Features Of Urinary Tract Infection Research Articles

Characteristics of Urinary Tract Infections and the Use of Cranberry Products in Patients With Urinary Diversions: A Narrative Review.

The aim of this narrative literature review was to summarize evidence regarding bacteriuria and urinary tract infections (UTIs) in patients living with a urinary diversion and the use of cranberry products for the prevention of these infections. We searched for articles in the English language and available in full text to address the role of cranberry products in the management of UTIs in those with urinary diversions. We searched the electronic databases of MEDLINE, PubMed, and the Cochrane Central Register of Controlled Trials between January 2003 and December 2023. Thirty-two elements were read in full and 9 elements that evaluated UTIs and/or the role of cranberries in preventing UTIs are included in this narrative review. Research indicates no significant difference in UTI rates, microbiology, or antibiotic sensitivity and resistance patterns between the different types of urinary diversions (orthoptic diversions, ileal conduit diversions, and continent cutaneous diversions). Similar to persons with an intact urinary tract, Escherichia coli (a prevalent coliform bacteria) was the most prevalent pathogen resulting in symptomatic UTIs. In addition, we found that E. coli strains persisted in urinary diversions involving reconstructed intestinal segments for prolonged periods of time despite antibiotic treatment. We found sparse evidence suggesting that cranberry products are effective for the prevention of UTIs after ileal conduit urinary diversion. There are inconsistencies in the definition of bacteriuria in the literature making it difficult to compare findings among the studies. Clinical guidance discussing the optimal method for obtaining a urine specimen from a urinary diversion and its management is limited. Research studies on the use of cranberry products to treat UTIs in persons living with a urinary diversion are urgently needed.

Clinical and microbiological characteristics of urinary tract infections in the first year after renal transplantation

Urinary tract infections (UTI) are the most frequent infection in kidney transplant (KT) patients. The main objective was to determine the clinical and microbiological characteristics of UTIs that occur during the first year after KT. Retrospective cohort study that included patients over 18 years of age who received KT between 2009-2020 in two hospitals in Córdoba city, Argentina. Patients were followed up during the first year after the transplant by recording them in the medical records, and those who presented at least one episode of UTI were analyzed. During the study period, 568 KTs were performed, of which 207 (36.4%) had at least one episode of UTI. In total, there were 419 UTI episodes, 6 (1.4%) polymicrobial UTI episodes, so a total of 426 microorganisms were identified in the urine cultures. Of the total number of episodes, 206 (49.2%) occurred between 31 and 180 days post-transplant. The main etiological agent was E. coli with 225 isolates (52.8%) followed by Klebsiella sp. with 94 (22.1%). 52.1% of all episodes were caused by multi-resistant microorganisms (MRM). Among the E. coli isolates, 94 (41.8%) were MRM. In the multivariate analysis, the risk factors associated with UTI due to MRM were a history of recurrent UTI (Odds ratio 2.43; 95% CI: 1.37-4.30) and induction with basiliximab (Odds ratio 1.53; 95% CI: 1.029-2.29). UTIs occurred in more than a third of kidney transplant patients, being slightly more than half caused by MOR.

Late presentation of supernumerary kidney in a 35-year-old man: a case report

The supernumerary kidney is the rarest of all renal anomalies, and few cases have been diagnosed and reported over the years. Supernumerary kidneys are most commonly located on the left side of the abdomen with associated pathologic conditions which include malformations of the upper urinary tract and genital tract. More importantly, it usually presents with either unusual abdominal mass or features of urinary tract infections which might pose diagnostic challenges due to infrequent occurrence. In this case report, we present a 35-year-old man with a right-sided unilateral supernumerary kidney complicated by pyelonephritis. He was treated with antibiotics, and the treatment outcome was satisfactory.

