Presence Of Asymptomatic Bacteriuria Research Articles

Бессимптомная бактериурия у беременных: всегда ли оправдана антибиотикотерапия?

Introduction. Asymptomatic bacteriuria (ABU) occurs in 2–15% of pregnant women, but opinions about ABU in pregnant women are controversial. The aim of the study was to assess the outcomes of delivery in pregnant women with ABU, depending on the therapy and urological history. Material and methods. The histories of childbirth of 46 women with ABU detected during prenatal screening, were analyzed. The outcomes of pregnancies were analyzed, and the relationship between the presence of ABU, the type of therapy, the presence of pyelonephritis in history and the development (exacerbation) of pyelonephritis during pregnancy was determined. Results. The structure of uropathogens was typical: E. coli was found in 36 cases (78.3%), Enterococcus faecalis - in 10 cases (21.7%). Seven women (15.2%) had a history of chronic pyelonephritis, 4 (8.7%) had chronic cystitis. The remaining 35 pregnant women (76.1%) had no any urological diseases. More than half of pregnant women with ABU (32/69.6%) received Сanephron; all of them had normal delivery. The average weight of newborns was 3768±101.9 grams. The rest of the 14 (30.4%) pregnant women with ABU, including 7 patients with a history of pyelonephritis, received amoxicillin with clavulonic acid. In more than half of the them (4/57.1%) gestational pyelonephritis developed. Correlational analysis showed that the low weight of the newborn, the development of gestational pyelonephritis and the likelihood of preterm birth did not depend on the therapy for ABU (antibacterial or herbal medicine), but on the presence of chronic pyelonephritis in the pregnant woman. Conclusion. The detection of ABU in a healthy pregnant woman without urological history is not a convincing basis for prescribing antibiotics. Preventive phytotherapy with the drug «Canephron» in such women was sufficient; none of the cases developed gestational pyelonephritis or preterm labor

227. Impact of Asymptomatic Bacteriuria on Primary Efficacy Analyses in the Evaluation of Novel Antimicrobials for the Treatment of Patients with Urinary Tract Infection

Abstract Background Per FDA Guidance, the primary efficacy endpoint for trials evaluating antimicrobials for treatment of uncomplicated urinary tract infection (uUTI) and complicated urinary tract infection (cUTI) is a combined clinical/microbiologic outcome response. Overall success requires both resolution of UTI symptoms and demonstration that the causative uropathogen is reduced to < 103 CFU/mL at a fixed time point after randomization, regardless of whether the patient is symptomatic. In clinical practice, it is not standard of care to routinely screen for or treat asymptomatic bacteriuria (ASB), nor to obtain ‘proof of cure’ cultures. In the clinical trial setting, the impact of post-treatment asymptomatic bladder recolonization on the rates of microbiologic response, re-infection, or emergence of resistance is unknown. Methods Study IT001-301 and -302 are double blind, double-dummy, Phase 3 randomized trials comparing sulopenem to comparator for patients with pyuria, bacteriuria, and clinical signs/symptoms of uUTI and cUTI, respectively. In Study 301, 1671 ambulatory female adults with uUTI were randomized to oral sulopenem bid x 5d or oral ciprofloxacin bid x 3d. In Study 302, 1395 hospitalized adults with cUTI were randomized to sulopenem IV once daily x 5d followed by oral sulopenem bid or ertapenem IV once daily x 5d followed by either oral ciprofloxacin or amoxicillin-clavulanate bid, depending on baseline uropathogen susceptibility. The primary endpoint was overall (clinical + microbiologic) response in micro-MITT population at TOC visit (D12 in uUTI study and D21 in cUTI study). Results Figure 1 Conclusion Different classes of antibiotics appear to have a differential effect on the frequency of post-treatment ASB with quinolones having a lower rate relative to beta-lactams. The presence of ASB a week or more after completing UTI therapy was not associated with a higher rate of clinical relapse for UTI patients; treatment with ciprofloxacin was associated with the selection of resistant pathogens in the post-treatment flora. Inclusion of ASB in the primary endpoint for studies of UTI should be reconsidered as it implies that a post-treatment culture should be obtained to document resolution of infection, a practice inconsistent with available treatment recommendations. Disclosures Steven I. Aronin, MD, Iterum Therapeutics: Stocks/Bonds Michael Dunne, MD, Iterum Therapeutics: Advisor/Consultant|Iterum Therapeutics: Board Member|Iterum Therapeutics: Stocks/Bonds Sailaja Puttagunta, MD, Iterum Therapeutics: Stocks/Bonds.

