Tract Infections In Young Women Research Articles

Genomic Epidemiology of Major Extraintestinal Pathogenic Escherichia coli Lineages Causing Urinary Tract Infections in Young Women Across Canada.

BackgroundA few extraintestinal pathogenic Escherichia coli (ExPEC) multilocus sequence types (STs) cause the majority of community-acquired urinary tract infections (UTIs). We examine the genomic epidemiology of major ExPEC lineages, specifically factors associated with intestinal acquisition.MethodsA total of 385 women with UTI caused by E. coli across Canada were asked about their diet, travel, and other exposures. Genome sequencing was used to determine both ST and genomic similarity. Logistic regression was used to identify factors associated with the acquisition of and infection with major ExPEC STs relative to minor ExPEC STs.ResultsST131, ST69, ST73, ST127, and ST95 were responsible for 54% of all UTIs. Seven UTI clusters were identified, but genomes from the ST95, ST127, and ST420 clusters exhibited as few as 3 single nucleotide variations across the entire genome, suggesting recent acquisition. Furthermore, we identified a cluster of UTIs caused by 6 genetically-related ST1193 isolates carrying mutations in gyrA and parC. The acquisition of and infection with ST69, ST95, ST127, and ST131 were all associated with increased travel. The consumption of high-risk foods such as raw meat or vegetables, undercooked eggs, and seafood was associated with acquisition of and infection with ST69, ST127, and ST131, respectively.ConclusionsReservoirs may aid in the dissemination of pandemic ExPEC lineages in the community. Identifying ExPEC reservoirs may help prevent future emergence and dissemination of high-risk lineages within the community setting.

D-serine transporter in Staphylococcus saprophyticus identified.

Among staphylococci Staphylococcus saprophyticus is the only species that is typically uropathogenic and an important cause of urinary tract infections in young women. The amino acid D-serine occurs in relatively high concentrations in human urine and has a bacteriostatic or toxic effect on many bacteria. In uropathogenic Escherichia coli and S.saprophyticus, the amino acid regulates the expression of virulence factors and can be used as a nutrient. The ability of uropathogens to respond to or to metabolize D-serine has been suggested as a factor that enables colonization of the urinary tract. Until now nothing is known about D-serine transport in S.saprophyticus We generated mutants of putative transporter genes in S.saprophyticus 7108 that show homology to the D-serine transporter cycA of E. coli and tested them in a D-serine depletion assay to analyze the D-serine uptake rate of the cells. The mutant of SPP1070 showed a strong decrease in D-serine uptake. Therefore, SSP1070 was identified as a major D-serine transporter in S.saprophyticus 7108 and was named D-serine transporter A (DstA). D-serine caused a prolonged lag phase of S.saprophyticus in a chemically defined medium. This negative effect was dependent on the presence of DstA.

Вагинальная атрофия в практике акушера-гинеколога

Vaginal atrophy is a characteristic symptom of menopause, which can develop in young women as a result of temporary or permanent deficiency of estrogen, as well as after operations of the cervix or connective tissue diseases. Manifestations of diverse vaginal atrophy, affect sexuality and significantly reduce the quality of life of women. The diagnosis of vaginal atrophy is clinical and depends solely on the skill of the doctor who expertly evaluates medical history and examines, since patients with vaginal atrophy often do not complain. Estrogens are considered to be the most effective option for the treatment of all forms of vaginal atrophy in the local application. In Russia, it is only estriol - estrogen deprived of systemic metabolic effects and does not require monitoring of the endometrium and breast, as well as the additional use of progestogen to protect the endometrium - that is registered for the vaginal use. Estriol in the form of vaginal suppositories (Ovipol Clio®) can be used in women with urogenital atrophy in postmenopausal women with amenorrhea or in the reproductive age, in the treatment of stenosis of the cervical canal, or after unclear smear from the cervix to the background of vaginal atrophy, as well as in urology in relapsed urinary tract infection in young women or as a preoperative preparation for operations on the pelvic floor.

