Outcome Of Urinary Tract Infections Research Articles

Uropathogens and Gestational Outcomes of Urinary Tract Infections in Pregnancies that Necessitate Hospitalization

Background and Objectives: Our aim is to identify uropathogens that cause urinary tract infections (UTIs) that necessitate hospitalization, and analyze outcomes of gestational UTIs. Methods: This study consisted of 30 pregnant women who necessitate hospitalization because of UTI (7.8% of gestational UTIs during the same period of time). UTI that necessitates hospitalization is defined as clinical complaints, urination problems, urine analysis and culture positivity, fever and uterine discomfort. Patients with at least two positive cultures (≥ 100,000 cfu/ml) were included to this study. Antimicrobial susceptibility tests were obtained in all cases in order to determine antimicrobial resistance and to choose the ideal antibiotics for treatment. Results: In our study, we have found that Escherichia coli is the most common microorganism (56.7%). Enterococcus faecalis (13.3%) and Klebsiella pneumonia (10%) were other frequently observed microorganisms. In this series, mean gestational week at birth was 35 weeks 5 days (range 23-40 weeks). Mean birthweight was 2,656 g (range 500-3,700 g). Twenty-three cases (76.7%) were hospitalized before 37th gestational week and preterm delivery rate was 56.3%. Maternal risk factors and coexisting diseases were detected in 11 (36.7%) patients as follows: diabetes mellitus in 4, thrombophilia in 3, thyroid disorders in 3 and hydroureteronephrosis in 1 case. Cesarean section rate was 65.2%. Conclusions: Knowing uropathogens of patient population is beneficial in the management of patients and better planning of future medical treatments. Preterm labor seems to be an important complication in pregnancies with UTIs going together with fever and urination problems.

Long-term outcomes of urinary tract infection (UTI) in Childhood (LUCI): protocol for an electronic record-linked cohort study

IntroductionCurrent guidelines advise the prompt diagnosis and treatment of urinary tract infection (UTI) in children to improve both short and longer term outcomes. However, the risk of long-term complications following...

A prospective study of clinical presentation, need for hospitalisation, microbiology and outcome of urinary tract infections in diabetes mellitus

Background: Diabetics are more prone to infections than their non diabetic counterparts. The urinary tract is the most common site of infection in diabetes mellitus patients. Urinary tract infections (UTIs) most of the time in diabetic patients are relatively asymptomatic, which can lead to renal failure and severe kidney damage. A combination of local risk factors and host factors in diabetes mellitus lead to bacteriuria commonly compared to non diabetics. Objective: To evaluate clinical presentation, need for hospitalisation, microbiology and outcome of UTI in diabetes mellitus. Methods: This prospective, descriptive study was conducted at Kerala Institute of Medical Sciences, a tertiary level multispecialty hospital in South India to study the clinical profile of UTI (clinical presentation, need for hospitalisation, microbiological profile and outcome) in Diabetes mellitus; also to find out reasons for hospitalisation and for UTI in Diabetes mellitus. Results: Among study population, 24% patients were in age group of 30 to 50 years, 52% patients were in age group of 51 to 70 year, 13% were in 71 to 80 year group. 32% (32patients) had growth of E. coli in urine, 14% (14 patients) had growth of k. pneumonia, 10%(10 patients) had growth of proteus, 9% (9 patients) had growth of S. aureus, 5%(5 patients) had growth of C. perfringens, 5% (5 patients) had growth of candida, 4% (4 patients) had growth of pseudomonas and Enterococcus. 52% (52 patients) had sepsis as the reason for hospitalization, 32% (32 patients) had fever as the reason, and 14% (14 patients) had flank pain as the reason and 1 patient each had pelvic pain and vomiting as the reason for hospitalisation. 18% (18 patients) had renal dysfunction and 32% (32 patients) had proteinuria. Conclusion: UTI requiring hospitalization in Diabetes mellitus was more common after 50 years of age and equal in men and women. Diabetics are at risk of an increased susceptibility to infections of the urinary tract and occur with increased frequency and severity, and complications are more common.

Variations in presentation, management, and patient outcomes of urinary tract infection: a prospective four-country primary care observational cohort study.

