Tract Infection Susceptibility Research Articles

Obesity Augments Urinary Tract Infection Susceptibility by Activating Focal Adhesion Kinase in Kidney Intercalated Cells

Obesity Augments Urinary Tract Infection Susceptibility by Activating Focal Adhesion Kinase in Kidney Intercalated Cells

The Human Ribonuclease 3 Antimicrobial Peptide Reduces Urinary Tract Infection Susceptibility In Vivo

The Human Ribonuclease 3 Antimicrobial Peptide Reduces Urinary Tract Infection Susceptibility In Vivo

Risk factors for recurrent respiratory tract infection in preschool-aged children.

We aimed to identify potential risk factors for recurrent respiratory tract infection among Chinese preschool-aged children, and further to construct a nomogram prediction model. This is a cross-sectional survey conducted in Beijing. Utilizing a stratified cluster random sampling strategy, a total of 7222 children from 20 kindergartens were enrolled. Data are analyzed by STATA software and R language. Five independent factors were identified to be significantly associated with recurrent respiratory tract infection risk overall and by pathogenic sites. The significant odds of recurrent respiratory tract infection was 8.31 (95% confidence interval [CI]: 5.69-12.12, P < 0.001), 2.31 (2.06-2.58, P < 0.001), 1.72 (1.48-1.99, P < 0.001), 1.24 (1.08-1.43, P = 0.002), and 1.19 (1.09-1.31, P < 0.001) for asthma, allergy, initial use of antibiotics <6 months, breastfeeding duration <6 months, and maternal body mass index, respectively. Besides the leading role played by asthma, allergy, initial use of antibiotics, and breastfeeding might exert a graded, dose-dependent effect on recurrent respiratory tract infection susceptibility. We have identified five potential risk factors for the risk of recurrent respiratory tract infection from 7222 preschool-aged Chinese children. Notably, asthma plays a leading role, and allergy, initial use of antibiotics, and breastfeeding might exert a graded, dose-dependent effect on recurrent respiratory tract infection susceptibility. This is the first report of examining the joint contribution of multiple potential risk factors to recurrent respiratory tract infection among Chinese preschool-aged children. We have identified five potential risk factors for the risk of recurrent respiratory tract infection via analyzing survey data from 7222 preschool-aged Chinese children. Asthma plays a leading role, and allergy, initial use of antibiotics, and breastfeeding might exert a graded, dose-dependent effect on recurrent respiratory tract infection susceptibility.

Effects of Dapagliflozin-Induced Glucosuria on Urinary Tract Infection Susceptibility

Effects of Dapagliflozin-Induced Glucosuria on Urinary Tract Infection Susceptibility

The Effect of Vitamin-D Supplementation in Severe Pneumonia Among Infants

AbstractBackground: Worldwide, acute lower respiratory tract infection (ALRTI) is a leading cause of mortality in children less than 5 years old, more than 90% are in developing countries. Pneumonia is the leading infectious cause of death in children, accounting for 18.3% of all deaths in children less than 5 years of age. Vitamin D is thought to have roles in the improvement of immune function and the reduction of inflammation and may reduce respiratory tract infection susceptibility in children. Vitamin D has an important influence on the host's immune system, modulating both innate and adaptive immunity and regulating the inflammatory cascade.Aim of Study: We aimed to compare the duration and outcome of severe pneumonia of children in the two study groups receiving the standard therapy (appropriate antibiotic and other supportive therapy) with those receiving vitamin D3 supplementation in addition to the standard therapy. Our hypothesis is that vitamin D supplementation decreases the duration of resolution of severe pneumonia in children less than two years of age.Patients and Methods: This was a double-blinded, rand-omized, placebo-controlled trial undertaken in the Children University Hospital, Assiut University during winter. Infants with severe pneumonia between the ages of 3 and 23 months are studied. Patients were randomized to receive vitamin D3 treatment (intervention group) or placebo (control group) to assess the clinical benefit of oral supplementation of vitamin D3, in addition to standard antibiotic and other supportive therapy, to hospitalized infants less than two years of either sex with severe pneumonia.Results: The results of this small randomized controlled clinical trial indicate that short-term supplementation with vitamin D along with antibiotic treatment, significantly reduces the mean time taken for resolution of severe pneumonia (p<0.001) and the mean time taken for the improvement of oral feeding (p<0.05), in the intervention group receiving vitamin D 100IU/kg for at least 5 days from the first day of admission. Vitamin D supplementation was well tolerated in all patients without showing any side effects.

