Symptomatic Urinary Tract Infection Research Articles

Factors associated with symptomatic urinary tract infection in persons with spinal cord lesions who perform clean intermittent catheterization with single-use catheters.

To investigate factors associated with symptomatic urinary tract infection (sUTI) in persons with chronic spinal cord lesion (SCL) who were using single-use catheters for intermittent self-catheterization (ISC). Among respondents to an internet survey on the burden of illness on persons with SCL who were considered to be able to perform ISC, 111 persons using single-use catheters were included to examine factors associated with self-reported sUTI by univariate as well as multivariable analysis. The incidence of sUTI was significantly higher in males than in females (56.9% vs. 31.6%, p = .011), persons with stocks of antibiotics than those without it (82.9% vs. 28.6%, p < .011), and persons with more frequent bleeding during catheterization than those with less frequent bleeding (100% vs. 46.5%, p = .036). The incidence did not significantly differ between respective groups when various variables were evaluated by other characteristics of the participants, adherence to ISC procedures, and complications. On multivariable analysis, male gender and stocks of antibiotics were significant independent factors for sUTI. Male gender and stocks of antibiotics were associated with sUTI in persons with SCL who were performing ISC with single-use catheters.

Self-reported urinary tract infection and bacterial vaginosis symptoms among indigenous adolescents during seasonal periods of water scarcity: A cross-sectional study in Bandarban Hill District of Bangladesh.

Water scarcity and poor water quality could lead to suboptimum menstrual hygiene practices, and subsequently urinary tract infection (UTI) and bacterial vaginosis (BV). In this study, we estimate the prevalence of self-reported UTI and BV among indigenous adolescent girls during the water scarcity period in the Bandarban Hill Districts in south-eastern Bangladesh. Using a cross-sectional design, a total of 242 indigenous adolescent girls were selected and interviewed during the seasonal water scarcity period (from February to May 2022) in Bandarban. The difference in prevalence of any self-reported UTI or BV symptoms by respondents' characteristics was assessed by χ 2 test. Multivariable logistic regression model was used to observe the associated factors. The prevalence of self-reported UTI, BV, and any symptoms of UTI or BV among the respondents were 35.54%, 28.93%, and 43.80%, respectively. Ethnicity, studentship status, source of water used for menstrual hygiene, and perceived water quality were significantly associated with the prevalence of any self-reported UTI or BV symptoms. Findings recommend further research to cross-check the validity of self-reported prevalence and investigate if the episodes of UTI or BV could be attributable to water scarcity and poor water quality in study areas during dry period.

Antibiotic Resistance of Bacteria isolated in Urinary Tract Infections

Abstract Objectives: This study aimed to examine the relationships between isolated bacterial agents, age, and gender, as well as antibiotic resistance of UTI isolates, in addition to investigate the antibiotic resistance in a section of Iraqi patients with UTI.  Methods: Isolates (885) from patients and outpatients with symptomatic urinary tract infections at Al-Sadder teaching hospital in Basra province, southern Iraq, from January to August 2022.  Results: The results of patient specimens cultured on appropriate culture media indicate that the number of negative cultures was 528 while the number of positive cultures was 357; females are more susceptible to UTIs than males (170). The age category 60 years had the highest infection rate (31%), followed by 20-29 years (19.3%).  The most prevalent etiological agent was Escherichia coli (28.3%), followed by Staphylococcus spp. (19.3%), Candida albicans (14.9%), and Klebsiella pneumonia (14.9%). Conclusion: The results demonstrate that various bacteria exhibit variable degrees of sensitivity to different antibiotics, with the significant finding that the majority of urinary isolates were highly resistant to commonly used antibiotics.

