Factors Of Urinary Tract Infection Research Articles

TRACING THE ANTIBACTERIAL, ANTIFUNGAL AND ANTI-BIOFILM ACTIVITIES OF ROOT EXTRACT BAJAKAH TAMPALA (SPATHOLOBUS LITTORALIS HASSK)

Biofilm is a common causative factor for urinary tract infections due to catheter usage with a percentage of infection around 70-80%. The Bajakah tampala (Spatholobus littoralis Hassk) is one of native plants of Kalimantan which contains phenolic compounds, flavonoids and tannins which are proven to accelerate wound healing, have antibacterial activity, and have very high and strong antioxidant activity. This study aims to determine the antibacterial and anti-biofilm activity of bajakah root extract (Spatholobus littoralis Hassk) on catheter colonies of Staphylococcus aureus, Escherichia coli and Candida albicans and to determine their mechanism of action in vitro. This research is carried out with an in vitro experimental study design using a microplate reader. Extraction was carried out by maceration method using 96% ethanol solvent. The results showed that the ethanol extract of Bajakah tampala (Spatholobus littoralis Hassk) had antibacterial activity against S. aureus with a concentration of 1% w/v of 88.33% ± 0.01 and anti-biofilm activity of 82.21% ± 0.01. E. Coli bacteria had an antibacterial activity of 84.83% and an anti-biofilm activity of 80.11 at a concentration of 1% w/v. C. albicans had an antifungal activity at a concentration of 1% w/v of 82.31% ± 0.01 and anti-biofilm activity of 77.00% ± 0.01. From these results it can be concluded that the ethanol extract of Bajakah tampala (Spatholobus littoralis Hassk) has antibacterial and antifungal activities and the potential as a new anti-biofilm agent against S.aureus, E. coli and C. albicans

Risk factors for urinary tract infection in infants with unexplained hyperbilirubinemia: a single center case-control study

BackgroundUrinary tract infection (UTI) is a potential cause of neonatal jaundice. Nevertheless, there remains a lack of consensus regarding appropriate screening practices for UTI in infants with hyperbilirubinemia. This study aimed to analyze a group of jaundiced infants to assess the prevalence of UTI, explore potential risk factors, and examine the impact of UTI on the course and severity of neonatal jaundice.MethodsThis retrospective case-control study was conducted on 150 jaundiced infants (aged < 8 weeks) without a known etiology in the hyperbilirubinemia work-up. All subjects underwent phototherapy treatment and UTI screening by catheterization. They were then classified into UTI and non-UTI groups based on urine culture results, with a positive urine culture indicating the growth of ≥10,000 colony-forming units. The clinical characteristics and jaundice-related parameters of both groups were analyzed.ResultsAmong the 150 jaundiced patients, the prevalence of UTI was 29%. There was a significantly higher male predominance in the UTI group, and patients with UTI also had a significantly longer duration of hospitalization compared to those without UTI. Significant risk factors associated with UTI in jaundiced infants included male gender and a peak total bilirubin level higher than 18 mg/dl during hospitalization. The most common pathogens identified in urine culture were Escherichia coli (41.9%) and Enterococcus faecalis (30.2%).ConclusionIn cases of neonatal jaundice where the underlying cause is not evident, screening for UTI should be performed, particularly when associated risk factors or inadequate response to phototherapy is present.

Exploring the nexus: prevalence, risk factors, and clinical correlations of urinary tract infections in diabetes mellitus patients - a comprehensive retrospective analysis

