Introduction: Urinary Tract Infections (UTIs) are among the most common healthcare-associated infections and significantly impact morbidity, healthcare costs, and quality of care. Catheterassociated Urinary Tract Infections (CAUTIs) constitute up to 40% of hospital-acquired infections globally, primarily driven by indwelling catheter use. Routine catheterisation during minor gynaecological surgeries is a common practice to prevent postoperative urinary retention. However, prolonged catheter use increases the risk of CAUTIs. Aim: To compare the UTI rates between catheterised and non-catheterised groups among women undergoing minor gynaecological surgeries. Materials and Methods: This prospective observational study was conducted at Dr. DY Patil Medical College, Pune, Maharashtra, India from July to December 2024, and included 150 women undergoing minor gynaecological surgeries. Participants were divided into two equal groups: catheterised (n=75) and non-catheterised (n=75). Demographic and clinical data were collected. UTIs were diagnosed based on clinical symptoms and significant bacteriuria (>105 Colony Forming Units (CFU)/mL). Statistical analysis was performed using SPSS version 28.0, with p<0.05 considered significant. Results: The incidence of confirmed UTIs was significantly higher in the catheterised group (21/75; 28%) compared to the non-catheterised group (6/75; 8%) (p<0.001). Escherichia coli was the most common pathogen, identified in 14 of 21 UTI cases in the catheterised group and 3 of 6 cases (50%) in the non-catheterised group. In the non-catheterised group, 5 out of 75 patients (6.7%) experienced urinary retention, which was successfully managed with clean intermittent catheterisation, without increasing UTI risk. Conclusion: Routine catheterisation during minor gynaecological surgeries substantially increases the risk of CAUTIs. Reducing unnecessary catheter use, adhering to evidence-based guidelines, and employing clean intermittent catheterisation are critical strategies to minimise UTI risk and improve patient outcomes.

Long-term exposure to ambient air pollution and the risk of urinary tract infections in women: A nationwide cohort study.

Introduction: Urinary Tract Infections (UTIs) are a common yet serious medical condition that can impact individuals of all ages and genders. UTIs in Chronic Kidney Disease (CKD) patients lead to a low quality of life, and the situation becomes worse when the pathogens exhibit antibiotic resistance due to Extended Spectrum Beta-Lactamases (ESBLs), Metallo-BetaLactamases (MBLs), and Carbapenemase genes. Aim: To to evaluate the clinical profile, antibiotic resistance, and frequency of resistance genes in Klebsiella pneumoniae isolates from urine samples of suspected UTIs in CKD patients. Materials and Methods: This cross-sectional study was conducted at Yenepoya Medical College Hospital in Mangalore, Karnataka, India, from January 2023 to January 2024. A total of 138 Klebsiella spp. isolates were collected and included in the study. Antimicrobial susceptibility was assessed using the Vitek2 method. The production of MBL, carbapenemase, and ESBL was confirmed by tests described in the Clinical and Laboratory Standards Institute (CLSI) 2023 document, and genes were detected using multiplex Polymerase Chain Reaction (PCR). Statistical analyses were expressed as percentages for all quantitative data, and categorical variables were compared using Fisher’s exact test, with a p-value of <0.001 considered significant. Results: Among the study participants, 79 (57.25%) were male, and approximately 84 (60.87%) were over 50 years of age. About 46 (33.33%) patients had a history of recurrent UTIs and stage 1 renal impairment. A total of 85 (61.59%) of Klebsiella spp. isolates exhibited Multidrug Resistance (MDR). The maximum resistance was observed against ceftazidime and cefepime, while lower resistance was noted for amikacin, gentamicin, piperacillin-tazobactam, and trimethoprim-sulfamethoxazole. Eighteen of the MDR isolates (72%) carried β-lactamase genes, such as bla-SHV and bla-CTX-M. Additionally, 33 (82.5%) had bla-KPC, 21 (52.5%) had bla-IMP, and OXA genes (58, 23, 51, and 48) were found in 2 (2.8%) isolates each. Conclusion: The present study emphasises the significance of the co-occurrence of ESBL and carbapenemase-encoding genes in K. pneumoniae isolates implicated in UTIs among CKD patients, which could pose challenges for effective treatment options.

Accuracy of leukocyte esterase and nitrite tests for diagnosing bacteriuria in older adults: a systematic review and meta-analysis.

