Presence Of Urinary Tract Infection Research Articles

Using the Sysmex UF-4000 urine flow cytometer for rapid diagnosis of urinary tract infection in the clinical microbiological laboratory.

Urinary tract infections are responsible for a significant worldwide disease burden. Performing urine culture is time consuming and labor intensive. Urine flow cytometry might provide a quick and reliable method to screen for urinary tract infection. We analyzed routinely collected urine samples received between 2020 and 2022 from both inpatients and outpatients. The UF-4000 urine flow cytometer was implemented with an optimal threshold for positivity of ≥100 bacteria/μL. We thereafter validated the prognostic value to detect the presence of urinary tract infection (UTI) based on bacterial (BACT), leukocyte (WBC), and yeast-like cell (YLC) counts combined with the bacterial morphology (UF gram-flag). In the first phase, in 2019, the UF-4000 was implemented using 970 urine samples. In the second phase, between 2020 and 2022, the validation was performed in 42,958 midstream urine samples. The UF-4000 screen resulted in a 37% (n = 15,895) decrease in performed urine cultures. Uropathogens were identified in 18,673 (69%) positively flagged urine samples. BACT > 10.000/μL combined with a gram-negative flag had a >90% positive predictive value for the presence of gram-negative uropathogens. The absence of gram-positive flag or YLC had high negative predictive values (99% and >99%, respectively) and are, therefore, best used to rule out the presence of gram-positive bacteria or yeast. WBC counts did not add to the prediction of uropathogens. Implementation of the UF-4000 in routine practice decreased the number of cultured urine samples by 37%. Bacterial cell counts were highly predictive for the presence of UTI, especially when combined with the presence of a gram-negative flag.

Prevalence and Risk Factors of Urinary Retention in Patients With Cervical Cancer: A Meta-analysis and Systematic Review.

The literature is inconsistent on the prevalence and risk factors of urinary retention in patients with cervical cancer. The aim of this study was to review the literature on the prevalence of urinary retention in patients with cervical cancer and consolidate the risk factors. For this meta-analysis, eligible articles published in English or Chinese by December 10, 2021, were systematically searched for and retrieved from PubMed, Cochrane Library, Ovid-Embase Medline, Web of Science, PsycINFO, CINAHL, and Scopus. Prevalence, odds ratios (ORs), and 95% confidence intervals (CIs) were used for meta-analysis. Twenty-five studies were included in the analysis. The pooled overall prevalence was 0.26 (95% CI, 0.21-0.30, I2 = 95.0%). The identified risk factors were age (OR, 1.13; 95% CI, 1.08-1.19), urinary tract infection (UTI) (OR, 3.33; 95% CI, 1.48-7.49), surgical extent (OR, 2.95; 95% CI, 1.27-6.85), and catheter indwelling time (OR, 3.44; 95% CI, 2.43-3.87). The prevalence of urinary retention in patients with cervical cancer is 0.26. Older age, UTI, longer catheter indwelling time, and a larger surgical extent may increase the risk of urinary retention. Clinicians should identify patients at risk and adopt interventions such as individualized catheter care. Nursing staff should assess the risk of urinary retention in a patient with cervical cancer according to her age, presence of UTI, surgical extent, and catheterization time. A carefully chosen surgical procedure and interventions such as individualized education, timely catheter removal, treatment of UTI, and rehabilitation should be offered.

Kidney pathology in liver cirrhosis

Objective. To analyze the structure and frequency of kidney pathology in liver cirrhosis according to sectional analysis and to study the relationship between acute renal injury and urinary tract infection.Materials and methods. The design of the study is mixed: descriptive and analytical, which included conducting a retrospective case–control study of kidney pathology based on the results of the protocols of pathoanatomical autopsies on the basis of the state healthcare institution “Gomel Regional Clinical Pathoanatomical Bureau” for the period of January 2022 – July 2023 and clinical, laboratory, instrumental, cytological, microbiological data of patients with liver cirrhosis. The study included 98 deceased patients, including 70 (71.4%) men, 28 (28.6%) women. The average age was 53.9 years, the majority of patients were persons of working age — 72.9% of men and 60.7% of women, 21.4% were young people.Results. The most common kidney pathology in liver cirrhosis according to sectional analysis is acute renal injury (57.1%). Kidney abscesses (3%), tubulointerstitial nephritis (2%) and pyelonephritis (4%) were less frequently diagnosed. Despite the absence of a history of kidney diseases in most patients with cirrhosis, classical clinical, laboratory and instrumental signs of renal tissue damage, macroscopic and microscopic changes of the kidneys were revealed in 100% of cases at autopsy. In 84.7% of cases, acute tubular necrosis was morphologically diagnosed from focal (51%) to total (19.4%), which was not always accompanied by an increase in serum creatinine levels. A moderate relationship was established between acute kidney injury and urinary tract infection (OR = 14; 95 % CI 11.13–16.61).Conclusion. The most common complication of liver cirrhosis associated with an unfavorable prognosis is acute renal injury, which is associated with the presence of urinary tract infection.

