Urinary Tract Infections In Women Research Articles

Management of uncomplicated recurrent urinary tract infections.

To discuss optimal management of recurrent urinary tract infections (UTIs) in women. About every second woman experiences at least one UTI in her lifetime, of those 30% experience another UTI, and 3% further recurrences. Especially young healthy women without underlying anatomical deficiencies suffer from recurrent UTIs (rUTI), which are associated with significant morbidity and reduction in quality of life. This is a narrative review, investigating publications dealing with recurrent UTI in women. Risk factors and options for management are discussed. The increased susceptibility of women to rUTI is based on the female anatomy in addition to behavioural, genetic, and urological factors. However, why some women are more likely than others to develop and maintain rUTI remains to be clarified. Invasive characteristics of certain uropathogenic Escherichia coli that are able to form extra- and intracellular biofilms and may therefore cause delayed release of bacteria into the bladder, may play a role in this setting. Treatment recommendations for an acute episode of rUTI do not differ from those for isolated episodes. Given the nature of rUTI, different prophylactic approaches also play an important role. Women with rUTI should first be counselled to use non-antibiotic strategies including behavioural changes, anti-adhesive treatments, antiseptics, and immunomodulation, before antibiotic prophylaxis is considered. In addition to the traditional treatment and prophylactic therapies, new experimental strategies are emerging and show promising effects, such as faecal microbiota transfer (FMT), a treatment option that transfers microorganisms and metabolites of a healthy donor's faecal matter to patients using oral capsules, enemas, or endoscopy. Initial findings suggest that FMT might be a promising treatment approach to interrupt the cycle of rUTI. Furthermore, bacteriophages, infecting and replicating in bacteria, have been clinically trialled for UTIs. Due to the limitation of available data, novel treatment options require further clinical research to objectify the potential in treating bacterial infections, particularly UTIs.

The evolution of recommendations for cranberry use in recurrent urinary tract infections: A systematic review

Abstract. Urinary tract infections (UTI) constitute a major complaint in medical offices worldwide, especially concerning women. Although the efficacy of cranberry in UTI prevention is still controversial it has long been recommended for use in clinical practice. Based on the recommendation evaluation, the present study aimed to conduct a systematic review to assess the efficacy of cranberry prophylaxis in recurrent UTIs in women. Main changes among reviewed publications revolved around the mechanism by which cranberry produce the results observed and once it was established that it relates to bacterial fimbriae-mediated adhesion, most authors now struggle to establish accurate measures to come up with a protocol for its use. Many studies compared cranberry effects to placebo and traditional antibiotic treatment and showed promising results about effectiveness, as well as economic drawbacks. Altogether, cranberries could help to delay ecological resistance to antibiotics as well as protect patients from infections. Further investigation, mainly regarding dosage, is needed to formulate protocols and safely introduce cranberries to clinical practice

Abstracts from Society for Acupuncture ResearchPandemics, Pain, & Public Health:Roles and Relevance of Traditional East Asian MedicineJune 14–17, 2021

Abstracts from Society for Acupuncture ResearchPandemics, Pain, &amp; Public Health:Roles and Relevance of Traditional East Asian Medicine<i>June 14–17, 2021</i>

Virulence and Resistance Characterization of Staphylococci-associated Urinary Tract Infection in Pregnant Women in Lagos, Nigeria

