Urinary Infection Research Articles

Cefdinir vs cephalexin for the treatment of urinary tract infections: A retrospective evaluation.

Cefdinir and cephalexin are cephalosporin antibiotics commonly used in the treatment of urinary tract infections (UTIs). Their efficacy depends on achieving sufficient time with concentrations exceeding the minimum inhibitory concentration (MIC). Despite being frequently prescribed for UTIs, cefdinir has markedly lower urine penetration compared to cephalexin. It is possible that differences in pharmacokinetics could result in dissimilar efficacy between these agents; however, comparative studies of cephalosporins in UTIs are lacking. This was a retrospective comparative study of patients discharged from emergency departments within a community health system with a diagnosis of acute cystitis who were prescribed cefdinir or cephalexin. Treatment failure rates at 7 and 14 days were compared between the 2 agents using a χ2 or Fisher's exact test, as appropriate. There were no differences in overall treatment failure between the cefdinir and cephalexin groups. Treatment failure at 7 days occurred in 11.6% (n = 14) of patients in the cefdinir group and 8.3% (n = 10) of patients in the cephalexin group (P = 0.389). Treatment failure at 14 days was higher for cefdinir at 20.7% (n = 25) than for cephalexin at 11.8% (n = 14), but this difference was not statistically significant (P = 0.053). There were no differences in the rate of treatment failure in subgroup analyses of uncomplicated or complicated UTIs. The results of this study suggest that cefdinir and cephalexin have comparable efficacy for the treatment of lower UTIs. While there was a numerically higher rate of treatment failure with cefdinir, there were no significant differences in treatment failure between the agents.

Improving the antibiotic duration of therapy with the implementation of antimicrobial lanyard cards and education in a regional hospital

AbstractBackgroundThere is increasing evidence to support reducing antibiotic duration of therapy (DoT). The Therapeutic Guidelines: Antibiotic (version 16 [TG]) have been updated accordingly. However, these recommendations are not consistently followed.AimThe project aimed to reduce antibiotic DoT for common infections using antimicrobial lanyard cards and education.MethodA retrospective pre‐ and post‐implementation audit was undertaken to examine whether antimicrobial stewardship education and lanyard cards defined DoT per infection and severity in accordance with the TG improved antibiotic DoT for common respiratory, urinary, abdominal, and skin infections. Cards were distributed to doctors and pharmacists, with education delivered by an antimicrobial stewardship (AMS) pharmacist. This project was exempt due to the local policy requirements that constitute research by the Darling Downs Hospital and Health Service Human Research Ethics Committee (Reference no: EX/2022/QTDD/86644). The justification for this ethics exemption was as follows: the study conformed with the National Health and Medical Research Council (NHMRC) Ethical considerations in quality assurance and evaluation activities; education was incorporated as part of routine, scheduled sessions ran at Toowoomba hospital and staff were provided with information on the project as part of the education; consent was not required from staff to attend the education nor for using the lanyard cards; the research did not include any assessment of the education program, use of lanyard cards, or involvement of staff.ResultsFor all patients an improvement was found in the percentage of antibiotics prescribed per the TG (55–72%, p = 0.0095). This included statistically significant differences for respiratory (42–89%, p = 0.0002), but not for urinary (87–91%, p = 0.99), skin (58–77%, p = 0.3039), or abdominal infections (48–44%, p = 0.6990). The mean total excess treatment days decreased across all infections from 1.86 to 0.95 days (p = 0.0036, 95% confidence interval = −1.52 to −0.30).ConclusionThe introduction of antibiotic DoT cards, with AMS education, can improve antimicrobial prescribing in line with the TG in a regional hospital.

Plant-Origin Components: New Players to Combat Antibiotic Resistance in Klebsiella pneumoniae.