Regional variations in the presentation of uncomplicated urinary tract infection (UTI) and pathogen sensitivity to antibiotics have been cited as reasons to justify differences in how the infections are managed, which includes the prescription of broad-spectrum antibiotics. To describe presentation and management of UTI in primary care settings, and explore the association with patient recovery, taking microbiological findings and case mix into account. Prospective observational study of females with symptoms of uncomplicated UTI presenting to primary care networks in England, Wales, the Netherlands, and Spain. Clinicians recorded history, symptom severity, management, and requested mid-stream urine culture. Participants recorded, in a diary, symptom severity each day for 14 days. Time to recovery was compared between patient characteristics and between countries using two-level Cox proportional hazards models, with patients nested within practices. In total, 797 females attending primary care networks in England (n = 246, 30.9% of cohort), Wales (n = 213, 26.7%), the Netherlands (n = 133, 16.7%), and Spain (n = 205, 25.7%) were included. In total, 259 (35.8%, 95% confidence interval 32.3 to 39.2) of 726 females for whom there was a result were urine culture positive for UTI. Pathogens and antibiotic sensitivities were similar. Empirical antibiotics were prescribed for 95.1% in England, 92.9% in Wales, 95.1% in Spain, and 59.4% in the Netherlands There were no meaningful differences at a country network level before and after controlling for severity, prior UTIs, and antibiotic prescribing. Variation in presentation and management of uncomplicated UTI at a country primary care network level is clinically unwarranted and highlights a lack of consensus concerning optimal symptom control and antibiotic prescribing.

Quality Improvement Initiatives in Colorectal Surgery: Value of Physician Feedback

The impact of process improvement through surgeon feedback on outcomes is unclear. We sought to evaluate the effect of biannual surgeon-specific feedback on outcomes and adherence to departmental and Surgical Care Improvement Project process measures on colorectal surgery outcomes. This was a retrospective analysis of prospectively collected 100% capture surgical quality improvement data. This study was conducted at the department of colorectal surgery at a tertiary care teaching hospital from January 2008 through December 2013. Each surgeon was provided with biannual feedback on process adherence and surgeon-specific outcomes of urinary tract infection, deep vein thrombosis, surgical site infection, anastomotic leak, 30-day readmission, reoperation, and mortality. We recorded adherence to Surgical Care Improvement Project process measures and departmentally implemented measures (ie, anastomotic leak testing) as well as surgeon-specific outcomes. We abstracted 7975 operations. There was no difference in demographics, laparoscopy, or blood loss. Adherence to catheter removal increased from 73% to 100% (p < 0.0001), whereas urinary tract infection decreased 52% (p < 0.01). Adherence to thromboprophylaxis administration remained unchanged as did the deep vein thrombosis rate (p = not significant). Adherence to preoperative antibiotic administration increased from 72% to 100% (p < 0.0001), whereas surgical site infection did not change (7.6%-6.6%; p = 0.3). There were 2589 operative encounters with anastomoses. For right-sided anastomoses, the proportion of handsewn anastomoses declined from 19% to 1.5% (p < 0.001). For left-sided anastomoses, without diversion, anastomotic leak testing adherence increased from 88% to 95% (p < 0.01). Overall leak rate decreased from 5.2% to 2.9% (p < 0.05). Concurrent process changes make isolation of the impact from individual process improvement changes challenging. Nearly complete adherence to process measures for deep vein thrombosis and surgical site infection did not lead to measureable outcomes improvement. Process measure adherence was associated with decreased rate of anastomotic leak and urinary tract infection. Biannual surgeon-specific feedback of outcomes was associated with improved process measure adherence and improvement in surgical quality.

Clinical risk factors, bacterial aetiology, and outcome of urinary tract infection in children hospitalized with diarrhoea in Bangladesh.

Urinary tract infection (UTI) is common in children aged <5 years with diarrhoea, but little is known about risk factors, aetiology and outcome of such children. We aimed to evaluate these knowledge gaps of UTI in children aged <5 years with diarrhoea. We enrolled all children aged <5 years with diarrhoea admitted to Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh, between May 2011 and April 2013, who had history of fever (⩾38 °C) and obtained a urine sample for culture. Diarrhoea with UTI (confirmed by culture) constituted cases (n = 26) and those without UTI constituted controls (n = 78). Threefold controls were randomly selected. The case-fatality rate was comparable in cases and controls (4% vs. 1%, P = 0·439). Escherichia coli (69%) and Klebsiella (15%) were the most commonly isolated pathogens. Persistent diarrhoea, pneumonia and prior antibiotics use were identified as risk factors for UTI in logistic regression analysis (P < 0·05 for all). Thus, children with diarrhoea presenting with persistent diarrhoea, pneumonia, and prior antibiotic use should be investigated for UTI for their prompt management that may reduce morbidity.