Aims: This study investigates the frequency and associated factors of urinary tract infections (UTIs) in patients with diabetes mellitus (DM). Methods: This retrospective chart review focused on patients with diabetes mellitus. Data collection involved demographic details, DM diagnosis, comorbidities such as hypertension, hyperlipidemia, and coronary artery disease, along with medication usage. Laboratory values including blood glucose and HbA1c levels were also analyzed. The primary outcome of interest was the diagnosis of UTI, identified from clinical records. Results: 173 DM patients were included in the study. These patients were divided into two groups according to the presence of UTI: 52 patients in the UTI group and 121 patients in the non-UTI group. The incidence of UTI was significantly higher in women (37.9%) compared to men (10.2%). No significant differences were observed between the groups in terms of age, presence of hypertension, hyperlipidemia, or coronary artery disease. Interestingly, the usage of SGLT-2 inhibitors was significantly higher in the UTI group compared to the non-UTI group (26.8% vs. 14%, p=0.043). No significant differences were found in other medication usage or in the levels of glucose and HbA1c between the groups. Conclusion: The study highlights the increased risk of UTIs in DM patients, particularly among women and those using SGLT-2 inhibitors. These findings suggest the need for careful monitoring and tailored approaches in managing UTIs in DM patients, considering gender and specific DM treatments.

Risk Factors Analysis and Pathogen Distribution of Urinary Tract Infection in Patients Undergoing Cutaneous Ureterostomy After Radical Cystectomy for Bladder Cancer.

Postoperative urinary tract infection is a common complication that not only significantly prolongs the hospital stay and amplifies the economic burden on patients, but also affects their quality of life and prognosis. This study aimed to investigate risk factors and distribution of pathogenic bacteria in urinary tract infections among bladder cancer patients who underwent cutaneous ureterostomy following radical cystectomy. A total of 137 bladder cancer patients, who underwent cutaneous ureterostomy after radical cystectomy at our hospital from November 2018 to October 2022, were enrolled in this retrospective study. Univariate and multivariate logistic regression analyses were employed to investigate the risk factors associated with postoperative urinary tract infection and the distribution of pathogenic bacteria among the infected patients. The results of both univariate and multivariate analyses confirmed that age, proficiency in ostomy knowledge, frequency of ureteral stent tube replacement, ureteral stent tube dislodgement, urine immersion at the outer end of the ureteral stent tube, and the interval of ostomy bag replacement were independent risk factors for urinary tract infection after radical cystectomy and cutaneous ureterostomy in bladder cancer patients. A total of 55 pathogenic bacteria were isolated from 52 patients with infections. Predominantly, these were gram-negative bacteria (34 strains, 61.8%), with Proteus mirabilis having the highest proportion. Urinary tract infections after radical cystectomy and cutaneous ureterostomy predominantly involve gram-negative bacteria. This is correlated with factors such as the age of bladder cancer patients, the level of nursing education, the duration of ureteral stent tubes and ostomy bag usage, as well as issues related to impaired urine drainage.

Retrospective Analysis of Risk Factors for Urinary Tract Infection after Ureteral Calculi Surgery.

Ureteral calculi are a common diagnosis in the field of urology worldwide, and they represent a prevalent subtype of urolithiasis. Ureteroscopic stone surgery is the cornerstone treatment, but postoperative urinary tract infection (UTI) remains a clinical concern. Our study aims to analyse specific risk factors associated with postoperative UTIs following ureteroscopic stone surgery. We conducted a case-control study and collected clinical data from 145 patients who underwent ureteroscopic lithotripsy at our hospital from January 2021 to January 2023. Binary logistic regression analysis was used to investigate risk factors for postoperative UTI. Receiver operating characteristic curves were plotted, and area under the curve (AUC) was calculated to evaluate the predictive value of each factor. Forty patients developed UTI after ureteroscopic stone surgery. Compared with the control group, the case group showed significant differences in stone size, history of diabetes mellitus and preoperative urine culture results (p < 0.05). Multivariable binary logistic regression analysis revealed that stone size (Odds Ratio (OR) = 1.952, p = 0.010), history of diabetes mellitus (OR = 2.438, p = 0.038) and preoperative urine culture (OR = 2.914, p = 0.009) were independent risk factors for postoperative UTI. The AUC values of stone size, history of diabetes mellitus and preoperative urine culture were 0.680, 0.627 and 0.630, respectively. The AUC of the combined prediction was 0.756. This study identified risk factors for postoperative UTI following ureteroscopic stone surgery and emphasised the importance of stone size, history of diabetes mellitus and preoperative urine culture in the diagnosis.

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.

