methods. Of a total 514 patients who underwent HoLEP, 473 patients with complete followup data were included. Mean (± standard deviation) age and median (interquartile range) prostate volume were 72±9.1 years and 89 (68-126) g, respectively. Preoperative positive urine culture and urine retention were seen in 28.5% (n=135) and 23.46 % (n=111) of patients, respectively. At six-week followup, irritative urinary symptoms were seen in 32.3% (n=153) of patients, while 13.5% (n= 64) of patients had positive urine culture. Bivariate and multivariate analysis showed that factors associated with significant higher rate of postoperative UTI at six weeks were high body mass index (BMI) (p= 0.023), weak grip strength within preoperative frailty assessment (p=0.042), positive preoperative urine culture (p=0.025), and postoperative incontinence (p=0.002). Storage urinary symptoms are common complaints post-HoLEP; however, it may be caused by an inflammatory rather than infective process in a significant percentage of patients. Possible predictors of UTI after HoLEP are high BMI, preoperative positive urine culture, higher frailty scale, and postoperative urinary incontinence.

MP51-20 PREDICTORS OF URINARY TRACT INFECTION POST-HOLMIUM LASER ENUCLEATION OF PROSTATE (HOLEP)

You have accessJournal of UrologyCME1 Apr 2023MP51-20 PREDICTORS OF URINARY TRACT INFECTION POST-HOLMIUM LASER ENUCLEATION OF PROSTATE (HOLEP) Mohamed Elsaqa, Katherine Dowd, Amr Elmekresh, and Marawan M. El Tayeb Mohamed ElsaqaMohamed Elsaqa More articles by this author , Katherine DowdKatherine Dowd More articles by this author , Amr ElmekreshAmr Elmekresh More articles by this author , and Marawan M. El TayebMarawan M. El Tayeb More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003299.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Irritative urinary symptoms and urinary tract infection (UTI) are among the most common complications following Holmium Laser Enucleation of Prostate (HoLEP). We aimed to study the incidence and risk factors for early irritative urinary symptoms and postoperative UTI post-HoLEP. METHODS: A maintained HoLEP database of over 5 years at our institution was reviewed. Patients' demographics, perioperative characteristics, post-operative irritative symptoms, and UTI rates (defined by irritative symptoms with positive urine culture) were analyzed. RESULTS: Total 473 patients with complete follow-up data were included. Tables 1 and 2 show the baseline and postoperative data of included patients respectively. Preoperative positive urine culture and urine retention were seen in 128 (27%) and 111 (23.4%) patients respectively. At 6-week follow-up, irritative urinary symptoms were reported by 153 (32.3%) patients, while urine culture was positive in only 64 (13.5%) patients. Multivariate analysis showed that high body mass index (BMI) (HR=2.02; CI=1.36-2.58, p=0.023), weak grip strength within preoperative frailty assessment (HR=1.36; CI=1.06-2.13, p=0.042), preoperative positive urine culture (HR=1.92; CI=1.3-3.38, p=0.025) and postoperative incontinence (HR=2.82; CI=1.8-5.67, p=0.002) were associated with statistically significant risk of positive urine within 1st 6 weeks post-HoLEP. CONCLUSIONS: Irritative urinary symptoms are common complaints post-HoLEP; however, it may be caused by inflammatory rather than infective process in significant percentage of patients. Irritative Symptoms can be associated with over-treatment with empirical antibiotics. Possible predictors of early UTI post-HoLEP are high BMI, preoperative positive urine culture, higher frailty scale, and postoperative urinary incontinence. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e701 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mohamed Elsaqa More articles by this author Katherine Dowd More articles by this author Amr Elmekresh More articles by this author Marawan M. El Tayeb More articles by this author Expand All Advertisement PDF downloadLoading ...

Infantile colic patients' rates of urinary tract infections at Khyber Teaching Hospital in Peshawar, Pakistan

