Positive Esterase Research Articles

Analysis of the Spectrum of Common Pathogens and the Resistance of Mycoplasma in Sialidase-Positive Bacterial Vaginosis.

The objective of this study is to understand the characteristics of the common spectrum of pathogen and the resistance of Mycoplasma in Sialidase-positive bacterial vaginosis. The vaginal secretion specimens collected from August 2018 to October 2018 for the analysis of bacterial vaginosis (BV) were subjected to various techniques. These included routine leukorrhea examination, bacterial vaginosis sialidase testing, routine culture for common pathogens, mass spectrometry identification, and Mycoplasma resistance testing. A total of 238 patients with BV were identified. The cleanliness grading was mostly clean (+) and clean (2+), accounting for 38.24% and 30.67%, respectively. The bacterial vaginosis test for vaginal secretions showed leukocyte esterase positivity in 220 cases, resulting in a positivity rate of 92.44%. The spectrum of routine culture was analyzed and divided into four groups: A, B, C, and D. Group A consisted of Candidal vaginitis (13.45%); group B consisted of Gardnerella vaginalis vaginitis (32.77%); group C consisted of gram-negative bacillus vaginitis (46.22%); and group D consisted of Streptococcus agalactiae vaginitis (7.56%). The identification and antimicrobial susceptibility testing results for Mycoplasma showed a high detection rate of BV, with a positivity rate of 86.13%. There was a high sensitivity to tetracyclines for Ureaplasma urealyticum and Mycoplasma hominis, but a high resistance to macrolides and quinolones. Bacterial vaginosis existed in various complex forms, including Candida, Gardnerella vaginalis, Gram-negative bacillus, and Streptococcus agalactiae types. Moreover, there was an increasing trend of multi-drug resistance in Mycoplasma hominis. Therefore, it is crucial to pay attention to this condition and make accurate judgments based on the etiological characteristics and common antimicrobial susceptibility tests. This will enable the implementation of effective therapeutic interventions.

Effect of Vaginal Microecological Alterations on Female Pelvic Organ Prolapse

Introduction and HypothesisThe objective was to investigate the correlation between endogenous vaginal microecological alterations and female pelvic organ prolapse (POP).MethodsPatients who underwent vaginal hysterectomy were retrospectively analyzed as the POP group (n = 30) and the non-POP group (n = 30). The vaginal microbial metabolites and enzyme levels were tested using the dry chemoenzymatic method. The mRNA and protein expression were tested using real-time quantitative PCR and immunohistochemistry. SPSS version 25.0 and GraphPad Prism 8.0 were performed for statistical analysis.ResultsCompared with the non-POP group, the vaginal pH, H2O2 positivity and leukocyte esterase positivity were higher in patients with POP (all p < 0.05). Further analysis showed that patients with pelvic organ prolapse quantification (POP-Q) stage IV had higher rates of vaginal pH, H2O2 positivity and leukocyte esterase positivity than those with POP-Q stage III. Additionally, the mRNA expression of decorin (DCN), transforming growth factor beta 1 (TGF-β1), and matrix metalloproteinase-3 (MMP-3) in uterosacral ligament tissues were higher, whereas collagen I and III were lower. Similarly, the positive expression of MMP-3 in uterosacral ligament tissue was significantly upregulated in the POP group compared with the non-POP group (p = 0.035), whereas collagen I (p = 0.004) and collagen III (p = 0.019) in uterosacral ligament tissue were significantly downregulated in the POP group. Correlation analysis revealed that there was a significant correlation between vaginal microecology and collagen metabolism. In addition, MMP-3 correlated negatively with collagen I and collagen III (p = 0.002, r = −0.533; p = 0.002, r = −0.534 respectively), whereas collagen I correlated positively with collagen III (p = 0.001, r = 0.578).ConclusionsVaginal microecological dysbiosis affects the occurrence of female POP, which could be considered a novel therapeutic option.

Saprochaete/Magnusiomyces: identification, virulence factors, and antifungal susceptibility of a challenging rare yeast.

Saprochaete/Magnusiomyces is among rare yeasts which might emerge as causes of breakthrough infections and nosocomial outbreaks. Identification to the species level might be a challenge in clinical laboratories. Data on virulence factors are scarce and antifungal susceptibility testing methodology is not definite. The aim of this study was to confirm species identification of clinical Saprochaete/Magnusiomyces isolates, find out their virulence factors, and obtain antifungal minimum inhibitory concentrations with two reference methods. Of the 57 isolates included, 54 were Saprochaete capitata and four were Saprochaete clavata as identified by ID32C, MALDI-TOF MS, and sequencing. When tested using phenotypic methods, all isolates were negative for coagulase, hemolysis, acid proteinase, and phospholipase, 56.1% were positive for esterase, and 19.3% had intermediate surface hydrophobicity. All isolates formed biofilms, with 40.4% of the isolates producing more biomass than biofilm-positive reference strain Candida albicans MYA-274. Antifungal susceptibility testing needed an adjusted spectrophotometric inoculum than recommended in reference methods for Candida/Cryptococcus. In conclusion, Saprochaete/Magnusiomyces species could be identified using methods available in the clinical laboratories. Despite the disadvantages of the phenotypic methods, esterase positivity was observed for the first time. A high biomass production was observed in biofilms. The need for standardization of antifungal susceptibility testing was brought to attention.