Background: Urinary Tract Infection (UTI) is the most prevalent bacterial infection in developing countries. UTI is sometimes asymptomatic. The occurrence of UTI in pregnancy can result in complications such as premature or low-birth-weight babies. Escherichia coli is the most common cause of UTI followed by Staphylococci species. However, E.coli associated UTI has been well studied while there is paucity of data on the virulence and resistance of Staphylococci-associated UTIs in women. This study aimed to characterize the virulence and resistance genes in Staphylococci species isolated from the urine of pregnant women. Methods: This was a cross-sectional study involving pregnant women attending ante-natal clinic in Lagos State, Nigeria. Clean catch midstream urine specimens were collected from the women and cultured on appropriate agar. Bacteria were identified using both biochemical and molecular methods and evaluated for resistance to antibiotics. Polymerase chain reaction was used to detect the mecA and blaZ resistance genes and the PVL and TSST virulence genes. Results: Staphylococci species were isolated from 21 (26.25%) of the 80 urine samples of which 7 (29%) were Staphylococcus aureus and 17 (71%) coagulase-negative staphylococcus (CoNS). S. epidermidis and S. saprophyticus were the most commonly isolated CoNS. All the isolates tested were resistant to cotrimoxazole, cloxacillin, erythromycin, ampicillin, amoxicillin-clavulanate, and tetracycline. Both blaZ and the mecA genes were detected in the isolates that were phenotypically susceptible to methicillin and cefoxitin. There was an occurrence of the mecA, blaZ and PVL genes in S. saprophyticus in patients who were co-infected with S. aureus. Conclusion: UTI caused by Staphylococci is common among pregnant women. There is a need to consider staphylococcal associated UTI screening in both symptomatic and asymptomatic cases of UTI in pregnant women.

Profiles and genetic determinants of antimicrobial resistance in pathogens causing community-acquired urinary tract infections in reproductive-age women

Objective. To characterize the profiles and genetic determinants of antibiotic resistance in pathogens of community-acquired urinary tract infections (UTI) in women of reproductive age in St. Petersburg (Russia).Materials and methods. The study included strains of microorganisms obtained from 145 women of reproductive age with diagnosed with a UTI. Antibiotic susceptibility was evaluated by disk diffusion method; the interpretation of the results was carried out in accordance with the EUCAST criteria. Strains of uropathogenic enterobacteria were tested by PCR for the presence of beta-lactamase genes: beta-lactamase genes encoding enzymes of the AmpC group (MOX, CMY, LAT, BIL, DHA, ACC, MIR, ACT, FOX), TEM, SHV, OXA‑1, ESBL genes of the CTX–M group, genes of carbapenemases (KPC, OXA‑48) and metal-beta-lactamases (VIM, IMP, NDM).Results. Most cases (81 %) of UTIs in women in St. Petersburg were due to enterobacteria, with Escherichia coli highly prevailing (66 %). Fosfomycin, meropenem and nitrofurantoin had the highest in vitro activity against uropathogenic Enterobacteriaceae. High rates of resistance to betalactam antibiotics were found (from 16 % to cefotaxime to 28 % to amoxicillin/clavulanic acid). The genes of TEM-beta-lactamases were found in 31 isolates (26.7 %), SHV – in 17 (14.6 %), CTX–M type – in 15 (12.9 %), DHA – in 2 (1.7 %). The other beta-lactam resistance genes (MOX, CMY, LAT, BIL, ACC, MIR, ACT, FOX, KPC group, OXA-like group, VIM, IMP, NDM) were not detected.Conclusion. Microbiological and molecular analysis of the structure of beta-lactam resistance is important for the effective of epidemiological control of antimicrobial resistance in pathogens causing urinary tract infections.

Five versus seven days of nitrofurantoin for urinary tract infections in women with diabetes: a retrospective cohort study

ObjectiveTo compare the effectiveness of 5 versus 7 days of nitrofurantoin treatment for urinary tract infection (UTI) in women with diabetes. MethodsData were collected retrospectively from Dutch general practitioners between 2013 and 2020. Nitrofurantoin prescriptions with a duration of 5 days (5DN) or 7 days (7DN) in women with diabetes were included. Inverse propensity weighting was performed to calculate adjusted risk differences (RD) for treatment failure within 28 days. Secondary outcomes were 14-day treatment failure, severe treatment failure and 28-day treatment failure in defined risk groups. ResultsNitrofurantoin was prescribed in 6866 episodes, 3247 (47.3%) episodes with 5DN and 3619 (52.7%) episodes with 7DN. Patients in the 7DN group had more co-morbidities, more diabetes-related complications and were more insulin-dependent. There were 517/3247 (15.9%) failures in the 5DN group versus 520/3619 (14.4%) in the 7DN group. The adjusted RD for failure within 28 days was 1.4% (95% CI –0.6 to 3.4). ConclusionWe found no clinically significant difference in treatment failure in women with diabetes with UTI treated with either 5DN or 7DN within 28 days. A 5-day treatment should be considered to reduce cumulative nitrofurantoin exposure in DM patients.