Klebsiella pneumoniae (Kpn) is an opportunistic pathogen that causes intrahospital complications such as pneumonia, liver abscesses, soft tissue infections, urinary infections, bacteraemia, and, in some cases, death. Since this bacterium has a higher frequency than other Gram-negative pathogens, it has become an important pathogen to the health sector. The adaptative genome of Kpn likely facilitates increased survival of the pathogen in diverse situations. Therefore, several studies have been focused on developing new molecules, synergistic formulations, and biomaterials that make it possible to combat and control infections with and dispersion of this pathogen. Note that the uncontrolled antibiotic administration that occurred during the pandemic led to the emergence of new multidrug-resistant strains, and scientists were challenged to overcome them. This review aims to compile the latest information on Kpn that generates intrahospital infections, specifically their pathogenicity-associated factors. Furthermore, it explains the natural-product-based treatments (extracts and essential oils) developed for Kpn infection and dispersion control.

Sensitivity profile of pathogens identified in the diagnosis of urinary infection by uroculture carried out at the National Institute for Health Research, Luanda/Angola, during the pre - pandemic, intra - pandemic and post - pandemic of COVID 19

Urinary tract infection (UTI) is an infectious disease that affects any part of the urinary system, including the kidneys, ureters, bladder, and urethra. Antimicrobial resistance (AMR) is currently a public health problem. To understand the antibiotic susceptibility profile of microorganisms isolated in urine samples at the reference microbiology laboratory in Luanda/Angola from 2016-2022 (pre-pandemic, pandemic, and post-pandemic). Methodology: A descriptive, quantitative, documentary study was carried out using a survey of secondary data, based on the results of urocultures from patients with a suspected diagnosis of UTI. A total of 2,800 (50.99%) were studied (n=5,491) and confirmed as having a UTI. From 2016 to 2019, 2,060 were confirmed; in 2020, 51 cases were investigated and 24 (0.86%) were confirmed. In 2022, corresponding to the period after the COVID-19 pandemic, a total of 246 patients (8.78%) had a confirmed urinary tract infection. In general, in all periods, the most sensitive drugs were amikacin, fosfomycin, norfloxacin, nalidixic acid, tobramycin, akanamycin and cefotaxime. Females and the E. coli strain followed by proteus vulgaris and mirabilis and the 20-29 and 30-39 age groups were the most prevalent.

Novel Genetic and Phenotypic Expansion in Ameliorated PUF60-Related Disorders.

Heterozygous variants in the Poly(U) Binding Splicing Factor 60kDa gene (PUF60) have been associated with Verheij syndrome, which has the key features of coloboma, short stature, skeletal abnormalities, developmental delay, palatal abnormalities, and congenital heart and kidney defects. Here, we report five novel patients from unrelated families with PUF60-related disorders exhibiting novel genetic and clinical findings with three truncating variants, one splice-site variant with likely reduced protein expression, and one missense variant. Protein modeling of the patient's missense variant in the PUF60 AlphaFold structure revealed a loss of polar bonds to the surrounding residues. Neurodevelopmental disorders were present in all patients, with variability in speech, motor, cognitive, social-emotional and behavioral features. Novel phenotypic expansions included movement disorders as well as immunological findings with recurrent respiratory, urinary and ear infections, atopic diseases, and skin abnormalities. We discuss the role of PUF60 in immunity with and without infection based on recent organismic and cellular studies. As our five patients showed less-severe phenotypes than classical Verheij syndrome, particularly with the absence of key features such as coloboma or palatal abnormalities, we propose a reclassification as PUF60-related neurodevelopmental disorders with multi-system involvement. These findings will aid in the genetic counseling of patients and families.

Incidence and risk factors of stress urinary incontinence after laparoscopic hysterectomy