Features of pyelonephritis course in adolescent females with co-existing anаemic syndrome

Background. Anaemic syndrome of complex origin is not uncommon in urinary tract infection, particularly in dietary non-adherence, menstrual cycle disorders, or concomitant digestive diseases, recurrent respiratory infections, etc. However, there is currently insufficient epidemiological data on this comorbidity in the literature. This study aims to establish the features of pyelonephritis course in its combination with anaemic syndrome in children. Materials and methods. We analysed the medical records of 200 children aged 0 to 17 years with acute non-complicated pyelonephritis, complicated and recurrent urinary tract infections for 2012–2017. In the second stage of our work, we comprehensively examined 85 girls aged 11 to 17 who underwent inpatient treatment between 2018 and March 2023. Thirty children of the same age and gender made up the comparison group. A paediatric gastroenterologist, a paediatric gynaecologist and/or urologist examined all patients. Immunochemical method with electrochemiluminescence immunoassay was used to assess ferritin content; also, serum iron and total iron-binding capacity were measured. Results. Anaemic syndrome is common in most girls with urinary tract infections (58.8 % of сases). Among the causes, the follo­wing are distinguished: menstrual cycle disorders with abnormal uterine bleeding (50.0 %), chronic digestive disorders, in particular malabsorption syndrome of unknown origin (25.0 %), recurrent bronchopulmonary disorders (15.0 %), and unbalanced diet (10.0 %). The features of urinary tract infections and concomitant iron deficiency in children include fatigue (55.0 % in acute non-complicated pyelonephritis vs. 40.0 % in complicated urinary tract infections, р < 0.05), dizziness (35.0 % in acute non-complica­ted pyelonephritis vs. 15.0 % in recurrent urinary tract infections, χ2 = 48.6532, р < 0.05), and pallor (25.0 % in complicated urinary tract infections vs. 10 % in recurrent urinary tract infections, χ2 = 0.7168, р > 0.05). The ferritin level was the highest in patients with complicated urinary tract infections (18.2 µg/mL). In patients with recurrent urinary tract infections, this indicator was the lo­west — 5.0 µg/mL. Conclusions. Retrospective analysis of medical records confirmed the presence of anaemia in 30.0 % of girls with inflammatory kidney diseases. During the physical examination, 58.8 % of female adolescents with urinary tract infections had signs of anaemic syndrome.

Clinical and laboratory features of urinary tract infection in hospitalized children

Background: Urinary tract infections (UTIs) is a common infection in children and a significant problem in Indonesia. Epidemiological data in developing countries are not widely available. This study aimed to determine the clinical and laboratory features of UTIs in hospitalized children. Methods: A retrospective study at a tertiary hospital in Denpasar–Bali. Children diagnosed with UTIs from January 1st, 2021–December 31st, 2022 were enrolled. Subjects are characterized based on age, nutritional status, and comorbidity. Clinical and laboratory features were described. Results: There were 84 children diagnosed with UTIs. A total of 30 subjects (35.7%) were <1–year-old and mostly female (52.4%). Most subjects (47.6%) were well–nourished and had comorbidities (92.9%) from a non-kidney disease (65.5%). Eight (9.5%) of the 52 subjects had hypertension. The most common symptom in the < 1–year–old group was jaundice (50%). The predominant symptom in the 1–5–year–old group was also fever (71.4%). Localized symptoms in the > 5–year–old groups showed dysuria (38.5%), urinary retention (30.8%), and frequency (26.9%). Urinalysis showed 30 subjects (35.7%) with positive nitrites and pyuria (66.7%). Leukocytosis was found in 24 subjects (72%) with a median NLR of 1.8. Abnormalities found in imaging examinations were cystitis (19.2%), hydronephrosis (42.1%), and hydroureter (11.5%). Conclusion: Age < 1–year–old, female, had comorbidities with predominant symptom was fever found in hospitalized UTIs. Half of the subjects had leukocytosis, abnormalities in urinalysis, and urology imaging. However, further research is needed to know the association and risk factors for UTIs in hospitalized children.

Exploring the Dynamic Role of Bacterial Etiology in Complicated Urinary Tract Infections.