Correlations between C-myc expression, BMI-1 expression, and vaginal microecology with HPV-DNA load in patients with different cervical lesions.

To investigate the correlations between the expressions of proto-oncogenes C-myc and B-cell-specific Moloney leukemia virus integration site-1 (BMI-1), vaginal microecology, and human papillomavirus-DNA (HPV-DNA) load in patients with different cervical lesions. A total of 51 patients with cervix squamous cell carcinoma (CSCC), 72 patients with cervical intraepithelial neoplasia (CIN) and 50 patients with normal cervix (NC) who were diagnosed or admitted between Jan. 1st 2020 and Dec. 31st 2022 at the Suzhou Hospital of Integrated Traditional Chinese and Western Medicine were selected and divided into three groups, i.e., the CSCC group, the CIN group and the NC group, for a retrospective analysis. Hybrid capture 2 (hc2) was used to detect the HPV-DNA load in each group. Immunohistochemistry was performed to detect C-myc and BMI-1 expressions in each group. The indicators of vaginal microecology in patients were compared among groups to analyze the correlations between C-myc, BMI-1 expressions, vaginal microecology and HPV-DNA load. The HPV-DNA load and expression levels of positive C-myc and BMI-1 in the CSCC group were all higher than those of the CIN and NC groups (P<0.05). The detection rate of lactobacillus in the CSCC group was lower than that of the CIN and NC groups. The percentages of leukocyte esterase (LE) positivity and pH ≥4.6 were higher in the CSCC group than those in the CIN and NC groups (P<0.05). The difference in the detection rate of spores among the three groups was not significant (P>0.05). Both C-myc and BMI-1 scores were positively correlated with HPV-DNA load in the 173 samples. The proto-oncogenes C-myc and BMI-1 were highly expressed in the cervical tissues of CIN and CSCC patients, whose vaginal microecology was also altered. Both may play an important role in the progression of cervical lesions.

Correlation of Leukocyte Esterase Positivity Levels Against the Results of Several Examination Parameters Laboratory Urinary Tract Infection in Patients at Mataram City Regional Hospital

Background : Urinary tract infection (UTI) is caused by the multiplication of bacteria in the urinary tract. The standard proving procedures for UTI are urine culture examination and urine dipstick examination (leukocyte esterase and nitrite). Objective : This study aims to measure leukocyte and nitrite values, calculate the total number of bacteria, identify Gram type, species and antibiotic sensitivity and analyze the correlation of leukocyte esterase positivity to the results of several UTI examination parameters. Research Methods : The method used is an analytic observational design with cross sectional design using primary data and analyzed with the Spearman rank test. Results : The results showed that in 198 patients with suspected UTI, 123 (62%) were positive for leukocyte esterase, 16 (8.1%) were positive for nitrite. The total number of bacterial countshowed 82 people (41%) with bacteriuria ≥10 5 CFU/mL. Found 61 Gram-negative bacilli and 21 Gram-positive cocci with 21 different bacterial species. Antibiotic sensitivity test showed 51% sensitive, 6% intermediate and 43% resistant. Correlation of leukocyte esterase with nitrites (p 0.023&lt;0.05), total bacteria count (p 0.00&lt;0.05), Gram negative bacilli (p 0.00&lt;0.05), and Gram positive cocci (p 0.533&gt;0.05), antibiotic sensitivity test (p 0.794 &gt;0.05) and bacterial species (p 0.316&gt;0.05). Conclusion : The results showed that there was a correlation between the level of positivity of leukocyte esterase and nitrite, total bacteria count and Gram-negative bacilli, but there was no correlation between Gram-positive cocci, bacterial species and antibiotic sensitivity tests.

