Manifestation Of Urinary Tract Infection Research Articles

Modern approach to the treatment of urinary tract infections during pregnancy

Urinary tract infections (UTIs) are an extremely common pathology among pregnant women and women in labor, the manifestation of which occurs during pregnancy. Physiological changes in a woman’s organism form an optimal background for infection or activation of the aggression of one’s own microbial environments – the microflora that colonizes the periurethral area and mostly belongs to the family of enterobacteria and staphylococci.Clinical manifestations of UTIs during pregnancy are extremely variable and do not always correspond to the usual course of the disease, which necessitates the search for modern approaches to diagnosis and treatment. Also, UTI is one of the leading factors that provoke severe pregnancy complications and can lead to adverse obstetric outcomes.The objective: to evaluate the effectiveness of the modern etiopathogenetic approach to the treatment of UTIs during pregnancy.Materials and methods. In the study, which began in 2022 and is ongoing, 1615 pregnant women at gestational ages 6-37 weeks with clinical manifestations of urinary tract infections (UTIs). This work presents the survey results of 615 pregnant women with UTIs at gestational ages from 20 to 28 weeks, both before and one month after treatment initiation. These women were monitored during their pregnancies in prenatal care clinics of municipal non-commercial enterprises across all regions of Ukraine. At the stage of prescribing treatment the examined women are divided into two groups. The main group included 374 pregnant women with established diagnoses of acute urethritis, acute cystitis, gestational pyelonephritis (GP) and asymptomatic bacteriuria (ABU), who have received antibacterial and uroseptic agents for treatment in accordance with current clinical guidelines in combination with a herbal uroantiseptic containing 120 mg of cranberry berry extract and 36 mg each of extracts of goldenseal, lovage root, rosemary, as well as auxiliary substances. The comparison group included 241 pregnant women with established diagnoses of acute urethritis, acute cystitis, GP and ABU, who were treated exclusively with antibacterial and uroseptic agents for UTIs manifestations.The effectiveness of treatment methods was evaluated on the basis of a developed questionnaire with information on the main symptoms characteristic of diseases of the urinary system, before and one month after the prescribed treatment.Results. On the background of addition to the main antibacterial and uroseptic therapy the herbal uroantiseptic, containing 120 mg of cranberry berry extract and 36 mg each of extracts of yarrow, lovage root, rosemary, as well as auxiliary substances already a month after the start of treatment, the absence of complaints was found in the majority of pregnant women in the main group, related:with frequent urination – 354 (94.6%) (comparison group – 208 (86.3%); p<0.05), the need for urgent urination – 374 (99.1%) (comparison group – 232 (96.3%); p<0.05), the feeling of incomplete emptying of the bladder – 348 (93.3%) (comparison group – 202 (83.9%); p<0.05),with pain: during urination – 369 (98.7%) (comparison group – 231 (95.9%); p<0.05), in the lower abdomen, not associated with urination – 366 (97.9%) (comparison group – 230 (95.9%); p<0.05), in the lower back – 369 (98.7%) (comparison group – 229 (95.1%); p<0.05),with discharge from the urethra not related to urination – 374 (100.0%) (comparison group – 233 (96.7%); p<0.05).Conclusions. On the background of the prescribing of a herbal uroantiseptic containing 120 mg of cranberry extract and 36 mg of extracts of yarrow, lovage root, and rosemary, as well as auxiliary substances, additionally to the main antibacterial and uroseptic therapy in pregnant women of the main group, in a significantly greater number of cases the absence of complaints, which are associated with manifestations of urinary tract infections, was determined.The use of the herbal uroantiseptic, containing 120 mg of cranberry berry extract and 36 mg of extracts of yarrow, lovage root, and rosemary, is safe and creates favorable conditions for the course of pregnancy and further childbirth due to the potentiation of the effects of antibacterial and uroseptic therapy and the effective prevention of recurrences of urinary tract infections.

