Proportion Of Urinary Tract Infections Research Articles

Proportion of Urinary Tract Infection in Children between 6 Months to 5 Years of Age Presenting with Fever

Proportion of Urinary Tract Infection in Children between 6 Months to 5 Years of Age Presenting with Fever

Antibiotic Duration and UTI Outcomes in Recurrent UTI Patients.

Little evidence is available to inform management of acute urinary tract infections (UTIs) in women with recurrent urinary tract infection (rUTI). This study aimed to compare the proportion of acute UTIs with persistence/relapse or recurrence based on duration of treatment antibiotics (acute UTI guideline-consistent versus extended). A retrospective noninferiority study of women with rUTI was performed at an academic tertiary referral center from January 2016 to December 2020. Exposure was UTI treatment with acute UTI guideline-consistent versus extended antibiotics. Outcomes were persistent/relapsed UTI (subsequent culture with the same pathogen requiring additional antibiotics within 4 weeks), recurrent UTI (culture with different pathogen), or resolution. Sample size was calculated under the null hypothesis that the proportion of acute UTIs with persistence/relapse or recurrence after acute UTI guideline-consistent antibiotics would be within a 10% noninferiority margin of extended duration (α = 0.05, β = 0.20, 2-sided tests, P < 0.05 significant). We included 219 patients with 553 acute UTIs. The mean ± SD number of UTIs per patient was 2.53 ± 1.88, the mean ± SD age was 68.60 ± 16.29 years, and the mean ± SD body mass index was 29.73 ± 7 (calculated as weight in kilograms divided by height in meters squared). There were no differences in prior surgical procedures postvoid residual volume, pelvic floor disorders, or preventive treatments between groups. Two-hundred sixty UTIs (260 of 553 [47%]) were treated with acute UTI guideline-consistent antibiotics. Overall, 86 of 553 UTIs (15.6%) persisted/relapsed, and 29 of 553 (5.2%) recurred. The difference in the proportions of UTIs with persistence/relapse or recurrence excluded the noninferiority margin (4.4%; 95% confidence interval, -0.04 to 6.80%). In total, 115 of 553 UTIs (20.8%) had persistence/relapse or recurrence. In this cohort of patients with rUTI experiencing acute UTIs, acute UTI guideline-consistent duration of antibiotics was noninferior.

Diagnostic and Therapeutic Management of Urinary Tract Infections in Catalonia, Spain: Protocol for an Observational Cohort Study.

Antibiotic resistance is an individual and public health problem; multidrug-resistant infections could cause an estimated 10 million deaths worldwide by 2050. Unnecessary use of antimicrobials is the most important cause of resistance generation in the community, and an estimated 80% of antimicrobials are prescribed in primary health care, frequently for urinary tract infections (UTIs). This paper presents the protocol for the first phase of the Urinary Tract Infections in Catalonia (Infeccions del tracte urinari a Catalunya) project. We aim to examine the epidemiology of the different types of UTIs in Catalonia (an autonomous community in Spain) and their diagnostic and therapeutic management by health professionals. Furthermore, we aim to evaluate the correlation between types and total consumption of antibiotics for recurrent UTIs in 2 cohorts of women with the presence and severity of infectious complications of urological origin, especially pyelonephritis and sepsis, and 2 potentially serious infections: pneumonia and COVID-19. The study is a population-based observational cohort study including adults with a diagnosis of UTI registered in the Information System for the Development of Research in Primary Care (in Catalan: Sistema d'informació per al desenvolupament de la investigació en atenció primària), the Minimum Basic Data Sets of Hospital Discharges and Emergency Departments (in Catalan: Conjunt mínim bàsic de dades a l'hospitalització d'aguts i d'atenció urgent), and data from the Hospital Dispensing Medicines Register (in Catalan: Medicació hospitalària de dispensació ambulatòria) of Catalonia from the period between 2012 and 2021. We will evaluate the variables obtained from the databases to analyze the proportion of different types of UTIs, the percentage of adequate antibiotic treatments prescribed or received for recurrent UTIs according to the national guidelines, and the proportion of UTIs with complications. We expect to describe the epidemiology of UTIs in Catalonia from 2012 to 2021, as well as describe the diagnostic and therapeutic management of UTIs by health professionals. We expect to find a high percentage of UTI cases with inadequate management according to the national guidelines, considering that on many occasions UTIs are treated with second- or third-line antibiotic therapies with a preference for the longest regimens. Furthermore, the use of antibiotic suppressive therapies, or prophylaxis, in recurrent UTIs will likely be highly variable. Moreover, we aim to determine whether women with recurrent UTIs treated with antibiotic suppressive therapies have a higher incidence and severity of potentially serious future infections, with special attention to acute pyelonephritis, urosepsis, COVID-19, and pneumonia, compared to women who receive antibiotic treatment after they present with a UTI. This is an observational study of data from administrative databases that will not allow causality analysis. The limitations of the study will be handled according to the appropriate statistical methods. European Union Electronic Register of Post-Authorisation Studies EUPAS49724; https://www.encepp.eu/encepp/viewResource.htm?id=49725. DERR1-10.2196/44244.

