Culture Of Urine Samples Research Articles

Urinary Tract Infection in Pediatric Patients on Clean Intermittent Catheterization via a Mitrofanoff port with Reused Catheters - Any Association with Catheter Sterility?

Objective:The objective of this study is to find out whether the reused catheters for clean intermittent catheterization (CIC) are colonized before insertion and its association with urinary tract infection (UTI).Materials and Methods:This is a study conducted on 28 pediatric surgery patients who are on CIC via a Mitrofanoff port and who were reusing catheters, in a tertiary care private medical college hospital for 6-month period. Catheters to be used for the next catheterization were sent for culture along with urine culture. A questionnaire was utilized to assess CIC practice and UTI.Results:Diseases of patients were: neurogenic bladder and exstrophy–epispadias and posterior urethral valve. Twenty-one of them had an augmented bladder. Hydronephrosis was present in ten and vesicoureteral reflux (VUR) in five. Their mean duration of CIC was 5.3 years. Of 28 catheter tip samples, 16 catheters were colonized with organism. Of the 28 urine culture samples, 17 cultures were positive and all were asymptomatic except one. Of the 16 positive catheter samples, only 9 had positive urine culture; four of them had grown different organisms and five of them had the same organism, and even in these five, single organism was seen only in three. Urine culture grew Gram-negative organism in 85%, but catheter grew Gram-positive organism in 46%. No difference was found in the variables between both groups such as hydronephrosis, VUR, and augmented bladder.Conclusion:Reused catheters were colonized in 57% of the study patients, but reused catheter may not be the cause of culture positivity or UTI in the study population.

Current Management of Urinary Tract Infection and Vesicoureteral Reflux.

Urinary tract infection (UTI) is defined as the growth of a significant number of microorganisms of a single species in the urine, in the presence of symptoms. Symptoms in young children are non-specific such as fever without focus; young infants may manifest with irritability, failure to thrive, jaundice, vomiting and diarrhea. Older children usually have symptoms of cystitis or pyelonephritis. Symptoms of cystitis are dysuria, frequency, new onset incontinence and malodorous urine while symptoms of pyelonephritis are high grade fever, flank pain and vomiting. Rapid urine testing by microscopy for pus cells, dipstick testing for leukocyte esterase and nitrite, and enhanced urinalysis are supportive tests. Urine culture samples should be collected with proper technique and results interpreted for significant growth accordingly. Antibiotic therapy for 7-14 d for complicated UTI and 3-4d for uncomplicated UTI is adequate. Further evaluation is recommended clinically for bladder-bowel dysfunction and obvious anatomical defects and by imaging for vesicoureteral reflux (VUR), usually by micturating cystourethrography (MCU). Since MCU involves exposure to radiation and urethral catheterization, it is now reserved for children with parenchymal involvement or recurrent UTI. VUR is the backward flow of urine into one or both ureters. Clinical manifestations other than UTI include incidental diagnosis on antenatal ultrasonography. Reflux nephropathy, the renal scarring associated with VUR may manifest clinically as hypertension, proteinuria and renal failure. The management of VUR is primarily with antibiotic prophylaxis. Anatomical correction is indicated in case of breakthrough febrile UTI. No intervention has been shown to reduce renal scarring.

Implementation of global antimicrobial resistance surveillance system (GLASS) in patients with bacteriuria