Frequency of Urinary Tract Infection and its Relationship with Disease Severity in Patients with Behçet’s Disease

Background: The role of infections in the etiopathogenesis of Behçet’s Disease has been mentioned, but there is no study in the literature on the frequency of Urinary Tract Infections in Behçet’s Disease.&#x0D; Objective: The purpose of the present study was to investigate the frequency of Urinary Tract Infections and its relationship with disease severity in patients who had Behçet’s Disease.&#x0D; Methods: The study had a retrospective cross-sectional design. A total of 113 Behçet’s Disease patients were included in the study. The files of the patients were reviewed and their symptoms as of the date of admission and the results of total urine analysis and urine culture performed in line with this date were recorded. The frequency of urinary system infections and its relationship with disease severity were examined.&#x0D; Results: A total of 113 Behçet’s Disease patients who had a median age of 38 (IQR: 29 - 47) and 74.3% (n=84) women were evaluated in the present study. Urinary tract infection was defined in 8.8% (n=10) of the patients. Escherichia coli was identified as the causative microorganism in 90% (n=9) and Klebsiella spp. in 10% (n=1) of patients who had Urinary Tract Infections. Behçet’s Disease patients who had Urinary Tract Infections were older and Urinary Tract Infections were more common in those with longer disease duration (p=0.001 and p=0.005, respectively). No statistically significant relationship was detected between the severity of Behçet’s Disease and the presence of urinary system infections (p&gt;0.05). Dysuria and pyuria were detected more frequently in Behçet’s Disease patients who had positive pathergy test results and no Urinary Tract Infections (p=0.007, p=0.038, respectively). Leukocyte esterase positivity was detected more frequently in Behçet’s Disease patients who did not have urinary infections but had genital ulcers (p=0.039).&#x0D; Conclusion: Urinary system infection was detected in 8.8% (n=10) of Behçet’s Disease patients. Although no relationship was found between the severity of the disease and urinary system infection in the present study, we think that patients who have Urinary Tract Infections should be treated because there are infectious causes in the etiopathogenesis of Behçet’s Disease.

The relationship between abnormal urinalysis findings and appendicitis location.

Acute appendicitis is a common cause of acute abdomen in general surgery and early diagnosis is crucial for prognosis. Abnormal urinalysis results have been associated with appendicitis in some studies, with reports of microscopic hematuria or pyuria in laboratory tests. The aim of this article is to evaluate the relationship between laboratory findings of hematuria, pyuria, and the location of acute appendicitis. This retrospective study included 577 patients who underwent appendectomy for suspected acute appendicitis between January 1, 2018, and December 31, 2022, at the general surgery clinic of Samsun Training and Research Hospital. Among the 577 patients, 247 were female and 330 were male, with a median age of 34years. A statistically significant difference was observed between appendicitis location and erythrocyte values (p = 0.009), specifically in paraileal and retrocecal locations. There was a statistically significant difference between appendicitis location and leukocyte values (p < 0.001), with significant differences found in paraileal, promontoric, and retrocecal locations. A statistically significant difference was observed between appendicitis location and leukocyte esterase values (p = 0.002), specifically in paraileal and retrocecal locations. Abnormal urinalysis findings are not uncommon in patients with acute appendicitis. Our study demonstrated a significant correlation between tit erythrocyte, tit leukocyte, and tit leukocyte esterase positivity with appendicitis locations. Therefore, we believe that pathological findings in urine tests of patients undergoing surgery with a preliminary diagnosis of appendicitis can provide valuable information to surgeons regarding the location of the appendix, ultimately aiding in optimizing the timing and cost of the operation.

175. Evaluation of Optimal Urinalysis Criteria for Conditional Urine Culturing

Abstract Background Asymptomatic bacteriuria is a common condition that is often treated unnecessarily with antimicrobials. Conditional urine reflex culturing leverages the negative predictive value of the absence of pyuria, often defined by a minimum urine white blood cell (WBC) count cutoff &amp;gt; 10 cells/hpf. This value has not been extensively validated. This study evaluated parameters from urinalysis (UA), including various WBC cutoffs, and their ability to detect urinary tract infections (UTIs). Methods Retrospective cohort study of adult patients with or without urinary catheters with at least one UA between July 2020 to July 2021. Conditional reflex urine culturing with urine WBC cutoff of &amp;gt; 10 cells/hpf was standard practice. Pregnant patients, patients with urologic procedures, and those who were mechanically ventilated at time of UA were excluded. UTIs were defined as definitive, probable, possible, or unlikely (Table 1). Comparisons between definitions and those with definitive/probable versus possible/unlikely UTIs were made using Chi-squared test. Table 1.UTI definitions Results 368 patients were included in the final analysis. 154 (41.8%) were male and mean age was 56.9 ± 17.9 years. 117 (31.8%) had urinary catheters. 296 (80.4%) of UAs were treated with antibiotics which were administered after UA collection 89.2% of the time. The total incidence of definitive, probable, possible, and unlikely UTIs according to WBC count is listed in Table 2. UA parameters including leukocyte esterase positivity and presence of nitrites did not differ when compared between definitive/probable versus possible/unlikely UTIs (94.3% vs. 97.1% and 23.9% vs 26.4% respectively). Differences in leukocyte esterase positivity and presence of nitrites were not seen for non-catheterized patients when compared between definitive/probable versus possible/unlikely UTIs (92.3% vs. 96.5% and 21.2% and 29.3% respectively). Table 2.Urine WBC categorization stratified by UTI definition Conclusion Urine WBC cutoff &amp;gt; 10 cells/hpf identifies many patients with unlikely UTIs. Current UA parameters do not definitively differentiate UTIs from not in catheterized or non-catheterized patients. Most patients with a positive UA were treated. Disclosures Kimberly C. Claeys, PharmD, BioFire Diagnostics: Honoraria.