Bacterial profile and extended spectrum beta lactamase screening of urinary tract infection among asymptomatic and symptomatic pregnant women attending antenatal care in ALERT Hospital, Addis Ababa, Ethiopia.

The occurrence of extended spectrum beta lactamase-producing uropathogens, especially in pregnant women can result in life-threatening condition and morbidity for both the mother and the newborn due to very limited drug options for treatment of these pathogens. The aim of this study was to determine the bacterial profile, associated factors, and their antimicrobial susceptibility patterns and to identify extended spectrum beta lactamase-producing bacterial uropathogens. A hospital-based cross-sectional study was conducted from July to September 2018 on a total of 177 pregnant women with and without symptoms of urinary tract infection at ALERT Hospital, Addis Ababa, Ethiopia. From these study participants, 72 have symptoms, whereas 105 have no symptoms. All urine samples were inoculated onto cysteine lactose electrolyte deficient medium and MacConkey agar. Colonies were counted to check the presence of significant bacteriuria. Pure isolates of bacterial pathogen were characterized and identified at species level by colony morphology, gram stain, and standard biochemical procedures. All Gram-negative isolates were put into Muller-Hinton agar plates for antibiotic susceptibility test by Kirby-Bauer disc diffusion technique. Extended spectrum beta lactamase was detected using double-disk synergy methods on Muller-Hinton agar. The data were double entered into epidemiological Information system and analyzed using Statistical Package for Social Science version 26. The overall proportion of urinary tract infection among pregnant women was 14.7% (n = 26/177). Klebsiella pneumoniae was the predominant bacterial etiologic agent of urinary tract infection 26.9% (n = 7/26). The proportion of extended spectrum beta lactamase among Gram-negative isolates was 50% (n = 6/12). Among extended spectrum beta lactamase-producing isolates (100%), all are resistance to amikacin and gentamicin while intermediate level resistance rate of 66.7% was observed among trimethoprim-sulphamethoxazole. They were susceptible for some limited drugs, and these were Nitrofurantoin (83.3%) and Chloramphenicol (83.3%). Majority of extended spectrum beta lactamase-producing isolates exhibited co-resistance to other commonly prescribed antibiotics. This indicates that the option of treatment for these pathogens rapidly decreased from time to time which results serious life-threatening conditions, especially in mother and newborn unless the appropriate measure is taken.

Antibiotic Sensitivity Pattern and Demographic Characteristics of Urinary Tract Infection among Hospitalized Children