Purple Urine Bag Syndrome: a Rare Manifestation of Urinary Tract Infection

Purple urine bag syndrome (PUBS) is rare manifestation of urinary tract infection (UTI). Epidemiological study showed the prevalence of purple urine bag syndrome about 8.3%-16.7% worldwide. There are some factors which lead to the disease including female, long-term urinary catheter, bedridden or immobile for long time, constipation, and urinary tract infection. The mechanism of this condition involves the tryptophan in intestine that is degraded into indole. In the liver, indole is conjugated into indoxyl sulphate. This conjugate product then is excreted into urine by the kidney. In the infected urinary tract, some gram-negative bacteria produce enzymes called sulphatase and phosphatase. It converts the conjugated product, indoxyl sulphate into pigments, red indirubin and blue indigo. The two pigments-combination produces purple pigment which appears in urine. We present a-61-year-old female who has history of cerebrovascular accident who came to our emergency room with purple urine over the previous seven days.

A Peculiar Manifestation of Urinary Tract Infection in a 76-year-old Female

Purple Urine Bag Syndrome (PUBS) is a rare and benign clinical phenomenon associated with urinary tract infections, characterized by the distinctive purple discoloration of a urinary catheter bag. The underlying cause of PUBS is related to bacterial activity involved in the breakdown of tryptophan, mainly in individuals with predisposing factors such as long-term catheterization, constipation, alkaline urine, and being female. We present the case of a 76-year-old female patient with a history of tuberculous spondylitis who developed PUBS during her hospital stay. The patient had been bedridden for three years and had been given a urinary catheter, which was routinely replaced by a non-medical family member and without a proper antiseptic procedure. A urine culture revealed the presence of Proteus mirabilis, and the patient was treated with intravenous antibiotics while also replacing the urinary catheter and bag. After five days of treatment, the urine bag and catheter remained clear, and the patient was discharged. PUBS is a significant indicator of urinary tract infection, necessitating prompt medical intervention to prevent complications. Healthcare professionals should be aware of this syndrome to enable early detection and appropriate management.

Urethral discharge as an early manifestation of urinary tract infection in children ≤24 months old.

Children with febrile urinary tract infections (UTIs) are prone to kidney scarring if they are not treated promptly; however, ambiguous symptoms before fever onset makes the early detection of UTIs difficult. Our study aimed to identify urethral discharge as an early manifestation in children with UTI. This study enrolled 678 children younger than 24 months with paired urinalysis and culture performed between 2015 and 2021; 544 children were diagnosed with UTIs. Clinical symptoms, urinalysis, and paired urine culture results were compared. Urethral discharge was observed in 5.1% of children with UTI and yielded a specificity of 92.5% for diagnosing UTI. Children with urethral discharge had a less severe UTI course, furthermore, nine of them received antibiotics before fever occurred and seven of them were free of fever during UTI course. Urethral discharge was associated with alkalotic urine and Klebsiella pneumonia infection. Urethral discharge is an early symptom in children with UTI; it may present before fever onset and help ensure prompt antibiotic intervention.

Purple urine bag syndrome: An unusual manifestation of urinary tract infection, our experience at a tertiary care center.

Purple urine bag syndrome (PUBS) is an unusual condition in which a purple discoloration of urine and bag occurs in people with urinary catheters. People with purple urine usually do not complain of any symptoms. The purple discoloration of the urine bag is often the only finding, frequently noted by caregivers. This prospective observational study was conducted at our tertiary care institute from June 2018 to May 2020. A total of 46 patients with PUBS were included in this study. The objective of our study was to record the prevalence of each predisposing factor and to correlate the pathological mechanism through which the PUBS is manifested. The mean age of PUBS patients was 67.4years and 67.4% were males. Most patients of PUBS (60.9%) had a urethral catheter, while there was percutaneous nephrostomy in 26.1% patients and 13% patients had a percutaneous suprapubic cystostomy catheter. Among the patients, 69.65% were bedridden or in an institutionalized situation, 73.9% were suffering from chronic constipation, 21.7% were associated with dementia, and 47.8% were cerebrovascular accidents with hemiparesis patients. In addition, 93.5% of patients presented with alkaline urine and 3 patients with acidic urine. The most common bacteria isolated in urine culture were E coli and Pseudomonas. Urinary catheter associated urinary tract infection and PUBS is most commonly documented in females, but our study showed that it is more common in males. The appearance of a purple bag does not depend on the material and type of the catheter or the catheterization method. In addition, no correlation was found between the microorganisms isolated from the environment and patients' urine.