Background: Urinary tract infections (UTIs), which impact 8% of girls and 2% of boys by age seven and have a repeat rate of 10% to 30%, are common in infants and young children. Infantile colic is a very difficult condition for parents to manage. Objective: To discover the prevalence of uti among patients who appear with neonatal distress Study design: A Prospective observational cohort study. Place and duration of study. Department of Paediatrics, Khyber teaching Hospital, Peshawar, from 01 January to 01 august 2019 Material And Methods: 126 male and female painful babies participated in the research. Khyber Teaching Hospital's paediatrics division, Peshawar. Duration: from January 1, 2020, to August 1, 2019, inclusive. Each infant had two clear middle pee samples collected two hours apart to be tested for UTIs. The UTI was considered positive if the child had a history of temperature &gt;99 °F, dysuria, and more than five WBC per HPF or &gt;10 4 CFU/HPF on pee culture. Results: Children in this research ranged in age from 6 weeks to 6 months, with a mean age, weight, and height of 3.1501.42 months, 4.9790.82 kg, and 56.6503.08 cm, respectively. Men made up the overwhelming bulk of the cases. (69.8 per cent). 61.1 per cent of mothers breastfed their babies, while 38.9 per cent used bottles to nurse them. The prevalence of urinary tract infections among individuals was 8.7%. Conclusion: The frequency of UTI among babies who appear with diarrhoea is 8.7%, it can be inferred. This research emphasises the value of early newborn UTI detection and therapy and the requirement for preventative steps to lower the risk of UTI in this group. Keywords: frequency, Infantile colic, urinary tract infection

Recurrent Urinary Tract Infection in Living Donor Renal Transplant Recipients and the Role of Behavioral Education Program in Management: A Single-Center Experience

Urinary tract infections (UTIs) are the most prevalent type of kidney transplant (KT) recipients. We aimed to investigate the incidence, causes, and clinical impact of early recurrent UTI post-living donor KT and to examine the role of behavioral education program in management. This retrospective cohort chart-review study included all KT recipients with recurrent UTI necessitating hospital admission between September 2017 and August 2021. All patients with recurrent UTI were subjected to behavioral education for a month. UTI was found in 14 of 145 patients (9.6%), with recurrent UTI in 11 (7.6%). A total of 93% of UTIs occurred during the first 6 months post-transplant and represented 52% of KT readmissions during the same period. A total of 64.3% of patients were older than 50 years. The mean (SD) length of hospital stay was 5 (2.5) days, with an equal incidence in both sexes. The most common bacterial isolates in early recurrent UTI were Escherichia coli in 80.9%. Both Extended-spectrum beta-lactamases and multidrug-resistant organisms (resistance in ≥3 drugs) were seen in 82.4% of isolates. Furthermore, the most effective antibiotic was meropenem, with 86.7% effectiveness. A total of 65% of UTIs were managed with a single antibacterial course. A total of 64.3% of patients were older than 50 years. In patients who developed UTI, the mean (SD) serum creatinine was 1.31 (0.52) mg/dL, with a mean increase in serum creatinine of 0.19 mg/dL on having the episodes; at 1 year post-transplant, serum creatinine declined to 1.23 (0.43) mg/dL. Four patients (36%) had no recurrence of UTI after behavioral education. The multidrug-resistant bacterial isolates account for 82.4% of the UTIs. Therefore, antibiotic prescription should follow the antimicrobial stewardship guidelines. Behavioral education significantly reduced the incidence of recurrent UTI.

Reduction of early surgical site and other care related infections in 3553 hip fracture patients: lessons learned from the 5-year Safe Hands project

BackgroundSurgical site infection (SSI) after acute hip fracture surgery is a devastating complication associated with increased suffering and mortality. The aim of the study was to investigate early SSI, sepsis, pneumonia and urinary tract infections over five years, before and after the implementation of the Safe Hands project.MethodsThis was a single-centre observational study with a 5-year longitudinal design, investigating the effects of an infection-prevention intervention targeting the clinical care pathway of individuals with acute hip fracture. Statistical analyses were based on routinely collected patient outcome data comprising 3553 patients. The study conforms to the criteria of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE).ResultsThe incidence of early SSIs decreased from 2.5% in years 1–2 to 1.1% in years 4–5. Similar results were observed for sepsis (2.7% to 1.3%) and urinary tract infections (14.2% to 4.2%). The multivariable regression results suggest that, for every observed year, the odds of early SSIs decreased. Male gender, procedure time, sepsis and preoperative skin damage increased the odds significantly.ConclusionsOur preventive bundle, based on partnership between researchers, managers and clinicians and a strong commitment to change from the involved professions, appear to be effective in reducing the frequency of potentially devastating SSIs and other hospital acquired infections after hip fracture surgery. The use of external and internal facilitators was crucial to enable individual and organisational learning and overcoming barriers to improvements.Trial registration: Clinical Trials.gov ID: NCT02983136 Registered 6 December 2016—Retrospectively registered.