Antibiotic resistance of microorganisms isolated from the urine of patients before surgical treatment for benign prostatic hyperplasia: results from a 7-year single-center study

Introduction. The tendency of microorganisms to develop resistance mechanisms is a widely discussed and significant problem worldwide. Studying regional differences in the qualitative characteristics of microorganisms provides valuable information for empirically preventing and treating infectious complications, as well as providing an enhanced understanding of the variability in microbial community properties within the clinical context of diseases and patients' comorbidity status.Objective. To assess the antibiotic resistance of microorganisms isolated in high titers from the urine samples of patients with benign prostate hyperplasia (BPH) prior to surgery.Materials &amp; Methods. This single-center, retrospective study conducted from March 2016 to February 2023 included 59 suprapubic-draining BPH-patients (Group I), 46 drainage-free BPH-patients with leukocyturia (Group II), and 44 drainage-free BPH-patients and no leukocyturia (Group III). Inclusion criteria: indications for BPH surgery, no history of sexually transmitted diseases, no symptoms of urinary tract infection, and no prostate cancer. The patient's voluntary informed consents to participate were also obtained.Results. The rates of resistance to ciprofloxacin in patients of Group I were statistically significantly higher compared to Group II (85.7% vs 55.6%, p = 0.002). Resistance of gram-negative microorganisms to meropenem and imipenem was higher in Group III compared to Group I (31.1% vs 13.7%, p = 0.006 for meropenem and 44.5% vs 9.8%, p = 0.001 for imipenem, respectively). Resistance of Gram-positive microorganisms to ampicillin in Groups I to III was 13.6%,6.3% and 20.0%, respectively with no significant difference between groups (p &gt; 0.05). However, there was extremely high resistance among verified Gram-positive organisms to all the drugs in the fluoroquinolone class (ciprofloxacin, norfloxacin, levofloxacin) ranged from 63.6% to 80.0%.Conclusion. The present study demonstrates that the isolation frequency of antibiotic-resistant microorganisms from the urine sample of drainage-free BPH-patients or no clinical and laboratory signs of inflammation in the urinary tract is high. The presence of antibiotic resistance provides risks for developing difficult-to-control infectious complications. Currently, assessment of urine-derived microbial antibiotic resistance should be considered in every BPH-patient with indications for surgical management of bladder outlet obstruction, regardless of the presence of risk factors.

Long-Term Care Healthcare-Associated Infections in 2023: An Analysis of 23,970 Reports

Background The Pennsylvania Patient Safety Reporting System (PA-PSRS) is the largest database of patient safety event reports in the United States. In addition to over 4.7 million acute care reports, the PA-PSRS database contains more than 420,000 long-term care (LTC) healthcare-associated infection (HAI) reports. Methods LTC HAI data from PA-PSRS were extracted on March 1, 2024. Infection counts were calculated based on report submission date and rates were calculated based on infection confirmation date. Reports submitted by LTC facilities and specific care areas were included for infection rates each month if resident and device days were also entered in PA-PSRS for the facility and care area. Results A total of 23,970 infection reports were submitted by Pennsylvania’s LTC facilities in 2023, representing an 18.6% increase from 2022. The overall infection rate increased by 11.4%, from 0.88 in 2022 to 0.98 in 2023, and all six regions of the state had an increase in infection rate. The Northeast region had the highest rate, with 1.28 reports per 1,000 resident days, and the Southeast region had the lowest rate, at 0.72. The overall rate increase was driven by rates of urinary tract infection (UTI) and skin and soft tissue infection (SSTI), which increased by 20.1% and 17.4%, respectively. Within the UTI infection type, symptomatic urinary tract infection (SUTI) rates increased by 21.1% and catheter-associated urinary tract infection (CAUTI) rates increased by 11.8%. Conclusion There was an increase in the total number and rate of infections reported to PA-PSRS in 2023.