Introduction: Urinary tract infection (UTI) is the third most common infection during childhood and considered as an important risk factor for the development long-term complications. It was aimed to look into the demographic characteristics, clinical presentations, and antimicrobial resistance among children hospitalized for UTI. Methods: This cross-sectional observational study was conducted at the Inpatients Department of Uttara Adhunik Medical College and Hospital, Dhaka, Bangladesh. The study duration was 2 years, from July 2017 to June 2019, during which period, a total of 90 children with urinary tract infection visiting the study place were included in the study, following the inclusion and exclusion criteria. Result: The age of the participants ranged from over 1 months to 5 years., with majority (55.56%) being between the age of 2-5 years. The male to female ratio was 1:1.73. Fever was the commonest presenting symptom in participants, with 87.78% prevalence, followed by vomiting in 80% of the participants. The commonest organism cultured in this study was E. coli (80%), followed by Klebsiella spp. (20%). Isolated pathogens were highly sensitive to Amikacin (100.0%), Meropenem (100.0%), Imipenem (97.0%) and Nitrofurantoin (90.9% - 100.0%), moderately sensitivity to third generation Cephalosporine and highly resistant to Ampicillin (75.0 - 78.8%), Amoxiclav (72.7% - 87.5%) and Cephalexin (81.1% - 87.5%). Conclusion: The proportion of urinary tract infection in females was higher than males. Most patients presented with more than one symptom but most commonly presented with fever. E. coli was the most common isolated bacteria in hospitalized children with a principal diagnosis of UTI. Most of the isolated pathogens were highly resistant to ampicillin, cotrimoxazole, and highly sensitivity to amikacin, nitrofurantoin and meropenem.

What to do about recurrent urinary tract infections

Urinary tract infections are among the most common bacterial infections. A significant proportion of urinary tract infections recur, which leads to impairments in patients' physical intimacy, social contacts and ability to work. The standardised ACSS questionnaire can provide help in establishing a diagnosis and assessing the course of the disease. In addition to general education and counselling on risk factors for urinary tract infections, non-antibiotic treatment options are particularly important for reducing recurrence. This aims to prevent the development of resistance to antibiotics and their undesirable side-effects. Non-antibiotic strategies most notably include personal counselling with communication of behavioural recommendations, immunoprophylaxis, phytotherapeutics and local oestrogen substitution. However, in cases of high patient suffering, antibiotic prophylaxis should also be considered after due deliberation. In summary, individual counselling should take place and treatment should be given in a multimodal therapeutic approach.

Expression of plasmid-mediated resistance genes ESBLs and PMQR among uropathogens, isolated from non-dialysis CKD patients with pyelonephritis

Urinary tract infections (UTIs) are thought to be the most common group of bacterial infections, worldwide. It is estimated that the proportion of UTIs remains at a high level reaching 150 million episodes per year worldwide and accounting for $6 billion in health care expenditures. In USA more than 100,000 hospital admissions per year are the UTIs patients, among them the patients with pyelonephritis are the most frequent. For the US outpatients, approximately 15 % of antibiotics used are prescribed for UTIs. However, recent studies in Europe and the United States have demonstrated a steady increase in the rate of uropathogen resistance to commonly prescribed antibiotics, and this obviously will lead to a reduction in therapeutic possibilities of UTI. CDC has estimated that more thаn 2 million infections and 23,000 deaths are due to antibiotic resistance each year. By 2050, it is estimated, that antibiotic resistance will cause 10 million deaths every year. Infection is an importаnt cause of mоrbidity and mоrtality amоng patients with kidney failurе and is the sеcond lеading causе of death following CVD. At the EU/EEA level, more than half (54 %) of the E.coli isolates reported to EARS-Net for 2020 were resistant to at least one of the antimicrobial groups under regular surveillance, i.e. aminopenicillins, fluoroquinolones, third-generation cephalosporins, aminoglycosides and carbapenems. A majority (87.4 %) of the third-generation cephalosporin-resistant E.coli isolates from 2020 were extended-spectrum beta-lactamase (ESBL) positive. Use of broad-spectrum antimicrobials is a known risk factor for colonization and spread of resistant Enterobacteriaceae, including E.coli. The high levels of ESBLs and increasing resistance to key antimicrobial groups might also lead to an increased consumption of carbapenems, which in turn can increase the selection pressure and facilitated the spread of carbapenem-resistant Enterobacteriaceae. The article presents data on the antibacterial susceptibility of isolated uropathogens, and their association with the presence or absence of plasmid-mediated resistance genes ESBLs and PMQR.

Trends in the epidemiology of urinary tract infections in pregnancy at a tertiary hospital in Johannesburg: Are contemporary treatment recommendations appropriate?