Background and Objectives. Numerous studies have been conducted to explore the epidemiological characteristics of urinary tract infections (UTI) and sepsis. However, there is still a lack of relevant bacteriological features and prognostic information regarding urosepsis based on bacteriological etiology. The current study aims to evaluate the bacterial etiology of complicated UTI (cUTI) and bacterial resistance to antibiotics and whether they present an intrinsic risk of developing urosepsis. Materials and Methods. A retrospective study was performed that included 102 patients who were diagnosed with cUTI and admitted to the urology department of the "Sfântul Apostol Andrei" County Emergency Clinical Hospital (GCH) from September 2019 to May 2022. Results. A considerable number of patients, n = 41 (40.2%), were diagnosed with multi drug-resistant (MDR) infection. Escherichia coli (E. coli) was identified as the prevailing pathogen, accounting for 51 patients. Klebsiella manifested itself as the subsequent causative agent in 27 instances. The presence of Enterococcus spp. infection was documented in 13 patients, whereas Pseudomonas emerged as the etiological perpetrator in the clinical context of 8 patients. The current study found a substantial prevalence of resistance to first-line antibiotics. The overall resistance rate was 74.5% for penicillin, 58.82% for trimethoprim-sulfamethoxazole and 49% for fluoroquinolones; cephalosporin resistance displayed an inverse correlation with antibiotic generation with fourth-generation cephalosporins exhibiting a resistance rate of 24.5%, and first-generation cephalosporins demonstrating a resistance rate of 35.29%. Conclusions. Age, comorbidities and indwelling urinary catheters are risk factors for developing MDR infections. While the intrinsic characteristics of the causative bacterial agent in cUTI may not be a risk factor for developing urosepsis, they can contribute to increased mortality risk. For empiric antibiotic treatment in patients with cUTI who are at a high risk of developing urosepsis and experiencing a potentially unfavorable clinical course, broad-spectrum antibiotic therapy is recommended. This may include antibiotics, such as amikacin, tigecycline, carbapenems and piperacillin-tazobactam.

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.

Associated Morbidities Seen in Women with Obstetric Fistula

Background: Obstetric fistula continues to be a source of misery for women in developing countries. It usually occurs in association with other morbidities. The study was carried out to determine the morbidities that co-exist with obstetric fistula. Methodology: It was a cross-sectional descriptive study carried out among women seeking treatment of obstetric fistula in Cross River State of Nigeria. A combined purposive and proportionate sampling technique was used to select 210 participants. Ethical approval was obtained. A semi-structured interviewer-administered questionnaire was used to obtain information on biodata, obstetric characteristics and morbidties associated with obstetric fistula. Data was analyzed with SPSS version 20. Chi-square was used to compare categorical variables. A P-value of less than 0.05 was considered significant. Results: Among the 210 women, 59 (28.1%) were aged 30 and 39 years. Eighty-one women (38.6%) were grandmultipara and 80 (38.1%) had no living child. Majority (178; 84.8%) of the women delivered stillbirths. At presentation, 175 women (83.3%) had depression, 138 (65.7%) had sexual dysfunction, 97 women (46.2%) had amenorrhoea, 138 (65.7%) had secondary infertility, 128 (61%) had obstetric palsy (foot drop), 171 (81.4%) had urine dermatitis, while 49(23.3%) had features of urinary tract infection. Fifteen women 15 (7.1%) had co-existing rectovaginal fistula. Increased duration of leakage was significantly associated with development of urine dermatitis (P=0.001). Also, increased duration of labour was significantly associated with development of obstetric palsy (P=0.000). Conclusion: Morbidities associated with obstetric fistula are depression, sexual dysfunction, amenorhoea, inferlility, urine dermatitis, obstetric palsy and urinary tract infection. Fistula patients should be assessed for these and be managed by a multidisplinary team.

Risk factors and etiological characteristics of urinary tract infection in hospitalized continuous ambulatory peritoneal dialysis patients.

