Previous History Of Urinary Tract Infection Research Articles

O PAPEL DO ENFERMEIRO NA PREVENÇÃO DE INFECÇÃO DO TRATO URINÁRIO ASSOCIADA À GESTANTE NA ATENÇÃO PRIMÁRIA: UMA REVISÃO INTEGRATIVA

Introduction: Urinary tract infection (UTI) is one of the most common perinatal complications, affecting approximately 8% of Brazilian pregnant women. In this understanding, primary health care for these pregnant women is the main form of prevention and treatment for UTI. Objective: To understand the role of nursing in preventing urinary tract infection associated with pregnancy. Methodology: This is an integrative review, involving data collection through health research platforms (pubmed, scielo and BVS). The data were obtained through bibliographic references, books and articles that include urinary tract infection in pregnant women in primary care in the time interval between 2014 and 2024. Results: A total of 133 articles were analyzed, making it necessary to create inclusion and exclusion criteria, with 112 samples being excluded and 21 included. Furthermore, a significant association was identified between UTI and factors such as lack of sexual health education, genital hygiene, previous history of UTI, asymptomatic bacteriuria, resistance to antibiotics and laboratory tests and how prenatal care with nurses is satisfactory for pregnant women and important for reducing these risk factors. Conclusion: This study highlights important areas for improving early detection and adequate management of urinary tract infections in pregnant women, aiming to improve obstetric care and reduce potential complications during pregnancy.

A Cross Sectional Study of Cytokines in Women with Refractory Detrusor Overactivity versus Controls.

Previous work has suggested that refractory detrusor overactivity (DO) was commonly associated with urinary tract infection (UTI), which can lead to inflammatory changes in the bladder. This study aimed to investigate the concentrations of urinary cytokines in a large sample of women with refractory detrusor overactivity (DO) and age matched controls. The urinary concentration of 27 cytokines in 140 women (95 with refractory DO and 45 age matched controls (women without urge incontinence)) was determined using the Human Cytokine 27-plex Assay. Cytokine concentrations were correlated with a "UTI score", the presence or absence of bacteriuria or pyuria on the day of sample collection and a previous history of UTI. Pro-inflammatory cytokines were increased in refractory DO women compared to the controls. In women with refractory DO, the UTI score significantly correlated with urinary cytokine concentrations in 15 of the 22 cytokines detected. A previous history of UTI did not affect urinary cytokine concentrations in refractory DO women with no current UTI. Increasing pyuria was associated with increasing concentrations of urinary cytokines. Careful comparison of cytokine concentrations in women with refractory DO versus age matched controls has shown that changes in pro-inflammatory cytokines are related to the UTI disease burden, suggesting that an underlying inflammatory response, together with UTI, may be an aetiological contributor to the development of refractory DO.

Bacterial profiles, antibiotic susceptibility patterns, and associated factors of symptomatic urinary tract infections among symptomatic university students at Haramaya University, Eastern Ethiopia: Cross-sectional study.

Urinary tract infection (UTI) is a highly prevalent infection that can affect individuals of all ages, posing a significant risk to global health in terms of both morbidity and mortality. The emergence of multidrug-resistant bacteria adds to the complexity of this public health issue. There is limited data on the current study area. Therefore, this study aimed to determine the bacterial profiles, antibiotic susceptibility patterns, and associated factors of UTIs among symptomatic university students at Haramaya University, Eastern Ethiopia from May 10 to June 15, 2021. A cross-sectional study was conducted among 281 Haramaya University students. A systematic random sampling technique was used to select the study participants. Data were collected using a self-administered questionnaire. Ten to 15 mL of midstream urine samples were collected aseptically from patients. Standard microbiological techniques were used for bacterial identifications and drug susceptibility testing. The association between dependent and independent variables was determined by the logistics regression model. Variables with a P-value of <.05 were considered statistically significant. The overall prevalence of UTI among university students was 18.1% (95% confidence interval [CI]: 13.5-23.1). The most frequently isolated bacteria were Escherichia coli (33.3%) and Staphylococcus epidermidis (29.4%). Gram-negative bacteria demonstrated high resistance against ceftazidime (100%), penicillin (96%), ampicillin (92%), and tetracycline (71%). Similarly, gram-positive bacteria exhibited significant resistance to ceftazidime (100%) and ampicillin (81%). Multidrug-resistant isolates constituted an overall prevalence of 35 (68.6%) (95% CI: 63.6-73.6). Furthermore, year of study (adjusted odds ratios [AOR] = 2.66; 95% CI: 1.23-5.76), history of UTI (AOR = 2.57; 95% CI: 1.10-6.00), and sexual activity (AOR = 0.08; 95% CI: 0.02-0.39) were identified as factors. In this study, university students exhibited a higher prevalence of UTI compared to previous studies conducted in Africa. The most commonly identified bacteria causing UTIs were E coli, followed by S epidermidis. Factors such as the year of the study, presence of flank pain, history of previous UTIs, and frequency of sexual activity were found to be associated with UTIs. All the isolates have acquired resistance to the majority of commonly prescribed antibiotics. It is crucial to regularly monitor UTIs and the proliferation of antibiotic-resistant bacteria among university students.