ObjectiveTo observe the long-term effects of total hysterectomy on urinary function, evaluate the effects of preoperative nutritional status, urinary occult infection, and surgical factors on the induction of postoperative stress urinary incontinence (SUI), and explore the incidence and risk factors of SUI.Study designFrom January 2017 to December 2017, 164 patients with benign non-prolapsing diseases who underwent a laparoscopic total hysterectomy in the First People's Hospital of Taicang were selected as the analysis objects. The International Incontinence Standard Questionnaire for Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) and Pelvic Floor Impact Questionnaire-short version 20 (PFDI-20) were used for telephone follow-up to subjectively assess the urinary function of patients, collect their medical records, and statistically analyze the number of postoperative SUI cases. Logistic multivariate analysis was used to analyze the influencing factors of postoperative female SUI, presented as adjusted odds ratios with 95% confidence intervals.ResultsOnly 97 out of 164 patients completed the ICIQ-FLUTS and PFDI-20 questionnaires. Among these participants, 28 patients (28.86%) were diagnosed with SUI (study group), while 69 patients (71.13%) were classified as women without SUI (control group). The age, menopause, parity ≥ 2 times, Body mass index (BMI) ≥ 28 kg/m2, neonatal weight ≥ 4000 g, history of chronic cough, preoperative hemoglobin ≤ 100 g/L, preoperative urine bacteria ≥ 100u/L, preoperative uterine volume ≥ 90 cm3, intraoperative blood loss, and operation time of the study group were compared with those of the control group. The differences were statistically significant (P < 0.05). Further Logistic multivariate analysis showed that menopause, preoperative hemoglobin ≤ 100 g/L, preoperative urine bacteria ≥ 100u/L, uterine volume ≥ 90 cm3, history of chronic cough, BMI ≥ 28 kg/m2 were risk factors for postoperative SUI in patients undergoing hysterectomy (P < 0.05).ConclusionsHysterectomy for benign non-prolapse diseases has a long-term potential impact on the urinary system of patients, and the risk of postoperative SUI increases. The main risk factors of SUI are parity, menopausal status, obesity, preoperative nutritional status, and occult infection of the urinary system.

Suspected Hematuria: Adverse Effects of Rivaroxaban in Older Adult Treated for Atrial Fibrillation

Background: The modern concept of pharmaceutical healthcare implies monitoring the pharmacotherapy outcomes and reporting adverse drug reactions. Objective: To present a suspected hematuria as the adverse rivaroxaban reaction in a patient with atrial fibrillation observed by pharmacists in a community pharmacy. Case presentation: A 69-year-old female patient came to a pharmacy with a prescription for cranberry-based supplement. She was diagnosed with a mild urinary infection after experiencing blood in her urine for about two weeks. The pharmaceutical anamnesis revealed that the patient was treated with irbesartan and rivaroxaban. Rivaroxaban was applied for atrial fibrillation, and the patient was treated for nine months. The patient was treated with omeprazole gastro-resistant capsules for mild dyspepsia and stomach ache over a three-week period. The pharmacist counselled the patient to contact the clinician who introduced rivaroxaban, further suggesting substitution with different anticoagulant. Although the urine culture was negative, the physician introduced ciprofloxacin, which was followed by blood in the patient’s stool. Thus, gastroscopy, colonoscopy, and gynecological examination were advised. All findings were normal. Four days after rivaroxaban was substituted with acenocoumarol, no blood in the urine or stool was detected. Conclusions: Rivaroxaban can cause spot urine blood even when applied in therapeutic doses among older female patients when applied with omeprazole. Possible rivaroxaban interaction with omeprazole metabolites is suspected and should be carefully monitored.

Fabrication of levofloxacin-loaded porcine acellular dermal matrix hydrogel and functional assessment in urinary tract infection

Bacterial cystitis, a commonly occurring urinary tract infection (UTI), is renowned for its extensive prevalence and tendency to recur. Despite the extensive utilization of levofloxacin as a conventional therapeutic approach for bacterial cystitis, its effectiveness is impeded by adverse toxic effects, drug resistance concerns, and its influence on the gut microbiota. This study introduces Lev@PADM, a hydrogel with antibacterial properties that demonstrates efficacy in the treatment of bacterial cystitis. Lev@PADM is produced by combining levofloxacin with decellularized porcine acellular dermal matrix hydrogel and exhibits remarkable biocompatibility. Lev@PADM demonstrates excellent stability as a hydrogel at body temperature, enabling direct administration to the site of infection through intravesical injection. This localized delivery route circumvents the systemic circulation of levofloxacin, resulting in a swift and substantial elevation of the antimicrobial agent’s concentration specifically at the site of infection. The in vivo experimental findings provide evidence that Lev@PADM effectively prolongs the duration of levofloxacin’s action, impedes the retention and invasion of E.coli in the urinary tract, diminishes the infiltration of innate immune cells into infected tissues, and simultaneously preserves the composition of the intestinal microbiota. These results indicate that, in comparison to the exclusive administration of levofloxacin, Lev@PADM offers notable benefits in terms of preserving the integrity of the bladder epithelial barrier and suppressing the recurrence of urinary tract infections.Graphical

Mechanisms of oxidative stress in interstitial cystitis/bladder pain syndrome.