BackgroundUrinary tract infections (UTIs) are common during pregnancy and are associated with maternal and foetal complications. Empiric antibiotic choices in pregnancy require consideration of efficacy and safety, resulting in limited oral options. With rapidly evolving antibiotic resistance, surveillance to guide empiric treatment recommendations is essential.MethodsA retrospective analysis of urine culture isolates from the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) Obstetrics Department for 1 January 2015 to 31 December 2020 was performed.ResultsThe top 3 pathogens were Escherichia coli, Enterococcus faecalis and Klebsiella pneumoniae. For E. coli susceptibility to cefuroxime declined (95% to 81%, p < 0.0001). Similarly, the E. coli extended spectrum beta-lactamase rate increased from 5% to 10% (p = 0.04). E. coli susceptibility to nitrofurantoin (93%) and fosfomycin (96%) remained high. In 2019, carbapenem-resistant K. pneumoniae emerged. Ampicillin susceptibility was high amongst the E. faecalis isolates. Amoxicillin-clavulanate demonstrated high levels of activity against the top 3 uropathogens.ConclusionThe Essential Drug List recommended antibiotics for lower UTIs, nitrofurantoin and fosfomycin, are appropriate empiric options for E. coli, the most common uropathogen in the CMJAH obstetric population. The high rate of E. faecalis susceptibility to nitrofurantoin reported from other Gauteng tertiary obstetric patients, suggests that nitrofurantoin will provide adequate empiric cover for a large proportion of UTIs. However, the determination of the E. faecalis nitrofurantoin and fosfomycin susceptibility rates in the CMJAH obstetric population will provide useful data. Periodic surveillance at the various levels of antenatal care in different regions of South Africa and the determination of risk factors for infections with resistant uropathogens is needed.

Proportion of urinary tract infection in neonatal sepsis

Background: Urinary tract infection (UTI) in neonates might be associated with bacteremia and congenital anomalies of the kidney and urinary tract (CAKUT), that in complicated situations can lead to renal parenchymal scarring and chronic kidney disease. Aim: To determine occurrence of UTI in neonatal sepsis. Methods: This cross sectional study was conducted on 500 term, extramural hospitalized neonates, suspected to have infection underwent, a detailed history, physical examination and a comprehensive sepsis workup. The diagnosis of neonatal UTI was based, on positive urine culture, obtained by suprapubic aspiration (SPA). Results: Out of 500 neonates included in our study (324 boys and 176 girls), blood culture was positive in 84 (36.5%) neonates in early-onset sepsis group (n=230), while in late-onset sepsis group (n=270) blood culture was positive in130 (48.1%), p-value < 0.05. In both early-onset sepsis (EOS) and late-onset sepsis (LOS) groups, blood culture was found to be positive in a greater proportion of male (41.3%) than female (29.3%) patients, p-value <0.05. The most common organism isolated from blood and urine culture was Klebsiella, followed by E-coli. Urine culture was positive in 34 (6.8%) patients, among whom 29 (85%) culture-positive cases were from the LOS group, a p-value of <0.05. Conclusions: UTI is not uncommon among the hospitalized neonates, and UTI evaluation among septic neonates can prove beneficial for the prevention of long-term sequelae of neonatal UTI.

What to do about recurrent urinary tract infections

Urinary tract infections are among the most common bacterial infections. A significant proportion of urinary tract infections recur, which leads to impairments in patients' physical intimacy, social contacts and ability to work. The standardised ACSS questionnaire can provide help in establishing a diagnosis and assessing the course of the disease. In addition to general education and counselling on risk factors for urinary tract infections, non-antibiotic treatment options are particularly important for reducing recurrence. This aims to prevent the development of resistance to antibiotics and their undesirable side-effects. Non-antibiotic strategies most notably include personal counselling with communication of behavioural recommendations, immunoprophylaxis, phytotherapeutics and local oestrogen substitution. However, in cases of high patient suffering, antibiotic prophylaxis should also be considered after due deliberation. In summary, individual counselling should take place and treatment should be given in a multimodal therapeutic approach.