#2289 Pregnancy outcomes in patients with congenital abnormality of the urinary tract: experience of a tertiary Portuguese center

Abstract Background and Aims Congenital abnormalities of the urinary tract (CAKUT) represent a broad range of disorders that occur due to abnormal kidney development. Maternal, obstetric, and perinatal outcome in pregnant woman with CAKUT have not been extensively evaluated, although small series report an increased incidence of urinary tract infections (UTI) and obstructive uropathy. Method Retrospective analysis of maternal, obstetric, and perinatal outcomes in pregnant patients with CAKUT (including genetic cystic kidney disease) that were surveilled in our tertiary center by a nephro-obstetric team between 2011 and June 2023. Information was obtained from medical records. Results We evaluated 47 gestations in 41 patients, with mean age of 31 ± 5 years [17-40], 89% were Caucasian, 11% black; 40% were nulliparous, 36% had hypertension (HT) and 42% a previous history of UTI. Regarding CAKUT specificity, 17/41 patients had genetic cystic diseases, 10/41 ureteropelvic junction obstruction (UPJ), 4/41 duplicate collecting system, 5/41 vesicourethral reflux, 2/41 ectopic kidney, 3/41 renal hypoplasia. Genetic testing was done before, during or after pregnancy in 2/4/4 patients, respectively. Teratogenic therapy exposure occurred in 25% of gestations. Most patients were CKD stage 1 (33/41), with 2/4/1/1 with patients in CKD stage 2/3/4/5, respectively. Mean baseline SCr was 0.99 ± 0.8 mg/dL [0.4-4.6] and mean proteinuria was 194 ± 357 mg/g [22-1500]. Renal function (RF) deterioration occurred in 9/47 (19%) women due to pre-eclampsia (PE), pregnancy hyperfiltration (PH) and hydronephrosis in 3/3/3 patients, respectively. Urologic intervention was needed in 2 patients due to hydronephrosis, and one of the patients required transient dialysis. All patients fully recovered RF except for the 1 CKD stage 3 patients that had partial RF recovery. De novo and worsening proteinuria occurred in 7/47 gestations due to PE (3/7) and PH (4/7). De novo or aggravation of HTN occurred in 25% gestations, UTI in 19% and PE in 6% gestations. Regarding fetal outcomes, mean duration of gestation was 38 ± 2 weeks [32-41] and mean birth weight 2910 ± 634 g [1360-4600]. There was 1 miscarriage and 1 medical termination of pregnancy at 17 weeks (neural tube defect). Cesarean was performed in (8/47, 17%) gestations and 10/47 (17%) newborns were admitted to the neonatal care unit (NICU) mainly due to prematurity, sepsis and feeding intolerance. Conclusion Our cohort of CAKUT patients was very heterogenous and only 19.5% had CKD stage 2-5. Still, we found a significant incidence of maternal, obstetric, and perinatal complications, namely HT UTI, PE, and the need for NICU. UPJ obstruction can evolve with RF deterioration and the need for intervention during pregnancy. This study underlines the importance of the management of these patients by a multidisciplinary team.

Secretory leukocyte protease inhibitor protects against severe urinary tract infection in mice.

