Urinary Research Articles

Characteristics of urinary stone composition among patients with urolithiasis: a retrospective study in China

ObjectiveTo present the most recent data on urinary calculi characteristics in the southern region of China and explore the effects of sociodemographic, clinical and laboratory characteristics on stone composition to...

Rapid Dynamic Surface-Enhanced Raman Spectroscopy Detection of Amoxicillin-Mediated Morphological Changes in a Pathogen for Diagnosis of Clinical Urine Samples.

The swift and stable detection of pathogens in urine samples holds significant implications for the immediate clinical diagnosis and treatment of urinary tract infections (UTIs). In this study, we propose a detection strategy utilizing a hybrid substrate composed of graphene oxide (GO) and silver nanoparticles (Ag NPs) for the detection of pathogens subjected to amoxicillin-mediated (amo-mediated) treatment. This strategy employs dynamic surface-enhanced Raman spectroscopy (D-SERS) for stable and rapid detection, capturing signal variations induced by amo-mediated changes in pathogen morphology. During the 5 min D-SERS detection time window, stable SERS signals were detected for three types of pathogens and four types of pathogens were successfully distinguished using principal component analysis (PCA). In comparison to conventional nanosubstrates, the GO/Ag NP hybrid substrate exhibits outstanding stability and enhancement effects. This approach enables the dual detection of the pathogen cell structure and metabolites, facilitating specific identification of pathogens in the urinary tract, with a detection limit for Escherichia coli reaching 1 × 104 colony-forming units (CFU)/mL, meeting the clinical microbiology laboratory diagnostic standards for UTIs (105 CFU/mL). Testing of 188 clinically collected urine samples using this strategy yielded a sensitivity (SENS) of 86.4% and a specificity (SPC) of 89.7%. This introduces a novel method for diagnosing UTIs, offering broad applications in the field of clinical pathogen detection.

The effect of urinary diversion on kidney function in posterior urethral valves and ureterovesical obstruction.

Posterior urethral valves (PUV) and ureterovesical junction obstruction (UVJO) are common etiologies of lower urinary tract obstruction. The primary objective of therapy is to alleviate the obstruction in the urinary system. Temporary urinary diversion may be necessary in certain situations, such as Urinary tract infection (UTI), sepsis, and unchanging hydronephrosis. This study, aims to assess kidney parameters after urinary diversion (either pyelostomy or ureterostomy) in patients with PUV and UVJO. We conducted a retrospective analysis of all patients diagnosed with PUV or UVJO and treated with urinary diversion following urinary undiversion at our facility between 2015 and 2020. The following variables were collected: demographic details, surgical interventions (type of diversion), serum creatinine throughout follow-up, anterior-posterior diameter of the pelvis (APP), anterior-posterior diameter of the ureter (APU), and sonographic findings of renal parenchymal thickness (PT) as documented by a pediatric radiologist. Additionally, before and after urinary diversion, a Dimercapto succinic acid (DMSA) nuclear renal scan was conducted to assess renal function. We analyzed 67 patients, with a mean follow-up of 38.3months, undergoing either ureterostomy (42 patients) or pyelostomy (25 patients). This included 38 patients with PUV and 29 with UVJO. In PUV patients, significant improvements were observed in APP (MD = 5.56 ± 11.6, p = 0.0194), APU (MD = 5.57 ± 7.28, p < 0.001), and PT (MD = 3.66 ± 2.75, p < 0.001). Similarly, UVJO patients experienced significant improvements in APP (MD = 12.18 ± 18.63, p = 0.005), APU (MD = 7.82 ± 8.98, p = 0.001), and PT (MD = 2.79 ± 3.33, p = 0.001). DMSA scores did not significantly change in either group (p > 0.05). Notably, APP improved more in UVJO patients compared to PUV patients (p = 0.047). Our study suggests that urinary diversion could improve APP, APU, and renal parenchymal thickness in PUV and UVJO patients. The improvement of APP in UVJO patients was greater than in the PUV group. We propose further multi-center studies with longer durations of follow-up and more detailed additional data to support and confirm our results.