Risk Factors for Urinary Tract Infection in Elderly Patients with Type 2 Diabetes: A Retrospective Cohort Study.

The risk factors of urinary tract infection in elderly patients with type 2 diabetes were investigated. A total of 72 elderly patients admitted to our hospital from December 2019 to September 2023 because of with type 2 diabetes were retrospectively included. They were divided into the observation group (n = 35) and control group (n = 37) according to whether they had urinary tract infection. The general clinical data, clinical characteristics and the distribution of pathogenic bacteria in the observation group were collected and analysed. Then, t-tests, chi-square tests, regression analysis and receiver operating characteristic curve analysis were conducted. Escherichia coli (E. coli) accounted for 51.43% of the pathogenic bacteria in the observation group, whereas Klebsiella pneumoniae (K. pneumoniae) accounted for 22.86%. The remaining pathogens accounted for 2.86% each. Differences in gender, course of disease, glycosylated haemoglobin and comorbid urinary calculi were found between the groups (p < 0.05); These factors were all risk factors for concurrent urinary infection, and the odds ratios were all >1. The obtained values for gender, disease course, glycosylated haemoglobin and comorbid urinary calculi were respectively 0.594, 0.654, 0.738 and 0.696 (area under the curve); 0.971, 0.714, 0.800 and 0.743 (sensitivity); 0.216, 0.595, 0.676 and 0.649 (specificity); And 0.188, 0.309, 0.476 and 0.392 (Youden index). Common pathogens in elderly people with type 2 diabetes and comorbid urinary tract infection are E. coli and K. pneumoniae. Risk factors include gender, disease duration, glycosylated haemoglobin and urinary stones. The prompt identification of pathogens and risk factors facilitates clinical treatment, reducing infection incidence.

Prevalence and Contributing Factors of Urinary Tract Infection in Human Immunodeficiency Virus Patients: A Systematic Review

Prevalence and Contributing Factors of Urinary Tract Infection in Human Immunodeficiency Virus Patients: A Systematic Review

Catheter-associated bladder mucosal trauma during intermittent voiding: An experimental study in pigs.

The objective of this study is to characterize bladder mucosal trauma associated with intermittent catheterization with conventional eyelet catheters (CECs) and to assess if a microhole zone catheter (MHZC) design concept reduces this adverse effect. A porcine model was developed to reflect human catheterization and bladder drainage. Nine pigs were randomized for catheterization with CEC (n= 6) or MHZC (n= 3). The bladder was drained repeatedly 20 times through the catheter. Cystoscopy was performed before and after the procedure, and bladders were analysed by histopathology. Two additional pigs were used for cystoscopy visualization of suction events in vivo. Cystoscopy, gross pathology, histopathological score, leucocyte infiltration, and intracatheter pressure at flow stops during voiding were compared for each group. A significant higher pressure gradient was measured inside the CECs compared with MHZCs during flow stop. Consequently, CECs resulted in suction events inflicting bladder trauma characterized by loss of epithelium, oedema, haemorrhage, and neutrophil tissue infiltration. No significant trauma was identified when using MHZC. Considerable mucosal bladder trauma is inflicted by CECs which may be an overlooked risk factor for urinary tract infection. Catheters can be designed to minimize mucosal suction and reduce associated trauma. This may be a solution to reduce infection frequency and increase user comfort. Furthermore, the study demonstrates the potential of pigs as an attractive animal model for investigating urinary catheter performances.

Prevalence and Risk Factors of Urinary Tract Infection in Pregnant Women: Systematic Review and Meta-Analysis

