scholarly journals 174. Development of a Machine Learning Prediction Model to Select Empirical Antibiotics in Patients with Clinically Suspected Urinary Tract Infection using Urine Culture Data

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S196-S196
Author(s):  
Chungsoo Kim ◽  
Rae Woong Park ◽  
Sandy J Rhie
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Prediction Model ◽  
Prediction Models ◽  
Urine Culture ◽  
Antibiotics Resistance ◽  
Empiric Antibiotics ◽  
Extreme Gradient Boosting ◽  
Study Population

Abstract Background Increasing antimicrobial resistance and the emergence of superbugs are problems globally. Inappropriate empiric antibiotic use would be a reason to cause antibiotic resistance. However, it has been a challenge to prescribe empiric antibiotics as it is difficult to identify the causative organism beforehand. In this study, we aimed to develop a prediction model to estimate the risk of antibiotics resistance using urine culture tests. Methods The study population included adult patients who had at least one of the results from a urine culture test and antibiotic susceptibility tests (from ampicillin, ceftriaxone, ciprofloxacin, gentamicin, levofloxacin, nitrofurantoin, tetracycline, trimethoprim/sulfamethoxazole) on admission to Ajou University Medical Center. Outcomes were defined as a resistant or intermediate susceptibility. Candidate predictors were diagnosis, prescription, visit, laboratory, procedures of the study population. We split data to 75:25 for training and test. Lasso logistic regression (LLR), extreme gradient boosting machine (XGB), Random Forest (RF) were used as model algorithms. The models were evaluated by an area under the curve of receiver operator characteristics curve (AUROC), precision-recall curve (AUPRC), and its calibration. All codes are available in https://github.com/ABMI/AbxBetterChoice Results Total 33 covariates were selected for final prediction models. The RF showed the highest AUROC in the ceftriaxone and tetracycline models (0.823, 0.626, respectively). The XGB presented the highest AUROC for ciprofloxacin and nitrofurantoin (0.731, 0.706, respectively). The AUROC of RF and the XGB were the same in an ampicillin model (0.633). For gentamicin, levofloxacin, and trimethoprim/sulfamethoxazole, the AUROC of LLR was the highest (0.838, 0.831, 0.615, respectively). Among the models, the AUROC was the highest in the gentamicin model regardless of algorithms. All calibrations of the models were acceptable. Conclusion We developed prediction models with competing performances of discrimination and calibration. It would contribute to the proper selection of empiric antibiotics susceptible to those causative pathogens in hospitalized patients with a clinically suspected urinary tract infection. Disclosures All Authors: No reported disclosures

scholarly journals A study of prevalence of culture positive UTI in children: clinical profile, risk factor analysis, and microbiological profile

2019 ◽  
Vol 6 (2) ◽  
pp. 394
Author(s):  
K. Rajendran ◽  
Kiruba Shankar
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urine Culture ◽  
Indian Academy ◽  
Clinical Profile ◽  
Differential Count ◽  
Ascending Infection ◽  
Study Population ◽  
Culture Positive

Background: Urinary infection is one of the common infections occurring in children. Different literature says different definition for UTI. Indian Academy of Pediatrics defines urinary tract infection as the growth of a significant number of organisms of single species in urine culture with the presence of symptoms of UTI. The objective is to study the clinical profile of children with urine culture positive UTI.Methods: The study was conducted in Kovai medical centre and hospital Coimbatore. The sample size is 150 children. The study population includes children with culture-positive UTI who are admitted between October 2015 to September 2016 over a period of 1 year. Child’s history was then recorded as answers to the pre-prepared questionnaire in a proforma. Clinical examination was done, and the findings were recorded. Blood sampling was done for all patients and sent to a laboratory to measure total count, differential count, ESR.Results: Previous urinary tract infection was present in 2.7% of children. All children had the same organism grown in urine culture as in previous episode suggesting unresolved or persistent bacteremia. This is comparable with the literature stating unresolved bacteremia as the most common type of recurrent.Conclusions: The study group in which the risk factors were analysed had a female preponderance (may be due to the short urethra, easy ascending infection). In present study population fever and increased frequency are two important symptoms followed by abdominal pain.