POSTOPERATIVE EFFECTIVENESS OF PREOPERATIVE PREPARATION AND TREATMENT OF PATIENTS AT THE TIME OF THE THIRD STAGE OF RETRO AND PELVIC PROLAPSE IN WOMEN

Genital prolapse remains one of the unsolved problems of modern gynecology. The aimof the study is to improve the preoperative preparation and postoperative management of patients with grade III pelvic organ prolapse, using modern innovative technology in combination with drugs to reduce postoperative complications and relapses. Materials and methods of research.The object of the study was 217 patients with grade III pelvic organ prolapse who underwent surgical treatment. Results and discussion.110 women with grade III PG received an improved method of preoperative preparation, including irrigation with cavitated low-frequency ultrasound with an aqueous 0.05% chlorhexidine solution in the amount of 200.0, up to 4 times, locally conjugated estrogen, and in the presence of urinary tract infection, acute cystitis -once fosfomycintrimetabol 3.0 grams orally, in recurrent forms of phytopreparation (Canephron N) for 14.5 ±2.5 days. Conclusion:The improved method of preoperative preparation of patients with PTO of the III degree contributed to the reduction of the days of preoperative preparation by 6.0±0.5 days, reduced interoperative blood loss by 2.0 times, reduced the duration of the operation by 37.0±6.35 minutes, the hospital stay decreased by an average of 3.5±0.5 days, and postoperative recurrences after 1 year decreased by 2.4 times and after 2 years by 2.8 times.

There’s No Place Like Home: Delirium as a Barrier in Geriatric Trauma

IntroductionDelirium is associated with a three-fold increase in frequency of 6-mo mortality following intensive care unit admission. Outside of mortality, it has been linked with severe morbidity including long-term cognitive decline, loss of autonomy, and increased risk of institutionalization. There is a paucity of literature regarding delirium and geriatric trauma patients. The aim of our study is to determine predictive factors of delirium in geriatric trauma patients. MethodsThis is a retrospective review of all geriatric (>65 y) trauma patients with a documented frailty score at a Level I Trauma Center from 1/2019 to 9/2021. Univariate and multivariate logistic regressions were performed. Geriatric patients with delirium (D) and those without delirium (ND) were compared. Patients were excluded if they did not have a documented frailty score or died before admission. ResultsOne thousand three hundred and seventeen patients met criteria; 40 (3%) patients developed delirium. Neither age nor gender was different between the two groups. Frailty scores were not different between the two groups. Patients with documented delirium had a higher incidence of a positive drug screen on admission (85% versus 62.2%, P = 0.0034), higher median injury severity score (10 versus 9, P = 0.0088), and longer hospital (7 d versus 3 d, P < 0.001) and intensive care unit (1 d versus 0 d, P < 0.001) length of stay (LOS) than their ND counterparts. The D group had a higher frequency of benzodiazepine (47.5% versus 19.3%, P < 0.001) and narcotic use (77.5% versus 56.5%, P = 0.0085). Tethers nor bedrest orders were significantly associated with delirium. Incidence of urinary tract infection (12.5% versus 1%, P < 0.001) and restraint use (P < 0.001) were significantly associated with increased risk of delirium. Additionally, those with a diagnosis of delirium were more often discharged to a skilled nursing facility than those in the ND group (45% versus 30.8%, P = 0.0006). ConclusionsWe aimed to identify key predictive factors of delirium in our study population and found that certain factors correlated with higher frequencies of delirium in our geriatric trauma patients. Preadmission and early controlled substance use were significantly associated with delirium, as were the presence of urinary tract infection and extended intensive care unit LOS. By recognizing some of these modifiable factors, LOS may decrease while increasing the likelihood of discharge home.

