Methenamine for Recurrent Urinary Tract Infections in Solid Organ Transplantation

2021 ◽  
pp. 152692482110648
Author(s):  
Helen Sweiss ◽  
Suverta Bhayana ◽  
Reed Hall ◽  
Joelle Nelson ◽  
Elisabeth Kincaide
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Kidney Transplant ◽  
Urinary Tract Infections ◽  
Recurrent Urinary Tract Infection ◽  
Solid Organ ◽  
Therapy Initiation ◽  
Tract Infections

Introduction Recurrent urinary tract infections remain a challenge in solid organ transplant and have a negative impact on morbidity/mortality. Project Aim The purpose of this program evaluation was to determine the impact of methenamine on recurrent urinary tract infection in kidney and liver-kidney transplant recipients. Design This retrospective review included patients > 18 years of age who received a kidney or liver-kidney transplant. Patients were divided into the following groups: (1) Methenamine therapy initiation received methenamine for ≥ 180 days or (2) Non-methenamine therapy: did not receive recurrent urinary tract infection prophylaxis. A total of 60 patients were included. Results When comparing outcomes between methenamine therapy initiation and non-methenamine therapy group, a significant reduction in the rate of recurrent urinary tract infection was reported in the methenamine therapy initiation group (0.6 vs 1.3 per 180 patient days follow-up, P = 0.0005). A significant reduction was also noted with rate of asymptomatic bacteriuria, treatment failures, bacteremia, hospitalizations due to recurrent urinary tract infection, multi-drug resistant organism isolated, and the average duration of antibiotic use. A significant difference in the time to failure of methenamine therapy initiation versus non-methenamine therapy is noted up to 180 patient-days follow-up (RR 1.56, P = 0.0019). Conclusion This evaluation supported methenamine therapy for recurrent urinary tract infection in kidney and liver-kidney transplant. The most significant impact of methenamine recurrent urinary tract infection was seen in the first 30 days after initiation.

scholarly journals Infeções do Trato Urinário numa Coorte de Transplantados Renais

2014 ◽  
Vol 27 (3) ◽  
pp. 364 ◽  
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

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

Extended Therapy with a Trimethoprim-Sulphonamide for the Treatment of Established Urinary Tract Infection

1971 ◽  
Vol 16 (12) ◽  
pp. 506-508 ◽  
Author(s):  
H. Gavras ◽  
D. H. Lawson ◽  
A. L. Linton
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Success Rate ◽  
Urinary Tract Infections ◽  
Allergic Reactions ◽  
Extended Treatment ◽  
Recurrent Urinary Tract Infections ◽  
Tract Infections

Thirty patients with recurrent urinary tract infections who had failed to respond to previous extended treatment with Sulphadimidine and/or Ampicillin were treated with a Trimethoprim-sulphamethoxazole combination ‘Septrin’. Twenty six per cent developed allergic reactions. In those who completed a 3-months' course there was a 59 per cent success rate in eradicating bacteriuria at a 6-months follow-up.

scholarly journals Draft Genome Sequence of Staphylococcus epidermidis UMB7765, Isolated from the Urobiome of a Woman with Recurrent Urinary Tract Infection

2020 ◽  
Vol 9 (20) ◽  
Author(s):  
Lucy Kemper ◽  
Taylor Miller-Ensminger ◽  
Adelina Voukadinova ◽  
Alan J. Wolfe ◽  
Catherine Putonti
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Staphylococcus Epidermidis ◽  
Recurrent Urinary Tract Infection ◽  
Draft Genome ◽  
Positive Bacterium ◽  
Content Type ◽  
Tract Infections

Staphylococcus epidermidis is a Gram-positive bacterium that is resistant to many antibiotics. Here, we present the 2.5-Mb draft genome of S. epidermidis UMB7765, isolated from a voided urine sample from a female with recurrent urinary tract infections.

scholarly journals Recurrent Urinary Tract Infections due to Asymptomatic Colonic Diverticulitis

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Evangelos Falidas ◽  
Georgios Anyfantakis ◽  
Stavros Boutzouvis ◽  
Michail Kyriakopoulos ◽  
Stavros Mathioulakis ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Abdominal Pain ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Recurrent Urinary Tract Infection ◽  
Common Complication ◽  
Colonic Diverticulitis ◽  
Colovesical Fistula ◽  
Tract Infections

Colovesical fistula is a common complication of diverticulitis. Pneumaturia, fecaluria, urinary tract infections, abdominal pain, and dysuria are commonly reported. The authors report a case of colovesical fistula due to asymptomatic diverticulitis, and they emphasize the importance of deeply investigate recurrent urinary tract infection without any bowel symptoms. They also briefly review the literature.