This study aimed to explore the risk factors and etiological characteristics of urinary tract infection (UTI) in continuous ambulatory peritoneal dialysis (CAPD) patients. A total of 90 CAPD patients with UTI comprised the infection group, while 32 CAPD patients without UTI constituted the control group. The risk factors and etiological characteristics of UTI were analyzed. Of the 90 bacterial strains isolated, 30 were Gram-positive (33.3%) and 60 were Gram-negative (66.7%). Urinary stones or urinary tract structural changes were more prevalent in the infection group (71.1%) than in the control group (46.9%) (χ² = 6.076, p = 0.018). The proportion of patients with residual diuresis less than 200 ml was higher in the infection group (50%) than in the control group (15.6%) (χ² = 11.533, p = 0.001). The distribution of primary disease differed between the two groups. Patients in the infection group had higher CAPD vintage, levels of triglycerides, fasting blood glucose, blood creatinine, blood phosphorus, and calcium-phosphorus product than those in the control group. Multivariate binary logistic regression analysis indicated that residual diuresis less than 200 ml (OR = 3.519, p = 0.039) and urinary stones or structural changes (OR = 4.727, p = 0.006) were independent risk factors for UTI. Urine cultures of CAPD patients with UTI contained a complex distribution of pathogenic bacteria. Urinary stones or structural changes and residual diuresis less than 200 ml were independent risk factors for UTI.

Clinical Features of Urinary Tract Infection in Neonates with Hyperbilirubinemia: A Cross-sectional Study

Introduction: Neonatal hyperbilirubinemia is a common physiological finding in neonates but sometimes Urinary Tract Infections (UTI) can occur in these neonates and it can be asymptomatic or may lead to complications. Many causative factors are listed out for development of neonatal jaundice but the UTI is less mentioned in previous studies. Aim: To study the prevalence of UTI and its clinical features in the neonates with hyperbilirubinemia. Materials and Methods: This cross-sectional study was conducted in Aakash Healthcare super specialty Hospital, Dwarka, New Delhi, India, between June 2019 and May 2020. Total 116 infants with neonatal hyperbilirubinemia were included in the study. The demographic features including date and time of admission, age at presentation of jaundice, mode of parturition, type of assistance for delivery (if any used), presence of cephalohaematoma, bruising or caput succedaneum, weight at birth, age at onset of jaundice (days of life), baby’s and mother’s blood group, any metabolic diseases in mother and father etc. were studied. A thorough haematological work-up was done and urine was collected in a sterile container by catheterisation. All samples were sent to the laboratory for microscopic analysis and culture. Data was statistically analysed using Mann-Whitney U-test and level of significant p-value was considered as less than 0.05. Results: A total of 116 cases of neonatal hyperbilirubinemia were included in this study. Out of the 116 cases, 66 cases (56.89%) were male neonates and infants and 50 cases (43.11%) were female neonates and infants. In this study, out of 116 neonates with hyperbilirubinemia, only 20 babies showed pus cells >5 //hpf (high power field microscope) (suggesting UTI), out of the 20 babies, 08 babies showed culture negative and pus cells >5 /hpf and remaining 12 babies showed culture positive and pus cells >5 /hpf. Out of 12 cases of culture and sensitivity, 8 cases showed culture for Escherichia coli (E.coli) and remaining four cases, organism cultured was Klebsiella pneumonia. Conclusion: Hyperbilirubinemia may be the initial sign of UTI in neonates; it may be asymptomatic in jaundiced newborns. It is recommended that, evaluation of UTI should be made in cases of asymptomatic hyperbilirubinemia cases which helps the paediatrician for early detection and treatment of these affected newborns reducing the hospital stay and long term complications.

Dysentery and leg ulcer as an atypical presentation of systemic lupus erythematosus: A case report

Due to heterogeneity in the organs involved and a variety of influencing factors, a wide range of clinical manifestations are possible in systemic lupus erythematosus (SLE). In our knowledge, a combination of leg ulcer and dysentery as presenting symptoms of SLE has never been reported previously. A 13-year-old female child presented with a chronic wound over right medial malleolus for 6 months, and passing of watery stool, later mixed with blood, for 4 days. On examination, she had a fever of 38.5°C. Lab reports revealed anemia, thrombocytopenia, proteinuria, and features of urinary tract infection. Renal biopsy showed membranous glomerulonephropathy. She was positive for antinuclear antibodies (ANA) and antidouble stranded DNA (anti-dsDNA). Immunofluorescence revealed reduced C4 and C3 levels. Abdominal ultrasound showed symmetrical circumscribed thickening, and edematous cecum and ascending colon. The patient was diagnosed with SLE based on the Systemic Lupus International Collaborating Clinics classification criteria. The patient was treated with prednisolone, hydroxychloroquine, metronidazole, ciprofloxacin, trypsin-chymotrypsin, zinc, calcium, and calcitriol tablets. Fever subsided within 3 days of treatment. Gastrointestinal symptoms subsided within 1 week of treatment. On 31 day of treatment, the wound had been reduced and showed features of healing. Dysentery and leg ulcers can be the manifestations of SLE. Therefore, SLE should also be considered when a patient presents with such symptoms. Any suspicion of infection in SLE should be treated aggressively with antibiotics.

