Rectovaginal Group B streptococcus and urinary tract infections: Lessons from over one million urine cultures

This chapter includes the latest guidance on antenatal screening for infections, viral infections, bacterial infections, rubella antibodies (latest guidance), syphilis, HIV screening, and group B haemolytic Streptococcus. Other infections, such as coughs and colds, influenza, urinary tract infections, chickenpox, toxoplasmosis, and postnatal infections, and recognition and management of sepsis are included. Discussions includes diagnosis, the latest recommendations for treatment options, potential outcomes, and fetal effects.

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The Treatment of Urinary Tract Infections in Out-Patients. A Double-Blind Comparison between Trimethoprim and Nitrofurantoin

Journal of International Medical Research ◽

10.1177/030006058100900305 ◽

1981 ◽

Vol 9 (3) ◽

pp. 181-185 ◽

Cited By ~ 3

Author(s):

Jan Sander ◽

Einar Aandahl ◽

Helga Fellner ◽

Steinar Kalstad

Keyword(s):

Urinary Tract ◽

Side Effects ◽

Urinary Tract Infections ◽

Diffusion Method ◽

Cure Rate ◽

Disc Diffusion Method ◽

Double Blind ◽

Group A ◽

Group B ◽

Tract Infections

The rate of side-effects should today be more important for the choice of an agent for treatment of acute urinary tract infections than the cure rate, as this usually is above 90%. The side-effects with co-trimoxazole (trimethoprim-sulphamethoxazol) have been viewed as caused mainly by the sulphonamide component. In this randomized, double-blind trial Group A has been treated with trimethoprim 200 mg x 2 and Group B with nitrofurantoin 50 mg x 4 for a duration of 10 days. There was no difference in cure rate between the two groups. The rate of side-effects was 26% in Group A and 12% in Group B. In Group A 12% had skin eruptions, mostly appearing on Day 7 or later, in Group B 1.3% had eruptions. These differences are statistically significant (p < 0.05). This result, together with a survey of the literature, indicates that the frequency of these rashes might be related both to dosage and duration of treatment. The origin of the side-effects caused by co-trimoxazole should be reconsidered. The in vitro sensitivity against trimethoprim and nitrofurantoin was tested using a disc diffusion method in 98 infecting strains from patients in this study. Two per cent were resistant against trimethoprim and 81% against nitrofurantoin. We found no correlation between the size of the inhibition zone and bacteriological cure rate. This makes the value of the disc diffusion method in out-patients with acute urinary tract infections questionable.

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1446. The Impact of Enterobacteriaceae Isolate Breakpoints on Prescriber Treatment Choices for Discordant Pattern Urinary Tract Infections

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1310 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S528-S528

Author(s):

Philip Lee ◽

Yi Guo ◽

Wendy Szymczak ◽

Vijaya L Soma ◽

Priya Nori

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Broad Spectrum ◽

White Blood Cells ◽

Narrow Spectrum ◽

Broad Spectrum Antibiotics ◽

Group A ◽

Group B ◽

Tract Infections ◽

The Impact

Abstract Background Our institution revealed Enterobacteriaceae with discordant cefazolin (CEF)-resistant / ampicillin-sulbactam (SAM) susceptible patterns (CRASS-P). This discordance could be from the multiple MIC cephalosporin breakpoint adjustments from CLSI. SAM has higher resistance for gram-negative bacteria compared with cephalosporins such as CEF which is confirmed by our antibiogram. We sought to understand if narrow-spectrum antibiotic choices for CRASS-P urinary tract infections (UTIs) led to clinical cure (CC). Methods We conducted a retrospective review from January 2018 to February 2019 of all CRASS-P Escherichia coli, Proteus mirabilis, and Klebsiella pneumoniae isolates from urine cultures. Patients with any symptom related to a UTI, urinalysis with >10 white blood cells/high-powered field, urine culture with >10,000 colony-forming units/mL, and receipt of an antibiotic were included. CC was defined as symptom resolution within 48 hours with no return to care within 28 days of the positive urinary culture. “Group A” included patients prescribed narrow-spectrum antibiotics such SAM, CEF, or an oral cephalosporin (OC) vs. broad-spectrum antibiotics such as ceftriaxone, quinolones or sulfa-medications (“Group B”). Results There were 960/1356 (70.8%) CRASS-P urinary isolates and 244 patients met inclusion criteria. Of 244 patients, 72 were in Group A and 172 were in Group B. There was no difference in the diversity of the 3 uropathogens, P = 0.34 (Table 1). Median age was 69±20.3 and 67.5±23.9 years for Group A and Group B, respectively, P = 0.23. Females accounted for 73.6% and 77.9% in Group A and B, respectively, P = 0.51. Overall, patients reached CC in 98.6% (71/72) of Group A patients, compared with 92.4% (159/172) of Group B patients, P = 0.07. Antibiotics used in treatment are outlined in Figure 1. UTI was associated with bacteremia for 2 patients in Group A and 4 patients in Group B (P = 0.84). Both patients in Group A reached CC and used AMC for treatment. However, 1 out of 4 patients did not achieve CC in Group B. Conclusion The use of SAM or OC can spare the broad-spectrum antibiotics use for CRASS-P UTIs as there was no statistical difference in CC between the two groups. The use of SAM with CRASS-P bacteremia secondary to UTI is possible; however, future studies are needed. Disclosures All authors: No reported disclosures.

