Recurrent Infections Research Articles

Therapeutic Profile of IgA Nephropathy Regarding Pharyngeal Kidney Theory

IgA nephropathy (IgAN) is the most common glomerular disease, which is one of the main causes of chronic kidney disease. The course of this disease is prolonged, and the condition is often recurrent, and most of the disease changes after respiratory, gastrointestinal, and urinary infections, and respiratory infections are the most common of the three, which makes the treatment more difficult. In Chinese medicine, there is no direct name for this disease, but according to its symptoms, it can be categorized as "hematuria", "edema", "urolithiasis", "slow kidney wind" and other diseases. The disease is often caused by the recurrence of exogenous infections. For the recurrence of this disease due to exogenous infection, Chinese medicine treats IgA nephropathy from the pharynx according to the theory of "pharyngeal and renal correlation", which has achieved good clinical efficacy, and this point of view has received more and more attention nowadays. This article focuses on the treatment of IgA nephropathy from the pharyngeal-renal theory.

Antibiotic Resistance and Presence of Persister Cells in the Biofilm-like Environments in Streptococcus agalactiae

Objectives: This study investigated antibiotic resistance and presence of persister cells in Streptococcus agalactiae strains belonging to capsular types Ia/ST-103, III/ST-17, and V/ST-26 in biofilm-like environments. Results: S. agalactiae strains were susceptible to penicillin, clindamycin, and erythromycin. Resistance genes were associated with tetM (80%), tetO (20%), ermB (80%), and linB (40%). Persister cells were detected in bacterial strains exposed to high concentrations of penicillin, clindamycin, and erythromycin. S. agalactiae capsular type III/ST-17 exhibited the highest percentage of persister cells in response to penicillin and clindamycin, while type Ia/ST-103 presented the lowest percentages of persister cells for all antimicrobials tested. Additionally, persister cells were also detected at lower levels for erythromycin, regardless of capsular type or sequence type. Further, all S. agalactiae isolates presented efflux pump activity in ethidium bromide-refractory cell assays. LIVE/DEAD fluorescence microscopy confirmed the presence of >85% viable persister cells after antibiotic treatment. Conclusions: These findings suggest that persister cells play a key role in the persistence of S. agalactiae during antibiotic therapy, interfering with the treatment of invasive infections. Monitoring persister formation is crucial for developing strategies to combat recurrent infections caused by this pathogen.

Mimicking Urinary Tract Infections Caused by Uropathogenic Escherichia coli Using a Human Three-Dimensional Tissue Engineering Model

Uropathogenic Escherichia coli are the main causal agent of urinary tract infections. These diseases can affect more than half of women during their lifetime. Moreover, recurrent urinary tract infections can affect up to 30% of patients, leading to higher social and economic costs for the community. No efficient treatment against the recurrent form of the disease has been discovered. Due to the low average rate of successful translation from 2D cell culture and in vivo animal models into clinical trials, new models that mimic pathologies, such as those produced by tissue engineering, are needed. A model of human-derived 3D bladder mucosa was produced by tissue engineering techniques using collagen gels and organ-specific primary human stromal and epithelial cell populations. This model was used to mimic the different steps of a urinary tract infection: adhesion, invasion, intracellular bacterial community and quiescent intracellular reservoir formation and, finally, bacteria resurgence after umbrella cell exfoliation through chitosan exposure to mimic the recurrent infection. The uropathogenic strain UTI-89-GFP was used as infectious bacteria and BL-21-GFP strain as a control. Our model is unique and is the first step toward mimicking the different phases of a UTI in a human context.