A rare variant of obstruction of the pyeloureteral segment of the lower half in a child with doubling of the upper urinary tract: Сase report

Presentation of a rare clinical case of hydronephrosis of the lower half of the kidney due to vasoureteral conflict against the background of the complete doubling of the upper urinary tract. The rarity of this anomaly is demonstrated by only a single mention of a similar case in an adult patient in the literature.
 The patient, three years old, had dilatation of the upper urinary tract that was detected antenatally. According to the postnatal ultrasound results at three months, the anterior-posterior size of the pelvis of the lower half of the left kidney was 13 mm, and the parenchyma of the left kidney was 11 mm. The child was followed up on an outpatient basis. There were no laboratory or clinical manifestations of urinary tract infection. Ultrasound monitoring revealed progression of dilatation of the pelvis of the lower half max up to 40 mm and thinning of the kidney parenchyma in the projection of the lower pole up to 7 mm, in connection with which the child successfully underwent antevasal ureteropyeloanastomosis of the lower half of a completely doubled kidney. The anterior-posterior size of the pelvis of the lower half after removal of the pyelostomy was 16 mm. The child did not have any clinical and laboratory disease manifestations in the postoperative period.
 The described clinical case expands our understanding of the anatomy of obstruction of the pyeloureteral segment and hydronephrosis of the lower half of the duplex kidney. It enables us to plan surgical tactics, considering the possible intraoperative detection of the described anatomical configuration.

Unilateral hypoplastic kidney in adults: An experience of a tertiary-level urology center.

BACKGROUNDUnilateral small-sized kidney is a radiological term referring to both the congenital and acquired causes of reduced kidney volume. However, the hypoplastic kidney may have peculiar clinical and radiological characterizations.AIMTo evaluate the clinical presentations, complications, and management approaches of the radiologically diagnosed unilateral hypoplastic kidney. METHODSA retrospective review of the records of patients with a radiological diagnosis of unilateral hypoplastic kidney between July 2015 and June 2020 was done at Assiut Urology and Nephrology Hospital, Assiut University, Egypt.RESULTSA total of 33 cases were diagnosed to have unilateral hypoplastic kidney with a mean (range) age of 39.5 ± 11.2 (19-73) years. The main clinical presentation was loin pain (51.5%), stone passer (9.1%), anuria (12.1%), accidental discovery (15.2%), or manifestations of urinary tract infections (12.1%). Computed tomography was the most useful tool for radiological diagnosis. However, radioisotope scanning could be requested for verification of surgical interventions and nephrectomy decisions. Urolithiasis occurred in 23 (69.7%) cases and pyuria was detected in 22 (66.7%) cases where the infection was documented by culture and sensitivity test in 19 cases. While the non-complicated cases were managed by assurance only (12.1%), nephrectomy (15.2%) was performed for persistent complications. However, symptomatic (27.3%) and endoscopic (45.6%) approaches were used for the management of correctable complications. CONCLUSIONUnilateral hypoplastic kidney in adults has various complications that range from urinary tract infections to death from septicemia. Diagnosis is mainly radiological and management is usually conservative or minimally invasive.

