Prevalence Of Urinary Tract Infection Research Articles

Prevalence of Urinary Tract Infection and Its Associated Factors among Pregnant Women in Ethiopia: A Systematic Review and Meta-Analysis.

Objective Urinary tract infection (UTI) is the most common bacterial infections during pregnancy. It is associated with different maternal and neonatal adverse outcomes such as low birth weight, preterm birth, still birth, preeclampsia, maternal anemia, sepsis, and amnionitis, even when the infection is asymptomatic. However, in Ethiopia, it is represented with fragmented and inconclusive pocket studies. Therefore, this systematic review and meta-analysis is aimed at estimating the pooled prevalence of UTI and its associated factors among pregnant women in Ethiopia. Methods PubMed/Medline, Embase, Cochrane Library, Google Scholar, and local sources were used to access eligible studies. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was applied for critical appraisal. Heterogeneity and publication bias were evaluated using I2 statistic, funnel plot asymmetry, and Egger's tests. Random effect model was employed to estimate the pooled burden of UTI and its associated factors among pregnant women with its corresponding odds ratio (OR) and 95% confidence interval (CI). Result From all systematically searched articles, 14 studies were eligible for this analysis. The overall pooled prevalence of UTI among pregnant women in Ethiopia was 15.37% (95% CI: 12.54, 18.19). Family monthly income (OR = 3.8 and 95% CI: 1.29, 11.23), parity (OR = 1.59 and 95% CI: 1.01, 2.50), history of catheterization (OR = 2.76 and 95% CI: 1.31, 5.84), and history of UTI (OR = 3.12 and 95% CI: 1.74, 5.60) were factors significantly associated with UTI among pregnant women in Ethiopia. Conclusion The overall pooled estimate of UTI among pregnant women in Ethiopia was higher compared with CDC estimation which was 8%. Family monthly income < 1000ETB, multipara, previous history of catheterization, and history of UTI were factors increased burden of UTI during pregnancy. So, strategies targeting in economic reforms, universal access of family planning, and standardized prenatal care service should be addressed to alleviate this high prevalence of UTI during pregnancy.

URINARY TRACT INFECTION IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA ADMITTED FOR PROSTATECTOMY

&nbsp; &nbsp;Urinary Tract Infection (UTI) in patients with Benign Prostatic Hyperplasia (BPH) causes UTI related complication before and after prostatectomy, reduction in their health-related quality of life and overall well-being, thus the knowledge of UTI may play a complementary role in management.The aim of this research was to study the prevalence of urinary tract infection (UTI), its causative organism and antibiotic susceptibility. All BPH patients who were admitted for prostatectomy were included to the study. Information on age, presence of an indwelling catheter, other factors related to UTI and antibiotic susceptibility results were obtained and analyzed using IBM SPSS version 26. Three hundred twenty six patients were studied. The age range of study participants was 51 to 89 years and displayed a median of 70 year (IQR=12). More than half of study participants 168 (51.5%) were between 61 to 70 years. Bacterial isolates were noted in 96 (29.4%) patients. Escherichia Coli noted in (25.3%) specimens was the most common organism isolated. The bacterial isolates were mostly sensitive to imipenem, meropenem, and fosfomycin, but showed greater resistance to cefotaxime, ceftazideme and cefazulin accordingly. The age of study participants was significantly greater for those who had bacteriuria (Mdn = 70) years than those who did not have bacteriuria (Mdn = 67), U = 9569, P = 0.048. The same it was significant for PSA level (P = 0.000) but were not significant for prostate size (P = 0.558). Less than one third of BPH patients had UTI (29.4%), E. Coli was the most common microbial cause of UTI in study participants it was the cause in one fourth of cases (25%), Imipenem group of antibiotic was the most sensitive antibiotics in study participants (93.9%), Cefotaxime was the most resistant antibiotics (66.7%)

Bacterial uropathogens and burden of antimicrobial resistance pattern in urine specimens referred to Ethiopian Public Health Institute.

