scholarly journals Predictors of Hospital-Acquired Urinary Tract–Related Bloodstream Infection

2012 ◽  
Vol 33 (10) ◽  
pp. 1001-1007 ◽  
Author(s):  
M. Todd Greene ◽  
Robert Chang ◽  
Latoya Kuhn ◽  
Mary A. M. Rogers ◽  
Carol E. Chenoweth ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Bloodstream Infection ◽  
Urine Culture ◽  
Conditional Logistic Regression ◽  
Tertiary Care ◽  
Incidence Density ◽  
Care Hospital ◽  
Positive Urine Culture ◽  
Positive Urine

Objective.Bloodstream infection (BSI) secondary to nosocomial urinary tract infection is associated with substantial morbidity, mortality, and additional financial costs. Our objective was to identify predictors of nosocomial urinary tract-related BSI.Design.Matched case-control study.Setting.Midwestern tertiary care hospital.Patients.Casesn= 298) were patients with a positive urine culture obtained more than 48 hours after admission and a blood culture obtained within 14 days of the urine culture that grew the same organism. Controls (n= 667), selected by incidence density sampling, included patients with a positive urine culture who were at risk for BSI but did not develop one.Methods.Conditional logistic regression and classification and regression tree analyses.Results.The most frequently isolated microorganisms that spread from the urinary tract to the bloodstream wereEnterococcusspecies. Independent risk factors included neutropenia (odds ratio [OR], 10.99; 95% confidence interval [CI], 5.78-20.88), renal disease (OR, 2.96; 95% CI, 1.98-4.41), and male sex (OR, 2.18; 95% CI, 1.52-3.12). The probability of developing a urinary tract-related BSI among neutropenic patients was 70%. Receipt of immunosuppressants (OR, 1.53; 95% CI, 1.04-2.25), insulin (OR, 4.82; 95% CI, 2.52-9.21), and antibacterials (OR, 0.66; 95% CI, 0.44-0.97) also significantly altered risk.Conclusions.The heightened risk of urinary tract-related BSI associated with several comorbid conditions suggests that the management of nosocomial bacteriuria may benefit from tailoring to certain patient subgroups. Consideration of time-dependent risk factors, such as medications, may also help guide clinical decisions in reducing BSI.Infect Control Hosp Epidemiol2012;33(10):1001-1007

scholarly journals 1371. Trends in Antibiotic Resistance Among Uropathogens in the Pediatric Population: A Single Center Experience in the US

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S695-S695
Author(s):  
Leena B Mithal ◽  
Sebastian Otero ◽  
Shan Sun ◽  
Mehreen Arshad
Keyword(s):  
Antibiotic Resistance ◽  
Urine Culture ◽  
Pediatric Population ◽  
Tertiary Care ◽  
Fourth Generation ◽  
Care Hospital ◽  
Beta Lactams ◽  
Positive Urine Culture ◽  
Positive Urine ◽  
Tract Infections

Abstract Background Urinary tract infections (UTIs) are common infections in children. Overuse of antibiotics has led to an increasing prevalence of antibiotic resistance among uropathogens in adults; however, data on pediatric trends have not been previously reported. Our objective was to characterize antibiotic resistance trends in uropathogens among children at a tertiary care hospital in a diverse urban US city. Methods Positive urine culture data (>20,000 CFU/ml) from January 1st, 2010 through December 31st, 2019 were obtained from the electronic medical records (inpatient and outpatient). Yearly antibiotic agent-specific resistance rates were calculated based on culture, patient, and organism level data. Results A total of 7,512 patients had ≥1 positive urine culture, with 13,327 positive individual cultures. The average age at sample collection was 6 yrs (IQR 2-11). Overall, 66% of cultures showed resistance to at least 1 antibiotic. Ampicillin resistance (50.1% IQR: 48.2%-52.4%) was the most common and remained stable over the study period. However, resistance against amoxicillin-sulbactam, third and fourth generation cephalosporins, and fluoroquinolones has increased significantly over this period (Figure 1). There was also a corresponding increase in the prevalence of extended spectrum beta-lactamase (ESBL) Enterobacteriaceae (Figure 2). Among infants < 1 year, a similar trend in increasing resistance against beta-lactams was noted (ampicillin-sulbactam 0% to 38%, ceftriaxone 0% to 9% and cefepime 0% to 4%, Figure 3). Figure 1 Figure 2 Figure 3 Conclusion There are rising rates of antibiotic resistance to broad spectrum antibiotics, including beta-lactams and quinolones, in a pediatric population over the last 10 years, with a notable increase in resistance starting in 2015-2016. While we were not able to distinguish patients with community acquired UTI, the increase in resistance among infants < 1 year suggests a community reservoir of multi-drug resistant gram-negative bacteria. Colonization by resistant uropathogens has implications for empiric antibiotic choice, limited oral therapy options, and clinical outcomes which necessitate further study. Disclosures All Authors: No reported disclosures