Prevalence of asymptomatic Bacteriuria among Pregnant Women in Sirte City (Libya).

Asymptomatic bacteriuria (ASB) is known as significant presence of pathogenic bacteria more as 105 CFU/ml in urine culture of pregnant women without any symptoms indicate of urinary tract infections. Which is may lead to serious complications on health of a pregnant woman, and the fetus if left untreated. The purpose of this study was designed to find the prevalence of asymptomatic urinary tract infection (AUTI) among pregnant women, and also to determine the antibacterial susceptibility of the isolates to various antibiotics to reduce risk factors in pregnancy. However, little is known about asymptomatic bacteriuria in pregnancy in Libya, namely in Sirte city. A total of 265 samples were collected in 7 months study involving women attending antenatal clinics in Sirte City-Libya, mid-stream urine samples were collected for microscopically examination. A colony culture growth were identified by biochemical tests and conventional antibiotic susceptibility tested in microbiology laboratory. Isolates were identified and tested against commonly used antimicrobial drugs using Kirby Bauer disc diffusion method. The prevalence of 265 pregnant women in different age groups were enrolled in this study, only 76 (28.7%) pregnant women had bacteriuria. The organism isolated from the urine sample according to the frequency of occurrence was Escherichia coli 32(42.1%), Coagulase negative Staphylococcus 11 (14.4%), Staphylococcus aureus 9(11.8%), Klebsiella Pneumoniae 9(11.8%), Streptococcus agalactiae 8 (10.5%), Enterococcus spp 5(6.6%), Proteus mirabilis 2(2.6%), respectively. The overall prevalence of asymptomatic bacteriuria among pregnant women in the study area was not high, but need to be taken on consider reducing risk of infections. The presence of asymptomatic bacteriuria and their antibiotic susceptibility test results should be taken into consideration during the management of pregnant women who are visiting antenatal care clinic; because there was high resistance to the most commonly used antibiotics. Routine urine culture and antimicrobial sensitivity for antenatal women should be carried out to detect asymptomatic bacteriuria to treat early infections, to prevent any serious complication associated with pregnancy.

ROLE OF ASYMPTOMATIC BACTERURIA IN SURGICAL SITE INFECTION IN PATIENTS UNDERGOING CARDIOVASCULAR SURGICAL PROCEDURES

Introduction:Asymptomatic bacteruria (ASB) is defined as the presence of significant bacteruria [>105) in a clean voided midstream urine from a patient without fever or symptoms of UTI. ASB should be screened and treated only in pregnant patients and individuals prior to their urological procedures as recommended by Infectious disease society of America in 2005. ASB is common in healthy women, older women,men, diabetic patients, patients with Indwelling catheters and spinal cord injury, treatment is not recommended for such individuals. Surgeons all over the world perceive any undiagnosed infection in the pre-operative period as the source of SSI, so its prevention is necessary .Its not clear whether this is true for a ASB as well. Aim: identify whether an association exists between the preoperative presence of asymptomatic bacteriuria or urinary tract infection and SSI in patients undergoing cardiovascular surgery. Material and methods:The current study was conducted over a period of one year which included 3025 patients. Midstream urine was collected asceptically and semiquatitative culture was done on chromogenic media. Further identification and antibiotic sensitivity testing was done by Vitek 2 system. Results:SSI was found more in Diabetic than non diabetic patients, more in females than males. The infective organisms found in SSI were are not found the same as in the pre-operative ASB patients. Conclusion: The presence of bacteriuria in asymptomatic patients is not a risk factor for presenting SSI in cardiovascular surgery. Pre-operative screening with urinalysis or urine culture would not be recommended for patients without clinical symptoms of UTI.

Should asymptomatic bacteriuria be treated in lupus nephritis?