Improved health-related quality of life in patients with recurrent Clostridioides difficile infection after treatment with faecal microbiota transplantation

Background Clostridioides difficile is a major burden for both healthcare systems and the patients. Faecal microbiota transplantation (FMT) is becoming more common as a treatment since it reduces the risk of recurrent Clostridioides difficile infection (rCDI). Objectives To evaluate how treatment with FMT is affecting the health-related quality of life (HRQoL) in patients with rCDI. Methods A prospective observational cohort study was conducted where patients who were offered FMT as a treatment for rCDI were asked to fill in a questionnaire based on the Short Health Scale (SHS) and EuroQol 5-Dimensions 5-Levels (EQ-5D-5L) about their HRQoL before and after treatment. Results Patients with rCDI had poor HRQoL, which improved following FMT. Conclusions Since FMT cures, reduces the risk of new recurrences of CDI and improves the HRQoL of the patients, it should be offered as a treatment for patients with rCDI. Also, SHS is a useful and reliable instrument for measuring HRQoL in patients with rCDI.

Clinical characteristics and nomogram model for predicting the risk of recurrence of complicated urinary tract infection in pediatric patients

Complicated urinary tract infection (cUTI) has higher incidences of antibiotic resistance, recurrence, chronicity, and progression. There exist differences in the immune functions, anatomical structures and physiological functions of urinary tract system between children and adults. In addition, the immature stage of hygiene habit development and the inability to express discomfort accurately all contribute to cUTI recurrence in pediatric patients. cUTI recurrence in children can lead to serious consequences such as growth and development delay, renal scars, and progression to end-stage kidney diseases. Despite the high incidence of cUTI recurrence, no predictive model currently exists to guide targeted intervention in pediatric patients. This study aimed to establish a nomogram to predict the risk of cUTI recurrence in children, thereby facilitating targeted prevention and treatment strategies in pediatric patients. The nomogram was developed based on a retrospective cohort that included 421 pediatric patients with cUTI at West China Second University Hospital from January 2020 to August 2023. The patients were randomly divided into a training set and a validation set in a 3:1 ratio. Logistic regression analysis was used to identify risk factors and construct the nomogram for predicting the risk of cUTI recurrence, followed by validation and performance analysis. Of the 421 children with cUTI, the recurrence rate of cUTI was 68.4% (288 cases) during an average follow-up duration of 22.9 months. The nomogram comprised female gender, history of urinary tract surgery, Escherichia coli in urine culture, renal dysfunction, and vesicoureteral reflux as predictors of cUTI recurrence in pediatric patients. The model showed favorable performance with C-index values of 0.735 and 0.750 in the training dataset and the validation dataset, respectively. The decision curve analysis revealed that the nomogram might be clinically useful. The reliable nomogram would be beneficial for clinicians to identify children with high risks of cUTI recurrence for targeted intervention.

The Psychosocial Impact of Urinary Dysfunction.

Urinary dysfunction encompasses a wide range of syndromes and symptoms and is highly prevalent among the adult population. Urinary issues have been associated with psychosocial sequelae. The interplay between psychosocial comorbidity and symptoms impacts perceived severity and treatment success. While the correlation has been described in the literature, much remains unknown. This article describes the psychosocial impact on conditions such as overactive bladder (OAB), neurogenic lower urinary tract dysfunction (LUTD), recurrent urinary tract infection (UTI), and interstitial cystitis/bladder pain syndrome (IC/BPS). This article also highlights potential interventions for patients afflicted with both urinary disorders and psychosocial comorbidity to improve overall treatment success.

Risk factors of obstructive sleep apnea syndrome in the developmental age

Background: Obstructive Sleep Apnea Syndrome (OSAS) is a prevalent respiratory sleep disorder in children, associated with severe health consequences, including hypertension, cardiac dysfunction, and neurocognitive impairment. Despite extensive research on OSAS in adults, the risk factors for pediatric OSAS remain underexplored. Objective: This literature review aims to identify and present the key risk factors associated with pediatric OSAS based on contemporary studies. Methods: A systematic search of the PubMed and Scopus databases was conducted for literature published between 2016 and 2024. Search terms included “obstructive sleep apnea,” “children,” and “risk factors.” A total of 93 relevant studies were reviewed after excluding non-pediatric and irrelevant papers from an initial pool of 283. Results: The most commonly identified risk factors for pediatric OSAS include adenoid and tonsillar hypertrophy, obesity, craniofacial abnormalities, and asthma. Additional risk factors such as allergic rhinitis, recurrent upper respiratory infections, nasal stenosis, congenital diseases, low vitamin D levels, and preterm birth were also noted. Conclusion: Pediatric OSAS is influenced by multiple factors, including anatomical, physiological, and genetic components. Further research is required to explore emerging risk factors, such as role of vitamin D deficiency and microbiota, and to clarify the impact of variables like ethnicity and breastfeeding.