Millions suffer from urinary tract infections (UTIs) worldwide every year with women accounting for the majority of cases. Uropathogenic Escherichia coli (UPEC) causes most of these primary infections and leads to 25% becoming recurrent or chronic. To repel invading pathogens, the urinary tract mounts a vigorous innate immune response that includes the secretion of antimicrobial peptides (AMPs), rapid recruitment of phagocytes, and exfoliation of superficial umbrella cells. Here, we investigate secretory leukocyte protease inhibitor (SLPI), an AMP with antiprotease, antimicrobial, and immunomodulatory functions, known to play protective roles at other mucosal sites, but not well characterized in UTIs. Using a preclinical model of UPEC-caused UTI, we show that urine SLPI increases in infected mice and that SLPI is localized to bladder epithelial cells. UPEC-infected SLPI-deficient (Slpi-/-) mice suffer from higher urine bacterial burdens, prolonged bladder inflammation, and elevated urine neutrophil elastase (NE) levels compared to wild-type (Slpi+/+) controls. Combined with bulk bladder RNA sequencing, our data indicate that Slpi-/- mice have a dysregulated immune and tissue repair response following UTI. We also measure SLPI in urine samples from a small group of female subjects 18-49 years old and find that SLPI tends to be higher in the presence of a uropathogen, except in patients with a history of recent or recurrent UTI, suggesting a dysregulation of SLPI expression in these women. Taken together, our findings show SLPI promotes clearance of UPEC in mice and provides preliminary evidence that SLPI is likewise regulated in response to uropathogen exposure in women.IMPORTANCEAnnually, millions of people suffer from urinary tract infections (UTIs) and more than $3 billion are spent on work absences and treatment of these patients. While the early response to UTI is known to be important in combating urinary pathogens, knowledge of host factors that help curb infection is still limited. Here, we use a preclinical model of UTI to study secretory leukocyte protease inhibitor (SLPI), an antimicrobial protein, to determine how it protects the bladder against infection. We find that SLPI is increased during UTI, accelerates the clearance of bacteriuria, and upregulates genes and pathways needed to fight an infection while preventing prolonged bladder inflammation. In a small clinical study, we show SLPI is readily detectable in human urine and is associated with the presence of a uropathogen in patients without a previous history of UTI, suggesting SLPI may play an important role in protecting from bacterial cystitis.

Prevalence and risk factors of urinary tract infection in pregnant women

Urinary tract infections (UTIs) are the most prevalent in pregnant women. There are associated risk factors that predispose the acquisition of a UTI in pregnancy, which can cause serious complications for mother and child. To determine the prevalence of UTI and associated risk factors in pregnant women at the Hospital Básico de Sangolquí. Observational, cross-sectional, analytical study conducted in 570 pregnant women from January 1 2021 to August 30 2022. The prevalence and risk factors associated with UTI were analyzed through 95% confidence intervals (95% CI) and odds ratio (OR) calculation. The global prevalence of UTI in pregnant women was 37.7% (IC 95% 33.7-41.7). The most frequent etiology was Escherichia coli (65.4%), followed by Staphylococcus spp. (21.8%). The age of pregnant women ranged from 12 to 45 years, with an average of 27.55 ± 7 years, out of which those with a previous history of UTI were at greater risk of presenting UTI (OR 4.05; 95% CI 2.65-6.18), followed by diabetes mellitus (OR 2.25; 95% CI 2.48-3.44), and overweight (OR 1.48; 95% CI 1.05-2.10). Regarding gestational age, the third trimester was a protective factor for UTI (OR 0.65; 95% CI 0.46-0.92]). The prevalence of UTI for pregnant women was 37.7%. The most frequent etiology was Escherichia coli. A history of UTI prior to pregnancy was the main risk factor.

The Epidemiology, Associated Factors and Bacterial Profile of Asymptomatic Bacteriuria in Pregnant Women: A Retrospective Chart Review Study in Saudi Arabia.

Asymptomatic bacteriuria (ASB) is the presence of significant amounts of bacteria within the urinary tract in the absence of urinary tract infection (UTI) symptoms, resulting in negative neonatal and pregnancy consequences. This study determined the prevalence, bacteriology patterns, and associated factors with ASB among pregnant women in both primary and hospital levels of care in the Eastern Province of Saudi Arabia. This retrospective chart review study included pregnant women between 18 and 50 years who performed the screening urine culture test during their first antenatal visit between 2017 and 2021, without UTI symptoms. The collected data involved the demographic, medical, and obstetric characteristics, and urine culture results. T-tests and chi-squared tests were used for bivariate associations followed by binary logistic regression models. ASB was positive among 03.42% of the 6471 pregnant women included in the study. Logistic regression revealed that the risk of positive ASB increased in pregnant women in the first and second trimesters (OR = 2.04, 95% CI = 1.41-2.93 and OR= 1.50, 95% CI = 1.03-2.19, respectively), as well as pregnant women with a history of previous UTI (OR = 2.98, 95% CI = 2.14-4.15). The predominant organism isolates were E. coli, followed by GBS, Klebsiella pneumoniae, and Enterococcus faecalis. With limited data on ASB among pregnant women in Saudi Arabia, findings from the current study could help decision-makers in the country assess the epidemiological characteristics of the condition. Further study is recommended to investigate the susceptibility patterns of commonly prescribed antibiotics with different uropathogens to guide the clinicians who deal with these cases. Additionally, a large national study across the other regions in the kingdom is suggested to calculate the prevalence of ASB in Saudi Arabia.