Interstitial cystitis/bladder pain syndrome (IC/BPS) is characterized by bladder and/or pelvic pain, increased urinary urgency and frequency and nocturia. The pathophysiology of IC/BPS is poorly understood, and theories include chronic inflammation, autoimmune dysregulation, bacterial cystitis, urothelial dysfunction, deficiency of the glycosaminoglycan (GAG) barrier and urine cytotoxicity. Multiple treatment options exist, including behavioural interventions, oral medications, intravesical instillations and procedures such as hydrodistension; however, many clinical trials fail, and patients experience an unsatisfactory treatment response, likely owing to IC/BPS phenotype heterogeneity and the use of non-targeted interventions. Oxidative stress is implicated in the pathogenesis of IC/BPS as reactive oxygen species impair bladder function via their involvement in multiple molecular mechanisms. Kinase signalling pathways, nociceptive receptors, mast-cell activation, urothelial dysregulation and circadian rhythm disturbance have all been linked to reactive oxygen species and IC/BPS. However, further research is necessary to fully uncover the role of oxidative stress in the pathways driving IC/BPS pathogenesis. The development of new models in which these pathways can be manipulated will aid this research and enable further investigation of promising therapeutic targets.

Beta-Lactam Resistance and Phenotypic Detection of Extended-Spectrum Beta-Lactamase in Entero bacteriaceae Isolated from Community-Acquired Urinary Tract Infections

Introduction: Urinary tract infections can affect all individuals, regardless of gender and age, occupying a prominent place in nephrological pathology. The biggest problem is that a pathology with a wide range of antibiotics and other hygiene measures that can remedy it, remains so frequent with sometimes serious complications that can compromise the vital prognosis.&#x0D; Objectives: To determine antibiogram profile of enterobacteria in urinary infections.&#x0D; Methodology: This is a cross-sectional study with an analytical aim of enterobacteria isolated from urinary infections from samples from patients of all ages from January 1, 2020 to October 21, 2022.&#x0D; Results: the isolated enterobacteria strains presented high rates of resistance, i.e. 92.61% for Ampicillin, 47.94% for cefadroxil, 45.14% for cefuroxime and 46.46% for cefotaxime, 72.86% for amoxicillin and 40.44% for amoxicillin + clavulanic acid. Qualitative detection of extended spectrum Beta Lactamase was generally evaluated at 24.8% with peaks for Citrobacter sp, Klebsiella sp and E coli. For the latter, cross-resistance to quinolones was evaluated in proportions ranging from 49.45% to 85.51%.&#x0D; Conclusion: This study shows that the level of resistance of enterobacteria to beta-lactams is very high. We have observed co-resistance between beta-lactams and quinolones, antibiotics commonly used against Gram-Negative bacteria. This observation requires an improvement in the antibiotic management policy.

The Impact of Glycemic Control on Sodium-Glucose Co-Transporter 2 Inhibitor-Associated Genitourinary Infections.

Patients with type 2 diabetes (T2D) are at an increased risk of genital urinary (GU) infections, with the risk increasing with higher A1Cs. Given the broad adoption of sodium-glucose co-transporter 2 inhibitors (SGLT2is) in patients with T2D, both providers and patients need to be aware of common adverse effects associated with these medications, specifically GU infections. However trials involving SGLT2is looked at patients with an average A1C of less than 9%, and thus, the incidence of GU infections may not truly reflect the general diabetic population. The purpose of this study is to assess the association between GU infections in patients started on SGLT2is and A1C levels. A retrospective study was conducted on patients seen in an adult, primary care clinic, at New York City Health and Hospitals, South Brooklyn Health. Men and nonpregnant, nonlactating women >18 years old with a diagnosis of T2D who were initiated on an SGLT2i between January 2018 and January 2023 were included in the analysis. The primary endpoint is to compare the risk of GU infections in patients with T2D who were started on SGLT2is, regardless of dose, with hemoglobin A1C of >9% to those with hemoglobin A1C <9% at baseline. Three hundred and twenty-eight patients were eligible based on specified inclusion and exclusion criteria. Overall, there was a statistically significant difference in the number of GU infections that occurred in patients with a baseline A1C >9% compared with those with an A1C <9% (95% confidence interval [CI] = 1.05-2.88; P = 0.041). Type 2 diabetes patients initiated on SGLT2is may experience an increased risk of GU infection, especially in those patients with an A1C of 9% or greater. Further research is necessary to validate and expand upon these findings.