A COMPARATIVE STUDY OF ANTIMICROBIAL SUSCEPTIBILITY OF E. COLI AMONG NONELDERLY VERSUS ELDERLY PATIENTS WITH URINARY TRACT INFECTION IN A TERTIARY CARE HOSPITAL.

Introduction: As there is rise in the elderly population, there is increase in the geriatric illnesses, urinary tract infection is one of the commonly seen among them. There is increasing prevalence of antibiotic resistance in the elderly patients. Aim: Study was conducted to look for the difference in antibiotic susceptibility in nonelderly compared to elderly patients. We took 100 cases with 50 elderly and 50 nonelderly with E.coli grown in urine Material and methods: samples with features of urinary tract infection. There was no significant difference in the antibi Results: otic susceptibility in both the groups except for the cefepime being good choice in nonelderly amongst cephalosporins. Amongst oral antibiotics to choose empirically are Nitrofurantoin, Cotrimoxazole and Amoxycillin in both the groups with no significant differences. We can use all the groups of antibiotics empirically especially inj Conclusions: ectables like Cephalosporins, Piperacillin, Aminoglycosides and Carbapenems as and when indicated in both groups with almost equal results. But we need to take a prospective study with larger number of cases to arrive at a more definitive conclusion.

Antibiotic Sensitivity Pattern and Demographic Characteristics of Urinary Tract Infection among Hospitalized Children

Introduction: Urinary tract infection (UTI) is the third most common infection during childhood and considered as an important risk factor for the development long-term complications. It was aimed to look into the demographic characteristics, clinical presentations, and antimicrobial resistance among children hospitalized for UTI. Methods: This cross-sectional observational study was conducted at the Inpatients Department of Uttara Adhunik Medical College and Hospital, Dhaka, Bangladesh. The study duration was 2 years, from July 2017 to June 2019, during which period, a total of 90 children with urinary tract infection visiting the study place were included in the study, following the inclusion and exclusion criteria. Result: The age of the participants ranged from over 1 months to 5 years., with majority (55.56%) being between the age of 2-5 years. The male to female ratio was 1:1.73. Fever was the commonest presenting symptom in participants, with 87.78% prevalence, followed by vomiting in 80% of the participants. The commonest organism cultured in this study was E. coli (80%), followed by Klebsiella spp. (20%). Isolated pathogens were highly sensitive to Amikacin (100.0%), Meropenem (100.0%), Imipenem (97.0%) and Nitrofurantoin (90.9% - 100.0%), moderately sensitivity to third generation Cephalosporine and highly resistant to Ampicillin (75.0 - 78.8%), Amoxiclav (72.7% - 87.5%) and Cephalexin (81.1% - 87.5%). Conclusion: The proportion of urinary tract infection in females was higher than males. Most patients presented with more than one symptom but most commonly presented with fever. E. coli was the most common isolated bacteria in hospitalized children with a principal diagnosis of UTI. Most of the isolated pathogens were highly resistant to ampicillin, cotrimoxazole, and highly sensitivity to amikacin, nitrofurantoin and meropenem.