Clinical profile and outcome of urinary tract infection caused by extended spectrum beta-lactamase producing Escherichia coli in critically ill patients in a tertiary care hospital in South India:a case control study

Background: Infections with Extended spectrum beta-lactamase (ESBL) producing organisms have been associated with poor outcome. Our aim of this study is to compare clinical profile of Urinary tract infection (UTI) caused by ESBL producing Escherichia coli ( E. coli ) with Non-ESBL producing E. coli. Methods: Retrospective analysis of patients admitted in Intensive care unit in a tertiary care hospital was done. 50 Patients with ESBL producing E. coli infection were assigned as cases; 50 Patients with Non-ESBL producing E. coli were assigned as controls. Clinical characteristics of UTI caused by both ESBL & non-ESBL producing E. coli in critically ill patients and their clinical outcome were observed. Mortality risk on admission was calculated using sepsis scoring system. Results: Most patients in both groups were in 6 th and 7 th decade. Male to female ratio in both groups were almost similar. Incidence of complications was higher in ESBL group. Mortality rate was 10% in ESBL group; 4% in Non-ESBL group. Mean duration of ICU stay was 4.2 days (ESBL) and 3.1 days (Non-ESBL). APACHE IV and SOFA scoring system mortality prediction accuracy was 60% in both groups. Conclusions: Initiation of empirical therapy with carbapenem antibiotics on admission in critically ill with UTI showed significant impact on mortality. Mean duration of ICU stay in ESBL group was longer than non-ESBL group which is statistically significant. Mortality risk was predicted by APACHE IV & SOFA scores on admission with good accuracy.

A Nationwide Assessment of the Burden of Urinary Tract Infection among Renal Transplant Recipients.

Objective. Evaluate the prevalence and outcomes of urinary tract infection (UTI) among renal transplant recipients. Methods. A secondary analysis of the Nationwide Inpatient Sample 2009–2011 was conducted. Survey-weighted multivariable regression analyses were used to examine the impact of UTI on transplant complications, total charges, and length of stay. Results. A total of 1,044 renal transplant recipients, representing a population estimate of 49,862, were included in the study. UTI was most common in transplant recipients with hypertension (53%) and prevalence was noted to be 28.2 and 65.9 cases per 1,000 for men and women, respectively. UTI increased the likelihood of transplant complications (182% for men, 169% for women). Total charges were 28% higher among men as compared to 22% among women with UTI. Such infection also increased the length of stay by 87% among men and 74% among women. Discussion. UTI in renal transplant recipients was associated with prolonged length of stay, total charges, and increased odds of transplant complications. Interventions to prevent UTI among such patients should be a priority area for future research and practice.

Impact of therapy and strain type on outcomes in urinary tract infections caused by carbapenem-resistant Klebsiella pneumoniae.

Carbapenem-resistant Klebsiella pneumoniae (CRKP) is an important healthcare-associated pathogen. We evaluated the impact of CRKP strain type and treatment on outcomes of patients with CRKP bacteriuria. Physician-diagnosed CRKP urinary tract infection (UTI)-defined as those patients who received directed treatment for CRKP bacteriuria-was studied in the multicentre, prospective Consortium on Resistance against Carbapenems in Klebsiella pneumoniae (CRaCKle) cohort. Strain typing by repetitive extragenic palindromic PCR (rep-PCR) was performed. Outcomes were classified as failure, indeterminate or success. Univariate and multivariate ordinal analyses to evaluate the associations between outcome, treatment and strain type were followed by binomial analyses. One-hundred-and-fifty-seven patients with physician-diagnosed CRKP UTI were included. After adjustment for CDC/National Healthcare Safety Network (NHSN)-defined UTI, critical illness and receipt of more than one active antibiotic, patients treated with aminoglycosides were less likely to fail therapy [adjusted OR (aOR) for failure 0.34, 95% CI 0.15-0.73, P=0.0049]. In contrast, patients treated with tigecycline were more likely to fail therapy (aOR for failure 2.29, 95% CI 1.03-5.13, P=0.0425). Strain type data were analysed for 55 patients. The predominant clades were ST258A (n=18, 33%) and ST258B (n=26, 47%). After adjustment for CDC/NHSN-defined UTI and use of tigecycline and aminoglycosides, infection with strain type ST258A was associated with clinical outcome in ordinal analysis (P=0.0343). In multivariate binomial models, strain type ST258A was associated with clinical failure (aOR for failure 5.82, 95% CI 1.47-28.50, P=0.0113). In this nested cohort study of physician-diagnosed CRKP UTI, both choice of treatment and CRKP strain type appeared to impact on clinical outcomes.