scholarly journals Urinary tract infection in full-term newborn infants: risk factor analysis

2000 ◽  
Vol 55 (1) ◽  
pp. 9-16 ◽  
Author(s):  
Mário Cícero Falcão ◽  
Cléa Rodrigues Leone ◽  
Renata A. P. D'Andrea ◽  
Roberta Berardi ◽  
Nilce A. Ono ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Parenteral Nutrition ◽  
Urine Culture ◽  
Positive Urine Culture ◽  
Intravascular Catheter ◽  
Positive Urine ◽  
Urinary Tract Malformations

OBJECTIVE: To analyze the correlation of risk factors to the occurrence of urinary tract infection in full-term newborn infants. PATIENTS AND METHODS: Retrospective study (1997) including full-term infants having a positive urine culture by bag specimen. Urine collection was based on: fever, weight loss > 10% of birth weight, nonspecific symptoms (feeding intolerance, failure to thrive, hypoactivity, debilitate suction, irritability), or renal and urinary tract malformations. In these cases, another urine culture by suprapubic bladder aspiration was collected to confirm the diagnosis. To compare and validate the risk factors in each group, the selected cases were divided into two groups: Group I - positive urine culture by bag specimen collection and negative urine culture by suprapubic aspiration, and Group II - positive urine culture by bag specimen collection and positive urine culture by suprapubic aspiration . RESULTS: Sixty one infants were studied, Group I, n = 42 (68.9%) and Group II, n = 19 (31.1%). The selected risk factors (associated infectious diseases, use of broad-spectrum antibiotics, renal and urinary tract malformations, mechanical ventilation, parenteral nutrition and intravascular catheter) were more frequent in Group II (p<0.05). Through relative risk analysis, risk factors were, in decreasing importance: parenteral nutrition, intravascular catheter, associated infectious diseases, use of broad-spectrum antibiotics, mechanical ventilation, and renal and urinary tract malformations. CONCLUSION: The results showed that parenteral nutrition, intravascular catheter, and associated infectious diseases contributed to increase the frequency of neonatal urinary tract infection, and in the presence of more than one risk factor, the occurrence of urinary tract infection rose up to 11 times.

scholarly journals Risk factors and clinical relevance of positive urine cultures in cats with subcutaneous ureteral bypass

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Julie Deprey ◽  
Arnaud Baldinger ◽  
Véronique Livet ◽  
Margaux Blondel ◽  
Mathieu Taroni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Condition ◽  
Bacterial Culture ◽  
Urine Culture ◽  
Body Condition Score ◽  
Positive Urine Culture ◽  
Positive Urine ◽  
Condition Score ◽  
Device Placement

Abstract Background The objective of the study was to report the incidence and risk factors associated with positive urine bacterial cultures as well as long-term outcome in cats with subcutaneous ureteral bypass (SUB) devices. Results Medical records of cats that underwent SUB device placement were retrospectively reviewed. Signalment of the cat, laterality of the ureteral obstruction, surgery, anesthesia and hospitalization duration, bacterial culture results and follow-up data were retrieved. Thirty-two cats met the inclusion criteria. Four cats (12.5%) had a positive intraoperative culture, with two of them being treated successfully. Ten cats out of 28 (35.7%) were documented with a positive urine culture during follow-up period, with a median time between discharge and identification of the first positive urine culture of 159 days (range 8–703 days). Bacteriuria resolved in 60% of cats (6/10). Escherichia coli was the most common organism, isolated in 4 out of 10 postoperative urine cultures. Overall, subclinical bacteriura was documented for 6 of 32 (18.8%) cats and 5 of 32 (15.6%) cats displayed clinicals signs suggestive of persistent UTI. One cat had subclinical bacteriuria. Three cats died during the follow-up period. There was a significant difference between negative and positive urine bacterial culture groups in median hospitalization duration (5 days versus 6 days, P = 0.022) and in median body condition score (5/9 versus 4/9, P = 0.03). Cats with a longer hospital stay and with a lower body condition score were more likely to have a positive urine culture during follow-up period. Conclusions SUB device placement surgery is associated with complications such as chronic bacteriuria. Bacteriuria in our study resolved with appropriate antibiotic treatment in more than half of cats. Risk factors identified for positive urine culture were a longer hospitalization duration and a decreased body condition score.