Prevalence of various pathogens isolated from urine cultures causing urinary tract infections in Bakhtawar Amin Trust Hospital, Multan

Objective: This study is conducted to ascertain the microbial agents along with their prevalence leading to urinary tract infections in patients admitted in Bakhtawar Amin Hospital, Multan with manifestations of urinary tract infections. Design: Descriptive observational study Place and duration of study: Department of Microbiology Bakhtawar Amin Medical & Dental College & Hospital, Multan from January 2021 to July 2021. Material and Methods: A total of 220 positive urine cultures were analyzed in this study extended for six months. All the appropriate details like age, gender, major presenting complaints, history of catheterization etc were noted. All the isolated urinary pathogens were recorded along with their frequency and percentages. Results: Out of these 220 patients with positive urine cultures, majority (63.6%) were male. Gram negative bacteria (E. Coli) constitute the major bulk of urinary pathogens followed by Candida. Conclusion: Urinary tract infections were commonly seen in men in our region. E. Coli was the most frequently encountered bacteria. A large number of Candida species were segregated in immunocompromised critically ill ICU admitted patients. Keywords: Urinary tract infection, culture, pathogens, E.Coli, Candida.

Нефрэктомия у пациентов с аутосомнодоминантной поликистозной болезнью почек после трансплантации почки

Introduction. In recent years, the number of patients with autosomal dominant polycystic kidney disease (ADPKD) who undergo kidney transplantation without nephrectomy has increased. The most frequent and adverse complication from your own kidneys is infection of cysts (IC). This dictates the need to predict the probability of IC and determine diagnostic and therapeutic approaches in this category of patients. Materials and methods. The results of observation and treatment of 55 patients with ADPKD who underwent kidney transplantation from 2000 to 2019 without prior nephrectomy were evaluated. Results. Bilateral nephrectomy in connection with IC was performed in 10 (18.1%) patients, and one patient died from sepsis progression. Burdened urological history (kidney operations for suppuration of cysts and recurrent urinary tract infection (UTI)) significantly increased the chances of nephrectomy for IC by 6.8 times (AOR 6.83; 95% CI 1.34-34.8; p=0.021). The median time from kidney transplantation to nephrectomy was 7 months (Q1-Q3: 2-8). Acute graf pyelonephritis was associated with IR (p=0.045) in single-factor analysis. Forty-five patients are under observation, with a median follow-up of 41 months (Q1-Q3: 19-76). Seventeen patients underwent magnetic resonance imaging using diffusely weighted image protocols (MRI-DWI). MR-signs of infection were detected in 5 patients. Given the absence of clinical and laboratory manifestations of inflammation, nephrectomy was not performed. Further followup did not indicate the development of clinical and laboratory signs of UTI in any case. Discussion. As our study and a number of other studies have shown, in patients with ADPKD after kidney transplantation, the most frequent indication for nephrectomy is inflammatory changes in their own kidneys. Patients with a history of severe pyelonephritis or IC who previously had pyelonephritis or IC before kidney transplantation are at risk for developing inflammatory changes after kidney transplantation, and it does not matter how long ago they had a history of pyelonephritis attacks or kidney surgery. This fact should be taken into account before kidney transplantation and offer patients a nephrectomy before kidney transplantation. Our work is consistent with a number of non-numerous publications that have shown that in the diagnosis of IC, the most informative non-invasive, imaging method is MRI of the kidneys, but this method has low specificity, which can lead to an increase in the number of false positive conclusions and an increase in the number of unjustified nephrectomies. Conclusion. The predictor of infection of own kidney cysts after transplantation is a burdened urological history. MRI DWI has high sensitivity and low specificity in the diagnosis of IR in ADPKD. When identifying single cysts with MR-signs of infection in the absence of clinical, laboratory manifestations of UTI, nephrectomy is not indicated.