Uşak İlinde Çocuklarda Üriner Sistem Enfeksiyonlarının Mikrobiyolojik ve Antimikrobiyal Profili

Aim: One of the most prevalent pediatric diseases is urinary tract infection (UTI), accounting for 3% of all infections among the pediatric population and affect 2% of males and 8% of females by age seven. Bacteria are the most prevalent cause of UTIs, accounting for more than 95 percent of cases. The most prevalent causal bacteria of UTI is Escherichia coli. Antibiotics are included in the treatment of these infections. As a result, determining the correct antibiotic susceptibility is critical in the therapeutic treatment of bacterial infections. This study aimed to analyse the aetiology and antimicrobial resistance characteristics of urinary tract infection among children presenting with symptoms in Uşak. Material and Method: A total of 1250 urine culture results were retrospectively analyzed from pediatric patients aged 0–16 years who were admitted to Uşak Öztan Hospital as outpatients with symptoms and complaints of urinary tract infection and whose urine analysis and urine culture were taken between January 2018 and December 2020. Result: Gram-negative microorganism growth was found in 238 (19%) of the 1250 pediatric patients evaluated in our study. There was no growth in the urine cultures of 877 (70%) patients. E. coli was the most isolated microorganism in our study, which was detected in 168 (70.5%) of the patients. Conclusions: We present the first antimicrobial resistance data for the city of Uşak. Our study showed that amoxicillin/clavulanate is not the best option for the empirical therapy of community acquired UTIs, contrary to current local practice. In addition, ceftriaxone was found to be the second most resistant antibiotic in our study.

The Characteristics of Urinary Tract Infection and Antimicrobial Sensitivity Patterns in Pregnant Women

Objective: To determine the comparison of uropathogenic patterns and antimicrobial sensitivity tests in pregnant women in Manado.
 Methods: This study was a cross-sectional study on 28 pregnant women with UTI who presented to Prof. Dr. R. D. Kandou General Central Hospital, Pancaran Kasih Hospital, and Manado City Bhayangkara Hospital in Manado from February 2021 to April 2021. The data were analyzed using Microsoft Excel software.
 Results: Most pregnant women with UTI were within the age range of 20-35 years, namely 16 subjects (57.14%). Most had parity status of multipara, namely 15 subjects (53.57%). For the history of UTI, most subjects had no history of UTI, namely 16 subjects (57.14%), and had no history of contraception uses, namely 20 subjects (71.43%). Most subjects also had no history of vaginal discharge, namely 18 subjects (64.29%). Of 28 pregnant women with UTI, 23 (82.14%) were asymptomatic, while 5 (17.86%) were symptomatic. E.coli was the most commonly found pathogen and was still sensitive to most antibiotics.
 Conclusion: The description of pregnant women with UTI in Prof. Dr. R. D. Kandou General Central Hospital, Pancaran Kasih Hospital, and Bhayangkara Hospital in Manado City was pregnant women aged 17-34 years, multigravida, in the 3rd trimester, had an education level of Elementary-High school, unemployed, under the minimum wage, had no history of UTI or contraception uses and had a history of vaginal discharge. Most pregnant women with UTI were asymptomatic. The most common bacterial growth was in E.coli, and it was still sensitive to most antibiotics.
 Keywords: antimicrobial, microorganism, pregnancy, UTI.
 
 Abstrak
 Tujuan: Untuk mengetahui perbandingan pola uropatogen dan uji kepekaan antimikroba pada perempuan hamil di kota Manado.
 Metode: Penelitian ini merupakan penelitian yang menggunakan pendekatan potong lintang terhadap 28 perempuan hamil dengan ISK yang datang memeriksakan diri di RSUP Prof dr. R. D. Kandou Manado, RS Pancaran Kasih, dan RS Bhayangkara kota Manado dari Februari 2021 hingga April 2021. Analisis data dilakukan menggunakan program Microsoft Excel.
 Hasil: Kelompok usia terbanyak dengan ISK pada ibu hamil adalah 20-35 tahun sebanyak 16 orang (57,14%). Karakteristik graviditas paling banyak adalah pada kelompok multipara yaitu sebanyak 15 orang (53,57%). Hasil karakteristik kelompok tanpa riwayat ISK merupakan yang paling banyak yaitu sebanyak 16 orang (57,14%). Mayoritas peserta penelitian tidak mempunyai riwayat pemakaian KB yaitu sebanyak 20 orang (71,43%). Mayoritas peserta penelitian mempunyai riwayat flour albus yaitu sebanyak 18 orang (64,29%). Hasil sebaran distribusi ibu hamil dengan ISK, didapatkan dari 28 subyek, terdapat 23 orang (82,14%) yang tidak memiliki gejala, sedangkan 5 orang (17,86%) memiliki gejala. Hasil sebaran jenis mikroorganisme yang tumbuh pada kultur paling banyak adalah E. coli dan mikroorganisme ini masih sensitif terhadap mayoritas antibiotik.
 Kesimpulan: Gambaran sebaran perempuan hamil dengan ISK di RSUP Prof. Dr. R. D. Kandou, RS pancaran Kasih, dan RS Bhayangkara di kota Manado adalah pada perempuan hamil dengan usia 17-34 tahun, multigravida, hamil trimester 3, berpendidikan SD-SMA, tidak bekerja, memiliki penghasilan di bawah UMR, tidak memiliki riwayat ISK, tidak memiliki riwayat KB, dan memiliki riwayat fluor albus. Mayoritas perempuan hamil dengan ISK tidak memiliki gejala Pertumbuhan bakteri terbanyak adalah E.coli dan mikroorganisme tersebut masih sensitif terhadap mayoritas antibiotik.
 Kata kunci: antimikroba, ISK, kehamilan, mikroorganisme.

