Incidence of Urinary Tract Infection Following Transrectal Ultrasound Guided Prostate Biopsy at a Tertiary-Care Medical Center in Lebanon

2004 ◽  
Vol 25 (10) ◽  
pp. 873-877 ◽  
Author(s):  
Zaher K. Otrock ◽  
Gerard O. Oghlakian ◽  
Mariana M. Salamoun ◽  
Maurice Haddad ◽  
Abdul Rahman N. Bizri
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Prophylaxis ◽  
Medical Center ◽  
Care Center ◽  
Tertiary Care ◽  
Transrectal Ultrasound ◽  
Ultrasound Guided ◽  
Tertiary Care Medical Center ◽  
The Mean ◽  
Tract Infections

AbstractObjective:To determine the incidence of urinary tract infections (UTIs) following transrectal ultrasound guided needle biopsy of the prostate (TRUBP) and the bacteriology of these infections.Design:Retrospective evaluation of the charts and records of all patients who underwent TRUBP between June 1, 2002, and August 31, 2003.Setting:American University of Beirut Medical Center, a tertiary-care center in Lebanon.Patients:Two hundred seven patients underwent TRUBP. All received prophylactic antibiotics. One hundred twenty (58%) received ciprofloxacin alone, whereas 87 (42%) received both ciprofloxacin and gentamicin. Sixty-one patients (29.5%) had an enema prior to the procedure, whereas 146 (70.5%) did not.Results:Thirteen patients (6.3%) were admitted with UTI. All had rigors and fever on admission. Symptoms appeared at a mean of 2.7 days and the mean hospital stay was 9.2 days. The mean duration of antibiotic treatment was 23.2 days. Ten (77%) of the patients had positive bacteriology. Urine cultures were positive in 8 (61.5%) of the patients and blood cultures in 6 (46.2%). All positive cultures grew Escherichia coli resistant to ciprofloxacin, with 5 isolates producing extended-spectrum beta-lactamases.Conclusions:TRUBP continues to be associated with significant infectious complications, especially UTI. Given the increasing incidence of antibiotic resistance mainly among the Enterobacteriaceae, antimicrobial prophylaxis practices should be reevaluated and the universal administration of quinolones alone or in combination with aminoglycosides should be reconsidered.

scholarly journals Prevalence of Community Acquired Uropathogens and their Antimicrobial Susceptibility in Patients from the Urology Unit of A Tertiary Care Medical Center

2020 ◽  
Vol 14 (3) ◽  
pp. 2009-2015
Author(s):  
Manzoor Ahmad ◽  
Pushkar Kumar ◽  
Asfia Sultan ◽  
Anees Akhtar ◽  
Bhanu Chaudhary ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Medical Center ◽  
Tertiary Care ◽  
Carbapenem Resistance ◽  
Urine Specimen ◽  
Aminoglycoside Resistance ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Tertiary Care Medical Center ◽  
Tract Infections

Urinary tract infections (UTI) are one of the most common community acquired infections and can also present with similar lower urinary tract symptoms (LUTS). Moreover, UTI can be a complication of these urological diseases. Thus, this study was conducted in patients with LUTS to find out the prevalence of uro-pathogens and their antibiotic susceptibility pattern so that appropriate antibiotics can be started on clinical suspicion of UTI. The study was conducted over a period of 12 months. Culture and susceptibility of urine specimen was done as per standard microbiological guidelines. Apart from the growth of common bacteria with their antibiogram, Methicillin-resistant Staphylococcus aureus (MRSA), high level aminoglycoside resistance (HLAR) was investigated among Enterococci, and metallo beta-lactamases(MBL) production was production was investigated among gram-negative pathogens. Out of 407 urine samples included in the study, 80 (19.6%) samples showed bacterial growth. The commonest isolate was E. coli 44 (55 %). Majority of the isolates were multidrug resistant with two E.coli strains showing pan-resistance to the first line drugs tested. Carbapenem resistance was seen in 67.2% of all gram negative isolates tested. Metallo beta-lactamases production was found to be highest among the Klebsiella isolates. Among the Enterobacterales, highest susceptibility was noted to Fosfomycin (87.7%) followed by Nitrofurantoin (62.7%). Similarly in gram positive group, highest susceptibility was again to Fosfomycin followed by Nitrofurantoin. Overall the prevalence of MDR is increasing however Fosfomycin or Nitrofurantoin, both oral antibiotics, can be the considered for starting empirical antibiotic therapy.