A Hemagglutination, serum resistance, cell surface hydrophobicity and ESBL production among uropathogenic Escherichia coli

Abstract&#x0D; Background&#x0D; Bacteria have adapted themselves with increased pathogenesis and drug resistance mechanisms to overcome host defense systems. Uropathogenic E. coli (UPEC) responsible for symptomatic Urinary tract infections (UTIs) carry diverse virulence factors and extended spectrum beta-lactamase (ESBL) production which play pivotal role in pathogenesis and antibiotic resistance. Objective: The purpose of this study was to determine the phenotypic expression of virulence factors; i.e. Hemagglutination, serum resistance, cell surface hydrophobicity and resistance factor ESBL production among UPEC isolates. Methods: In this prospective study 50 drug resistant UPEC strains were evaluated for hemagglutination by slide method, cell surface hydrophobicity by salt aggregation test, serum resistance by serum bactericidal assay and ESBL detection by double disc synergy test. Results: Among 50 UPEC strains 46 (92%) showed mannose resistant hemagglutination, 48 (96%) were found to be serum resistant, 40 (80%) isolates were positive for cell surface hydrophobicity, while 43 (86%) were ESBL producers. Most of the UPEC that expressed virulence factors were ESBL producers as well. Conclusion: Over all, this study indicated that MDR UPEC isolates have expressed a number of virulence factors with ESBL production, which explains how pathogens have increased their virulence and resistance repertoire resulting in treatment failures.

21 The Microbial Antibiogram as a Function of Testing Indication: Susceptibility Analysis of Escherichia coli from Symptomatic and Asymptomatic Bacteriuria Patients, 2020-2021

OBJECTIVES/GOALS: Antibiograms are used to guide empiric antibiotic selection. However, it is unclear if antibiotic profiles differ between symptomatic urinary tract infections (UTIs) and asymptomatic bacteriuria (ASB). We aimed to compare antibiotic susceptibility profiles of urinary E. coli isolates from patients with a symptomatic UTI to those with ASB. METHODS/STUDY POPULATION: We conducted a cohort study of 1,140 urinary E. coli isolates from unique patients that received care through Vanderbilt University Medical Center (VUMC) from Nov 2020 – Jun 2021. We included any patient that was seen at VUMC as an inpatient, outpatient or at the emergency department with ≥ 105 colony forming units/mL E. coli detected from a clinical urine specimen. Chart abstractions were performed to capture reported UTI symptoms and demographic information. Descriptive statistics were conducted to compare antibiotic susceptibility profiles (i.e., susceptible, intermediate, resistant) between symptomatic and ASB groups. The risk of detection of a multidrug-resistant organism (MDRO) (intermediate, or resistant to at least one antibiotic in three or more classes) was assessed between groups. RESULTS/ANTICIPATED RESULTS: Among 1,140, 1,018 (89%) and 122 (11%) were symptomatic and ASB, respectively. When comparing symptomatic and ASB, the median ages were 50 and 46. Groups had similar proportions of no indwelling catheter (94% v. 95%) and without diabetes (87% v. 88%). The collection setting between inpatient, emergency department, and outpatient were similar with most being outpatient (79% v. 83%). The proportion of patients who were pregnant, immuno compromised, or had a structural/functional urinary tract abnormality were higher in the symptomatic group. The proportion of isolates resistant and susceptible to tested antibiotics were similar between groups, with only ciprofloxacin showing slightly higher resistance among ASB (16% v. 25%). The risk of MDRO detection was similar between groups (RR: 0.858, 95% CI: 0.64, 1.15). DISCUSSION/SIGNIFICANCE: Antibiotic susceptibility comparison demonstrated similar profiles, which suggests antibiogram use as appropriate to guide ASB treatment. Results offer insight on whether traditional methods for assessing antibiotic susceptibility on population-levels could benefit from further refinement by patient-specific clinical parameters.

Bacteriological profile, antimicrobial susceptibility, and factors associated with urinary tract infection in pregnant women.

