scholarly journals Evaluation of Urinary Tract Infection following Corticosteroid Therapy in Patients with Multiple Sclerosis Exacerbation

Author(s):  
Aliyeh Bazi ◽  
Seyed Mohammad Baghbanian ◽  
Monireh Ghazaeian ◽  
Sahar Fallah ◽  
Narjes Hendoiee

The first treatment for multiple sclerosis exacerbation is usually short-term intravenous methylprednisolone (IVMP), with or without a regimen of oral prednisone taper (OPT). This study aims to evaluate the effects of IVMP and OPT in comparison with IVMP alone in raising the risk of urinary tract infection (UTI) and posttreatment improvement of urinary tract symptoms in patients with relapsing-remitting multiple sclerosis. This double-blind randomized clinical trial was conducted on 56 people with multiple sclerosis relapse who had undergone methylprednisolone for 5 days. Patients were randomly split into two groups: oral prednisolone and placebo (tapering for 20 days). Demographic data, duration of multiple sclerosis, urinary tract symptoms, the Expanded Disability Status Scale (EDSS) score, and urine data were analyzed. The incidence of UTI in the intervention and control groups did not differ significantly ( p = 560 ). However, the improvement of urinary tract symptoms in the intervention group was significantly more favorable than in the control group ( p ≤ 0.001 ). Furthermore, administering OPT after IVMP did not increase the risk of UTI occurrence in patients with multiple sclerosis exacerbation. The urine analysis results did not show any differences at baseline and after the corticosteroid tapering regimen. Due to the risk of infection by corticosteroids, it is no longer necessary to do further urinary screening in this group of patients.

2021 ◽  
Author(s):  
Zohreh Kalani ◽  
Sedigheh Ebrahimi ◽  
Hossein Fallahzadeh

Abstract Background Two of the most serious complications after stroke are pneumonia, and urinary tract infection. Liaison nurse, from hospital admission to discharge and then at home helps patients with complicated caring issues stroke. This study investigates the effect of liaison nurse management on the incidence of pneumonia and urinary tract infection in patients with stroke after discharge from the hospital. Methods This randomized controlled trial was conducted on 80 patients in a hospital in Iran. The intervention group was assessed and developed a caring program by the liaison nurse and the control group received routine care. Two weeks and two months after discharge, the patients were evaluated for the incidence of pneumonia and urinary tract infection. Collected data were analyzed using the Chi-square test. P < 0.05 was considered statistically significant. Results The two groups were homogenous in terms of mean age; gender frequently distribution, and having urinary catheter. The incidence of pneumonia in intervention and control groups (11.6% vs. 19.2%, P = 0.35) had no statistically significant differences, but there was a significant difference in the incidence of urinary tract infection (0% vs. 24.6%, P < 0.001). Conclusions With liaison nurse performance, there was a significant difference in the incidence of urinary tract infection, in two months after discharge from hospital, but the incidence of pneumonia had no statistically significant differences in two groups. Nurse's evaluation each patient individually according to needs, developing and monitoring the home-based care program, beyond overall education to these patients, could reduce some of complications of a stroke. Trial registration: This study is retrospectively registered by Iranian Registry of Clinical Trials with decree code: IRCT20170605034330N3 on April 4, 2018.


2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Ahmed Mahrous Kamal Baz ◽  
Osama Abd El-Fattah El-Agamy ◽  
Ashraf Mohamed Ibrahim

Abstract Background Indirect hyperbilirubinemia is frequently encountered during neonatal period. Although it has different causes, in some cases it can’t be explained. Previous studies have illustrated that jaundice could be a major sign of urinary tract infection (UTI) in neonates. Aim of the work We aimed to determine the association between UTI and significant unexplained neonatal indirect hyperbilirubinemia. Methods This prospective controlled study was performed on 150 neonates divided in two groups (100 as cases and 50 as controls) to investigate the incidence of UTI in neonates with significant unexplained hyperbilirubinemia. Urine sample was obtained using urine catheterization technique from neonates and full urine analysis was done and cases with pyuria had urine culture to confirm UTI. Immediate renal ultrasonography (USG) was performed for neonates with UTI. Results UTI incidence was 11% in cases while none of neonates in control group had UTI with statistical significance between cases and controls (P value < 0.05). The most common (36.4%) pathogen was Escherichia coli. Posterior urethral valve with mild hydronephrosis was diagnosed in 18.2% of UTI positive patients by renal ultrasonography. Conclusion In neonates with unexplained indirect hyperbilirubinemia, UTI should be considered as a pathological cause.