Effects of Routine Catheterization on Urinary Tract Infection Rates After Minor Gynecologic Surgeries

This pilot study describes urinary tract infection (UTI) rates after routine single catheterization during minor gynecologic surgeries at a tertiary care community hospital. Records from 762 patients from 2021 were reviewed, including procedures such as hysteroscopy, loop electrosurgical excision procedure, and dilation and curettage. Findings revealed a 42.4% catheterization rate, with a significantly higher proportion of catheterized patients having UTIs (5.6%) compared with noncatheterized patients (2.5%). This study suggests that catheterization, unless medically necessary, should be avoided to reduce nosocomial infection risk. These results advocate for reconsidering current practices to enhance patient care and minimize preventable UTIs.

Epidemiological and clinical management aspects related to urinary tract infections diagnosed in the emergency department in elderly patients in Spain: Results of the EDEN-36 study

To estimate the incidence of urinary tract infections (UTI) in elderly patients in Spanish emergency departments (ED), the need for hospitalization, diagnostic confirmation in hospitalized patients, adverse events and the predictive capacity of several biomarkers. In this a posteriori substudy of a generic study of reasons for ED visits in elderly patients, we included patients aged ≥65 years seen in 52 Spanish EDs for 1 week, selecting those diagnosed with UTI. As adverse events, in-hospital and 30-day mortality and combined adverse event (death or hospitalization) at 30 days post-discharge were collected. Relative risks (RR) were calculated. The predictive capacity of 10 variables and 6 biomarkers was investigated. A total of 25,375 patients were included, 1058 with UTI (annual incidence: 24.7 per 1000 inhabitants aged ≥65 years and year, 95%CI: 24.5-24.9). A total of 36.5% were hospitalized, and in 80% the diagnosis of UTI was confirmed at discharge. Overall 30-day mortality was 5.4% and in-hospital mortality was 3.4%. Functional dependence was associated with both events (RR:2.91;1.18-7.17 and RR:12.61;1.47-108.11, respectively), as was having a CRP greater than 100 mg/L (RR:2.24;1.17-4.30 and RR:3.21;1.37-7.51, respectively). The combined post-high event occurred in 10.6%, and was associated with functional dependence (RR:2.05;1.04-4.06). CRP and hemoglobin had significant value in predicting 30-day post-discharge mortality or hospitalization. UTI is a frequent diagnosis in elderly patients consulting in the ED. Functional dependence is the best factor associated with adverse events. The biomarkers analyzed do not have a good predictive capacity.

Quality of Publicly Available Information About Urinary Tract Infections.

This cross-sectional study examines the content and quality of information about urinary tract infections and asymptomatic bacteriuria on publicly available websites.

Population-Based Survey of Urinary Incontinence, Overactive Bladder, and Other Lower Urinary Tract Symptoms in Five Developing Countries: Results of the BEBIC Study.

This study aimed to assess the prevalence of urinary incontinence (UI) and lower urinary tract symptoms (LUTS) in five selected low and middle-income countries to provide appropriate evidence for other related studies. In this multinational population-based cross-sectional survey between August 2019 and April 2021, validated questionnaires were used to assess LUTS in adults over 18 years from Iran, Egypt, Bangladesh, Brazil, and Cameroon. A total of 1477 participants from five countries completed the questionnaires. The mean age of participants was 43.5 ± 15.7 years. 37.1% reported at least one episode of UI per week. UUI prevalence in different countries analysis showed that the commonest prevalence was reported in Cameron (40.0%; n = 30), while the lowest was 15.0% (n = 31) in Brazil. Stress UI was common in Iran (38.7%; n = 338), and Bangladesh had the lowest rate (7.8%; n = 16). Urinary urgency was the common LUTS among participants (59.9%, n = 818 out of 1477 participants). Nocturia was the other prevalent symptom among cases (50.6%; 748 out of 1477 cases), and this symptom had a higher rate in elderly populations. Men reported voiding and postmicturition symptoms more frequently than women. Storage symptoms except for nocturia, including frequency, urgency, and UI were common in women while voiding symptoms, including straining, and intermittency were reported more frequently in men than women. A high prevalence of urinary symptoms was reported in low to middle-income countries.

Clinical characteristics and survival of patients with de novo metastatic prostate cancer treated with androgen deprivation therapy and taxane-based chemotherapy in Uganda: a retrospective study.