Urinary tract infection (UTI) is a common bacterial complication in pregnancy. The study aimed to estimate the prevalence, risk factors, and bacterial etiology of UTI during pregnancy and determine the efficacy of antimicrobial drugs in treating UTIs. Urine specimens and clinical data were collected from pregnant women who attended primary health centers in Erbil, Iraq. All specimens were cultured on appropriate media and identified by standard microbiological methods. The pregnant women were grouped into symptomatic UTI group, asymptomatic bacteriuria group, and the control group. The agar dilution method was used to determine antimicrobial susceptibility. Among the 5,042 pregnant women included in this study, significant bacteriuria was found in 625 (12.40%) of the cases, and 198 (31.68%) had symptomatic UTI, of which 43.59% were diagnosed during the third trimester. Out of the 643 bacteria isolated, 33.28% were symptomatic UTI, of which 43.59% developed during the third trimester. There was a significant difference in the bacterial etiology between symptomatic UTI and asymptomatic bacteriuria (p = 0.002), as well as between cystitis and pyelonephritis (p = 0.017). The most common bacterial species isolated was Escherichia coli, which was susceptible to fosfomycin (100%), meropenem (99.45%), and nitrofurantoin (97.8%). Pregnant women are more likely to develop UTI in the third trimester. Escherichia coli is the predominant pathogen. The study suggests the use of fosfomycin, meropenem, and nitrofurantoin for the treatment of UTI. No Gram-positive isolates were resistant to daptomycin.

Occurrence and antimicrobial resistance patterns of bacterial and fungal pathogens from patients with urinary tract infections in Ojo, Lagos Nigeria

Urinary tract infections (UTIs) is a common bacterial and fungal infection affecting millions of people globally. The aim of this study was to investigate the distribution and antimicrobial susceptibility patterns of bacteria and fungi from patients with UTI. Urine samples were collected aseptically from patients with symptoms of UTI in sterile universal containers from five hospitals in a period of three months. A total of 200 urine samples from 75 males and 125 females were analyzed and subjected to culture, biochemical identification and antimicrobial susceptibility testing using the Kirby-Bauer technique. Fungal isolates were identified based on cultural characteristics, lactophenol cotton blue stain, chlamydospore formation, and colony colour on CHROM agar Candida medium. Most samples were positive for one microorganism each and a few had two isolates, thus giving a frequency of 210 microbial isolates. The most commonly isolated bacteria were Escherichia coli, 71(34%), followed by Staphylococcus aureus, 63(30%), Enterobacter spp., 32(15.2%), Klebsiella spp., 17(8.1%), Proteus mirabillis, 15(7.1%) and Candida albicans 12(5.7%), being the only fungus isolated. Antimicrobial susceptibility testing showed that Escherichia coli showed 57.7% susceptibility to streptomycin. Klebsiella spp. were 70.5% susceptible to septrin, but with susceptibility as low as 47.1% to chloramphenicol. Enterobacter spp. showed 71.9% susceptibility to septrin, 68.8% to gentamycin, 59.4% to streptomycin and chloramphenicol, 53.1%. Proteus spp showed 53.5%, and 66.7% to pefloxacin, septrin and streptomycin respectively. Staphylococcus aureus showed susceptibility of 56(88.9%), 55(87.3%), and 47 (74.6%) to gentamicin, ciprofloxacin. and pefloxacin respectively. Candida albicans was highly susceptible to nystatin, fluconazole and miconazole by 7(58.3%) but was highly resistant to ketoconazole, 41.7%. The findings of this study provide valuable information on the distribution of bacterial and fungal agents that are common etiology of UTIs, and likely antimicrobial drugs for the treatment of UTIs.

Urinary tract infections in very premature neonates: the definition dilemma.

Data on urinary tract infections (UTIs) in very preterm neonates (VPTNs) are scarce. We aimed to (i) describe the characteristics of UTIs in VPTNs and (ii) compare the diagnostic practices of neonatal clinicians to established pediatric guidelines. All VPTNs (<29 weeks GA) with a suspected UTI at the CHU Sainte-Justine neonatal intensive care unit from January 1, 2014, and December 31, 2019, were included and divided into two definition categories: Possible UTI, and Definite UTI. Most episodes were Possible UTI (87%). Symptoms of UTIs and pathogens varied based on the definition category. A positive urinalysis was obtained in 25%. Possible UTI episodes grew 2 organisms in 62% of cases and <50,000 CFU/mL in 62% of cases. Characteristics of UTIs in VPTNs vary based on the definition category and case definitions used by clinicians differ from that of established pediatric guidelines.