Urinary tract infections (UTIs) are the leading causes of morbidity in the general population, and is the second most common infectious disease after respiratory infections. Appropriate antibiotic therapy is essential to achieving good therapeutic results. Therefore, the purpose of this study was to investigate the profile of pathogens cultured from urinary tract infections and to determine their resistance profiles to commonly prescribed antibiotics. A cross-sectional study was carried out at the National Referral Laboratory of the Ethiopian Institute of Public Health from January 2017 to December 2018. All positive cultures were characterized by colony morphology, Gram stain, and standard biochemical tests. The antimicrobial susceptibility test of the isolate was performed using the Kirby- Bauer disk diffusion test on Muller-Hinton agar. In addition, bacterial identification, antimicrobial susceptibility testing and phenotypic detection of MDR were performed with VITEK 2 Compact according to the manufacturer's instructions. Out of 1012 cultured urine specimens, 325 (32.1%) was showed significant bacteriuria. The overall prevalence of UTIs was 325(32.1%) and the highest prevalence rate was obtained from 21-30 years age group 73(22.5%). Among UTIs patients, 583(57.6%) were females and 429(42.4%) were males. The UTIs of 179 (55%) women is relatively higher than that of men 146 (45%). Among 325 isolates, Gram-negative bacteria (GNB) appeared more frequently 252 (51.7%) than Gram-positive bacteria 63 (19.4%). In GNB, E. coli 168(66.7%), Klebsiella species 32(12.7%), and Enterobacter species 13 (5.2%) were dominated isolates whereas in GPB accounted for coagulase-negative staphylococcus (CoNS) 33(52.4%), Enterococcus species 16(25.4%), and Staphylococcus aureus 10(15.9%). Major of the isolates showed high levels of antibiotic resistance to commonly prescribed antimicrobials. Imipenem, Amikacin, and Nitrofurantoin were the most sensitive antibiotics for Gram-negative isolates while Nitrofurantoin, clindamycin, and Gentamycin were effective against gram-positive uropathogens. Overall, 156/256(60.9%), 56/256(22.4%), 10/256(4%) of gram-negative isolates were MDR, XDR, and PDR respectively while among the GPB isolates, 34/63(53.1%), 10/63(15.8%), and 1/63(1.6%) were MDR, XDR, and PDR isolates respectively. Among the tested bacterial strains, 190/319 (59.5%) were MDR, 66/319 (20.7%) strains were XDR, and 11/319 (3.45%) were PDR isolated. The prevalence of urinary tract infection was high, and Gram-negative organisms were the most common causes of UTIs in this study. It was found that the resistance to commonly used antibiotics is very high. Early detection and close monitoring of MDR, XDR, or even PDR bacterial strains must be started by all clinical microbiology laboratories to reduce the menace of antimicrobial resistance that is now a global problem.

Higher Prevalence of Extended Spectrum β-Lactamase Producing Uropathogenic Escherichia coli Among Patients with Diabetes from a Tertiary Care Hospital of Kathmandu, Nepal

This study aimed to determine the occurrence of antibiotic resistance genes for β-lactamases; blaTEM and blaCTX-M in uropathogenic Escherichia coli isolates from urinary tract infection (UTI) suspected diabetic and nondiabetic patients. A hospital-based cross-sectional study was conducted in Kathmandu Model Hospital, Kathmandu, in association with the Department of Microbiology, GoldenGate International College, Kathmandu, Nepal, from June to December 2018. A total of 1,267 nonduplicate midstream urine specimens were obtained and processed immediately for isolation of uropathogens. The isolates were subjected to antibiotic susceptibility testing and extended spectrum β-lactamase (ESBL) confirmation. In addition, blaTEM and blaCTX-M genes were detected using specific primers. The overall prevalence of UTI was 17.2% (218/1,267), of which patients with diabetes were significantly more infected; 32.3% (31/96) as compared with nonpatients with diabetes, 15.9% (187/1,171). A total of 221 bacterial isolates were obtained from 218 culture-positive specimens in which E. coli was the most predominant; 67.9% (150/221). Forty-four percent (66/150) of the total E. coli was multidrug resistant and 37.3% (56/150) were ESBL producers. Among 56 isolates, 92.3% (12/13) were from patients with diabetes, and 83.0% (44/53) were from nondiabetics. Furthermore, 84.9% of the screened ESBL producers were confirmed to possess either single or both of blaTEM and blaCTX-M genes. The blaTEM and blaCTX-M genes were detected in 53.6% and 87.5% of the phenotypically ESBL confirmed E. coli, respectively. Higher rates of ESBL producing uropathogenic E. coli are associated among patients with diabetes causing an alarming situation for disease management. However, second-line drugs with broad antimicrobial properties are still found to be effective drugs for multidrug resistance strains.

