Symptomatic Urinary Tract Infection Research Articles

Transurachal Catheter for Management of Difficult Catheterization in Anorectal Malformations: A Novel Technique

BackgroundUrinary tract drainage is necessary to facilitate the maneuver in laparoscopic-assisted anorectoplasty (LAARP). Male patients with Anorectal malformations (ARM) are often encounter difficult catheterization during surgery. ObjectiveWe pioneered the urinary catheterization through the urachus in ARM patients and evaluated the efficacy. MethodFourteen ARM patients undergoing urinary catheterization through urachus between September 2015 and September 2023 were reviewed. ResultsThe median age at the time of surgery was 0.06 months. Nine neonatal patients underwent the one-stage LAARP, while five patients underwent staged procedure. Four ARM patients with rectoprostatic fistula, while ten with rectobulbar fistula. All patients successfully underwent transurachal catheterization. No incidents of catheter blockage, accidental removal, or urinary tract infection symptoms were detected during hospitalization. ConclusionsTransurachal catheterization is a safe, effective, and cosmetic procedure for ARM patients with difficulty urethral catheterization. Level of EvidenceIV.

Uropathogenic distribution and antibiotic resistance patterns according to multidrug-resistant bacteria colonization status in patients with stroke.

Urinary tract infections (UTI) are common in patients with stroke. The colonization of multidrug-resistant organisms (MDR) has recently become a global issue, and infection with MDR is associated with a poorer prognosis. This study aimed to investigate the uropathogenic distribution in stroke patients according to MDR colonization and investigate the infection risk and antibiotic resistance of each uropathogen to help determine initial antibiotic treatment. This study is a retrospective study conducted on patients who underwent inpatient treatment for stroke at Kosin University Gospel Hospital in 2019 to 2021. The participants were classified into Group VRE if vancomycin-resistant Enterococcus (VRE) colonization was confirmed, Group CRE if carbapenem-resistant Enterobacteriaceae (CRE) colonization was confirmed, and Group Negative if no MDR colonization was confirmed. Urine culture was performed if symptomatic UTI was suspected. Uropathogenic distribution, antibiotic resistance patterns were assessed by one-way analysis of variance, independent t-test, and Pearson chi-square test. And the infection risk factors for each uropathogen were assessed by multinomial logistic regression analysis. Six hundred thirty-three participants were enrolled. The mean age of all participants was 69.77 ± 14.91, with 305 males and 328 females, including 344 hemorrhagic strokes and 289 ischemic strokes. No growth in urine culture was the most common finding (n = 281), followed by Escherichia coli (E.coli) (n = 141), and Enterococcus spp. (n = 80). Group Negative had significantly more cases of no growth in urine culture than Group VRE (Odds ratio [OR], 11.698; 95% confidence interval [CI], 3.566-38.375; P < .001) and than Group CRE (OR, 11.381; 95% CI, 2.665-48.611; P < .001). Group VRE had significantly more E.coli (OR, 2.905; 95% CI, 1.505-5.618; P = .001), and more Enterococcus (OR, 4.550; 95% CI, 2.253-9.187; P < .001) than Group Negative. There was no statistical difference in antibiotic resistance according to MDR colonization in E coli, but for Enterococcus spp., Group VRE and CRE showed significantly more resistance to numerous antibiotics than Group Negative. MDR colonization increases the risk of UTI and is associated with greater antibiotic resistance. For appropriate administration of antibiotics in UTI, continuous monitoring of the latest trends in uropathogenic distribution is required, and clinicians should pay more attention to the use of initial empirical antibiotics in patients with MDR colonization.

Acidic Urine pH and Clinical Outcome of Lower Urinary Tract Infection in Kidney Transplant Recipients Treated with Ciprofloxacin and Fosfomycin.