Prostate cancer is the second most common cancer among men worldwide. Mortality is highest among patients in resource-limited settings (RLS), in part due to late-stage disease. Among patients with metastatic prostate cancer (mPCa), studies have shown significant improvement in overall survival with the use of androgen deprivation therapy (ADT) and taxane-based chemotherapy. However, outcome data among patients treated with chemo-endocrine therapy are scarce in many resource-limited settings. The aim of this study was to determine the clinical characteristics and 5-year overall survival (OS) of patients with de novo mPCa treated at the Uganda Cancer Institute (UCI). A retrospective chart review study was conducted between 2015 and 2019, and the data of patients with histologically confirmed prostate cancer and radiological evidence of metastasis were reviewed. Sample size was estimated for Cox Proportion Hazard regression. Data on clinical and laboratory characteristics, overall survival, and predictors of survival were extracted. P < 0.05 was considered to indicate statistical significance. A total of 300 patients were enrolled over the 5-year study period. The median age was 68 (IQR 61.5-74) years. At presentation, lower urinary tract symptoms were reported in nearly all patients (96.7%, n = 290), median total prostate specific antigen (PSA) was 414.75 ng/ml and 40% (n = 120) of patients had grade 5 histological scores. In addition to receiving ADT, majority of patients (70.3%, n = 211) received at least 6 cycles of chemotherapy. Overall survival at one year was 92.4% (95% CI: 88.6-94.9%), but it declined to 45.2% (95% CI: 36.8-53.2%) at 5 years. A high Gleason score, the presence of visceral metastasis and receiving less than 6 cycles of chemotherapy were predictors of poor outcomes. Patients with de novo mPCa in Uganda present with high histologic grades and high baseline Prostate Specific Antigen (PSA) levels but have improved 5-year overall survival with a combination of chemotherapy and ADT as a first-line treatment. We recommend interventions to reduce late presentation and prospective studies to evaluate treatment efficacy in this population.

Characteristics of Urinary Tract Infections in Patients with Diabetes from Timișoara, Romania: Prevalence, Etiology, and Antimicrobial Resistance of Uropathogens

Characteristics of Urinary Tract Infections in Patients with Diabetes from Timișoara, Romania: Prevalence, Etiology, and Antimicrobial Resistance of Uropathogens

Antibiotic efficacy and resistance patterns of urinary tract infection-causing bacteria in dogs and resistome of multidrug-resistant Klebsiella pneumoniae via whole genome sequencing in South Korea

Bacterial urinary tract infections (UTIs) are prevalent in dogs and necessitate antibiotic intervention. However, the emergence of multidrug-resistant (MDR) bacteria poses significant challenges to antibiotic therapy. Although fosfomycin has been demonstrated to achieve and maintain high concentrations in urine, suggesting its potential for treating UTIs in dogs, its efficacy and the resistance profiles of urinary pathogens from canine UTIs remain elusive. Therefore, this study was conducted to investigate the antibiotic susceptibility of bacterial pathogens isolated from companion dogs with UTIs, with a particular focus on their susceptibility and resistance to fosfomycin. A total of 70 isolates from urine samples were analyzed, of which Escherichia coli (n = 18), Proteus mirabilis (n = 9), Klebsiella pneumoniae (n = 5), and Staphylococcus pseudintermedius (n = 5) were predominant. Resistance to erythromycin was most prevalent (94.59%), followed by clindamycin (91.89%) and ampicillin (78.37%), whereas the lowest resistance rate was observed for amikacin (5.40%). Resistance to fosfomycin was observed in 15 out of the 37 predominant isolates (40.54%), including all K. pneumoniae isolates (100%). All isolates, except 4 E. coli strains, were categorized as MDR (33 out of 37; 89.18%). The resistance rates for amoxicillin/clavulanic acid and trimethoprim-sulfamethoxazole, which are common first-line antibiotics for canine UTIs, were 48.64 and 56.75%, respectively. Whole-genome sequencing of K. pneumoniae isolates, which exhibited high resistance to fosfomycin, revealed multiple antibiotic resistance genes, with chromosomal fosA present in all isolates. Among the 27 dogs with recurrent infection included in this study, 2 were administered fosfomycin, resulting in clinical remission, as evidenced by negative urine culture tests. Overall, this study is the first to demonstrate the importance of assessing fosfomycin resistance profile for optimal treatment of canine UTIs, particularly in cases involving MDR strains.