Urinary Tract Infection (UTI) Prevention in Patients with Chronic Indwelling Catheters

Abstract Purpose of Review In this review, we discuss urinary tract infections in the setting of indwelling urethral foley catheters. We focus on infection prevention in setting of a chronic indwelling foley and review the recent literature findings on biofilm prevention, catheter duration and exchange intervals, prophylactic supplements, irrigation solutions, and consideration of alternative bladder management options. Recent Findings Ongoing research has found a reduction in UTI rates through the use of biofilm preventing catheters, D-mannose and Methenamine hippurate supplementation, prophylactic antibiotic use at time of catheter exchange, and intravesical antibiotic instillations within the chronically catheterized patient population. Summary Overall, research on recurrent urinary tract infections is fairly robust. However, data focusing on preventing infections in the setting of indwelling catheters is overall lacking. Continued research remains to be done to translate findings to patient care.

Living without pain: A 10-year study of congenital insensitivity to pain with anhidrosis.

Congenital Insensitivity to Pain with Anhidrosis (CIPA) is a rare hereditary neuropathy caused by NTRK1 gene mutations, predisposing patients to recurrent infections and chronic wounds. Long-term studies on microbial and clinical outcomes in CIPA are limited. This study presents analysis of infection patterns, antibiotic resistance, and clinical outcomes in CIPA patients. A comprehensive ten-year retrospective cohort study was conducted at Soroka University Medical Center, Beer Sheva, Israel, from January 2014 to January 2023. Electronic medical records were reviewed to identify 63 CIPA patients, all were of consanguineous Bedouin families. Data collection included demographic details, clinical presentations, genetic analysis, documentation of infections, wound sites, hospital duration, and surgical interventions. Staphylococcus aureus, notably methicillin-resistant, dominated, with Gram-negative bacteria common in lower limbs. The study noted reduced extended-spectrum beta-lactamase bacteria and linked demographic factors to infection traits, antibiotic resistance, and surgical needs. This study provides valuable insights into the clinical and microbial patterns of CIPA, highlighting dynamic shifts in microbial compositions and antibiotic resistance profiles over time. Staphylococcus aureus, and Gram-negative bacteria particularly in lower limb infections, pose significant challenges in patient management. The findings underscore the importance of tailored approaches to address evolving microbial profiles and optimize patient care in CIPA. Key Message: This is the largest cohort study on CIPA to date, highlighting the dominance of Staphylococcus aureus, including methicillin-resistant strains, and significant Gram-negative bacterial infections in lower limbs. Contribution to Literature: It draws parallels between infection dynamics in CIPA and diabetic foot ulcers, emphasizing similar challenges due to neuropathy and ischemia, enhancing understanding of infection susceptibility and management in neuropathic conditions. The findings inform clinical practices by detailing infection and resistance patterns, supporting the development of targeted treatment strategies to improve outcomes for CIPA and similar conditions.

Piezoelectric Heterojunctions as Bacteria-Killing Bone-Regenerative Implants.