Different factors, including antimicrobial resistance, may diminish the effectiveness of antibiotic therapy, challenging the management of post-transplant urinary tract infection (UTI). The association of acidic urine pH with microbiological and clinical outcomes was evaluated after fosfomycin or ciprofloxacin therapy in 184 kidney transplant recipients (KTRs) with UTI episodes by Escherichia coli (N = 115) and Klebsiella pneumoniae (N = 69). Initial urine pH, antimicrobial therapy, and clinical and microbiological outcomes, and one- and six-month follow-up were assessed. Fosfomycin was prescribed in 88 (76.5%) E. coli and 46 (66.7%) K. pneumoniae UTI episodes in the total cohort. When the urine pH ≤ 6, fosfomycin was prescribed in 60 (52.2%) E. coli and 29 (42.0%) K. pneumoniae. Initial urine pH ≤ 6 in E. coli UTI was associated with symptomatic episodes (8/60 vs. 0/55, p = 0.04) at one-month follow-up, with a similar trend in those patients receiving fosfomycin (7/47 vs. 0/41, p = 0.09). Acidic urine pH was not associated with microbiological or clinical cure in K. pneumoniae UTI. At pH 5, the ciprofloxacin MIC90 increased from 8 to >8 mg/L in E. coli and from 4 to >8 mg/L in K. pneumoniae. At pH 5, the fosfomycin MIC90 decreased from 8 to 4 mg/L in E. coli and from 512 to 128 mg/L in K. pneumoniae. Acidic urine is not associated with the microbiological efficacy of fosfomycin and ciprofloxacin in KTRs with UTI, but it is associated with symptomatic UTI episodes at one-month follow-up in E. coli episodes.

Bacteriological Profile and Antimicrobial Resistance Patterns in Pediatric Urinary Tract Infections: A Cross-Sectional Study at Dhaka Shishu Hospital

Background: Urinary tract infections (UTIs) are a prevalent concern in pediatric healthcare, causing distress to children, raising parental concerns, and potentially leading to lasting kidney damage. The highest incidence of first-time symptomatic UTIs occurs in infants during the first year of life, with a subsequent marked decrease. Febrile infants under 2 months, presenting with unexplained fever, constitute a critical subset requiring particular attention. Knowledge of the bacteriological profile and antimicrobial resistance patterns in specific regions is crucial for guiding effective treatment strategies. Methods: A cross-sectional study was conducted at 250 Bedded General Hospital, Jamalpur, Bangladesh from Feb 2016 to Aug 2016 to assess the bacteriological profile and antibiotic resistance patterns in pediatric UTIs. A total of 147 culture-positive UTI patients were included. Bacterial isolates were identified, and colony counts for samples with ≥105 CFU/mL bacteria were considered positive. Antimicrobial susceptibility testing was performed using twelve agents, and resistance patterns were analyzed. Results: Among the 147 culture-positive UTI patients, Escherichia coli (E-coli) was the predominant isolate (70%), followed by Klebsiella spp. (13.6%), Pseudomonas (5.44%), Enterobacter spp (3.40%), Staphylococcus Aureus (3.40%), Proteus (2.72%), and Enterococcus (1.36%). Antimicrobial resistance analysis revealed varying patterns, with Cefradine (79.59%), Co-trimoxazole (SXT) (69.39%), Nalidixic acid (NA) (66.67%), and Ceftazidime (CTM) (48.98%) showing higher resistance rates. No drug exhibited 100% resistance against urinary pathogens, indicating a dynamic resistance landscape. Conclusion: This study highlights the importance of understanding local prevalence and resistance patterns in guiding empirical antibiotic selection for pediatric UTIs. The observed decrease in antimicrobial resistance underscores the need for continuous surveillance and tailored antibiotic strategies. Clinicians should base their treatment decisions on the specific epidemiological context rather than relying solely on universal or national guidelines.

Treatment seeking and antibiotic use for urinary tract infection symptoms in the time of COVID-19 in Tanzania and Uganda.