Purple Urinary Bag Syndrome (PUBS) in Benign Prostate Hyperplasia (BPH) with long-term indwelling urinary catheter use: a case report and literature review

Background: PUBS is one of the clinical manifestations of urinary tract infection. This condition often leads patients, patients’ families, and medical workers to worrisome. Metabolism of tryptophan and infection of sulfatase and phosphatase - producing bacteria is the most acceptable pathogenesis explaining PUBS. Many risk factors are underlying this condition, including long-term use of indwelling urinary catheters, constipation, dementia, chronic kidney disease, and bedridden patients. This case study aims to evaluate the recent treatment of supporting factors in treating the underlying urinary infection.Case Presentation: We presented a case report of a 67year-old man with Benign Prostate Hyperplasia (BPH) and long-term use of indwelling urinary catheter who complained of purple discoloration of urine a day prior to Transurethral Resection of the Prostate (TURP) surgery. The patient complained of no fever and pain while urinating and having no history of the same complaint and other diseases. In addition, the patient has diagnosed with BPH and Urinary Tract Infection. The administration of Cefazolin 2 grams dosage was given before the TURP procedure, and the following procedure continued.Conclusion: PUBS is a rare clinical course alarming the urinary tract infection. Appropriate treatment by Cefazolin 2 grams dosage following by TURP shows a favorable outcome in this case study.

Purple urinary bag syndrome: Our experience

BackgroundPurple urinary bag syndrome (PUBS) is a visually striking and rare manifestation of urinary tract infection characterised by purple discolouration of the catheter and the urobag, which are seen primarily in patients who are on long-term indwelling catheter. This rare syndrome results due to the breakdown of indole, a by-product of dietary tryptophan metabolism, to coloured pigments indigo and indirubin by urinary bacteria, which reacts with the catheter and the bag to impart a purple colour. MethodsThis was a prospective observational study, wherein all cases of PUBS diagnosed between March 2012 and February 2020 were analysed and followed up. ResultsA total of five patients were presented with PUBS. Among them, four were women, and four were chronically constipated. All of them were elderly and debilitated with either being bed bound or having restricted mobility. Three of them had associated chronic kidney disease. All of them were treated successfully with change of catheters and antibiotics. ConclusionThis rare but alarming condition occurs in elderly patients who are on long-term indwelling catheters. The diagnosis is visually apparent, and the treatment may be just a simple change of catheter with oral antibiotics. The awareness may help in correct diagnosis and treatment.

Clinical Features of Urinary Infections in Pregnant Women with Type 1 Diabetes Mellitus

Aim. To study clinical manifestations of urinary tract infections in pregnant women with type 1 diabetes mellitus (DM).Materials and methods. Pregnant women with urinary tract infections (UTIs) were examined: 110 with type 1 diabetes mellitus (main group) and 133 without diabetes mellitus (comparison group). The diagnosis of UTI was based on the clinical picture (for manifestation forms) and confirmed by a dual culture method using both the classical approach and DipStreak tests. The determination of the sensitivity of the isolated microorganisms to antibacterial drugs was carried out by the disk diffusion test on Mueller-Hinton agar using paper disks. Instrumental research included ultrasound of the kidneys, urinary tract and fetoplacental complex.Results. In the main group, UTIs were pyelonephritis, asymptomatic bacteriuria (AB) and low AB (102–104 CFU/ml) was detected in 38, 69 and 31 patients, respectively. In the comparison group, pyelonephritis, AB and low AB was detected in 41, 63 and 29 patients, respectively. In the main group, the classic course of pyelonephritis was observed in 44.7%, low-symptomatic — in 26.3%, “according to the type of carbohydrate metabolism decompensation” — in 21%, and the obstetric variant — in 7.9% of patients. In the comparison group, the classic version of pyelonephritis was in 70.7%, low-symptomatic — in 24.4%, asymptomatic — in 4.9%. Bilateral pyelonephritis in pregnant women with type 1 diabetes mellitus prevailed over unilateral: 65.8 vs 34.2%. During AB, in patients with type 1 diabetes mellitus, hyperglycemia was observed in 23.1% (n = 16), the threat of pregnancy termination in 53.6% (n = 37), and moderate preeclampsia in 17.4% (n = 12). In patients with low AB, glycemia above the target values was recorded in 16.1% (n = 5), the threat of pregnancy termination in 38.7% (n = 12), and moderate preeclampsia in 12.9% (n = 4).Conclusion. Based on the specifics of the clinical manifestations of UTIs in pregnant women with type 1 diabetes mellitus, the following types of pyelonephritis can be distinguished: classic, low-symptom, “decompensation of carbohydrate metabolism” and obstetric. The classical course of pyelonephritis in pregnant women with type 1 diabetes mellitus is statistically significantly less common (p <0.05) as compared with pregnant women without diabetes mellitus. The features of AB in pregnant women with type 1 diabetes mellitus are the development of hyperglycemia and obstetric complications.