The effect of anal hygiene method in prevention from recurrent lower urinary tract infections in women

Aim: To evaluate the effects stopping the use of water and hands on preventing urinary tract infections (UTI) for a group of female patients having recurrent UTIs (rUTI).&#x0D; Material and Method: A retrospective observational study conducted in a tertiary care hospital between February 2017 and March 2018. 273 female patients which had rUTIs without any concomitant risk factors were included. In the study, 2 or more bacteriologically documented UTIs in the last 6 months were accepted as rUTI. The groups of the study defined as using their hands, using water only and using toilet paper (using either one of these two methods and then using toilet paper). Patients were observed for an average time of 10.4 months after stopping the use of water and hands for anal cleansing after defecation. Instead they were all given toilet education and started wiping for anal hygiene.&#x0D; Results: There was a statistically significant relationship between previous history of UTI and washing with hands + water (p=0.021). The rate of previous UTIs were significantly higher in the group of patients using their hands for anal washing (69% vs 31%). No relation was found between previous UTI history variable for using toilet paper and flushing with water only (p&gt;0.05). Our results showed a statistically significant decrease of UTIs after stopping the use of water and hands in the patient group who had a previous UTI history (p=0.001).&#x0D; Conclusion: We managed to underline that washing with hands for anal cleansing as a risk factor for rUTIs in women. Also showed the positive effect of stopping the use of water and hands for anal cleansing after defecation for prevention from rUTIs. We encourage all clinicians for further studies to investigate this issue in the future.

Urinary Tract Infection and Its Risk Factors in a Tertiary Care Hospital

Background: Urinary tract infection (UTI) is common health issue all over the world and several factors predispose the people to urinary tract infection.&#x0D; Objective: The study aimed at determining the incidence of Urinary tract infection and factors associated with it.&#x0D; Material and Methods: This cross-sectional study was performed among 205 patients in a tertiary care hospital of Rawalpindi, Pakistan. Simple convenient sampling and an established inclusion and exclusion criteria was applied to select the participants. After obtaining the informed consent from all participants, data was acquired via a self-designed proforma. Data analysis was carried out through SPSS version 25. Chi square test was applied to check the association between urinary tract infection and predisposing factors. The p-value less than 0.05 was taken as statistically significant.&#x0D; Results: The incidence of urinary tract infection was 12.68%. Urinary tract infection was significantly associated age group (p=0.003), gender (p=0.001), marital status (p=0.004), educational status (p=0.0001), socioeconomic status (p=0.005), previous history of UTI (p=0.0002), family history of UTI (p=0.0004), history of stone in urinary tract (p=0.003), history of recent use of antibiotics (p=0.04), history of catheterization (p=0.001), hygienic condition of external genitalia (p=0.0005), frequency of intercourse (p=0.04), history of diabetes mellitus (p=0.002), and hydration status (p=0.0007), whereas, association of urinary tract infection with holding urine was insignificant (p=0.05).&#x0D; Conclusion: The incidence of urinary tract infection was high among research population. Risk factors that could lead to UTI were young age, female gender, married marital status, lower educational status, lower socioeconomic status, previous history of UTI, family history of UTI, history of stone in urinary tract, history of recent use of antibiotics, history of catheterization, poor hygienic condition of external genitalia, high frequency of intercourse, history of diabetes mellitus, and dehydration.&#x0D; Recommendations: People should be educated about the UTI and its causes and prevention. People should also take special care when they are on antibiotics or when they are diabetics, to prevent UTI. People should maintain hygiene when they are catheterized and during intercourse. People should stay hydrated.