A Multiplex PCR for Detection of hlyA, papC, and traT genes in multidrug resistance Escherichia coli isolated from pregnant women

Urinary tract infection (UTI) in pregnancy is a common clinical problem which causes morbidity and, in a small minority of cases, renal damage and chronic renal failure. Urine samples from three hundred pregnant women were collected from Baghdad Teaching Hospital, were examined between January to June 2012 for the presence of bacteria. Their ages ranging from 15 to 50 years. Up to 32.6% (98) of women have a urinary tract infection (UTI). Escherichia coli was detected in 27.5% (27) of all the urine samples. All isolates were screened for some virulence factors: α-haemolysin, adhesion factor type P fimbriae and serum resistance. Multiplex PCR systems were used to detect genes encoding α-hemolysin (hlyA), adhesion P(papC), and traT associated with serum resistance.The results indicated that the occurrence of papC was detected in (18.5%), while traT was detected in (96.2%) of isolates on the other hand hlyA can't detected in any E. coli isolates. All the isolates were also studied for antibiotic susceptibility pattern using a disc diffusion method.The rate of resistance of E. coli Amoxicillin (92.5%), Amoxicillin/Clavulanic acid (89%), Cefotazidime, Cefotaxime and Cefepime (78%), kanamycin (59%), levofloxacin (55.5%), Ciprofloxacin (52%) and showed high degree of sensitivity toward Cefoxitin and Imipenem (7% and 0%) respectively. Additionally,17 (62.9%) isolates were multidrugresistant.The finding of this study indicated that the traT widespread among pathogenic E. coli in Iraq. Furthermore it concludes that E. coli is one of the important multidrug resistance causative agents of urinary tract infection in young women especially during the state of pregnancy.

Adolescent Urethral Coitus: 2 Cases and Review of the Literature

BackgroundUrethral coitus is a very rare finding in adolescent women. There are 26 reported cases in the literature, but only two were in adolescents. Urethral coitus has been most commonly described in women with müllerian anomalies and less commonly in other unusual clinical circumstances. CasesWe report 2 cases of adolescent women with known müllerian anomalies who were unknowingly engaging in urethral coitus; 1 adolescent with known vaginal agenesis and VACTERL association and one 16-year-old with an oblique vaginal septum and non-communicating functioning uterine horn. Both young women had significant urethral dilation at the time of examination under anesthesia. ConclusionsUrethral intercourse is rare but may have significant consequences. Ongoing follow-up, careful history, and physical examination in adolescent women with müllerian anomalies are important in order to avoid possible complications, particularly when they are contemplating sexual activity. A history of urinary incontinence, dyspareunia, and urinary tract infections in young women with müllerian anomalies should raise suspicion of urethral coitus. If possible, the müllerian anomaly should be corrected to allow vaginal intercourse and discontinuation of urethral coitus.

SdrI ofStaphylococcus saprophyticus is a multifunctional protein: localization of the fibronectin-binding site

Staphylococcus saprophyticus, an important cause of urinary tract infections in young women, expresses the surface protein SdrI, a member of the serine-aspartate repeat (SD) protein family. Here we analyse the fibronectin-binding ability of SdrI, as S. saprophyticus is known to bind fibronectin and there is no known SD protein with this function. This protein does not contain the binding motif typical for fibronectin-binding proteins. Using recombinant fragments of SdrI, we localized the binding domain in the A region and show that SdrI bound to the N-terminal 30-kDa fragment of fibronectin. The fibronectin-binding function was shown in the natural host using an SdrI knockout mutant that showed decreased binding to fibronectin compared with wild-type strain 7108.

Clinical significance of Staphylococcus saprophyticus identified on blood culture in a tertiary care hospital

Staphylococcus saprophyticus is a well-known cause of acute uncomplicated urinary tract infection in young women. However, the clinical significance of this organism isolated from blood culture has not been determined. We assessed the clinical significance and characteristics of S. saprophyticus identified on blood culture. A total of 24 patients were identified, and 7 patients (29.2%) were considered to have clinically significant bacteremia. Of the 7 patients with clinically significant bacteremia, hematologic malignancy was the most common underlying illness (5 patients), and tunneled-central venous catheter was the most common portal of entry (4 patients). In no case did S. saprophyticus bacteremia originate from the urinary tract. One patient died during hospitalization. However, the death was not directly related to bacteremia. In conclusion, our data suggest that bacteremia caused by S. saprophyticus is most commonly associated with tunneled-central venous catheter in patients with hematologic malignancies and may be associated with a lower risk of mortality.