Diagnostic Accuracy of Urinary Reagent Strip to Determine CSF Chemistry and Cellularity

Background: Cerebrospinal Fluid (CSF) examination is a common investigation to diagnose and evaluate different neurological diseases. The gold standard method of CSF examination is microscopy, biochemistry and culture in a standard laboratory, which require an experienced microscopist and laboratory support. Urinary reagent strip can be a point of care test in such condition. The study aimed to document the diagnostic accuracy of urinary reagent strip for the semi-quantitative analysis of CSF chemistry and cellularity.&#x0D; Materials and methods: One hundred hospitalized patients from the Department of Neurology, Chittagong Medical College Hospital were included in this study. CSF samples of the patients were subjected for the de nitive test (CSF microscopy and laboratory biochemical values) and the index test [Combur-10 urinary reagent strip was used as the index test for protein, glucose, leukocytes and erythrocytes. The diagnostic accuracy of each index test was calculated using different cut-off levels (Glucose 1+ vs. CSF glucose &gt;50 mg/dL, protein 1+ vs. CSF protein &gt;30 mg/dL, leukocyte esterase 1+ positivity vs. &gt;10 granulocytes/mm3 and erythrocyte 1+ positivity versus &gt;5 RBC/mm3 in CSF sample).&#x0D; Results: The diagnostic accuracy of protein estimation by reagent strip shows 100% sensitivity, 84.21% specificity for detection of CSF protein at level 30mg/dl. Glucose reagent strip positivity had 98.8% sensitivity and 75% specificity for detection of CSF glucose at level 50 mg/dl. Leukocyte esterase positivity by test strip had sensitivity of 60% and specificity of 100% for the detection of CSF granulocyte of &gt;10 granulocytes/mm3. The diagnostic accuracy of erythrocyte estimation by reagent strip show 92% sensitivity, 92% specificity for detection of CSF RBC &gt;5 cells/mm3.&#x0D; Conclusion: Urinary reagent strip can be used routinely for rapid analysis of CSF.A resource-limited hospital might find it useful as a point-of-care laboratory workup of CSF.&#x0D; Chatt Maa Shi Hosp Med Coll J; Vol.21 (2); July 2022; Page 9-13

Diagnosis of leucospermia in the stallion

The lack of standardized tests and interpretative criteria makes the diagnosis of stallion leucospermia difficult. Our objectives were to evaluate the ability of six diagnostic tests to detect polymorphonuclear cells (PMNs) in stallion semen, and to determine the concentration of PMNs that affects sperm motility. We hypothesized that all tests have diagnostic value, and that low concentrations of PMNs affect sperm motility. One ejaculate was obtained from six stallions. Aliquots of 50 ×106 purified sperm from each stallion were incubated with six concentrations of purified PMNs: 1) no PMNs, 2) 0.25 ×106 PMN/ml, 3) 0.5 ×106 PMN/ml, 4) 2.5 ×106 PMN/ml, 5) 5 ×106 PMN/ml, and 6) 10 ×106 PMN/ml. Each treatment was performed in triplicate. The PMNs were quantified using a hemacytometer (phase contrast microscopy), cytology (light microscopy), a commercial leucocyte esterase test (dipstick), a commercial peroxidase test (light microscopy), and immunolabeling of the neutrophil marker CD13 (flow cytometry). Sperm motility was evaluated after 4 h at 38 °C. The frequency of results obtained with the esterase test differed among treatments (P<0.0001). Negative or trace results were observed only with ≤ 0.5 ×106 PMNs/ml. A small number was observed in intermediate samples. In samples with ≥ 5 ×106 PMN/ml, only moderate or large results were obtained. Among quantitative tests, the hemacytometer count and flow cytometry detected differences with the control treatment at the lowest PMN concentration (2.5 ×106 PMN/ml; P<0.001). Total and progressive sperm motility were lower in samples with ≥5 ×106 PMN/ml than in those with lower concentrations (P<0.0001). Thus, a sample was considered leucospermic with ≥ 5 ×106 PMN/ml. The leucocyte esterase dipstick test had the best sensitivity (100%), followed by cytology (78%), peroxidase test (60%), flow cytometry (56%) and hemacytometer count (47%). The esterase test had the lowest specificity (65%), whereas the specificity of all other tests was 95%. In conclusion, presence of ≥5 ×106 PMNs/ml was associated with impaired sperm motility. The leucocyte esterase dipstick test is a simple, economic and sensitive stall-side test to screen semen for presence of PMNs in quantities capable of affecting sperm motility. Because of the lower specificity, we recommend confirming positive esterase results with the identification of peroxidase-positive cells under light microscopy, or CD13-positive cells using flow cytometry.