This study aimed to evaluate the practicality and advantage of Global Antimicrobial Resistance Surveillance System (GLASS) for surveillance of urine culture samples collected from patients with bacteriuria. GLASS has been implemented at a tertiary care university hospital in Thailand by using the web application program to collect clinical data and urine culture data from patients with positive urine culture. There were 5085 urine samples from 3545 patients that were sent to our microbiology laboratory during June-December 2017. Bacteriuria was found in 1944 patients. Of those, 952 had urinary tract infection (UTI), and 1161 had colonization. Among UTI patients, hospital-acquired infection (HAI) was observed in 74.2 %, and community-acquired infection (CAI) was found in 28.7 %. E. coli and S. agalactiae were more frequently observed in CAI, but P. aeruginosa, P. mirabilis, E. faecium, and A. baumannii were more prevalent in HAI. UTI isolates demonstrated less resistance to antibiotics than colonized isolates. Non-duplicate isolates of bacteria demonstrated less resistance than duplicate isolates. E. coli, K. pneumoniae, P. aeruginosa, P. mirabilis, E. faecalis, and E. faecium causing HAI were more resistant to antibiotics than those causing CAI. GLASS is feasible to implement and more beneficial than laboratory-based surveillance. This study collects additional information beyond GLASS including causative bacteria and colonizing bacteria; types of UTI; and more specific criteria to distinguish HAI from CAI so that such data can be used for developing more valid local guidelines for selecting antibiotic therapy in UTI patients in addition to AMR surveillance in urine samples.

Association between urine pH and common uropathogens in children with urinary tract infections.

Urinary tract infections (UTIs) are one of the most common pediatric infections. Our objective in this study is to investigate the association between urine pH and uropathogens in pediatric patients. The source population comprised 26 066 paired urinalysis (UA) and urine culture (UC) samples obtained from pediatric patients. We classified the paired UA-UC samples into UTI positive (N=6348) and UTI negative (N=19 718) according to the colony forming units corresponding to the sampling source. We included UTI positive patients with infection caused by a single species of pathogen (N=5201) and frequency matched them with UTI negative patients (N=4729) by age, sex, sampling source, and visit type. This study included 5201 pediatric patients with UTIs and found that urine with Proteus mirabilis or Pseudomonas aeruginosa demonstrated the least acidic pH (mean pH=6.72 and 6.62, respectively), whereas urine with Escherichia coli or Klebsiella pneumoniae exhibited the most acidic pH (pH=6.21 and 6.18). After stratifying the UTI samples by their pH range (<6, 6-6.9, 7-7.9, and ≥8). The prevalence of P. mirabilis increased significantly across increasing pH categories. This research is the first epidemiological study that linked urine pH to specific uropathogens in a pediatric population. Both urine pH and age are associated with certain causative uropathogens. Urine that grew P. mirabilis or P. aeruginosa had the least acidic pH. Additional studies should validate the role of urine pH in predicting uropathogens and UTI.

High prevalence of multiple drug resistant enteric bacteria: Evidence from a teaching hospital in Southwest Nigeria

The development and evolution of antimicrobial resistance (AMR) in pathogens has been reported to be one of the major issues confronting the global health community. The aim of this study was to examine the period prevalence of antibiotic resistance, as well as the trends and patterns in sensitivity profile of enteric bacteria isolated from urine samples of patients with UTIs in a teaching Hospital in south west Nigeria. Urine samples were collected from 77 patients with UTIs from February 2017 to October 2018. Standard laboratory methods were used for urine sample culture and bacterial identification. The Kirby–Bauer disk diffusion method was used to evaluate antimicrobial sensitivity. Predominant enteric bacteria isolates were Escherichia coli (24, 39.3%), Salmonella species (12, 19.7%), Klebsiella species (4, 6.6%), Providencia species (6, 9.8%), Proteus species (8, 13.1%), Serratia species (2, 3.3%), Yersinia species (1, 1.6%) and Morganella species (4, 6.6%). A large proportion (90.2%) of isolates obtained were multi-drug resistant. High resistance in amoxycillin–clavulanate (98%), cefuroxime (92%), erythromycin (90%) and ceftazidime (84%) were recorded. These results emphasize the importance of continuous screening and surveillance programmes for detection of AMR in enteric bacteria of public health importance.