Background: Urinary Tract Infections (UTIs) are the second-most frequent bacterial infections, with an overall incidence of 5-10%. This study aimed to investigate the prevalence and risk factors associated with UTI in pregnant women. Method: A systematic search was conducted in the open domain, electronic databases such as PubMed and Google Scholar. Citation searching was also performed to identify all relevant studies. All the steps were carried out by two independent reviewers to avoid bias. Based on inclusion &amp; exclusion criteria, followed by qualitative evaluation, the studies were included and analyzed by fixed or random effects model using CMA. A sub-group analysis was also performed for Asian and African countries for prevalence and for different categories of risk factors. Results: Out of 45 studies, 41 studies were included for the prevalence of UTI in pregnant women and 19 studies were included to evaluate the risk factors. The pooled prevalence of UTI in African pregnant women was higher when compared to Asian pregnant women (28.6% vs. 20.7%). The risk factors statistically significantly associated with UTI were found to be undergarment texture (silk), history of catheterization, diabetes mellitus, past history of UTI and HIV. Conclusion: UTIs are prevalent in pregnant women in Asian and African pregnant women. Hence, identification of risk factors and frequent screening of UTIs during pregnancy is recommended to avoid maternal-fetal complications.

Factors Associated with Increased Risk of Urosepsis during Pregnancy and Treatment Outcomes, in a Urology Clinic.

Background and Objectives: Urosepsis is a significant cause of maternal and fetal mortality. While certain risk factors for urinary tract infections (UTIs) in pregnant women are well established, those associated with an elevated risk of urosepsis in pregnant women with upper UTIs remain less defined. This study aims to identify factors linked to an increased risk of urosepsis and examine urologic treatment outcomes in such cases. Materials and Methods: We conducted a retrospective analysis on 66 pregnant women diagnosed with urosepsis over a nine-year period. A control group included 164 pregnant women with upper UTIs, excluding urosepsis, admitted during the same timeframe. This study highlights factors potentially contributing to urosepsis risk, including comorbidities like anemia, pregnancy-related hydronephrosis or secondary to reno-ureteral lithiasis, prior UTIs, coexisting urological conditions, and urologic procedures. Outcomes of urologic treatments, hospitalization duration, obstetric transfers due to fetal distress, and complications associated with double-J catheters were analyzed. Results: Pregnant women with urosepsis exhibited a higher prevalence of anemia (69.7% vs. 50.0%, p = 0.006), 2nd-3rd grade hydronephrosis (81.8% vs. 52.8%, p = 0.001), and fever over 38 °C (89.4% vs. 42.1%, p = 0.001). They also had a more intense inflammatory syndrome (leukocyte count 18,191 ± 6414 vs. 14,350 ± 3860/mmc, p = 0.001, and C-reactive protein (CRP) 142.70 ± 83.50 vs. 72.76 ± 66.37 mg/dL, p = 0.001) and higher creatinine levels (0.77 ± 0.81 vs. 0.59 ± 0.22, p = 0.017). On multivariate analysis, factors associated with increased risk for urosepsis were anemia (Odds Ratio (OR) 2.622, 95% CI 1.220-5.634), 2nd-3rd grade hydronephrosis (OR 6.581, 95% CI 2.802-15.460), and fever over 38 °C (OR 11.612, 95% CI 4.804-28.07). Regarding outcomes, the urosepsis group had a higher rate of urological maneuvers (87.9% vs. 36%, p = 0.001), a higher rate of obstetric transfers due to fetal distress (22.7% vs. 1.2%, p = 0.001), and migration of double-J catheters (6.1% vs. 0.6%, p = 0.016), but no maternal fatality was encountered. However, they experienced the same rate of total complications related to double-J catheters (19.69% vs. 12.80%, p > 0.05). The pregnant women in both groups had the infection more frequently on the right kidney, were in the second trimester and were nulliparous. Conclusions: Pregnant women at increased risk for urosepsis include those with anemia, hydronephrosis due to gestational, or reno-ureteral lithiasis, and fever over 38 °C. While the prognosis for pregnant women with urosepsis is generally favorable, urological intervention may not prevent a higher incidence of fetal distress and the need for obstetric transfers compared to pregnant women with uncomplicated upper UTIs.

Effectiveness of various treatment modalities in children with vesicoureteral reflux grades II–IV: a systematic review and network meta-analysis

BackgroundVesicoureteral reflux (VUR) is one of the most common risk factors of urinary tract infection (UTI) among children. Various treatment modalities including antibiotic prophylaxis, surgical or endoscopic corrections and conservative...

