Clinical Effects of Polymyxin B Hemoperfusion in Patients With Septic Shock Caused by Urinary Tract Infection

2018 ◽  
Vol 23 (1) ◽  
pp. 80-85 ◽  
Author(s):  
Yasushi Suzuki ◽  
Masahiro Kojika ◽  
Hisaho Sato ◽  
Yoshihiro Inoue ◽  
Shigeatsu Endo
Keyword(s):  
Septic Shock ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Polymyxin B ◽  
Clinical Effects ◽  
Polymyxin B Hemoperfusion

AN OUTBREAK OF URINARY TRACT AND OTHER INFECTIONS DUE TO E. COLI

PEDIATRICS ◽  
1964 ◽  
Vol 33 (6) ◽  
pp. 865-871
Author(s):  
Avron Y. Sweet ◽  
Emanuel Wolinsky
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Premature Infant ◽  
Fatal Case ◽  
Polymyxin B ◽  
Susceptibility Pattern ◽  
E Coli ◽  
Stool Cultures

In a premature infant nursery 3 infants died of E. coli infections and 5 babies contracted urinary tract infection due to E. coli within a 5-month period. The causative organisms were found to be resistant to tetracycline, streptomycin, chloramphenicol, and sulfisoxazole, and sensitive to kanamycin, polymyxin B, and nitrofurantoin. From throat and stool cultures of 25 infants in the nursery, E. coli with this susceptibility pattern were recovered from 13. Of these, 9 were serotype 04:H5 and one was group 04 but nonmotile. Isolates from the urine of 3 infants with urinary tract infection and meninges of one fatal case were serotype 04:H5. Stool cultures revealed group 04 E. coli only in infants with that organism in the throat. The findings indicate that an outbreak of infections due to E. coli 04:H5 had occurred as a consequence of widespread colonization with that organism in a premature infant nursery. The unusual incidence of urinary tract infection due to a specific E. coli serotype indicates that urosepsis in the newborn can occur in epidemic form.

scholarly journals Unexpected Septic Shock after Ureteroscopic Lithotripsy in a Patient Preoperatively Treated for a Urinary Tract Infection

2016 ◽  
Vol 11 (2) ◽  
pp. 66
Author(s):  
Jong Wook Kim ◽  
Hyoung Kook Jeong ◽  
Jong Jin Park ◽  
Ji Yun Chae ◽  
Hong Seok Park ◽  
...  
Keyword(s):  
Septic Shock ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Ureteroscopic Lithotripsy

scholarly journals Epidemiology of sepsis and its various characteristics in a tertiary care adult-multidisciplinary ICU in South India: a retrospective study

2020 ◽  
Vol 8 (4) ◽  
pp. 1260
Author(s):  
Hussain Khan Tharappel Jalal ◽  
Teju P. Thomas ◽  
Alfy Ann George ◽  
Hamadan Mohammed
Keyword(s):  
Septic Shock ◽  
Urinary Tract Infection ◽  
Retrospective Study ◽  
Urinary Tract ◽  
Tract Infection ◽  
Sofa Score ◽  
South India ◽  
Tertiary Care ◽  
Organ Involvement ◽  
Common Source