Early post-transplant urinary tract infection epidemiology and risk factor

Background and objectives: Renal Transplantation became the most successful management for end stage renal failure; postoperative urinary tract infection is the most common complication. The aim is to evaluate the outcome and risk factors of posttransplant urinary tract infection. Methods: This is a prospective study for renal transplant patients between 2018-2019 in Hawler/ Rizgary and Paky hospital. Patients, who underwent renal transplant, with 1 year follow up. Variable risk factors assessment done including chronic renal failure etiology, preoperative dialysis duration, operation time, length of drain and Foley’s catheter, type of immune suppressive therapy used, time and numbers of hospitalization associated with posttransplant urinary tract infection were examined, the relation between the risk factors and urinary tract infection was evaluated. Results: Total of 63 patients was involved, 12 had a total of 24 urinary tract infection attacks; the most common isolated microorganisms were E-coli and Klepsiella. The infection frequently appeared during the first 120 days postoperatively. Among the analyzed variables, there was no significant difference. Assessing all the variables, number of hospitalization after discharge were significantly more frequent in the 12 patients with infection attacks, although 31 patients out of 63 had hospitalized, as compared to patients without infection, but this difference was statistically insignificant. Conclusions: The most significant period for infection in renal transplanted patients after 1 year follow up is the first 4 months postoperatively. Patients who were admitted to hospital for different reasons and those who had preoperative history of urinary tract infection, have a higher risk.

The Role of Preoperative Urinalysis in Predicting Postoperative Infection After Retrograde Intrarenal Surgery in Patients with Sterile Urine Culture.

Postoperative urinary tract infection is the most common complication of retrograde intrarenal surgery, and no consensus has been obtained that would reveal exact reasons yet. It was aimed to determine the possible factors, especially preoperative urinalysis, of postoperative urinary tract infection after retrograde intrarenal surgery. Patients who underwent retrograde intrarenal surgery in our clinic between 2013 and 2019 were retrospectively screened. Stone size 2 cm and pediatric patients were excluded from the study. The patients were divided into 2 groups as those with and without urinary infections in the early postoperative period. Urine analysis parameters and sterile urine cultures that were taken before the procedure were also analyzed separately. A total of 289 patients meeting the defined criteria were included in the study. There was no statistical difference between the 2 groups in terms of demographics. The number of patients with previous urinary tract infection history (55% vs. 20.5%) and operation time (62.5 ± 16.6 minutes vs. 60 ± 19.4 minutes) were significantly higher in those who had postoperative early urinary tract infection. Among urinalysis, the presence of pyuria, leukocyte count, leukocyte esterase positivity, and nitrite positivity were significantly higher in those who had postoperative early urinary tract infection. In multivariate analysis, urinary tract infection history, operation time, and nitrite positivity were found as independent factors in predicting postoperative early urinary tract infection. Previous urinary tract infection history, prolonged operation time, and nitrite positivity in urinalysis were determined as independent risk factors for postoperative urinary tract infection in kidney stones between 1 and 2 cm.

Association between Hematology Indices as Early Markers and Urinary Tract Infection, Septicemia, Pneumonia, and Diabetic Foot Infection

Association between Hematology Indices as Early Markers and Urinary Tract Infection, Septicemia, Pneumonia, and Diabetic Foot Infection

Construction of a nursing solution to prevent and control urinary tract infection in the early stages of kidney transplantation.

BackgroundTo construct a nursing solution for the prevention and control of urinary tract infection (UTI) in the early stage after kidney transplantation, and to provide systematic and standardized nursing intervention measures for patients in the early stage after kidney transplantation.MethodsThe preliminary draft of intervention plan was formulated based on risk factor analysis research results of early UTI after kidney transplantation, combined with theoretical research, literature review, and research group meeting. The Delphi method was used to consult 15 experts for two rounds, and the entries were modified according to the opinions of the experts.ResultsAfter two rounds of consultation, the expert opinions tended to be consistent, and expert authority coefficient was 0.87. The Kendall harmony coefficient of importance and feasibility indexes of the two rounds of consultation were 0.407, 0.651 and 0.545, 0.686, respectively, with statistically significant differences (P<0.001). The nursing solution consisted of eight first-level indexes and 35 second-level indexes. The eight first-level indexes included admission symptom evaluation, UTI monitoring, health education, sports intervention, nutrition intervention, ward management, risk factor prevention and nursing, and psychosocial intervention.ConclusionsThis study constructed a scientific and reliable nursing solution for the prevention and control of early UTI after kidney transplantation, which is hugely important for guiding clinical nursing work.