Epidemiologic, microbiologic and imaging characteristics of urinary tract infections in hospitalized children < 2 years of age diagnosed with anatomic abnormalities of the urinary tract.

To compare the epidemiologic, microbiologic and imaging characteristics of urinary tract infections (UTI) in children <2 years of age with and without anatomic urinary tract abnormalities (AA). All children hospitalized with UTI during 1.1.2005-31.12.2018 were included. The study group (patients with AA) included 76 patients. The control group (99 patients) included patients without AA. 1163 children were hospitalized. Age at diagnosis was younger in the study group vs. controls (5.2±6.0 vs. 7.9±7.5 months, P=0.038). Uropathogens distribution was different (P=0.007), with lower Escherichia coli (Ec) and Proteus mirabilis (Pm) percentages in the study group and higher percentages of Enterococcus spp. (Ent) in controls. In the study group, Ec nonsusceptibility rates to ampicillin, amoxicillin/clavulanic acid, cefazolin, cefuroxime, TMP/SMX and ceftriaxone were 58%, 40%, 14%, 14%, 12% and 10%, respectively, with no differences vs. controls. Ultrasound (US) was performed in 69/76 (98%) patients with AA (84.1%, abnormal); bilateral (39.7%) and unilateral (32.7%) ureteral dilatation were the most frequent findings. Voiding cystourethrography was performed in 46 patients (pathologic in 35, 76%); 31 (81.6%) patients had vesicoureteral reflux (VUR) (bilateral in 11, 35.5%; grade 4/5 in 7 patients). Uropathogens distribution in VUR patients differed between study and control groups, with lower Ec and Pm in the first group and higher Pseudomonas aeruginosa and Ent percentages in the control group. Age at diagnosis was lower and pathogen distribution was different in patients with AA. Antibiotic susceptibility patterns of the main uropathogens were similar between patients with or without AA.

Clinical, Subclinical Characteristics and Classify Urinary Tract Malformation in Children with Urinary Tract Infections at the National Children’s Hospital

Aim: To describe clinical, subclinical characteristics and classify urinary tract malformation in children with urinary tract infections at the National Children’s Hospital. Subjects and research methods: A cross-sectional descriptive study on 100 children with urinary tract infections and urinary tract malformations treated at the Department of Nephrology and Dialysis of National Children’s Hospital from June 2019 to June 2021. Results: The rate of malformed urinary tract infections in children accounted for 2.1% of the total urinary tract infections. The male/female ratio was 1.22/1. The most common age was from 3 months to 3 years old (78%). The most common clinical manifestations were fever (89%) and urination disorder (52%). Symptoms of other organs included the digestive system 45%, respiratory system 24%, and nervous system 17%. Children with white blood cell count ≥15 G/L and CRP ≥ 20 mg/L accounted for 60% and 77% respectively. Kidney failure was 11% of children. There was a strong correlation between nitrite-positive and children with positive urine culture (OR: 4.7, Cl95% [1.2-15.2]). Vesicoureteral reflux was the highest observed of urinary malformation of the kidney (78%), followed by the duplex kidney (16%) and ureteropelvic junction narrowing (14%). The rates of recurrence and complications were 59% and 11%, respectively. The rate of recurrent urinary tract infections increased with the severity of reflux. Conclusion: The clinical and subclinical characteristics of urinary tract infections in urinary tract malformations children are most commonly fever, urination disorder, and vesicoureteral reflux get the highest rate.