Heterojunctions are widely used in energy conversion, environmental remediation, and photodetection, but have not been fully explored in regenerative medicine. In particular, piezoelectric heterojunctions have never been examined in tissue regeneration. Here the development of piezoelectric heterojunctions is shown to promote bone regeneration while eradicating pathogenic bacteria through light-cellular force-electric coupling. Specifically, an array of heterojunctions (TiO2/Bi2WO6), made of piezoelectric nanocrystals (Bi2WO6) decorating TiO2 nanowires, is fabricated as a biocompatible implant. Upon exposure to near-infrared light, the piezoelectric heterojunctions generate reactive oxygen species and heat to kill bacteria through photodynamic and photothermal therapy, respectively. Meanwhile, the mechanical forces of the stem cells grown on the implant trigger the heterojunctions to produce electric fields that further promote osteogenesis to achieve osteointegration. The heterojunctions effectively suppress postoperative recurrent infections while promoting osseointegration through the local electric fields induced by cells. Therefore, the piezoelectric heterojunctions represent a promising antibacterial tissue-regenerative implant.

A Perspective on the Interaction Between Recurrent Lower Urinary Tract Infections and Irritable Bowel Syndrome.

Given the potential overlap in risk factors associated with both irritable bowel syndrome (IBS) and lower urinary tract infections (LUTIs), we aimed to identify factors that may contribute to the development of both conditions, as well as recurrent lower urinary tract infections (RLUTIs). Our research also sought to explore overlapping symptoms and interactions between these two disorders. The study included young women with a history of urinary tract infections. Participants were divided into three groups: women with sporadic LUTIs (NRLUTIs), women with recurrent LUTIs (RLUTIs), and women with both a history of urinary infections (NRLUTI or RLUTI) and a diagnosis of IBS. The diagnosis of IBS is primarily clinical, relying on symptoms and the exclusion of other gastrointestinal disorders. Data from intestinal microbiota tests were combined with information on patients' symptom perception, dietary habits, lifestyle, and knowledge regarding their conditions. Abdominal pain, constipation, insufficient knowledge about antibiotic and probiotic use, and nutritionally unbalanced diets were identified as common factors associated with both LUTI-IBS and RLUTI. Our research identified shared risk factors between LUTI, IBS, and RLUTI, suggesting a pathological interdependence between these conditions. Notably, women with RLUTIs often experience gastrointestinal symptoms such as abdominal pain and constipation after consuming foods known to trigger IBS. This highlights that gut dysbiosis is both a risk factor and a potential consequence of RLUTI. The presence of either condition appears to exacerbate the symptoms of the other, further underscoring the intricate connection between RLUTI and IBS in affected individuals.

Differential frequency of persister cells in clinically derived isolates of Pseudomonas aeruginosa after exposure to cefiderocol and ceftolozane/tazobactam.

Bacterial persistence is a phenomenon whereby a subpopulation of bacteria survive high concentrations of an active antibiotic in the absence of phenotypic alterations. Persisters are associated with chronic and recurrent infections for pathogens including Pseudomonas aeruginosa. Understanding persister profiles of newer antibiotics such as cefiderocol and ceftolozane/tazobactam against P. aeruginosa is warranted as these agents generally target difficult-to-treat infections. Persister formation was assessed using in vitro assays against nine clinical P. aeruginosa isolates exposed to cefiderocol or ceftolozane/tazobactam. Quantitative persister assays were performed using a stationary phase of bacteria challenged with 10-fold MIC drug concentrations. Persisters were quantitated as the percent persisters at 24 h and the log ratio (LR) difference in AUC for cfu for each antibiotic alone compared with growth control. The tolerance disc test (TDtest) was used to qualitatively detect persisters. Percent persisters at 24 h was lower with cefiderocol compared with ceftolozane/tazobactam for six of the nine tested isolates. Eight of the nine isolates had higher reduction in LR for cefiderocol groups, suggesting an overall higher and more rapid bacterial reduction in cefiderocol groups. For cefiderocol, five of the nine tested isolates lacked regrowth after replacement with glucose disc, suggesting no persistence via the TDtest. For ceftolozane/tazobactam, three isolates lacked persister formation. Cefiderocol resulted in less bacterial persistence relative to ceftolozane/tazobactam against nine clinical P. aeruginosa isolates. Cefiderocol's siderophore mechanism may be advantageous over ceftolozane/tazobactam through enhanced anti-persister effects. Clinical correlation of these findings is warranted as persisters can lead to antibiotic resistance and treatment failure.