Multicenter epidemiological analysis of related factors in 10,808 hospitalized children with lower limb and pelvic fractures in China.

To analyze the causes, locations, associated injuries, and relevant factors of lower limb and pelvic fractures in hospitalized children in China to provide a theoretical basis for reducing the incidence of such fractures. A retrospective analysis of children with lower limb and pelvic fractures admitted to 27 tertiary children's hospitals affiliated with China's Futang Research Center of Pediatric Development between December 1, 2015, and December 31, 2019, was conducted. Inpatient cases were analyzed in the following age groups: Infants (< 2years), Preschool children (2-5years), School children (6-11years), and Adolescents (12-18years). This study included 10,808 pediatric patients (7152 males, 3656 females). The proportion of preschool children of lower limb and pelvic fractures was the highest. The 10,808 patients sustained a total of 14,398 fractures. The shafts of the femur, tibia, and fibula, the distal tibia, distal fibula, and the pelvis were the six most common locations. Of the 734 pelvic fractures in children and adolescents, the top three locations were the ilium, pubic bone, and the ischium. Of the total patients, 9599 underwent surgery, while 1209 received non-surgical treatment. The three most common causes of pediatric lower limb and pelvic fractures were falling over, traffic accidents, and falling from a height. Among the 1806 concomitant traumas, respiratory traumas was the most common, mainly pulmonary contusion. The most common concomitant traumas of nervous, digestive and urinary system were scalp hematoma, liver injury and kidney injury respectively. The analysis of the location, age, causes, and concomitant injuries of lower limb and pelvic fractures showed that the most common fracture requiring hospitalization was tibia fracture, which was most common in preschool children. The most common cause of injury in preschool children was traffic accident. In addition, children are susceptible to accidental injuries from multiple sources in life, which can cause serious consequences of multi-system injuries.

Prevention of infectious complications after radical cystectomy: a systematic review and meta-analysis

The aim of this study was to conduct a systematic review and meta-analysis of the literature to evaluate the impact of different antibiotic prophylaxis (АР) strategies on the incidence of infectious complications within 30 days after radical cystectomy (RC).Material and Methods. The meta-analysis protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO): ID-CRD42023480525. A systematic search for studies published in the last 10 years (November 2013 – November 2023) was conducted in the PubMed and Cochrane Library databases by two independent researchers. A total of 7 full-text articles were included in the final statistical analysis (data from 90,935 patients). The analysis focused on three aspects: comparison of the effectiveness of different durations of antibiotic prophylaxis (24 hours or more), the impact of the type of antibacterial agent used, and the application of Enhanced Recovery after Surgery (ERAS) protocols on the overall incidence of infectious complications, the development of soft tissue infections, and upper urinary tract infections (UTIs). Meta-analysis was performed using R 4.3.2 (R Foundation for Statistical Computing, Vienna, Austria) and the metafor 4.2-0 package.Results. The median overall incidence of infectious complications was 31.78 % (23.8–58.8 %), surgical site infections – 16.46 % (6.25–35.41 %), and UTIs – 25.11 % (3.86–35.7 %), including cases leading to urosepsis. The meta-analysis did not reveal a statistically signifшcant effect of the duration of AP (24 hours or more) on the risk of infectious complications: for overall infectious complications, the risk was OR 1.11 (95 % CI 0.92–1.33; p=0.27), for surgical site infection OR 1.00 (95 % CI 0.87–1.15; p=0.97), and for UTIs OR 0.96 (95 % CI 0.84–1.10; p=0.59). However, the overall incidence of infectious complications was significantly higher in the standard perioperative management group, without ERAS protocols (OR=3.02 [95 % CI 2.07; 4.39], p&lt;0.001, I 2 =93.1 %). Conclusion. The results of this study indicate that existing AP strategies may be ineffective in reducing postoperative infectious complications in patients undergoing cystectomy with urinary diversion. Extending AP beyond 24 hours, as well as the standard regimen, did not demonstrate a reduction in infection risk, highlighting the need for a revision of clinical guidelines in this area. The principles of the ERAS program may play a crucial role in reducing infectious complications, showing promising results and requiring further research and implementation in clinical practice. Key words: radical cystectomy, antibiotic prophylaxis, complications, surgical site infection, upper urinary tract infections, ERAS&gt; ˂ 0.001, I2 =93.1 %).Conclusion. The results of this study indicate that existing AP strategies may be ineffective in reducing postoperative infectious complications in patients undergoing cystectomy with urinary diversion. Extending AP beyond 24 hours, as well as the standard regimen, did not demonstrate a reduction in infection risk, highlighting the need for a revision of clinical guidelines in this area. The principles of the ERAS program may play a crucial role in reducing infectious complications, showing promising results and requiring further research and implementation in clinical practice.