Prevalence and risk factors of urinary tract infection among children with bronchiolitis

BackgroundThe co-occurrence of bronchiolitis and urinary tract infections (UTI) in hospitalized children is associated with high morbidity and economic strain. However, due to a low prevalence (<3%) and inconsistent diagnostic criteria, there is ongoing debate regarding the necessity of systematic screening. This study estimated the prevalence of UTI among children admitted for bronchiolitis and analyzed the associated demographic and clinical factors. MethodsA 5-year (2016–2020) retrospective chart review was conducted among all children admitted for bronchiolitis at a referral pediatrics department in Jeddah, Saudi Arabia. UTI was diagnosed according to the American Association of Pediatrics criteria. Demographic, clinical, microbiological, and imaging data were extracted from the hospital electronic records. ResultsOf the 491 cases of children with bronchiolitis, urine culture and analysis were available for 320 patients. Based on urine culture criteria alone, the prevalence of UTI was 13.1% (95% CI 9.6–17.3), and the most common pathogens included E. coli (33.3%), K. pneumoniae (23.8%), and Enterococcus faecalis (14.3%), and 13 (31.0%) of the isolates were EBSL. By considering urinalysis criteria, i.e., pyuria or nitrituria, the estimated prevalence of UTI decreased to 3.4% (1.7–6.1%), and the most common pathogens were K. pneumoniae (5/11) and E. coli (3/11), with 6/11 ESBL-producing isolates. Regurgitation associated with a higher risk of UTI compared to absence of regurgitation (5.3% versus 0.8%; p = 0.031). Urinary tract ultrasound showed high specificity (98.7–100%) and negative predictive value (97.4–97.7%) in UTI using either criterion. ConclusionsThere is a higher prevalence of UTI among children with bronchiolitis in the study center, which has several implications in screening, diagnosis, and management. Further multicenter studies are required to enhance the external validity of these findings and assess the cost-effectiveness of screening strategy at a national level.

Dementia, stroke, age, use of medical devices and antipsychotic drugs may increase the risk of nosocomial infections among elderly patients hospitalized at Neurology Clinics

Healthcare-acquired infections (HCAI) represent a major health problem worldwide. Stroke and dementia are considered risk factors for HCAI. Preliminary data suggest that use of antipsychotic drugs also increase the risk for HCAI. Here, we performed a retrospective study aimed at investigating the major risk and protective factors for HCAI in a cohort of elderly subjects hospitalized at an Italian tertiary Neurology Clinics. We included all patients with age ≥ 65 years hospitalized at Neurology Clinics of National Institute on Ageing, Ancona, Italy from 1st January 2018 to 31st December 2021. For each patient, the following data were collected: age, sex, use of medical devices, comorbidities, use of antipsychotic medications, development of HCAI. We included 1543 patients (41.4% males; median age 85 years [80–89]). According to multivariable analysis, age, stroke, duration of urinary catheter placement (for all p < 0.001) and midline placement (p = 0.035) resulted to be risk factors for HCAI, Diabetes resulted to be a protective factor for pneumonia (p = 0.041), while dementia and nasogastric tube were risks factor for this condition (p = 0.022 and p < 0.001, respectively). Urinary catheter was a risk factor for urinary tract infections (p < 0.001). Duration of placement of vascular catheters and use of antipsychotic drugs resulted to significantly increase the risk for bloodstream infections. Stroke, age and use of medical devices were confirmed to be risk factors for HCAI. Antipsychotic drugs resulted to increase risk for bloodstream infections. Further prospective studies will be needed to confirm these findings.