Letter to the Editor

PEDIATRICS ◽  
1974 ◽  
Vol 53 (2) ◽  
pp. 289-289
Author(s):  
Thomas F. Dolan ◽  
Alan Meyers
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Family Practitioners ◽  
Letter To The Editor ◽  
Routine Basis ◽  
Tract Infections

We agree that follow-up urine culture should be obtained after the diagnosis of a urinary tract infection is made. The frequency with which such cultures are obtained is, however, debatable. Our questionnaire did not include this aspect of management. Since 59% of family practitioners and 45% of pediatricians diagnosed urinary tract infections without benefit of culture on a routine basis, it would seem likely that follow-up urine cultures are not performed with regularity. We would join with Dr. Browning in urging careful follow-up and evaluation for children with documented urinary tract infections.

scholarly journals P009: Quality improvement and implementation of urine culture follow up process

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S67-S68
Author(s):  
N. Walji ◽  
A. Greer ◽  
M. Hewitt ◽  
M. BinKharfi
Keyword(s):  
Urinary Tract Infection ◽  
Quality Improvement ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Chart Review ◽  
Urine Culture ◽  
Urinary Culture ◽  
Tract Infections

Background: The diagnosis of urinary tract infection (UTI) is made based on symptoms, urinalysis and urine culture. While simple urinary tract infections do not require routine culture, the Infectious Disease Society of America (IDSA) Guidelines state that complicated urinary tract infections should have urine cultures performed to determine which antibiotics are effective, as there is a higher risk of infection with resistant organisms. We hypothesized that the rate of urine cultures sent for complicated UTI is less than is recommended by the literature. Aim Statement: We aimed to implement a follow-up reporting system for Urinary Culture in patients diagnosed with complicated UTIs and raise our Urinary Culture rates in this population to 80% by June 2019. Measures & Design: We performed a single-center chart review using Emergency Department (ED) charts of non-admitted patients. They were audited daily for two weeks to obtain a sample of patients who had a discharge diagnosis of urinary tract infection, pyelonephritis or cystitis. Charts capturing these diagnoses were assessed to see if a culture was clinically indicated and if it was ordered. Charts were screened for the presence of any of the following criteria indicating complicated UTI: known structural or functional abnormality of the urinary tract, genitourinary obstruction, pregnancy, immunosuppression, diabetes, indwelling or intermittent catheter use, fever, male patient, clinical pyelonephritis, antimicrobial failure, or transfer from a nursing home. Data was then compiled to determine culture rates in complicated and uncomplicated UTIs. This prevalence rate established the baseline performance in the ED which was used to inform the quality improvement project. Evaluation/Results: Over a two week period, 26 patients were discharged from the ED with a diagnosis of UTI, with 17 of these patients meeting criteria for complicated UTI. Only 6 of 17 complicated UTIs were sent for urine culture, therefore our pre-implementation culture rate was 35%. After initial data collection, a follow-up system was designed ensuring that urine culture and sensitivities results would be compiled and reviewed daily at Hamilton Health Sciences. This system was created with input from key stakeholders including department chiefs, core lab services, ED physicians and business clerks. A discrepancy form was created for documentation of culture result recognition and any required patient follow up ie. antibiotic change. In October 2019, the system had been implemented for a month, after which another chart review was completed. 27 cases were captured, 18 of which were complicated. The complicated culture rate had increased significantly from 35% to 72%. Discussion/Impact: In the ED, ordering of cultures for patients being discharged, regardless of type, is commonly associated with concern of result follow up, which may take up to 72 hours. This discrepancy system was implemented to ensure that all urine cultures ordered had appropriate follow up, thus supporting physicians in ordering cultures when indicated. The significant improvement in culture rate from 35% to 72% is balanced by one single culture of all 9 simple UTIs (11%). In PDSA cycle 2, we hope to increase rates to 90% by improving current challenges with the system.