SdrI, a Serine-Aspartate Repeat Protein Identified in Staphylococcus saprophyticus Strain 7108, Is a Collagen-Binding Protein

A gene encoding a serine-aspartate repeat protein of Staphylococcus saprophyticus, an important cause of urinary tract infections in young women, has been cloned and sequenced. In contrast to other SD repeat proteins, SdrI carries 21 additional N-terminal repeats with a consensus sequence of (P/A)ATKE(K/E)A(A/V)(T/I)(A/T/S)EE and has the longest SD(AD)(1-5) repetitive region (854 amino acids) described so far. This highly repetitive sequence contains only the amino acids serine, asparagine, and a distinctly greater amount of alanine (37%) than all other known SD repeat proteins (2.3 to 4.4%). In addition, it is a collagen-binding protein of S. saprophyticus and the second example in this organism of a surface protein carrying the LPXTG motif. We constructed an isogenic sdrI knockout mutant that showed decreased binding to immobilized collagen compared with wild-type S. saprophyticus strain 7108. Binding could be reconstituted by complementation. Collagen binding is specifically caused by SdrI, and the recently described UafA protein, the only LPXTG-containing protein in the genome sequence of the type strain, is not involved in this trait. Our experiments suggest that, as in other staphylococci, the presence of different LPXTG-anchored cell wall proteins is common in S. saprophyticus and support the notion that the presence of matrix-binding surface proteins is common in staphylococci.

Allergy to lingonberry: A case report

Past few years cranberry/lingonberry products have been incorporated as healthy products to the US and European market as prophylaxis of recurrent urinary tract infections in young women as well as in chronic infections in elderly which because of there are many biological activities attributed to the that fruit is a very popular additive to the new diets. To the best of our knowledge, this is the first case of allergy to lingonberry. We speculate that previous exposure to lingonberry products could be sensitising. The symptoms, timing of the episode, positive skin test, IgE-ELISA and western-blot strongly support the role of lingonberry as the causative agent.

Molecular Epidemiology of Acute, Uncomplicated Urinary Tract Infections in Young Women.

Molecular biological methods, a relatively new addition to the epidemiologist's tool chest, are now applied to the study of urinary tract infection (UTI). By combining sound epidemiologic methods and the ability to genetically stratify UTI-causing Escherichia coli, recent studies have added to our understanding of UTI. These advancements include the possible identification of outbreaks of community-acquired UTI, the contribution of person-to-person transmission of E. coli to the risk for UTI in young women, and changes in the community prevalence and distribution of UTI caused by drug-resistant organisms. The application of molecular methods to future UTI research studies may yield novel approaches to UTI prevention.

Incidence of acute urinary tract infection in young women and use of male condoms with and without nonoxynol-9 spermicides.

Acute urinary tract infection is one of the most common infections seen in primary care. We conducted a nested case-control study among a cohort of 519 women, ages 15-29 years, enrolled in a contraceptive acceptability study to examine whether recent use of male condoms increases urinary tract infection risk. One hundred sixty-five incident urinary tract infections were identified during 12-month follow-up periods in a cohort study that was conducted between 1996 and 1999. After exclusions for urinary tract infection recurrences, pregnancy, antibiotic use, diabetes, diaphragm/cervical cap use, or urinary tract abnormalities, there were 100 cases and 200 controls. Compared with women not using barrier methods (and after adjustment for age, urinary tract infection history, hormonal method use, and frequency of sex) the odds ratio (OR) for any reported use of condoms coated with spermicide (Nonoxynol-9) in the previous 30 days was 2.8 (95% [confidence interval] CI = 1.2-6.5). The OR was 11.5 (95% CI = 2.5-53) for exclusive Nonoxynol-9-coated condom use. The OR for exclusive use of non-Nonoxynol-9-coated condoms was 7.4 (95% CI = 1.6-35). In this study, use of male condoms was associated with increased urinary tract infection risk; the largest risk was associated with exclusive condom use and use of Nonoxynol-9-coated condoms.