Sondayla İlişkili İdrar Yolu Enfeksiyonları: Farklı Hasta Popülasyonlarında Üreyen Patojenlerin ve Antibiyotik Dirençlerinin Değerlendirilmesi

Objective: In this study it was aimed to research whether or not there is a difference in pathogens that cause urinary tract infections (UTIs) for patients using urinary catheters between patients admitted to our hospitals intensive care unit (ICU) and using home care services Material-Method: Urine culture samples of patients with urinary catheters who were admitted to reanimation department of our Hospital between January-June 2018 and used home care services between January 2017-June 2018, were scanned from data processing database and patients with proliferation were included to the study. The difference between groups were evaluated with z-Test using Minitab and significance level (a) was settled as %5. Findings: The pathogen that caused urinary tract infection the most at ICU was candida spp. (%40,92). The pathogens after candida were, E. coli (%23,3) and Enterococcus spp. (%10,02) in that order. The most proliferating pathogen for patients that used home care services was differing from the patients in ICU as E.coli (%56,6). Candida spp. was the second most prevalent factor (%13,3). The patients with candida at ICU was higher than the patients that used home care services with statistical significance(Z=-6,51,p=0,001). On the other hand, E.coli for patients using home care services was higher than the patients in ICU with statistical significance (Z=5,53,p=0,001). ESBL positive E.coli and Klesebiella spp. had antibiotic resistance to beta lactam group antibiotics such as cefuroxime, cefazolin and ampicillin. Most sensitive antibiotics were amikacin and cefepime. Result: The study shows that the pathogens, which develop due to urinary catheter application and causing UTIs, can vary due to patient’s condition, environment, antibiotic use, existing diseases, organ failures and hygiene. Also the antibiotics, which pathogens that cause UTIs are sensitive-resistant to, are similar in the country.

Çocuklarda İdrar Kültürü İçin Örnek Almada İki Temizlik Yönteminin Karşılaştırılması

Çocuklarda İdrar Kültürü İçin Örnek Almada İki Temizlik Yönteminin Karşılaştırılması

Perioperative Chemoprophylaxis οr Treatment for Extensively Drug Resistant Gram-Negative Bacteria in Patients Undergoing Liver Transplantation Based on Preoperative Donor/Recipient Surveillance Cultures: A Prospective Study

IntroductionThe importance of preoperative donor/recipient colonization or donor infection by extensively drug-resistant Gram-negative bacteria (XDR-GNB) and its relation to serious post-transplantation infection pathogenicity in liver transplantation (LT) patients has not been clarified. AimPrevention of postoperative infection due to XDR-GNB with the appropriate perioperative chemoprophylaxis or treatment based on preoperative donor/recipient surveillance cultures in LT patients, as well as their outcome. Materials and MethodTwenty-six patients (20 male, 6 female) were studied (average preoperative Model for End-Stage Liver Disease score ≈15, range: 8–29) from January 2017 to January 2018. In all patients, blood, urine, and bronchial secretions culture samples as well as a rectal colonization culture were taken pre- and postoperatively, once weekly after LT, and after intensive care unit discharge. Recipients with positive XDR-GNB colonization and patients receiving a transplant from a donor with an XDR-GNB positive culture or colonization received the appropriate chemoprophylaxis one half hour preoperatively according to culture results. De-escalation of the antibiotic regimen was done in 2 to 5 days based on the colonization/culture results of the donor and recipient and their clinical condition. Evaluation for serious infection was done at 1 week and at 28 days for outcome results. ResultsFourteen out of 26 recipients (53.8%) were positive for XDR-GNB colonization preoperative, with 2/14 (14.28%) presenting serious infection due to the same pathogen. Intensive care unit length of stay was significantly longer in colonized with XDR-GNB patients (P < .0001). The outcome of colonized patients was 6/14 (42.8%) expired, but only in 2/14 (14.2%) was mortality attributable to infection. ConclusionAdministering appropriate perioperative chemoprophylaxis and treatment may limit the frequency of XDR-GNB infections and intensive care unit length of stay and may improve the outcome in LT recipients.

