Spectrum Of Urinary Tract Infections Research Articles

Emphysematous cystitis: A singular case enriching medical literature

Emphysematous cystitis, a rare entity within the spectrum of urinary tract infections, poses a crucial diagnostic challenge, particularly when it occurs in diabetic patients [1]. Here, we present the case of a 74-year-old man with type 2 diabetes and chronic tobacco use, who was admitted to the emergency room for right lower back pain associated with dysuria in a febrile context. This condition, characterized by the presence of gas in the bladder and/or its wall, is often associated with aero-anaerobic microbial fermentation, placing diabetic patients in a high-risk category. The physiopathological complexity of emphysematous cystitis underscores the importance of understanding the underlying mechanisms of this condition, particularly in individuals with risk factors such as diabetes and smoking. In the current clinical context, where the prevalence of diabetes is constantly rising, the rapid recognition of these atypical manifestations becomes imperative for appropriate management. This specific case, though uncommon, highlights the necessity of increased vigilance among diabetic patients presenting with urinary symptoms, thus emphasizing the importance of a proactive clinical approach. A thorough examination of this case provides an opportunity to explore the links between diabetes, smoking, and emphysematous cystitis, enriching our understanding of the risk factors and physiopathological mechanisms associated with this rare clinical entity.

Clinical spectrum of urinary tract infection in children

Urinary tract infection (UTI) is a common in children presenting with non-specific symptoms, often undiagnosed and managed with indiscriminate antibiotics. We made an attempt to study the clinico-epidemiological and microbiological profile in children presenting with UTI. Aim of the study was to analyze the clinico-epidemiological and microbiological profile in children upto 5 years of age presenting with UTI. In this prospective study, we analyzed the clinical presentation, antibiotic sensitivity pattern and outcome of children with UTI. Children of age group up to 5 years, with culture positive UTI was taken. Total of 101 children presented with culture positive UTI. 47 were males and 54 females. 21 were neonates and 80 were older children. Neonates mainly presented with failure to thrive, prolonged jaundice and lethargy with poor suck whereas older children presented mainly with fever, dysuria, abdominal pain and vomiting. E coli was the commonest offending agent followed by Klebsiella pneumoniae and Proteus mirabilis. Antibiotic resistance was least with Amikacin, followed by Colistin, Iimipenem, Meropenem, Levofloxacin, Piperacillin/Tazobactum and Ceftriaxone. Vesico-ureteric reflux (03) and Pelvi-ureteric junction obstruction (03) were the structural renal anomaly detected on further evaluation of these babies. Hence, to conclude, UTI in children is not uncommon. Children often present with non-specific symptoms, and a high index of suspicion is warranted for its diagnosis. Urine culture is the gold standard of diagnosis. All children must further be evaluated for associated structural renal anomaly and provided appropriate therapy so as to prevent long term renal scarring.

A Study of the spectrum of Urinary Tract infections in patients with Adult Polycystic Kidney Disease – An old problem with a better outcome

A Study of the spectrum of Urinary Tract infections in patients with Adult Polycystic Kidney Disease – An old problem with a better outcome

Prevalence and bacterial spectrum of urinary tract infection in nephrotic syndrome: a cross sectional study from a tertiary care centre

Background: Nephrotic syndrome is a common renal disorder in paediatric population, which predisposes to various systemic infections. Out of these UTI remains most important as it can be easily missed, if active search is not made. The present study was conducted to find out the prevalence of UTI in these children and to uncover the bacterial spectrum and their sensitivity pattern.Methods: It was a cross sectional descriptive study which included all children less than 18 years of age admitted with nephrotic syndrome. All the relevant data pertaining to history, examination and investigations were recorded in a pre-designed performa. A clean-catch midstream urine specimen was obtained in all at admission for bacterial culture besides routine investigations.Results: Among all the seventy six children of nephrotic syndrome studied, boys were affected more than the girls with a male to female ratio of 3.47:1. Their mean age at presentation was 6.4±3.74 years. Urinary tract infection was detected in twenty children (26.32%). The commonest micro-organism isolated was Escherichia coli (45%), followed by Klebsiella (20%), Proteus (20%), Staphylococcus aureus (10%) and Enterococcus (05%). Most of the micro-organisms were sensitive to fluoroquinolones and cefepime.Conclusions: About one fourth of nephrotic syndrome children have UTI at admission and relapse episode serves as an additional risk factor for it. Gram negative enteric bacilli remain the most common agent. For empirical coverage fluoroquinolones and cefepime show the best sensitivity pattern.