Changes in the management of urinary tract infections in women: impact of the new recommendations on antibiotic prescribing behavior in France, between 2014 and 2019

BackgroundUrinary tract infections (UTIs) are among the most common infections that require antibiotic therapy. In December 2015, new guidelines for UTI management were published in France with the aim of reducing antibiotic misuse and the risk of antimicrobial resistance.ObjectivesTo analyze changes in antibiotic prescribing behavior for acute uncomplicated UTI in women in France from 2014 to 2019.MethodsRetrospective study using data extracted from the medico-administrative database ‘OpenMedic’ that is linked to the French National Health Data System and collects data on the reimbursement of prescribed drugs. The analyses focused on the number of boxes of antibiotics delivered by community pharmacies, the molecule class, and the prescriber’s specialty.ResultsOverall, antibiotic dispensing by community pharmacies increased by 2% between 2014 and 2019, but with differences in function of the antibiotic class. The use of antibiotics recommended as first-line and second-line treatment increased (+ 41% for fosfomycin and + 7430% for pivmecillinam). Conversely, the dispensing of lomefloxacin and norfloxacin decreased by 80%, and that of ciprofloxacin by 26%. Some antibiotics were mostly prescribed by general practitioners (lomefloxacin, pivmecillinam) and others by secondary care physicians (ofloxacin). Dispensing increased for antibiotics prescribed by secondary care physicians (+ 13% between 2014 and 2019) and decreased for antibiotics prescribed by GPs (− 2% for the same period).ConclusionThese data suggest that the new recommendations are followed, as indicated by the increased prescription of fosfomycin and pivmecillinam and decreased prescription of fluoroquinolones. However, the efficient transmission and implementation of new recommendations by practitioners requires time, means and dedicated tools.

Contemporary management considerations of urinary tract infections for women with spina bifida.

Urinary tract infections (UTIs) are one of the leading health concerns and causes of hospitalization for adults with spina bifida (SB). The risk factors, evaluation, management, and prevention of UTIs in women with SB must take into consideration their unique pelvic anatomy and function as well as the desire for pregnancy or the occurrence UTI during pregnancy. This article reviews published literature regarding this topic and offers recommendations for UTI evaluation, management, and prevention in the context of the unique pelvic floor health needs of women with SB. A systematic review was conducted using the following keywords: spinal dysraphism, spina bifida, myelomeningocele, meningocele, urinary tract infections, females, and adults. Articles were included if they were in English, published during or after 2000, peer reviewed, included women with spina bifida aged 18 or greater, and included outcomes related to urinary tract infection. No articles met inclusion criteria. As no articles were found based on the initial search criteria, articles pertaining to neurogenic bladder UTI risks, evaluation, and management were discussed to develop consensus recommendations for the unique care of UTIs in women with SB.

P0176 - Prophylaxis for recurrent urinary tract infections in women with StroVac – Efficacy and patient`s compliance in a 2-year follow-up

P0176 - Prophylaxis for recurrent urinary tract infections in women with StroVac – Efficacy and patient`s compliance in a 2-year follow-up

Current prescribing practices and guideline concordance for the treatment of uncomplicated urinary tract infections in women