Urinary HSP70 improves diagnostic accuracy for urinary tract infection in children: UTILISE study.

The accuracy of conventional urinalysis in diagnosing urinary tract infection (UTI) in children is limited, leading to unnecessary antibiotic exposure in a large fraction of patients. Urinary heat shock protein 70 (uHSP70) is a novel marker of acute urinary tract inflammation. We explored the added value of uHSP70 in discriminating UTI from other infections and conditions confused with UTI. A total of 802 children from 37 pediatric centers in seven countries participated in the study. Patients diagnosed with UTI (n = 191), non-UTI infections (n = 178), contaminated urine samples (n = 50), asymptomatic bacteriuria (n = 26), and healthy controls (n = 75) were enrolled. Urine and serum levels of HSP70 were measured at presentation in all patients and after resolution of the infection in patients with confirmed UTI. Urinary (u)HSP70 was selectively elevated in children with UTI as compared to all other conditions (p < 0.0001). uHSP70 predicted UTI with 89% sensitivity and 82% specificity (AUC = 0.934). Among the 265 patients with suspected UTI, the uHSP70 > 48ng/mL criterion identified the 172 children with subsequently confirmed UTI with 90% sensitivity and 82% specificity (AUC = 0.862), exceeding the individual diagnostic accuracy of leukocyturia, nitrite, and leukocyte esterase positivity. uHSP70 had completely normalized by the end of antibiotic therapy in the UTI patients. Serum HSP70 was not predictive. Urine HSP70 is a novel non-invasive marker of UTI that improves the diagnostic accuracy of conventional urinalysis. We estimate that rapid urine HSP70 screening could spare empiric antibiotic administration in up to 80% of children with suspected UTI. A higher resolution version of the Graphical abstract is available as Supplementary information.

PD06-07 REAL-WORLD URINARY TRACT INFECTION RATES AND ANTIBIOTIC PRACTICE WITH URETHRAL INJECTION OF POLYACRYLAMIDE HYDROGEL (BULKAMID®)

You have accessJournal of UrologyCME1 May 2022PD06-07 REAL-WORLD URINARY TRACT INFECTION RATES AND ANTIBIOTIC PRACTICE WITH URETHRAL INJECTION OF POLYACRYLAMIDE HYDROGEL (BULKAMID®) Shreeya Popat, Justina Tam, Hannah Koenig, Alvaro Lucioni, Kathleen Kobashi, and Una Lee Shreeya PopatShreeya Popat More articles by this author , Justina TamJustina Tam More articles by this author , Hannah KoenigHannah Koenig More articles by this author , Alvaro LucioniAlvaro Lucioni More articles by this author , Kathleen KobashiKathleen Kobashi More articles by this author , and Una LeeUna Lee More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002525.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Polyacrylamide hydrogel (PAHG) (Bulkamid®) is a transurethral bulking agent that has demonstrated safety, efficacy, and durability in the treatment of stress urinary incontinence in women. Initial clinical trials report a post-procedure urinary tract infection (UTI) rate of 3.5%. While manufacturer information recommends pre-procedure antibiotics, the American Urological Association best practice statement is uncertain about antibiotic prophylaxis, and real-world practice is varied. Therefore, we report a single institution’s experience with UTI following PAHG urethral bulking. METHODS: Charts of patients who underwent PAHG urethral bulking from May 2020 to March 2021 were retrospectively reviewed. Demographic characteristics were collected, along with pre-procedure urinalyses (UA) and if prophylactic antibiotics were administered. In addition, charts were reviewed for post-procedure UTI. UTI was defined by prescription of antibiotics for UTI symptoms within 14 days of the procedure. Statistical analysis examining significant differences between groups that did and did not have post-procedure UTI was performed using Fisher’s exact test. RESULTS: During the study period, 103 women underwent PAHG for urethral bulking by 3 FPMRS surgeons at a single institution. 72 (69.9%) received pre-procedure prophylactic antibiotics. On pre-operative UA, 93 (88.3%) were positive for leukocyte esterase, 23 (22.3%) for blood, and only 1 was positive for nitrites. Only 3 of these samples resulted in a positive urine culture. Eleven of the 103 (10.7%) patients were prescribed antibiotics within 14 days of PAHG urethral bulking for a UTI. Of the 3 patients with incidentally positive urine cultures prior to the procedure, only one developed UTI symptoms and was treated with antibiotics. Presence of blood or nitrites on pre-procedure UA was not significantly related with post-procedure UTI. However, leukocyte esterase positivity was significantly related with post-procedure UTI (p = 0.03). Limitations include that this was a retrospective study and therefore not powered to determine UTI rate. CONCLUSIONS: In this cohort of real-world practice of PAHG urethral bulking, the incidence of UTI was 10.7%. Administration of prophylactic antibiotics varied and was not associated with lower rates of post-procedure UTIs. Although leukocyte esterase on pre-procedure urinalyses correlated with post-procedure UTIs on this initial analysis, more studies are needed to meaningfully guide clinical practice. Source of Funding: N/A © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e95 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shreeya Popat More articles by this author Justina Tam More articles by this author Hannah Koenig More articles by this author Alvaro Lucioni More articles by this author Kathleen Kobashi More articles by this author Una Lee More articles by this author Expand All Advertisement PDF DownloadLoading ...