Proportion of Three Types of Health Care Associated Infections among Hospitalized Patients in a Tertiary Care Hospital in Sri Lanka

Health care associated infections are considered as an indicator of quality and safety of health care institutions. The study aimed to determine the proportion of health care associated urinary tract infections, respiratory tract infections, surgical site infections, and to evaluate the association of medical devices and duration of hospitalization which predispose to health care associated infections. Four hundred and twenty three patients who stayed more than 48 hours or readmitted to surgical, medical, pediatric and gynecology wards in a tertiary care hospital in Sri Lanka during the study period were included in the study. Data extraction sheets were used and were filled with information obtained from bed head tickets and laboratory reports. A total of 79 (18.7%) patients had been diagnosed to have health care associated infection. The predominant type was respiratory tract infections 24 (30.4%) followed by urinary tract infections 21(26.6%), surgical site infections 17 (21.5%), and other infections 17 (21.5%). The highest proportion of urinary tract infections were seen in surgical wards (38.1%) whereas the highest proportion of respiratory tract infections were seen in medical wards (45.8%). Patients aged more than 60 were found to be affected most (27/94). Health care associated infections were significantly associated with usage of medical devices (p&lt;0.05) and length of stay in hospital (p&lt;0.05). The study concludes that these infections account for a noteworthy percentage in hospitalized patients and the predominant type was respiratory tract infections in this tertiary care hospital in Sri Lanka and elders were the mostly affected category compared to children and adults age groups.

Public Health Interventions for the COVID-19 Pandemic Reduce Respiratory Tract Infection-Related Visits at Pediatric Emergency Departments in Taiwan.

Background and objective: Public health interventions such as social distancing, wearing surgical or N95 masks, and handwashing are effective in significantly reducing the risk of infection. The purpose of this article is to analyze the effect of public health interventions on respiratory tract infection-related visits to pediatric emergency departments during the COVID-19 pandemic in Taiwan.Method: Pediatric emergency department visits between January 1 2020 and April 30 2020 were included for trend analysis and compared to the same period during the past 3 years. The datasets were retrieved from Taiwan National Infectious Disease Statistics System and Kaohsiung Chang Gung Memorial Hospital. Respiratory tract infections with other diagnoses categories, including fever, asthma, and urinary tract infections, were included for subgroup analysis.Result: A significant decrease of more than 50% in respiratory tract infection-related visits was found from February to April 2020 in the national database. With regard to diagnosis category, the proportion of respiratory tract infections in Kaohsiung Chang Gung Hospital also became significantly lower in 2020 during the months of March (43.4 vs. 37.4%, p = 0.024) and April (40.1 vs. 32.2%, p < 0.001). On the other hand, the proportion of urinary tract infections was significantly higher in 2020 during March (3.7 vs. 5.2%, p = 0.033) and April (3.9 vs. 6.5%, p < 0.001), and that of asthma was also higher in April (1.6 vs. 2.6%, p = 0.025). Furthermore, the intensive care unit admission rate was relatively higher in 2020 from February, with significant differences noted in March (1.3 vs. 2.8%, p < 0.001).Conclusion: Due to public health interventions for the COVID-19 pandemic, the transmission of not only COVID-19 but also other air droplet transmitted diseases in children may have been effectively prevented.

Novel antibiotic-loaded particles conferring eradication of deep tissue bacterial reservoirs for the treatment of chronic urinary tract infection

A significant proportion of urinary tract infection (UTI) patients experience recurrent episodes, due to deep tissue infection and treatment-resistant bacterial reservoirs. Direct bladder instillation of antibiotics has proved disappointing in treating UTI, likely due to the failure of infused antibiotics to penetrate the bladder epithelium and accumulate to high enough levels to kill intracellular bacteria. This work investigates the use of nitrofurantoin loaded poly(lactic-co-glycolic acid) (PLGA) particles to improve delivery to intracellular targets for the treatment of chronic UTI. Using electrohydrodynamic atomisation, we produced particles with an average diameter of 2.8 μm. In broth culture experiments, the biodegradable particles were effective against a number of UTI-relevant bacterial strains. Dye-loaded particles demonstrated that intracellular delivery was achieved in all cells in 2D cultures of a human bladder epithelial progenitor cell line in a dose-dependent manner, achieving far higher efficiency and concentration than equivalent quantities of free drug. Time-lapse video microscopy confirmed that delivery occurred within 30 min of administration, to 100% of cells. Moreover, the particles were able to deliver the drug to cells through multiple layers of a 3D human bladder organoid model causing minimal cell toxicity, displaying superior killing of bacterial reservoirs harboured within bladder cells compared with unencapsulated drug. The particles were also able to kill bacterial biofilms more effectively than the free drug. These results illustrate the potential for using antibiotic-loaded microparticles to effectively treat chronic UTIs. Such a delivery method could be extrapolated to other clinical indications where robust intracellular delivery is required, such as oncology and gene therapy.