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Role of phytotherapy associated with antibiotic prophylaxis in female patients with recurrent urinary tract infections

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2013.4.197 ◽

2013 ◽

Vol 85 (4) ◽

pp. 197 ◽

Cited By ~ 1

Author(s):

Emanuela Frumenzio ◽

Daniele Maglia ◽

Eleonora Salvini ◽

Silvia Giovannozzi ◽

Manuel Di Biase ◽

...

Keyword(s):

Urinary Tract ◽

Antibiotic Prophylaxis ◽

Urinary Tract Infections ◽

Female Patients ◽

Recurrent Urinary Tract Infections ◽

Long Term Follow Up ◽

Group A ◽

Group B ◽

Tract Infections

Objective: Aim of this study is to evaluate the efficacy of a phytotherapic which includes Solidago, Orthosiphon and Birch extract (Cistimev®) in association with antibiotic prophylaxis in female patients affected by recurrent urinary tract infections (UTIr). Materials and methods: Patients affected by UTIr older than 18 years started a 3-months antibiotic prophylaxis (Prulifloxacin 600 mg, 1 cps/week or Phosphomicyn 1 cachet/week) according to antibiogram after urine culture. The patients were divided in 2 groups: Group A: antibiotic prophylaxis plus phytotherapy (1 cps/die for 3 months) and Group B: antibiotic prophylaxis alone. Results: 164 consecutive patients were studied: 107 were included in group A (mean age 59 ± 17.3 years) and 57 (mean age 61 ± 15.7) in group B. During the treatment period the relapse frequencies between the two groups were not significantly different (p = 0.854): 12/107 (11.21%) patients interrupted the treatment for UTIr in group A and 6/57 (10.52%) in group B. In the long term follow-up the relapse UTI risk was significant different in the two groups with a relapse risk 2.5 greater in group B than in group A (p < 0.0001). Conclusion: Our study demonstrated that in female patients affected by recurrent UTI, the association between antibiotic prophylaxis and of a phytotherapic which includes Solidago, Orthosiphon and Birch extract reduced the number of UTI in the 12 months following the end of prophylaxis and obtained a longer relapsing time, greatly improving the quality of life of the patients.

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Features and outcomes of secondary sepsis and urinary tract infections in COVID-19 patients treated with stem cell nebulization

10.1101/2020.12.05.20244483 ◽

2020 ◽

Author(s):

Gina M. Torres Zambrano ◽

Rene Antonio Rivero ◽

Carlos A. Villegas Valverde ◽

Yendry Ventura Carmenate

Keyword(s):

Stem Cells ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Protective Factor ◽

Antimicrobial Agents ◽

Rational Approach ◽

Significant Difference ◽

Group A ◽

Group B ◽

Tract Infections

AbstractBackgroundCOVID-19 is the defining global crisis of our time. Secondary complication such as urinary tract infections and sepsis, worsen the already established problem, creating a new challenge.ObjectiveTo characterize the features and outcomes in COVID-19 patients with sepsis and urinary tract infection.MethodsAn observational and analytical study was conducted within the framework of the SENTAD COVID clinical trial at the Abu Dhabi Stem Cells Center, were the patients received a nebulization therapy with the use of autologous stem cells (group A). Those patients were compared with a not stem cells treated control arm (group B), and both received the UAE COVID 19 standard management. An analysis of the culture samples, antimicrobial agents and the efficacy of the therapy on patient’s outcomes was done.ResultsA significant difference between the groups was found in the UTI incidence (p=*0.0206). Patients in group A showed a lower tendency to sepsis in comparison with group B (7% vs 21%), HR=0.35, (95% Confidence Interval: 0.13 – 0.91), p=0.0175. It was calculated a NNT=7.3. Candida albicans was the most frequently agent causing sepsis and UTI. The massive use of broad-spectrum antimicrobials was striking.ConclusionsWe found a protective factor of stem cells against secondary infection in COVID 19 cases, in terms of sepsis and UTI. The suggested immunomodulatory effect of stem cells offers a therapeutic strategy to manage the disease and avoid several complications. Antimicrobial agents can lead to increased opportunistic infections, so a rational approach to these treatments must be considered.

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