There is still little empirical evidence on how the outbreak of coronavirus disease 2019 (COVID-19) and associated regulations may have disrupted care-seeking for non-COVID-19 conditions or affected antibiotic behaviours in low- and middle-income countries (LMICs). We aimed to investigate the differences in treatment-seeking behaviours and antibiotic use for urinary tract infection (UTI)-like symptoms before and during the pandemic at recruitment sites in two East African countries with different COVID-19 control policies: Mbarara, Uganda and Mwanza, Tanzania. In this repeated cross-sectional study, we used data from outpatients (pregnant adolescents aged >14 and adults aged >18) with UTI-like symptoms who visited health facilities in Mwanza, Tanzania and Mbarara, Uganda. We assessed the prevalence of self-reported behaviours (delays in care-seeking, providers visited, antibiotics taken) at three different time points, labelled as 'pre-COVID-19 phase' (February 2019 to February 2020), 'COVID-19 phase 1' (March 2020 to April 2020), and 'COVID-19 phase 2' (July 2021 to February 2022). In both study sites, delays in care-seeking were less common during the pandemic than they were in the pre-COVID phase. Patients in Mwanza, Tanzania had shorter care-seeking pathways during the pandemic compared to before it, but this difference was not observed in Mbarara, Uganda. Health centres were the dominant sources of antibiotics in both settings. Over time, reported antibiotic use for UTI-like symptoms became more common in both settings. During the COVID-19 phases, there was a significant increase in self-reported use of antibiotics like metronidazole (<30% in the pre-COVID-19 phase to 40% in COVID phase 2) and doxycycline (30% in the pre-COVID-19 phase to 55% in COVID phase 2) that were not recommended for treating UTI-like symptoms in the National Treatment Guidelines in Mbarara, Uganda. There was no clear evidence that patients with UTI-like symptoms attending health care facilities had longer or more complex treatment pathways despite strict government-led interventions related to COVID-19. However, antibiotic use increased over time, including some antibiotics not recommended for treating UTI, which has implications for future antimicrobial resistance.

Prevalence of Multi Drug Resistance Escherichia coli Bacteriuria among Antenatal Women in a Tertiary Hospital in Enugu, Nigeria

Background: Urinary Tract Infection (UTI) due to Escherichia coli (E. coli) is a common health problem among women. Pregnant women are at increased risk due to the physiological changes associated with pregnancy. The present study was designed to determine the prevalence of E. coli UTI and its antibiotic susceptibility pattern among pregnant women at the antenatal clinic of the Enugu State University of Science and Technology Teaching Hospital, Enugu, Nigeria.&#x0D; Materials and Methods: A cross sectional study was carried out on a total of 200 pregnant women with and without symptoms of UTI. Mid-stream urine samples were collected and inoculated into Cysteine Lactose Electrolyte Deficient (CLED) and MacConkay. Colony counts &gt; 102 cfu/ml of urine were regarded as significant bacteriuria. Pure isolates of bacterial pathogen were characterized by colony morphology, gram-stain and standard biochemical procedures. The method of agar disc diffusion susceptibility testing was used to determine the antibiotic resistance and sensitivity of the isolates.&#x0D; Results: The overall prevalence of UTI was 15.4% while 48.5% were symptomatic cases and 5.0% asymptomatic cases. E,Coli was the most frequently isolated organism with a prevalence of 53.4% (111 samples) while other pathogens accounted for 46.6% (89 samples). E. coli showed the highest resistance to the antibiotic Ampicillin 100%, 78% to Tetracycline and 70% to Rocephine but a low resistance of 16.7% against Nitrofurantoin and Ceftriazone respectively.&#x0D; Conclusion: UTI due to E. coli in pregnant women in Enugu is relatively high and shows high resistance to routine antibiotics. It is therefore, strongly recommended to undertake a routine culture as part of the antenatal care for pregnant women.

URINARY TRACT INFECTIONS IN PATIENTS YOUNGER THAN 60 DAYS OLD.

The safety and efficacy of transitioning from parenteral to oral antibiotics in patients aged less than 60 days with urinary tract infections were assessed. Patients who transitioned to oral therapy had a lower mean length of stay with no significant difference in medically attended urinary tract infection symptoms within 30 days of treatment.

Diagnostic validation study of rapid urinary tract infection diagnosis kit at peripheral health facilities of West Bengal, India

