scholarly journals Recurrence of Urinary Tract Infection in a Primary Care Setting: Analysis of a I-Year Follow-up of 179 Women

1996 ◽  
Vol 22 (1) ◽  
pp. 91-99 ◽  
Author(s):  
R. Ikahelmo ◽  
A. Siitonen ◽  
T. Heiskanen ◽  
U. Karkkainen ◽  
P. Kuosmanen ◽  
...  
2019 ◽  
Vol 13 (03) ◽  
pp. 219-226
Author(s):  
Alison A Jackson ◽  
Pauline Siew Mei Lai ◽  
Aqtab Mazhar Alias ◽  
Nadia Atiya ◽  
Siti Nurkamilla Ramdzan ◽  
...  

Introduction: Diagnosis and management of urinary tract infection (UTI) are complex, and do not always follow guidelines. The aim of this study was to determine adherence to the 2014 Malaysian Ministry of Health guidelines for managing suspected UTI in a Malaysian primary care setting. Methodology: We retrospectively reviewed computerized medical records of adults with suspected UTI between July-December 2016. Excluded were consultations misclassified by the search engine, duplicated records of the same patient, consultations for follow-up of suspected UTI, patients who were pregnant, catheterised, or who had a renal transplant. Records were reviewed by two primary care physicians and a clinical microbiologist. Results: From 852 records, 366 consultations were a fresh episode of possible UTI. Most subjects were female (78.2%) with median age of 61.5 years. The major co-morbidities were hypertension (37.1%), prostatic enlargement in males (35.5%) and impaired renal function (31.1%). Symptoms were reported in 349 (95.4%) consultations. Antibiotics were prescribed in 307 (83.9%) consultations, which was appropriate in 227/307 (73.9%), where the subject had at least one symptom, and leucocytes were raised in urine full examination and microscopic examination (UFEME). In 73 (23.8%) consultations antibiotics were prescribed inappropriately, as the subjects were asymptomatic (14,4.6%), urine was clear (17,5.5%), or UFEME did not show raised leucocytes (42,13.7%). In 7 (2.3%) consultations appropriateness of antibiotics could not be determined as UFEME was not available. Conclusion: Several pitfalls contributed to suboptimal adherence to guidelines for diagnosis and management of suspected UTI. This illustrates the complexity of managing suspected UTI in older subjects with multiple co-morbidities.


Author(s):  
Lotem Goldberg ◽  
Yael Borovitz ◽  
Nir Sokolover ◽  
Asaf Lebel ◽  
Miriam Davidovits

2014 ◽  
Vol 35 (5) ◽  
pp. 793-805 ◽  
Author(s):  
A G Deakin ◽  
G R Jones ◽  
J W Spencer ◽  
E J Bongard ◽  
M Gal ◽  
...  

1979 ◽  
Vol 1 (5) ◽  
pp. 133-136
Author(s):  
Richard H. Rapkin

The identification of urinary tract infection (UTI) is important in order to reduce its morbidity, to prevent its sequelae, and to identify underlying disease. This article will discuss methods of diagnosis and management of UTI, screening for UTI, and the importance of further evaluation and follow-up of children with UTIs. Much of what we know about UTI is controversial and rapid generation of new knowledge may make current recommendations passé. CASE V.M., a 4-year-old girl, was brought to the physician's office with the chief complaint of frequency of urination. Nine months before she had been seen because of frequency and dysuria and two consecutive midstream urine cultures grew >100,000 colonies/ml of a Gramneative rod. Sulfisoxazole was begun and a urine culture was sterile 48 hours after therapy was begun. The dysuria and frequency disappeared; therapy was continued for ten days and a urine culture four days later was sterile. One week later a voiding cystourethrogram (VCU) and an intravenous pyelogram (IVP) were performed and were interpreted as normal. Repeat urine cultures at one, two, three, and six months after the episode were sterile. Two days before the child was seen, she had become irritable and wet the bed during sleep (she had been successfully trained at 27 months of age), and she began to void frequently during the next 24 hours.


2014 ◽  
Vol 27 (3) ◽  
pp. 364 ◽  
Author(s):  
Ana Bispo ◽  
Milene Fernandes ◽  
Cristina Toscano ◽  
Teresa Marques ◽  
Domingos Machado ◽  
...  

<strong>Introduction:</strong> Urinary tract infection is the most common infectious complication following renal transplantation and its frequency is insufficiently studied in Portugal. The aim of this study was to characterize the incidence of urinary tract infections and recurrent urinary tract infections in renal transplant recipients.<br /><strong>Material and Methods:</strong> This was a retrospective cohort observational study, obtained from clinical files of all patients who received a renal transplant at the Hospital of Santa Cruz, from January 2004 to December 2005, with a mean follow-up period of five years or until date of graft loss, death or loss of follow-up. After a descriptive analysis of the population, we used bivariate tests to identify risk factors for urinary tract infections.<br /><strong>Results:</strong> A total of 127 patients were included, with a 593 patients.year follow-up. We detected 53 patients (41.7%) presenting with at least one episode of urinary tract infection; 21 patients (16.5%) had recurrent urinary tract infection. Female gender was the only risk factor associated with the occurrence of urinary tract infections (p &lt; 0.001, OR = 7.08, RR = 2.95) and recurrent urinary tract infections (p &lt; 0.001, OR = 4.66, RR = 2.83). Escherichia coli (51.6%), Klebsiella pneumoniae (15.5%) and Enterobacter spp (9.9%) were the<br />most frequently identified pathogens. Patients did not reveal an increased mortality or allograft loss. However, urinary tract infections were the most important cause of hospital admissions.<br /><strong>Discussion:</strong> Female gender was the only risk factor for urinary tract infections in this population. Escherichia coli was the most frequent agent isolated.<br /><strong>Conclusion:</strong> Despite preventive measures, urinary tract infections remain an important cause of morbidity and hospital admissions.<br /><strong>Keywords:</strong> Urinary Tract Infections; Postoperative Complications; Risk Factors; Kidney Transplantation; Portugal.


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