Conservative Management of Unusual Keratinising Squamous Metaplasia of the Bladder in a 28-Year-Old Female and Overview of the Literature

Keratinizing squamous metaplasia of the bladder is rare and is usually associated with urinary tract infections and chronic irritation. It is considered a precancerous condition of squamous cell carcinoma, especially when more than 50% of the bladder surface is affected. Medical treatment cannot eradicate this lesion. When it is limited to a small area of the bladder, transurethral resection is possible. Annual cystoscopy with multiple biopsies as well as annual upper tract imaging is proposed in the follow up of these patients. We present a preliminary 2-year followup report of a keratinizing squamous metaplasia of the bladder in a 28-year-old female patient with no previous risk factors.

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Infeções do Trato Urinário numa Coorte de Transplantados Renais

Acta Médica Portuguesa ◽

10.20344/amp.4959 ◽

2014 ◽

Vol 27 (3) ◽

pp. 364 ◽

Cited By ~ 2

Author(s):

Ana Bispo ◽

Milene Fernandes ◽

Cristina Toscano ◽

Teresa Marques ◽

Domingos Machado ◽

...

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Urinary Tract Infections ◽

Hospital Admissions ◽

Female Gender ◽

Tract Infections

Introduction: 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. Material and Methods: 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. Results: 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 < 0.001, OR = 7.08, RR = 2.95) and recurrent urinary tract infections (p < 0.001, OR = 4.66, RR = 2.83). Escherichia coli (51.6%), Klebsiella pneumoniae (15.5%) and Enterobacter spp (9.9%) were the 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. Discussion: Female gender was the only risk factor for urinary tract infections in this population. Escherichia coli was the most frequent agent isolated. Conclusion: Despite preventive measures, urinary tract infections remain an important cause of morbidity and hospital admissions. Keywords: Urinary Tract Infections; Postoperative Complications; Risk Factors; Kidney Transplantation; Portugal.

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Intermittent self-catheterization and the risk of squamous cell cancer of the bladder: An emerging clinical entity?

Canadian Urological Association Journal ◽

10.5489/cuaj.1162 ◽

2013 ◽

Vol 3 (5) ◽

pp. 51 ◽

Cited By ~ 9

Author(s):

Rowan G. Casey ◽

Ivor M. Cullen ◽

Tom Crotty ◽

David M. Quinlan

Keyword(s):

Risk Factors ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Squamous Cell ◽

Squamous Cell Cancer ◽

Squamous Metaplasia ◽

Cell Cancer ◽

Dismal Prognosis ◽

Cancer Of The Bladder ◽

Tract Infections

There are only 7 cases reported in the literature of squamous cellcancer of the bladder in patients performing intermittent selfcatheterization(ISC). We report on an eighth case, and the firstcase described in a patient with a Mitrofanoff continent appendicovesicostomy.A description of the case and review of the literatureare presented. Risk factors for squamous cell cancer includerecurrent urinary tract infections, keratinising squamous metaplasia(leukoplakia) and local mucosal trauma from intermittent selfcatheterization.There is no recognized or validated monitoringprogram for patients performing ISC who may also have theserisk factors. Reasonable protocols may include regular urinarycytology and cystoscopy with random or targeted bladder biopsies.Squamous cell cancer may present late in this cohort of patientsand is associated with a dismal prognosis.

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Egyptian pediatric clinical practice guidelines for urinary tract infections in infants and children (evidence based)

Egyptian Pediatric Association Gazette ◽

10.1186/s43054-021-00073-z ◽

2021 ◽

Vol 69 (1) ◽

Author(s):

Bahia H. Moustafa ◽

Moftah M. Rabie ◽

Ihab Z. El Hakim ◽

Ahmed Badr ◽

Moustafa El Balshy ◽

...