Method for Stratification of a Patient with Suspected Urinary Tract Infection for Use of Phytotherapy as an Alternative to the Antibacterial Regimen (by Clinical Trial)

At the present stage, there is a risk of hyperdiagnosis of urinary tract infection (UTI) in a child with urological signs on an outpatient basis and because of this – the threat of a false diagnosis, abuse of antibacterial therapy (ABT), the development of resistance.The objective: of the effectiveness of the method of stratification of a child suspected of UTI for the use of herbal medicine with the drug Canephron® N, as an alternative to the antibacterial regimen.Materials and methods. A prospective clinical study was conducted among outpatient patients suspected of having UTI during 2019. There were 50 children aged 12 to 18 with urological symptoms without signs of a systemic inflammatory response (normal body t, absence of leukocytosis). The observation duration was 90 days. The study was conducted with the informed consent of children and parents per under the Declaration of Human Rights in Helsinki. The method of stratification of the patient’s outpatient plan for antibacterial therapy or phytotherapy was based on the provisions of the National British Guidelines NICE, 2018, by analyzing a fresh urine sample test strips Uriscan U 25, Nephro.Results. The method of stratification of a patient with urological symptoms to decide on ABT at the outpatient stage has proven its effectiveness and safety. Among patients, 100% clinical recovery and 100% positive laboratory dynamics were noted. Phytotherapy with Canephron® N as an alternative measure has proven its ability in girls 12–18 years with urological symptoms without signs of systemic inflammatory reaction. Yes, 72% ± 8.73 (36/50) confirmed the possibility of using Canephron® N without the use of ABT. On day 7 of phytotherapy, 100% of patients (p<0.05) had a recurrence of dysuria, pain, and leukocyturia. There was a 1.8-fold decrease in the number of patients with bacteriuria (40±20,77 (14/36) vs 22±30,99 (8/36); p<0,05) at the end of 1 week of phytotherapy. The crystallolytic effect of the drug Canephron® N was noted early in therapy (crystalluria level increased by 1.4 times on day 3 of therapy; p>0.05, 2.8 times on day 7; p<0.05). The efficacy and safety of outpatient UTI treatment by prescribing a 7 day phytotherapy course with Canephron® N as an alternative to ABT is demonstrated. Among children with manifestations of UTI, 44% ± 22.57 (11/25) patients recovered after 7 days of therapy. A recurrent episode of UTI at the end of the 3rd month of follow-up after phytotherapy was observed in 9% ± 98 (1/11) patients, which was significantly lower than the mean recurrent UTI rates in children after ABT.Conclusions. The testing of this method of stratification of a child suspected of UTI, conducted among girls aged 12–18 years, proved its safety and effectiveness. The diagnostic-treatment algorithm developed based on this method can also be applied among children of other age categories with suspected UTI, namely from 3 years of age.