Assessment of Urine Gram Stain and Urine Culture in the Diagnosis of Urinary Tract Infection

2012 ◽  
Vol 3 (2) ◽  
pp. 472-473
Author(s):  
Dr G Sucilathangam Dr G Sucilathangam ◽  
◽  
Dr G Velvizhi Dr G Velvizhi
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urine Culture ◽  
Gram Stain

URINARY INFECTION AT DEPARTMENT OF UROLOGY OF HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2018 ◽  
pp. 100-108
Author(s):  
Dinh Khanh Le ◽  
Dinh Dam Le ◽  
Khoa Hung Nguyen ◽  
Xuan My Nguyen ◽  
Minh Nhat Vo ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
University Hospital ◽  
E Coli ◽  
Positive Urine ◽  
Tract Infections

Objectives: To investigate clinical characteristics, bacterial characteristics, drug resistance status in patients with urinary tract infections treated at Department of Urology, Hue University Hospital. Materials and Method: The study was conducted in 474 patients with urological disease treated at Department of Urology, Hue Universiry Hospital from July 2017 to April 2018. Urine culture was done in the patients with urine > 25 Leu/ul who have symptoms of urinary tract disease or infection symptoms. Patients with positive urine cultures were analyzed for clinical and bacterial characteristics. Results: 187/474 (39.5%) patients had symptoms associated with urinary tract infections. 85/474 (17.9%) patients were diagnosed with urinary tract infection. The positive urine culture rate was 45.5%. Symptoms of UTI were varied, and no prominent symptoms. E. coli accounts for the highest proportion (46.67%), followed by, Staphycoccus aureus (10.67%), Pseudomonas aeruginsa (8,0%), Streptococcus faecali and Proteus (2.67%). ESBL - producing E. coli was 69.23%, ESBL producing Enterobacter spp was 33.33%. Gram-negative bacteria are susceptible to meropenem, imipenem, amikacin while gram positive are vancomycin-sensitive. Conclusions: Clinical manifestations of urinary tract infections varied and its typical symptoms are unclear. E.coli is a common bacterium (46.67%). Isolated bacteria have a high rate of resistance to some common antibiotics especially the third generation cephalosporins and quinolones. Most bacteria are resistant to multiple antibiotics at the same time. Gram (+) bacteria are susceptible to vancomycin, and gram (-) bacteria are susceptible to cefoxitin, amikacin, and carbapenem. Key words: urinary tract infection

Urinary Tract Infection

1979 ◽  
Vol 1 (5) ◽  
pp. 133-136
Author(s):  
Richard H. Rapkin
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urine Culture ◽  
Underlying Disease ◽  
Chief Complaint ◽  
Voiding Cystourethrogram ◽  
Intravenous Pyelogram ◽  
Rapid Generation

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.

scholarly journals Canine Cystitis Caused by Salmonella enterica subsp. enterica

2019 ◽  
Vol 47 ◽  
Author(s):  
Raylson Pereira De Oliveira ◽  
Débora Mirelly Sobral da Silva ◽  
Maria De Nazaré Santos Ferreira ◽  
Camila Maria Coutinho Moura ◽  
Rômulo Francelino Freitas Dias ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Salmonella Enterica ◽  
Urine Culture ◽  
Clinical Signs ◽  
Blood Agar ◽  
Salmonella Spp ◽  
Gram Negative ◽  
Northeast Region