Patients reporting to the outpatient departments of peripheral health care settings in India with symptoms of urinary tract infection (UTI) receive one or the other antibiotic before culture confirmation and out of the total culture confirmed UTI cases, in less than one third cases the prescribed antibiotics matches to the antibiotic sensitivity test result. Hence, in this study, an indigenous point-of-care (POCT) rapid diagnostic kit (Rapidogram) for UTI was validated against conventional urine culture and sensitivity to understand its possible applicability at peripheral health care settings. This cross-sectional study was conducted during November 2021 to June 2022 in OPDs of two peripheral hospitals. A sample size of 300 was calculated using prevalence of urinary tract infection (UTI) as 33% for sensitivity and specificity using Buderer’s formula. Urine specimens were collected following standard aseptic procedures from the recruited suspected UTI cases and transferred to laboratory maintaining the cold chain. The validation work up was done in two sections: lab validation and field validation. Out of 300 urine samples, 29 were found positive for the growth of UTI pathogen by both methods and 267 were found negative by both methods. Thus, the kit shows very high specificity (99.6%; 97.9–99.9%) and considerably high sensitivity (90.6%; 74.9–98.0%). We also observed higher PPV, NPV, test accuracy (> 96%). Diagnostic Odds Ratio and Youden index were respectively 2581 and 0.89. Clinical data showed that 44% of the suspected UTI cases were prescribed at least one antibiotic before urine test. Mostly they received Norfloxacin whereas the mostly identified organism E.coli was sensitive to Nitrofurantoin. In the context of absence of microbiology facility at peripheral setting and rampant empirical use of antibiotics in UTI, this highly specific and sensitive POCT for UTI may be used as it not only identifies the organism, also shows the antibiotic sensitivity pattern.

Bacterial aetiology, antimicrobial susceptibility patterns, and factors associated with urinary tract infection among under-five children at primary health facility, North-Western Tanzania.

Urinary tract infections (UTI) are common in under-five children, with significant consequences leading to bacteremia, dehydration, kidney scarring, and renal failure. The incidence of UTI varies with patients' demographics and geographic location. Limited studies have addressed UTI issues, particularly in children. We determined the proportion of UTI, bacterial aetiology, and antimicrobial susceptibility patterns and associated factors among under-five children at the district hospital between March and April 2023. We conducted a cross-sectional study using a convenient non-probability sampling technique to collect urine samples from participants with signs and symptoms of UTI. Written informed consent was obtained from parents or guardians. We collected Participants' information using a pretested structured questionnaire. Urine samples were processed at the Regional Referral Hospital. All analyses were conducted using STATA version 15.0. We determined the factors associated with UTI using a modified Poisson model multivariable analysis of the modified Poisson model. The results were presented as a prevalence ratio and 95% confidence interval. The level of significance was specified at 0.05. The study recruited 368 under-five children; 194 (52.7%) were males, and the median age (interquartile range) was 24 (13-36) months. Of all, 28.8% (95% CI-24.3-33.6) had culture-confirmed UTI. One hundred and six pathogens were isolated, the majority being Escherichia coli (E. coli), 37 (34.9%), and Staphylococcus aureus (S. aureus), 26 (24.5%). The susceptibility of E. coli to cefepime, piperacillin-tazobactam, nitrofurantoin, and meropenem ranged from 81.1% to 97.3%. S. aureus was most susceptible to nitrofurantoin (96.2%) and ciprofloxacin (92.3%). Multidrug resistance was observed in 33.0% of isolates. The proportion of Methicillin-resistant S. aureus and extended-spectrum beta-lactamases was 23.1% and 25%, respectively. UTI was observed more in patients presenting with vomiting, dysuria, and abdominal pain, patients below 24 months of age, nappy users, and uncircumcised males. Our study found a relatively high proportion of UTI among under-five children associated with vomiting, dysuria, abdominal pain, nappy use, and uncircumcision in males. The pathogens were least susceptible to (trimethoprim-sulfamethoxazole, gentamycin, ampicillin, and penicillin) the commonly used antibiotic. We advocate a thorough clinical analysis to detect the predictors of UTI and a periodic review of empirical treatment of UTI based on the antibiotic susceptibility pattern.

Urinary tract infections in children with cancer and febrile neutropenia - single center experience

Background/Aim. Urinary tract infection (UTI) in children with febrile neutropenia (FN) after receiving chemotherapy could be followed by atypical symptoms and signs. The absence of routine urine culture (UC) sampling for analysis could lead to undiagnosed disease and inadequate treatment of these patients. The aim of the study was to indicate the importance of sampling UC in children who have developed FN and to point out the most probable causative agents of UTI in children with FN and antibiotic sensitivity/resistance of the isolated strains. Methods. During a five-year observation period, 40 UTIs were registered in 30 patients with FN. In the study group of patients with FN, the number of UTIs, the number of recurrent UTIs, isolated pathogens, their sensitivity to antibiotics, characteristics of urine sediment, the presence of localized symptoms of UTI, and the presence of urosepsis were analyzed. The obtained results were compared with the control group which consisted of children who were healthy prior to hospitalization due to febrile urinary infection. Results. When compared to the control group, significant differences in the presence of symptoms of UTI and urine sediment findings in patients with FN were observed. A higher percentage of resistant strains of Escherichia coli isolated from UC of cancer patients with FN was noted when compared to the control group. Three UTI cases were followed by urosepsis. Conclusion. UC findings are important not only in establishing the diagnosis of UTI and detecting multi-resistant bacterial strains but also in choosing appropriate antibiotics and selecting a subgroup of patients with recurrent UTI who require further monitoring and detecting potential complications in a timely manner.