The prevalence and predictors of extended spectrum B-lactamase urinary tract infections among emergency department patients: A retrospective chart review.

Inadequate initial antibiotic treatment of ESBL urinary tract infections (UTI) can lead to increase in the number of antibiotics used, return visits, longer hospitalizations, increased morbidity and mortality and increased costs. Given the important health implications on patients, this study aimed to examine the prevalence and predictors of ESBL UTIs among Emergency Department (ED) patients of a tertiary care center in Beirut, Lebanon. Single-center retrospective observational study involving all adult UTI patients who presented to the ED of the American University of Beirut Medical Center, a tertiary care center between August 2019 and August 2020. Out of the 886 patients that were included, 24.9% had an ESBL organism identified by urine culture. They had higher bladder catheter use within the previous 90 days, antibiotic use within last 90 days, and were more likely to have a history of an ESBL producing isolate from any body site in the last year. Antibiotic use in the last 90 days and a history of ESBL producing isolate at any site in the previous year were significantly associated with developing an ESBL UTI (OR = 1.66, p = 0.001 and OR = 2.53, p < 0.001 respectively). Patients diagnosed with cystitis were less likely to have an ESBL organism (OR = 0.4 95%CI [0.20-0.81], p = 0.01) CONCLUSION: The prevalence of ESBL organisms was found to be 24.9% in urinary tract infections. The predictors of an ESBL UTI infection were antibiotic use in the last 90 days, a history of ESBL producing isolate at any site in the previous year. Based on the findings of our study, we can consider modifying initial empiric antibiotic treatment for patients presenting with a UTI with the above stated risk factors.

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

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

Prevalence of Urinary Tract Infection in Iranian Newborns with Jaundice: A Meta-Analysis

Background: Jaundice is the most common clinical problem among newborns. It could be caused by different factors, including infections such as urinary tract infection (UTI). We investigated the prevalence of UTI in Iranian newborns with jaundice and prolonged jaundice in this study based on a larger sample of existing data. Methods: We searched the databases of PubMed, Web of Sciences, Scopus, CNKI, SciELO, and Google Scholar for English articles, and a search was also done in Persian in Magiran and Scientific Information Database (SID) published until July 2021. Data analysis was performed by Comprehensive Meta-Analysis (CMA) version 2.0 software. Results: This study included 19 eligible articles out of approximately 240 retrieved articles. The prevalence of UTIs in neonates with jaundice was estimated by pooling the data from 7416 neonates with jaundice. Of those, 369 cases had UTI. Combined data revealed that the prevalence of UTI in neonates with jaundice was 5.4% (95% CI 0.032-0.089, P ≤ 0.001) and there was no publication bias. Conclusion: The overall prevalence of UTI in Iranian newborns with jaundice was 5.4%. However, more studies with a large sample size are required for better results. Also our review showed a screening of UTI should be considered for infants with jaundice, especially prolonged jaundice.

A Cross-Sectional Assessment of Urinary Tract Infections Among Geriatric Patients: Prevalence, Medication Regimen Complexity, and Factors Associated With Treatment Outcomes.