Estimation of the Efficacy of Retroperitoneoscopic Renal Cysts Deroofing

Introduction. The intensive introduction of modern endovideosurgical techniques creates the prerequisites for the further expansion of minimally invasive surgical interventions. Literature reviews` data on the results of retroperitoneoscopic operations suggest that endovideosurgery in urology has broad prospects for further development.Purpose of the study. To estimate of the efficacy and safety of the retroperitoneoscopic operations for renal cysts.Materials and methods. Retroperitoneoscopic operations (renal cysts deroofing) were performed for 152 symptomatic patients with Bosniak I kidney cysts (from 4.4 х 3.8 cm to 14.5 х 14.0 cm). Proposal of the operations were classified according to the technical difficulty as “Easy” in 147 (96.7%) cases (Е: sum of scores 3-5), in 5 (3.3%) cases – «Slightly difficult» (SD: score 7). Statistical analyses of the results performed by the program Microsoft Office Excel 2007, StatSoft Statistica 8.0 with using the Student-Fisher`s criteria.Results. The mean duration of the operations was 35.7 ± 6.1 min (30-90 min); there were not any intraoperative complications; the mean blood loss was 23.0 ± 4.1 ml (10-100 ml); there was no need for blood transfusion; incidence of postoperative complications were 2.4% - in 4 cases there were manifestation of urinary tract infection during the postoperative period (II category of the complications according to Clavien-Dindo classification); mean hospital stay was 2.2 ± 0.1 day (1-6 days); drainages were removed on second postoperative day; there were not any conversions to open operations and additional procedures in postoperative period.Conclusions. Retroperitoneoscopic renal cysts deroofing is effective and safe procedure for the treatment of simple kidney cysts. This method has the advantages of minimal invasiveness, minimal complications, short in hospital stay and fast recovery of the patients.The study did not have sponsorship. The authors have declared no conflicts of interest.

Basic approaches to treatment of urinary tract infection in the practice of a family doctor

The objective: a comparative study was aimed at the study of the effectiveness and evaluation of the dynamics of clinical and laboratory parameters of therapy with oral antimicrobial Flaprox versus nitrofuran therapy in patients with exacerbation of chronic urinary tract infection in outpatient settings.Materials and methods. Тhe study included 40 patients (16 men, 24 women) with exacerbation of chronic pyelonephritis. Participants in the study were divided into 2 groups: 26 patients who received Flaprox 500 mg twice a day for 10 days in the main group (A), 14 patients in the control group (B) received nitrofuran 100 mg 4 once a day for 10 days. The mean age of the patients was 39,8±8,9 years.Results. The regression of clinical manifestations of urinary tract infection in the study process was noted in both groups. In the main group, the dynamics of reduction of symptoms of general intoxication and normalization of local symptoms and inflammatory changes in blood and urine has a more pronounced tendency from 5 days of treatment and persisted throughout the course of therapy.Conclusions. Flaprox useing for 10 days allowed to reliably reduce or eliminate dysuria, infection of the urinary tract (bacteriuria), and inflammatory process (leukocythria) without negative changes in the blood biochemistry analysis. Therapy of UTI with Flaprox demonstrates efficacy in comparison with the use of nitrofurans and the achievement of positive dynamics of clinical and laboratory parameters in a shorter time.

URINARY INFECTION AT DEPARTMENT OF UROLOGY OF HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

Objectives: To investigate clinical characteristics, bacterial characteristics, drug resistance status in patients with urinary tract infections treated at Department of Urology, Hue University Hospital. Materials and Method: The study was conducted in 474 patients with urological disease treated at Department of Urology, Hue Universiry Hospital from July 2017 to April 2018. Urine culture was done in the patients with urine > 25 Leu/ul who have symptoms of urinary tract disease or infection symptoms. Patients with positive urine cultures were analyzed for clinical and bacterial characteristics. Results: 187/474 (39.5%) patients had symptoms associated with urinary tract infections. 85/474 (17.9%) patients were diagnosed with urinary tract infection. The positive urine culture rate was 45.5%. Symptoms of UTI were varied, and no prominent symptoms. E. coli accounts for the highest proportion (46.67%), followed by, Staphycoccus aureus (10.67%), Pseudomonas aeruginsa (8,0%), Streptococcus faecali and Proteus (2.67%). ESBL - producing E. coli was 69.23%, ESBL producing Enterobacter spp was 33.33%. Gram-negative bacteria are susceptible to meropenem, imipenem, amikacin while gram positive are vancomycin-sensitive. Conclusions: Clinical manifestations of urinary tract infections varied and its typical symptoms are unclear. E.coli is a common bacterium (46.67%). Isolated bacteria have a high rate of resistance to some common antibiotics especially the third generation cephalosporins and quinolones. Most bacteria are resistant to multiple antibiotics at the same time. Gram (+) bacteria are susceptible to vancomycin, and gram (-) bacteria are susceptible to cefoxitin, amikacin, and carbapenem. Key words: urinary tract infection

A single center, open-label, randomized, parallel group study assessing the relationship between asymptomatic bacteriuria and inflammation in maintenance hemodialysis patients.