Proteomic profiles of Leptospira borgpetersenii serovar Hardjo strains JB197 and HB203 cultured at different temperatures

Leptospirosis is a global zoonotic disease affecting humans, domestic, and wild animals. Leptospira are typically shed in the urine of reservoir hosts which persist in suitable environments where incidental host transmission occurs after direct contact with infected urine or contaminated environments. Interestingly, serologically identical L. borgpetersenii serovar Hardjo strains JB197 and HB203 show divergent disease severity in the hamster model; JB197 causes severe acute infection while HB203 causes persistent chronic infection. Historically, serovar Hardjo was limited to culture at 29 °C, but utilization of HAN media allows propagation from host tissues at 37 °C. Here, the proteome of strains JB197 and HB203 were characterized after culture from experimentally challenged hamsters at 29 °C and 37 °C. Comparative analyses of JB197 and HB203 samples cultured at 29 °C yielded 425 significantly differentially expressed (DE) proteins, while strains at 37 °C yielded 613 DE proteins including prominent outer membrane proteins and known virulence factors. In agreement, membrane protein GO terms were identified by STRING network analyses along with numerous metabolic KEGG pathways consistent with condition differences. Within strain, JB197 cultured at 29 °C vs 37 °C identified 529 DE proteins, while HB203 identified 524 DE proteins. Investigating differential protein profiles provide insights into strain specific behaviors with implications for better understanding host-pathogen interactions, disease transmission, and response to environmental conditions which can contribute to vaccine development, diagnostic improvement, and ultimately leptospirosis control. SignificanceLeptospirosis is a devastating zoonotic disease affecting humans, wild and domestic animals around the globe. Different species and serovars of Leptospira can affect various animal host species differently; for instance, a serovar that is asymptomatic in the rat may cause severe disease in a dog or human. These differences in host response are not only found at the species and serovar level for Leptospira, but also at the strain level. A prime example comes from strains JB197 and HB203, both species L. borgpetersenii, both serovar Hardjo. Interestingly, JB197 causes a severe acute infection in the hamster while HB203 causes an asymptomatic chronic infection. Understanding these unique relationships between pathogen and host species is important, especially in the context of prevention technologies such as vaccine design, where the strain of Leptospira used as a bacterin might have different efficiencies in different hosts. In this study, proteomic profiles of strains JB197 and HB203 were analyzed, and results revealed diverse protein expression profiles of outer membrane proteins, as well as proteins functioning in motility and growth.

Novel Antimicrobial Approaches to Combat Bacterial Biofilms Associated with Urinary Tract Infections.

Urinary tract infections (UTIs) are prevalent bacterial infections in both community and healthcare settings. They account for approximately 40% of all bacterial infections and require around 15% of all antibiotic prescriptions. Although antibiotics have traditionally been used to treat UTIs for several decades, the significant increase in antibiotic resistance in recent years has made many previously effective treatments ineffective. Biofilm on medical equipment in healthcare settings creates a reservoir of pathogens that can easily be transmitted to patients. Urinary catheter infections are frequently observed in hospitals and are caused by microbes that form a biofilm after a catheter is inserted into the bladder. Managing infections caused by biofilms is challenging due to the emergence of antibiotic resistance. Biofilms enable pathogens to evade the host's innate immune defences, resulting in long-term persistence. The incidence of sepsis caused by UTIs that have spread to the bloodstream is increasing, and drug-resistant infections may be even more prevalent. While the availability of upcoming tests to identify the bacterial cause of infection and its resistance spectrum is critical, it alone will not solve the problem; innovative treatment approaches are also needed. This review analyses the main characteristics of biofilm formation and drug resistance in recurrent uropathogen-induced UTIs. The importance of innovative and alternative therapies for combatting biofilm-caused UTI is emphasised.