Urinary Tract Infection Among Women in Child Bearing age in Rajshahi Region

Background: Urinary Tract Infection (UTI) is the second leading cause of bacterial infection worldwide. More female are affected compared to male, particularly in their reproductive age group. Untreated and repeated UTI cases lead to health complication and antimicrobial resistance.&#x0D; Objective: To know the proportion of UTI among women in child bearing age group in Rajshahi and also to know the influence of socio-demographic parameters on UTI incidence in this region.&#x0D; Methodology: A cross sectional descriptive study was conducted on women in their reproductive age group (15-45 years) in Institute of Biological Sciences (IBSc), Rajshahi University and Rajshahi Medical College (RMC) from July 2014 to June 2017 where mid-stream urine samples were collected and cultured following all standard procedure. Positive cultures were compared with sociodemographic parameters to know their association with UTI cases.&#x0D; Result: Out of Total 450 patients screened for UTI, 151 (33.55%) were culture positive. Married women showed the highest rate of UTI 95 (62.91%) compared to single and widowed/divorced women which was 49 (32.4%) and 7(4.6%) respectively. Pregnancy and diabetes showed greater incidence or association with UTI which was 116 (76.8%) and 93 (61.59%) respectively. In all cases combined, symptomatic UTI was much higher than asymptomatic bacteriuria 54 (35.7%). Good hygiene and cleanliness associated with use of sanitary napkins and latrines have greatly reduced UTI rates among women which were 31 (20.5%) and 27 (17.8%) respectively.&#x0D; Conclusion: UTI has a high rate among women in their childbearing age, particularly when associated with pregnancy and diabetes. Good personal hygiene and awareness can greatly reduce its incidence and prevent further complications and most importantly antimicrobial resistance.&#x0D; KYAMC Journal Vol. 10, No.-3, October 2019, Page 156-159

PUK39 URINARY TRACT INFECTIONS (UTIS) AFTER UROGENITAL PROCEDURES AND RELATED OUTCOMES AND COSTS: ANALYSIS OF DATA FROM THE NATIONAL HOSPITAL INFORMATION SYSTEM

The purpose of this study was to evaluate the proportion of Urinary Tract Infections (UTIs) after urogenital procedures and the associations between UTIs and in-hospital mortality, length of stay (LOS) and costs using the Hospital Information System of Italy. The National Hospital Discharge Database was retrospectively reviewed for all admissions between 2010 and 2014 with a urogenital procedure in the primary or secondary fields. UTIs were identified according to the presence of primary or secondary diagnosis of pyelonephritis; UTI, site not specified; other post-operative infections; other infections due to medical care; cystitis; and urethritis. The associations between the presence of a UTI and outcomes or costs were assessed with the Mann–Whitney unpaired test and Pearson's Chi-square test, when appropriate, and multivariable generalized linear models. A further sensitivity analysis was performed considering UTIs as only the presence of a primary or secondary diagnosis of a post-operative infection. Within the 5-year study period, we selected 272,133 acute admitted inpatients with a reported urogenital procedure; the proportion of admitted patients with UTIs was 7.0% (95% CI: 6.9% - 7.4%). The multivariate model showed no association between in-hospital mortality and the presence of a UTI (OR 0.95; 95% CI: 0.83 - 1.10) but indicated a strong association between in-hospital mortality and the diagnosis of a post-operative infection (OR 2.42; 95% CI: 1.26 - 4.66). Compared with patients without UTIs, those with UTIs had significantly longer hospital stays and mean hospitalization costs (IRRadj 1.50; 95% CI: 1.48 - 1.51 and βadj 1.19; 95% CI: 1.18 - 1.21, respectively). In this study we demonstrated that the presence of UTI after a urogenital procedure is associated with a prolonged hospital stay and elevated mean hospitalization costs. The study may help advance out understanding of the outcomes and costs related to UTIs after urogenital procedures in the Italian context.