Prevalence and antimicrobial susceptibility pattern of urinary tract infection among pregnant women attending Hargeisa Group Hospital, Hargeisa, Somaliland

The aim of this study was to determine the prevalence, antimicrobial susceptibility pattern and associated factors of urinary tract infection (UTI) among pregnant women attending Hargeisa Group Hospital (HGH), Hargeisa, Somaliland. A cross-sectional study was conducted at HGH, Hargeisa, Somaliland and participants were selected by systematic random sampling technique. Clean catch midstream urine samples were collected from 422 participants and cultured and antimicrobial susceptibility pattern was determined for the isolates. Univariable and multivariable logistic regression analyses were utilized to identify the independent risk factors for UTI. The prevalence of UTI was 16.4% (95% CI 13.3–19.9). The predominant bacteria isolate was E. coli (43.5%) followed by Coagulase negative staphylococcus (CoNS) 11(16%), S. aureus 9(13%), K. pneumonia 6(8.7%), Pseudomonas aeruginosa 5(7.2%), Proteus mirabilis 4(5.8%), Citrobacter spp 3(4.4%) and M. morganii 1(1.5%) Gram negative bacilli were resistant to ampicillin (96%) and tetracycline (71.4%) and Gram-positive cocci were also resistant to ampicillin (90%), tetracycline (55%). Multidrug resistance was observed in 85.5% of bacterial isolated. No formal education participants, previous history of catheterization and previous history of UTI had 3.18, 3.22 and 3.73 times respectively more likely to develop UTI than their counterparts. Culture and susceptibility test is vital for appropriate management of UTI in the study area.

Urinary Tract Infections Among Geriatric Patients: A Systematic Review

Urinary tract infection (UTI) is the second most popular infection in the geriatric community, and the first popular is urine and fecal incontinence. Because of the effects of immunological aging, elderly are more susceptible to bacterial microorganisms and viral infections. The disease ranges from relatively harmless cystitis to potentially fatal pyelonephritis. This article aims to discuss the epidemiology, diagnosis, risk factors, progress of the disease, causative microorganisms, and guidelines for drug management of UTIs in geriatric patients. This study was performed following the PRISMA checklist. PubMed (2016-2022), Biological Sciences (ProQuest) (2012-2022), and ScienceDirect were used to locate English-language literature (2018-2022). We extracted data to assess the epidemiology, diagnosis, risk factors, causative microorganisms, and treatment management of UTIs in geriatric patients. This systematic review encompassed 11 observational studies including a total of 945,908 elderly patients and were published between 2012 and 2022. The prevalence varies across the studies. Urinary catheterization, gender, polypharmacy, comorbidities especially diabetes mellites older age, dementia, older age, vaginitis, previous history of UTI, bedridden state, and antimicrobial use were the independent risk factors. E. coli was the most found causative agent. Antibiotics were given specifically for UTIs. Despite the high rate of risk factors and prevalence of UTIs in the geriatric, treatment options are minimal. There is no evidence to support the use of antibiotics for long-term UTI prevention. However, alternative prophylaxis methods for patients with recurring infections must be developed. Although further studies are required to properly understand the clinical features and treatment modalities in elderly patients within the community or under institutional care.

Bacterial drug-resistance patterns and genetic diversity of bacteria-associated bacteriuria in diabetic patients in Ghana

Our study aimed to determine the etiology of urinary tract infections (UTIs), resistance profiles of isolated bacteria, and virulence factors of Escherichia coli associated with bacteriuria in diabetic patients in Ghana. Midstream urine samples from 982 diabetic patients were tested for uropathogens at the National Diabetes Management and Research Centre in Ghana, using standard bacteriological methods, with antibiogram testing of the isolates using the Kirby-Bauer disk diffusion, as per CLSI guidelines. Polymerase chain reaction (PCR) was used to investigate the phylogenetic groupings and virulence factor (VF) genes of isolated E. coli. The overall prevalence of UTIs was 9.2%, and the main uropathogens were Klebsiella spp. (55.6%) and Escherichia coli (31.3%). Age, duration of diabetes, and a previous history of UTIs were risk factors associated with UTI (p-value < 0.05). High levels of antibacterial resistance to cefuroxime (84%), ampicillin (80%), and gentamicin (70.7%) were observed. The distribution of VFs in each phylogenetic group revealed that sfa-iutA-KpsTMII-KpsTMIII genes were associated with group B2, and iutA-ibe were associated with group D. The isolated uropathogens were highly resistant, and the E. coli isolates possessed varying VFs. Continuous monitoring of bacteria associated with UTI in diabetics is highly recommended.

Antimicrobial resistance and ESBL profile of Uropathogens among pregnant women at Edna Adan Hospital, Hargeisa, Somaliland.