Keyword(s):

Risk Factors ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Practice Guidelines ◽

Medical Documentation ◽

Evidence Based ◽

Renal Hypodysplasia ◽

Febrile Uti ◽

Tract Infections

Abstract Background National evidence-based recommendations for diagnosis, treatment, imaging, and follow-up in urinary tract infection are crucial being a major health problem in pediatrics. Every region should follow international recommendations with respect to the disease local profile and available facilities for that area. Methods Based on AGREE II (the assessment tool of practice guidelines), Egyptian CGLs used *American Academy Pediatrics, *European Association Urology, European Society Pediatric Urology, and *Asian Association Urinary tract infections as its evidence-based references. Health questions were listed for evidence base answers adopted from selected CGLs after their permission. Key statements were approved by all members and further approved by the Egyptian Pediatric Guidelines Committee after local and international external peer reviewing. Results (1) Diagnosis recommendations: Urine culture with diagnostic colony counts is essential for diagnosis. Catheter samples are important for critical cases and non-toilet-trained cases especially when they show significant bacteriuria and pyuria. (2) Treatment plan included areas of debate as choice of antibiotic, oral versus intravenous, duration, antibiotic prophylaxis considering age, disease severity, recurrence, + risk factors, and imaging reports. (3) Imaging recommendations were tailored to suit our community. Renal bladder ultrasound is important for children with febrile UTI, due to the high prevalence of congenital anomalies of the kidney and urinary tract, paucity of prenatal ultrasound, and lack of medical documentation to reflect previously diagnosed UTI or US reports. We recommend renal isotopic scan and voiding cystography for serious presentation, high-risk factors, recurrence, and abnormal US. (4) Urological consultation is recommended: in urosepsis or obstruction, male infants < 6 months. Acute basal DMSA is recommended in congenital renal hypodysplasia. Six months post-infection, US and DMSA are recommended in severe pyelonephritis and vesico-ureteric reflux, where those with abnormal US or DMSA or both should have voiding cystography. (5) Follow-up recommendations include family orientation with hazards of noncompliance and monitoring at pregnancy. Conclusion Diagnosis and treatment show strong recommendations. Imaging depends on patient assessment. Referral to a pediatric nephrologist and urologist in complicated cases is crucial. Follow-up after the age of 16 years in adult clinics is important.

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Asymptomatic Bacteriuria in Pregnant Women in Outpatient Facilities

Central Asian Journal of Global Health ◽

10.5195/cajgh.2015.53 ◽

2015 ◽

Vol 4 (1) ◽

Author(s):

Maral G. Nogayeva ◽

Svetlana A. Tuleutayeva

Keyword(s):

Risk Factors ◽

Urinary Tract ◽

Pregnant Women ◽

Urinary Tract Infections ◽

Kidney Diseases ◽

Asymptomatic Bacteriuria ◽

Postnatal Period ◽

Tract Infections ◽

Early Diagnostic

Urinary tract morbidity has increased by 7% in Kazakhstan between 2007 to 2011. Pregnant women with extragenital pathologies or kidney diseases had the greatest prevalence of morbidity. Asymptomatic bacteriuria (AB) is one of the most important risk factors of pyelonephritis development in pregnant women, and it can affect the course and outcome of pregnancy, delivery, and postnatal period. AB prevention requires prevention of pregnancy complications including early diagnostic of urinary tract infections, timely optimization of therapy at outpatient facilities, and dynamic follow-up.

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Dichotomy in Fatal Outcomes in a Large Cohort of People Living with HTLV-1 in São Paulo, Brazil

10.20944/preprints201911.0057.v1 ◽

2019 ◽

Author(s):

Rosa Maria N. Marcusso ◽

Johan Van Weyenbergh ◽

João Victor Luisi de Moura ◽

Flávia Esper Dahy ◽

Tatiane Assone ◽

...

Keyword(s):