The risk of infection in systemic lupus erythematosus (SLE) is associated with factors related to disease activity and immunosuppressive treatment. Recently, the persistence of asymptomatic bacteriuria (ASB) has been proposed as an environmental trigger for SLE and its flares, raising the question whether it should be treated systematically to reduce the risk of infection. To our knowledge, there is limited evidence on the screening and treatment of ASB in SLE. The objective is to analyze the occurrence of infection and flare in patients with lupus nephritis with and without ASB. A cross-sectional study of a cohort of patients with lupus nephritis during induction therapy with high-dose cyclophosphamide regimen was carried out between January 2018 and 2020, with a total of 37 patients investigated. Urine and blood samples from the two groups (with ASB and without ASB) where taken before the administration of cyclophosphamide. From the sampled 37 patients, 19 (51.4%) had ASB and 18 (48.6%) without ASB; both groups were well balanced in their demographics and clinical characteristics. No statistically significant association was found between the presence of ASB and the systemic lupus erythematosus disease activity index score (p = 0.604), and neither with the 24-h urine protein and leukocyte count (p > 0.177). Urinary tract infection occurred in 5.3% (1) of the patients with ASB, while 5.6% (1) of the patients in the group without ASB presented the infection, and the RR was 0.944 (0.06, 16.33) 95% CI; in addition, no statistically significant association was found between the presence of ASB and the occurrence of infection (p = 1,000). Our study did not find a statistically significant association of ASB with the occurrence of infection or disease activity. Further studies need it to clarify this, since treatment of ASB has been recognized as an important contributor to inappropriate antimicrobial use, which promotes emergence of antimicrobial resistance.

PREVALENCE OF ASYMPTOMATIC BACTERIURIA AND ITS DISTRIBUTION BY SEX AND AGE GROUPS IN CHILDREN COMING FOR ROUTINE IMMUNIZATION IN DISTRICT PESHAWAR, PAKISTAN

Background: Asymptomatic bacteriuria (ASB) in not an uncommon disease in children. It may lead to symptomatic infection and later on renal damage. The objectives of this study were to determine the prevalence of ASB and its distribution by sex and age groups in children coming for routine immunization in District Peshawar, Pakistan.Material and methods: This cross-sectional study was conducted in Department of Pediatrics, Khyber Girls Medical College, Peshawar, Pakistan form March 2017 to August 2017. 146 children presenting for routine immunization were selected. Sex, age groups, age in years and presence of ASB were variables. Sex, age groups and presence of ASB were analyzed by count and percentage with 80%CL. Age in years was analyzed by mean, SD and range with 95%CI.Results: Out of 146 children, 65 (44.52%) were males and 81 (55.48%) females, and 51 (34.93%) in age group ≤3 years, 52 (35.62%) in 3.0-6.50 years and 43 (29.45%) in 6.51-10 years. Mean age of sample was 4.82±2.81 (09-9.50, range 8.60) (95%CI 4.36-5.28) years. ASB was found in 16 (10.96%) cases. Prevalence of ASB was higher 4.11% in boys than 6.856% girls. It was highest 6.85% in age group 3.0-6.50 years, followed by 2.74% in 6.51-10 years and 1.37% in age group ≤3.0 years.Conclusion: Asymptomatic Bacteriuria is quite common in our children. It is a significant health risk especially among females, and we suggest more studies to find out the underlying factors and follow up studies on its complications.

Risk Indicators for Urinary Tract Infections in Low Risk Pregnancy and the Subsequent Risk of Preterm Birth.

Symptomatic urinary tract infections are associated with preterm birth. However, data on risk indicators for urinary tract infections are limited and outdated. The research is a secondary analysis. The study was a prospective multicenter cohort study of low-risk pregnant women. Logistic regression was used to identify risk indicators for urinary tract infections. The incidence of urinary tract infections was 9.4%. Multivariate logistic regression showed that a history of recurrent urinary tract infections and the presence of asymptomatic bacteriuria in the present pregnancy were associated with urinary tract infections (resp. OR 3.14, 95%CI 1.40–7.02 and OR 1.96 95%CI 1.27–3.03). Women with a urinary tract infection were at increased risk of preterm birth compared to women without a urinary tract infection (12 vs. 5.1%; adjusted HR 2.5 95%CI 1.8–3.5). This increased risk was not found in women with the identified risk indicators (resp. 5.3% vs. 5.1%, adjusted HR 0.35 95%CI 0.00–420 and adjusted HR 1.5 95CI% 0.59–3.9). In conclusion, in low-risk pregnant women, risk indicators for urinary tract infections are: a history of recurrent urinary tract infections and the presence of asymptomatic bacteriuria. The risk of preterm birth is increased in women with a urinary tract infection in this pregnancy. However, women with recurrent urinary tract infections and asymptomatic bacteriuria this pregnancy appear not to be at increased risk of preterm birth.

A short course of antimicrobial therapy for asymptomatic bacteriuria is safe and effective before urologic procedures.