Background: Urinary tract infections (UTIs) are the second most prevalent infection among the elderly population. Hence, the current study aimed to evaluate the prevalence of UTIs among older adults, medication regimen complexity, and the factors associated with the treatment outcomes of elderly patients infected with UTIs.Methods: A retrospective cross-sectional study was conducted at the Department of Urology, Hospital Pulau Pinang, Malaysia. The patients ≥65 years of age were included in the present study with a confirmed diagnosis of UTIs from 2014 to 2018 (5 years).Results: A total of 460 patients met the inclusion criteria and were included in the present study. Cystitis (37.6%) was the most prevalent UTI among the study population followed by asymptomatic bacteriuria (ASB) (31.9%), pyelonephritis (13.9%), urosepsis (10.2%), and prostatitis (6.4%). Unasyn (ampicillin and sulbactam) was used to treat the UTIs followed by Bactrim (trimethoprim/sulfamethoxazole), and ciprofloxacin. The factors associated with the treatment outcomes of UTIs were gender (odd ratio [OR] = 1.628; p = 0.018), polypharmacy (OR = 0.647; p = 0.033), and presence of other comorbidities (OR = 2.004; p = 0.002) among the study population.Conclusion: Cystitis is the most common UTI observed in older adults. Gender, the burden of polypharmacy, and the presence of comorbidities are the factors that directly affect the treatment outcomes of UTIs among the study population.

Onset of urinary tract infections in ICU patients

Background: Urinary tract infections are widespread among intensive care unit patients than in the general population. But what makes the occurrence of UTIs more common in ICU patients? Although studies about the prevalence of urinary tract infections are available, significantly less data is available on the onset of UTIs in intensive care units. Therefore, we aimed this study to evaluate the prevalence of urinary tract infections in ICU patients. We also tried to find out different risk factors and their possible solutions. Aims and ObjectivesRisk factors involved in the onset of urinary tract infections in ICU patientsTo make recommendations based on the studyMaterials and MethodsThe primary target audience in our research work is particularly, i.e. intensive care unit patients. Therefore, we decided to collect data from 3 intensive care units from three hospitals. We also included a questionnaire for physicians to know their points of view about the issue. Finally, we collected data and compiled it in MS Excel for further processing.Results: The prevalence of the population was found to be very high. Almost forty per cent was recorded. Conclusion: Cleanliness, hygiene and proper sterilization is needed and is the need of the hour.

Prevalence of Vancomycin-Resistant Enterococcus Causing Urinary Tract Infection in a Tertiary Care Hospital of Eastern India

Background: The increasing prevalence of urinary tract infection (UTI) caused by vancomycin-resistant Enterococcus (VRE) is of particular concern within many institutions because of limited treatment options. Objective: The objective of the study is to estimate the prevalence of VRE amongst the urinary pathogens along with detection of the antimicrobials effective against VRE in vitro. Materials and Methods: This hospital-based descriptive cross-sectional study was performed from January 1, 2019, to December 31, 2020, with 1037 adult patients developing symptoms of UTI. Mid-stream urine was collected in proper aseptic manner for microbiological culture to isolate and identify the bacterial pathogen. Collected urine samples were screened for pus cells and bacteria. This was followed by plating on (basal media), blood agar (enriched media), and MacConkey's agar media (differential and selective media), followed by overnight incubation at 37°C. Species confirmation and minimum inhibitory concentration value determination were done by automation. Results: Out of total 1037 collected urine samples, 693 were culture positive for bacterial etiology (66.8%). 457 urine cultures were positive for Enterococcus spp., of which 41 were vancomycin resistant (8.97%). A total of 18 Enterococcus faecalis isolates (4.72%) were vancomycin resistant, whereas significantly higher number of Enterococcus faecium, i.e., 23 isolates (30.26%) were vancomycin resistant (P &lt; 0.01). All of 41 VRE isolates were resistant to ampicillin. No trends were observed for resistance against nitrofurantoin, tigecycline, linezolid, and daptomycin. These remained highly effective against VRE across the study period. Conclusion: Since VRE is emerging as a prevalent uropathogen with limited therapeutic options, the use of vancomycin demands judicious administration to treat UTI. Hence, antimicrobial stewardship deserves a crucial role to play.