The effectiveness of modified stone recurrence predictive score in predicting recurrence of urinary stone disease

Aims: The present study is intended to define the scoring system consisting of questions to be answered by the patients in an outpatient clinic setting in order to predict recurrence of urinary system stone disease. Methods: Two hundred patients who were admitted for urinary system stone treatment in our clinic between 2016 and 2017 were included in the study. A Modified Stone Recurrence Predictive Score (MSRPS) comprising 23 questions under 14 headings including risk factors such as age, gender, smoking and alcohol consumption, family history of stone, number of stones, additional diseases and medications, presence of urinary tract infection, dietary characteristics, stress factors, occupation, and obesity was created. Three-year follow-up data of all patients were recorded. Results: The mean MSRPS was 18.4±6.2 (6-35). We noted that the high Modified Stone Recurrence Predictive Score correlated significantly with the incidence of recurrent stone formation (p&lt;0.001 r2: 0.923). When the cutoff value was considered as 18, the sensitivity was 89.4% and the specificity was 93.1% in predicting recurrent stones. Recurrent stone formation was observed within 3 years in all patients with an MSRPS value of 26 and above. Conclusion: Thanks to this scoring system developed by expanding the scope of similar studies conducted in previous years, the possibility of recurrence of urinary stone disease is predicted using a questionnaire that can be filled easily, and it would be an appropriate choice regarding both patient health and cost-effectiveness in terms of directing patients to metabolic analyses or recommending preventive measures.

URINALYSIS AS A PREDICTOR FOR URINARY TRACT INFECTION: AN OBSERVATIONAL STUDY

Aims and Objectives: The aims and objectives of the study are to find the usefulness of urine dipstick and urinalysis in children with an intention to identify the parameters which most likely point toward the presence of urinary tract infection (UTI), whether a combination of the parameters analyzed rather than single parameter is useful in suggesting the presence or absence of UTI. Methods: The study was a prospective observational study done in 401 children below 16 years of age with clinically suspected UTI. Results: The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of dipstick leukocyte esterase (LE) and nitrite were 85%, 93.1%, 75.6%, 96.1% and 51.2%, 99.1%, 93.2%, 89.1%, respectively. In urine microscopic analysis, the sensitivity, specificity, PPV, NPV of bacteria were 68.5%, 96.9%, 84.6%, and 92.6% and those of pus cells were 80%, 93.1%, 74.4%, and 94.9%. Conclusion: Combination of parameters, i.e., LE, nitrite, and bacteria or LE, nitrite, and pus cells are good screening tools to predict and rule out UTI. Of the individual parameters analyzed, negative nitrites in dipstick and absence of bacteria in urine microscopy almost rule out UTI caused by most uropathogens.

PD22-08 ACOUSTIC RADIATION FORCE IMPULSE IMAGE FOR EVALUATION OF PARENCHYMA ELASTICITY IN ACUTE HYDRONEPHROTIC KIDNEY: A PRELIMINARY REPORT