Prevalence and antibiotic resistance pattern of urinary tract bacterial infections in Dessie area, North-East Ethiopia.

BackgroundDifferent studies have indicated that urinary tract infections frequently occur in both community and hospital environments and are of the most common bacterial infections in humans. the outcomes of urinary tract infections are increased hospitalization, increased direct patient costs and mortality. In Dessie, the prevalence of the commmon pathogens and antibiotic susceptibility pattern is not well studied sofar. Thus, the aim of this study is to address these gaps in the study area.MethodsRetrospective study was conducted in Dessie regional health reseacrh laboratory from January 1-March 31, 2012. All culture and antibiotic susceptibility test results of patients’ diagnosed with UTI from September 2002 to September 2011 G.C were included in the study. Data were abstracted using structured questionnaires and finally, entered into SPSS Windows version 16.0, and descriptive statistics was generated to meet the study objective.ResultsDuring the last ten years 680 (27.35%) bacteria were isolated in the regional laboratory. The most commonly isolated were E. coli 410 (60.29%), Pseudomonas species 59 (8.68%), Proteus species 53 (7.79%), S. aurous 50 (7.35%) and Klebsiella species 40 (5.88%). The E.coli were susceptible to Nitrofurantoin 43 (89.6%), furantoin 124 (87.3%), Nalidixic acid 91 (86.7%), kanamycin 116 (80%) & ciprofloxacin 66 (71.7%) but were almost resistant to Ampicillin, tetracycline, & trimethoprim-sulfamethoxazole. Similarly Pseudomonas and proteus species were resistant to almost all antibiotics except Gentamycin.ConclusionThe E.coli, pseudomonas and proteus species were the commonly isolated bacteria in the regional health research laboratory. A majority of isolated bacterial microbes were resistant to antibiotics commonly used in clinical practices and generally available in the local economy without prescription. Culture results are necessary before initiating antibiotics.

Impact of therapy and strain type on outcomes in urinary tract infections caused by carbapenem-resistant Klebsiella pneumoniae

Impact of therapy and strain type on outcomes in urinary tract infections caused by carbapenem-resistant Klebsiella pneumoniae

Urinary tract infection in patients with chronic kidney disease.

Chronic kidney disease (CKD) has become a burden of health care globally. However, data on epidemiology, clinical features, and outcomes of urinary tract infection (UTI) in this population are scarce. This study aims to retrospectively review such data. A retrospective cohort study was conducted from 1 January 2005 to 31 December 2011 in patients with CKD requiring hospitalization. Patients who had upper and lower UTIs were compared for demography and clinical data. Logistic regressior was used to assess which variables were associated with upper UTI. A total of 276 bacteriuria patients were admitted to our ward with upper and lower UTIs. The average ages of the upper and lower UTI patients were 59.21 +/- 16.54 and 71.18 +/- 14.77 years, respectively. The results of logistic regression analysis showed that age (OR 0.946, P < 0.001), female sex (OR 4.695, P < 0.001), and renal stones (OR 8.232, P < 0.001) were independently associated with upper UTI. This study shows that patients with CKD and UTIs were elderly, and that females were prone to have more bacteriuria and upper UTIs than males. In addition, patients who had renal stones were more prone to have upper UTI than other bacteriuria patients Aggressive treatment of renal stones should be considered in these patients.

Experience with Fosfomycin for Treatment of Urinary Tract Infections Due to Multidrug-Resistant Organisms