Urinary Tract Infection among Diabetic Women in Kirkuk City

Background: Urinary tract infection (UTI) is the most common of all bacterial infections in diabetes mellitus; it affects persons throughout their life spans. The term UTI encompasses a variety of clinical entities ranging from asymptomatic bacteriuria to cystitis, prostatitis and pyelonephritis. Patients and methods: In the present study, 200 diabetic women,100 of them were at active age group(AAG) their ages range from (25-35)years with mean age of 31 years. Another 100 women were post-menopausal (PM) their ages range from (55-75) years with mean age of 64 years. Two hundred non diabetic women were taken as control group and were divided into 100 at AAG and 100 PM. The patients and control groups were attendant of Kirkuk general hospital. Results: UTI was found to be present in 28 out of 100 cases of AAG diabetic women (p value =0.02) while it presents in 25 out of 100 PM diabetic women (p value =0.04). Also this study shows that 13 out of 25 PM diabetic women received insulin for treatment while 7 out of 25 PM diabetic women received oral antidiabetic drugs, and only 5 out of 25 PM diabetic women didn't receive any treatment (p value=0.03). The present findings shows that 14 out of 28 AAG diabetic women received insulin for treatment, while 8 out of 28 of them received oral antidiabetic drugs and only 6 out of 28 AAG diabetic women didn't receive any treatment (p value =0.043) Conclusion: The prevalence of UTI is higher among diabetic patient compared to nondiabetic patient regardless of age .Diabetes treated with insulin is related to substantial increases in the risk of UTI among both age groups included in the present study

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.

Antimicrobial Resistance Patterns and ESBL of Uropathogens Isolated from Adult Females in Najran Region of Saudi Arabia.

Background: To explore the prevalence of urinary tract infections (UTIs) among female patients in the Najran region of Saudi Arabia and determine their antimicrobial resistance pattern. Methods: This study was conducted on 136 urine samples collected from outpatient departments (OPDs) of the different government hospitals in the Najran region of Saudi Arabia. Over one year, the results of susceptibility testing reports of outpatient midstream urine samples from three government hospitals were prospectively evaluated. Results: Of 136 urine samples, only 123 (90.45%) were found to show significant growth for UTIs, from which 23 different uropathogens were identified. Escherichia coli (58.5%) was the most commonly isolated organism, followed by Klebsiella pneumoniae (8.1%). The isolated microorganism showed increased resistance patterns from 3.3% to 62.6%, with an overall resistance of 27.19%. Meropenem was the most effective antimicrobial, followed by amikacin and ertapenem (0.47%, 0.91%, and 1.5% resistance, respectively). At the same time, ampicillin and cephazolin were the least (62.6% and 59.5% resistance, respectively) effective. Overall, eleven (8.94%) uropathogens isolates were ESBLs, among which there were eight (6.5%) Escherichia coli, one (0.81%) Klebsiella pneumoniae, one (0.81%) Klebsiella oxytoca, and one (0.81%) Citrobacter amalonaticus. Conclusions: E. coli remains the most commonly isolated causative uropathogens, followed by Klebsiella species. The prevalence of pathogenic E. coli and Klebsiella species underscores the importance of developing cost-effective, precise, and rapid identification systems to minimize public exposure to uropathogens. Antibiotic susceptibility data revealed that most of the isolates were resistant to the majority of the antibiotics. The patients with UTIs in the Najran region of Saudi Arabia are at a high risk of antibiotic resistance, leading to significant problems in outpatient department (OPD) treatment outcomes and raising the alarm for the physician to change their empiric treatment.

Detection of extended-spectrum beta-lactamase genes among Escherichia coli isolates from urinary tract infection in Mashhad