Dynamics of antimicrobial resistance of uropathogenic isolates of Escherichia coli

Objective. To evaluate the dynamics of antimicrobial resistance of Escherichia coli isolates from the urine of patients hospitalized in medical institutions of Tashkent city from 2018 to 2021. Materials and Methods. The study included 1020 E. coli isolates from the urine of patients with clinical symptoms of urinary tract infections admitted to the reference laboratory of the Antimicrobial Resistance Research Center (ARRC) from three medical institutions in Tashkent city for the period 2018– 2021. Determination of sensitivity to 15 antimicrobial agents was carried out by disc-diffusion method in accordance with the guidelines of the European Committee for the Determination of Sensitivity to Antimicrobial Agents (EUCAST v.8-v.12, depending on the year of isolates isolation and testing). Results. A high level of resistance to aminopenicillins, including inhibitor-protected ones (88.0–91.1%), 3–4 generation cephalosporins (84.5–87.7%) and fluoroquinolones (74.2–81.8%) was detected. Carbapenems showed the highest activity among the tested antimicrobials: resistance to imipenem, meropenem and ertapenem was 0%, 0.8% and 18%, respectively. Notable increase in resistance to ampicillin and ceftazidime was found, but a consistently high level of resistance to piperacillin-tazobactam. A statistically significant increase (p &lt; 0.001) was found between 2018–2021 in resistance to the aminoglycoside antibiotics amikacin and gentamicin from 3.2% and 37.8% to 85.4% and 80.6%, respectively. Conclusions. In our study, for most antibiotic groups, the level of resistance remained relatively stable from 2018 to 2021, except for an explosive increase in the frequency of resistance to aminoglycosides, as well as a further increase in resistance to ampicillin and ceftazidime. The need for monitoring and tracking of antibiotic pathogens when choosing treatment regimens for various infections is obvious.

Escherichia coli: Epidemiology, Impact, Antimicrobial Resistance and Prevention: A review

Public health aims to protect and improve community health by preventing and controlling infectious diseases. This includes surveillance, policy development, health education, immunization, research, and collaboration. Escherichia coli (E. coli) is a bacterium found in the intestines of humans and animals, with harmless and pathogenic strains causing serious illnesses. Pathogenic E. coli, like Shiga toxin-producing E. coli (STEC), can lead to severe food poisoning and outbreaks, making it a major public health concern. E. coli is transmitted through contaminated food, water, and direct contact with infected animals or individuals. It can survive in various environments and acquire antibiotic resistance. Vulnerable populations, such as children, elderly, and immunocompromised individuals, are at higher risk of severe infections. Studies in Egypt show high resistance rates to commonly used antibiotics in both clinical and food samples.E. coli isolates from various sources in Egypt and Tunisia demonstrated high resistance to commonly used antibiotics, limiting treatment options and posing a public health risk. E. coli isolates from patient urine in Nigeria showed high resistance to most antibiotics tested except newer drugs, indicating misuse of antibiotics in healthcare. The typical symptoms of infection include diarrhea, abdominal pain, symptoms of urinary tract infection and fever. The most serious complication is hemolytic uremic syndrome (HUS), which can cause acute kidney failure and be life-threatening, especially in young children and elders. Long-term consequences of infection and HUS can include chronic kidney disease and neurological impairment. The present review article summarizes the current knowledge, highlights the challenges and gaps and provides recommendations and solutions.

Antibiogram data of urinary tract infection in spinal cord injury patients in an outpatient setting.