You have accessJournal of UrologyCME1 Apr 2023PD22-08 ACOUSTIC RADIATION FORCE IMPULSE IMAGE FOR EVALUATION OF PARENCHYMA ELASTICITY IN ACUTE HYDRONEPHROTIC KIDNEY: A PRELIMINARY REPORT Jen-Chieh Chen, Shih-Yen Lu, Tzu-Ping Lin, and William J. Huang Jen-Chieh ChenJen-Chieh Chen More articles by this author , Shih-Yen LuShih-Yen Lu More articles by this author , Tzu-Ping LinTzu-Ping Lin More articles by this author , and William J. HuangWilliam J. Huang More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003295.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The acoustic radiation force impulse (ARFI) imaging is a new technique with great promise in the field of elastography. It had been used widely in evaluation of various disease involving tissue stiffness, such as liver fibrosis, thyroid nodules, subcutaneous lymph nodes, and breast lesions. However, in kidney, the blood flow is thought to affect the elasticity more than tissue stiffness. To date, the utility of ARFI imaging in acute hydronephrotic kidney remains unexplored. In this study, we aim to compare the shear wave velocity (SWV) measured by ARFI ultrasound elastography of hydronephrotic kidneys caused by ureteral stones and the normal contralateral kidneys. METHODS: A total of 31 patients presented to our emergency room (ER) due to unilateral renal colic caused by ureteral stone with hydronephrosis from April 2020 to September 2022 were prospectively recruited. The patient’s character was recorded. The kidney ultrasound with ARFI imaging of the affected kidney and the contralateral side was performed by a single experienced technician immediately after the diagnosis was made. The SWV value, expressed as speed (m/sec.) of wave propagation through the tissue, was calculated for each kidney in its outer renal cortex. To each of the kidney, the SWV value was assigned through the average of ten different measurements. The Wilconxon signed rank test was used to compare the SWV value of affected and contralateral kidney in an individual. All P values less than 0.05 were considered statistically significant. RESULTS: Among 31 patients, 16 patients presented to our ER at acute/intermediate phase (<24 hours of symptoms onset) and 15 patients at late phase (≥ 24 hours). The SWV value showed variable changes between the affected and contralateral kidneys in patients who came to our ER within 24 hours of symptoms onset. However, in patients who presented to our ER at late phase, the SWV value was significantly lower in their affected kidney (p=0.043). Subsequent analysis found that the SWV value did not showed any significant correlations with age, side of the affected kidney, pain score, stone size, degree of hydronephrosis, presence of urinary tract infection, or presence of acute kidney injury. All patients received stone management successfully afterward. After a mean follow-up of 3 months, there was no evidence of significant sequelae. CONCLUSIONS: The SWV value showed variable changes in patients whose interval between the onset of the symptoms and the kidney stiffness measurement was less than 24 hours. However, SWV value decreased significantly in patients whose interval was greater than 24 hours. This finding may compatible with the concept that the renal blood flow decreases after 24 hours of obstructive uropathy. To our knowledge, this is the first study to evaluate the ARFI image in acute hydronephrotic kidney. Source of Funding: Nil © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e667 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jen-Chieh Chen More articles by this author Shih-Yen Lu More articles by this author Tzu-Ping Lin More articles by this author William J. Huang More articles by this author Expand All Advertisement PDF downloadLoading ...

Prevalence and Clinical Significance of Urinary Tract Infection among Neonates Presenting with Unexplained Hyperbilirubinemia in Lebanon: A Retrospective Study.

Neonatal jaundice is commonly seen in term and preterm newly born babies. It could be either physiologic or secondary to multiple underlying pathologies like urinary tract infection (UTI). Our main objective was to confirm the relationship between neonatal jaundice without apparent cause like hemolysis and the presence of UTI. We, retrospectively over a period extended from 2017 to 2020, included 496 babies admitted for elevated indirect hyperbilirubinemia for whom demographic, clinical, laboratory, and therapeutic data were collected through a detailed questionnaire. Our study included 496 neonates and showed a prevalence of UTI in 8.9% of neonates. The two most common microorganisms in urine culture were Escherichia coli (65.9%) and Klebsiella pneumoniae (25.0%). A multivariate logistic analysis showed that UTI was associated with male neonates (odds ratio [OR] = 2.366, 95% confidence interval [CI]: 1.173 - 4.774; P = 0.016), history of prenatal UTI (OR = 5.378, 95% CI: 2.369 - 12.209; P <0.001), poor feeding (OR = 3.687, 95% CI: 1.570 - 8.661; P = 0.003), and positive urine culture in catheter (OR = 2.704, 95% CI: 1.255 - 5.826; P = 0.011). The mean length of stay was higher in patients with positive UTI (Median = 216 hours) compared to patients with negative UTI (Median = 48 hours) (P <0.001). Neonatal sreening for UTI should be recommended whenever there is unexplaind early or prolonged hyperbilirubinemia with no evidence of alloimmune hemolysis or blood group incompatibility and to prevent the morbidity of urosepsis and congenital kidneys malformations.