Fosfomycin has shown promising in vitro activity against multidrug-resistant (MDR) urinary pathogens; however, clinical data are lacking. We conducted a retrospective chart review to describe the microbiological and clinical outcomes of urinary tract infections (UTIs) with MDR pathogens treated with fosfomycin tromethamine. Charts for 41 hospitalized patients with a urine culture for an MDR pathogen who received fosfomycin tromethamine from 2006 to 2010 were reviewed. Forty-one patients had 44 urinary pathogens, including 13 carbapenem-resistant Klebsiella pneumoniae (CR-Kp), 8 Pseudomonas aeruginosa, and 7 vancomycin-resistant Enterococcus faecium (VRE) isolates, 7 extended-spectrum beta-lactamase (ESBL) producers, and 9 others. In vitro fosfomycin susceptibility was 86% (median MIC, 16 μg/ml; range, 0.25 to 1,024 μg/ml). Patients received an average of 2.9 fosfomycin doses per treatment course. The overall microbiological cure was 59%; failure was due to either relapse (24%) or reinfection UTI (17%). Microbiological cure rates by pathogen were 46% for CR-Kp, 38% for P. aeruginosa, 71% for VRE, 57% for ESBL producers, and 100% for others. Microbiological cure (n = 24) was compared to microbiological failure (n = 17). There were significantly more solid organ transplant recipients in the microbiological failure group (59% versus 21%; P = 0.02). None of the patients in the microbiological cure group had a ureteral stent, compared to 24% of patients within the microbiological failure group (P = 0.02). Fosfomycin demonstrated in vitro activity against UTIs due to MDR pathogens. For CR-KP, there was a divergence between in vitro susceptibility (92%) and microbiological cure (46%). Multiple confounding factors may have contributed to microbiological failures, and further data regarding the use of fosfomycin for UTIs due to MDR pathogens are needed.

Treatment and Clinical Outcomes of Urinary Tract Infections Caused by KPC-Producing Enterobacteriaceae in a Retrospective Cohort

BackgroundOptimal treatment regimens for infections caused by Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae are not well-defined. ObjectivesThis study describes the treatment and outcomes in patients with urinary tract infection (UTI) caused by KPC-producing Enterobacteriaceae. MethodsThis retrospective cohort study analyzed data from adult inpatients with bacteriuria caused by KPC-positive organisms treated at Barnes-Jewish Hospital from June 1, 2006, to February 1, 2008. KPC-positive isolates were identified utilizing disk-diffusion susceptibility testing and confirmed to contain blaKPC via molecular methods. ResultsTwenty-one patients met the inclusion criteria and all were classified as having symptomatic UTI. The majority of patients were female (15/21 [71%]), and the mean (SD) age was 62.4 (15.2) years. Successful clinical and microbiologic responses were observed in 16 patients (76%) for both outcomes. Patients with urinary catheters had them removed or replaced in 9 of 15 cases (60%). Antibiotics active against the isolated pathogen were provided in 14 of 21 cases (67%), often after considerable delay (median, 72.5 hours [range, 4–312 hours]). All 7 patients receiving aminoglycoside therapy had successful clinical and microbiologic responses, and in vitro testing of an extended antibiotic panel revealed high susceptibility rates for tigecycline (28/29 [97%]), minocycline (22/29 [76%]), and fosfomycin (25/29 [86%]) against the KPC-positive isolates. ConclusionsAlthough receipt of appropriate therapy was delayed in many cases, clinical outcomes investigated revealed high rates of successful response in this defined group of patients. Aminoglycosides and tetracycline derivatives suggested therapeutic promise in the treatment of KPC-producing Enterobacteriaceae UTI.

Urinary Tract Infections Caused by Multi-Drug Resistant Proteus mirabilis: Risk Factors and Clinical Outcomes

Proteus mirabilis (PM) as well as other members of the Enterobacteriaceae family are a leading cause of infectious diseases in both the community and acute care settings. The prevalence of multi-drug resistant (MDR) bacterial isolates have increased in the last few years, affecting the prognosis and survival of hospitalized patients. The aim of our study was to determine the risk factors and clinical outcomes of urinary tract infections (UTIs) caused by MDR PM in patients hospitalized in our institution. This was a retrospective matched case-control study. Records of patients with PM-positive urine culture were reviewed, and data were included for analysis. Univariate analysis revealed that the variables significantly associated with acquisition of MDR PM vs non-MDR PM UTI were younger age ([in years] median 77.5, range 20-94 vs median 78, range 40-94, p = 0.04), other concomitant infectious diseases (57.1 vs 35.7%, p = 0.037),number of prior infectious diseases (mean 0.95 +/- 0.99 vs 0.57 +/- 0.85, p = 0.035), diagnosis of infection at hospital admission (67.9 vs 42.9%, p = 0.008), and prior therapy with antipseudomonal penicillin (17.9 vs 1.8%, p = 0.004),respectively. Mean length of hospitalization was 29.95 days for the MDR group and 30.04 days for the non-MDR group(p = non-significant [NS]). The crude mortality rate following hospital admission was 19/56 (33.9%) vs 14 (25%)in the MDR PM and non-MDR PM groups, respectively(p = 0.300, odds ratio [OR] 1.54, 95% confidence interval[CI] 0.63-3.82). The production of extended-spectrum beta lactamases(ESBL) was found in 100% of MDR-PM vs 31.5%of non-MDR-PM urine isolates (p < 0.001). All variables found to be significantly associated with MDR-PM UTI were included in a logistic regression model. Independent risk factors for MDR-PM UTI were empiric cephalosporin therapy(OR 4.694, 95% CI 1.76-12.516, p = 0.002) and prior antipseudomonal penicillin (piperacillin/tazobactam) therapy during the last year (OR 11.175, 95% CI 1.09-114.2,p = 0.04). Prior piperacillin/tazobactam and empiric cephalosporin use were the independent risk factors of MDR-PM strains. All MDR-PM urinary isolates at our institution were ESBL producers. Therefore, carbapenem use remains the only available treatment option for MDR-PM isolates in our institution.