To establish antibiogram data for patients with spinal cord injury (SCI) that would help differentiate the organisms commonly present depending on the voiding method and antibiotic sensitivity for empirical treatment. A total of 499 urine culture results were obtained from 151 SCI patients with symptomatic urinary tract infection (UTI) with significant bacteriuria and pyuria with more than 10 white blood cells per high power field. The voiding method was categorized as follows: self-intermittent catheterization (SIC), suprapubic catheter (SPC), Foley catheter, condom catheter, or voiding freely. The demographic data were as follows: male, n=124 (82.2%); female, n=27 (17.8%); mean age, 39; paraplegic n=105 (69.5%); and tetraplegic, n=45 (29.8%). The SIC was the most common voiding method (n=64, 42.3%), followed by Foley catheter (n=39, 25.8%). Escherichia coli was the most common organism overall (29%) and more frequent in patients using SIC as the voiding method. Proteus mirabilis was present more frequently in patients using SPC (33%), and Klebsiella pneumoniae in voiding freely cultures (30%). Antibiotic sensitivity was as follows Gentamicin (44.1%), Nitrofurantoin (39.1%), Augmentin (33.5%), and Ciprofloxacin (31.5%). Increased preference of the local population to foley catheter as a voiding method which needs to be investigated more. The type of voiding methods in patients with SCI results in different common causative organisms of UTI. Ciprofloxacin resistance profile increased overall except in patients voiding with SPC. Nitrofurantoin is the most overall sensitive oral antibiotic in our sample followed by Augmentin then Cefuroxime.

Primena antibiotske terapije u lečenju rekurentne urinarne infekcije uzrokovane bakterijom Escherichia coli

Introduction: Urinary tract infections (UTIs) are among the most common infections and a leading reason for antibiotic prescriptions. They are more common in women, particularly during menopause. The cost of treating urinary tract infections significantly impacts the health system and affects the quality of life, especially when the infections are recurrent. Reinfections account for 80% of recurrent infections, with the primary cause usually being the colon bacterial flora, with Escherichia coli as the dominant culprit. Case report. A 63-year-old female patient visited her GP with complaints of low-grade fever and frequent urination without dysuria. She was diagnosed with cystitis and was prescribed a seven-day course of antibiotics, which effectively resolved her urinary tract infection symptoms. Due to frequent urinary tract infections, she was subsequently placed on a prophylactic six-month course of nitrofurantoin, 50 mg. The patient remained symptom-free during the antibiotic prophylaxis. Conclusion. Many protocols have been shown to reduce the occurrence of urinary tract infections. Antibiotic treatment based on the antibiogram, as well as antibiotic prophylaxis (continuous and post-coital), has proven to be the most effective method for preventing recurrent cystitis. The choice of treatment method and approach depends on the frequency and severity of symptoms.

Bacteriuria Among Type 2 Diabetes Mellitus Patients Attending Ejisu Government Hospital in the Ashanti Region, Ghana.

Type 2 diabetes mellitus (T2DM) patients are at increased risk of infections, such as malignant otitis externa and rhinocerebral mucormycosis, with the urinary tract being the most affected (for example, emphysematous pyelonephritis commonly caused by Escherichia coli). Hence, this study assessed the prevalence of bacteriuria and antibiogram patterns of bacteria isolates among T2DM patients visiting the Ejisu Government Hospital in the Ashanti Region, Ghana. In this cross-sectional study, 58 patients visiting the hospital for routine healthcare were conveniently recruited after obtaining informed consent. Data on sociodemographic characteristics and medical history were obtained using pretested structured questionnaires. Mid-stream urine was collected for bacteria isolation and identification using standard bacterial culture and biochemical tests. Bacteria cultures ≥ 105 CFU/mL were considered significant bacteriuria. The antibiotic sensitivity patterns of the bacteria isolates were evaluated using the Kirby-Bauer disc diffusion method. Bacteriuria was recorded among 15.5% (9/58) of the patients, mainly those with no previous history (77.8%) and no symptoms (55.6%) of urinary tract infections (UTIs). E. coli (55.6%) and Klebsiella spp. (44.6%) were primarily isolated from the T2DM patients. All the bacteria isolates (E. coli and Klebsiella spp.) demonstrated the highest resistance to co-trimoxazole and tetracycline (55.6%) and a complete susceptibility to amikacin and levofloxacin (100%). However, 60% of the E. coli isolates and 25% of the Klebsiella isolates were multidrug resistant (MDR; resistant to at least one antibiotic agent in three or more antimicrobial categories). The study shows that T2DM patients have bacteria in their urine which are resistant to most common antibiotics, even among those with no history of UTIs; hence, routine bacterial culture and antibiotic sensitivity testing among T2DM patients is recommended for better patient management to reduce the co-morbidities of UTIs.