In the presence of asymptomatic bacteriuria (ASB) before the urological procedure, the duration of antimicrobial treatment is controversial. This study aims to evaluate whether a short course of antimicrobial therapy is safe and effective in cases with ASB before urological procedures. We retrospectively reviewed adult patients who had ASB before undergoing several urological procedures between 2011 and 2019. The patients received a single dose of an appropriate parenteral antibiotic, determined by antimicrobial sensitivity testing, 30 to 60 minutes before the urological procedure. If a urinary catheter was placed post-procedure, a second dose was given. A total of 293 patients who had ASB before undergoing several urological procedures were included in the study. The total number of procedures was 328. Female/male ratio was 92 (31.4%)/201 (68.6%). The mean age was 63.7 ± 14.9 years. The most common isolated microorganisms were Escherichia coli (155 [47%]), Klebsiella pneumoniae (38 [11.6%]), and Pseudomonas aeruginosa (28 [8.5%]). The most common antimicrobial used was ertapenem. A second dose antimicrobial was given for 290 procedures due to a urinary catheter after a urological procedure. The mean hospitalization time was 3.97 ± 3.42 days. None of the patients developed infectious complications. This study has demonstrated that a single dose of parenteral antimicrobial drug administered 30-60 minutes before the urologic procedures and a second dose in the presence of a post-procedure catheter, was adequate to prevent post-procedure septicemia and urinary tract infection.

MP46-09 RISK OF URINARY TRACT INFECTION AFTER INTRADETRUSOR BOTULINUM TOXIN A INJECTION IN CATHETER-DEPENDENT PATIENTS WITH NEUROGENIC BLADDER WITH ASYMPTOMATIC BACTERIURIA

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Kidney & Bladder I (MP46)1 Apr 2020MP46-09 RISK OF URINARY TRACT INFECTION AFTER INTRADETRUSOR BOTULINUM TOXIN A INJECTION IN CATHETER-DEPENDENT PATIENTS WITH NEUROGENIC BLADDER WITH ASYMPTOMATIC BACTERIURIA Alyssa Greiman*, Giulia Lane, Rachel Bergman, Paholo Barboglio Romo, J. Quentin Clemens, Priyanka Gupta, Diana O'Dell, John Stoffel, and Anne P. Cameron Alyssa Greiman*Alyssa Greiman* More articles by this author , Giulia LaneGiulia Lane More articles by this author , Rachel BergmanRachel Bergman More articles by this author , Paholo Barboglio RomoPaholo Barboglio Romo More articles by this author , J. Quentin ClemensJ. Quentin Clemens More articles by this author , Priyanka GuptaPriyanka Gupta More articles by this author , Diana O'DellDiana O'Dell More articles by this author , John StoffelJohn Stoffel More articles by this author , and Anne P. CameronAnne P. Cameron More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000901.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: It is not well known if asymptomatic bacteriuria (ASB) at the time of botox injection increases the risk of post-procedure urinary tract infections (UTI) in catheter-dependent patients with neurogenic bladder. We aim to determine the incidence of symptomatic UTI in patients with neurogenic bladder who undergo detrusor botox injection and to determine if asymptomatic bacteriuria increases this risk. METHODS: As part of an ongoing prospective study, we obtained urine cultures and urologic history from 43 asymptomatic patients with a diagnosis of neurogenic bladder who managed their bladder with intermittent catheterization or suprapubic catheter before they underwent intradetrusor botox injection. Each patient received a single dose of prophylactic antibiotics at the time of their procedure. We then followed these patients to determine if they developed a symptomatic UTI after their procedure. RESULTS: Of the 43 patients enrolled, 53.5% were women and the mean age was 52 years (19-78 years). Most had neurogenic bladder due to spinal cord injury (58.1%) or multiple sclerosis (14%). Most patients performed intermittent catheterization (91%), while the remainder had a suprapubic catheter. Urine cultures among these asymptomatic patients were positive in 79.1% (n=34). Two patients had a symptomatic UTI during the first week after botox (at 1 and 3 days post-procedure). This resulted in an overall risk of a symptomatic UTI of 4.7% in the entire population and a risk of 5.9% if ASB was present. Both patients who developed a symptomatic UTI after botox had ASB prior to the procedure with cultures growing two organisms (one with 10-100K CFU Enterococcus spp. plus 10-100k CFU E. coli and one with 10-100K CFU Enterococcus spp. plus 1-10K CFU Klebsiella pneumoniae). One patient’s pre-procedure antibiotic did not cover the Enterococcus in the urine. Symptoms were mild and included nausea, and chills with increased odor to the urine. CONCLUSIONS: The rate of symptomatic UTI after intradetrusor botox injections was 4.7% overall and 5.9% in catheter-dependent patients with neurogenic bladder who had asymptomatic bacteriuria at time of procedure. The presence of ASB at time of botox injection did not result in an increased risk of symptomatic UTI when compared to the available literature. It may not be necessary to screen the urine of this population prior to intradetrusor botox injections if they are asymptomatic. More data is needed to determine risk factors for developing a UTI after botox in this population. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e676-e677 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alyssa Greiman* More articles by this author Giulia Lane More articles by this author Rachel Bergman More articles by this author Paholo Barboglio Romo More articles by this author J. Quentin Clemens More articles by this author Priyanka Gupta More articles by this author Diana O'Dell More articles by this author John Stoffel More articles by this author Anne P. Cameron More articles by this author Expand All Advertisement PDF downloadLoading ...