Background: The incidence of sepsis is increasing, especially in elderly populations with more comorbidities. It is now estimated that sepsis is a leading cause of mortality and critical illness worldwide. The Epidemiological data regarding sepsis, septic shock and organ involvement is mainly from western literature. Data from India, especially south India, are less when compared to western data. In this background authors conducted a retrospective study in tertiary care hospital in south India. Objectives of the study was epidemiology of sepsis and its various characteristics in a tertiary care adult-Multi disciplinary ICU in South India.Methods: This study was a retrospective observational study, conducted during the time period of June 2016 and May 2017. The study population was patients above 18 yrs admitted in MDICU with sepsis. The study was conducted in a tertiary care adult -Multidisciplinary ICU in South India. Various characteristics like age group, comorbidities, organ involvement, septic shock, sofa score, need for ventilatory support, RRT support and outcome data was collected.Results: In this study, 497 patients who satisfied the Surviving Sepsis Campaign guidelines were included. The majority of the patients (59.8%) were male; the majority was above 60 yr (range 18 to 92 yr). 76.3% Patients had comorbid disease. Hypertension was the most common co-morbid (62%) followed by diabetes mellitus (51.3%). Chronic Kidney Disease was found in 132 patients (26.6%) and Coronary artery disease in 121 patients (24.3%). 186 patients (46.5%) had single organ involvement 140(35%) patients had 2 organ involvement. 74(18.5%) patients had more than 2 organ involvement. Septic shock was found in 155 patients (31.2%). Renal involvement was the most common organ involvement found in 279 patients(59.9%). Most common source for sepsis was the respiratory system found in 230 patients (46.3%), followed by urinary tract infection in 117 patients (23.5%). The study shows a significant association between SOFA score and mortality (p-value 0.001) 52% of mortality happened in group of patients with SOFA score more than 15 and mortality was 28 % in group with a SOFA score of 10-15.Conclusions: In this retrospective study of sepsis, authors found that the most common source of sepsis was pneumonia (46.3%) followed by urinary tract infection (23.5%). Majority of the patients had one organ involvement (46.5%). Among the organ involvement, Acute Kidney injury was the most common organ involvement (56.1%) followed by septic shock (31.2%) and respiratory support (29.6%). Mortality in this study was higher with higher SOFA score.

scholarly journals A COMPARATIVE CLINICAL STUDY TO EVALUATE THE EFFECT OF CHARAKOKTA MUTRAVIRECHANIYA MAHAKASHAYA IN MUTRAKRICHRA OR LOWER URINARY TRACT INFECTION

2020 ◽  
pp. 39-45
Author(s):  
Aryamol A D ◽  
Umesh C ◽  
Gopal Krishna G
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Lower Urinary Tract ◽  
Clinical Symptoms ◽  
Clinical Effects ◽  
Lower Urinary Tract Infection ◽  
Significant Difference ◽  
Group B ◽  
Lower Urinary

Mutrakrichra the disease of Mutravaha Srotas is caused due to Sanga (obstruction). Mutrakrichra means difficulty in micturition. Mutrakrichra can be compared to lower urinary tract infection (LUTI) symptoms. LUTI is the most common infection known to mankind and a common condition seen in general practice. Urinary tract infection affects more than 150 million people every year worldwide. Objective: To evaluate the effect of Mutravirechaniya Mahakashaya in LUTI and to compare its efficacy with Tab. Norfloxacin. Methods: 45 patients of either gender with the symptoms of LUTI were randomized into three groups of 15 patients each. Group A- received Mutravirechaniya Mahakashaya 50ml. Group B- received Tab. Norfloxacin 400mg and Group C- Mutravirechaniya Mahakashaya and Tab. Norfloxacin in the above mentioned dose for ten days. Efficacy outcomes were assessed through subjective parameters and routine urine and microscopic examination. Observation and results: When compared all the groups showed better results in relieving the clinical symptoms of LUTI. Overall patients treated with Mutravirechaniya Mahakashaya and Tab. Norfloxacin showed better results, but there was no significant difference between the groups (P<0.351). Conclusion: Mutravirechaniya Mahakashaya was able to meet the efficacy outcomes measures in comparison to Tab. Norfloxacin. Clinical effects of Mutravirechaniya Mahakashaya were similar to Tab. Norfloxacin owing to its diuretic, analgesic and anti-inflammatory properties.

scholarly journals Risk Factors for Development of Septic Shock in Patients with Urinary Tract Infection

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Chih-Yen Hsiao ◽  
Huang-Yu Yang ◽  
Chih-Hsiang Chang ◽  
Hsing-Lin Lin ◽  
Chao-Yi Wu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Septic Shock ◽  
Congestive Heart Failure ◽  
Acute Kidney Injury ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Kidney Injury ◽  
Subsequent Treatment ◽  
Care Hospital