Urinary biochemical ecology reveals microbiome-metabolite interactions and metabolic markers of recurrent urinary tract infection.

Recurrent urinary tract infections (rUTIs) are a major clinical challenge in postmenopausal women and their increasing prevalence underscores the need to define interactions between the host and the urinary microbiome that may underlie rUTI susceptibility. A body of work has identified the taxonomic profile of the female urinary microbiome associate with aging, menopause, and urinay disease. However, how this microbial community engages with the host niche, including the local biochemical environment of the urogenital tract, in health and disease is yet to be fully defined. This study directly assesses differences in the biochemical environment of the urine, or biochemical ecology, associated with recurrent urinary tract infection (UTI) and defines a microbe-metabolite association network of the female urinary microbiome. By integrating metagenomic and metabolomic data collected from a controlled cohort of women with rUTI, we find that distinct metabolites, such as methionine sulfoxide (Met-SO) and trimethylamine oxide (TMAO), are associated with differences in urinary microbiome diversity. We observe associations between microbial and biochemical beta diversity and unique metabolic networks of uropathogenic Escherichia coli and uroprotective Lactobacillus species, highlighting potential metabolite-driven ecological shifts that may influence UTI susceptibility. We identify a urinary lipid signature of active rUTI that can accurately distinguish (AUC = 0.987) cases controls. Finally, using time-to-relapse data we identify deoxycholic acid (DCA) as a new prognostic indicator for rUTI recurrence. Together these findings suggest that systemic metabolic processes may influence susceptibility, opening new avenues for therapeutic intervention and the development of more accurate diagnostic and prognostic to improve patient outcomes.

Intravesical Therapies for Recurrent Urinary Tract Infections: A Systematic Review.

Recurrent urinary tract infections (rUTIs) present a significant clinical challenge, particularly due to the associated overuse of antibiotics and the rise in antimicrobial resistance. This systematic review evaluates the current literature on the use of intravesical therapies as an alternative treatment for rUTIs. Two established primary therapies are reviewed: glycosaminoglycan (GAG) instillations and intravesical antibiotic instillations. Both therapies offer localised treatment, reducing systemic antibiotic exposure and targeting infection sites more directly. A literature search was conducted using PubMed and Cochrane Controlled Register of Trials (CENTRAL), yielding 5,963 relevant articles, of which seven studies met the inclusion criteria. The review indicates that both GAG and antibiotic instillations significantly reduce UTI recurrence rates and improve symptoms such as pain and urinary urgency. However, significant variations in treatment schedules and dosages exist, and no direct comparative studies between GAG instillations and intravesical antibiotics were found. Moreover, intravesical antibiotics show great potential in minimising antimicrobial resistance, though further large-scale studies are needed to confirm these findings. While intravesical therapies are generally well-tolerated, GAG instillations can cause mild irritation. Further research is required to optimise therapy regimens and to perform cost-benefit analyses, particularly considering the high costs of these therapies compared to traditional antibiotic prophylaxis. Randomised controlled trials comparing different intravesical treatments are crucial to inform future clinical practice.

One-Stage Tibiotalocalcaneal Arthrodesis for Severe Septic Destruction of the Ankle Joint Using a Retrograde Intramedullary Nail: A Retrospective Cross-sectional Study.