Risk of infection in patients undergoing urologic surgery based on the presence of asymptomatic bacteriuria: A prospective study

Treatment of asymptomatic bacteriuria (ASB) is recommended in pregnant women and prior to urologic procedures with anticipated mucosal disruption. However, there is still insufficient evidence of the usefulness of treating ASB prior to urologic procedures. Therefore, the aim of this study was to ascertain the risk of infections in patients undergoing urologic surgery based on the presence of ASB. We conducted a cohort study among patients undergoing urologic surgery at a single center located in Medellín, Colombia. All patients were screened for ASB prior to their procedures. Patients were evaluated for the development of any postoperative infectious complications for up to 30 days after the procedure. A total of 149 patients were included in this cohort. Incidence of ASB was 14.8%. Thirteen patients (8.72%) developed infectious complications: 3 (13.64%) with ASB and 10 (7.87%) without ABS. Factors associated with postoperative infectious complications included urologic cancers (hazard ratio [HR], 5.26; 95% confidence intervals [CI], 1.24-22.37), urologic interventions in the preceding 3 months (HR, 3.72; 95% CI, 1.02-13.51), and use of antibiotics 3 months prior to surgery (HR, 3.83; 95% CI, 1.01-15.49). Presence of ASB was not associated with postsurgical infectious complications (HR, 1.02; 95% CI, 0.26-3.96). There was no association between ASB and postoperative infectious complications. There were other factors associated with infectious complications, such as urologic cancer, previous history of urologic manipulation, and antibiotic use.

Uro-Vaxom\xae versus placebo for the prevention of recurrent symptomatic urinary tract infections in participants with chronic neurogenic bladder dysfunction: a randomised controlled feasibility study

BackgroundPatients with lower neurogenic bladder dysfunction are at an increased risk of suffering from recurrent urinary tract infections. Recurrent symptomatic urinary tract infection is occasionally treated with antibiotics as a prophylactic prevention strategy. This risks increasing the frequency of antibiotic resistance. National healthcare policymakers have requested further research into alternative preventive measures for pathologies that require antibiotic treatment.MethodsThis study protocol describes a two-centre, randomised, double-blinded, placebo-controlled study to evaluate the prevention of recurrent urinary tract infections with the commercial immunotherapy agent Uro-Vaxom®, based on Escherichia coli pathogen-associated molecular patterns. Eligible participants are recruited by the direct healthcare team and randomised to receive Uro-Vaxom® in the form of an oral capsule, or a matching placebo. Participants will receive the study treatment daily for 3 months and followed up for an additional 3 months so that the number of symptomatic urinary tract infection episodes and individual signs and symptoms per episode can be recorded using participant study diaries. Primary outcome measures are: number of symptomatic urinary tract infections experienced over 3 months, number of symptomatic urinary tract infections experienced over 6 months, time from the start of treatment to the first urinary tract infection, and the presence of asymptomatic bacteriuria at 3 and 6 months. Secondary outcome measures are: individually recorded symptoms normally associated with recurrent urinary tract infection and consistency of reported symptoms during the symptomatic urinary tract infection experienced during the study, compliance with study protocol and study medication, and adverse events.DiscussionHealthcare policymakers recommend that alternative preventative strategies are identified for symptomatic urinary tract infections that require antibiotic treatment. If Uro-Vaxom® is shown to be effective, this feasibility study would warrant a larger, statistically powered, multicentre study to investigate whether this immunotherapy strategy is an effective preventative measure for recurrent symptomatic urinary tract infection for people with spinal cord injuries and neurological pathologies.Trial registrationISRTCN. Registered on 30 October 2015.ClinicalTrials.gov, ID: NCT0251901. Registered on 30 October 2015.URL of trial registry record: Ethics Ref: 15-LO-2069. IRAS Number: 185760. Sponsor Number: RXQ/648.NIHR Funding Reference: PB-PG-1013-32017.