Urinary tract infections (UTIs) are known as one of the most important infections around the world, and Escherichia coli is the most important cause of UTI. Also, the empiric treatment and misusing of antimicrobial agents has led to increasing multi-drug resistance around the world which is a worldwide concern. Extended-spectrum beta-lactamase (ESBLs) is an enzyme group that is produced by the Enterobacteriaceae family. The three main ESBLs enzyme are as follow: bla CTX-M , bla TEM , and bla SHV , additionally, there are several types of each of them by the same mechanism. This study was conducted to evaluate the prevalence of ESBL genes among E. coli isolated from UTI patients. A total of 105 isolates were collected from UTI patients at two hospitals in Mashhad from 2017 to 2019. Bacterial identification was performed by standard microbiologic methods. The assessment of antimicrobial susceptibility was accomplished by the disk diffusion method. The presence of ESBL genes was investigated by multiplex-PCR. The prevalence of UTI, among females, was identified more than males. Furthermore, the bla TEM and bla CTX-M genes were detected in all isolates, but only six isolates (5.7%) were harboring bla SHV . The considerable role of E. coli in UTI infection, as well as the presence of ESBL genes in E. coli strains, emphasize the need for surveillance of antimicrobial therapy to prevent the extension of resistance among clinical strains.

MP29-10 INCREASED PREVALENCE OF URINARY TRACT INFECTIONS AND CATHETER-ASSOCIATED URINARY TRACT INFECTIONS IN DISORDERS CHARACTERIZED BY IRON DYSREGULATION

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Kidney & Bladder II (MP29)1 Sep 2021MP29-10 INCREASED PREVALENCE OF URINARY TRACT INFECTIONS AND CATHETER-ASSOCIATED URINARY TRACT INFECTIONS IN DISORDERS CHARACTERIZED BY IRON DYSREGULATION Barbara Prol, Arrie Selva, Pamela Patton, Zhaoyi Chen, and Victoria Bird Barbara ProlBarbara Prol More articles by this author , Arrie SelvaArrie Selva More articles by this author , Pamela PattonPamela Patton More articles by this author , Zhaoyi ChenZhaoyi Chen More articles by this author , and Victoria BirdVictoria Bird More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002026.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urinary tract infection (UTI) accounts for up to 40% of all healthcare-associated infections and its prevalence varies among different populations. Bacteria require iron-rich environments for optimal survival. Escherichia coli (E. coli), the most common pathogen responsible for UTI, has been shown to thrive in iron-rich environments. Our aim was to explore the prevalence of UTI and catheter-associated urinary tract infection (CAUTI) in a cohort of patients with iron-sequestering disorders compared to other populations. METHODS: The University of Florida Health Informatics for Integrating Biology and the Bedside (i2b2) system was queried for the purpose of retrospective analysis of UTI and CAUTI associated with E. coli sepsis. International Classification Codes (ICD-9 and ICD-10) were used to obtain our target diagnoses of interest, subjects with the classically iron-wasting diseases: sickle cell anemia (SS), thalassemia (T), and hemochromatosis (H). Control groups included the general population (GP) and subjects with Crohn’s disease (CD) and ulcerative colitis (UC). Univariate analysis was performed. We used SASv.9.4 for our analysis. P-values were calculated in comparison with the GP. RESULTS: A total of 1.1 million patients from 2012-2018 were included in our data query. UTI prevalence in GP, CD and UC was 4.8%, 12.8% and 12.5%, respectively (p <0.0001 for CD and UC). CAUTI prevalence in GP, CD, and UC was 0.1%, 0.4%, and 0.6%, respectively (p <0.0001 for CD and UC). In comparison, UTI prevalence in SS, T, and H was 21.1%, 14.8% and 14.9%, respectively (p <0.0001 for SS, T, and H). CAUTI prevalence in SS and H was 0.9 and 0.7%, respectively (p <0.0001 for SS and H). The prevalence of E. coli sepsis in SS, H, T, UC, and CD was 1.3%, 0.4%, 0.3%, 0.4%, 0.3%, respectively, and 0.05% in GP (p <0.0004 for T; p <0.0001 for SS, H, UC, and CD). CONCLUSIONS: Both iron-sequestering and iron-deficient disorders have a significantly higher prevalence of UTI and CAUTI when compared to the GP. In particular, our data suggest that individuals with SS represent a vulnerable group susceptible to all: UTI, CAUTI, urosepsis, and E. coli-related septicemia. Iron imbalance is a novel risk factor for the development of UTI and related infections. Efforts aimed at prevention of UTI should be pursued in these high-risk groups and further research should be directed towards this phenomenon. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e493-e493 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Barbara Prol More articles by this author Arrie Selva More articles by this author Pamela Patton More articles by this author Zhaoyi Chen More articles by this author Victoria Bird More articles by this author Expand All Advertisement Loading ...