SCREENING ASYMPTOMATIC URINARY TRACT INFECTION IN BOYS SCHOOL AGE IN TANJUNG JOHOR, PELAYANGAN, JAMBI

ABSTRACT&#x0D; &#x0D; Background: Urinary Tract Infection (UTI) is a common infection in children. Prompt diagnosis and appropriate treatment are very important to reduce the morbidity associated with this condition. Rapid screening with Urine dipstick is helpful for early detection urinary tract infection. The purpose of this study to identification urinary tract infection in school age boys.&#x0D; Method: this was a cross sectional study. The samples were boys in elementary school without urinary tract infection sign, with presumptive UTI criteria based on dipstick examination who had positive nitrit or positive leukocyte esterase or both of them. &#x0D; Result: There were 126 boys with mean age 8.3 years old (6-12 years old). Boy with presumtive UTI based on dipstick found in only one case (0.8%). Most of them were underwent circumcision (90/71.4%) and have good daily habit such as washing genital area after miction (108 / 85.7%) and hand washing (108/85.7%). &#x0D; Conclusion: the number of UTI cases in this study was very small, most of sample were underwent circumcision and they have good daily habit. &#x0D; &#x0D; Key word: dipstick, screening, UTI

Atypical Presentation of Bacteremic Urinary Tract Infection in Older Patients: Frequency and Prognostic Impact.

In older patients, urinary tract infection (UTI) often has an atypical clinical presentation, making its diagnosis difficult. We aimed to describe the clinical presentation in older inpatients with UTI-related bacteremia and to determine the prognostic impact of atypical presentation. This cohort study included all consecutive patients older than 75 years hospitalized in a university hospital in 2019 with a UTI-related gram-negative bacillus (GNB) bacteremia, defined by blood and urine cultures positive for the same GNB, and followed up for 90 days. Patients with typical symptoms of UTI were compared to patients with atypical forms. Among 3865 inpatients over 75 with GNB-positive urine culture over the inclusion period, 105 patients (2.7%) with bacteremic UTI were included (mean age 85.3 ± 5.9, 61.9% female). Among them, UTI symptoms were reported in only 38 patients (36.2%) and 44 patients (41.9%) had no fever on initial management. Initial diagnosis of UTI was made in only 58% of patient. Mortality at 90 days was 23.6%. After adjustment for confounders, hyperthermia (HR = 0.37; IC95 (0.14–0.97)) and early UTI diagnosis (HR = 0.35; IC95 (0.13–0.94)) were associated with lower mortality, while UTI symptoms were not associated with prognosis. In conclusion, only one third of older patients with UTI developing bacteremia had UTI symptoms. However, early UTI diagnosis was associated with better survival.

Urological Complications in Kidney Transplant Recipients: Analysis of the Risk Factors and Impact on Transplant Outcomes in the Era of “Extended Criteria Donors”

Urological complications (UC) following kidney transplantation (KT) are associated with increased morbidity. The aim of this study is to evaluate the risk factors for UC in the era of “extended criteria donors” (ECD) and their impact on patient and graft survivals. A retrospective monocentric study of all patients undergoing KT from 2010 to 2019 with a follow-up ≥30 days was performed. Out of 459 patients (males: 296 (64.5%); age: 57 (19–77) years) enrolled, 228 (49.7%) received ECD organs, moreover, 166 (67.2%) grafts had a cold ischemia time ≥10 h. UCs were reported in 32 (7%) patients. In 21 (65.6%) cases UC occurred within 3 months post-KT and 24 (5.2%) were associated with early urinary tract infection (UTI). The overall 5 year patient and graft survival rates were 96.5% and 90.6%, respectively. UC decreased graft survival (UC-group: 75.0% vs. noUC-group: 91.8%, p &lt; 0.001), especially if associated with early UTI (UC-group: 71.4% vs. noUC-group: 77.8%, p &lt; 0.001). At multivariate analysis, early UTI after KT (OR: 9.975, 95%-IC: 2.934–33.909, p &lt; 0.001) and delayed graft function (DGF) (OR: 3.844, 95%-IC: 1.328–11.131, p: 0.013) were significant risk factors for UC, while ECD graft did not increase the risk of post-transplant UC. ECD grafts are not associated with UC. DGF and early UTI post-KT increase the risks of UC and reduce graft survival in the long-term. Therefore, aggressive management of early post-transplant UTI and strategies to reduce DGF incidence, such as machine preservation, are essential to prevent UC after KT.