Effect of asymptomatic bacteriuria treatment prior to total hip or knee arthroplasty on hospital outcomes: A retrospective cohort study

Background: Although treatment of asymptomatic bacteriuria (ASB) in patients undergoing total hip (THA) or knee (TKA) arthroplasty does not seem to effect the rate of secondary joint infections (SJI), the effect on hospital outcomes has yet to be evaluated. This study aimed to determine the clinical effect of ASB treatment in TKA or THA on hospital outcomes. Methods: A retrospective evaluation of patients undergoing TKA or THA with the presence of ASB was conducted. Inclusion criteria were TKA or THA and presence of ASB. Patients were excluded if symptomatic, receiving nonspecified antibiotics, catheterized, or pregnant. The primary outcome was comparing differences in time from admission to TKA or THA procedure in groups treated for ASB versus an untreated group. Secondary outcomes were length of stay (LOS) and rates of SJI. Results: A total of 1683 patients were screened, and 133 patients with ASB were included (53 treated; 80 untreated). Median time from admission to procedure was not statistically different between groups (3.63 hr [3.10-5.57 hr] treated vs. 3.68 hr [3.07-5.17 hr] untreated; P=0.412). An increase in LOS was observed in the treated group (3.4 days [3.15-4.36 days] treated vs. 2.36 days [2.21-3.35 days] untreated; P<0.0001). Rates of SJI were not different between groups (P=0.646). Conclusions: Although time from admission to TKA or THA procedure was not different between groups, a longer LOS was identified in the treated group. There was no difference in rates of SJI between groups. Larger studies are needed to determine if treating ASB for TKA or THA should be discontinued. Level of Evidence: Level III.

Asymptomatic bacteriuria and antimicrobial susceptibility pattern of the isolates among pregnant women attending Dessie referral hospital, Northeast Ethiopia: A hospital-based cross-sectional study.

The aim of the current study was to find out the prevalence of asymptomatic bacteriuria, antimicrobial susceptibility pattern of the isolates and related risk factors among pregnant women. A hospital-based cross-sectional study was carried out from February 2017 to May 2017 among asymptomatic pregnant mothers attending Dessie Referral Hospital, Northeast Ethiopia. About 10-15 mL of freshly voided midstream urine samples were collected from each study participants, and analyzed at Dessie regional research microbiology laboratory with conventional antibiotic susceptibility, and biochemical tests. Isolates were tested against commonly used antimicrobials using Kirby Bauer disc diffusion method. Data were analyzed by SPSS version 20 software and in all cases, p-values below 0.05 was considered as statistically significant. Overall, 358 pregnant women were included in the study with a mean age of 26.5±4.6 years (range, 19-43 yrs). The overall prevalence of asymptomatic bacteriuria was 56% (15.6%). Isolated microorganisms were mainly Escherichia coli and Staphylococcus aureus (for each, n=18; 31%). Escherichia coli and Staphylococcus aureus were resistant to ampicillin (66.7%), and penicillin (94.44%). The prevalence of multidrug- resistant isolates was 72.4%. History of catheterization [AOR=2.28, 95% CI=(1.03-5.06)] and anemia [AOR=4.98, 95% CI=(2.395-10.34) were statistically significant regarding the prevalence of asymptomatic bacteriuria. The overall prevalence of asymptomatic bacteriuria among pregnant women in the study area was high. The presence of asymptomatic bacteriuria and their antibiotic susceptibility test results should be taken into consideration during the management of pregnant women who are visiting antenatal care clinic.