Background: Urinary tract infection in dogs is usually associated with the presence of bacteria, with a higher prevalence of Gram-negative bacteria, represented mainly by enteric bacteria such as Escherichia coli and Proteus spp., followed by Gram-positive bacteria such as Staphylococcus spp., and Streptococcus spp. There are scant reports of Salmonella spp. as the causative agent of urinary tract infection in dogs.  Indeed, the literature describes only a few cases, most of which involve the isolation of these bacteria in feces. This paper reports a case of canine cystitis caused by Salmonella enterica subsp. enterica in the northeast region of Brazil.Case: A female dog of the Fila Brasileiro breed, about 9 year-old, wormed but unvaccinated, was evaluated at the Veterinary Hospital of the Federal University of Pernambuco – UFRPE.  The dog showed clinical signs of apathy, cachexia, polyphagia, polyuria and opacity of the crystalline lens. The dog’s owner stated that the animal was fed with commercial dog food. In the clinical exam, the patient presented pale mucosa, cachexia, absence of ectoparasites, and her rectal temperature was 39.5°C. Moreover, cardiorespiratory auscultation of the patient revealed tachycardia (190 bpm) and tachypnea (36 bpm). The owner’s main complaint was the clinical condition of frequent urination (polyuria). A urinalysis and urine culture with antibiogram were requested as complementary exams, after collecting the urine by cystocentesis. The volume obtained in the physical examination of urinalysis was 7 mL of yellow urine with a putrid smell, cloudy appearance and density of 1.024. The chemical examination revealed pH 6.5, protein (+++), bilirubin (+), normal urobilinogen and negative reactions for glycoses, ketone, nitrite and urine occult blood. Bacteriuria and pyuria were detected in a urine sediment test. Urine was cultured on blood agar and Levine agar in a bacteriological incubator at 37°C under aerobiosis, for 24 h. This culture produced an exuberant and pure growth of glossy grey bacterial colonies on blood agar and glossy colonies on Levine agar. The Gram test revealed gram-negative bacilli. The sample was subjected to biochemical tests to identify Gram-negative enterobacteria, whose results provided a presumptive identification of Salmonella species. The microbial species was identified using a VITEK 2 Compact®, and was followed by a serology test for the identification of the serogroup using a polyvalent serum, which enabled the identification of Salmonella enterica subsp. enterica. The antibiogram showed sensitivity to ciprofloxacin, gentamicin and penicillin, and resistance to amoxicillin and ampicillin.Discussion: Clinical signs of cachexia and polyuria may be related to canine urinary tract infection caused by Salmonella enterica subsp. enterica, since these symptoms had already been recorded previously in a case of a bacterial infection by the same serogroup. Isolation of Salmonella spp. in a non-selective medium was determinant in identifying these bacteria. Since these are not commensal bacteria of the canine urinary tract, their isolation in this tract indicates that they are responsible for the infection or disease, although such cases are rare. Another aspect that should be highlighted is the risk of human infection, because of the zoonotic potential of Salmonella spp., which may be transmitted by contact with dog urine. This is the first report of the isolation of Salmonella enterica subsp. enterica in a case of canine cystitis on the northeast region of Brazil, and underscores the importance of complementary diagnostic exams such as urine culture.

scholarly journals Clinical, Epidemiological and Bacteriological Profile of Culture Positive Urinary Tract Infections in Febrile Children – A Cross Sectional Study

2021 ◽  
Vol 8 (10) ◽  
pp. 522-526
Author(s):  
Bhavani Shankar Rokkam ◽  
Chowdary Babu Menni ◽  
Ramu Pedada ◽  
Deepak Kumar Alikana
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Signs And Symptoms ◽  
Cross Sectional ◽  
Bacteriological Profile ◽  
Tract Infections ◽  
Culture Positive

BACKGROUND Urinary tract infections (UTI) constitute a common cause of morbidity in infants and children. When associated with abnormalities of urinary tract, they may lead to long-term complications including renal scarring, loss of function and hypertension. Most urinary tract infections remain undiagnosed if investigations are not routinely performed to detect them. Prompt detection and treatment of urinary tract infections and any complicating factors are important. The objective of the study is to know the clinical, epidemiological and bacteriological profile (i.e. clinical signs and symptoms, age, sex, family history, associated urinary tract abnormalities, & causative organisms) of urinary tract infections in febrile children with culture positive urinary tract infection. METHODS This descriptive, cross sectional observational study was conducted at outpatient clinics of our “child health clinics” between May 2016 and April 2017 (one year). All children aged 0 to 12 years with culture positive urinary tract infections were included in this study to evaluate the clinical, epidemiological and bacteriological profile. RESULTS A total of 69 children with culture positive urinary tract infections were included in this study. Out of 69 children included in this study, 36 (52.2 %) were females and 33 (47.8 %) were males. Overall female preponderance was seen and the M: F ratio was 0.9:1. But during first year of life in our study group we had more boys (10, 14.49 %) affected with urinary tract infection than girls. 49.3 % of urinary tract infections in the present study belonged to lower socio-economic status. Most common organism causing urinary tract infection in our group was E. coli (56.5 %). Fever (100 %), anorexia or refusal of feeds (52.2 %), dysuria (46.4 %), vomiting (46.4 %) and abdominal pain (39.1 %) were the predominant clinical manifestations observed in our study. CONCLUSIONS Urinary tract infection is a common medical problem in children and it should be considered as a potential cause of fever in children. As febrile children with urinary tract infection usually present with non-specific signs and symptoms, urine culture should be considered as a part of diagnostic evaluation. KEYWORDS Urinary Tract Infections (UTI), Febrile Children, Bacteriological Profile, Urine Culture

scholarly journals Prevalence of Urinary Tract Infection and Antibiotic Susceptibility Pattern to Urinary Pathogens in Kathmandu Medical College and Teaching Hospital , Duwakot

2017 ◽  
Vol 2 (1) ◽  
pp. 134-137 ◽  
Author(s):  
Binita Pradhan ◽  
SB Pradhan
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Teaching Hospital ◽  
Urine Culture ◽  
College Teaching ◽  
Pathogenic Microorganism ◽  
Medical College ◽  
Sensitivity Pattern ◽  
Tract Infections