PERIOPERATIVE ANTIBIOTIC PROPHYLAXIS IN UROLOGICAL SURGERY: AN UPDATE SYSTEMATIC REVIEW

Background: Perioperative antibiotic prophylaxis (PAP) is provided to avoid local or systemic infections, such as surgical site infections (SSI), urinary tract infections (UTI), or sepsis. However, PAP may not be effective in reducing symptomatic UTI in some procedures, such as extracorporeal shock wave lithotripsy and cystoscopy. The aim: This study aims to determine the effectiveness of perioperative antibiotic prophylaxis in urological surgery. Methods: By comparing itself to the standards set by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. So, the experts were able to make sure that the study was as up-to-date as it was possible to be. For this search approach, publications that came out between 2014 and 2024 were taken into account. Several different online reference sources, like Pubmed, SAGEPUB, and ScienceDirect, were used to do this. It was decided not to take into account review pieces, works that had already been published, or works that were only half done. Results: In the PubMed database, the results of our search brought up 105 articles, whereas the results of our search on SAGEPUB brought up 6 articles, our search on ScienceDirect brought up 129 articles. In the end, we compiled 9 papers, 7 of which came from PubMed, and 2 of which came from ScienceDirect. We included nine research that met the criteria. Conclusion: Perioperative antibiotic prophylaxis (PAP) can lower SSI, UTI, and sepsis incidences in urological surgery. In addition, PAP showed a lower positive blood culture. To minimize side effects and lower the risk of drug-resistant organisms, the use of reasonable PAP is advised.

Degree of awareness and practices on urinary tract infections: A study of Sri Lankan school teachers selected from a chronic kidney disease high-prevalent setting.

As key stakeholders in educational settings, teachers' awareness on Urinary Tract Infections (UTI) will ultimately enhance its management in schools and community. This study aimed to assess the level of knowledge, attitudes, and practices (KAP) on UTIs among teachers in Sri Lanka. Conveniently selected 373 school teachers were assessed using a pre-tested questionnaire. Each of the individual was scored and categorized as either satisfactory or poor. Descriptive statistics and chi-square tests were performed to describe the outcomes. Around 80% of respondents demonstrated awareness regarding the microbial origin of UTIs, while 42% possessed knowledge of women's increased susceptibility to UTIs. Over 90% of participants had favorable attitudes toward drinking adequate amounts of water, personal hygiene, and consulting doctors for UTI symptoms. Each inquiry demonstrated significant disparities between individuals with satisfactory and poor attitudes (p = 0.000), with over 95% adhered to effective hygiene practices as a preventive measure against UTIs. The demographics of the participants did not show any significance over the KAP results of the study (p < 0.05). The study revealed satisfactory levels of awareness and favorable attitudes among respondents on UTIs. However, there is a further need for increased awareness, specifically regarding the risk factors associated with UTIs.

Relation of poverty with treatment-seeking behavior and antibiotic misuse among UTI patients in Pakistan.