Predictive factors of infectious complications in patients undergoing prostatectomy

ObjectiveTo determine the factors associated with the development of infectious complications in patients undergoing prostatectomy for benign or malignant prostatic disease in Hospital Universitario Mayor. Materials and methodsA descriptive cross-sectional study was conducted between 2012 and 2013 on 866 patients subjected to prostate surgery. Univariate and multivariate analyses were performed using logistic regression analysis of perioperative variables using the statistical analysis program Wizard for Mac. ResultsA total of 284 patients (32.7%) received preoperative prophylaxis, and 167 (19.3%) patients had permanent urinary catheter. There were 89 (10%) patients with Diabetes Mellitus. Complications were identified in 149 (17.2%) patients, and among these, 59 (65.5%) had a urinary infection, 21 (23.3%) patients had orchiepididymitis, and 10 (11.1%) had a surgical wound infection. In the bivariate analysis the presence of diabetes mellitus was significantly associated with the development of UTI, OR 2.04, p=0.025. The presence of asymptomatic bacteriuria was associated with the development of vesicocutaneous fistula (p=0.00, OR 1.91), and the occurrence of surgical wound infection (p=0.004, OR 12.6). It was found that failure to use preoperative prophylactic antibiotics is associated with the formation of vesicocutaneous fistula (OR 0048, p=0.04). ConclusionsDiabetes mellitus patients are at increased risk of infectious complications, such as urinary tract infection or orchiepididymitis. The presence of asymptomatic bacteriuria is associated with a higher frequency of surgical wound infection. There was no relationship between patients with permanent urinary catheter use and the development of infectious complications.

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.

Caracterización y perfil de susceptibilidad de uropatógenos asociados a la presencia de bacteriuria asintomática en gestantes del departamento del Atlántico, Colombia, 2014-2015. Estudio de corte transversal

Objetivo: la bacteriuria asintomática con manejo inadecuado en el embarazo se asocia con pielonefritis que puede llevar a complicaciones maternas y fetales. El objetivo de este estudio fue caracterizar los uropatógenos y su perfil de susceptibilidad, asociados a la presencia de bacteriuria asintomática en una muestra de mujeres gestantes.Materiales y métodos: estudio descriptivo de corte transversal, en gestantes atendidas en el programa de control prenatal en una institución de primer nivel en el departamento del Atlántico, Colombia. Se realizó un muestreo por conveniencia a partir del universo de pacientes atendidas en el programa. Se hizo el diagnóstico de bacteriuria asintomática por la presencia de recuentos ≥ 105 colonias / mL de un solo germen. Para la identificación y determinación del perfil de susceptibilidad de las bacterias aisladas se utilizó el sistema automatizado Phoenix® BD. Se describe la prevalencia de bacteriuria asintomática, y la frecuencia y susceptibilidad por tipo de germen.Resultados: ingresaron 226 gestantes.La frecuencia de bacteriuria asintomática fue del 10,6 %. El uropatógeno más frecuentemente aislado fue la Escherichia coli en un 25 % de los casos, seguida por Enterococcus faecalis en un 20,8 %. La resistencia a la ampicilina fue del 33,3 y 20 % respectivamente; el resto de enterobacterias identificadas presenta una resistencia natural a dicho antibiótico. La resistencia de la E. coli y el E. faecalis a la nitrofurantoína fue del 16,6 y 20 % respectivamente.Conclusiones: se encuentra resistencia importante en el nivel de atención de los gérmenes más frecuentemente aislados en gestantes con bacteriuria asintomática a la ampicilina: en trimetoprim sulfametoxazol fue del 66 %. La nitrofurantoína sigue siendo una buena opción para el tratamiento en la primera mitad del embarazo.

Factores predictores de complicaciones infecciosas en pacientes sometidos a prostatectomía

ObjectiveTo determine the factors associated with the development of infectious complications in patients undergoing prostatectomy for benign or malignant prostatic disease in Hospital Universitario Mayor. Materials and methodsA descriptive cross-sectional study was conducted between 2012 and 2013 on 866 patients subjected to prostate surgery. Univariate and multivariate analyses were performed using logistic regression analysis of perioperative variables using the statistical analysis program Wizard for Mac. ResultsA total of 284 patients (32.7%) received preoperative prophylaxis, and 167 (19.3%) patients had permanent urinary catheter. There were 89 (10%) patients with Diabetes Mellitus. Complications were identified in 149 (17.2%) patients, and among these, 59 (65.5%) had a urinary infection, 21 (23.3%) patients had orchiepididymitis, and 10 (11.1%) had a surgical wound infection. In the bivariate analysis the presence of diabetes mellitus was significantly associated with the development of UTI, OR 2.04, P=.025. The presence of asymptomatic bacteriuria was associated with the development of vesicocutaneous fistula (P=.00, OR 1.91), and the occurrence of surgical wound infection (P=.004, OR 12.6). It was found that failure to use preoperative prophylactic antibiotics is associated with the formation of vesicocutaneous fistula (OR 0048 P=.04). ConclusionsDiabetes mellitus patients are at increased risk of infectious complications, such as urinary tract infection or orchiepididymitis. The presence of asymptomatic bacteriuria is associated with a higher frequency of surgical wound infection. There was no relationship between patients with permanent urinary catheter use and the development of infectious complications.