2021 ◽  
Author(s):  
Behzad Mohsenpur ◽  
Hero Azizzadeh ◽  
Ebrahim Ghaderi ◽  
Amjad Ahmadi

Abstract Objective: Urinary tract infection is among the most prevalent infections in humans, and E. coli is the most frequent pathogen causing this disease. The production of Beta lactamase enzymes (ESBL) in this bacterium makes it resistant to many antibiotics. The aim of this study was to evaluate a novel method single daily dose of Amikacin at 48 h intervals in a clinical trial This was a double-blind clinical trial study.Material and Methods: The patients were divided into two groups of Intervention (Administration of single daily dose of Amikacin at 48 h intervals Intervals for 1 week 3 doses) and control (Prescription of Meropenem for 1 Week). Results: The mean age of the Intervention group was (46.64±3.89) and control group (46.03±2.38). The frequency of E. coli infection was 61(54%), and that of other infections was 52(46%).Conclusion: The results of our study show the therapeutic effect of single daily dose administration of Amikacin every 48 hours


Author(s):  
Chia-Hung Huang ◽  
Ying-Hsiang Chou ◽  
Han-Wei Yeh ◽  
Jing-Yang Huang ◽  
Shun-Fa Yang ◽  
...  

To investigate the association among lower urinary tract infection (UTI), the type and timing of antibiotic usage, and the subsequent risk of developing cancers, especially genitourinary cancers (GUC), in Taiwan. This retrospective population-based cohort study was conducted using 2009–2013 data from the Longitudinal Health Insurance Database. This study enrolled patients who were diagnosed with a UTI between 2010 and 2012. A 1:2 propensity score-matched control population without UTI served as the control group. Multivariate analysis with a multiple Cox regression model was applied to analyze the data. A total of 38,084 patients with UTI were included in the study group, and 76,168 participants without UTI were included in the control group. The result showed a higher hazard ratio of any cancer in both sexes with UTI (for males, adjusted hazard ratio (aHR) = 1.32; 95% confidence interval (CI) = 1.12–1.54; for females, aHR = 1.21; 95% CI = 1.08–1.35). Patients with UTI had a higher probability of developing new GUC than those without UTI. Moreover, the genital organs, kidney, and urinary bladder of men were significantly more affected than those of women with prior UTI. Furthermore, antibiotic treatment for more than 7 days associated the incidence of bladder cancer in men (7–13 days, aHR = 1.23, 95% CI = 0.50–3.02; >14 days, aHR = 2.73, CI = 1.32–5.64). In conclusion, UTI is significantly related to GUC and may serve as an early sign of GUC, especially in the male genital organs, prostate, kidney, and urinary bladder. During UTI treatment, physicians should cautiously prescribe antibiotics to patients.


Author(s):  
Falah Hasan Obayes AL-Khikani

Around the world, there is no population clear from urinary tract infection (UTI), particularly among women. UTI is considered the most predominant bacterial infection. This study aimed to detect the incidence of the most common major uropathogens in patients severe from urinary tract infection with antibiotic sensitivity tests that assist urologist doctors for appropriate antimicrobial empirical therapy.Methods: This study was carried in a private laboratory in Babil city, Iraq from May 2019 to May 2020. Totally 70 individuals suffering from clear symptoms of UTI, as well as, 20 healthy persons participated in this study as a control group. Then, the standard microbiological methods carried out to isolate and identify bacterial species. Antimicrobial susceptibility tests were performed using different antimicrobial discs by applying the Kirby&ndash;Bauer disc diffusion method.Results: Totally, 90 specimens were obtained from them 20 control group, 19 with no growth, and 51 patients with bacterial growth distributed as 43 (83%) females and 8 (17%) males. E. coli were the most common predominant organisms. All isolates were showed a high rate of resistance to evaluated cephalosporins 100% and 82% to cefotaxime and ceftriaxone respectively, while very low resistance recorded in Aminoglycosides 20% and 13% to Gentamicin and amikacin respectively. Most age group infected with UTI was 21-40 years old.Conclusion: The current study showed an increasing burden of urinary tract infection caused by various bacteria implicated in UTI that causes changeable sensitivity to various antimicrobial agents. Therefore, in clinical use appropriate medications should be selected based on the data obtained from antimicrobial susceptibility tests.


Open Medicine ◽  
2013 ◽  
Vol 8 (5) ◽  
pp. 597-599 ◽  
Author(s):  
Tsuneaki Kenzaka ◽  
Ayako Kumabe ◽  
Yuka Urushibara ◽  
Kensuke Minami ◽  
Takeshi Ishida

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.


Author(s):  
Natalie M. Latuga ◽  
Pei C. Grant ◽  
Kathryn Levy ◽  
Debra L. Luczkiewicz

Background: The decision to initiate antibiotics in hospice patients that are very near end-of-life is a complex ethical and stewardship decision. Antibiotics may be ordered to improve urinary tract infection–related symptoms, such as delirium. However, infection symptoms may be managed using antipsychotics, antipyretics, antispasmodics, and analgesics instead. Currently, there are no studies that compare symptom management between those who receive antibiotics and those who do not. Methods: A retrospective chart review was conducted for patients admitted to a hospice inpatient unit. Charts were included if the patient was admitted for delirium and had a Palliative Performance Scale score ≤40%, the urine culture was positive for organism growth, and the patient died while in the HIU. Clinical and demographic data was collected. Medication use was tallied for the 5 days prior to the date of death. Results: Sixty-one charts met the inclusion criteria. Thirty-five patients received antibiotics (ABX+) and 26 did not (ABX−). There was no difference in any medication consumption between groups during the 5 days prior to death. The ABX+ group died 8.2 days after obtaining the urine sample vs 6 days ( P =0.046). The ABX+ group had more documented urinary tract–specific infection symptoms (66% vs 38%, P =0.042). More than half of antibiotic courses were discontinued prematurely. Conclusion: The results of this study do not show a difference in overall medication consumption between groups, which suggests that antibiotics may not help improve terminal delirium symptoms in those with a suspected urinary tract infection at end-of-life.


