Urinary Tract Infection Research Articles

Antibacterial Mechanisms and Clinical Impact of Sitafloxacin

Sitafloxacin is a 4th generation fluoroquinolone antibiotic with broad activity against a wide range of Gram-negative and Gram-positive bacteria. It is approved in Japan and used to treat pneumonia and urinary tract infections (UTIs) as well as other upper and lower respiratory infections, genitourinary infections, oral infections and otitis media. Compared to other fluoroquinolones, sitafloxacin displays a low minimal inhibitory concentration (MIC) for many bacterial species but also activity against anaerobes, intracellular bacteria, and persisters. Furthermore, it has also shown strong activity against biofilms of P. aeruginosa and S. aureus in vitro, which was recently validated in vivo with murine models of S. aureus implant-associated bone infection. Although limited in scale at present, the published literature supports the further evaluation of sitafloxacin in implant-related infections and other biofilm-related infections. The aim of this review is to summarize the chemical-positioning-based mechanisms, activity, resistance profile, and future clinical potential of sitafloxacin.

Investigation of Antibiotics Susceptibility and Resistance Pattern of ESBL and CRE Producing Escherichia coli and Klebsiella pneumonia Isolates from Northern Region of Saudi Arabia

The presence of ESBLs and CRE in E. coli and Klebsiella pneumoniae poses a significant challenge in healthcare and community settings. These enzymes can confer resistance to multiple antibiotics, limiting treatment options for infections caused by these strains. This resistance complicates infection management, leading to prolonged illness, increased healthcare costs, and higher mortality. This cross-sectional study, conducted from 2021 to 2022 at three hospitals in the northern border region of Saudi Arabia, involved collecting 541 samples from various wards and units. Samples were inoculated on blood-agar and MacConkey’s media, incubated overnight at 37°C, and analyzed for growth. Antibiotic susceptibility was tested using the “MicroScan WalkAway-96 SI-automated system. A total of 541 positive cases were collected from three major cities in the northern border territory of Saudi Arabia. Observations show that E. coli (18.66%, n = 101) was the most prominent pathogen, compared to Klebsiella pneumoniae (9.9%, n = 54). Females were more prone to ESBL-producing E. coli infections, with 67% having a urinary tract infection, whereas male patients were more predisposed to respiratory K. pneumoniae infections (54% compared to females at 46%). Out of 155 samples, 49.01% were ESBL-producing E. coli, and 20.38% were ESBL+CRE. Furthermore, 15.68% of K. pneumoniae were ESBL producers. E. coli showed resistance to 92% of ampicillin, 90% of oxacillin, 79% of ceftazidime, 76% of cefepime, 57% of aztreonam, and 53% of cephalothin, while amikacin (85%), imipenem, and meropenem were effective. Klebsiella pneumoniae showed 74% resistance to ampicillin, 67% to ceftazidime, 63% to co-trimoxazole, 57% to amoxicillin-clavulanate, and 42% to aztreonam. The sensitive antibiotics were imipenem (46%), aztreonam (42%), and amikacin (44%). The results are both intriguing and alarming. It is crucial to address the spread of ESBL and CRE-producing organisms.

Model-informed drug development for antimicrobials: translational pharmacokinetic-pharmacodynamic modelling of apramycin to facilitate prediction of efficacious dose in complicated urinary tract infections.

The use of mouse models of complicated urinary tract infection (cUTI) has usually been limited to a single timepoint assessment of bacterial burden. Based on longitudinal in vitro and in vivo data, we developed a pharmacokinetic-pharmacodynamic (PKPD) model to assess the efficacy of apramycin, a broad-spectrum aminoglycoside antibiotic, in mouse models of cUTI. Two Escherichia coli strains were studied (EN591 and ATCC 700336). Apramycin exposure-effect relationships were established with in vitro time-kill data at pH 6 and pH 7.4 and in mice with cUTI. Immunocompetent mice were treated with apramycin (1.5-30 mg/kg) starting 24 h post-infection. Kidney and bladder tissue were collected 6-96 h post-infection for cfu determination. A PKPD model integrating all data was developed and simulations were performed to predict bacterial burden in humans. Treatment with apramycin reduced the bacterial load in kidneys and bladder tissue up to 4.3-log compared with vehicle control. In vitro and in vivo tissue time-course efficacy data were integrated into the PKPD model, showing 76%-98% reduction of bacterial net growth and 3- to 145-fold increase in apramycin potency in vivo compared with in vitro. Simulations suggested that an 11 mg/kg daily dose would be sufficient to achieve bacterial stasis in kidneys and bladder in humans. PKPD modelling with in vitro and in vivo PK and PD data enabled simultaneous evaluation of the different components that influence drug effect, an approach that had not yet been evaluated for antibiotics in the cUTI model and that has potential to enhance model-informed drug development of antibiotics.