Diagnostic Value of Candida Colonization Index in The Early Diagnosis of Invasive Candidal Infection

Objective: To investigate the diagnostic value of Candida colonization index (CCI) in the early diagnosis of invasive candidal infection in medical mix (medical and surgical intensive care units (ICU). Methods: Mouth, axillae, nasogastric catheter, rectum, and urine culture samples taken from the patients admitted to the reanimation and neurological ICU for 19 months were retrospectively evaluated and CCI were calculated. Results: CCI reached ≥0,5 in the cultures of 29 patients. 29 patients developed candidal infection; 27 (27/29) of them had CCI ≥0,5. 18 patients developed urinary infections, 10 patients developed candidemia, and 1 patient developed wound infection. CCI ≥0,5 was found as the only independent predictor for invasive candidal infection (p<0,001, OR: 701,553, %95 CI; 28,310-17385,22). The positive predictive value, sensitivity, and specifity of CCI for the candidal infection were found to be 93.1% and 96.2%, respectively. Conclusions: We concluded that monitoring for CCI in patients with unknown fever, severe sepsis or septic shock in the medical ICU offers an early diagnosis and intervention to prevent invasive candidal infection. Independently from the other risk factors, CCI may be considered as an effective test for early diagnosis of invasive candidal infection in medical and surgical ICU patients.

Antimicrobial susceptibility of microorganisms causing Urinary Tract Infections in Saudi Arabia.

Urinary Tract Infections (UTIs) is one of the most common infections worldwide. UTIs remain a challenge to the healthcare system because of the emergence of antimicrobial resistance. The aim of this study is to report the most common UTI-causative organisms associated with the emergence of antimicrobial resistance in Saudi Arabia. a retrospective cross sectional study of 1918 positive urine culture samples of both gender collected over 9 months (May 2015 to February 2016) from a major tertiary hospital in Riyadh, Saudi Arabia. the median age of individuals involved in the study was 43 years, with males constituting 27.7% only of the population. Among cases deemed complicated (81.1%), common causes were diabetes, pregnancy, and immunocompromization, comprising 24.7%, 11.9%, and 10.8%, respectively. Escherichia coli (52%) was the most common uropathogen, followed by Klebsiella pneumoniae (15%), Pseudomonas aeruginosa (8%) Streptococcus agalactiae (Group B streptococcus) (7%), and Enterococcus faecalis (5%). Overall sensitivity studies showed the most highly resistant uropathogen was Escherichia coli (60%) followed by Klebsiella pneumoniae (16%), Pseudomonas aeruginosa (4%) Enterococcus faecalis (3%), and Enterobacter cloacae (2%). Concerning the first defense antibiotics prescribed for UTI, E. coli was most frequently resistant to Sulfamethoxazole/Trimethoprim (47%) followed by ciprofloxacin (34%). K. pneumoniae was most frequently resistant to Sulfamethoxazole/trimethoprim (35%) followed by cefuroxime (30%), while P. aeruginosa to ciprofloxacin (13%). Because of a high level of antimicrobial resistance amongst uropathogens in Saudi Arabia, the development of regional and national UTI guidelines is recommended.

Prevalence and antibiotic susceptibility patterns of pseudomonas aeruginosa in urinary tract infections in a Tertiary care hospital, Central Kerala: A retrospective study over 4 years