scholarly journals Multisite Study to Examine the Amount of Inpatient Physician Continuity Experienced by Hospitalized Patients

2015 ◽  
Vol 7 (4) ◽  
pp. 624-629 ◽  
Author(s):  
Kathlyn E. Fletcher ◽  
Siddhartha Singh ◽  
Jeff Whittle ◽  
Vishal Ratkalkar ◽  
Alexis M. Visotcky ◽  
...  
Keyword(s):  
Continuity Of Care ◽  
Medical Center ◽  
Care Center ◽  
Tertiary Care ◽  
General Medicine ◽  
Retrospective Chart Review ◽  
Hospitalized Patients ◽  
Inpatient Medicine ◽  
The Mean ◽  
Handoff Of Care

ABSTRACT Background Continuity for inpatient medicine has been widely discussed, but methods for measuring it have been lacking. Objective To measure the continuity of care experienced by hospitalized patients and to identify predictors of continuity. Methods This was a multisite prospective cohort study and retrospective chart review that took place at 3 hospitals: an academic tertiary care center, a Veterans Affairs medical center, and a community teaching hospital. Subjects were general medicine patients and internal medicine residents. We measured continuity of care using 3 metrics: (1) the percentage of hospital time covered by the primary intern; (2) the amount of time between admission and the first handoff of care; and (3) admission-discharge continuity. We conducted univariate analyses to identify patient and hospital factors that may be associated with each type of continuity of care. Results Our sample included 869 patients with a mean age of 62.6 years (SD = 17.2) and 34% female patients. The mean percentage of hospital time covered by the primary intern was 39.2% (SD = 16.3%). The mean time between admission and the first handoff of care was 13.3 hours (SD = 7.1). Forty percent of patients experienced admission-discharge continuity. In univariate and multivariable modeling, the site was significantly associated with each type of continuity. Conclusions The amount of continuity varied greatly and was influenced by the site and other factors. No site maximized every aspect of continuity. Programs and institutions should decide which aspects of continuity are most important locally and design schedules accordingly.

Platelet Utilization In a Tertiary Care Hospital: An Opportunity for Reduced Transfusion?

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 2575-2575
Author(s):  
Vipra Sharma ◽  
Maya Shah ◽  
Ravi Pullela ◽  
Alice J. Cohen
Keyword(s):  
Disease Transmission ◽  
Tertiary Care Hospital ◽  
Conflicts Of Interest ◽  
Medical Center ◽  
Tertiary Care ◽  
Invasive Procedure ◽  
Care Hospital ◽  
Tertiary Care Medical Center ◽  
The Mean ◽  
Transfusion Guidelines

Abstract Abstract 2575 Background: Use of platelet (plt) transfusions to treat and prevent bleeding varies widely between hospitals and by medical and surgical services. Standard indications include active bleeding with thrombocytopenia or plt dysfunction, pre or peri-invasive procedure, and prophylaxis for low plt counts. Rising demand for plt transfusions and donor shortage, coupled with the risks of transfusion (including infectious disease transmission and alloimmunization) are concerns which often lead to strict regulation of plt transfusion in hospitals. In order to evaluate appropriate use of plt transfusion based on Newark Beth Israel Medical Center transfusion guidelines, a review of plt use was undertaken at this tertiary care hospital. Design: A retrospective review was performed of plt utilization over a 3 month period from October to December 2009. All charts of hospitalized and outpatient patients receiving plt transfusions were reviewed to determine reasons for plt transfusion. Pre-transfusion plt values, site/service ordering plt transfusions, number of units transfused and cost were determined. Results: 421 plt units were transfused to 125 patients (51.6% female), mean age 44 years (yrs.) (range 0–89). All plt transfusions were single donor units. The mean plt count prior to transfusion for all procedures was 127,000, well above hospital guidelines. The majority of plt utilized were by cardiothoracic (CT) surgery (168/421, 40%) with the highest cost (Table 1). 124/421(29%) of transfusions occurred pre- or peri- invasive procedure, with 88/124 (71%) of those transfusions occurring prior or peri- cardio-thoracic procedure. 83/421 (20%) of transfusions had no clear indication based on hospital guidelines, predominately ordered by CT surgery and occurring post-op for asymptomatic thrombocytopenia (cost $45, 650). The mean plt count at which transfusion was found to have no indication was 55,000 (range 25,000–105,000). 136/421(32%) of the cases were prophylactic transfusions with a plt count < 20,000, with 121/136 (89%) in the oncology patients, and the rest in the medical pts due to sepsis. 114/421(27%) of the transfusions were for bleeding. Only 5 patients, 3 in the CT group, and 2 in neonate group had plt dysfunction as the indication for transfusion prior to procedure. The lowest incidence of plt transfusions without an indication was in the adult oncology department. Conclusion: Platelet utilization varied by departments. CT surgery followed by neonatal and pediatric oncology are the principal users of plt in our tertiary care medical center. CT surgery, general surgery, and neonatal services had the highest pre-transfusion plt counts. As 20% of all transfusions had no clinical reason for plt use (no bleeding, invasive procedure, or severely low plt count) the opportunities may exist for lower platelet usage by educating physicians about compliance to transfusion guidelines in order to decrease the risks associated with transfusion and resultant complications. Disclosure: No relevant conflicts of interest to declare.