Bacterial Profile, Antibiotic Susceptibility Pattern and Associated Risk Factors of Urinary Tract Infection Among Patient Suffering from Chronic and/or Acute Prostatitis at the Yaoundé Central Hospital, Centre Cameroon

Background: A febrile urinary tract infection in men should suggest acute prostatitis. Any infection of the male urinary tract has the potential to affect the prostate. Acute prostatitis happens when your prostate gland becomes suddenly inflamed. The objectives of our study were to determine the prevalence of urinary tract infections and the associated risk factors in men presenting chronic and/or acute prostatitis. Also, to identify the associated bacterial strains and finally to establish their antibiotic susceptibility profile.&#x0D; Materials and Method: We conducted a prospective and cross-sectional study. A total of 77 male participants were recruited, aged 24 years to 84 years at the Urology Department of the Yaounde Central Hospital that presented with clinical signs and symptoms of urinary tract infection from February to June 2021. Urine specimens were collected and analyzed at the Bacteriology laboratory of the Yaoundé University Teaching Hospital. Isolation and identification of bacteria were done using conventional methods. Antibiotic susceptibility testing and interpretation were performed according to CASFM 2021, V.1.0 April. The statistical analysis of our data was done using SPSS version 22.0 software.&#x0D; Results: The prevalence of urinary tract infection in our studied population was 15.58% (12/77). Among the 12 participants with urinary tract infection, we isolated and identified six (6) bacteria species; Escherichia coli 25% (3/12), Proteus vulgaris 25% (3/12), Citrobacter freundii 16.67% (2/12), Pseudomonas fluorescent 16.67% (2/12), Enterococcus spp. 8.33% (1/12) and Proteus penneri 8.33% (1/12) respectively. Antibiotic susceptibility testing revealed reduced susceptibility to 3rd generation cephalosporins (cefotaxime, ceftazidime, ceftriaxone). Beta-lactams showed very low activity on almost all the family of Enterobacteriaceae strains isolated. Flouroquinolones (ciprofloxacin, ofloxacin and nalidixic acid) showed a resistance of more than 50% on the majority of the species isolated. All the isolated Gram negative bacteria were multi-drug resistant. Patients with a history of urinary tract tumors, urinary catheters, and diabetes were the most exposed to urinary tract infection; 58.33% (7/12 patients), 50.00 % (6/12) and 41.66% (5/12 patients) respectively. Participants of age &gt;55 years were those presenting the most with urinary tract infection.&#x0D; Conclusions: Overall, Enterobacteriaceae were primarily isolated from patients with prostatitis. Urological history such as urinary tract tumors, and Diabetes were significantly associated with UTI.

Risk factors for urinary tract infections associated with lower quality of life among intermittent catheter users.

Evidence shows that intermittent catheterisation (IC) for bladder emptying is linked to urinary tract infections (UTIs) and poor quality of life (QoL). To investigate the association between UTI risk factors and QoL and patient-reported UTIs respectively. A survey was distributed to IC users from 13 countries. Among 3464 respondents, a significantly poorer QoL was observed when experiencing blood in the urine, residual urine, bowel dysfunction, recurrent UTIs, being female, and applying withdrawal techniques. A lower UTI risk was found when blood was not apparent in urine (RR: 0.63; 95% CI: 0.55-0.71), the bladder was perceived empty (RR: 0.83; 95% CI: 0.72-0.96), not having bowel dysfunction (RR: 0.86; 95% CI: 0.76-0.98), and being male (RR: 0.70; 95% CI: 0.62-0.79). This study underlines the importance of risk factors and their link to QoL and UTIs, highlighting the need for addressing symptoms before UTIs become problematic.

Prevalence and risk factors of urinary tract infection in kidney recipients: a meta-analysis study