Risk Factors ◽

Urinary Tract ◽

Mortality Rate ◽

Clinical Care ◽

Laboratory Data ◽

Strongyloides Stercoralis ◽

Increase Risk ◽

The Mean ◽

Tract Infections

BACKGROUND: During the natural history, the incidence HTLV-1 related diseases were 0.5% until 10% after decades of infection. Despite relative low lethality, previous study observed that HTLV-1 infection is associated with significantly increased mortality. For example, the incidence of ATLL and HAM/TSP, co-infections with HIV and HCV, parasitic co-infection with Strongyloides stercoralis may increase morbidity and mortality. OBJECTIVE: Determine the mortality rate and its major variables as possible risk factors, analyzing the HTLV Clinic at Emilio Ribas Institute, a continuous open cohort of HTLV patients since 1997. METHODS: This cohort open cohort possesses new patients added at a rate of approximately 50 patients/year. There were 1100 HTLV-infected subjects identified by September 30th 2018. All clinical data including clinical and laboratory data, which have been updated on a regular basis over the last 22 years, were entered into a specific REDCap database. The Ethical Board of the IIER approved the protocol. RESULTS: Along 22 years of clinical care in the HTLV-out clinic, 727 HTLV-1-infected subjects and 248 HAM/TSP cases. Four-hundred sixty-eight patients of whom remaining under active follow up. The mean follow-up time of the cohort was 12 years. Twenty-seven patients died (median age of 51,5 years old). From this total, 13 was asymptomatic carriers and 14 HAM/TSP subjects, 12 of asymptomatic and seven HAM/TSP possess co-infected with HIV or/and HCV. Other seven presented HAM/TSP without co-infection, and all was female, and sepsis was the majority cases the majority of cases of sepsis were related to infection of the urinary tract (p=0.058) and to ulcers of decubitus (p=0.021), and it was associated with risk factors for mortality. CONCLUSIONS: Overall, the mortality rate for HAM-TSP patients was six percent. The mean life expectancy in Brazil is about 78 years in 2018, twenty-two years higher than HAM/TSP patients without any other coinfection. This study highlights the possibility of higher death risk among HTLV-1-infected patients and HAM/TSP subjects in Brazil, and identified some risk factors for this outcome. Also, these patients may possess higher risk for morbidity, usually urinary tract infections and decubitus scars, which could increase risk for death.

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Risk Factors in Diabetes and Pregnant Women with Urinary Tract Infections Compared to Younger Aged Female.

International Journal of Medical Sciences ◽

10.32441/ijms.v1i3.99 ◽

2018 ◽

Vol 1 (3) ◽

pp. 26-38

Author(s):

Abdulghani Mohamed Alsamarai ◽

Shler Ali Khorshed

Keyword(s):

Risk Factors ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Pregnant Women ◽

Female Student ◽

Mean Value ◽

Infected Female ◽

Significant Difference ◽

Tract Infections

Background: Urinary tract infection is common with health impact in women and characterised by failure to treatment and recurrent episodes. Aim: This study was conducted to determine the risk factors for the development of urinary tract infection in diabetic and pregnant women in comparison to student female. Materials and methods: A prospective cross-sectional study conducted during the period from 1st of June 2015 to the end of January 2016. The population included in the study are 563 women, of them 425 were outpatients, and 138 were inpatients. Their age range between 18 and 80 years, with a mean age of 33.59±15.29 years. Urine samples collected and cultured on blood agar and MacConkey agar by spread plate technique. Bacterial colonies with different morphology were selected, purified and identified according to their biochemical characteristics using conventional standard methods. Results: In diabetic women, there were no significant difference in mean age and BMI values between culture positive and culture negative groups. However, pus cell mean scale was significantly higher [P=0.000] in women with urinary tract infection [1.76±1.25] than in those with negative culture [0.69±1.00]. In pregnant women, BMI mean value was significantly [P=0.013] lower in pregnant women with UTI [26.14] as compared to those without infection [26.99]. Pus cell scale mean value was significantly [P=0.000] higher in pregnant women with UTI [1.55] than women with negative UTI [0.85]. While there was no significant difference in mean age between UTI positive and negative pregnant women. In female student, there was a significant difference between UTI infected and non-infected in mean age [P=0.041] and pus cell scale [P=0.000]. However, BMI was not significantly different between infected and non-infected female student. Other risk factors association are variables in the 3 groups when analysed using X2, while AUC and OR show different trends of association between risk factors and UTI. Conclusion: BMI, pus cell scale, child number, delivery method, operation history and hospital setting were significantly associated with culture positivity in the 3 studied groups as determined by AUC. While OR confirmed association with pus sale scale in the 3 groups.

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Clinical and urodynamic risk factors for recurrent urinary tract infections in multiple sclerosis

10.26226/morressier.5b7578605aff7400151f3140 ◽

2018 ◽

Author(s):

paloma Montero ◽

Vanesa Pytel

Keyword(s):

Risk Factors ◽

Multiple Sclerosis ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Recurrent Urinary Tract Infections ◽

Tract Infections

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Prospective cohort study on hospitalised patients with suspected urinary tract infection and risk factors por multidrug resistance

Scientific Reports ◽

10.1038/s41598-021-90949-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Victor Garcia-Bustos ◽

Ana Isabel Renau Escrig ◽

Cristina Campo López ◽

Rosario Alonso Estellés ◽

Koen Jerusalem ◽

...

