scholarly journals Neonatal cholestasis mimicking biliary atresia: Could it be urinary tract infection?

2017 ◽  
Vol 5 ◽  
pp. 2050313X1769599 ◽  
Author(s):  
Noella Maria Delia Pereira ◽  
Ira Shah

Cholestasis can occur in newborns due to infections. However, the manifestations of the underlying infections usually dominate the presentation. We present a 2-month-old infant who presented with jaundice and no fever or signs of systemic illness. Liver biopsy was suggestive of cholangitis. He was subsequently detected to have urinary tract infection with Klebsiella pneumoniae. The child was treated with appropriate antibiotics for 2 weeks following which the cholestasis resolved. Thus, neonatal cholestasis due to infections can also occur in the post-neonatal period without clinical manifestations of an underlying infection.

2018 ◽  
pp. 100-108
Author(s):  
Dinh Khanh Le ◽  
Dinh Dam Le ◽  
Khoa Hung Nguyen ◽  
Xuan My Nguyen ◽  
Minh Nhat Vo ◽  
...  

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


Author(s):  
Alessandra Tammy Hayakawa Ito de Sousa ◽  
Marco Túlio dos Santos Costa ◽  
Herica Makino ◽  
Stéfhano Luis Cândido ◽  
Isabela de Godoy Menezes ◽  
...  

2020 ◽  
Vol 17 (35) ◽  
pp. 621-627
Author(s):  
May Ali Hussien UMRAN ◽  
Sumaya Najim AL-KHATEEB

The bacterium Escherichia coli is one of the best free-living organisms studied in depth. It is a surprisingly diverse species, since some strains of E. coli live in the intestine of animals as harmless commensals, while other distinct genotypes, such as an enteropathogenic or enterohemorrhagic E. coli, for example, cause morbidity and death marked as human intestinal pathogens. The purpose of this study was to develop and validate a PCR assay for a known and suspected uropathogenic E. coli virulence factor (kpsMT) gene region to determine the distribution of the gene and its role in the development of clinical diseases of the urinary system. A total of 25 urine samples were collected from patients with urinary tract infection (UTI) at Azadi and Kirkuk hospitals in the city of Kirkuk, Iraq. Samples of both genders and different ages were collected from patients with suspected urinary tract infection according to the clinical manifestations and symptoms diagnosed by the examining physician. The samples were cultured and positive samples were subjected to the IMViC test to identify E. coli bacteria and subsequently identified using the Vitek 2 compact system. Among 25 samples, 24 (96%) showed positive results for bacterial cultural growth. Of these, 17 (68%) were identified as Escherichia coli. Of the total of 17 isolates, 14 from patients with mild urinary tract infection, and 3 from patients with Urosepsis. The kpsMT gene was present in 14 isolates (82.3%), including 11 (78.5%) isolates from patients with mild urinary tract infection, and 3 (100%) isolates from patients with Urosepsis. It was concluded that Escherichia coli is the most prevalent in urine tract infection samples. Due to the abundance of the kpsMT gene in uropathogenic Escherichia coli (UPEC), this gene plays an important role in developing UTI if it is not treated correctly and quickly; mild cases of UTI can turn into Urosepsis.


2020 ◽  
Vol 11 (2) ◽  
pp. 2424-2432
Author(s):  
Nabil Salim Saaid Tuwaij ◽  
Huda Jameel Baker Al-khilkhali ◽  
Haneen Mohamed Mohsen

Klebsiella pneumoniae is a significant concern multidrug-resistant microorganism and a one common gram negative bacteria associated with infections of women urinary tract. Therefore, this work aimed to the molecular screening of Sul(1and 2), Gyr(A and B) and OXA genes among K. pneumoniae isolates in Najaf City, Iraq. Out of 250 urine specimens were collected from women showing symptoms of urinary tract infection during five months January to of May 2019, bacterial growth was157 isolates, included 133 gram negative compared with  24 gram positive bacteria while 98 specimens were no growth. According to the Vitek-2 system, 30 K. pneumoniae isolates were obtained.Data on current work revealed that the 26-35 age group was the highest 14 K. pneumoniae isolates. Results of antimicrobial susceptible recorded all isolates were multi-drug resistant (MDR) and they have a different range of resistance. However, all 30 isolates(100%) resistant to ampicillin drugs, while the lowest rate was 1(3.33%) forImipenemdrug. PCR assay revealed exist of oxa, sul-1, sul-2, gyr-A and gyr-B genes among K. pneumoniae isolates with rates 20(66.66%), 11(36.66%), 22(73.33%), 3(10%) and 17(56.66%) respectively.


Cureus ◽  
2017 ◽  
Author(s):  
Faizan Yasin ◽  
Salman Assad ◽  
Abdul Subhan Talpur ◽  
Mehr Zahid ◽  
Shuja A Malik

2020 ◽  
Vol 75 (12) ◽  
pp. 3656-3664
Author(s):  
Rasmus Richelsen ◽  
Jesper Smit ◽  
Henrik Carl Schønheyder ◽  
Pavithra Laxsen Anru ◽  
Belen Gutiérrez-Gutiérrez ◽  
...  

Abstract Objectives To assess the impact of ESBL production on mortality and length of hospital stay (LOS) of community-onset infections due to Escherichia coli or Klebsiella pneumoniae. Methods A population-based cohort study including all adult patients hospitalized with a first-time community-onset E. coli or K. pneumoniae bacteraemia or urinary tract infection in the North Denmark Region between 2007 and 2017. For each bacterial agent, we computed 1 year Kaplan–Meier survival curves and cumulative incidence functions of LOS, and by use of Cox proportional hazard regression we computed HRs as estimates of 30 day and 1 year mortality rate ratios (MRRs) and LOS among patients with and without ESBL-producing infections. Results We included 24 518 cases (among 22350 unique patients), of whom 1018 (4.2%) were infected by an ESBL-producing bacterium. The 30 day cumulative mortality and adjusted MRR (aMRR) in patients with and without ESBL-producing isolates was as follows: E. coli bacteraemia (n = 3831), 15.8% versus 14.0%, aMRR = 1.01 (95% CI = 0.70–1.45); E. coli urinary tract infection (n = 17151), 9.5% versus 8.7%, aMRR = 0.97 (95% CI = 0.75–1.26); K. pneumoniae bacteraemia (n = 734), 0% versus 17.2%, aMRR = not applicable; and K. pneumoniae urinary tract infection (n = 2802), 13.8% versus 10.7%, aMRR = 1.13 (95% CI = 0.73–1.75). The 1 year aMRR remained roughly unchanged. ESBL-producing E. coli bacteraemia was associated with an increased LOS compared with non-ESBL production. Conclusions ESBL production was not associated with an increased short- or long-term mortality in community-onset infections due to E. coli or K. pneumoniae, yet ESBL-producing E. coli bacteraemia was associated with an increased LOS.


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