Bacterial profile of urinary tract infection among pregnant women: a systematic review

Urinary tract infection (UTI) is the infection and colonization of microorganisms in the urinary tract. Women carry a higher risk of being affected by UTI compared to males, especially during pregnancy due to physiological and hormonal changes. Appropriate and adequate management of UTI reduces the incidence of further maternal and fetal complications. Nonetheless, there is a growing concern regarding resistance to antibiotics among the bacteria causing UTIs in pregnant women. To identify the bacterial profile of UTIs during gestation by exploring the previous research conducted on this subject. A systematic online search was performed on scientific databases to obtain articles related to the current subject using search terms, including bacteria, profile, causative agent, sensitivity, resistance, symptomatic, pregnancy, gestation, and pregnant women. The articles of relevance were considered if they were original articles, written in the English language, available for full-text, and reporting bacterial profile of UTI during pregnancy. A total of eight articles were eligible and met the inclusion criteria. The studies were published between 2020 and 2023 and included a total number of 3,702 pregnant females from five different countries. The bacterial profile of UTI among pregnant women including symptomatic UTI, and resistance and sensitivity of bacteria to antibiotics varied between different regions. However, the causative agents of UTI displayed less variation as Escherichia coli and K.pneomniae were the major causative agents of UTI during pregnancy.

To treat or not to treat asymptomatic bacteriuria in renal transplant patients, A systematic review

Background: Antibiotic therapy as a preventative measure for asymptomatic bacteriuria (AB) in kidney recipients can be beneficial in reducing subsequent symptomatic infections. Treating AB and acute graft pyelonephritis is crucial for reducing the risk of graft rejection after kidney transplantation, However, the effectiveness of antibiotics in these cases is still debate in the medical community. Objectives: This review aims to determine the benefits and risks of treating AB in kidney transplant recipients with antimicrobial agents to prevent symptomatic urinary tract infection (UTI) and all-cause mortality. Methods: The review included 10 articles published form January 2010 to January 2021 which examined the effectiveness of treating AB after renal transplantation. Results: AB treatment with antibiotics was found to have no benefit in all reviewed studies, as antibiotic treatment of AB increase the emergence of more resistant organisms in urine. During the months of follow-up, it was also a risk factor for UTI. Conclusion: Sufficient evidence has shown that AB treatment with antibiotics does not provide any significant benefit in the short and long term. Giving these findings, considering other important treatment options is vital to improve clinical outcome for this condition.

Schools’ toilets quality and its relation to urinary tract problems in pupils of primary schools in Hilla city

Abstract Background: Avoiding school toilets might cause irregular or infrequent voiding, which can lead to a variety of urinary issues. In this study, primary school-aged children’s bathroom habits, contributing factors, and relationships to lower urinary tract symptoms were examined. Objectives: The objectives of the study were: (1) to evaluate factors that affect students going to school toilets including toilet facilities and toilet hygiene in children of primary schools; (2) to evaluate urinary symptoms in those children; (3) to differentiate between private school children and public school children; and (4) to evaluate pupils-to-toilets ratio among primary school children. Materials and Methods: A cross-sectional study was conducted at Hilla city primary schools, and the time of this study was from February 15 to June 15, 2022. This study was conducted on 500 pupils by selecting 10 primary schools in Hilla city randomly (five of them were private schools and other five were public schools). Results: Public school students reported that toilets are significantly more dirty (72.2%) compared with private schools. Similar significant differences were reported regarding the presence of stool/urine on the floor, smell of toilet, lighting of toilet, and availability of soap. The presence of urinary tract infection symptoms (at least one symptom) was found to be significantly higher among public sector schools (53.1%) compared with private sector schools (46.9%), with P value of 0.031. Public schools had significantly higher number of children per toilet (108.0% ± 68.5%) compared with private schools (26.8% ± 7.6%), with P value of 0.030. Conclusions: Toileting habits and urinary tract symptoms were both significantly correlated. Many children influenced by negative perceptions of school toilets have adopted unhealthy toilet habits during school time. Public school students reported that toilets are significantly more dirty compared with private schools.