Urinary tract infection in a patient with a kidney transplant

2015 ◽  
Author(s):  
Mark Harber
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Kidney Transplant ◽  
Urinary Tract Infections ◽  
Post Transplant ◽  
Graft Outcome ◽  
Tract Infections ◽  
Transplant Complications ◽  
Very High

Urinary tract infection is the commonest bacterial infection and cause of septicaemia post kidney transplant, accounting for 40–50% of all infectious post-transplant complications. The risk of a urinary tract infection post transplant is very high with most studies recording at least 50%, and rates as high as 86% have been reported. Clinically overt urinary tract infections are a major cause of morbidity post transplant and are associated with worse graft outcome and increased mortality. This chapter discusses the epidemiology, aetiology, pathology, clinical presentation, investigations, consequences, treatment, and prophylaxis of post-transplant urinary tract infections.

scholarly journals High dose versus low dose standardized cranberry proanthocyanidin extract for the prevention of recurrent urinary tract infection in healthy women: a double-blind randomized controlled trial

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Asma Babar ◽  
Lynne Moore ◽  
Vicky Leblanc ◽  
Stéphanie Dudonné ◽  
Yves Desjardins ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Low Dose ◽  
Recurrent Urinary Tract Infection ◽  
High Dose ◽  
Double Blind ◽  
Symptomatic Urinary Tract Infection ◽  
Tract Infections

Abstract Purpose Our objective was to assess the efficacy of a high dose cranberry proanthocyanidin extract for the prevention of recurrent urinary tract infection. Material and methods We recruited 145 healthy, adult women with a history of recurrent urinary tract infection, defined as ≥ 2 in the past 6 months or ≥ 3 in the past 12 months in this randomized, controlled, double-blind clinical trial. Participants were randomized to receive a high dose of standardized, commercially available cranberry proanthocyanidins (2 × 18.5 mg daily, n = 72) or a control low dose (2 × 1 mg daily, n = 73) for a 24-week period. During follow-up, symptomatic women provided urine samples for detection of pyuria and/or bacteriuria and received an appropriate antibiotic prescription. The primary outcome for the trial was the mean number of new symptomatic urinary tract infections during a 24-week intervention period. Secondary outcomes included symptomatic urinary tract infection with pyuria or bacteriuria. Results In response to the intervention, a non-significant 24% decrease in the number of symptomatic urinary tract infections was observed between groups (Incidence rate ratio 0.76, 95%CI 0.51–1.11). Post-hoc analyses indicated that among 97 women who experienced less than 5 infections in the year preceding enrolment, the high dose was associated with a significant decrease in the number of symptomatic urinary tract infections reported compared to the low dose (age-adjusted incidence rate ratio 0.57, 95%CI 0.33–0.99). No major side effects were reported. Conclusion High dose twice daily proanthocyanidin extract was not associated with a reduction in the number of symptomatic urinary tract infections when compared to a low dose proanthocyanidin extract. Our post-hoc results reveal that this high dose of proanthocyanidins may have a preventive impact on symptomatic urinary tract infection recurrence in women who experienced less than 5 infections per year. Trial registration: Clinicaltrials.gov, identifier NCT02572895

Detection of tox A gene in Pseudomonas aeruginosa that isolates from different clinical cases by using PCR.

2018 ◽  
pp. 26
Author(s):  
Rana M. Abdullah Al-Shwaikh ◽  
Abbas Falih Alornaaouti
Keyword(s):  
Molecular Weight ◽  
Pseudomonas Aeruginosa ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Otitis Media ◽  
Urinary Tract Infections ◽  
Gel Electrophoresis ◽  
Wound Infections ◽  
Tract Infections

       Current study obtained (75) isolate of Pseudomonas aeruginosa collected from different cases included : 28 isolates from otitis media, 23 isolates from burn infections, 10 isolates from wound infections, 8 isolates from urinary tract infections and 6 isolates from blood, during the period between 1/9/2014 to 1/11/2014        The result revealed that the tox A gene was present in 54 isolates (72%) of Pseudomonas aeruginosa. The gel electrophoresis showed that the molecular weight of tox A gene was 352 bp. The result shows 17 isolates (60.71%) from otitis media has tox A gene, 18 isolates (78.26%) from burn followed by 8 isolate (80%) from wound infection and 5 isolates (62.5%) from urinary tract infection , finally 6 isolates (100%) from blood have this gene.

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

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