The emergence and spread of antimicrobial resistance (AMR) among uropathogens is increasing, especially in resource limited settings due to a number of reasons. The production of Extended Spectrum β-Lactamase (ESBL) by some strains of E. coli and methicillin resistant Staphylococcus species, limits the choice of antimicrobials in the treatment of urinary tract infection (UTI) globally. However, little is known about the type of uropathogenes and their current AMR profile among pregnant women in Hargeisa, Somaliland. Clean-catch mid-stream urine samples were collected and processed for bacteriological culture and antimicrobial sensitivity testing (AST). Ceftazidime (30µg) and Cefotaxime (30µg) disks were used for ESBL screening as per CLSI guideline and each ESBL screening positive isolate were phenotypically confirmed by a combination disk test. Among 376 study participants, 79 (21.0%) had significant bacteriuria (SBU). Majority at 58(73.4%) of the isolates were Gram-negative. The most predominant isolate was E.coli, 36(45.6%) followed by K. pneumonea 16(20.3%) and S. aureus at 9(11.4 %). The proportion of ESBL producing isolates was 25(32.9%). Gram-negatives showed high level resistance to ampicillin, amoxicillin, cefotaxime, and cephalexin at 87%, 85%, 57%, and 52%, respectively. Previous history of UTI, monthly income, educational status and having dysuria were significantly associated with SBU (p<0.05). Relatively high prevalence of uropathogens and an increased level of drug resistance were documented. Therefore, continued surveillance on the type of uropathogens and their AMR pattern is needed to ensure appropriate recommendations for the rational empirical treatment of UTI and for policy input.

Prevalence of Bacterial Urinary Tract Infection and Antimicrobial Susceptibility Patterns Among Diabetes Mellitus Patients Attending Zewditu Memorial Hospital, Addis Ababa, Ethiopia.

BackgroundUrinary tract infection (UTI) is caused by colonization and growth of microorganisms within the urinary system. Diabetic patients are more prone to bacterial UTI due to impaired host defense and high glucose concentration in urine. Surveillance of uropathogens and their antibiogram is a key to patient management.MethodsA hospital-based cross-sectional study was conducted from May to July, 2018. Urine samples were collected for culture and identification based on the standard protocol. An antimicrobial susceptibility test (AST) was done for all isolates using the Kirby–Bauer disk diffusion method. Data were entered into Epi-data version 3.2.1 and exported to the Statistical Package for the Social Science (SPSS) version 20.ResultsOut of 225 participants, significant bacteriuria was reported in 9.8% of the cultures. Five species of bacteria were isolated and E. coli (63.6%) was the leading uropathogen, followed by K. pneumoniae (13.6%). Duration of diabetes, previous history of UTIs and symptomatic UTI were found to be strongly associated with significant bacteriuria. Gram-negative bacterial isolates showed high sensitivity to nitrofurantoin and meropenem (100%). In contrast, a high level of resistance to ampicillin, doxycycline and cefuroxime (100%) and to amoxicillin-clavulanate (94.4%) was observed. Gram-positive bacteria showed high level of resistance to penicillin (100%). Multiple-drug resistance (MDR) was high for Gram-negative bacteria (100%).ConclusionPrevious history of UTIs and duration of diabetes were found to be important factors that increase the prevalence of UTI among diabetes patients. This study also showed a high prevalence of drug resistance to doxycycline, amoxicillin-clavulanate, cefuroxime and penicillin for both Gram-negative and Gram-positive bacteria. Since therapeutic selection for empirical treatment and management should be based on knowledge of the local bacterial profile and antimicrobial response, we suggest physicians take this high resistance profile in to consideration when prescribing antimicrobials against the pathogens in question.

Effect of Health Education Program Based on Health Belief Model on Prognosis of Urinary Tract Infection in Pregnant Women