Prevalence of urinary tract infection with asymptomatic bacteriuria among gravid females: A Pakistani multicenter cross-sectional study.

Objective: To determine the prevalence of urinary tract infection with asymptomatic bacteriuria among pregnant females. Study Design: Multi-center, Cross-sectional study. Setting: Department of Obstetrics and Gynecology, Jinnah Postgraduate Medical Center, Karachi, Sheikh Zayed Medical College and Hospital, Rahim Yar Khan, and Hayatabad Medical Complex, Peshawar, Pakistan. Period: January 2023 to June 2023. Material &amp; Methods: A total of 260 pregnant females aged between 18 to 45 years and visiting outpatient department for antenatal check-up were analyzed. Enrolled females were interviewed and demographical and clinical data were noted. All women had their urine analysis done as a routine antenatal test. Urine culture analysis was also done at the same time. Asymptomatic bacteriuria was labeled when urine culture revealed the presence of more than 105 bacteria per milliliter of urine but without showing symptoms of urinary tract infections. Results: In a total of 260 pregnant females, the mean age was 28.6±5.3 years (ranging between 18-45 years). There were 125 (48.1%) females who reported during 3rd trimester of pregnancy. Residential status of 209 (80.4%) females was urban. There were 65 (25.0) females who were illiterate. Family monthly income of 198 (76.2%) females was below 30,000 Pakistani Rupees. Asymptomatic bacteriuria was revealed in 69 (26.5%) pregnant females. The most common urinary bacterial isolates were E. coli and Klebsiella found in 36 (52.2%) and 10 (14.5%) respectively. Conclusion: The prevalence of asymptomatic bacterirua among pregnant females was high (26.5%). The most common urinary isolates found among asymptomatic bacteriuria cases were E.coli.

A STUDY TO ASSESS THE KNOWLEDGE ON URINARY TRACT INFECTION REGARDING ITS PREVENTION AND MANAGEMENT AMONG THE 1ST YEAR B.SC NURSING AT SMT. NAGARATHNAMMA COLLEGE OF NURSING, BENGALURU

Good health is the fundamental right of every human being and it is essential to lead a successful life. The preamble to the WHO constitution also affirms that it is one of the fundamental rights of every human being is to enjoy The highest attainable standards of health. Moreover, emphasis is based on health promotion andpreventivehealthcare.Goodphysicalandmentalhealthofchildrenandadolescentsmakesforgoodhealth in adulthood. Agreeably, adolescence is a transitional period from dependent childhood to independent adulthood,thatis,agegroupfrom10-19years.Aboutone-fifthofIndiaspopulationisintheadolescenceage group and this is the earliest age where we can prevent morbidity in later life by means of health. According to 2022–2023-year statical data, the human body gets rid of liquid waste products through the urinary system, and so, it is important to protect this system from infections. Urinary tract infections are the secondmostcommonbacterialdiseasewhichaccountsformorethaneightmillionofficevisitsperyear.More than one lakh (1,00,000) people are hospitalized annually because of urinary tract infection and it is an importantcauseofmorbidityandmortalityinIndiansubjects.Youngageandfemalesexarethetwoimportant factors that contributes to the development of urinary tract infection and therefore it is the most common infection among adolescent girls, which distresses them, concerns their parents, and may cause permanent kidney damage, if there is any delay in treatment. According to the National Institute of Health and Clinical Excellence guidelines urinary tract infection is defined by a combination of clinical symptoms of urinary tract infection that usually include frequency, dysuria, pyuria, abdominal pain, back pain, fever, or urgency. Most urinary tract infections result from ascending infection by single gram-negative bacteria such as Escherichia coli, Klebsiella, Proteus, Enterobacter,orPseudomonas.Staphylococcalinfections,especiallyduetostaphylococcalsaprophyticus are common cause of urinary tract infection among adolescent girls. The two broad categories of urinary tract infectionarepyelonephritisorupperurinarytractinfectionandcystitisorlowerurinarytractinfection.Lower urinary tract infections are common among adolescent girls.