Severe septic destruction of the ankle joint poses a therapeutic challenge but lacks a consensus optimal treatment. Tibiotalocalcaneal arthrodesis (TTCA) is considered as a valuable salvage procedure, but the literature remains scarce. Conventional treatment approaches, including 2-stage procedures, have been associated with prolonged recovery times and varying success rates. Many authors prefer classical external fixation in these scenarios, citing concerns that internal implants might pose a risk for recurrent infection. To date, no study has investigated the outcomes of 1-stage surgery using a retrograde intramedullary (IM) nail. The main purpose was to assess the rate of recurrent infection at 2 years following 1-stage TTCA using a retrograde IM nail in severe septic destruction of the ankle joint. Fusion rates and functional outcomes were evaluated as secondary purposes. The clinical and radiologic data of patients who underwent 1-stage TTCA with retrograde IM nail following severe septic destruction of the ankle joint with a minimal follow-up of 2 years were retrospectively analyzed. Reinfection rate, fusion rate, functional outcomes, and complications were evaluated. A total of 25 patients were included with a mean follow-up of 42 months (24-92 months). The mean age was 55 ± 18 years old. At the last follow-up, reinfection occurred in 6 patients (24%) and fusion was obtained in 19 patients (83%). Eight patients (32%) required revision surgery. The mean postoperative modified American Orthopaedic Foot & Ankle Society (AOFAS) score, 12-Item Short Form Health Survey physical and mental component summary scores were respectively 53 ± 19.5, 35.5 ± 11.4, and 46.7 ± 13.5 points. One-stage TTCA with retrograde IM nail appears to be an acceptable alternative in severe septic destruction of the ankle joint, with a high eradication rate of infection and ankle fusion.

Mid-term results of a case series on branched xenopericardial roll graft replacement to treat aortic arch/arch graft infection.

We conducted this case series to evaluate the feasibility and mid-term outcomes of orthotopic aortic arch reconstruction using xenopericardial grafts to treat native aortic arch/arch graft infection. Between 2010 and 2023, adopting a multidisciplinary approach, we treated consecutive patients with aortic arch/arch graft infection by orthotopic branched xenopericardial roll graft replacement and tissue filling. The end-points of the study were the graft re-infection, graft-related complications such as pseudoaneurysm formation, thromboembolism, graft stenosis, graft calcification, and death. The subjects were 11 patients (8 men and 3 women) with a median age of 66 (51 to 79, [IQR] 59.0, 70.5) years. Of the 11 patients, 7 underwent preoperative mediastinal irrigation/negative-pressure wound treatment. The 30-day mortality was 0% (0/11 patients), and one patient died in hospital, after 8 months. Aorta-related death occurred in 18.2% (2/11 patients), with both cases developing local recurrence of fungal infection. The remaining 9 patients (81.8%) remained free of re-infection. The estimated 1-, 3-, 5-, and 7-year risk-adjusted survival rates were 91 ± 9%, 81 ± 12%, 58 ± 16%, and 58 ± 16%, respectively. The estimated 1-, 3-, 5-, and 7-year cumulative aorta-related mortality rates were 9 ± 9%, 19 ± 12%, 19 ± 12%, and 19 ± 12%, respectively. Graft-related complications included branch kinking in 1 patient and graft rupture in 1 patient. There were no cases of graft-related thromboembolism or graft calcification. The median follow-up period was 45 (8 to101, [IQR] 36.5, 70.9) months. The longest follow-up period until date of the currently surviving patients is 101 months. Although the xenopericardium appeared to be vulnerable to fungal infection, based on the favorable results obtained, we consider that branched xenopericardial roll graft replacement using a multidisciplinary, staged approach may serve as a useful treatment option for aortic arch/arch graft infection.

Biomimetic Nanozyme-Decorated Smart Hydrogel for Promoting Chronic Refractory Wound Healing.