ПРЕДИКТОРЫ УСПЕХА ЭНДОСКОПИЧЕСКОЙ КОРРЕКЦИИ ПУЗЫРНО-МОЧЕТОЧНИКОВОГО РЕФЛЮКСА У ДЕТЕЙ

Predicting the outcome of endoscopic correction of vesicoureteral reflux (VUR) is an urgent problem in pediatric urology because the identification of predictors for the effectiveness of endoscopic treatment of VUR will optimize the strategy for examination and treatment of the disease. The purpose of the research was to evaluate the statistical impact of various predictors on the success of endoscopic correction of VUR; to predict the clinical outcome by creating a mathematical model. Materials and methods used: a single-center experimental uncontrolled study was conducted in Sept. 2017 - Feb. 2022. The results of treatment of 150 pediatric patients (240 renal units) aged from 1 month till 7 years old who underwent endoscopic correction of VUR are presented. The following indicators were evaluated as predictors: gender, age of the disease manifestation, bilateral/unilateral VUR, grade of VUR, ureteral diameter ratio (UDR), cystography initial confirmation of VUR, expansion of the pelvicalyceal system and ureter according to ultrasound, the presence of urinary tract infection. Results: according to the data obtained, when comparing the grade of VUR, cystography initial confirmation of VUR, UDR, expansion of the pelvis and ureter depending on the result of treatment, the statistically significant differences have been found (p&lt;0.001). A prognostic model has been developed to determine the probability of the outcome of endoscopic correction of VUR using the binary logistic regression method. The area under the ROC curve was 0.985±0.007 with 95% CI: 0.967-1.000. The resulting regression model was statistically significant (p&lt;0.001). The sensitivity and specificity of the model were 96.4% and 95.3%, respectively. Conclusion: the results of the research show that UDR and the initial confirmation of VUR have greater predictive power for the success of the endoscopic urethroplasty compared to the grade of VUR alone. The use of the predictors and predictive modeling can help improving the selection of candidates for the endoscopic correction of VUR and developing personalized treatment tactics.

Association of Various Factors with the Presence of Urinary Tract Infections Among Patients Suffering from Stroke

Objective: To assess the association of various factors with the presence of urinary tract infections among patients suffering from stroke.&#x0D; Study Design: Comparative cross-sectional study.&#x0D; Place and Duration of Study: Department of Medicine, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jun to Sep 2021.&#x0D; Methodology: A total of 130 patients with ischemic or hemorrhagic stroke diagnosed by the consultant medical specialist or neurologist based on clinical and neuro-radiological findings were included in this study. Urinary tract infection was diagnosed based on urine culture and sensitivity test. Age, gender, type of stroke and severity of stroke was associated with the presence of urinary tract infection among the study participants.&#x0D; Results: Out of 130 patients with acute stroke included in the study, 81(62.3%) were males, while 49(37.3%) were females. The mean age of the stroke patients included in the study was 56.823±8.737 years. In addition, 33(25.4%) patients had urinary tract infections confirmed on the culture and sensitivity report, while 97(74.6%) had no evidence of urinary tract infection.Statistical analysis revealed that female gender and stroke severity had a statistically significant relationship (p-value &lt;0.05) with the presence of urinary tract infection among patients suffering from acute stroke.&#x0D; Conclusion: Around one-fourth of our patients presenting with acute stroke had urinary tract infections in our study participants. Female patients and patients with severe stroke symptoms were more at risk of urinary tract infctions than male patients and patients with less severe symptoms.

العلاقة بين التهاب المسالك البولية والمخاض الباكر للنساء الحوامل في سوريا

Objective: The aim of this study is to determine the prevalence of urinary tract infection (UTI) in pregnant women with preterm labor. In addition to, estimating the association between UTI and occurrence of preterm labor. Patients and Methods: Descriptive Case- Control Study conducted for the period one year (June 2020 –June 2021) at Tishreen University Hospital in Lattakia- Syria. The study included 125 pregnant women without risk factors for preterm labor who were divided into case group (70): with preterm labor, and control group (55) with full term labor. Investigations for presence of UTI were performed in two groups. Results: The mean age was 25.5±5.3 years in the case group and 26.2±4.89 years in control group without significant difference. Previous history of preterm labor was more frequently in case group (17.5% vs.2.7%, p: 0.03). E.COLI was more frequently in the two groups. It was found that 16 patients (22.8%) in the case group and 4 patients (7.3%) in the control group had UTI with significant difference (p&lt;0.05). In the multivariate regression model, UTI was significantly associated with preterm labor (OR: 3.7[1.18- 12.05], P: 0.02. Conclusion: UTI is associated with the risk of preterm labor. Therefore, early detection and treatment of the infection can reduce effectively the risk of preterm labor.