A non-interventional, prospective, multicenter study for evaluation of the use of the herbal medicinal product Canephron\xae N in the pediatric outpatient population in Russia

BackgroundA herbal medicinal product (HMP) with centaury, lovage, and rosemary as active ingredients (brand name: Canephron® N) has been widely used for treatment and prevention of urinary tract infections (UTIs) and other urinary system disorders. Non-clinical in vitro and in vivo data indicate its diuretic, spasmolytic, anti-inflammatory, antioxidative and analgesic effects. The purpose of this non-interventional, prospective, multicenter study was to collect data on the use of the HMP in the Russian pediatric outpatient population.ResultsIn total, 636 outpatients aged 1–17 years were enrolled. Of these, 634 received at least one dose of the HMP and were included in the safety set, which was used for analysis. 61 patients were 12–23 months, 227 were 2–5 years, 234 were 6–11 years and 112 were 12–17 years of age. The oral solution of the HMP was prescribed in 66.4%, and tablets (dragées) in 33.6% of the patients. For 48% of the patients the HMP was prescribed to treat an acute or chronic disease, 25% of the patients received it for prophylaxis, and 27% for both. More than half of the patients (53%) received the HMP as monotherapy.Main treatment indications were UTIs (34.1%) and pyelonephritis (30.0%). The proportion of UTIs was the highest within the youngest age group (51%), while the proportion of different cystitis forms increased in patients older than 2 years. Relevant proportions of different nephritis forms and urolithiasis were only observed in patients aged 12–17 years. Forms of cystitis were more frequent in female than in male patients (15% vs. 1%), while forms of nephritis, urolithiasis, and dysmetabolic nephropathy / crystalluria were more frequent in male patients.At the end of the observational period, 20% of the patients were reported as recovered from their disease, and 65% were reported to show improvements. For 91% of all patients with HMP monotherapy the investigators evaluated the effectiveness of the HMP as ‘good’ or ‘very good’. Nearly all patients (99%) evaluated the tolerability as ‘good‘or ‘very good‘. Five adverse drug reactions were observed.ConclusionsThe treatment of children aged 1–17 years with the HMP is safe and well tolerated. The study results support the use of the HMP for treatment and prophylaxis of urinary system diseases.

Transurethral thulium laser enucleation versus resection of the prostate for treating benign prostatic hyperplasia: a retrospective study.

This study aimed to compare the clinical outcomes between transurethral thulium laser enucleation of the prostate (ThuLEP) and transurethral thulium laser resection of the prostate (ThuLRP) for treating benign prostatic hyperplasia (BPH). From May 2014 to August 2015, 212 patients underwent ThuLRP and 188 patients underwent ThuLEP. The ThuLEP group was further divided into two subgroups according to the ways the prostate was taken out. The perioperative parameters were recorded and analyzed. The international prostate symptom score (IPSS), quality-of-life (QoL) score, maximum flow rate (Qmax), and postvoid residual urine volume (PVR) in both groups were estimated and compared 3, 6, and 12months after surgery. No significant difference was observed between the groups in terms of irrigated time, irrigated volume, catheterization time, and hospital stay. However, the significantly lower hemoglobin drop was observed in the ThuLRP group compared with the ThuLEP group. The ThuLEP group with a morcellator required a shorter operation time for patients with large prostate volume (> 60mL) compared with the ThuLRP and ThuLEP groups without a morcellator. During 12months of follow-up, IPSS, Qmax, QoL, and PVR improved significantly without significant differences between the groups. No severe complications were reported; however, the occurrence of transient urge incontinence was higher after ThuLEP compared with ThuLRP, and the proportion of urinary tract infection after surgery was higher in ThuLRP than in ThuLEP. ThuLRP and ThuLEP are safe and efficient for treating patients with symptomatic BPH. ThuLRP offers advantages in terms of minimal blood loss.