Introduction: Urinary Tract Infections (UTIs) are commonly caused by both Gram-negative and Gram-positive bacteria. In clinical microbiology, urine culture plays a crucial role in diagnosis, with traditional media like blood agar and MacConkey agar being widely used. However, Cystine Lactose Electrolyte Deficient (CLED) agar offers a more cost-effective alternative by inhibiting the swarming of Proteus species while supporting a wide range of uropathogens. Chromogenic media, such as HiCrome UTI agar, enable rapid identification but are limited by their high cost. Aim: To compare the diagnostic efficiency of CLED agar, HiCrome UTI agar, and MacConkey agar for the isolation and identification of common urinary tract pathogens. Materials and Methods: This cross-sectional comparative study was conducted in the microbiology department of Shri M.P. Shah Govt. Medical College, Jamnagar, Gujarat, India from October 2019 to December 2020. A total of 400 urine samples from patients with suspected UTIs, collected from both the outpatient and inpatient departments of a tertiary care hospital, were included for bacterial examination. Patients were instructed to collect clean-catch midstream or catheter-catch urine in sterile containers following aseptic protocols. Demographic data such as age, sex, and clinical symptoms were recorded. Statistical analysis was performed using the Chi-square test, with a p-value of <0.05 considered statistically significant. Results: Out of the 400 urine samples processed, 189 (47.3%) showed significant growth, with 158 (83.6%) exhibiting pure bacterial growth and 31 (16.4%) showing mixed bacterial growth. A total of 220 bacterial isolates were identified, predominantly Gram-negative bacilli (85%), with Escherichia coli (44.1%) and Klebsiella spp. (30.5%) being the most common pathogens. Among Gram-positive cocci, Staphylococcus aureus (9.1%) and Enterococcus spp. (5.9%) were prevalent. CLED agar, MacConkey agar, and HiCrome UTI agar all isolated Gramnegative bacteria, but only CLED and HiCrome UTI agar supported the growth of Gram-positive cocci. Mixed bacterial growth was observed in 31 samples, with E. coli and Klebsiella spp. being the most frequent combination. A cost comparison revealed CLED agar as the most economical and effective choice for routine use in resource-limited settings. Conclusion: This study emphasises the need for strategic selection of culture media to enhance the diagnostic efficiency of UTIs, particularly in resource-limited settings. The comparative analysis highlights CLED agar as a cost-effective and reliable option, balancing diagnostic accuracy with affordability. While HiCrome UTI agar offers the advantage of rapid presumptive identification, its higher cost may limit its routine use. The findings provide valuable insights for clinical microbiology laboratories aiming to optimise resource allocation without compromising diagnostic quality

Social determinants of health are independently predictive of increased hospital length of stay and complications following total elbow arthroplasty.

Introduction: The postoperative catheter duration after urethroplasty has been less studied, and available literature is variable. The Duration of Catheterisation (DUC) in the literature ranges from as early as three days to as late as 21 days. Aim: To determine the ideal DUC after both anastomotic and Buccal Mucosal Graft (BMG) urethroplasty. Materials and Methods: The present randomised controlled study was done from June 2023 to May 2024 at IPGME&RSSKM hospital (Institute of Postgraduate Medical Education and Research- Seth Sukhlal Karnani Memorial), Kolkata, West Bengal, India. A total of 30 patients of anastomotic and 30 patients of BMG urethroplasty were studied. Thirty patients of anastomotic urethroplasty were divided into group A (Early PUG done on Day 7) (n=15) and group B (Late PUG done on Day 14) (n=15). Thirty patients of BMG urethroplasty were divided into group I (Early PUG on Day 14) (n=15) and group II (Late PUG on Day 21) (n=15). Extravasation was assessed by performing a Pericatheter Urethrogram (PUG) and was compared by a Chi-square test. Patients without extravasation had their catheter removed immediately and patients with extravasation were kept on catheter for seven more days. The Urinary Tract Infection (UTI) and recurrence rates were compared by Fisher’s-Exact test. Results: Anastomotic urethroplasty patients had extravasation in 9/15 patients (60%) on Postoperative Day-7 (POD-7) (group A) and 2/15 patients (13.3%) on POD-14 (group B). BMG Urethroplasty patients had extravasation in 6/15 patients (40%) on POD-14 (group I) and 2/15 patients (13.3%) on POD21 (group II). Among anastomotic urethroplasty, 3/15 patients (20%) had UTI in group A and 2/15 patient (13.3%) had UTI in group B. About 2/15 patients (13.3%) had recurrences in group A and no recurrences in group B. In BMG urethroplasty, UTI occurred in 3/15 patients (20%) in group-I and 2/15 patients (13.3%) in group B. One patient in each group A and group B (6.7%) showed recurrence of stricture. Conclusion: In conclusion, early catheter removal cannot be considered safe in all patients but should be individualised.

Evaluation of the post-marketing safety of eculizumab from 2007 to 2025: A real-world pharmacovigilance study and signal analysis based on the FAERS database.

Effectiveness of educational seminar and customized prescription order sets on antibiotic appropriateness for urinary tract infections in primary care.

Treatment of asymptomatic bacteriuria during pregnancy: A risk-factor-based approach.

To evaluate the occurrence and the clinical outcome of bacteriuria in cats with neurogenic bladder (NB) resulting from chronic thoracolumbar spinal cord injury. 9 paraplegic cats with NB due to chronic T3-L3 spinal cord injury, housed in a shelter for neurologically impaired cats. Retrospective case series. Medical records from the Veterinary Teaching Hospital of the University of Bari (Italy) between January 2021 and May 2024 were reviewed. Cats with a confirmed diagnosis of NB, managed exclusively via manual bladder expression, resulting from chronic (> 3 months) thoracolumbar spinal cord injury were included. The keywords neurogenic bladder and spinal cord injury were used to identify cases. All 9 cats experienced at least 1 episode of bacteriuria over the observational period. Across 27 clinical evaluations, 18 positive urine cultures were identified. Of these 18 cultures, 12 were classified as subclinical bacteriuria (SB) and 5 as urinary tract infections (UTIs); 1 was unclassified. None of the SB episodes were treated with antibiotics. Progression from SB to UTI was observed in only 2 cats. This study highlights a high occurrence of bacteriuria in cats with NB, with SB being the most common presentation. In the absence of antimicrobial therapy, SB progressed to UTI in only 2 out of 9 cats. These finding suggested that, although diagnostic criteria may have limitations in this population, in the absence of comorbidities, a conservative approach to the management of bacteriuria in cats with NB, monitoring SB and reserving antimicrobial treatment for UTIs, may be appropriate.