Diagnostic and treatment patterns in urinary and genital tract infections: insights from a referral clinic in Beirut, Lebanon.

Urinary Tract Infections (UTIs) and Genital Tract Infections (GTIs) are common yet serious health concerns. Precise diagnosis is crucial due to the potential severe consequences of misdiagnosis. This study aims to distinguish between UTIs and GTIs, highlighting the importance of accurate differentiation. The study encompassed 294 patients, categorized into 4 groups: Group GNI (no infection, N = 57), Group GUI (urinary infection, N = 52), Group GGI (genital infection, N = 139), and Group GGUI (both infections, N = 46). Methods included patient interviews, clinical examinations, and laboratory tests such as urine and vaginal swab cultures. The investigation revealed no significant differences in age, BMI, residency, or nationality across groups. However, socioeconomic status varied, with Group GNI having the lowest proportion of low socioeconomic status. In obstetrical characteristics, non-pregnancy rates were higher in Groups GUI and GGUI, with GGUI showing a notably higher abortion rate. Symptom analysis indicated lower symptom prevalence in Group GNI, with pain, itching, pruritus, and vaginal discharge being less frequent, suggesting a link between infection presence and symptom severity. Treatment patterns showed higher usage of ciprofloxacin, antifungals, and vaginal tablets in Groups GUI and GGUI. Laboratory findings highlighted significant Leucocyte Esterase presence and variations in WBC and RBC counts, particularly in Group GGUI. The study emphasizes the need for advanced diagnostic techniques, especially those focusing on individual microbial patterns, to enhance UGTI diagnosis. Variations in symptom presentation and treatment across groups underline the necessity for personalized diagnostic and treatment strategies.

Incidence of Urinary Infections and Behavioral Risk Factors.

This evaluation of the impact of behavioral risk factors on the incidence of urinary infections was based on a questionnaire in which 1103 respondents, predominantly women (883), participated. From the statistical processing of the data, it was observed that 598 of the respondents were of normal weight; the rest, more than half, were underweight or overweight (χ2 = 32.46, p < 0.001), with male respondents being predominantly overweight or obese (169 out of a total of 220). Most of the respondents were young (χ2 = 15.45, p < 0.001), under the age of 45 (840). According to the processed data, it was found that respondents in the age group of 26-35 years showed the greatest vulnerability to recurrent urinary infections, while the age group of 18-25 years recorded the highest number of responses related to the rare presence or even absence of episodes of urinary infections. A body weight-related vulnerability was also noted among the respondents; the majority of obese people declared that they face frequent episodes of urinary infections. Regarding diet quality, 210 respondents reported an adherence to an unhealthy diet, 620 to a moderately healthy diet, and 273 to a healthy diet. Of the respondents who adhered to a healthy diet, 223 were women (χ2 = 2.55, p = 0.279). There was a close connection between diet quality and the frequency of urinary infections: from the statistical processing of the data, it was observed that the highest percentage of respondents who rarely (57.14%) or never got urinary infections (29.30%) were among those who adhered to a healthy diet, and the highest percentage of those who declared that they often got urinary infections were among those with increased adherence to an unhealthy diet (χ2 = 13.46, p = 0.036). The results of this study highlight a strong impact of obesity, reduced consumption of fruit and vegetables, and sedentary lifestyle on the risk of recurring urinary infections.

Effectiveness of flower of jamaica and arandano (red) in women with urinary infection

· Recibido: 18 de agosto de 2023 · Arbitrado: 5 de septiembre de 2023 · Aceptado: 30 de octubre de 2023 · Publicado: 1 de febrero de 2024 Adult women over 50 years of age are prone to having urinary infections due to different factors such as underlying disease, malnutrition, poor quality of life and bacteria. Therefore, we set ourselves the following objective: to determine the effectiveness of ingesting hibiscus flower and cranberry (red) in women with urinary tract infection between 50 and 80 years of age in the city of Santa Cruz. For which an experimental method was used, it was based on selecting women with symptoms of urinary tract infections (UTI) and giving them as a preventive method the ingestion of blueberries and Jamaica flower for 45 days. The consumption of cranberry extract and hibiscus flower infusion, the answers they gave to the survey questions: What was used as a variable, is that in the 45 days of consumption they felt improvement and were no longer recurrent to having urinary infections. Its effectiveness has been demonstrated as a preventive method for urinary infections in older women.