Impact of Covid-19 Infection on Incidence and Exacerbation of Overactive Bladder Symptoms: A Systematic Review

Background The COVID-19 pandemic continues to be a major global health concern. A key factor is the presence of angiotensin-converting enzyme 2 (ACE2) receptors in various organs, including the lungs, heart, bladder, and testicles. These receptors allow the SARS-CoV-2 virus to enter cells, making these organs vulnerable to damage. This vulnerability may explain why some patients experience non-respiratory symptoms. Notably, overactive bladder (OAB) symptoms and a condition called COVID-associated cystitis (CAC) have been reported to negatively affect the quality of life of COVID-19 patients. A systematic review is needed to summarize the current understanding of these urological aspects of SARS-CoV-2 infection, considering both short- and long-term effects. Methods We conducted a systematic review in accordance with PRISMA guidelines to investigate urological complications of COVID-19, with a specific focus on OAB symptoms and CAC (characterized by frequent urination, urgency, and nocturia). We searched databases, including Medline (PubMed), Embase, and Scopus. Two reviewers independently screened the studies, and the quality of each study was assessed using the Newcastle-Ottawa Scale (NOS). Results Our search identified 343 articles published up to March 2024, of which 12 were included in this review. Many of the studies utilized scoring systems such as the International Prostate Symptom Score (IPSS) and OAB symptom scores. The evidence suggests that COVID-19 may trigger or worsen lower urinary tract symptoms, OAB, and cystitis in some patients, regardless of gender or age. However, these effects appear to be uncommon. Several studies reported an increase in IPSS scores, though it remains unclear whether this increase is temporary or long-lasting. A few studies found that symptoms resolved over several months. Conclusion This systematic review suggests that COVID-19 may affect the urinary system, leading to symptoms such as frequent urination, urgency, and nocturia. These symptoms can negatively impact the quality of life in COVID-19 patients.

Maternal illnesses during pregnancy and the risk of childhood cancer: A medical-record based analysis (UKCCS).

Often relying on mother's recollections of past events, the possible relationship between maternal illness in pregnancy and risk of malignancy in their offspring has long been a focus of research. Free from recall bias, this study of childhood cancer (0-14 years) examined these associations using data abstracted from mothers' primary-care (1623 cases, 2521 controls) and obstetric (2721 cases, 5169 controls) records. Maternal infections and other illnesses in pregnancy were examined for any possible associations with childhood leukaemia, lymphoma, CNS or embryonal tumours using pooled information from the two medical record sources (2885 cases and 5499 controls), accounting for potential confounders. Maternal anaemia was associated with childhood acute myeloid leukaemia (AML) (odds ratio, OR = 2.07, 95%CI [1.40-3.08]). Anaemia during pregnancy was also recorded more frequently in the notes of mothers of children with medulloblastoma, retinoblastoma and embryonal rhabdomyosarcoma: ORs 2.36 [1.36-4.11], 1.83 [1.01-3.33] and 2.91 [1.64-5.16] respectively. Other associations included urinary tract infections (UTIs) and non-Hodgkin lymphoma (NHL); preeclampsia and NHL; and polyhydramnios with both AML and NHL. No evidence was found to suggest that influenza during pregnancy impacted on childhood leukaemia risk. In conclusion, our findings are supportive of an association between maternal anaemia in pregnancy and childhood AML, and maternal anaemia and embryonal tumours; underscoring the need for further research exploring the potential causes and roles of iron and vitamin deficiencies. Due to small numbers and lack of corroborative evidence, the associations observed for UTIs, preeclampsia, and polyhydramnios must be treated cautiously.