PD01-01 PREVALENCE OF URINARY TRACT INFECTIONS IN WOMEN WITH INTERSTITIAL CYSTITIS

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Interstitial Cystitis (PD01)1 Sep 2021PD01-01 PREVALENCE OF URINARY TRACT INFECTIONS IN WOMEN WITH INTERSTITIAL CYSTITIS Kyle Smith-Honore, Alexandra Dubinskaya, Catherine Bresee, Kai Dallas, Kamil Barbour, Jayoung Kim, Stephen Freedland, and Jennifer Anger Kyle Smith-HonoreKyle Smith-Honore More articles by this author , Alexandra DubinskayaAlexandra Dubinskaya More articles by this author , Catherine BreseeCatherine Bresee More articles by this author , Kai DallasKai Dallas More articles by this author , Kamil BarbourKamil Barbour More articles by this author , Jayoung KimJayoung Kim More articles by this author , Stephen FreedlandStephen Freedland More articles by this author , and Jennifer AngerJennifer Anger More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001965.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Flares, or the sudden increase in symptoms, are common in patient with interstitial cystitis/bladder pain syndrome (IC/BSP). Symptoms flares often have a clinical presentation similar to urinary tract infections (UTI), with pain, frequency and urgency. However, the prevalence of culture-proven UTIs that occur in women with an IC/BPS diagnosis is not well established. METHODS: This is a retrospective study of all women carrying an ICD-9/10 code for IC/BPS (595.1/N30.10) in the VA system between October 2004–July 2016 who presented to the clinic at least once with concern for IC/BPS symptom exacerbation. Female patients older than 18 years of age were identified as having IC/BPS if they had a diagnosis code for IC/BPS. Patient demographics, visit chief complaint, urine culture collection and urine culture positivity were assessed. Associations between the patients presenting symptom, and urine culture testing and results were compared with the chi-square test. RESULTS: Overall, 469 women (1,444 total visits) were identified with 0.8 average visits per year. The most common visit chief complaint was pelvic pain (n=734, 50.8%) (Table 1). A urine culture was more likely to be collected (122 of 200, 61.0%) if dysuria was present as compared to visits were only pelvic pain was present (213 of 734, 29.0%, p<0.001 ) or neither pelvic pain nor dysuria were present (51 of 262, 19.5%, p<0.001). If a culture was sent, a complaint of dysuria only was associated with the highest rate of culture positivity (23 of 122, 18.9%, p=0.001) as compared to all other groups. CONCLUSIONS: Overall, positive cultures in women with IC/BPS flares were relatively low. A positive urine culture was most common in visits where only dysuria was present. This data thus supports carrying a higher index of suspicion of UTI if patients present in this fashion. Source of Funding: CDC © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e30-e30 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kyle Smith-Honore More articles by this author Alexandra Dubinskaya More articles by this author Catherine Bresee More articles by this author Kai Dallas More articles by this author Kamil Barbour More articles by this author Jayoung Kim More articles by this author Stephen Freedland More articles by this author Jennifer Anger More articles by this author Expand All Advertisement Loading ...

Development of the New AAP Febrile Infant Clinical Practice Guideline.

Development of the New AAP Febrile Infant Clinical Practice Guideline.

Reducing Catheter-Associated Urinary Tract Infection: The Impact of Routine Screening in the Geriatric Hip Fracture Population.