Urinary Tract Infections in Hospitalized COVID-19 Patients, What's Up, Doc?

The SARS-CoV-2 pandemic might have increased the risks of healthcare-associated infections (HAIs); however, several studies of HAI such as urinary tract infections (UTIs) and catheter-associated urinary tract infections (CAUTIs) have shown contradictory results. The aim of this study is to assess the clinical features of UTIs and bacterial isolates from urine samples of hospitalized COVID-19 patients. We conducted a retrospective observational study including 87 COVID-19 patients with UTIs admitted to our centre. Bacterial UTIs presented were 87: 9 (10.3%) community-acquired UTIs (coinfection group) and 78 (89.6%) hospital-acquired UTIs (superinfection group). In the coinfection group, the most frequent type was non-CAUTI with 5 (55.5%) patients; however, the most frequent UTI in the superinfection group was CAUTI, with 53 (67.9%) patients. The median number of days of hospitalization in coinfected patients was lower than superinfection patients: 13 (IQR 11, 23) vs. 34 days (IQR 23, 47) p < 0.006. All UTI patients admitted to ICU, 38 (43.7%), belonged to the superinfection group. The mortality rate was 26.4% (23/87), 22/23 in the superinfection group. The most common microorganisms were E. coli 27 (28.4%), E. faecalis 25 (26.3%) and E. faecium 20 (21.1%). There was an increased incidence of E. faecalis and E. faecium in UTIs as well as hospital-acquired UTIs. This can be related to urethral catheterization during hospitalization, UCI admissions and the number of days of hospitalization.

Infección del tracto urinario en el servicio de Pediatría del Hospital Regional de Moquegua

Objective: To determine the clinical and epidemiological characteristics of urinary tract infections (UTIs) supported by the diagnosis, therapy and antimicrobial susceptibility of inpatients of the Pediatric Unit of the Hospital Regional de Moquegua from 2014 to 2020. Materials and methods: An observational, descriptive and retrospective study. The research included a population of 248 patients aged between 1 month and 14 years 11 months 30 days with a diagnosis of UTI who underwent a urine culture. A data collection sheet was used and the results were processed using the IBM SPSS Statistics statistical software 23.0. Results: The infection occurred more often in female patients (82.26 %), with fever being the most prevalent clinical manifestation (83.87 %). The most widely used medical treatment was amikacin (49.19 %). E. coli was the most frequently isolated germ (70.57 %). The isolated germs showed sensitivity to antibiotics such as nitrofurantoin (70.16 %), ceftazidime (51.20 %), gentamicin (43.14 %) and amikacin (28.62 %). In contrast, they were resistant to sulfamethoxazole–trimethoprim (74.59 %). One of the most common findings in the imaging tests was unilateral pyelectasis (43.14 %). Conclusions: UTIs occur more frequently in women. The anamnesis and clinical examination, together with a complete urinalysis and imaging tests, are essential for the diagnosis and treatment of these patients. The definitive diagnosis must be established by a urine culture. The choice of an empirical therapy will depend on the patient’s history of sensitivity and resistance to antibiotics based on the urine cultures performed.

POS-084 A RARE GENETIC DISORDER PRESENTING AS RECURRENT URINARY TRACT INFECTION IN CHILDREN

Familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) is a rare autosomal recessive renal tubular disorder. The incidence is <1/1,000,000 individuals and >50% cases develop chronic kidney disease (CKD) by 2nddecade of life. It presents with non-specific symptoms like failure to thrive, abdominal pain, polydipsia, polyuria and clinical features of urinary tract infection (UTI). To the best of our knowledge, only 5 case reports have been published from the Indian sub-continent and none describing long term follow up.