Chronic refractory wounds have become a serious threat to human health and are characterized by prolonged inflammation, recurrent bacterial infections, and elevated ROS levels. However, current therapeutic strategies usually target a unilateral healing function and are unable to tackle the complexity and sensitivity of chronic refractory wound healing. This study fabricated a biomimetic nanozyme based on rhein (Cu-rhein NSs), which effectively mimics the activity of superoxide dismutase (SOD) for scavenging various free radicals. Additionally, zinc oxide microspheres (ZnO MSs) were prepared to enhance the antibacterial activity and mechanical properties of the modified hydrogel. Cu-rhein NSs and ZnO MSs were comodified onto an extracellular matrix-mimetic dual-network smart hydrogel constructed from oxidized sodium alginate, gelatin, and borax via dynamic borate and Schiff base bonds. The smart hydrogel presented the good biocompatibility and targeted the unique acidic microenvironment with high oxidative stress of chronic refractory wounds, intelligently releasing bionic nanozymes to effectively eliminate bacteria, reduce inflammatory responses, and scavenge multiple free radicals for reducing ROS. In vivo experiments on the rat model based on diabetic infection showed that the smart hydrogel could effectively eliminate bacteria, promote vascular regeneration and collagen deposition, reduce inflammatory response, and accelerate the healing of diabetic-infected wounds (almost complete healing within 14 days). The advantages of an intelligent, biomimetic tissue regeneration cascade management strategy against diabetic infected wound healing are highlighted.

Gartner\'s Duct Cyst in Recurrent Vaginal Infection: A Case Report

Gartner\'s Duct Cyst in Recurrent Vaginal Infection: A Case Report

Giftedness and allergy: A comparative study of the risk factors in gifted and typical children

Aim: To compare the various parameters associated with giftedness and allergy in gifted children within their group and with typical children of average intelligence. Methods: The case-control questionnaire study was conducted in Adıyaman, Türkiye, in April-May 2023. The study included 75 gifted and 190 typical children aged 6-14. The face-to-face survey consisted of 37 questions, 16 of which were added to the 21 questions of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase 3. Results: The prevalence of recurrent ear infections in gifted children (33.3%) was found to be significantly higher than in typical students (20.5%) (P= 0.028). The rate of asthma in gifted students with recurrent ear infections (40%) was found to be significantly higher than the rate in gifted students without recurrent ear infections (16%) (P=0.022). The rate of allergic rhinitis in gifted students with food allergies (38.5%) was found to be significantly higher than the rate of those without food allergies (11.3%) (P=0.029). The high food selectivity (21.3%) of gifted students was found to be significantly higher than that of typical students (8.4%) (P=0.002). Among the gifted students, 50% of those who were very selective about food had asthma (P=0.014), and 37.5% had allergic rhinitis (P=0.029). Conclusions: The study has shown the association between giftedness and various allergic conditions, suggesting that certain factors like recurrent otitis and food selectivity behavior may contribute to the higher prevalence of these conditions in gifted children.

Recurrent Urinary Tract Infections in Older Adults Requiring Hospitalization in an Internal Medicine Ward

Urinary tract infection (UTI) is a common cause of recurrent infections, especially among young women, but also in patients with infections related to the insertion of urological devices. The aim of this study was to determine the recurrent UTI readmission rate among older patients and the risk factors for recurrent UTI in a prospective cohort of patients admitted to the hospital with community-acquired UTI. We assessed the frequency of recurrent UTIs over a one-year follow-up period after discharge and compared the clinical and epidemiological characteristics between cases with and without recurrences. Out of a total of 462 patients included in this study, 35 (7.6%) had a readmission due to UTI. The patients in the overall series had a median age of 78 (69–86) years, and 50% were women. Recurrent UTIs were associated with healthcare-associated UTIs (OR 2.8, 95% CI 1.1–6.9) and Pseudomonas aeruginosa infections (OR 2.7, 95% CI 1.1–7.2) according to multivariate analysis. Patients with recurrent UTIs experienced longer hospital stays, with no significant difference in mortality rates. Half of the recurrent UTIs were caused by the same microorganisms as those in primary UTIs, but the prolonged period up to recurrence, with a median of 4 months, suggests that they were mostly reinfections. In conclusion, elderly patients admitted to the hospital with complicated UTIs had a low long-term risk of recurrent UTIs. However, this risk was higher in patients with healthcare-associated infection criteria and in those with P. aeruginosa UTIs. Identifying these risk groups may aid in the early detection of recurrent UTIs.