STUDY ON URINARY TRACT INFECTIONS IN PREDISPOSED PATIENTS

INTRODUCTION: Urinary tract infections (UTIs) are more common in people presenting predisposing factors (urinary stones, malformations, diabetes, pregnancy). Choosing the proper medication is very important for an efficient treatment and to prevent recurrencies. MATERIAL AND METHODS: We selected 566 hospitalized and outpatients in the high risk group and 1265 patients in the control group. Urine samples were collected in sterile recipients and cultivated on proper culture media. Antibiotic susceptibility testing (AST) was performed for all significant isolates. RESULTS: Amongst the patients with predisposing factors we found the following proportions of UTI: diabetic patients - 38.5%, urolithiasis - 25.2%, urinary tract malformations - 23.85%, and pregnancy - 18.5% of the cases. The most frequent isolated strain was Escherichia coli in each group. Positive cultivation results were more frequent in women. We found multidrug resistant bacteria in every patient group (except the pregnant women), especially ESBL-producing E. coli. In the majority of cases enterobacteria presented good susceptibility to fluoroquinolones, cephalosporins and gentamycin. CONCLUSIONS: In high-risk group patients the UTI are common and resistant strains are often present. Positive results were more frequent in women. The optimal treatment requires the antibiotic susceptibility testing for all isolates. Keywords: antibiotics, bacteria, urinary tract infection Normal 0 21 false false false RO X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:Table Normal; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0cm; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:Calibri,sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Times New Roman; mso-bidi-theme-font:minor-bidi; mso-fareast-language:EN-US;}

Prevalence of healthcare-associated infections in Lithuania

To compare point prevalence surveys of healthcare-associated infections (HCAI) performed in 2003, 2005 and 2007 in half of the acute care hospitals in Lithuania. The prevalence of HCAI decreased slightly from 2003 to 2007 (from 4.3% to 3.4%). The rate decreased for each surveyed year in intensive care, surgical and paediatric units, and increased in rehabilitation-nursing units. The proportion of lower respiratory tract infections increased (from 26.3% to 32.3%), while the proportion of urinary tract infections and bloodstream infections decreased (from 11.6% to 6.7% and from 8.9% to 2.3%, respectively). The proportion of microbiologically investigated HCAI cases decreased from 2003 to 2007 (from 56.0% to 41.0%, P<0.02). Gram-positive organisms accounted for most cases of HCAI. Approximately one-third of patients were on antimicrobial therapy (31.1%, 29.3% and 32.1% in 2003, 2005 and 2007, respectively), including penicillins, broad-spectrum penicillins, first-/second-generation cephalosporins and aminoglycosides. Repeated surveys allowed determination of trends in HCAI prevalence, risk factors and antibiotic usage. The surveys established infection control priorities in Lithuania, and resulted in changes to the national HCAI surveillance system.

Use of the bacteriology laboratory to decrease general practitioners’ antibiotic prescribing

Objective: Use of the bacteriology laboratory to guide antibiotic prescribing in primary care is often considered inappropriate due to difficulties of access in a relevant time scale. The overnight analysis offered to general practitioners in the Grampian area of Scotland for the past 6 years (ABLE), and which had previously been shown to reduce antibiotic prescribing by two-thirds in a randomized controlled trial, was audited to see if it was being used correctly in general practice, that is to reduce unnecessary antibiotic prescribing. Methods: 699 consultations were audited. Of these, 357 were ABLE patients. The other 342 were chosen because an antibiotic had been prescribed. Results: Only 36.7% (140) of the ABLE patients were prescribed an antibiotic, 65.7% being given a delayed action script. All but 10 were culture positive. ABLE patients had a greater proportion of urinary tract infections than the non-ABLE patients, but less lower-respiratory and skin or soft-tissue infection. The antibiotics prescribed reflected the differences in infection type. The repeat visit rate and repeat antibiotic prescription rate were almost identical between the two groups.Conclusion: While the overall use of ABLE in Grampian is low, its use seems to be appropriate in that it is successfully being used to identify bacterial infection and reduce unnecessary antibiotic prescribing.