Isolation and Identification of Pathogenic Bacteria from Urinary Tract Infection in Patients Attending Rwanda Military Hospital

Background: About 150 million people worldwide are diagnosed with urinary tract infection every year and more than half of women will get at least one in their lifetimes. Overuse and misuse of antibiotics have contributed to the growing problem of resistance amongst uropathogenic bacteria making it hard to treat UTIs. There is an increasing prevalence of antibiotic resistance and that’s why area-specific monitoring studies to document the microorganisms causing UTIs and their antimicrobial susceptibility is mandatory for helping the selection of an effective empirical treatment. Aim: The present study aimed to determine bacteria causing UTIs and their antibiotic susceptibility patterns among patients attending Rwanda military hospital. Methodology: The study was a cross-sectional study and a total number of 118 patient’s urine samples were tested in microbiology Lab. Results: Most frequently isolated bacteria to cause UTIs in this study was E. coli (59%) followed by Klebsiella pneumonia (16%), S. aureus (6%), Citrobacter freundii (5%), Proteus spp. (3%), S. Saprophyticus (3%), Streptococcus spp. (3%), Pseudomonas aeruginosa (2%), Klebsiella oxytosa (2%) and Acinetobacter baumanii (2%). Meropem, imipem, gentamicin and cefotaxime were the most effective antibiotics in susceptibility testing. Thus, ciprofloxacin, sulfamethoxazole and norfloxacin were mostly developed resistance to isolated bacteria. Conclusion: The study recommended that the ministry of health in Rwanda should establish the commission or government body which will be in charge of controlling use of antibiotics properly and fighting against drugs resistance in Rwanda. Keywords: Pathogenic bacteria, Urinary tract infections, E.coli, Antibiotics

Clinical and laboratory antenatal profile screening and its associate factors among pastoralist women in Northern Part of Kenya

IntroductionAll pregnant women are encouraged to visit Antenatal Care (ANC) during pregnancy to ensure their wellbeing and that of their unborn baby. World Health Organization (WHO) recommends that all pregnant women attend antenatal clinics for care at least eight times during pregnancy. During antenatal care a series of essential tests are done for pregnant women, both clinical examination and laboratory screenings to detect potential issues which will guide clinicians on management. This study aims to investigate the clinical examination and laboratory screening profile results of pastoralist pregnant women and its associated factors during their first ANC visit in Marsabit County, Kenya.MethodsA cross-sectional study was conducted among pregnant women who attended Integrated Maternal Mobile (IMMH) outreach clinics for ANC in 10 mobile pastoralist communities. Data were collected on demographic information, clinical examination information, and laboratory profile screening outcomes. Frequency and percentages were used to describe the categorical variables and means and standard deviations were used to describe the continuous variables. Bivariate and multivariate analysis was conducted using IBM SPPS 27.0 following STROBE guidelines. The level of significance was set at p < 0.05.ResultsData (N = 237) were extracted, the mean age was 26.62 ± 5.371, of which the majority were in the age group of 20–29, 212 (89.5%) were married 180 (75.9%) and multigravida, 27 (11.4%) visited ANC and 121 (51.1%) traveling more than 15 km to seek healthcare services. The mean weight was 55.56 ± 9.019 kg, mean blood pressure systolic was 118.94 ± 19.95 mmHg, and diastolic was 73.87 ± 13.46 mmHg. Out of all specimens processed and tested, 135 (57%) were anaemic with Hgb <11.5 g/dL), 6 (2.5%) had malaria, 8 (3.4%) were hepatitis B positive, and 21 (8.9%) showed intestinal infection. Those women who are illiterate displayed a 12-fold higher likelihood of becoming anaemic during pregnancy (OR 11.50, 95% CI: 2.47–53.47), and those who didn’t attend ANC also have a 5-fold higher likelihood of being anaemic (OR 5.43, 95% CI: 2.52–11.70).ConclusionAnaemia, hepatitis B, syphilis, malaria parasites, intestinal parasites, and urinary tract infections were observed among the study participants. Integrated outreach programs with laboratory screening and health education should be enhanced, and women within pastoralist communities should be empowered through health education.