Antimicrobial Resistance Patterns of Escherichia coli Isolated from Urinary Tract Infections in the Midwestern United States

Aims: To determine the antimicrobial resistance of urinary tract infection isolates in a major metropolitan area for the purposes of tracking increases in resistance and to provide information that will help drive improved therapy. Study Design: Antimicrobial r esistance data on Escherichia coli isolated from urinary tract infections was collected and analyzed. Place and Duration of Study: Data was collected from several large healthcare centers in the Detroit, Michigan area. Data collected was from January to July of 2008. Methodology: Data on the antimicrobial susceptibility of 960 Escherichia coli isolated from urinary tract infections w as collected and analyzed to determine resistance to typical drugs used in urinary tract infection susceptibility testing. Results: The percentage of isolates that were resistant to one or more of the drugs tested was 47%. The most common drug resistance w as to ampicillin (41%); with 11.6% of the isolates being only resistant to ampicillin. As to total resistance, 22.4% of the isolates were resistant to only one drug class, 14.4% were resistant to two classes, 7.2% to three classes, and 4.4% to more than th ree classes. Resistance as to antimicrobial effects were: 87.9% were resistant to drugs that Original Research Article

Innate immunity and genetic determinants of urinary tract infection susceptibility.

Purpose of reviewUrinary tract infections (UTIs) are common, dangerous and interesting. Susceptible individuals experience multiple, often clustered episodes, and in a subset of patients, infections progress to acute pyelonephritis (APN), sometimes accompanied by uro-sepsis. Others develop asymptomatic bacteriuria (ABU). Here, we review the molecular basis for these differences, with the intention to distinguish exaggerated host responses that drive disease from attenuated responses that favour protection and to highlight the genetic basis for these extremes, based on knock-out mice and clinical studies.Recent findingsThe susceptibility to UTI is controlled by specific innate immune signalling and by promoter polymorphisms and transcription factors that modulate the expression of genes controlling these pathways. Gene deletions that disturb innate immune activation either favour asymptomatic bacteriuria or create acute morbidity and disease. Promoter polymorphisms and transcription factor variants affecting those genes are associated with susceptibility in UTI-prone patients.SummaryIt is time to start using genetics in UTI-prone patients, to improve diagnosis and to assess the risk for chronic sequels such as renal malfunction, hypertension, spontaneous abortions, dialysis and transplantation. Furthermore, the majority of UTI patients do not need follow-up, but for lack of molecular markers, they are unnecessarily investigated.

Retrospective Analysis of Nosocomial Urinary Tract Infections with Spinal Cord Injury Patients in a Rehabilitation Setting

Objective: To define the distribution and antibiotic susceptibility of nosocomial urinary tract infections (NAUTIs) in patients with spinal cord injury (SCI). Material and Methods: Records of the spinal cord injured patients were reviewed for NAUTIs between 2008 and 2010. Antibiotic resistance rates and factors that might affect urinary tract infection susceptibility were investigated retrospectively. Results: The data of 276 patients were included, of whom 159 were acute SCI patients and 117 were chronic SCI patients; 166 (61%) infections were asymptomatic bacteriuria (ASB), and 110 (39%) infections were symptomatic urinary tract infections (SUTIs). In patients with acute SCI, E. coli was the most frequently isolated pathogen of SUTIs, followed by Pseudomonas. In patients with chronic SCI, E. coli was the most frequently isolated pathogen in SUTIs and ASBs. There was no statistically significant difference in the rates of NAUTI (ASB and SUTI) between acute and chronic SCI patients in terms of bladder drainage method. The susceptibility ratios for E. coli were very low in both acute and chronic SCI patients using Foley catheters. Although the susceptibility ratios for E. coli were not that low in SCI patients using clean intermittent catheterization, the resistance ratios were higher than 50% for most of the uropathogens. Conclusion: These results reveal a blunt truth that the treatment of NAUTIs will be a great challenge in near future.