Asymptomatic Bacteriuria in Diabetic Adults

Introduction: Urinary Tract Infection (UTI) is a well- known complication of Diabetes Mellitus (DM). Its spectrum ranges from Asymptomatic Bacteriuria (ABU) to acute pyelonephritis. Many studies have delineated an increased prevalence of ABU in DM whereas to the same degree other studies have come to naught showing insignificant association. Hence, this study was drafted to evaluate the presence of ABU among diabetics and assess various risk factors.
 
 Methods: Total of 116 diabetic adults without symptoms of UTI attending medical out-patient department, Manipal Teaching Hospital were enrolled by detailed clinical history, examination and laboratorial examination as per standard set of questionnaire from February 2013 to May 2014. Data were analyzed by SPSS (17.0).
 
 Results: The rate of ABU in diabetic adults was 10.3% and was significantly associated with duration of DM, fasting blood glucose level and poor glycaemic control. Escherichia coli was the most frequently isolated pathogen which was sensitive to Nitrofurantoin and Imipenem.
 
 Conclusion: Being asymptomatic, diabetics fail to recognise ABU, however, ABU is preponderant in DM and is linked mainly with duration of DM and poor glycaemic control. Hence screening for ABU is imperative in diabetic adults if above mentioned risk factors are present.

A study of asymptomatic bacteriuria in North Indian type 2 diabetic patients

The prevalence of asymptomatic bacteriuria (ASB) in diabetic patients varies from 9 to 27 % in various studies which is certainly higher as compared to healthy individuals. The risk factors which lead to increased prevalence of asymptomatic bacteriuria in diabetic patients are immune system dysregulation, development of bladder dysfunction and prostatism. Studies have reported that ASB has a higher prevalence in diabetic individuals as compared to nondiabetics. Patients having type 2 diabetes mellitus along with age- and sex-matched controls who were hemodynamically stable were enrolled. A prospective case-control study was done. A total of 200 patients were enrolled, and they were divided into two groups, i.e. those with diabetes and nondiabetic patients (age- and sex-matched controls) without symptoms of UTI. Urine examination and biochemical investigations of the patients were done. In our study, the prevalence of ASB among the diabetic patients was significantly higher 28.2 % as compared to 7.5 % in the controls (p = 0.001). The main risk factors for asymptomatic bacteriuria in our study were female sex (p = 0.003), increased age (p = 0.007), longer duration of diabetes mellitus (p = 0.003), poor glycemic control (p < 0.001) and recent urinary tract infection (p = 0.02). There were no significant differences in the serum creatinine levels in the patients with asymptomatic bacteriuria among diabetics as compared to the culture-negative patients. The presence of ASB may be considered a marker of poorly controlled and long-standing diabetes.

Prevalence of Asymptomatic Bacteriuria in Malnourished Children (1-5 Years)

Objective: To determine the prevalence of asymptomatic bacteriuria in malnourished children and its correlation to the severity of Protein Energy Malnutrition. Design: Prospective cross-sectional observational study. Participants: 150 malnourished children (1-5 years) attending pediatric OPD with no obvious localization of urinary tract infection. Methods: Urine samples were collected by suprapubic aspiration and examined for microscopy and culture sensitivity to evaluate the presence of asymptomatic bacteriuria. Results: Out of 150 malnourished children, 80 (53.3%) were males and 70 (46.7%) were females and the mean age was 39.12 months. The overall prevalence of asymptomatic bacteriuria was found to be 6.6%. It was 15.9% in grade IV, 4.6% in grade III, 3.1% in grade II, none in grade I PEM. There was significant statistical correlation between asymptomatic bacteriuria and severity of PEM. Conclusion: Due to the subtle presentation of urinary tract infection in undernourished population, urine from all such children should be routinely screened for the presence of asymptomatic bacteriuria and the urine sample may be collected by suprapubic aspiration.