BackgroundA kidney recipient's urinary tract infection (UTI) can result in infectious problems and be a risk factor for less successful transplant outcomes. UTI risk factors are still controversial. The present study aimed to investigate the prevalence of UTI and its association with risk factors in kidney recipients.MethodTwenty-six papers published between 2005 and 2022 were retrieved using keywords and searching Medlib, ScienceDirect, PubMed, and other databases. If possible, the pooled prevalence of UTI in kidney recipients and odds ratio (OR) with a 95% confidence interval for each risk factor were calculated. The data were analyzed using the random effects model in R and Stata 14.ResultsThe total sample size was 72,600, with an average age of 48.7 years. The pooled prevalence of UTI was 35% (95% CI, 30–40%). The estimated risk factors for UTI were female (OR = 3.13; 95%CI: 2.35—4.17), older age (OR = 1.03; 95%CI: 1—1.05), history of UTI (OR = 1.31; 95%CI) CI: 1.05—1.63), receiving a kidney from a deceased donor (OR = 1.59; 95%CI: 1.23—2.35), long-term use of an indwelling catheter (OR = 3.03; 95%CI: 1.59—6.59), a ureteral stent (OR = 1.54; 95%CI: 1.16—2.06), diabetes (OR = 1.17; 95%CI: 0.97—1.41), hypertension (OR = 1.6; 95%CI: 1.26—2.28), acute rejection process (OR = 2.22; 95%CI: 1.45—3.4), and abnormal urinary tract anatomy (OR = 2.87; 95%CI 1.44—5.74).ConclusionThis meta-analysis revealed that UTIs are a significant problem in kidney recipients. Factors such as female sex, old age, history of UTIs, deceased donor, long-term use of an indwelling catheter, diabetes, acute rejection process, use of ureteral stent, abnormal urinary tract anatomy, and hypertension were related to an increased risk of UTIs in kidney recipients.

Characteristics of Nationwide Urinary Tract Infection (UTI) Visits by Age and Type II Diabetes Status in Women.

Background Through a national database search of office visits, we studied the contribution of two known risk factors for urinary tract infections (UTIs) in women: age and type 2 diabetes mellitus (T2DM). Methodology The National Ambulatory Medical Care Survey (NAMCS) database was queried for visits including a UTI diagnosis and a urine culture order. Data were included for all visits involving adult women for available years, 2014-2016 and 2018. Data on demographics, reason for visit, T2DM status, UTI workup, and UTI treatment were collected. Patients with Alzheimer's disease or chronic kidney disease were excluded. Descriptive statistics were displayed as weighted means with standard errors for continuous variables. The effect of age was compared based on a 65-year-old cutoff. Results One hundred sixty-seven surveyed visits were analyzed for the years 2014-2016 and 2018, representing an estimated 7.4 million visitsnationwide. Women ≥65 years were more likely to be white, non-Hispanic/non-Latino, from the Midwest or West, from metropolitan areas, and on Medicare/Medicaid than their younger counterparts. T2DM and urinalysis rates did not significantly vary between the two age groups (7.7% vs. 14.6%,P= 0.3; 78% vs. 76%,P= 0.9, respectively). For urinalysis rates between patients with and without T2DM, there was no significant difference in the <65-year-oldgroup (80% vs. 78%, P = 0.9) or the ≥65-year-oldgroup (93% vs. 73%, P = 0.12). Antibiotic prescription rates were also similar for T2DM and non-T2DM patients (67% vs. 75%, P = 0.7). Conclusions Through a national database analysis,we reported the demographic and visit differences aged <65 years and ≥65 years who sought care for UTIs in the United States over a four-year period.T2DM rates and urinalysis did not vary between age groups, and urinalysis rates and antibiotic prescription rates did not vary between T2DM and non-T2DM groups in an age-dependent matter. More research is needed to understand the demographic makeup and risk factors of UTI patients across the nation.

Risk factor analysis of urinary tract infection by cefotaxime-resistant Escherichia coli and Klebsiella pneumoniae: a simple and effective analysis using the National Health Insurance Data Sharing Service