A systematic review and meta-analysis evaluating the incidence, microbiological profile and risk factors associated with urinary tract infection after radical cystectomy.

Chromobacterium violaceum is a Gram-negative bacterium, which is an environmental pathogen causing fatal opportunistic infection in tropical and subtropical areas. This facultative anaerobe produces small colonies with dark violet metallic pigmentation due to the pigment 'Violacein', hence the organism derives its name. We report an uncomplicated urinary tract infection by this rare but fatal pathogen in a young immunocompetent female, who fortunately recovered completely with oral antibiotic therapy.

Clean intermittent catheterization (CIC) is the standard of care for patients with chronic retention of urine, particularly those with spinal cord injury, multiple sclerosis, and other causes of neurogenic lower urinary tract dysfunction, as well as in cases of idiopathic and non-neurogenic bladder dysfunction. The aim of this literature scoping review was to analyze the functional, practical, and psychological barriers to successful adoption and continuation of CIC among eligible patients. It also considers key principles of education on CIC for patients and healthcare professionals and the potential value of specific educational interventions. We conducted a literature scoping search on PubMed and Embase. The findings have been classified into the following four main categories: (A) functional ability as a driver of success or failure; (B) practical and psychological barriers; (C) guiding principles for designing patient education and training the trainers; (D) value of specific educational interventions. (A) Physical challenges can fundamentally affect ability to implement CIC. A number of studies focus specifically on degree of functional ability as a driver of success or failure. (B) As for practical and psychological barriers, specific numbers of common themes emerged from the studies, including education and support, access to choice of products, urinary tract infections and other medical complications, planning timings and opportunities for catheterization, and emotional adjustment. (C) Several studies highlight the need for evidence-based care and a structured, consistent approach, along with the need of verbal explanation, practical instruction, and written information. It has been noted that clinical staff who teach CIC should themselves be trained in a standardized way. (D) Relatively few studies have investigated specific educational interventions like web-based support, a centralized education system, or a simulator. Despite CIC is a widely recognized and accepted tool, its acceptance and long-term integration into patients' daily lives is often challenging. Functional, practical and psychological barriers may affect patients' adherence. Further studies are needed to gain a more in-depth knowledge of this specific issue. Not applicable.

'Omics technologies for the elucidation of the molecular mechanisms related to carbapenem-resistant and extended spectrum β-lactamase-producing Klebsiellapneumoniae.

Metabolic syndrome is associated with increased complications and healthcare costs after adhesive capsulitis surgery.

Intravenous lipid emulsions are a key component of parenteral nutrition, and their fatty acid compositions may influence immune responses and clinical outcomes. This retrospective cohort study conducted from January 2020 to December 2022 compared clinical outcomes of hospitalized non-critical care patients receiving parenteral nutrition with either mixed oil or soybean oil lipid emulsions for at least 48 h. The primary outcome was a composite of the presence of pneumonia, urinary tract infection, or an intra-abdominal collection diagnosed within 14 days of initiating parenteral nutrition. Secondary outcomes included catheter-related bloodstream infection, length of hospital stay, duration of antibiotic therapy, in-hospital mortality, and changes in the aspartate transaminase (AST)/alanine transaminase (ALT) ratio over time. Among 266 patients (mixed oil lipid emulsion: n = 130; soybean oil lipid emulsion: n = 136) there was no statistically significant difference in all-cause infections (P = 0.21). In patients receiving lipid emulsions for >7 days, the use of mixed oil lipid emulsions was associated with a shorter median antibiotic duration (4 days: interquartile range [IQR] 1-8.5 vs 7 days: IQR 5-10; P = 0.04). Additionally, patients who received mixed oil emulsions for >7 days had a significantly greater change in the AST/alkaline phosphatase ratio after 14 days compared with the soybean oil group (β = -0.51; P = 0.02). Although there was no difference in all-cause infections between types of lipid emulsions, mixed oil lipid emulsions were associated with shorter antibiotic use and lower AST/ALT ratio in hospitalized, non-critical care patients receiving parenteral nutrition for >7 days.

Molecular Detection of Extended-Spectrum Beta-Lactamases in Escherichia coli Isolated from Patients with Urinary Tract Infections

Impact of antimicrobial resistance measures and the emergence of COVID-19 on antimicrobial use throughout the Japanese population: A retrospective cohort study using a national claims database.

Does cognition status affect spinal surgery outcomes: a systematic review and meta-analysis.