25 Role of the urinalysis in managing infants less than 60 days old with a positive urine culture

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e18-e19
Author(s):  
Steffany Charles ◽  
Marissa Aycan ◽  
Michelle D’Alessandro ◽  
Andrew Latchman ◽  
Gita Wahi
Keyword(s):  
Blood Cell ◽  
Antibiotic Treatment ◽  
Urine Culture ◽  
Positive Urine Culture ◽  
Blood Cell Count ◽  
Intravenous Antibiotic ◽  
Biochemical Characteristics ◽  
E Coli ◽  
Positive Urine

Abstract Primary Subject area Hospital Paediatrics Background Urinary tract infections (UTIs) in infants less than 60 days of age, often lead to hospitalization and intravenous antibiotic treatment. There are currently no national recommendations for the diagnosis and management of UTIs in this population. Historically, the urine culture alone was thought to be sufficient for diagnosing UTI due to concerns regarding the sensitivity of urinalysis (UA) in young infants. However, there is evidence that in children of all ages, the absence of pyuria in children with UTIs is rare. The role of the UA in influencing the current management of infants aged less than 60 days, with a positive urine culture, remains unclear. Objectives The objective of this study was to describe the characteristics of infants aged less than 60 days old with a positive urine culture. Specifically, we sought to: 1) determine the differences in clinical and biochemical characteristics of infants with a positive UA versus a negative UA; and 2) determine if UA result was associated with length of intravenous antibiotic treatment. Design/Methods We completed a retrospective cohort study of infants aged 0 to 60 days with a positive urine culture, cared for in a Canadian tertiary care children’s hospital between April 2016 and March 2019. Patients with a history of prematurity and those with a concomitant bacteremia or meningitis were excluded. A positive urine culture was defined as greater than 10,000 CFU/ml of a single organism obtained from a catheter specimen. A positive UA was defined by positive nitrites and/or a positive leukocyte esterase screen, and/or pyuria (greater than 5 white blood cells per high power field). Clinical and biochemical characteristics of infant groups with a positive UA, versus negative UA, were compared. Linear regression analysis was used to understand the association between UA result and length of intravenous antibiotic treatment. Results A total of 718 charts were screened. Eighty-nine patients met inclusion criteria, of which 52 (58%) had a positive UA and 37 (42%) had a negative UA. Of the 89 included infants, the average age was 32.5 days (SD 16.7), 31.5% were female, 79.8% had fever at presentation, and the average length of stay was 5.6 days (SD 2.9). Patients with a positive UA were more often febrile at presentation (90.3% vs. 64.9%, p = 0.006), and had a higher CRP (51.0, SD 56.1 vs. 8.1, SD 13.0), p < 0.001), higher white blood cell count (15.2, SD 6.0 vs. 11.0, SD 5.7, p= 0.002), and more often had urine culture growth of E. Coli (96.2% vs. 62.9%, p < 0.001). UA result was not associated with length of intravenous antibiotic treatment (p= 0.15). Conclusion This study demonstrates that infants with a positive urine culture and a positive UA result had more characteristics of infection, including fever, elevated CRP, elevated white blood cell count, and growth of E. Coli uropathogen, compared to infants with a negative UA. Despite this difference, there was no significant difference in length of intravenous antibiotic treatment between UA-positive versus UA-negative groups. This study suggests that infants with clinical and biochemical findings supportive of a UTI more often had a positive UA, along with a positive culture, and that the UA should be used as a screening test for UTI in infants aged less than 60 days.

scholarly journals A study on the bacteriological profile of urinary tract infection in adults and their antibiotic sensitivity pattern in a tertiary care hospital in central Kerala, India

2017 ◽  
Vol 5 (2) ◽  
pp. 666 ◽  
Author(s):  
Jubina Bency A. T. ◽  
Priyanka R. ◽  
Ponnu Jose
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Antimicrobial Agents ◽  
Urine Culture ◽  
Antibiotic Sensitivity ◽  
Positive Urine Culture ◽  
E Coli ◽  
Sensitivity Pattern ◽  
Positive Urine ◽  
Culture And Sensitivity

Background: Urinary tract infection is one of the most common bacterial infections in humans and a major cause of morbidity. The etiology of UTI and the antibiotic sensitivity pattern varies with the widespread availability of antimicrobial agents; UTI has become difficult to treat because of appearance of pathogens with increasing resistance to antimicrobial agents.Methods: A descriptive study done during January-June 2013. All positive urine culture and sensitivity reports of males and females aged 20-70years were included. A total of 373 positive urine culture cases were taken from the culture and sensitivity register from Microbiology department and details were entered using a questionnaire.Results: Out of 373 adults, males were 137 (36.7%) and females were 236 (63.3%). E. coli (74.3 %) was the most common organism, followed by Klebsiella (15.8%), Enterococcus, Pseudomonas and Staphylococcus. The incidence of UTI was more in patients in the age group of 60-70years. E. coli and Klebsiella were sensitive to Amikacin (97.1%), Nitrofurantoin (90.7%), Gentamycin and Imipenem. Both organisms were resistant to Ampicillin (>90%).Conclusions: In this study, females were mostly affected and the most common organisms were E.Coli and Klebsiella. These organisms were most sensitive to Amikacin, Nitrofurantoin and resistant predominantly to Ampicillin. The sensitivity and resistance pattern of uropathogens to common antimicrobial agents must be taken into account when selecting treatment plans for UTI.