Risk factors for recurrent urinary tract infection in young women.

To define host factors associated with an increased risk of recurrent urinary tract infection (RUTI), a case-control study was conducted in 2 populations: university women and health maintenance organization enrollees. Case patients were 229 women 18-30 years old with RUTIs; control subjects were 253 randomly selected women with no RUTI history. In a multivariate model, independent risk factors for RUTI included recent 1-month intercourse frequency (odds ratio [OR], 5.8; 95% confidence interval [CI], 3.1-10.6 for 4-8 episodes), 12-month spermicide use (OR, 1.8; 95% CI, 1.1-2.9), and new sex partner during the past year (OR, 1.9; 95% CI, 1.2-3.2). Two newly identified risk factors were age at first urinary tract infection (UTI) </=15 years (OR, 3.9; 95% CI, 1.9-8.0) and UTI history in the mother (OR, 2.3; 95% CI, 1.5-3.7). Blood group and secretor phenotype were not associated with RUTI. In young women, risk factors for sporadic UTI are also risk factors for recurrence. Two predictors suggest that genetic/long-term environmental exposures also predispose to RUTI.

A Prospective Study of Risk Factors for Symptomatic Urinary Tract Infection in Young Women

Although acute urinary tract infections are common in young women, the associated risk factors have not been defined prospectively. We recruited sexually active young women who were starting a new method of contraception at a university health center or a health maintenance organization (HMO) and monitored them for six months for symptomatic urinary tract infections. Daily diaries and serial interviews were used to collect data on potential risk factors. Among 796 women, the incidence of urinary tract infections per person-year was 0.7 in the university cohort (mean age, 23 years; n = 348) and 0.5 in the HMO cohort (mean age, 29; n = 448). In both cohorts, there were strong dose-response relations between the risk of infection and both recent use of a diaphragm with spermicide (respective relative risks for one, three, and five days of use in the past week, 1.42, 2.83, and 5.68 in the university cohort, P<0.001; and 1.29, 2.14, and 3.54 in the HMO cohort, P=0.04) and recent sexual intercourse (respective relative risks for one, three, and five days with intercourse in the past week, 1.37, 2.56, and 4.81 in the university cohort, P<0.001; and 1.24, 1.91, and 2.96 in the HMO cohort, P=0.002). The risk of acute infection was also associated with a history of recurrent infection (relative risk, 5.58 in the university group and 2.10 in the HMO group) but not with cervical-cap use, ABO-blood-group nonsecretor phenotype, or delayed postcoital voiding. Among sexually active young women the incidence of symptomatic urinary tract infection is high, and the risk is strongly and independently associated with recent sexual intercourse, recent use of a diaphragm with spermicide, and a history of recurrent urinary tract infections.

A Clinical Model for Diagnosis of Urinary Tract Infection in Young Women

A Clinical Model for Diagnosis of Urinary Tract Infection in Young Women

Diferenças nas propriedades adesivas de Staphylococcus saprophyticus a células HEp-2 e eritrócitos

S. saprophyticus has been frequently isolated from urinary tract infections in young women. In contrast with S. aureus, no defined virulence factors have been recognized for the coagulase negative Staphylococcus species. The objective this study was to analyze the adherence of S. saprophyticus to HEp-2 cells and sheep erythrocytes. The sample were isolated from urine of patients with urinary infection. Hemagglutination, adherence to HEp-2 cells tests and inhibition by specific carbohydrates of the interactions between these cells were analyzed. Most of the strains were hemagglutinating whose properties was inhibited by mannose (100mM). There was a high adherence level to HEp-2 cells. The differences in specificity and attachment level noted in this study suggest that multiple adhesins are involved in the mechanism of cellular interaction.