Background: Urinary tract infection is a common cause of morbidity in pregnant women. The success of any educational intervention rests on the proper application of health behavior theories and models. Aim of the study was to investigate the effect of a health education program based on Health Belief Model (HBM) on the prognosis of Urinary Tract infection (UTI) in pregnant women. The study hypothesis was that women’s knowledge and practices will be improved, and this will lead to improvements in UTI symptoms and urine culture. Subjects & methods: Research design: an open label controlled quasi-experimental study with pre-post assessment was used in this study. Setting: the antenatal care (ANC) clinics in the primary health care centers affiliated to the Ministry of Health in urban areas of Port-Said city. Subjects: consisted of 90 pregnant women in first and second trimesters diagnosed with UTI were recruited consecutively in the study sample, each woman was randomly assigned to either the intervention or the control group as 45 women per group.Tools of data collection: include; structure interview schedule and a lab sheet. Results: showed that majority were living in urban areas, with no formal education. More women had a history of previous UTI (53.3% versus 40.0%) for studied and control women respectively. no statistically significant differences in their baseline (pre-intervention) scores of symptoms, knowledge of UTI, related health behavior practices, or Health Belief Model (HBM). At the post-intervention phase, the scores of symptoms severity and bothersome were statistically significantly lower among the study group with median scores zero. The knowledge and health behavior practices scores were statistically significantly higher among the study group with knowledge medians 81.00 and 31.00 respectively (p < 0.001). The scores of HBM were statistically significantly higher among the study group (p < 0.001). The pus cells and the urine culture in urine were less among the study group both in the post and 3-month follow up samples (p < 0.001) (p=0.03), respectively. Conclusion: the study concluded that the study intervention was protective against the risk of having a positive urine culture at 3-months follow-up. Recommendations: the study recommended that the program and its booklet should be implemented in ANC settings.

Urinary Tract Infection (UTI) in uncircumcised infants presenting in the pediatric floor of Faisalabad Medical University.

Circumcision is the commonest surgical procedure carried out on children. After evaluation of currently available studies and clinical trials the health benefits of newborn male circumcision outweigh the risks. Objectives: To determine the frequency of urinary tract infection (UTI) in uncircumcised infants presenting in the pediatric floor of Faisalabad Medical University. Study Design: Descriptive Cross Sectional study. Setting: Pediatric Ward, Emergency and OPD, Allied Hospital, Faisalabad. Period: July 2017 Dec 2017. Material &amp; Methods: After Ethical Review, all male uncircumcised subjects were included with consent from the patients. Data regarding the disease, presenting complaints was collected after complete examination of the child. Age, weight, temperature, history of previous UTI, dysuria, and colour and urine was noted. Urine sample was collected in a sterile container with the help of the parents and sent to the lab for complete examination and culture. Relevant baseline investigation was also sent to the laboratory for examination. Results of the urine complete examination and urine culture were also noted. Results: In this trial, mean age was calculated as 6.81+2.44 months, mean temperature and weight of the infants was recorded as 99.26+1.06F and 7.06+1.85kgs respectively. Frequency of history of dysuria was recorded in 30% (n=30), frequency of previous history of UTI was recorded in 13% (n=13), frequency of UTI was recorded in 25% (n=25). Conclusion: We concluded that the frequency of urinary tract infection (UTI) is higher in uncircumcised infants; however, timely circumcision may reduce the risk of UTI. The current data is primary in our population which needs authentication through some other trials.

Distribution of Pathogenicity Island Markers and H-Antigen Types of Escherichia coli O25b/ST131 Isolates from Patients with Urinary Tract Infection in Iran.

Escherichia coli serogroup O25b-sequence type 131 (E. coli O25b/ST131) is known as a multidrug-resistant organism with high virulence potential and has received attention internationally. We aim to investigate the prevalence of O25b/ST131 and the distribution of blaCTX-M-15, pathogenicity island (PAI) markers, phylogenetic groups, and H-antigen typing in the E. coli O25b/ST131 isolated from patients with urinary tract infection (UTI) in Tehran, the capital of Iran. Seventy (26.9%) E. coli isolates were identified as O25b/ST131. There was also a significant difference in the prevalence of virulence genes, including papA, sfa, sat, cnf1, iutA, kpMII, traT, and usp, in the O25b/ST131 isolates rather than non-O25b/ST131 ones (p ≤ 0.05). Furthermore, 78% of the O25b/ST131 isolates carried four to seven PAIs, while 71% of non-O25b/ST131 isolates carried two to four PAI markers (p ≤ 0.05). Our study showed that in addition to H4, other H-antigens may play a role in the O25b/ST131 virulence potential. Besides, a significant association was found between the history of previous UTIs and infection among the O25b/ST131 clone isolates. Pulsed-field gel electrophoresis revealed circulating of O25b:H4-ST131/PST43 clone in both hospital and community. Approximately one in every three uropathogenic E. coli isolates was the O25b/ST131 clone, representing a significant public health threat. Practical investigation on O25b/ST131 can be helpful in better understanding of ST131 evolution and controlling UTI in hospitals.