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.

Antifungal susceptibility and virulence profile of candida isolates from abnormal vaginal discharge of women from southern India

ObjectiveVaginal candidiasis is the most common opportunistic fungal infection, largely associated with a woman’s psychological and economic status. Recently, the rate of disease progression has increased extensively; however, region-specific studies are very limited. This study aimed to understand variation in hydrolytic activities and antifungal susceptibility of Candida isolates from vaginal discharge. Study designThe present study was aimed to understand the variation of hydrolytic activities and antifungal susceptibility of Candida isolates from vaginal discharge. ResultsIn total, 34 different Candida isolates were collected: C. albicans (n = 17; 50 %), C. glabrata (n = 6; 17.64 %), C. tropicalis (n = 4; 11.76 %) and C. parapsilosis (n = 7; 20.58 %). All isolates were primarily identified and confirmed by basic microbiological methods followed by the VITEK-2 system. Antifungal susceptibility of the isolates were evaluated using yeast antifungal susceptibility testing cards. The isolates of C. albicans, C. glabrata, C. tropicalis and C. parapsilosis were 100 % susceptible to amphotericin B. The non-albicans isolates presented 100 % of proteolytic and lipolytic activity compared with C. albicans. Eight (47.06 %) C. albicans isolates showed positive esterase activity (Pz<1), whereas nine (52.94 %) were negative to esterase (Pz = 1). Of the 34 Candida isolates, 28 (82.35 %) were found to be moderate-to-strong biofilm producers: 14 C. albicans, three C. glabrata, six C. parapsilosis and five C. tropicalis. ConclusionThis study clarified the antifungal susceptibility and virulence behaviour of Candida isolates; this will be of use in the selection of antifungal agents for Candida prophylaxis.

Evaluation of using urine strip in diagnosis of children's meningitis in Benghazi-Libya

Background: Bacterial meningitis is still considered as one of the most dangerous infectious diseases, which numerous complications and high mortality if not diagnosed and treated timely. Objective: to evaluate the usefulness of urine reagent strip tests in the diagnosis of meningitis Patients and methods: ninety of children aged less than 11 years were included. They clinically suspected to have meningitis from Benghazi children's hospital in the period from February 2017 to April 2018. CSF samples were tested using both Combur-10 urinary reagent strip and CSF microscopy examination as reference standards. Combur-10 was used to estimate ten parameters including protein, glucose, and leukocytes. Results: The diagnostic accuracy of protein estimation by reagent atrin show 91.7% sensitivity. 100% speciicity for detection of CSF proteins, Glucose reagent strip positivity had 97.5% sensitivity and 72.7% specificity for detection of CSF glucose. Leukocyte esterase positivity by test strip had sensitivity of 100% and specificity of 98.8% for the detection of CSF granulocytes of more than 10 granulocytea/mm. The majority of meningitis were found in children aged less than2 years 191.1%), and incidence of meningitis was found the same percentage in both males and females (41%) for each Conclusions: our results suggest that reagent strips may be a useful additional resource in the diagnosis of bac terial meningitis, especially when it is difficult to collect a sufficient amount of cerebrospinal fluid or to indicate the initial treatment.

MP58-07 CLINICAL AND PATHOLOGIC RELEVANCE OF A PROSTATE MRI DIAGNOSIS OF "PROSTATITIS"