Microbiological spectrum of urinary tract infection in patients with sepsis

Microbiological spectrum of urinary tract infection in patients with sepsis

Spectrum of Urinary Tract Infections in Pregnant Women

Spectrum of Urinary Tract Infections in Pregnant Women

Group B streptococcus cystitis presenting in a diabetic patient with a massive abdominopelvic abscess: a case report

IntroductionStreptococcus agalactiae or group B streptococcus is a Gram-positive pathogen that is typically associated with neonatal disease and infection in pregnant women. Group B streptococcus also causes invasive infections in non-pregnant adults including urinary tract infections. The spectrum of urinary tract infections caused by group B streptococcus includes cystitis, pyelonephritis, urosepsis and asymptomatic bacteriuria, which is particularly common among elderly individuals. A rare form of invasive group B streptococcus infection in adults is secondary abscess. Here, we present the first reported case of a patient who developed an unusual, massive abdominopelvic abscess secondary to acute group B streptococcus urinary tract infection.Case presentationA 46-year-old African-American woman presented to the University Emergency Department complaining of urinary tract infection symptoms and severe abdominal pain. Diagnostic imaging by transvaginal ultrasound and computed tomography revealed a massive peripherally-enhancing, low-attenuating fluid collection within her pelvis. The patient’s abdominopelvic abscess was drained by ultrasound-guided drainage and this yielded a septic aspirate that was culture positive for abundant S. agalactiae. A recent history of urinary tract infection symptoms in the patient suggested that her abscess developed secondary to cystitis. Complete resolution of the abscess as a favorable outcome was achieved in this case following surgical drainage and appropriate antimicrobial therapy.ConclusionAcute bacterial urinary tract infection leading to an abdominopelvic abscess has not previously been reported in the literature. This case report defines a new disease etiology associated with acute streptococcal cystitis and it will be of interest in cases of urinary tract infections where there is an association with abdominal and/or pelvic pain. A brief review of the literature on unusual secondary abscesses due to group B streptococcus is provided alongside this case to highlight the clinical significance and prognoses of these rare infections. Finally, this case emphasizes the requirement to distinguish unusual etiologies of pyogenic abscesses in order to guide successful clinical management and to treat patients with antibiotics active against the causal organism.

Are prophylactic antibiotics indicated after a urinary tract infection?

Many children with urinary tract infection (UTI) and urinary tract abnormality such as vesicoureteral reflux (VUR) are given prophylactic antibiotic to prevent recurrence of UTI and permanent kidney damage. Occasionally, children with normal urinary tract receive prophylactic antibiotic to alleviate the patient suffering and family inconvenience associated with recurrent symptomatic UTI. These recommendations are mostly opinion-based and are derived from studies that were not randomized and were done before the current renal imaging modalities became available. The purpose of this review is to discuss these recommendations in the context of recent research findings. Recent studies have raised serious doubts about the role of antibiotic prophylaxis after UTI by demonstrating the presence of preexisting renal scars without UTI in some patients, systematic reviews of published literature on UTI and VUR, and by comparing randomized patients with VUR who received antibiotic prophylaxis with those who did not receive any prophylaxis. However, the new knowledge has also highlighted that,apart from skillful management of individual patients, well designed studies are needed to answer the questions on antibiotic prophylaxis across the spectrum of UTI in different clinical situations. One such study currently underway is the Randomized Intervention for Children With Vesicoureteral Reflux (RIVUR) study, which will evaluate the role of antibiotic prophylaxis in preventing recurrent UTI and renal scarring in young children with VUR. It is advisable that, until the results of more appropriately designed studies become available, UTI in young children is considered as a risk factor for renal scarring and each patient is treated with prudence.

Antibiotics and Resistance of Uropathogens

This article shall give an overview of the commonly used antibiotics in urological practice, their resistance rates and the resistance mechanisms of uropathogens. The bacterial spectrum of urinary tract infections and the resistance rates of uncomplicated community acquired and complicated, nosocomially acquired uropathogens can differ substantially from region to region and over time. The results from different surveillance studies are evaluated and exemplary the resistance rates of uropathogens in the last ten years of our institution are reflected. Especially the increasing resistance of enterobacteria to fluoroquinolones is notable. Antibiotics are widely used in urological practice for the need of modern medicine and therefore antibiotic resistance is of increasing importance for the urologist. Knowledge of resistance rates is paramount for empirical antimicrobial therapy. A basic understanding of the resistance mechanisms is of great help in this respect.

HOW USEFUL ARE RAPID SCREENS FOR URINARY TRACT INFECTION

Recent studies have clarified the spectrum of urinary tract infections. We now know that in many cases patients have low bacterial counts and are infected with several species of organisms. Recently, several companies have marketed …

Urinary infection in kidney transplantation

Urinary tract infection is the most frequent complication following renal transplantation and is important in the etiology of post-transplantation sepsis. The 87 renal homografts done in 1974 at The New York Hospital-Cornell Medical Center were reviewed retrospectively, with at least one year follow-up, in all cases, with particular attention to factors relating urinary tract infection to ultimate success or failure of the renal graft. The over-all incidence of urinary tract infection was 61 per cent. Early infection was associated with a particularly poor prognosis for graft survival. Most patients with urinary infections after successful transplantation experience a combination of both early and late infections. Anatomic factors constitute a remediable cause of urinary infections after transplantation and should be searched for in cases of multiple, recurrent infections, de novo hypertension, or deterioration of previously stable graft function. There were significant differences in the bacteriologic spectrum of urinary tract infections associated with successful transplants as opposed to unsuccessful transplants.