P300 Does in vitro antimicrobial resistance predict clinical outcomes in urinary tract infections: systematic review and metaanalysis

The breakdown of socialism caused massive socio-economic and institutional changes that led to substantial agricultural land abandonment. The goal of our study was to identify the determinants of agricultural land abandonment in post-Soviet Russia during the first decade of transition from a state-controlled economy to a market-driven economy (1990–2000). We analyzed the determinants of agricultural land abandonment for approximately 150,550 km2 of land area in the provinces (oblasts) of Kaluga, Rjazan, Smolensk, Tula and Vladimir in European Russia. Based on the economic assumptions of profit maximization, we integrated maps of abandoned agricultural land from five ∼185 km × 185 km Landsat TM/ETM+ footprints with socio-economic, environmental and geographic variables, and we estimated logistic regressions at the pixel level to identify the determinants of agricultural land abandonment. Our results showed that a higher likelihood of agricultural land abandonment was significantly associated with lower average grain yields in the late 1980s and with higher distances from the nearest settlements, municipality centers, and settlements with more than 500 citizens. Hierarchical partitioning showed that the average grain yields in the late 1980s had the greatest power to explain agricultural land abandonment in our models, followed by the locational attributes of the agricultural land. We hypothesize that the termination of 90% of state subsidies for agriculture from 1990 to 2000 was an important underlying cause for the decrease of cultivation in economically and environmentally marginal agriculture areas. Thus, whereas the spatial patterns corresponded to the land rent theory of von Thünen, it was primarily the macro-scale driving forces that fostered agricultural abandonment. Our study highlighted the value of spatially explicit statistical models for studying the determinants of land-use and land-cover change in large areas.

Resistance Trends in Urinary Tract Pathogens and Impact on Management

The prevalence of antimicrobial resistance among urinary tract pathogens is reviewed and its clinical impact on management is determined.A Medline search supplemented with references quoted in bibliographies of articles on urinary tract infections, epidemiology of antimicrobial resistance among uropathogens and clinical outcomes in urinary tract infections was conducted.Although some geographic variation is noted in resistance rates among urinary tract Escherichia coli isolates, rates were highest for ampicillin (39% to 45%) and trimethoprim-sulfamethoxazole (14% to 31.4%) and lowest for nitrofurantoin (1.8% to 16%) and fluoroquinolones (0.7% to 10%). Resistance rates also varied based on patient age. A few studies suggested that antimicrobial resistance impacts clinical and bacteriological outcome but the results are limited by the small number of patients. A randomized trial in women with acute uncomplicated pyelonephritis indicated that those treated with trimethoprim-sulfamethoxazole had a clinical and bacteriological success rate that was significantly lower in those patients treated with this drug when the infecting organism was resistant compared to those in whom the organism was susceptible to trimethoprim-sulfamethoxazole.Resistance rates among common uropathogens continue to evolve and appear to be increasing to many commonly used agents. Continued surveillance of resistance rates among uropathogens is needed to ensure that appropriate recommendations can be made for treatment of infected patients. Further studies addressing the clinical and bacteriological outcomes of patients infected with a resistant pathogen are needed.

The Effect of Urethral Introducer Tip Catheters on the Incidence of Urinary Tract Infection Outcomes in Spinal Cord Injured Patients

The Effect of Urethral Introducer Tip Catheters on the Incidence of Urinary Tract Infection Outcomes in Spinal Cord Injured Patients