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia (MP58)1 Apr 2020MP58-07 CLINICAL AND PATHOLOGIC RELEVANCE OF A PROSTATE MRI DIAGNOSIS OF "PROSTATITIS" Sij Hemal*, Lewis Thomas, and Daniel Shoskes Sij Hemal*Sij Hemal* More articles by this author , Lewis ThomasLewis Thomas More articles by this author , and Daniel ShoskesDaniel Shoskes More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000927.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Non-malignant abnormalities in the peripheral zone are common in prostate mpMRI. Such findings include decrease in T2-weighted signal, decrease in diffusion coefficient or enhancement in a diffuse or linear pattern. These abnormalities are often reported as “prostatitis” and lead to patient anxiety and treatment referral. However, the relationship between these MRI findings and clinical prostatitis is unknown. We investigated the relationship between MRI evidence of prostatitis with clinical symptoms and pathology. METHODS: Retrospective review of patients undergoing prostate mpMRI (2016-2017) was performed, and patients were divided into two groups based on the presence of either “prostatitis” or “inflammation” in the radiology report. Patients with prior prostate cancer treatment were excluded. Clinical characteristics included age, PSA, biopsy/intervention history, lower urinary tract symptoms (LUTS), pain, use of urologic medications for LUTS, urinary findings of pyuria or leukocyte esterase positivity), prostate volume, and PIRADS score. Pathologic finding of inflammation on either prior biopsies or biopsy within 6 months was also recorded. Groups were compared using chi-square for dichotomous variables and t-tests for continuous variables. P<0.05 was considered significant. RESULTS: 104 patients were identified with “prostatitis/inflammation” and 119 without. Report of any LUTS was high in both groups (57% and 60% for prostatitis and no prostatitis respectively, p = 0.69), though report of moderate/severe LUTS (physician description or IPSS of 8-19 and 20+) was more common in the no prostatitis group (8% vs 17%, p=0.038). Use of urologic meds was similar between the two groups (66% and 55% for prostatitis and no prostatitis respectively, p = 0.074). Any biopsy finding of inflammation was more common in the prostatitis group (57% vs 35% p =0.002). Reports of pelvic/perineal pain, chronic dysuria, or urinary findings of inflammation/infection were uncommon in both groups (<5% for pain/dysuria and <10% for urinalysis findings in both groups) CONCLUSIONS: MRI findings of prostatitis may be associated with a pathologic finding of inflammation on biopsy, however, such findings did not correlate to reported LUTS, pelvic pain or use of urologic medications. While mpMRI findings of prostatitis may indicate NIH Category IV prostatitis, there is no evidence of correlation with categories I, II or III prostatitis nor with symptomatic LUTS and patients should be reassured that further investigation or treatment is not warranted. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e873-e873 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sij Hemal* More articles by this author Lewis Thomas More articles by this author Daniel Shoskes More articles by this author Expand All Advertisement PDF downloadLoading ...

Midstream Clean-Catch Urine Culture Obtained by Stimulation Technique versus Catheter Specimen Urine Culture for Urinary Tract Infections in Newborns: A Paired Comparison of Urine Collection Methods

Objective: The group of Herreros Fernández developed a new, safe, quick, and successful technique for collecting midstream clean-catch urine(MS-CCU) in newborns based on bladder stimulation and lumbar paravertebral massage maneuvers. The purpose of this study was to compare the contamination rates of catheter specimen urine (CSU) and MS-CCU by a lumbar/sacral stimulation technique in newborns. Materials and Methods: Full-term newborns ranging in age from 2 to 28 days who needed an investigation for a presumed urinary tract infection (UTI) were included in the study. Two samples, MS-CCU by lumbar/sacral stimulation technique and CSU, were collected consecutively for each patient. Suitable samples were obtained from 90 patients. Results: The contamination rate in MS-CCU cultures (n = 24/90, 26.66%) was higher than in CSU cultures (n = 9/90, 10%), and the difference was statistically significant (p = 0.039). Thirteen patients had UTI according to both samples (14.14%). In urine analysis, while there was no statistically significant difference in bacteriuria (p = 0.61) and nitrite positivity (p = 0.14) between patients with and without UTI, pyuria (p = 0.01) and leukocyte esterase positivity (p = 0.01) were higher in patients with UTI, and the difference was statistically significant. Conclusion: The contamination rate in MS-CCU cultures was two and a half times greater than in the CSU culture samples. Thus, MS-CCU cannot replace the catheter for the diagnosis of UTI.

Relationship between urinalysis findings and responsible pathogens in children with urinary tract infections