Background and Objective: Pseudomons aeruginosa (P.aeruginosa) is an important uropathogenthat has shown varied antibiotic susceptibility patterns. This study aims to findout the changing trends in th eprevalence and antibiotic susceptibility patterns ofurinary isolates of P.aeruginosa over four consecutive years. Methodology: A retrospective, record based study was conducted on all culture and sensitivity (C/S) reports ofurine samples obtained in the microbiology lab in a tertiary care centre, Central Kerala (January 2014 -December 2017). The C/S reports which were positive for significant growth of P.aeruginosa were analyzed to findout its prevalence and antibiotic susceptibility patterns. Descriptive statistics was used for data analysis and the results were expressed in percentages. Result: Out of total 6622 urine samples received (14%) showed significant bacteriuria. P.aeruginosa was the third most common uropathogen isolated with an isolation rate of 3.5%. The antibiotic resistance observed were Gentamicin (53.1%), Amikacin (28%), Cefipime (28%), Ceftazidime(34.4%), Ciprofloxacin (43.7%), Norfloxacin (40.6%), Ofloxacin (40.6%), Piperacillin (37.5%), Piperacilli-Tazobactam (25%) and Imipenem (28%). The isolation rates of P.aeruginosa were 3.9%, 2.6%, 4.5 % and 2.9% in 2014, 2015, 2016 and 2017 respectively and overthe years it maintained its third position.The year wise analysis of antibiotic resistance showed fluctuating pattern except Amikacin, Cefipime and Fluoroquinoles which displayed a decreasingtrend. The reserve drugs like Piperacillin –tazobactam and Imipenem showed alarming drug resistance, although a hopeful reduction in the resistance was noted in 2017. Conclusion: P.aeruginosa remains as a common uropathogen. Drug resistant strains are markedly high in our area. Antibiotic resistance of P.aeruginosado not show a consistent trend over years and vary from region to region. Soeach institution should have an antibiotic policy based on the local antibiogram which is to be renewed regularly. Instead of opting for higher antibioticseach time, strict implementation of restrictive and rotational antibiotic policies and adherence to the concept of ‘Reserve drugs” should be followed. This is the only modality to inhibit the emergence of resistance strains of all uropathogens especially opportunistic pathogens like P.aeruginosa.

Case report of urinary tract infection in sows of a commercial pig unit

In this paper, a case of urinary tract infection in sows of a commercial pig unit is presented for the first time in Greece. Within a period of one year, 21 cases of specific infection were recorded, representing 5.8% of the farrowings in the farm. The symptoms were obvious around the 3rd to 4th week post mating and were keeping on for 2 to 7 days. Anorexia, thirst, blood in the urine and subsequent death or survival with gradual loss of body condition were the main findings. A significant correlation between the number of sows that died, and the number of sows showing anorexia (p&lt;0,05), or showing hypothermia (p&lt;0,05) was observed. The average number of live born piglets at the last parturition compared to the respective figure during the previous parturitions was markedly reduced (p&lt;0,05). The findings of microscopic and biochemical examination of the urine were indicative of infection, while biochemical examinations of blood samples of diseased sows have shown significantly increased urea (BUN) and creatinine levels (p&lt;0,05). Bacteriological culture of urine samples have shown the presence of increased numbers of bacteria (&gt;106/ml) such as Escherichia coli and Actinomyces suis in almost all ill sows. It is concluded that porcine urinary tract infections may cause serious problems for pig enterprises as may be directly correlated with reproductive performance and viability of the sows.

Fosfomycin: a good alternative drug for prostate biopsy prophylaxis the results of a prospective, randomized trial with respect to risk factors.

ABSTRACTPurpose:To determine the risk factors and the efficiency of rectal swab samples to prevent infectious complications in prostate biopsy, and compare fosfomycin with ciprofloxacin use in prophylaxis.Materials and Methods:Between May and October 2014, pre-biopsy risk factors and their effect in ciprofloxacin and fosfomycin prophylaxis were determined. Pre-biopsy urinalysis, urine culture and rectal swab samples were obtained from all of the patients. Rectal swabs were obtained upon admission, and biopsy was performed in the following 3-7 days. The place of rectal swab samples and efficiency of fosfomycin use was evaluated.Results:Pre-biopsy rectal swabs were obtained from 110 patients who revealed 60.9% fluoroquinolone resistance (FQR), and 32.7% fluoroquinolone sensitivity (FQS). Fosfomycin resistance was present in 3 patients. Ciprofloxacin use in last 6 months was the only risk factor for FQR. Antibiotic prophylaxis was given to both groups with and without risk factors, according to swab results, and no infective complications were observed. Among the group where fosfomycin was used empirically, one patient had an infection needing hospitalization, however this constitutes no statistical difference between the Group that fosfomycin used empirically or according to swab results (p=0.164).Conclusions:In prostate biopsy prophylaxis, ciprofloxacin may be used liberally in patients without risk factors, but it should be given according to the rectal swab results in the patients with risk, and fosfomycin may be used independently of risk factors and rectal swab results.