Uncomplicated urinary tract infections are one of the most common bacterial infections in the United States. Clinical practice guidelines from the Infectious Diseases Society of America recommend nitrofurantoin, trimethoprim-sulfamethoxazole, and Fosfomycin as first-line antibiotic treatments and discourage the use of fluoroquinolone antibiotic agents. US Food and Drug Administration released several black box warnings about fluoroquinolones over the past decade owing to antibiotic resistance and a high burden of adverse events. Historically, uncomplicated urinary tract infections have high rates of guideline-discordant treatment with past studies noting substantial use of fluoroquinolones, directly contradicting clinical practice guidelines. This study aimed to assess the current concordance of physician prescribing practices with Infectious Diseases Society of America guidelines for the treatment of uncomplicated urinary tract infections in women and identify patient and physician predictors of guideline concordance. A retrospective observational secondary analysis was conducted using a series of cross-sectional data extracted from the IQVIA (Plymouth Meeting, Pennsylvania) National Disease and Therapeutic Index from 2015 to 2019. An estimated 44.9 million women with uncomplicated urinary tract infections at the age of 18 to 75 years were treated as outpatients. This population was selected to lack relevant comorbidities or urological abnormalities so that it matched the Infectious Diseases Society of America guidelines. The proportion of prescriptions for each antibiotic drug class were reported with 95% confidence intervals and compared with the Infectious Diseases Society of America guidelines. Patient and physician characteristics were included in a multivariate logistic regression model to identify independent predictors of antibiotic selection and thereby guideline concordance. Of the visits that resulted in antibiotic treatment, the overall concordance rate was 58.4% (26.2 million visits of 44.9 million visits) and increased from 48.2% (3.9 million visits of 8.1 million visits) in 2015 to 64.6% (6.3 million visits of 9.8 million visits) in 2019. The most commonly prescribed antibiotic agents were fluoroquinolones (36.4%, 16.3 million visits of 44.9 million visits), nitrofurantoin (31.8%, 14.3 million visits of 44.9 million visits), and trimethoprim-sulfamethoxazole (26.3%, 11.8 million visits of 44.9 million visits). From 2015 to 2019, fluoroquinolone use decreased whereas nitrofurantoin and beta-lactam use increased. Based on the logistic regression, patients aged 18 to 29 years (odds ratio, 1.60; 95% confidence interval, 1.36-1.88; P<.001) and 30 to 44 years (odds ratio, 1.21; 95% confidence interval, 1.03-1.42; P=.020) had a statistically significantly higher likelihood of receiving guideline-concordant treatment than patients aged 45 to 75 years (reference group). Obstetricians-gynecologists (odds ratio, 3.56; 95% confidence interval, 2.91-4.37; P<.001) and urologists (odds ratio, 3.51; 95% confidence interval, 2.45-5.13; P<.001) had a statistically significantly higher likelihood of concordant treatment than all other specialties combined (reference group). Guideline discordance continues in the treatment of uncomplicated urinary tract infections with the overuse of fluoroquinolones and the underuse of first-line antibiotic agents. Although improving, continued misuse of antibiotic agents may contribute to the growing rates of antibiotic resistance. Actions such as educating physicians about antibiotic resistance and clinical practice guidelines and providing feedback on prescription habits are needed to increase guideline concordance and therefore reduce the use of fluoroquinolones, especially for physicians in family and internal medicine.

Role of D-Mannose in the Prevention of Recurrent Uncomplicated Cystitis: State of the Art and Future Perspectives.

Background: Urinary tract infections (UTI) are highly frequent in women, with a significant impact on healthcare resources. Although antibiotics still represent the standard treatment to manage recurrent UTI (rUTI), D-mannose, an inert monosaccharide that is metabolized and excreted in urine and acts by inhibiting bacterial adhesion to the urothelium, represents a promising nonantibiotic prevention strategy. The aim of this narrative review is to critically analyze clinical studies reporting data concerning the efficacy and safety of D-mannose in the management of rUTIs. Methods: A non-systematic literature search, using the Pubmed, EMBASE, Scopus, Web of science, Cochrane Central Register of Controlled Trials, and Cochrane Central Database of Systematic Reviews databases, was performed for relevant articles published between January 2010 and January 2021. The following Medical Subjects Heading were used: “female/woman”, “urinary tract infection”, and “D-mannose”. Only clinical studies, systematic reviews, and meta-analyses reporting efficacy or safety data on D-mannose versus placebo or other competitors were selected for the present review. Evidence was limited to human data. The selected studies were organized in two categories according to the presence or not of a competitor to D-mannose. Results: After exclusion of non-pertinent studies/articles, 13 studies were analyzed. In detail, six were randomized controlled trials (RCTs), one a randomized cross-over trial, five prospective cohort studies, and one a retrospective analysis. Seven studies compared D-mannose to placebo or others drugs/dietary supplements. Six studies evaluated the efficacy of D-mannose comparing follow-up data with the baseline. D-mannose is well tolerated, with few reported adverse events (diarrhea was reported in about 8% of patients receiving 2 g of D-mannose for at least 6 months). Most of the studies also showed D-mannose can play a role in the prevention or rUTI or urodynamics-associated UTI and can overlap antibiotic treatments in some cases. The possibility to combine D-mannose with polyphenols or Lactobacillus seems another important option for UTI prophylaxis. However, the quality of the collected studies was very low, generating, consequently, a weak grade of recommendations as suggested by international guidelines. Data on D-mannose dose, frequency, and duration of treatment are still lacking. Conclusion: D-mannose alone or in combination with several dietary supplements or Lactobacillus has a potential role in the non antimicrobial prophylaxis or recurrent UTI in women. Despite its frequent prescription in real-life practice, we believe that further well-designed studies are urgently needed to definitively support the role of D-mannose in the management of recurrent UTIs in women.