Percutaneous nephrolitholapaxy performed under ultrasound and endovisual guidance: evaluation of the factors affecting the immediate outcomes

Introduction. In recent years, ultrasound and endovisual guidance have been introduced into clinical practice when performing percutaneous nephrolitholapaxy.Objective. To identify the most significant factors that influence the frequency of complete elimination of stones and the development of complications in percutaneous nephrolitholapaxy performed under ultrasound and endovisual guidance.Materials and methods. We analyzed the results of the treatment of 515 kidney stone patients who underwent percutaneous nephrolitholapaxy under ultrasound navigation and endovideoscopic guidance using a new method developed by us.Results. The average duration of the operation was 77.2 ± 1.9 min. Most of the operations were performed through one puncture access (95.1%) and in one stage (91.8%) with complete stone elimination in 80.6% of the cases. The degree of decrease in hemoglobin in the postoperative period was only 12.18 ± 0.6 g/l. The frequency of postoperative complications was 29.3%, in most cases there were 1 - 2 severity grades according to Clavien-Dindo. As a result of multivariate regression analysis, independent predictors influencing the frequency of complete stone eradication were the number of stones (p = 0.012), the fact of the presence of staghorn stone (p = 0.016), the number of stages of surgical intervention (p = 0.001). Correlation analysis revealed a statistically significant negative correlation between body mass index and the occurrence of complications (p = 0.005), a positive correlation between the presence of urinary tract infection and the occurrence of complications (p = 0.048), a positive correlation between the grade of blood loss and the occurrence of expectation (р &lt; 0.001).Conclusions. Percutaneous nephrolitholapaxy under ultrasound and endovisual guidance without the use of X-rays is an effective intervention for most patients with kidney stones. Complete stone eradication depends on the number of stones, the presence of staghorn stone, and the number of stages of surgery. The incidence of complications is significantly affected by the body mass index, the presence of urinary infection and the degree of decrease in hemoglobin during surgery.

Early endoscopic injection may prevent new scarring in idiopathic detrusor overactivity disorder with vesicoureteral reflux in children.

To present baseline characteristics and the long-term treatment results of three groups of patients with idiopathic detrusor overactivity (IDOD) and vesicoureteral reflux (VUR) according to different treatment regimens, which underwent endoscopic subureteric injection (STING) in the early phase of targeted treatment (TT) (ES group), underwent STING in the late phase of TT (LS group) and with TT only (TT group). A total of 49 IDOD cases with VUR which were divided into three groups according to treatment regimens were evaluated in terms of age, symptoms, bladder capacities, involuntary contraction pressures (ICP), presence and degree of renal scar, differential renal functions (DF), new scar formation and STING success. There was no significant difference between the groups in terms of age, side, symptoms, presence of urinary tract infection (UTI), DF, ICP and bladder capacity at diagnosis. A high grade of reflux was found to be significantly lower in the TT group (p = 0.037). There was no significant difference in terms of ICP, DF, bladder capacity and reflux grade between ES and LS Group. But new scar formation was more in LS Group (p = 0.003). The STING success is satisfactory in IDOD cases with VUR, waiting a long period of time for diminishing symptoms may cost new scar formation.

The assessment of etiology and risk factors of urinary tract infections in geriatric patients admitted to emergency department