IntroductionIn developing countries, urinary tract infections (UTIs) are one of the most commonly diagnosed diseases among the patient seeking medical service and being treated with empirical antibiotics which causes resistance.ObjectiveTo find out the prevalence of urinary tract infection and sensitivity pattern of antibiotics among bacterial pathogens isolated in patients attending Kathmandu Medical College Teaching Hospital, Duwakot.MethodologyAll the patients with the clinical suspicion of UTI were sent for urine culture. Prevalence of UTI and urinary pathogens isolated with antimicrobial profile was correlated.ResultA total number of 1735 clinically suspected as UTI cases were sent for urine culture sensitivity. Total culture positive were 239 (13.8%). The majority of isolates were from female patients comprising 180 (75%). The most common pathogenic microorganism isolated was E.coli (79.1%). Second most common organism was Klebsiella (11.7%) followed by Citrobacter (3.34%) and Proteus (2.92%). The isolated microorganism showed maximum number of sensitivity with the antibiotics Ofloxacin and Ciprofloxacin. The isolated microorganism demonstrated resistance with Nalidixic Acid and Co-Trimoxazole. ConclusionUrinary tract infection is a commonly encountered case in general practice. Females are commonly affected than men. The microbiological profile and the antibiotic sensitivity pattern while initiating empirical treatment must be taken into account while planning for the management. Regular supervision of the sensitivity pattern of pathogenic microorganism is mandatory for effective treatment.Birat Journal of Health Sciences Vol.2/No.1/Issue 2/ Jan - April 2017, Page: 134-137

Hyperammonemia in a patient with obstructive urinary tract infection due to Corynebacterium urealyticum

Open Medicine ◽  
2013 ◽  
Vol 8 (5) ◽  
pp. 597-599 ◽  
Author(s):  
Tsuneaki Kenzaka ◽  
Ayako Kumabe ◽  
Yuka Urushibara ◽  
Kensuke Minami ◽  
Takeshi Ishida
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urine Analysis ◽  
Urine Culture ◽  
Impaired Consciousness ◽  
Rapid Improvement ◽  
Urease Test ◽  
Tract Infections ◽  
Corynebacterium Urealyticum

AbstractA 93-year-old woman with neurogenic bladder was admitted to our hospital because of impaired consciousness. Her urine culture revealed urease-test-positive Corynebacterium urealyticum. She was diagnosed with hyperammonemia due to an obstructive urinary tract infection that was caused by urease-producing bacteria. The patient showed rapid improvement of impaired consciousness and hyperammonemia after urine analysis. It is necessary to consider obstructive urinary tract infection as a differential diagnosis of hyperammonemia, which commonly occurs in urinary tract infections owing to the presence of urease-producing bacteria. Relief from obstruction is the most important treatment for hyperammonemia caused by this mechanism.

Unexpected Neonatal Jaundice as an Early Diagnostic sign of Urinary Tract Infection

2021 ◽  
Author(s):  
Setareh Sagheb ◽  
Ziba Mosayebi ◽  
Zahra Nikseresht
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urine Culture ◽  
Group B Streptococcus ◽  
Cross Sectional Study ◽  
Contributing Factors ◽  
Term Infants ◽  
Cross Sectional ◽  
Group B

Background: Determination of contributing factors for jaundice would result in better programming for prevention. This study was performed to determine the prevalence rate of Urinary Tract Infection (UTI) among neonates with jaundice admitted in Arash Hospital from October 2013 to October 2014. Methods: In this descriptive cross-sectional study, term neonates with non-hemolytic jaundice admitted in Arash Hospital from October 2013 to October 2014 were evaluated for UTI by urine culture and the data were recorded by checklist using medical documents. Results: A total of 436 term infants were enrolled in the study. Mean age at the time of admission was 6.03±3.355 days with age range of 3-18 days including 291(0.66%) males and 145(0.33%) females. Urine culture was positive in 32 neonates (7.3%).The most common germs were Klebsiella in 37.5%, Escherichia coli (E. coli) in 21.9%, Staphylococcus in 9.4%, Pseudomonas in 3.1%, Enterococcus in 15.6%, Enterobacter in 9.4%, and Group B Streptococcus (GBS) in 3.1%. Conclusion: Urine culture should be a part of routine clinical evaluation for all icteric neonates at the age of 5-6 days or more who have no risk factors to exclude the possibility of coincidental UTI.

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