Oxalic acid quantification in mouse urine and primary mouse hepatocyte cell culture samples by ion exclusion chromatography-mass spectrometry.

Due to medical relevance and a direct correlation with some diseases, accurate quantification of oxalic acid in different complex matrices is required. Effective chromatographic separation of this strong carboxylic acid was achieved by ion exclusion chromatography (IELC). Sensitive and selective detection was carried out by means of electrospray ionization-tandem mass spectrometry. Furthermore, it was shown that the isobaric interference of lactic acid is chromatographically resolved. Structurally similar compounds like glyoxylic acid and glycolic acid were baseline separated as well. The application of stable isotope dilution analysis with 13C2 oxalic acid facilitated precise quantification. The developed method was validated with a reference oxalate sample of human urine diluted to a range of 10-500μM. Finally, the applicability of this method was demonstrated on complex matrices, like mouse urine and supernatants of primary mouse hepatocyte cell cultures.

Evaluation of Ureteral Stent Colonization in Live-Donor Renal Transplant Recipients

BackgroundUreteral stent insertion during kidney transplantation is a matter of debate. Stenting has been proven to reduce the risk of surgical complications. In addition, it has been reported to increase risks such as urinary tract infections especially after operation. Ureteral stent colonization (USC) is known to play a role in the pathogenesis of stent related-infections. The aim of this study was (1) to assess the frequency of USC and values of urine cultures in identifying colonizing bacteria; (2) to assess the importance of indwelling time for USC in live-donor renal transplant recipients; and (3) to evaluate the biomarker role of neutrophil-to-lymphocyte ratio (NLR) on USC. MethodsA total of 107 live-donor kidney transplant patients were included in the study (76 men and 31 women). The mean age was 43.7 years, and average indwelling time of the ureteral stent was 24.7 days. Patients were divided into three groups according to indwelling stent time as group 1: 15 to 21 days (3rd week), group 2: 22 to 28 days (4th week), and group 3: 29 to 35 days (5th week). The decision to remove the stent was primarily based on clinical judgment. Ureteral stents were removed with the use of flexible cystoscopy. Midstream urine for urine culture and blood samples for NLR were taken prior to stent removal. The removed stents were divided into three parts and taken for bacteriological investigation. ResultsOf 107 patients, USC was detected in 24 (22.4%) patients, whereas urinary proliferation was observed in 8 (7.4%) patients. The most common microorganisms found in USC was the Enterecoccus species. The most common microorganisms in urinary culture were Enterecoccus spp. and Klebsiella pnemoniae. All patients with isolated microorganisms in the urine had USC (P < .001). On the other hand, proliferation in urinary culture was observed only in 30% of patients. Urine culture was not significant in identification of USC (P = .063). The three patient groups that were determined according to indwelling stent time were compared in terms of USC, proliferation in urine culture, and NLR. The highest incidence of USC was found in group 3 (44%) and the least in group 2 (11%) (P < .05). No significant difference was found between the groups in terms of urine culture (P = .546). Although no significant difference was found between groups 1 and 2 in NLR values (P = .755), NLR was significantly higher in group 3 (P = .026). ConclusionsColonization is common in ureteral stents inserted in live-donor kidney transplant patients, although routine urine culture is insufficient in identfying this colonization. The most common microorganism detected in ureteral stent colonization was Enterecoccus spp. The 4th week was the most convenient time for stent removal time in terms of USC among the 3rd, 4th, and 5th weeks. In addition, increased NLR might have value as a biomarker for USC.