Author(s):  
Ulrich Honemeyer ◽  
Amira Talic

ABSTRACT Objective of the study was to assess the possible effect of maternal fever without clinical chorioamnionitis on fetal behavior. In a period of 18 months, in a prospective longitudinal cohort study, Kurjak antenatal neurological test (KANET) was applied to assess fetal behavior in both normal pregnancies and pregnancies complicated by maternal fever. According to the primary localization of the infection, maternal fever group was divided into four groups: Respiratory tract infection, urinary tract infection, malaria and gastrointestinal tract infection. According to KANET test, fetuses with scores >14 were considered normal, 6 to 13 borderline and abnormal, if KANET scores were <5. Differences between groups were examined by Mann-Whitney U-test, differences between subgroups by Steel test. KANET scores differed statistically significant between two main groups. The largest proportion of abnormal KANET scores was found in pregnancies complicated by malaria, while the largest proportion of borderline scores showed fetuses from pregnancies complicated by urinary tract infection. There was no statistical significant difference in KANET scores between the control group and fetuses from pregnancies complicated by respiratory tract infection. KANET test has been shown to be a reliable means to distinguish normal and abnormal fetal behavior. Postnatal follow-up should confirm the data from prenatal assessment of fetal behavior. How to cite this article Talic A, Kurjak A, Honemeyer U. Effect of Maternal Fever on Fetal Behavior Assessed by KANET Test. Donald School J Ultrasound Obstet Gynecol 2012;6(2):160-165.


2018 ◽  
Vol 25 (5) ◽  
pp. 727-739 ◽  
Author(s):  
Doreen McClurg ◽  
Carol Bugge ◽  
Andrew Elders ◽  
Tasneem Irshad ◽  
Suzanne Hagen ◽  
...  

Background: Clean intermittent catheterisation (CIC) is often recommended for people with multiple sclerosis (MS). Objective: To determine the variables that affect continuation or discontinuation of the use of CIC. Methods: A three-part mixed-method study (prospective longitudinal cohort ( n = 56), longitudinal qualitative interviews ( n = 20) and retrospective survey ( n = 456)) was undertaken, which identified the variables that influenced CIC continuation/discontinuation. The potential explanatory variables investigated in each study were the individual’s age, gender, social circumstances, number of urinary tract infections, bladder symptoms, presence of co-morbidity, stage of multiple sclerosis and years since diagnosis, as well as CIC teaching method and intensity. Results: For some people with MS the prospect of undertaking CIC is difficult and may take a period of time to accept before beginning the process of using CIC. Ongoing support from clinicians, support at home and a perceived improvement in symptoms such as nocturia were positive predictors of continuation. In many cases, the development of a urinary tract infection during the early stages of CIC use had a significant detrimental impact on continuation. Conclusion: Procedures for reducing the incidence of urinary tract infection during the learning period (i.e. when being taught and becoming competent) should be considered, as well as the development of a tool to aid identification of a person’s readiness to try CIC.


1970 ◽  
Vol 34 (1) ◽  
pp. 17-20 ◽  
Author(s):  
Seikh Azimul Hoque ◽  
Md Tariqul Islam ◽  
Farid Ahmed ◽  
Mohammed Hanif ◽  
Shahnoor Islam ◽  
...  

Objectives: The study was done to find out the relationship between constipation andurinary tract infection (UTI) in children.Methods: The study was a case control study between two groups in a tertiary carechildren hospital in Dhaka city. In group-1 (n=45) those children having history ofconstipation and in group-2 (n=78) as a control group having no history of constipationwere included in this study. Growths of a single species of organism with colony countof >105/ml in a clean-catch midstream single urine sample was considered as evidenceof urinary tract infection.Results: Positive urine culture was found in 8.9% (4/45) cases in children who hadhistory of constipation and 1.3% (1/78) in children who had no history of constipation.Though the number of positive urine culture was seven times more in children withconstipation than those who were not constipated but the difference between the twogroups was not statistically significant (p=0.059) .Conclusion: Culture documented UTI in children with constipation is seven timesmore than without constipation showing impact of constipation on urinary tract infection(UTI) in children.Key words: Urinary tract infection (UTI); constipation.DOI: 10.3329/bjch.v34i1.5697Bangladesh Journal of Child Health 2010; Vol.34(1): 17-20


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