The current study aimed to assess the relation between multi-dimension poverty, treatment-seeking behavior, and antibiotic misuse among urinary tract infection (UTI) patients. A cross-sectional approach was utilized to recruit patients who had a history of UTI in the previous month from two provinces of Pakistan. The treatment-seeking behavior and antibiotic misuse data were collected on a self-developed questionnaire, whereas the poverty data were collected on a modified multi-dimension poverty index (MPI). Descriptive statistics were applied to summarize the data. The logistic regression analysis was carried out to assess the association of multi-dimension poverty with patient treatment-seeking behavior and antibiotic misuse. A total of 461 participants who had UTI symptoms in the previous month were recruited. Most of the participants in the severely deprived stage treated the UTI (p < 0.001); however, there was a high proportion of the participants who consulted with friends and family for UTI treatment (p < 0.001). The patients with deprivation status (deprived and severely deprived) were less associated with formal consultation. The poorer subgroups were less likely to practice antibiotic course completion. The current study highlighted that poverty plays an important role in antibiotic misuse. Poorer subgroups were associated with informal consultations and the incompletion of the antibiotic course. Further studies are needed to explore the potential role of poverty in treatment-seeking behavior and antibiotic misuse.

Revelation of Specific Ferocity Genes in Escherichia coli Isolated from Patient with Urinary Tract Infections (UTIs)

Background:  The purpose of this research is to detect the occurrence of ferocity genes in uropathogenic E. coli that isolated from urinary tract infections by Polymerase chain reaction technique.  Method: A whole of five strains of E.coli were obtained from patient with urinary tract infections. Identification of E.coli was depended on colonial morphology in culture media, gram stain, and conventional biochemical tests.  ferocity factors genes (cnf-1, hly,urea A and ndv B) of E.coli strain were revelated by molecular technique. Results: ferocity genes were detected successfully by molecular technique in five isolates of E.coli, the predominance of  genes in isolates are seen in percentage    100% Conclusion: Urinary tract infections still the major universal infection in the worldwide. The one of the most prevalent infectious diseases induce renal failure in patients is UTI that generated by UPEC. The presence of ferocity factors are critical features where the grade of pathogenicity of UPEC strains relied on it. This study indicate that was a real relationship between the ferocity factor genes of E.coli  and clinical symptoms of UTI.

COMPREHENSIVE ANALYSIS OF CATHETER-ASSOCIATED URINARY TRACT INFECTIONS: RISK FACTORS, MICROBIAL DYNAMICS, AND ANTIMICROBIAL CHALLENGES IN A TERTIARY CARE SETTING

Introduction: Indwelling urinary catheters are frequently employed in medical procedures; yet, they pose a considerable risk, with catheter-associated urinary tract infections (CAUTIs) being a global healthcare challenge. CAUTIs account for 30–40% of nosocomial infections, contributing to heightened morbidity and mortality. Objective: Our objectives included investigating CAUTI incidence, exploring factors contributing to UTI risk, examining the correlation between bacteriuria and symptomatic CAUTI, and recording microbiological profiles and antibiotic sensitivities for insights into microbial dynamics and treatment strategies. Method: We aimed to assess patient and catheter-related factors influencing urinary tract infections (UTIs) in 105 catheterized patients. Results: Among the studied cohort, with an average age of 47.73 years, various catheter sizes were employed, and post-operative catheterization was the predominant indication. Microbial presence in urine samples was detected in 31.4% of cases, with a 21% prevalence of symptomatic UTIs. Diabetes mellitus showed a significant association with increased UTI occurrences (p=0.019). Notably, catheterization outside the operating theater (OT) and prolonged catheterization duration were significantly associated with increased infection rates (p=0.000 and p=0.003, respectively). Despite antibiotic treatment, Escherichia coli remained the most prevalent organism causing infection (17.1%), and antibiotic resistance trends were observed, highlighting the challenges of antimicrobial stewardship. Conclusion: The study emphasizes the importance of preventive measures, such as reducing catheterization duration and meticulous diabetes management, to mitigate the burden of CAUTIs. In conclusion, this study provides valuable insights into the prevalence, risk factors, and microbial dynamics of CAUTIs, urging a shift toward proactive prevention strategies and judicious antibiotic use to enhance patient outcomes and alleviate the strain on health-care resources.