Urinary Retention After GreenLight Laser Photoselective Vaporization of the Prostate (GLL.PVP) Surgery for Benign Prostatic Hyperplasia (BPH): A 3-6 Month Retrospective Follow-Up Study.

Objective Our study was designed to evaluate the postoperative urinary retention (UR) and success rate of the GreenLight Laser (Boston Scientific, Marlborough, MA, USA) photoselective vaporization of the prostate (GLL.PVP) procedure for Benign Prostatic Hyperplasia (BPH) patients, both with and without high-risk factors. Methodology We conducted a retrospective follow-up study of postoperative patients who underwent GLL.PVP for BPH. We collected data from clinical health records, including notes from the lower urinary tract symptoms (LUTS) clinic, trial without catheter (TWOC) clinic, and emergency department presentations with UR. The analysis examined several parameters, including the patient's age, high-risk factors, prostate volume, and both preoperative and postoperative objective voiding parameters. These voiding parameters included post-void residual (PVR) and maximum flow rate (Qmax). Additionally, the analysis looked into whether the patient had a catheter or experienced urinary retention prior to the surgery. Results A total of 50 GreenLight Laser PVP surgeries were performed over a 14-month period from May 2023 to July 2024 at West Middlesex University Hospital in London. Most of the patients were between the ages of 60 and 80. Prior to the surgery, data indicated that 17 patients (34%) were using long-term catheters, whereas 33 patients (66%) were not. Additionally, 25 patients (50%) were identified as having high-risk factors, which included being on anticoagulation therapy, a history of urinary retention, and a prostate volume exceeding 100 cc.Notably, the patient without h/o urinary retention had an average preoperative PVR of 150 mL and an averageQmaxof 7 mL/second In our 3-6 month retrospective postoperative follow-up study, we found that eight cases (16%) developed urinary retention, while 42 cases (84%) did not, with an average PVR volume of 105 mL and an average Qmax of 13.5 mL/second. In patients with preoperative urinary retention, 13 cases (76%) did not develop UR postoperatively whereas four cases (24%) developed. Conclusion Our study conclusively found that 42 cases (84%) of patients did not experience urinary retention (UR) in the follow-up after undergoing the GLL PVP operation, irrespective of any history of urinary retention or other high-risk factors. This unequivocally demonstrates the operation's efficacy. Furthermore, our findings revealed that three-quarters of patients with a preoperative history of urinary retention also did not develop UR post-surgery. The GLL.PVP procedure is safe and effective, leading to rapid improvements in voiding parameters.

Prevalence and antimicrobial susceptibility profile of uropathogens in dogs and cats with signs of urinary tract infection.

To determine the prevalence of uropathogens in dogs and cats with signs of urinary tract infection and to characterise their antimicrobial susceptibility. Urine samples from canine and feline patients with clinical signs of urinary tract infection were collected between September 2015 and December 2019 in Santiago, Chile. Bacterial identification and bacterial susceptibility profile was performed through biochemical and antimicrobial susceptibility tests. Four hundred sixty-six samples from dogs (37.7%) and 152 from cats (26.1%) showed bacterial growth. Positive samples were mainly from females (dogs: 52.8%; cats: 48.0%), with the highest infection rates in senior dogs (57.7%) and adult cats (45.4%). A single organism caused the infection in 78.2% of the cases, whereas the remaining 21.8% corresponded to a mixed infection. The most prevalent isolated pathogen in dogs and cats was Escherichia coli (42.6% and 49.7%, respectively). Staphylococcus spp. (15.6% and 14.6%), Enterococcus spp. (8.6% and 15.2%) and Proteus spp. (9.7% and 6.4%) were also commonly isolated. A total of 52.4% of Escherichia coli isolates were resistant to amoxicillin, 44.3% to amoxicillin/clavulanic acid, 40.0% to cephradine and 25.3% to ciprofloxacin. Regarding the other three uropathogens commonly isolated in this study, all of them showed a percentage of resistance to the antimicrobials analysed. In addition, 24.6% of multidrug resistance was detected in the E. coli isolates. Penicillin, cephalosporins and fluoroquinolones showed the lowest susceptibility levels. The observed high rates of resistance to commonly prescribed antimicrobials raise concerns for public health.