scholarly journals Incidence of Acute Pyelonephritis in Hospitalized Children under 5 Years Old with Positive Urine Culture

2018 ◽  
Vol 59 (4) ◽  
pp. 1-5
Author(s):  
Alexandra Castaño González ◽  
Juan Gabriel Ruiz Peláez
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Acute Pyelonephritis ◽  
Urine Culture ◽  
Renal Scintigraphy ◽  
Hospitalized Children ◽  
Positive Urine Culture ◽  
Positive Urine ◽  
Urinary Culture

Introduction: Urinary tract infection is a major cause of child morbidity. The diagnosis of acute pyelonephritis is important to decide the treatment. Methods: Retrospective observational study. We collected information of urinalysis, urine Gram and urine culture of hospitalized children between 3 months and 5 years old, with suspected urinary tract infection between January 2008 and December 2010. In patients with positive urine culture, the results of renal scintigraphy (Gamma scan) were evaluated to estimate the incidence of acute pyelonephritis. Results: We identified 1,463 medical records. Urinary culture was obtained in 237 patients, of whom 54.4% were positive. Renal scintigraphy was obtained in 93 of these patients and 59.1% were positive. Conclusions: The incidence of acute pyelonephritis in patients with confirmed urinary tract infection was 59.1%.

scholarly journals Impact of Constipation in Children on Urinary Tract Infection (UTI)

1970 ◽  
Vol 34 (1) ◽  
pp. 17-20 ◽  
Author(s):  
Seikh Azimul Hoque ◽  
Md Tariqul Islam ◽  
Farid Ahmed ◽  
Mohammed Hanif ◽  
Shahnoor Islam ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urine Culture ◽  
Single Species ◽  
Control Group ◽  
Positive Urine Culture ◽  
Positive Urine ◽  
History Of ◽  
The Difference

Objectives: The study was done to find out the relationship between constipation andurinary tract infection (UTI) in children.Methods: The study was a case control study between two groups in a tertiary carechildren hospital in Dhaka city. In group-1 (n=45) those children having history ofconstipation and in group-2 (n=78) as a control group having no history of constipationwere included in this study. Growths of a single species of organism with colony countof >105/ml in a clean-catch midstream single urine sample was considered as evidenceof urinary tract infection.Results: Positive urine culture was found in 8.9% (4/45) cases in children who hadhistory of constipation and 1.3% (1/78) in children who had no history of constipation.Though the number of positive urine culture was seven times more in children withconstipation than those who were not constipated but the difference between the twogroups was not statistically significant (p=0.059) .Conclusion: Culture documented UTI in children with constipation is seven timesmore than without constipation showing impact of constipation on urinary tract infection(UTI) in children.Key words: Urinary tract infection (UTI); constipation.DOI: 10.3329/bjch.v34i1.5697Bangladesh Journal of Child Health 2010; Vol.34(1): 17-20

scholarly journals Risk Factors and Significance of Gentamicin Resistant Positive Urine Culture in Patients Undergoing Urological Surgery: A Short Report

2014 ◽  
Vol 8 (4) ◽  
pp. 175-177
Author(s):  
Mazen Alsinnawi ◽  
Sean Egan ◽  
Emma Groarke ◽  
Eddie McCullagh ◽  
Jerome Fennell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urine Culture ◽  
Short Report ◽  
Positive Urine Culture ◽  
Urological Surgery ◽  
Positive Urine

scholarly journals Risk Factors of Candida parapsilosis Catheter-Related Bloodstream Infection