Herbal Solutions for Urinary Tract Infections: A Literature Review

If treatment is not received, Urinary Tract Infections (UTIs), which are frequent microbial illnesses affecting the urinary system, can lead to discomfort and problems. Because they have antibacterial qualities and can potentially reduce UTI symptoms, natural treatments have been used. Supplements or juice made from cranberries are one popular natural treatment. Proanthocyanidins, which are found in cranberries, have the potential to inhibit bacteria, especially E. coli, from adhering to the lining of the urinary tract, hence decreasing the risk of infection. Its efficacy is still up for discussion, though, and certain drinks’ high sugar content may make UTI symptoms worse. D-mannose, a kind of sugar included in fruits like peaches and cranberries, is another commonly utilised treatment. D-mannose inhibits germs from sticking to the walls of the urinary system, in a manner akin to that of cranberries. It’s believed to be effective against E. coli, a common UTI-causing bacterium, but it’s ideal dosage and long-term effects require further research. Probiotics are thought to be helpful for UTIs, particularly those that contain lactobacilli strains. They may lessen the chance of infection by assisting in the maintenance of a balanced population of bacteria in the urinary tract and gut. There is, however, little data to support their direct influence on UTI treatment. Herbal treatments with possible antibacterial effects, such as buchu, goldenseal, and bearberry (uva-ursi), have been used historically. These herbs have ingredients that may aid in the battle against germs in the urinary system, but further research is needed to determine how safe and effective they are. Increasing water consumption is a simple yet effective treatment. Drinking enough water dilutes urine, which lowers the quantity of bacteria that could lead to an illness, and aids in the removal of bacteria from the urinary system. Even while these natural treatments seem promising for treating UTIs, it is important to see a doctor before using them, particularly if you think the illness may be serious. Certain medical issues may prevent the use of natural therapies, or they may interact negatively with medicines. When used as the only treatment for acute UTIs, they are frequently less successful than when used as preventative measures or in conjunction with traditional medicines. The main line of treatment for severe or persistent UTIs is still medical intervention with antibiotics to avoid complications and recurrent infections.

Uncovering Surface Penetration by Enterococci From Urinary Tract Infection Patients.

The relationship between Enterococcus faecalis vaginal colonization and urinary tract infections (UTIs) remains uncertain. We aimed to evaluate the surface invasion capability of E faecalis isolates from patients with and without UTIs as a potential readout of pathogenicity. Participants were females from urogynecology clinics, comprising symptomatic UTI and asymptomatic non-UTI patients, categorized by the presence or absence of E faecalis-positive cultures identified via standard urine culture techniques. Vaginal and urine samples from patients were plated on enterococci selective medium, and E faecalis isolates detected in both cohorts were species specific identified using 16S rRNA sequencing. Clinical isolates were inoculated on semisolid media, and both external colonies and underneath colony prints formed by agar-penetrating enterococci were imaged. External growth and invasiveness were quantified by determining colony-forming units of the noninvading and agar-penetrating cells and compared with the E faecalis OG1RF. We selected E faecalis isolates from urine and vaginal samples of 4 patients with and 4 patients without UTIs. Assays demonstrated that most isolates formed similarly sized external colonies with comparable colony-forming unit. Surface invasion differed across patients and isolation sites compared with OG1RF. The vaginal isolate from UTI patient 1, who had the most recurrences, exhibited significantly greater agar-invading capacity compared with OG1RF. Our pilot study indicates that ex vivo invasion assays may unveil virulence traits in E faecalis from UTI patients. Enhanced enterococcal surface penetration could increase urogenital invasion risk. Further research is needed to correlate penetration with disease severity in a larger patient group.

Healthcare Resource Utilization Following Minimally Invasive Sacrocolpopexy: Impact of Concomitant Rectopexy.