Unveiling the hidden arsenal: new insights into Proteus mirabilis virulence in UTIs

Proteus mirabilis is a Gram-negative bacterium commonly found in urinary tract infections (UTIs) and catheter-associated urinary tract infections (CAUTIs). The pathogenic mechanisms of Proteus mirabilis are complex and diverse, involving various virulence factors, including fimbriae, flagella, urease, polyphosphate kinase, lipopolysaccharides, cyclic AMP receptor protein, Sigma factor RpoE, and RNA chaperone protein Hfq. These factors play crucial roles in bacterial colonization, invasion, evasion of host immune responses, biofilm formation, and urinary stone formation. This paper is the first to comprehensively describe the hydrogenase system, autotransporter proteins, molybdate-binding protein ModA, and two-component systems as virulence factors in Proteus mirabilis, providing new insights into its pathogenic mechanisms in urinary tract infections. This review explores the mechanisms of biofilm formation by Proteus mirabilis and the various virulence factors involved in UTIs, revealing many newly discovered virulence factors from recent studies. These findings may offer new targets for clinical treatment of UTIs and vaccine development, highlighting the importance of understanding these virulence factors.

Prevalence and Antibiotic Resistance of Streptococcus agalactiae in Women of Childbearing Age Presenting Urinary Tract Infections from Western Romania

Urinary tract infections (UTIs) are a common bacterial infection in women of childbearing age. Streptococcus agalactiae (Group B Streptococcus—GBS), a rare causative pathogen of UTIs in this population, is particularly important due to the potential risk during pregnancy, when it can lead to life-threatening neonatal infections. The current study analyzed 17,273 urine samples collected from consecutive women aged 18–45 years from Arad County, Western Romania. A total of 2772 samples tested positive for UTIs. In 130 cases, GBS was identified as the causative agent. Univariate logistic regression analysis revealed that women aged 25–34 years were more likely to test positive for GBS than those aged 18–24 years (cOR = 1.91, 95% CI: 1.07–3.43, p = 0.03). Antibiotic sensitivity testing revealed that all GBS strains were fully sensitive to penicillin, ampicillin, and vancomycin. High resistance was observed for clindamycin (77.34%) and tetracycline (88.46%). While GBS was found to be a rare pathogen in UTIs, our results underscore the importance of monitoring GBS in women of childbearing age, especially due to its risks during pregnancy, and emphasize the need for appropriate antibiotic management.

A Five-Year Retrospective Study on the Clinical Outcomes of Sacral Nerve Stimulation for Neuromodulation of the Lower Urinary Tract in a Tertiary Hospital

A Five-Year Retrospective Study on the Clinical Outcomes of Sacral Nerve Stimulation for Neuromodulation of the Lower Urinary Tract in a Tertiary Hospital

Frequency and risk factors of nosocomial infections in atrauma center: acase study from the Beni Suef University Hospital, Egypt.

Hospital-acquired infections (HAI) cause asignificant risk to patient maintenance and wellbeing, particularly within the specialized environment of atrauma center. This study focuses on investigating the frequency of HAI in atrauma center through acomprehensive surveillance and monitoring system. This observational study, conducted between January 2023 and June 2023, focused on the 16-bed trauma center. HAI diagnoses were based on the centers for disease control and prevention (CDC) definitions that typically include specific criteria for different types of infections, for example, urinary tract infections, surgical site infections, bloodstream infections, and others. Among the 160 trauma center-admitted patients, 89were included in the study. 44patients contracted HAI, resulting in afrequency of 49.4%. The incidence rates (IR) were 21/1000 central venous catheter (CVC) days for catheter-related bloodstream infections (CRBSI), 10/100 urinary catheter days for catheter-associated urinary tract infections (CAUTI), and 34/1000 ventilator days for ventilator-associated pneumonia (VAP). The HAI percentages noticed in the trauma center are comparatively lower than those reported in other developing country hospitals. The incidence of VAP aligns with findings from other studies.