Infection Risk Associated with High-Efficacy Disease-Modifying Agents in Multiple Sclerosis: A Retrospective Cohort Study.

In patients with multiple sclerosis (MS), infections represent a significant concern, particularly given the immunomodulatory effects of disease-modifying agents (DMAs). High-efficacy DMAs (heDMAs) play a pivotal role in delaying MS progression, yet their use also raises concerns regarding the risk of infection. This study aimed to compare the infection risk with the use of heDMA and moderate-efficacy disease-modifying agents (meDMAs) in MS patients. This retrospective cohort study involved adult (18-64 years) MS patients with incident DMA use based on the 2015-2019 MarketScan Commercial Claims and Encounters Database. Patients initiating heDMAs (natalizumab, alemtuzumab, and ocrelizumab) or meDMAs (interferon beta-1a, interferon beta-1b, fingolimod, teriflunomide, dimethyl fumarate, and glatiramer acetate) were included. The outcomes of interest were comparative risk of overall infection, serious infection, and frequently reported types of infection. Adjusted hazard ratios (aHR) were estimated in inverse probability treatment weighting (IPTW) based on Cox proportional hazard models. Among 10,003 eligible incident DMA users, 22.92% of patients initiated heDMAs. The IPTW-CPH model revealed that patients with heDMAs were associated with a higher risk of serious infection (aHR: 1.24, 95% confidence interval (CI): 1.06-1.44) and urinary tract infection (UTI; aHR: 1.21, 95% CI: 1.14-1.30). Sensitivity analyses with different follow-up periods yielded consistent findings with the main analyses. In MS, heDMAs were associated with a greater risk of serious infection and UTI compared with meDMAs. These findings suggest the need to carefully monitor and manage the infection risk to optimize the use of heDMAs in MS.

The mystery of abdominal snow-grip sensation: emphysematous cystitis complicated with bladder gangrene and rupture—case report and literature review

Emphysematous cystitis (EC) refers to a rare form of complicated urinary tract infection (UTI), which is typically observed in elderly females with severe diabetes mellitus. EC was triggered by bacteria, producing gas filled cysts in the bladder wall and lumen, the most common of which are Escherichia coli and Klebsiella pneumoniae. Since EC could be potentially life-threatening, severe form of EC (like septic shock) can cause gangrenous cystitis (GC). This case report describes an 85-year-old female patient with type 2 diabetes mellitus (DM) who presented with EC and bladder gangrene due to the growth of Candida glabrata in urine. Our case describes patient’s progression in detail, ranging from the initial clinical manifestations to specific management actions, which may provide new insights and ideas for the diagnosis and treatment of such disease.

Multicolor Gold Clusterzyme-Enabled Construction of Ratiometric Fluorescent Sensor Array for Visual Biosensing.

The simultaneous detection of multiple bioanalytes with similar structures has been a long-standing challenge for biological research and disease diagnosis. Bioreceptor-inspired sensor arrays provide an attractive and competitive solution for addressing this challenge, but applying this technique to biosensing in practical application scenarios is complicated by many factors such as the lack of robust probes, interference from the biological matrix, and difficulty for on-site analysis. In this work, by taking advantage of the intrinsic fluorescence and enzyme-mimic properties of gold nanoclusters (AuNCs), we report the design of an innovative ratiometric sensor array toward enhanced fluorescent visual biosensing. With biologically important phosphates as an example, we show that the present fluorescent clusterzyme-based ratiometric sensor array could effectively discriminate and detect eight types of phosphates. In particular, AuNCs with three different emission colors (blue, green, and red) and good peroxidase-mimic properties were employed as the sensing units, and the presence of phosphates affected both the intrinsic fluorescence and the enzymatic activity of these AuNCs, yielding distinct optical responses in a ratiometric manner. Moreover, a portable sensor array was established by further integrating these fluorescent clusterzymes into a hydrogel matrix, which could visually identify different phosphates based on their distinct fluorescence color changes. Consequently, the point-of-care diagnosis of urinary tract infections at different levels was achieved by analyzing urinary microbial ATP via the present strategy. This study illustrates the great potential of clusterzyme-based fluorescent sensor arrays as a promising biosensing platform for disease diagnosis.

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.

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.

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.

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

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.

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.

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.

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.

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.

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.