Background/Aim: A urinary tract infection (UTI) is one of the most common bacterial infections in the elderly population. This study aimed to evaluate the etiology and risk factors of UTI among patients aged 65 and over who were admitted to the emergency department and then hospitalized. Methods: This study was designed as a descriptive epidemiological study. Data of patients aged 65 and over, who were admitted to the adult emergency department of Kahramanmaraş Sütçü İmam University Medical Faculty and hospitalized between October 2015 and October 2018 with a diagnosis of UTI, were included in the study. Study data were collected through a retrospective scan of the patient files from the automated hospital system. Results: Of the patients, 51% (n = 50) were female, and 49% (n = 48) were male. Of the patients diagnosed with UTI, 68.4% were aged 75 years or older. Fever, flank pain, and dysuria were found to be among the main reasons for patients with UTI to present to the emergency department. The most common risk factors for UTI were found to be the presence of diabetes mellitus and immunosuppression. Benign prostatic hyperplasia and nephrolithiasis were found to be the most common risk factors in males. In 83.7% of the patients, urine cultures were obtained at the initial presentation, and Escherichia coli was found to be the most common microorganism in patients with positive urine cultures. Conclusion: The presence of UTI causes an increase in the risk of mortality in geriatric patients. Therefore, UTI should be considered in the differential diagnosis when the general condition has deteriorated in the geriatric patient even if the patient is asymptomatic. Urine culture samples should be obtained in cases of suspected infection, and antibiotic therapy should be started immediately to decrease mortality and increase recovery rates when the urine results indicate infection.

Microbiological and microstructural analysis of indwelling bladder catheters and urinary tract infection prevention.

To analyze the microbiological and microstructural part of indwelling urinary catheters and their association with urinary tract infection prevention. This is a cross-sectional study, from June to December 2020, in which 42 indwelling urinary catheter tips and sterile urine samples were collected for analysis of crystals in optical microscopy and biofilms in scanning electron microscopy. Culture analysis and specification of the type of bacteria were performed. It was found that 35.71% of the samples had mature biofilm adhered to the catheter tip. Biofilms of Proteus mirabilis, Enterococcus faecalis, Staphylococcus epidermidis, Enterococcus faecium and Enterobacter cloacae stood out. The presence of magnesium-ammonium-phosphate crystal was associated with the presence of urinary tract infection and with Proteus mirabilis. There was a significant association (p = 0.001) between the use of prophylactic antibiotics versus urine culture >105 CFU/mL. The analyzes contributed to clinical practice, as it reinforces the development of effective and monitored strategies on cultures and urinary tract infection prevention associated with indwelling urinary catheters.

Phimosis - Are we on right track?

Background:Phimosis, a common paediatric condition, is defined as the inability to retract the preputial skin behind the glans. Current practice shows there is some confusion among the paediatricians towards this common condition and in differentiating it from the more common physiological preputial adhesion; leading to frequent referrals to a paediatric surgeon or a general surgeon, which can be addressed by the parents and the child physicians themselves.Aim:To find out the awareness towards the management of phimosis among the paediatricians.Materials and Methods:A questionnaire on this topic was generated using ‘Google Forms’ and was circulated among junior and senior residents, faculty in various medical colleges and consultants in private practice all over India and their response was collected and analysed.Results:We received a total of 221 responses from all over India from paediatric medicine trainees and consultants. Among them, majority (48%) were senior residents. According to the survey participants, the most (46%) find inability to retract the prepuce as the major presenting complaint. A straight away reference to a paediatric surgeon was preferred by majority of paediatricians (62.9%), though most of them were aware of them were aware of physiological adhesions and conservative management (94.2%). There was a belief among 43% about counselling each and every patient presenting with phimosis for circumcision. Among the respondents, 60.2% advised ultrasound of kidneys, ureter, and bladder to their patients and believed that backpressure changes alter the management of the child. A urine routine examination was advised by 70.1% of participants, with 46.6% believing that the presence of urinary tract infection changes the management of phimosis. Waiting up to 1 year of age before going for surgery was advocated by 71.5%. A major proportion of respondents (76%) believed all cases of phimosis should be referred to a surgeon, only 58.8% would voluntarily follow them up. There is still a belief among 69.7% of participants that all cases of phimosis should be referred to a paediatric surgeon and only few of them, 5.4% feel referring only indicated cases.Conclusion:Physiological phimosis is a common condition which can be addressed by the paediatricians themselves. Awareness is to be increased among them, especially during the training period regarding the proper management of this common condition, avoiding unnecessary circumcisions.