Посткоитальный цистит: хирургическое лечение

Introduction. Urinary tract infection is one of the most common urological infectious diseases. An important risk factor for uncomplicated urinary tract infection in women is sexual intercourse. Post-coital cystitis is a special form of recurrent cystitis, associated with a low location of the external urethral orifice. This condition is called vestibulo-vaginal dislocation of the urethra. Materials and methods. PubMed and Elibrary (Scientific Electronic Library) databases were searched for studies describing surgical treatment of recurrent post-coital cystitis in women. Based on the relevance and reliability of the sources, 23 articles in peer-reviewed medical journals were selected. All of the selected studies contained data on evolution of surgical treatment approaches for post-coital cystitis. Results. In the middle of the 20th century the interest of medical community in surgical treatment of post-coital cystitis has gradually faded. Such trend was caused by imperfect surgical techniques of existing procedures (O'Donnell and Hirschhorn operations). Subsequent accumulation of experience, over several decades, allowed to establish possible mistakes in diagnosis and operation techniques. Furthermore, a constant search for new techniques and improvement of existing ones minimized potential risk of complications. Great hopes are pinned on the works of B.K. Komyakov et al., who proposed extravaginal transposition of the urethra, that implies the transposition of the urethra and its external orifice as high as possible toward the clitoris. The technique is characterized by high efficacy and a low number of complications, as demonstrated by the treatment results of 228 patients diagnosed with post-coital cystitis. Conclusions. Various curative procedures for post-coital cystitis show the need to determine and standardize the optimal amount of surgical intervention for urethral dystopia in women.

Influence of Sex on Early Outcomes of Elective Lumbar Fusions: An Updated Propensity-Matched and Subgroup Analysis

Existing data have demonstrated significant differences in morbidity and mortality measures between men and women undergoing various spinal surgeries. However, studies of lumbar fusion surgery have been limited. Thus, we investigated the effects of patient sex on 30-day perioperative outcomes after elective lumbar fusion spine surgery. Patients who had undergone lumbar fusion from 2015 to 2018 were reviewed from the American College of Surgeons National Surgical Quality Improvement Program database. Propensity score matching was used to determine whether the patient's sex had influenced the 30-day perioperative complications. A total of 44,526 cases had met the inclusion criteria and were reviewed. Of the 44,526 patients, 13,715 had undergone posterior lumbar fusion, 21,993 had undergone posterior/transforaminal lumbar interbody fusion, and 8818 had undergone anterior/lateral lumbar interbody fusion. The women were more likely to be older, functionally dependent, and taking steroids for chronic conditions and to have a higher body mass index and lower preoperative hematocrit level. The men were more likely to be white, to smoke, and to have diabetes mellitus, hypertension, and bleeding disorders. In all cohorts, except for a higher incidence of urinary tract infection in the female patients and myocardial infarction in the male patients, no significant differences were found in morbidity and mortality between the sexes. Several differences in demographics and baseline health status were found between men and women undergoing lumbar fusion. When attempting to control for comorbid conditions using propensity score matching, we found that sex was an independent predictor of urinary tract infection in women and myocardial infarction in men across major morbidity and mortality categories in patients undergoing lumbar fusion surgery.