Efficacy of Plant Extracts against Aphid &lt;i&gt;Lipaphis erysimi&lt;/i&gt; (Kalt) in Brown Mustard &lt;i&gt;Brassica juncea&lt;/i&gt; L

Brown mustard is one of the widely consumed leafy vegetables in Sikkim, India. The present investigation was an effort to find out an alternative approach to control aphid incidence organically, by using locally available plant extracts with high spray efficacy on mustard aphid Lipaphis erysimi (kalt) in the organic state of Sikkim. The experiment included six plant extracts viz. Schima wallichii, Datura stramonium, Athyrium filix-femina, Piper betle, Alnus nepalensis and Artemisia vulgaris along with cow urine and neem oil at two concentrations. Results revealed that maximum reduction in incidence was observed with Schima wallichii @5%. Growth, yield and quality components were also found to be significantly superior in the treatment with S. wallichii.

The Impact of Sulfa Allergy Label on Clinical Outcomes of Patients with Acute Cystitis

The Impact of Sulfa Allergy Label on Clinical Outcomes of Patients with Acute Cystitis

A machine learning-based nomogram model for predicting the recurrence of cystitis glandularis.

Cystitis glandularis is a chronic inflammatory disease of the urinary system characterized by high recurrence rates, the reasons for which are still unknown. This study aims to identify potential factors contributing to recurrence and propose a simple and feasible prognostic model through nomogram construction. Patients with confirmed recurrence based on outpatient visits or readmissions were included in this study, which was subsequently divided into training and validation cohorts. Machine learning techniques were utilized to screen for the most important predictors, and these were then employed to construct the nomogram. The reliability of the nomogram was assessed through receiver operating characteristic curve analysis, decision curve analysis, and calibration curves. A total of 252 patients met the screening criteria and were enrolled in this study. Over the 12-month follow-up period, the relapse rate was found to be 57.14% (n = 144). The five final predictors identified through machine learning were urinary infections, urinary calculi, eosinophil count, lymphocyte count, and serum magnesium. The area under curve values for all three time points assessing recurrence exceeded 0.75. Furthermore, both calibration curves and decision curve analyses indicated good performance of the nomogram. We have developed a reliable machine learning-based nomogram for predicting recurrence in cystitis glandularis.

Analysis of pathogen distribution and associated risk factors for surgical site infections following laparoscopic urological surgeries

AbstractSurgical site infections (SSIs) pose a significant complication following laparoscopic urological surgeries, impacting patient recovery and healthcare resources. Understanding the pathogen distribution and identifying associated risk factors for SSIs is critical for improving surgical outcomes. A retrospective analysis was performed on 90 patients, from March 2020 to June 2023, to investigate the risk factors and pathogen profiles in SSIs post‐laparoscopic urological procedures. Patients with documented infections were compared to a control group without SSIs. Data on demographics, comorbidities and perioperative variables were collected. Pathogens were identified using the VITEK‐2 Compact system. Statistical analyses included univariate and multivariate logistic regression models. Upon evaluation, demographic and clinical characteristics showed no significant variance in patients with SSIs compared to those without such infections. The predominant pathogen identified was Escherichia coli. Administration of prophylactic antibiotics correlated with a reduced incidence of SSIs, whereas an array of risk factors including surgery duration of 2 h or more, anaemia, white blood cell counts exceeding 10 × 109/L, a history of urinary tract infections, the presence of diabetes mellitus and incidences of urinary leakage post‐surgery were identified as contributors to a heightened risk of SSIs. Prophylactic antibiotics serve as a protective factor against SSIs, whereas several modifiable risk factors, including operation duration, anaemia, elevated leukocytes, history of urinary infections, diabetes and urinary leakage, contribute to the increased risk.