Diabetes Mellitus and Urinary Tract Infection: Epidemiology, Pathogenesis and Proposed Studies in Animal Models

We reviewed the current state of knowledge about urinary tract infection in patients with diabetes from the clinical and basic science perspectives. We identified key knowledge gaps and areas for further research. We performed a focused literature search on certain topics, including clinical studies related to etiology and pathophysiology of urinary tract infection in patients with diabetes, urinary tract infection studies in animal models of diabetes and basic science studies of the molecular mechanisms of urinary tract infection. Individuals with diabetes are at higher risk for urinary tract infection. Increased susceptibility in patients with diabetes is positively associated with increased duration and severity of diabetes. Clinical epidemiological data identifying mechanisms of increased urinary tract infection susceptibility in patients with diabetes are generally lacking and indicate only that urinary tract infections in women with and without diabetes are qualitatively similar in bacterial etiology and morbid sequelae. Existing animal models for diabetes have not been well characterized for urinary tract infection research. The increased incidence, prevalence and severity of urinary tract infection in patients with diabetes argue for aggressive antibacterial chemotherapy but novel therapies resulting from urinary tract infection research in nondiabetic animal models are still not available. Future clinical investigations of urinary tract infection in patients with diabetes should focus on how the disease differs from that in patients without diabetes, notably on the role of glycosuria and urinary tract infection risk. Basic science research priorities for urinary tract infection in patients with diabetes should emphasize further development of diabetic animal models for urinary tract infection research and clinical translation of known important virulence determinants into new therapies.

The Presence of Urinary Nitrites Is a Significant Predictor of Pediatric Urinary Tract Infection Susceptibility to First- and Third-Generation Cephalosporins

Previous studies in adults have refuted the use of nitrites as a predictor of bacterial resistance to both trimethoprim-sulfamethoxazole and cephalosporins. Some centers now consider first-line outpatient therapy with an oral third-generation cephalosporin appropriate for young children. The objective of this study was to determine if nitrite-negative pediatric urinary tract infections (UTIs) were more likely than nitrite-positive UTIs to be resistant to cephalosporins. This may enable physicians to adjust antimicrobial therapy before patients leave the Emergency Department (ED) to avoid the complications of ineffectively treated pediatric UTIs. A retrospective chart review examined, over a 9-month period, 173 pediatric patients who were diagnosed with a clinical UTI in the ED and who also had a positive urine culture and a recorded dipstick at the time of visit. The chi-squared test and Fisher's exact test were used to compare nitrite-negative vs. nitrite-positive UTIs for resistance to third-generation cephalosporins and other empiric antimicrobials. For third-generation cephalosporins, 1.4% of nitrite-positive UTIs were resistant, whereas 14.4% of nitrite-negative UTIs were resistant (95% confidence interval [CI] -0.22 to -0.05). For first-generation cephalosporins, 8.4% were resistant in the nitrite-positive group, compared to 22.2% in the nitrite-negative group (95% CI -0.24 to -0.03). The absence of urinary nitrites is a significant indicator for potential resistance to cephalosporins in pediatric UTIs. Due to low levels of pediatric UTI resistance, cephalosporins continue to represent useful empiric therapy in the general pediatric population. However, in high-risk patients, physicians may opt to alter their empiric choice of antibiotic based on the presence of urinary nitrites.