Инфекции нижних мочевыводящих путей у женщин – проблемы и ошибки

Lower urinary tract infections in women represent an urgent medical and social problem due to their high prevalence, frequent recurrences, and the need for an interdisciplinary approach to diagnosis and treatment. Timely and adequate diagnosis of the causes of urinary disorders in women with the determination of risk factors, concomitant diseases and isolation of pathogens allows to choose a rational therapy that may alleviate patients symptoms, improve the quality of life, and prevent the transformation of the disease to a chronic form. It is extermely important that treatment should not contribute to the growth of antibiotic resistance of pathogens, not disrupt the normal microbiome, and not aggravate the disturbances of the normal vaginal and intestinal microflora in women.

Twice-Daily Nitrofurantoin Administration Following Short-term Transurethral Catheterization After Pelvic Reconstructive Surgery: A Randomized Clinical Trial.

The objective of this study was to evaluate if twice-daily nitrofurantoin for 5 days after discontinuation of transurethral catheterization decreases the rate of urinary tract infection (UTI) in women with postoperative urinary retention (POUR) after pelvic reconstructive surgery. This was a double-blind, placebo-controlled, randomized trial conducted across 2 clinical sites between October 2017 and April 2019. Women with acute POUR after pelvic reconstructive surgery were included and randomized to nitrofurantoin (100 mg) or placebo twice-daily for 5 days. The primary outcome was clinically suspected UTI (defined as dysuria, frequency, and irritation in the absence of vaginal discharge) and/or culture-proven UTI (defined as greater than 105 colony forming units of a single organism) within 30 days of surgery. Secondary outcomes included evaluation of adverse events related to study medication and medication adherence. Data from 164 participants were eligible for intention-to-treat analysis (nitrofurantoin, n = 82; placebo, n = 82). There were no significant demographic or intraoperative differences except for body mass index and race. Median duration of catheterization was 3 days (interquartile range, 2-5 days, P = 0.12). Fifteen women in the nitrofurantoin group and 14 women in the placebo group experienced UTI within 30 days (18.3% vs 17.1%; P = 0.84; odds ratio, 1.09; 95% confidence interval, 0.49-2.43). There were no study medication allergies; however, nausea was the most common intolerance. Most women in each group completed the study drug treatment (91.5% vs 86.4%, P = 0.30). Nitrofurantoin prophylaxis after transurethral catheter removal did not reduce the risk of UTI in women with acute POUR after pelvic reconstructive surgery.

Do probiotics reduce the frequency of urinary tract infections in women?

IUSM Arnett Family Medicine Residency Program, Lafayette, IN The authors declare no conflicts of interest.

Alternative to Prophylactic Antibiotics for the Treatment of Recurrent Urinary Tract Infections in Women (ALTAR): A Multi-Centre Randomised, Non-Inferiority Trial

Background: Systematic review of previous randomised controlled trials concluded that the non-antibiotic option of methenamine hippurate may be effective for urinary tract infection (UTI) prevention but outlined the need for further large, well-conducted randomised trials. We aimed to satisfy this requirement by testing its efficacy, compared to the current standard prophylactic treatment of daily low-dose antibiotics. Methods: This randomised, non-inferiority trial recruited from eight UK centres. Women with recurrent UTI, requiring prophylactic treatment, were randomly assigned (1:1), (using permuted blocks of variable length via a web-based system), to receive antibiotic prophylaxis or methenamine hippurate for 12-months. Treatment allocation was not masked and crossover between arms was permitted. The primary outcome was the absolute difference in symptomatic, antibiotic-treated UTI incidence during treatment. The non-inferiority margin was one UTI episode per person-year. Analyses performed in a modified intention-to-treat (mITT) population comprised all participants observed for at least six months. Trial registration was via ISRCTN registry, ISRCTN70219762. Findings: Between June 23, 2016 and June 20, 2018, 240 participants were randomised to antibiotic prophylaxis (n=120) or methenamine hippurate (n=120). The mITT analysis comprised 205 (85%) participants [102 (85%) antibiotics, 103 (86%) methenamine hippurate]. The incidence of antibiotic-treated UTI during the 12-month treatment period was 0·89 episodes per person-year (95% CI 0·65-1·12) in the antibiotic group and 1·38 (1·05-1·72) in the methenamine hippurate group with an absolute difference of 0·49 (90% CI 0·15-0·84) confirming non-inferiority. Adverse reactions were reported by 34/142 (24%) and 35/127 (28%) participants receiving antibiotics and methenamine hippurate respectively and the majority were mild. Interpretation: Non-antibiotic prophylactic treatment using methenamine hippurate should now be considered as a first-line option in women with a history of recurrent UTI episodes, given the robust demonstration of non-inferiority to daily antibiotic prophylaxis seen in this trial. Clinical Trial Registration Details: ISRCTN registry, ISRCTN70219762. Funding Information: National Institute for Health Research Health Technology Assessment Programme. Declaration of Interests: CH, HM, TH,TC , WK, JL, AAb, LV, RF, KW and AAl report grants from the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme pertaining to the reported study. All other authors have nothing to declare. Ethics Approval Statement: The study protocol was approved by North East Tyne and Wear South Research Ethics Committee (15/NE/0381) and has been published. All participants provided written informed consent.