2021 ◽  
Vol 9 ◽  
Author(s):  
Dina Hussein Yamin ◽  
Azlan Husin ◽  
Azian Harun
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Bloodstream Infection ◽  
Candida Parapsilosis ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Solid Organ ◽  
Care Hospital ◽  
Icu Admission ◽  
Catheter Related Bloodstream Infection

Catheter-related bloodstream infection (CRBSI) is an important healthcare-associated infection caused by various nosocomial pathogens. Candida parapsilosis has emerged as a crucial causative agent for the CRBSI in the last two decades. Many factors have been associated with the development of CRBSI including, demography, pre-maturity, comorbidities (diabetes mellitus, hypertension, heart diseases, neuropathy, respiratory diseases, renal dysfunction, hematological and solid organ malignancies, and intestinal dysfunction), intensive care unit (ICU) admission, mechanical ventilation (MV), total parenteral nutrition (TPN), prior antibiotic and/or antifungal therapy, neutropenia, prior surgery, immunosuppressant, and type, site, number, and duration of catheters. This study aims to determine C. parapsilosis CRBSI risk factors. A retrospective study has been performed in an 853-bedded tertiary-care hospital in north-eastern Malaysia. All inpatients with C. parapsilosis positive blood cultures from January 2006 to December 2018 were included, and their medical records were reviewed using a standardized checklist. Out of 208 candidemia episodes, 177 had at least one catheter during admission, and 31 cases had not been catheterized and were excluded. Among the 177 cases, 30 CRBSI cases were compared to 147 non-CRBSI cases [81 bloodstream infections (BSIs), 66 catheter colonizers]. The significance of different risk factors was calculated using multivariate analysis. Multivariate analysis of potential risk factors shows that ICU admission was significantly associated with non-CRBSI as compared to CRBSI [OR, 0.242; 95% CI (0.080–0.734); p = 0.012], and TPN was significantly positively associated with CRBSI than non-CRBSI [OR, 3.079; 95%CI (1.125–8.429); p = 0.029], while other risk factors were not associated significantly. Patients admitted in ICU were less likely to develop C. parapsilosis CRBSI while patients receiving TPN were more likely to have C. parapsilosis CRBSI when compared to the non-CRBSI group.

scholarly journals Clinical, Etiological and Antibiotic Susceptibility Profiles of Community-Acquired Urinary Tract Infection in a Western Hemisphere of Baghdad

2015 ◽  
Vol 14 (4) ◽  
pp. 352-358
Author(s):  
Naser S Hussein
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Clinical Presentation ◽  
Urine Culture ◽  
Medical Science ◽  
Antibiotic Sensitivity ◽  
Western Hemisphere ◽  
Positive Urine Culture ◽  
Positive Urine

Background: In majority of community-acquired urinary tract infection (CA-UTI) cases, physicians can prescribe empirical therapy without a pretreatment urine culture especially in resource poor settings, where the cost of urine culture is more than cost of treatment itself. Objective: With growing problem of drug resistance globally as well as data on CA-UTI in Iraq are scare. We conduct this study to analyze clinical presentation, etiology and antibiotic sensitivity of bacteria causing community acquired urinary tract infection (CA-UTI). Material and Methods: Outpatients urine cultures and clinical presentations were collected from April 2012 to October 2012. A positive urine culture was defined as growth of a single bacteria with colony count of more than 100,000 CFU/ml and disk diffusion technique was performed to determine antibiotics susceptibility of isolated bacteria species. Clinical symptoms, causative uropathogens and their antibiotic sensitivity were recorded. Results: Of 299 urine cultures processed, a positive urine culture was detected in 100 subjects. Dysuria and bladder irritability (frequency and urgency) were the most common clinical presentation. 39% of isolated bacteria was Escherichia coli and Staphylococcus strains (30%). The isolated uropathogens showed a substantial sensitivity reduction to most of test antibiotics. Conclusion: Clinical presentation had a minor role in diagnosis of CA-UTI and this study revealed that E. coli and Staphylococcus strains were most prevalent isolated uropathogens. Susceptibility test showed there was a high sensitivity to nitrofurantoin, amikacin and imipenem.Bangladesh Journal of Medical Science Vol.14(4) 2015 p.352-358

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