Aspectos físico-químicos e sedimentoscopia da urina de matrizes suínas na fase de gestação criadas em sistema intensivo

The impact of pig farming on the worldwide economy causes production to be directed at an industrial scale, requiring the control of diseases that affect economic performance. Urinary infection (UI), for example, has a high prevalence in current production systems, causing economic losses due to the predisposition to reproductive failures, leading to an increase in disposal of sows and replacement rates. In this context, the objective of this work was to evaluate the prevalence of urinary tract infection (UTI) and possible changes in the urine sediment examination of pregnant sows to survey changes compatible with inflammation of the lower urinary tract. The samples were collected, randomly, from 43 sows of commercial genetic lineage, in different stages of gestation, and that belonged to a pig farm located in Guapimirim-RJ. The pig farm’s herd consisted of 200 sows, 90 of which were in the gestation phase. The samples were collected by spontaneous urination, using the first morning urine, before feeding, which happened around 7 am. The presence of UTI was identified in 12 of the 43 sows analyzed, with 21.5% of the herd being evaluated. A prevalence of 27.9% was observed with animals showing compatible UTI changes. This data was considered severe. The urine sediment examination is the best way to diagnose UTI with sedimentcopy being the most conclusive part. Despite this, it is necessary to relate the laboratory data with the zootechnical management used, as well as the environmental conditions.

Observational Study on the Prevalence of Urinary Incontinence in Female Athletes.

Purpose: To study the prevalence of UI in female athletes, the category of sports with the highest number of cases, the most incident risk factors and the bio-psycho-social consequences. Methods: Preparation of a survey, based on two validated questionnaires answered by 63 participants, to carry out an analytical, transversal and observational study. All participants were European, adult, female athletes (mean age 30.78 years, standard deviation 12.16 years). Results: UI has a high prevalence (44.4%) in female athletes (compared to 10% in non-athletes), being more frequent in those who practice long-distance running. As age and years of sport practice increase, the incidence of this pathology increases. Absorbent pads are used by more than half of women with incontinence, while the rest wet their underwear. Menopause, childbirth and surgery in the region are risk factors for UI, while the presence of urinary tract infections or candidiasis is not. The results state that urine loss does not cause anxiety or depression, but it does affect sporting life. Conclusions: The prevalence of UI in this study is very high and more common in female athletes and the incidence increases with age and other risk factors. The salient consequence of this study is that urine loss affects their sporting environment, but does not induce depression or anxiety.

Urinary Tract Infection, Drug Resistance Profile And Fetal Outcomes Among Pregnant Women In Selected Health Facilites Of Addis Ababa, Ethiopia: A CrossSectional Study Design

Background: Urinary tract infection (UTI) is a commonly encountered health problem among pregnant women. Untreated UTI may result in fetal complications like preterm birth, low birth weight, intra uterine growth retardation and intrauterine fetal death. One of the major problems with bacterial pathogens is their ability to develop drug resistance. Determining drug susceptibility pattern of bacteria from urinary tract helps to identify effective drugs and minimize further adverse perinatal outcomes. The purpose of this study was to describe the magnitude and drug resistance profile of pregnant women and related fetal outcomes. Methods:A cross-sectional study was conducted from March to June 2019. Socio-demographic data of the study participants was collected by administering structured questionnaire after obtaining full consent of the participants. Clean catch mid-stream urine was collected from the study participants and the samples were transported to the laboratory with screw-capped container. Blood and MacConkey agar were used to cultivate bacteria from urine sample. Bacterial colonies were isolated and identified using standard biochemical properties. Antibacterial susceptibility test was done on Muller-Hinton agar using antibiotic discs. At the time of delivery, infant’s birth weight and gestational age was recorded on the log book as part of the daily work. Fetal outcome data were recorded from the log book and entered to EPI data management software then transferred to SPSS for analysis. Results:Out of 424 urine samples processed, 63 (14.9%) yielded significant bacteriuria. Fifty-nine out of 63 (93.7%) cases of UTIs were recorded among age group of 15-34 years. Escherichia coli, Klebsiellapneumoniae, and Staphylococcus aureus were the three dominant bacterial isolates. Most of the gram negative bacterial isolates were resistant to ampicillin and ceftazidime (43.2% each) while gram positive was resistant for tetracycline (36.8%). The result of this study showed that UTI had statistical association with the occurrence of Intrauterine Fetal Death (IUFD) and Prerupture of Membrane (PROM) (P&lt;.05). Conclusion: Adverse fetal outcomes are significantly linked with the presence of UTI during pregnancy. The condition can be managed if early diagnosis and treatments are made for the mother