Urinary tract infection in women.

Urinary tract infection (UTI) is one of the most common infections afflicting women. UTI often accompanies vaginal infections and is frequently caused by pathogens originating in the digestive tract. The paper discusses the prevalence of UTI in various patient populations, including postmenopausal, pregnant, diabetic, epileptic, and perioperative female patients. Current UTI treatment and prevention guidelines both for primary and recurring UTIs were reviewed. Antibiotic treatment duration should be minimized, with the exact dosage and time schedule depending on the type of infection. Asymptomatic bacteriuria does not always require antibiotic treatment, because their excessive use may lead to the emergence of antibiotic resistant strains. The role of non-antibiotic prophylaxis of recurrent infections involving immunomodulants (OM-89), probiotics, and behavioural interventions was underlined.

Evaluation of a community pharmacy service for uncomplicated urinary tract infection

Introduction: Urinary tract infections (UTIs) are one of the most common conditions seen in female patients in general practice. Community pharmacy can supply antibiotics under minor ailment service patient group directions (PGDs) for a variety of indications, including uncomplicated UTI in women. The NHS Kernow Clinical Commissioning Group (CCG) funds such a locally commissioned minor […]

A Study on Prevalence of Serum Resistant &amp; Sensitive Escherichia Coli in Urinary Tract Infection

Background: Escherichia coli is the commonest organism causing urinary tract infection in women and children especially in those with uncom- plicated infections. It has been traditionally described Serotypes of Escherichia coli were consistently associated with Uropathogenicity and designated as Uropathogenic Escherichia coli.It is now recognized that a subset of fecal Escherichia coli can be colonized in the peri-urethral area, enter the urinary tract and cause symptomatic disease. These are currently defined as Uropathogenic Escherichia coli. The aims &amp; objectives are to the isolation of Escherichia coli in Urinary tract infection. 2. To determine the prevalence of Serum resistant Uropathogenic Escherichia coli. 3. To compare antimicrobial efficacy in Serum resistant and Serum sensitive Uropathogenic Escherichia coli. Subjects &amp; Methods: An observational study was conducted on 100 patients and urine samples collected from suspected and suffering from urinary tract infection. Study period from August 2018 to July 20019 attending General medicine OP in Hospital. Escherichia coli were isolated and identified by conventional techniques Mackie &amp; Mc Cartney. The strains were subjected to multiple drugs to study serum resistance and sensitivity. Results: From 100 urine samples 71 Uropathogenic, 18 males &amp; 53 females. 40% Sero-resistant and 60% Sero-sensitive among them 2 to 18 years males and &gt; 40 years females resistant, above 40 years males and 19 to 40 years females are sensitive to multiple antibiotics. Conclusion: it emphasizes Serum resistance is an important virulence factor, It may lead to pyelonephritis and septicemia. Serum resistant E. coli are multiple drug-resistant, so the present study formulating guidelines for planning effective treatment and Periodic surveillance to monitor resistance.