Background: This study aims to analyze the risk factors for urinary tract infection (UTI) by cefotaxime-resistant Escherichia coli or Klebsiella pneumoniae, using data from the National Health Insurance Data Sharing Service. Methods: A retrospective case-control study was conducted to analyze the risk factors during 11 years (2010–2020). Study groups were selected based on the laboratory data of the hospital, which comprised 3,638 and 877 cases of cefotaxime-resistant E. coli and K. pneumoniae, respectively. Controls comprised 8,994 and 1,573 cases of cefotaxime-nonresistant (intermediate or susceptible) E. coli and K. pneumoniae, respectively. Clinical and socioeconomical features were obtained from the National Health Insurance service data. Results: In a multivariate analysis of risk factors for UTI by cefotaxime-resistant E. coli, the odds ratio (OR) of the male sex was 1.335 (95% confidence interval, 1.204–1.480), age 0–9 years was 1.794 (1.468–2.191), chronic renal disease was 1.227 (1.062–1.417), and hemodialysis was 1.685 (1.255–2.262). Moreover, the ORs of L-tube, central venous pressure catheter, and Foley catheter use were 1.204 (1.047–1.385), 1.332 (1.156–1.534), and 1.473 (1.316–1.649), respectively; the OR of previous antimicrobial use was 1.103 (1.009–1.206) and that of healthcare facility use was 1.782 (1.576–2.014). In a multivariate analysis of risk factors for UTI by cefotaxime-resistant K. pneumoniae, OR of the male sex was 1.460 (1.199–1.778), liver disease was 1.295 (1.037–1.617), and hemodialysis was 2.046 (1.263–3.315). The ORs of L-tube and Foley catheter use were 2.329 (1.861–2.915) and 1.793 (1.431–2.246), respectively, and the OR of the healthcare facility use was 1.545 (1.161–2.056). Conclusion: In this study, the risk factors for UTI caused by cefotaxime-resistant E. coli or K. pneumoniae were analyzed based on the data of a specific healthcare facility linked to the National Health Insurance system. We suggest that it is a simple and effective way to elucidate risk factors of infections caused by major antimicrobial-resistant pathogens.

Etiological features of urinary tract infections in pregnant women: current state of the problem

Background. Urinary tract infections in pregnant wo­men occupy a leading place in the structure of extragenital patho­logy. The purpose of the study is to determine the etiological features of urinary tract infections in pregnant women. Materials and ­methods. The study included 89 pregnant women with urinary tract infections. The material for microbiological research was urine, the samples of which were collected on the day of hospitalization of a pregnant woman before treatment. Identification of microorganisms was carried out with the use of ­MIKROLATEST® test systems (Erba Lachema, Czech Republic). Preparation of bacterial suspensions with a certain concentration of microbial cells was carried out using Densi-La-Meter electronic device (PLIVA-Lachema a.s., Czech Republic) according to the McFarland scale. Optical density was measured using a Multiskan EX microplate reader (type 355). Results. Escherichia coli, Proteus mirabilis, Proteus vulgaris, Streptococcus pyogenes, Enterococcus faecalis, Klebsiella pneumoniae, Pseudomonas aeruginosa are the leading pathogens of urinary tract infections in pregnant women of the Kharkiv region; Escherichia coli, Proteus mirabilis, Streptococcus pyogenes are predominant ones. The selected spectrum of etiological factors of urinary tract infections does not depend on the age of a pregnant woman. In the etiological structure of the urinary tract infections in pregnant women, Escherichia coli and Proteus mirabilis take the first and the second place during the first three trimesters of pregnancy. The third place in the first trimester belongs to Enterococcus faecalis, in the second trimester — to Proteus vulgaris and Streptococcus pyogenes, in the third trimester — to Streptococcus pyogenes. The etiological structure of urinary tract infections in pregnant women is determined by the topography of the inflammatory process. Thus, in women with asymptomatic bacteriuria, Proteus mirabilis takes the first place, Escherichia coli — the second place, Proteus vulgaris and Enterococcus faecalis — the third place; in acute pyelonephritis, the first place belongs to Escherichia coli, the second place to Streptococcus pyogenes, the third place to Proteus mirabilis, Enterococcus faecalis, Klebsiella pneumoniae; in urethritis, Escherichia coli takes the first place, Enterococcus faecalis, Klebsiella pneumoniae — the second place, Proteus mirabilis, Proteus vulgaris — the third place; in cystitis, the first place belongs to Escherichia coli, the second place to Proteus mirabilis, Proteus vulgaris, Enterococcus faecalis, Klebsiella pneumoniae, Pseudomonas aeruginosa. Conclusions. The etiological features of urinary tract infections with different topography of the inflammatory process of bacterial etiology determined by the authors must be taken into account in the treatment of this category of pregnant women.