Comparison of microbiological diagnosis of urinary tract infection in young children by routine health service laboratories and a research laboratory: Diagnostic cohort study

ObjectivesTo compare the validity of diagnosis of urinary tract infection (UTI) through urine culture between samples processed in routine health service laboratories and those processed in a research laboratory.Population and methodsWe conducted a prospective diagnostic cohort study in 4808 acutely ill children aged <5 years attending UK primary health care. UTI, defined as pure/predominant growth ≥105 CFU/mL of a uropathogen (the reference standard), was diagnosed at routine health service laboratories and a central research laboratory by culture of urine samples. We calculated areas under the receiver-operator curve (AUC) for UTI predicted by pre-specified symptoms, signs and dipstick test results (the “index test”), separately according to whether samples were obtained by clean catch or nappy (diaper) pads.Results251 (5.2%) and 88 (1.8%) children were classified as UTI positive by health service and research laboratories respectively. Agreement between laboratories was moderate (kappa = 0.36; 95% confidence interval [CI] 0.29, 0.43), and better for clean catch (0.54; 0.45, 0.63) than nappy pad samples (0.20; 0.12, 0.28). In clean catch samples, the AUC was lower for health service laboratories (AUC = 0.75; 95% CI 0.69, 0.80) than the research laboratory (0.86; 0.79, 0.92). Values of AUC were lower in nappy pad samples (0.65 [0.61, 0.70] and 0.79 [0.70, 0.88] for health service and research laboratory positivity, respectively) than clean catch samples.ConclusionsThe agreement of microbiological diagnosis of UTI comparing routine health service laboratories with a research laboratory was moderate for clean catch samples and poor for nappy pad samples and reliability is lower for nappy pad than for clean catch samples. Positive results from the research laboratory appear more likely to reflect real UTIs than those from routine health service laboratories, many of which (particularly from nappy pad samples) could be due to contamination. Health service laboratories should consider adopting procedures used in the research laboratory for paediatric urine samples. Primary care clinicians should try to obtain clean catch samples, even in very young children.

Urinary tract bacterial infection of local Iraqi buffaloes (Bubalus Bubalis) in Mosul city

This study is conducted on the samples of urine obtained from buffaloes. Eighty six urine samples were obtained from local buffaloes of different ages, of both sex in Mosul abattoir. The results showed that urine of infected animals was cloudy, dark yellow to reddish color with putrid odor of low specific gravity. Microscopic examination of urine sediment demonstrated increased number of pus cell, erythrocytes, epithelial cell, presence of casts and crystals/ high power filed. Chemical examination revealed elevated urine pH and protein content. Serum examination displayed increase levels of urea and creatinine compered to normal urine samples. Culture of urine samples confirmed 24 positive samples (27.90%). Corynebacterium renale being the most isolated organisms 12(50%), Trueperella pyogens 5(20.83%), Staphylococcus aureus 4(16.66%) and 1(4.16%) for each of Acinetobacter lwoffii, Corynebacterium pilosum and Corynebacterium cystitidis. Male buffalo calves at age 1-3 years revealed high percentage (18.60%) of urinary tract infection, while low percentage of urinary tract infection existed by female buffaloes age more than 3 years (6.98%).

Subclinical Bacteriuria in Older Cats and its Association with Survival.

BackgroundBacterial urinary tract infections are uncommon in cats in general but the prevalence increases to 29% in older cats with comorbidities (Veterinary Clinical Pathology 2008, 37, 317; Journal of Feline Medicine & Surgery 2007, 9, 124; Veterinary Microbiology 2009, 136, 130). Frequently, the infections are subclinical. The clinical relevance of subclinical bacteriuria (SB) is uncertain, and the optimal treatment requires clarification.ObjectiveProspective, observational study to: (i) identify the prevalence and incidence count of SB in older (≥7 years), nonazotemic cats, (ii) evaluate specific risk factors for SB, and (iii) investigate the potential relationship between untreated SB and survival.AnimalsSixty‐seven, nonazotemic cats were tested on 5 occasions over 3 years.MethodsUrine samples were obtained by cystocentesis for quantitative urine culture and blood samples for measurement of serum creatinine concentration. Episodes of SB were not treated. Serum creatinine concentration, body weight, urine specific gravity, sex, and age were evaluated as potential risk factors for a positive urine culture. The association between urine culture results and survival was evaluated with Cox's proportional hazard model.ResultsA total of 256 urine samples was obtained. The prevalence of SB varied between 10 and 13%, and incident infections were uncommon. Female cats were 21 times more likely to have a positive urine culture than were male cats (odds ratio [OR], 21.2; confidence interval [CI], 4.1–110; P = .00028). Subclinical bacteriuria was not significantly associated with survival.Conclusion and clinical importanceSubclinical bacteriuria is common in nonazotemic, older cats. Although antimicrobial treatment was withheld, the presence of SB was not adversely associated with survival.