The relationship between vaginal douching and lower genital tract infection in young women

The purpose of the study was to investigate the relationship between a history of vaginal douching and gynecologic history, genital examination findings, and laboratory data in predominantly black adolescent and young adult females at an inner city family planning clinic. Of 175 females (mean age 17.7 ± 1.46 years), 69% reported douching. Of those reporting douching, 25% reported douching 48 hours prior to their clinic visit. Univariate analysis indicated significant associations between vaginal douching and a past history of gonorrhea and trichomonas infection, current Neisseria gonorrhoeae and current bacterial vaginosis (p < 0.05). Multiple logistic regression analysis indicated this was not an independent association. Recent vaginal douching did not appear to significantly influence microscopic detection of vaginal infections, vaginal white blood counts (WBCs), and endocervical polymorphonuclear cells (PMNs) indicating that recent douching had no effect on laboratory tests performed in the clinic.

Advances in the understanding and treatmentof urinary tract infections in young women

Despite relative ease of management, the high rate of urinary tract infections (UTI) among young women presents substantial problems for the health care community. Although the majority of UTIs in young women are simple and uncomplicated, the rate of recurrence is substantial. Each treatment of UTI recurrence brings greater antibiotic resistance, requiring the use of broader spectrum and more expensive antibiotic therapy. Moreover, infection in patients with underlying urinary tract or systemic diseases can lead to serious medical and financial consequences. A better understanding of antibiotic resistance, particularly in regard to beta-lactamase-producing pathogens, has allowed us to develop more appropriate criteria for selecting antibiotics as well as the duration of therapy. The overall cost for treating UTIs in young women is a substantial health care expenditure, and requires an ongoing examination of new information concerning pathogenesis and available antibiotic therapies.

Clinical Model for Diagnosis of Urinary Tract Infection in Young Women

To the Editor .—I was, to say the least, quite surprised that the authors of the article entitled A Clinical Model for Diagnosis of Urinary Tract Infection in Young Women 1 have only recently discovered the fact that bacterial counts of less than 100 000 per milliliter obtained from midstream urine specimens may indicate a true urinary tract infection in women. We, and others, have, starting in 1963, repeatedly and exhaustingly proven that, in view of the relatively high percentage of bacterial counts of less than 100 000 per milliliter obtained from the midstream urine specimens in women in the presence of urinary tract infection, 2-6 the criteria for a correct diagnosis of urinary tract infection vs bacterial contamination in midstream urine specimens carefully collected by a trained nurse with the patient in lithotomy position after adequate preparation is 1000 and not 100 000 colonies of a single species per

Clinical model for diagnosis of urinary tract infection in young women

Clinical model for diagnosis of urinary tract infection in young women

Postcoital Antimicrobial Prophylaxis for Recurrent Urinary Tract Infection

We conducted a randomized, double-blind, placebo-controlled study to determine the efficacy of postcoital antibiotic prophylaxis in healthy young women prone to recurrent urinary tract infections. Sixteen patients were randomized to receive postcoital administration of a combination product of trimethoprim and sulfamethoxazole, while 11 received postcoital placebo. The treatment groups were similar with respect to age, parity, diaphragm use, history of lifetime urinary tract infections, frequency of intercourse, and number of lifetime sexual partners. In over 6 months of observation, postcoital administration of trimethoprim-sulfamethoxazole was highly effective in preventing recurrent urinary tract infections. Nine of 11 patients who took the placebo developed urinary tract infections (infection rate, 3.6 per patient-year), compared with only two of 16 patients who received postcoital trimethoprim-sulfamethoxazole (infection rate, 0.3 per patient-year). Postcoital administration of trimethoprim-sulfamethoxazole was effective in patients with both low (two or fewer times per week) and high (three or more times per week) intercourse frequencies. Side effects were few and compliance was excellent. We conclude that postcoital trimethoprim-sulfamethoxazole is a safe, effective, and inexpensive approach to management of recurrent urinary tract infections in young women.