Catheter-associated urinary tract infection (CAUTI) is a noted complication among geriatric hip fracture patients. This complication results in negative outcomes for both the patients and the institution providing care. Screening measures to identify predisposing factors, with early diagnosis and treatment of urinary tract infection (UTI) present on admission, may lead to reduced rates of CAUTI. The goals of this study were to determine the prevalence of UTI on admission among geriatric hip fracture patients and whether routine screening for UTI or predisposing factors at presentation resulted in reduced rates of CAUTI. A retrospective observational study of geriatric hip fracture patients from January 2017 to December 2018 at a Level I trauma center was performed. Rates of UTI on admission and CAUTI were calculated using routine admission urinalysis. Of the 183 patients in the sample, 36.1% had UTI on admission and 4.4% of patients developed CAUTI. There were no significant differences in patient demographics, comorbidities, and complications between those with UTI on admission and those without. Urinary tract infection on admission may be present among a large portion of geriatric hip fracture patients, leading to increased rates of CAUTI. Routine screening for UTI and its predisposing factors at admission can identify these patients earlier and lead to earlier treatments and prevention of CAUTI.

Characteristics of Women with Urinary Tract Infection in Pregnancy.

Background: Urinary tract infection (UTI) is the most common bacterial infection in pregnancy. Known risk factors for UTI in pregnancy include diabetes and certain urologic conditions. Other maternal characteristics might also be associated with risk and could provide clues to the etiology of UTI in pregnancy. Our objective was to identify maternal characteristics associated with UTI in pregnancy. Materials and Methods: We used data from pregnant women participating in the National Birth Defects Prevention Study, a population-based study of risk factors for major structural birth defects in 10 U.S. sites, from 1997 to 2011. In cross-sectional analyses, we used multivariable log-binomial regression to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for associations between self-reported maternal characteristics and UTI in pregnancy. Results: In our sample of 41,869 women, the overall prevalence of reported UTI in pregnancy was 18%, but ranged from 11% to 26% between study sites. In adjusted models, diabetes was moderately associated with higher UTI prevalence (PR 1.39, 95% CI: 1.24-1.57). Higher UTI prevalence was associated even more strongly with low educational attainment (PR 2.06, 95% CI: 1.77-2.40 for some high school vs. graduate school), low household income (PR 1.64, 95% CI: 1.46-1.84 for <$10,000 vs. ≥$50,000), and race/ethnicity (PR 1.45, 95% CI: 1.13-1.80 for American Indian or Alaska Native vs. White women). Conclusions: About one in six women reported UTI in pregnancy but the prevalence varied markedly by geography and maternal characteristics. This variability could provide clues to the causes of UTI in pregnancy.

Clinical and laboratory differences between extended-spectrum β-lactamase-positive and extended-spectrum β-lactamase-negative bacteria in febrile urinary tract infection in pediatrics

Introduction: The prevalence of urinary tract infections (UTIs) due to extended-spectrum beta-lactamase (ESBL)-producing bacteria is rising, which needs more potent antibiotics, such as carbapenems. Objectives: To evaluate the clinical and laboratory differences between ESBL-positive and ESBL-negative bacteria in febrile UTI in children between one month to seven years to indicate prognostic parameters for ESBL+ UTI and to suggest appropriate antibiotic treatment. Patients and Methods: This cross-sectional study investigated 282 patients diagnosed with the first febrile UTI. The participants were assigned to ESBL-positive and ESBL-negative UTI groups. The groups were compared based on their clinical and laboratory characteristics and outcomes; the infant group was assessed separately (with the onset age of &lt;3 months). Results: The ESBL UTI was detected in 10.2% of the cases with a history of more frequent hospitalization (P=0.002), longer hospitalization (P=0.04), higher recurrence rate (P=0.003), and more red blood cell count in urine analysis findings (P=0.02). In the antimicrobial susceptibility assay, the ESBL-positive UTI group indicated resistance to third-generation cephalosporins; nevertheless, 93.1% of the cases responded clinically. The infant group showed 13% of the patients with ESBL-positive UTI that was correlated with a history of longer preonset hospital stay (P=0.001), elevated C-reactive protein (CRP) concentration (P=0.002), and elevated recurrence rate (P=0.03), compared to the older group. Conclusion: The ESBL UTI should be further considered due to the resulted recurrence rate. The antimicrobial sensitivity assay indicated resistance to third-generation cephalosporins; however, these drugs are applied as the first choice due to the high response rate. Aminoglycosides are applicable as second choice drugs prior to initiating the use of carbapenems, if third-generation cephalosporins did not indicate bactericidal impacts on ESBL UTI.