Bacterial associated urinary tract infection, risk factors, and drug susceptibility profile among adult people living with HIV at Haswassa University Comprehensive Specialized Hospital, Hawassa, Southern Esthiopia

People living with human immunodeficiency virus (HIV) are more likely to develop urinary tract infections (UTI) due to the suppression of their immunity. The aim of this study was to determine the prevalence, risk factors of UTI, and drug susceptibility pattern of bacteria isolated among peoples infected with HIV. A hospital-based cross-sectional study was conducted among 224 HIV positive individuals attending Hawassa University Comprehensive Specialized Hospital (HUCSH) from September 17 to November 16, 2018. Midstream urine was collected from all study participants and inoculated on to Blood and MacConkey agar. Bacterial isolates were characterized by Gram stain and standard biochemical tests. Kirby-Bauer method was used for antimicrobial susceptibility testing. Sociodemographic and clinical data were collected by a semi-structured questionnaire. Data were analyzed using SPSS version 20. A bivariate and a multivariable regression model were employed to determine the association between dependent and independent variables. From the total 224 study participants, 23 (10.3%) (95% CI 6.7–14.7) had culture-confirmed UTIs. The distributions of the bacteria were as follows: Escherichia coli 16 (69.6%), Staphylococcus aureus 2 (8.7%), Klebsiella pneumoniae 2 (8.7%), Enterobacter aerogenes 2 (8.7%) and Pseudomonas species 1 (4.3%). UTI prevalence was also high among study participants with a previous history of UTI and CD4+ count < 200/mm3. Female study participants were about five times more likely to have UTI (AOR 5.3, 95% CI 1.5–19.2). Ninety-three percent of bacteria isolated were susceptible to nitrofurantoin, ceftriaxone, and gentamycin; 87.5% were susceptible to meropenem and norfloxacin; whereas 93.8%, 68.8%, and 62.5% of isolates were resistant to ampicillin, tetracycline, and cotrimoxazole respectively. Multidrug resistance (MDR) was seen in 18 (78.3%) of bacterial isolates.

Association Between Urinary Tract Infection in the First Trimester and Risk of Preeclampsia: A Case-Control Study.

BackgroundUrinary tract infection (UTI) is a common clinical problem during pregnancy that can have serious consequences for the mother and fetus. Some studies have suggested that UTI can trigger or aggravate preeclampsia. The present study aimed to investigate the association between urinary tract infection in the first trimester and the risk of preeclampsia in pregnant women referring to Bahar hospital of Shahroud.Patients and MethodsIn this case–control study, 92 pregnant women with a diagnosis of preeclampsia were selected as cases, and for comparison 92 pregnant women were selected as control. History of previous UTI in the first trimester was assessed as a risk factor. Data were analyzed using SPSS 16 software and related statistical tests such as mean and standard deviation, chi-square, and independent t-test.ResultsIn this study, the mean age of the patients was 28.6 ± 6.9 years that no significant differences were found between the two groups. It was also found that 37 (40.2%) patients in the case group and 29 (31.5%) patients in the control group had a UTI which was significantly (p<0.043) higher in the case group. Also, in the multivariate regression model, UTI was significantly associated with preeclampsia (p<0.048), so that UTI increases the risk of preeclampsia (OR=1.86).ConclusionThe results of this study showed UTI during the first trimester of pregnancy is associated with the risk of preeclampsia. Therefore, controlling and treatment of urinary infections can reduce the risk of preeclampsia in the later months.

Prevalence of urinary tract infections and risk factors among pregnant women attending antenatal clinics in government primary health-care centers in Akure, Nigeria

Background: Urinary tract infection (UTI) has become the most common bacterial infection in humans, both at the community and hospital settings. It has been reported in all age groups and in both sexes. This is also a leading cause of Gram-negative sepsis in hospitalized patients. This study was carried out to identify and evaluate the associated risk factors of UTIs in relation to the sociodemographic characteristics among pregnant women in the study area. Materials and Methods: A cross-sectional study was conducted from February to June, 2018, on the urine of pregnant women, and the sociodemographic information of the women was collected. A total of 300 clean midstream urine samples were collected, and a general urine microscopic examination and culture were carried out. Results: Out of the 300 urine samples cultured, 183 (61.0%) yielded significant growth of urinary pathogens, whereas 117 (39.0%) yielded either insignificant growth or no growth of any urinary pathogen. Prevalence of UTI was statistically significantly associated with the type of toilet used, symptoms of UTI, and previous history of UTI (P