Successful Treatment of Urinary Tract Infection in Kidney Transplant Recipients Caused by Multiresistant Klebsiella pneumoniae Producing New Delhi Metallo-Beta-Lactamase (NDM-1) With Strains Genotyping

BackgroundKlebsiella pneumoniae New Delhi metallo-beta-lactamase-1 (NDM-1) strains have recently become a new threat in kidney transplant recipients due to the strains' resistance to almost all antibiotics, including carbapenems. MethodsWe present a case series of 3 patients with urinary tract infections (UTIs) caused by multiresistant K pneumoniae NDM-1 strains who were treated with the same protocol. Genotyping sequencing with pulsed-field gel electrophoresis was performed in all cases. ResultsAll patients were male and had undergone kidney transplantation 4, 7, and 8 months, respectively, before the admission. Combined antibiotic therapy consisting of imipenem/cilastatin in maximal doses, gentamicin and/or colistin for 21 to 27 days, followed by oral fosfomycin, was used in all cases. There were no further UTI episodes in 2 patients at the 12-month visit. Three months after initial treatment, the third patient presented with leukocyturia with no clinical symptoms and a urine culture positive for K pneumonia NDM-1 strain. Interestingly, the strain was susceptible to trimethoprim/sulfamethoxazole despite resistance in previous urine culture samples. The patient was successfully treated with trimethoprim/sulfamethoxazole 2 × 960 mg/d for 3 weeks followed by 480 mg/d and 3 doses of fosfomycin. Genotyping sequencing revealed identical DNA restriction fragments in bacterial strains from 2 patients. In the third case, although a difference in 2 restriction fragments was observed, the strain was considered related to the others. ConclusionsIn cases of UTI caused by K pneumoniae NDM-1 strains, prolong combined treatment followed by oral fosfomycin prophylaxis can be successful. Strain genotyping should be performed to optimize further treatment protocols in such cases.

Clinical Data of Urine Culture and Antimicrobial Sensitivity Tests according to the Voiding Method over 15 Years in Patients with Spinal Cord Injury

Purpose To analyze the results of urine cultures and antimicrobial sensitivity tests according to the voiding methods in patients with spinal cord injury (SCI) over a 15-year period. Materials and Methods A total of 1,579 urine culture samples, obtained from January 2000 to December 2014, for 73 SCI patients were analyzed according to the voiding method. We analyzed the following: positive urine culture rate, colony counts, isolated number of organism, major organisms, and antimicrobial sensitivity tests. The voiding methods were categorized into four methods: clean intermittent catheterization (CIC), suprapubic catheterization (SPC), urethral Foley catheter, and spontaneous voiding (SV). Results Among the 1,579 urine samples, 1,250 (79.2%) were positive. The CIC group showed the lowest rate of bacteriuria (p＜0.001), colony counts (p＜0.001), and polymicrobial infection (p＜0.001). Causative organisms were mostly gram-negative bacteria (86.7%). Pseudomonas aeruginosa (22.7%) was most common pathogen followed by Escherichia coli (22.3%), Klebsiella species (9.5%), Providencia species (4.4%), and Serratia marcescens (4.2%). Major pathogens and antimicrobial sensitivity tests were different according to the voiding method. Conclusions CIC is the best voiding method to reduce urinary tract infection (UTI) in SCI patients. To treat UTI in in SCI patients, empirical antibiotics can be chosen according to the voiding method based on the reference of our study prior to the availability of antimicrobial sensitivity results.