Keyword(s):

Risk Factors ◽

Urinary Incontinence ◽

Multidrug Resistance ◽

Urinary Tract ◽

Prospective Cohort ◽

Bacterial Infections ◽

Cohort Analysis ◽

Term Care ◽

Hospitalised Patients ◽

Tract Infections

AbstractUrinary tract infections (UTIs) are among the most common bacterial infections and a frequent cause for hospitalization in the elderly. The aim of our study was to analyse epidemiological, microbiological, therapeutic, and prognostic of elderly hospitalised patients with and to determine independent risk factors for multidrug resistance and its outcome implications. A single-centre observational prospective cohort analysis of 163 adult patients hospitalized for suspected symptomatic UTI in the Departments of Internal Medicine, Infectious Diseases and Short-Stay Medical Unit of a tertiary hospital was conducted. Most patients currently admitted to hospital for UTI are elderly and usually present high comorbidity and severe dependence. More than 55% met sepsis criteria but presented with atypical symptoms. Usual risk factors for multidrug resistant pathogens were frequent. Almost one out of five patients had been hospitalized in the 90 days prior to the current admission and over 40% of patients had been treated with antibiotic in the previous 90 days. Infection by MDR bacteria was independently associated with the previous stay in nursing homes or long-term care facilities (LTCF) (OR 5.8, 95% CI 1.17–29.00), permanent bladder catheter (OR 3.55, 95% CI 1.00–12.50) and urinary incontinence (OR 2.63, 95% CI 1.04–6.68). The degree of dependence and comorbidity, female sex, obesity, and bacteraemia were independent predictors of longer hospital stay. The epidemiology and presentation of UTIs requiring hospitalisation is changing over time. Attention should be paid to improve management of urinary incontinence, judicious catheterisation, and antibiotic therapy.

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Microbiome recovery in adult females with uncomplicated urinary tract infections in a randomised phase 2A trial of the novel antibiotic gepotidacin (GSK140944)

BMC Microbiology ◽

10.1186/s12866-021-02245-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Andrea Nuzzo ◽

Stephanie Van Horn ◽

Christopher Traini ◽

Caroline R. Perry ◽

Etienne F. Dumont ◽

...

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Human Microbiome ◽

Time Points ◽

Pharyngeal Cavity ◽

Adult Females ◽

Microbiome Diversity ◽

Antibiotic Drug ◽

Tract Infections

Abstract Background With increasing concerns about the impact of frequent antibiotic usage on the human microbiome, it is important to characterize the potential for such effects in early antibiotic drug development clinical trials. In a randomised Phase 2a clinical trial study that evaluated the pharmacokinetics of repeated oral doses of gepotidacin, a first-in-chemical-class triazaacenaphthylene antibiotic with a distinct mechanism of action, in adult females with uncomplicated urinary tract infections for gepotidacin (GSK2140944) we evaluated the potential changes in microbiome composition across multiple time points and body-sites (ClinicalTrials.gov: NCT03568942). Results Samples of gastrointestinal tract (GIT), pharyngeal cavity and vaginal microbiota were collected with consent from 22 patients at three time points relative to the gepotidacin dosing regimen; Day 1 (pre-dose), Day 5 (end of dosing) and Follow-up (Day 28 ± 3 days). Microbiota composition was determined by DNA sequencing of 16S rRNA gene variable region 4 amplicons. By Day 5, significant changes were observed in the microbiome diversity relative to pre-dose across the tested body-sites. However, by the Follow-up visit, microbiome diversity changes were reverted to compositions comparable to Day 1. The greatest range of microbiome changes by body-site were GIT followed by the pharyngeal cavity then vagina. In Follow-up visit samples we found no statistically significant occurrences of pathogenic taxa. Conclusion Our findings suggest that gepotidacin alteration of the human microbiome after 5 days of dosing is temporary and rebound to pre-dosing states is evident within the first month post-treatment. We recommend that future antibiotic drug trials include similar exploratory investigations into the duration and context of microbiome modification and recovery. Trial registration NCT03568942. Registered 26 June 2018.

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