The significance of asymptomatic bacteriuria in maintenance hemodialysis (MHD) patients remains controversial. We hypothesized that the presence of asymptomatic bacteriuria as a sole clinical manifestation of urinary tract infection (UTI) in asymptomatic MHD patient may contribute to the chronic inflammatory response. Our aim was to explore the relationship between asymptomatic bacteriuria and elevated levels of inflammatory markers in MHD patients. A randomized open-label single center study of 114 MHD patients was conducted. Forty-six patients presented negative urine culture and 41 subjects were excluded due to different reasons. The remaining 27 patients (mean age of 71.5 ± 12.2 years, 63% men), fulfilling the criteria for having asymptomatic bacteriuria, were randomly assigned to either the treatment group (13 patients) or the observational group (14 subjects). The treatment group received 7 days of antibiotic treatment given according to bacteriogram sensitivity. After 3 months of follow-up all measurements of the study were repeated. The primary end point was change in inflammatory biomarkers from baseline by the end of the study. There were no statistically significant differences in white blood cell changes (P = 0.27), ferritin (P = 0.09), C-reactive protein (P = 0.90), and interleukin-6 (P = 0.14) levels between the groups from baseline to the end of study or at the end of the study. Analyzing cross-sectional data, asymptomatic bacteriuria was found to not be a predictor of higher levels of inflammatory parameters at baseline. Asymptomatic bacteriuria is not a modifiable risk factor for chronic inflammation in the MHD population.

Purple Urine Bag Syndrome as a Rare Manifestation of Urinary Tract Infection: A Case Report

Purple urine bag syndrome (PUBS) is purple discoloration of urinary catheter, tubing and bag and it is a rare and uncommon manifestation of urinary tract infection. Female gender, constipation, urinary tract infection, dementia, alkaline urine and high urinary bacterial counts are main risk factors. Here we report a 70 year old woman living in a nursing home presented with diarrhea, decreased oral intake and purple urine. The urine was evaluated and urine analysis showed PH=7 and pyuria. The result of urine culture was growth of more than 10¬0000 colony of Proteus Mirrabilis sensitive to Imipeneme. The patient condition improved after antibiotic therapy. The main reason of this phenomenon is not clearly recognized but some authors believe that Indigo (blue pigment) and Indirubin (red pigment) which are metabolite derivate of tryptophan can cause this uncommon discoloration. This condition is benign without any serious consequences and the treatment of underlying disease should be considered.

EFFICACY OF IMMUNOCORRECTIVE TREATMENT WITH SYNTHETIC DIPEPTIDE IN CHILDREN WITH PYELONEPHRITIS

The results of the open controlled prospective clinical and immunological trial indicate that including of pidotimod into the complex therapy of pyelonephritis in children (n=30) lead to reliable decrease of recurrence risk and frequency during 6 months after treatment withdrawal in comparison with children receiving antibacterial monotherapy (n=20). The duration of etiotropic treatment for arresting of the active manifestations of urinary tract infection was lower in patients who were administered the afore-mentioned drug. Immunological monitoring of the urine cytokine status during pidotimod treatment showed that there were signs of T helper 1 cells activation predominance (increase in interferon/interleukin 10 ratio), as well as decrease in granulocyte macrophage colony-stimulating factor concentration, which seems to cause the delayed influence of the drug on the course of urinary tract infection.

1333 Clinical Manifestations of Urinary Tract Infections in Newborn Infants Admitted to Neonatal Intensive Care Unit

Background and AimsTo determine the demography, clinical manifestations and the most common organism isolated of the urinary tract infection (UTI) in the newborn infants who were admitted to the neonatal...