Effectiveness of standardized peri-operative protocol with combination of gentamicin and levofloxacin as prophylactic antibiotics on preventing infections after transrectal prostate biopsy: A retrospective study of 577 patients

2021 ◽  
Author(s):  
Heng-Chieh Chiang ◽  
Jesun Lin ◽  
Meng-Yi Yan ◽  
Chun-Chi Chen ◽  
Jian-Ting Chen ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Blood Culture ◽  
Prostate Biopsy ◽  
Urine Culture ◽  
Controlled Trial ◽  
Infectious Complications ◽  
Positive Urine Culture ◽  
Urine Retention ◽  
E Coli ◽  
Positive Urine

Abstract PurposeThis retrospective study to determine the effectiveness standardized peri-operative protocol in combination with prophylactic gentamicin and levofloxacin in preventing infectious complications after trans-rectal prostate biopsy.Material and MethodPatients were screened for prostate cancer at our out-patient department, either due to abnormal digital examination or elevated PSA level. Patients who underwent transrectal ultrasound (TRUS) guided prostate biopsy from January 2008 to December 2012 was included in this study. After using surgical code to identify the patients, charts were reviewed, and complications were recorded. Infectious complications were defined as any patient who experienced any signs systemic inflammatory response syndrome (SIRS) within 14 days after undergoing TRUS biopsy. Complications were graded according to Clavien-Dindo classification.ResultsOut of the 577 patients there were 20 patients (3.47 %) with infectious complications. Of the 20 patients with infectious complications, only four patients (0.7%) needed hospitalization due to bacteremia. Minor complications (i.e., hematuria, acute urine retention, hematospermia, etc.) were self-resolving. There were 9 positive urine culture and 4 positive blood culture with Escherichia coli (E. coli) as the predominant species. Three patients had positive urine culture for ciprofloxacin resistant strain, which was susceptible to 2nd an 3rd generation cephalosporin or amikacin. One patient had blood culture positive for extended-spectrum beta-lactamase (ESBL) E. coli infection, which was sensitive to amikacin. The infectious complication rate and number decrease each year without increase in resistant strain.ConclusionOur current peri-operative and post-operative protocol appears to be feasible in reducing infection complications after prostate biopsy; our complication and sepsis rate were similar compared to other English literatures. A prospective randomized controlled trial would be needed to determine if a single factor or a combination of several factors are responsible for the reduction in post-biopsy infections.

scholarly journals A STUDY ON THE BACTERIOLOGICAL PROFILE OF URINARY TRACT INFECTION INADULTS AND THEIR ANTIMICROBIAL SENSITIVITY PATTERN IN DMCH, LAHERIASARAI, BIHAR

2020 ◽  
pp. 31-32
Author(s):  
Neha Jha ◽  
R. S. Prasad ◽  
P. N. Jha ◽  
Debarshi Jana
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Antimicrobial Agents ◽  
Urine Culture ◽  
Positive Urine Culture ◽  
E Coli ◽  
Antimicrobial Sensitivity ◽  
Sensitivity Pattern ◽  
Positive Urine ◽  
Culture And Sensitivity

Background: Urinary tract infection is one of the most common bacterial infections in humans and a major cause of morbidity. The etiology of UTI and the antimicrobial sensitivity pattern varies with the widespread availability of antimicrobial agents; UTI has become difficult to treat because of appearance of pathogens with increasing resistance to antimicrobial agents. Methods: A descriptive study done during January 2020 to June 2020. All positive urine culture and sensitivity reports of males and females aged 20-70years were included. A total of 373 positive urine culture cases were taken from the culture and sensitivity register from Microbiology department and details were entered using a questionnaire. Results: Out of 373 adults, males were 137 (36.7%) and females were 236 (63.3%). E. coli (74.3 %) was the most common organism, followed by Klebsiella (15.8%), Enterococcus, Pseudomonas and Staphylococcus. The incidence of UTI was more in patients in the age group of 60-70years. E. coli and Klebsiella were sensitive to Amikacin (97.1%), Nitrofurantoin (90.7%), Gentamycin and Imipenem. Both organisms were resistant to Ampicillin (>90%). Conclusions: In this study, females were mostly affected and the most common organisms were E.Coli and Klebsiella. These organisms were most sensitive to Amikacin, Nitrofurantoin and resistant predominantly to Ampicillin. The sensitivity and resistance pattern of uropathogens to common antimicrobial agents must be taken into account when selecting treatment plans for UTI.

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

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 Bladder debris on renal and bladder ultrasound: A significant predictor of positive urine culture

2017 ◽  
Vol 13 (4) ◽  
pp. 385.e1-385.e5 ◽  
Author(s):  
Joseph W. McQuaid ◽  
Michael P. Kurtz ◽  
Tanya Logvinenko ◽  
Caleb P. Nelson
Keyword(s):  
Urine Culture ◽  
Positive Urine Culture ◽  
Positive Urine

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

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