Combined surgical procedures with sacrocolpopexy (SCP) and rectopexy (RP) are more commonly being performed for treatment of multicompartment pelvic organ prolapse. This study aimedto compare healthcare resource utilization (HRU) within 6weeks following combined surgery (SCP-RP) versus SCP alone (SCP-only). We hypothesized that concomitant RP does not impact HRU. A retrospective cohort study of patients who underwent minimally invasive SCP from 2017 to 2022 was conducted at a tertiary referral center. Patients were grouped based on the performance of concomitant RP. HRU was defined as a composite of unscheduled office visits, emergency department visits, and readmissions before the 6-week postoperative visit. HRU was compared in the SCP-RP and SCP-only groups. Multivariable regression analysis was performed to identify factors associated with HRU. There were 144 patients in the SCP-RP group and 405 patients in the SCP-only group. Patient characteristics were similar betweenthe two groups, with the following exceptions: the SCP-RP group was older, more likely to have comorbid conditions, and live >60 miles from the hospital. Of the 549 patients, 183 (33.3%) had ≥1 HRU encounter within 6weeks after surgery. However, there was no difference between the SCP-RP and SCP-only groups in composite HRU (34.0% vs 33.1%, p = 0.84). The most common reasons for HRU were pain, urinary tract infection symptoms, and wound issues. Concomitant mid-urethral sling was associated with a two-fold increased risk of HRU after surgery. One in 3 patients undergoing minimally invasive SCP had at least one unanticipated encounter within 6weeks after surgery. Concomitant RP was not associated with increased postoperative HRU.

Positive Bacterial Culture among Adults with Suspected Urinary Tract Infections Presenting to the Department of Medicine of a Tertiary Care Centre.

Urinary tract infections are the most common infections encountered in clinical practice. Treatment needs to take into account the likely organism, comorbidities and local antibiotic sensitivity pattern. This study aimed to find the prevalence of positive bacterial culture among adults with suspected urinary tract infections presenting to the department of medicine of a tertiary care centre. A descriptive cross-sectional study was conducted among adults with suspected urinary tract infections. Data was collected between 1 July 2022 to 31 December 2022 after obtaining ethical approval from the Institutional Review Committee. Individuals with symptomatic urinary tract infections were included in the study. The antibiotic susceptibility tests of the isolates were done. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Among 355 patients, positive cultures were obtained in 148 (41.69%) (36.56-46.82, 95% Confidence Interval). Escherichia coli 120 (81.08%) was the predominant organism cultured among the positive bacterial culture cases. The prevalence of positive bacterial culture was found to be higher than other studies done in similar settings. aminoglycosides; Escherichia coli; prevalence; urinary tract infections.

Postoperative Incidence of Symptomatic Urinary Tract Infection (UTI) and Microbial Pattern Seen in TURP Patients with Negative Cultures Preoperatively

Background: Transurethral Resection of the Prostate (TURP) is the gold standard for surgical treatment of benign prostate hyperplasia (BPH). One of the postoperative complications of TURP is urinary tract infection (UTI). Symptomatic UTI occur despite preoperative sterile urine, prophylactic antibiotics and a closed drainage system. We studied the incidence of such symptomatic UTI and the microbial pattern observed. Material and Methods: This was a prospective study of 220 patients who had monopolar TURP in our centre from 2015 to 2020. All patients had sterile urine before surgery. Catheters were removed three days postoperatively. Patients presenting with symptoms of UTI were subjected to urine culture and antibiotic sensitivity. The recorded variables include patient demographics, co-morbid factors; Diabetes, hypertension, presence or absence of preoperative catheterization, duration of surgery, presence of postoperative UTI, microbial patterns and antibiotic sensitivity patterns. Results: The mean age of the patient was 66.25 years. 35.5% had preoperative catheterization. 42 (19%) patients were established to have symptomatic UTI. Age ≥ 65 years, duration of surgery ≥60 mins led to higher infection rates but preoperative catheterization, diabetes and hypertension did not influence UTI rates. The commonest organism was E. Coli and the most common sensitive antibiotic was levofloxacin (quinolone). Conclusions: Symptomatic UTI post-TURP still occurs despite preoperative sterile urine and routine prophylactic antibiotics.