scholarly journals The Potential Impact of Excluding Funguria from the Surveillance Definition of Catheter-Associated Urinary Tract Infection

2015 ◽  
Vol 36 (4) ◽  
pp. 467-469 ◽  
Author(s):  
Kristen V. Dicks ◽  
Arthur W. Baker ◽  
Michael J. Durkin ◽  
Sarah S. Lewis ◽  
Rebekah W. Moehring ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Medical Center ◽  
Tertiary Care ◽  
Infect Control Hosp ◽  
Tertiary Care Medical Center ◽  
Potential Impact ◽  
Definition Of ◽  
True Infection

Funguria rarely represents true infection in the urinary tract. Excluding yeast from the catheter-associated urinary tract infection (CAUTI) surveillance definition reduced CAUTI rates by nearly 25% in community hospitals and at an academic, tertiary-care medical center.Infect Control Hosp Epidemiol 2015;00(0): 1–3

A STUDY OF URINARY TRACT ABNORMALITIES IN HOSPITALISED CHILDREN PRESENTING WITH URINARY TRACT INFECTION IN MIDNAPORE MEDICAL COLLEGE AND HOSPITAL

2021 ◽  
pp. 71-73
Author(s):  
Nabanita Das ◽  
Mitali Bera ◽  
Shabarna Roy ◽  
Dhruba Kumar Mahata
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Pediatric Patients ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Number Of Children ◽  
The Mean ◽  
Tract Infections

Introduction: Urinary tract infection is the most common bacterial infection in childhood and upto 30% of infants and children experience recurrent infections during the rst 6 to 12 months after initial UTI. Urinary tract infections (UTI) imply invasion of urinary tract by pathogens, which may involve the upper or lower urinary tract depending on the infection in the kidney or bladder and urethra. Aims And Objectives: Children presenting with UTI by Ultrasonography, MCU and / or DMSA depending on the child's age. structural abnormalities and the presence of VUR if any in children with UTI by USG, MCU and DMSAscan in indicated cases. Materials And Methods: The study was conducted in the Pediatrics ward of Midnapore Medical College and Hospital. This is a tertiary care centre. Pediatric patients from different districts of West Bengal are referred to our Institute. All pediatric patients from 3 months to 12 years of age patients with a diagnosis of, either rst episode or recurrent UTI admitted at Midnapore Medical College and Hospital. Our study was an Observational, Prospective study. All the pediatric patients fullling the inclusion criteria, admitted to the hospital during the study period was enrolled for the study. Result And Analysis: We found in abnormal DMSA, the mean age (mean±s.d.) of children was 21.9375 ± 29.1398 years. In normal DMSA, the mean age (mean±s.d.) of children was 24.7321 ± 18.3179. In not required DMSA, the mean age (mean±s.d.) of children was 97.1667 ± 21.9855. Distribution of mean age in years vs. DMSAwas statistically signicant (p<0.0001). In abnormal DMSA, Conclusion: Even a normal USG report does not rule out dysfunctional bladder as we have had 3 children aged 19 months, 6 months and 26 months who had normal USG ndings but clear evidence of VUR on MCU of grades 2 ,4 and 1 respectively. In conclusion, abnormal US may carry a higher probability of grades III-VVUR and RS, and can affect the management in a signicant number of children hospitalized with UTI.

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