Introduction. Severe sepsis and septic shock are associated with substantial mortality. However, few studies have assessed the risk of septic shock among patients who suffered from urinary tract infection (UTI).Materials and Methods. This retrospective study recruited UTI cases from an acute care hospital between January 2006 and October 2012 with prospective data collection.Results. Of the 710 participants admitted for UTI, 80 patients (11.3%) had septic shock. The rate of bacteremia is 27.9%; acute kidney injury is 12.7%, and the mortality rate is 0.28%. Multivariable logistic regression analyses indicated that coronary artery disease (CAD) (OR: 2.521, 95% CI: 1.129–5.628,P=0.024), congestive heart failure (CHF) (OR: 4.638, 95% CI: 1.908–11.273,P=0.001), and acute kidney injury (AKI) (OR: 2.992, 95% CI: 1.610–5.561,P=0.001) were independently associated with septic shock in patients admitted with UTI. In addition, congestive heart failure (female, OR: 4.076, 95% CI: 1.355–12.262,P=0.012; male, OR: 5.676, 95% CI: 1.103–29.220,P=0.038, resp.) and AKI (female, OR: 2.995, 95% CI: 1.355–6.621,P=0.007; male, OR: 3.359, 95% CI: 1.158–9.747,P=0.026, resp.) were significantly associated with risk of septic shock in both gender groups.Conclusion. This study showed that patients with a medical history of CAD or CHF have a higher risk of shock when admitted for UTI treatment. AKI, a complication of UTI, was also associated with septic shock. Therefore, prompt and aggressive management is recommended for those with higher risks to prevent subsequent treatment failure in UTI patients.

scholarly journals Isolation of Organism and its Drug Sensitivity Pattern in Patients with Urinary Tract Infection at Kathmandu Model Hospital

2018 ◽  
Vol 13 (1) ◽  
pp. 46-50
Author(s):  
Rajesh Dhoj Joshi ◽  
Sachin Khadka ◽  
Deepak Man Joshi ◽  
Basudha Shrestha ◽  
Ganesh Dangal ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Bacterial Resistance ◽  
Demographic Data ◽  
Empirical Therapy ◽  
Polymyxin B ◽  
Drug Resistant ◽  
Sensitivity Pattern ◽  
Culture Positive

Introduction: Lack of compliance and unjustified antibiotic prescriptions has resulted in increasing bacterial resistance and is proving as a major challenge in the management of infections. Knowing the commonly isolated uropathogens and their antimicrobial susceptibility is beneficial in planning treatment protocols.Methods: A retrospective review of records of patients with urinary tract infection from January 2012 to December 2016 was conducted at Kathmandu Model Hospital. All patients who were diagnosed as having culture positive urinary tract infection in medical ward of Kathmandu Model Hospital during 5 years period were analyzed for demographic data, prevalence of organism and antibiotic susceptibility patterns.Results: A total of 315 samples were culture positive. The majority of bugs were gram negative E.coli (48.57%) followed  by multi-drug resistant E.coli (28.89%).  The other major pathogens were E. faecalis (6.03%), S. epidermidis (4.44%), K. pneumoniae (4.13%), respectively. The highest level of sensitivity in first line antibiotics was seen in nitrofurantoin (84.9%), whereas least sensitivity was shown by amoxicillin/clavulanic acid (21%). Similarly, in second line antibiotics, highest sensitivity was seen in tetracycline (100%), imipenem (91.9%) and least to meropenem (49.2%). Ceftazidime is mostly (93.3%) resistant antibiotics among uropathogens. All the third line antibiotics such as polymyxin B, tigecycline and colistin were 100% sensitive to all our isolates.Conclusions: Nitrofurantoin may be an appropriate choice for initial empirical therapy of urinary tract infection. Similarly, the multi-drug resistant E.coli is increasing but it can be tailored if antibiotics are used appropriately on the basis of susceptibility data.

scholarly journals Concurrent NeonatalProteus mirabilisInfection in Dizygotic Twins

1999 ◽  
Vol 10 (2) ◽  
pp. 156-158
Author(s):  
Lillian Sung ◽  
Noni E MacDonald ◽  
James S Hutchison
Keyword(s):  
Septic Shock ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antimicrobial Therapy ◽  
Proteus Mirabilis ◽  
Dizygotic Twin ◽  
Concomitant Infection ◽  
Dizygotic Twins ◽  
Second Twin

A case of concomitant infection withProteus mirabilisin dizygotic twin neonates is presented. The first twin presented with meningitis and septic shock at eight days of age and subsequently died. An investigation of the asymptomatic second twin revealed a urinary tract infection that resolved with antimicrobial therapy. It is recommend that when infection with this virulent organism is diagnosed in one twin, the second twin should be fully evaluated for sepsis and empirical antimicrobial therapy should be considered.

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