Pyuria, presence of bacteria, leukocyte esterase, and nitrite positivity in urinalysis should be considered together, and simultaneous urine culture test should be performed in the diagnostic evaluation of urinary tract infection (UTI). The absence of pyuria in urinalysis cannot exclude UTI in patients with suggestive clinical findings. It was aimed to assess relationship between urinalysis tests and uropathogen and to evaluate antibiotic resistance in children. The study included patients (aged 0-18 years) with significant uropathogen growth in urine culture tests. The patients' data regarding age, gender, results of urine microscopy, urine culture, and antibiogram were recorded retrospectively. Overall, 705 patients (562 girls, 143 boys) with significant growth in urine culture test were included. Median age was 72 months among girls and 12 months among boys. Most common uropathogens were Escherichia coli (79.6%) and Klebsiella pneumoniae (8.2%). E. coli was more commonly among girls (87%) and Klebsiella spp. among boys (53.3%). Pyuria was positive in urinalysis in 75% of patients. Pyuria presence was more common in patients with E.coli or Proteus spp. (80.6% and 71.4%, respectively) than those with Enterococcus spp. and Klebsiella spp. (52.0% and 53.3%, respectively). In culture antibiogram tests, ampicillin resistance was 100% in Klebsiella oxytoca and Enterobacter spp. and 72% in E. coli strains. No ceftriaxone resistance was observed in K. oxytoca, Citrobacter spp., Pseudomonas aeruginosa, and Enterobacter spp. Most UTIs were seen in older girls. Pyuria might be lacking in UTIs associated to Klebsiella spp. and Enterococcus spp., and absence of pyuria may not exclude UTI in patients with compatible clinical findings. Ceftriaxone is still an option in empirical treatment; unnecessary use of third-generation cephalosporins should be avoided, particularly in infections other than UTI. It was found that E. coli more commonly caused leukocyturia, leukocyte esterase positivity, and pyuria; that pyuria might be lacking in UTIs associated to Klebsiella spp. and Enterococcus spp. and that pyuria was more prevalent among girls. It is though that urine culture tests should be performed in children with suspected UTI even in the absence of pyuria because lack of pyuria may lead delay in diagnosis and treatment as well as renal scar formation.

Hematological analysis of Ctenopharyngodon idella, Megalobrama amblycephala and Pelteobagrus fulvidraco: Morphology, ultrastructure, cytochemistry and quantification of peripheral blood cells

The grass carp (Ctenopharyngodon idella), blunt snout bream (Megalobrama amblycephala) and yellow catfish (Pelteobagrus fulvidraco) are economically important fishes in China. Fish hematological features, especially the type and number of peripheral blood cells, are crucial for the evaluation of fish health and the diagnosis of fish diseases. Since the automatic blood cell count equipment for human is not suitable for fishes, the manual method is critical in the quantification of fish blood cells. To make sense of the comparison and interpretation of the blood cell count studies in different articles, the standardization of blood cell classification is necessary. In this study, erythrocytes (red blood cell, RBC), thrombocytes (TC) and leucocytes (i.e. white blood cells, WBC, including lymphocytes, neutrophils and monocytes) were well distinguished in blood smears with Giemsa staining and confirmed by transmission electron microscopy. RBC, TC and WBC were directly counted with an improved Neubauer counting chamber in a modified diluting solution. The differential leucocyte count (DLC) was carried out in blood smears. In view of the labeling characteristics of peroxidase (PO) positivity in neutrophils and non-specific esterase (α-ANAE) positivity in monocytes, PO positive cell percentage and α-ANAE positive cell percentage were also determined in cytochemistry staining smears. No difference was found for the percentages of neutrophils and monocytes between Giemsa staining and cytochemistry staining. The standardized classification, normal count ranges and sizes of the peripheral blood cells by the present systemic studies will provide useful references for monitoring the health status of grass carp, blunt snout bream and yellow catfish.

Determining the degree of accuracy of Combar-10 reagent strip in diagnosing bacterial meningitis

Background: The gold standard for diagnosis of meningitis depends on cerebrospinal fluid (CSF) examination by microscopy, biochemistry, and culture, which require experienced personnel and laboratory support. We conducted this study to determine if urinary reagent strip is useful to make a semi-quantitative assessment of protein, glucose, and presence of leukocyte esterase in CSF.Methods: All consecutive CSF samples were evaluated in a blinded fashion. CSF was tested using Combur-10 urinary reagent strip as an index test, and CSF microscopy and biochemistry as reference standards. Combur-10 (Boehringer Mannheim) is an urinary reagent strip used to estimate ten parameters including protein, glucose, and leukocytes. We estimated diagnostic accuracy of each index test using corresponding cut-off levels (glucose &lt;1 + vs. CSF glucose &lt;50 mg/dL; protein 2 + and 3 + vs. CSF protein &gt;30 mg/dL and &gt;100 mg/dL; leukocyte esterase positivity vs. &gt;10 granulocytes in CSF sample). We constructed receiver operating curves (ROC) to evaluate overall performance of index tests and estimated area under the curve (AUC).Results: CSF samples of 150 patients were included in the study. Of the three tests, diagnostic accuracy of protein estimation (2+ or more on reagent strip) was best for detection of CSF proteins greater than 50 mg/dL [sensitivity 93.2% (95% CI 86.63-96.67); specificity 91.49% (95% CI 80.07, 96.64)], with AUC of 0.97. Leukocyte esterase positivity by test strip had a sensitivity of 90% (95% CI 82.08, 94.65) and specificity of 91.6% (95% CI 81.93, 96.39) for detection of CSF granulocytes of more than 10/mm3.Conclusions: The degree of accuracy of Combar-10 reagent strip in diagnosing bacterial meningitis is very high similar to CSF microscopy and biochemistry.