scholarly journals Patients with preoperative asymptomatic pyuria are not prone to develop febrile urinary tract infection after ureteroscopic lithotripsy

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kuan-Jung Lin ◽  
Eric Y. H. Huang ◽  
I-shen Huang ◽  
Yu-Hua Fan ◽  
Chih-Chieh Lin ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
White Blood Cells ◽  
Febrile Urinary Tract Infection ◽  
Emergency Visits ◽  
Stone Free Rate ◽  
Significant Difference ◽  
Febrile Uti ◽  
Free Rate

Abstract Background This study aimed to evaluate the association of asymptomatic pyuria before ureterorenoscopic lithotripsy (URSL) with postoperative febrile urinary tract infection (UTI). Methods This observational case–control study identified the patients undergoing URSL for ureteral stones between May 2011 and October 2015. The included patients were classified into two groups: the asymptomatic pyuria group (6–50 white blood cells [WBCs]/high-power field [HPF]) and the non-pyuria group (≤ 5 WBCs/HPF). All data were collected by reviewing medical records. Postoperative outcomes were collected in terms of febrile UTI, emergency visits, and stone-free rate. Results A total of 232 patients were included, 101 in the pyuria group, 131 in the non-pyuria group. Two (0.9%) patients developed febrile UTI after URSL and 12 (5.2%) patients visited emergency department for URSL-related symptoms. The overall stone-free rate was 90.9%. There was no significant difference between the pyuria and non-pyuria groups regarding febrile UTI, emergency visits, and stone-free rate. Multivariate analysis revealed that pyuria was neither significantly associated with postoperative febrile UTI (OR = 1.03, 95% CI = 0.06–18.10, P = 0.98), nor with emergency visits (OR = 0.48, 95% CI = 0.13–1.85, P = 0.29). Conclusions Compared to the patients with sterile urine prior to URSL, those with asymptomatic pyuria were not prone to develop febrile UTI after URSL.

scholarly journals Febrile Urinary Tract Infection after Radical Cystectomy with Urinary Diversion: Different Characteristics in Patients with Ileal Conduit and Orthotopic Neobladder

2020 ◽  
Vol 16 (3) ◽  
pp. e38-e46
Author(s):  
Seungsoo Lee ◽  
Seung Ryong Baek ◽  
Won Hoon Song ◽  
Tae Nam Kim ◽  
Sung-Woo Park ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Radical Cystectomy ◽  
Ileal Conduit ◽  
Orthotopic Neobladder ◽  
Febrile Urinary Tract Infection ◽  
Cox Regression Analysis ◽  
Significant Difference ◽  
Febrile Uti

Background and ObjectiveTo compare the incidence of febrile urinary tract infection (UTI) and bacterial identification between patients with orthotopic neobladder (ONB) and ileal conduit (IC). Materials and MethodsData of 164 patients who underwent radical cystectomy with ONB and IC for bladder cancer between January 2009 and January 2018 at our institution were analyzed. Febrile UTI observed was listed and subsequently compared. Incidence of febrile UTI, clinicopathological characteristics, and microorganisms identified were reported at 3 months interval; and preoperative predictors of febrile UTI were evaluated with Cox regression analysis. Patients were divided into ONB and IC. ResultsThe study cohort included 52 patients with ONB and 112 patients with IC. Febrile UTI was diagnosed in 49 (29.9%) patients. Compared to IC group, ONB group had significantly higher incidence of young age (p=0.00), lower cancer stage (p=0.013), longer hospital stay (p=0.049), longer operation time (p=0.00), and higher incidence of febrile UTI within the first 3 months after surgery (p=0.006). On univariable and multivariable analysis, factors associated with significantly increased febrile UTI risk were diabetes (odds ratio [OR]: 4.52; p=0.002) and ONB diversion (OR: 1.27; p=0.031). Forty-four (89.8%) patients were culture positive. However, significant difference in microorganisms was not detected between patients who under-went ONB or IC diversion. ConclusionDiabetes and ONB diversion were associated with higher risk symptomatic UTI following radical cystectomy.

Prediction of renal cortical defect and scar using neutrophil-to-lymphocyte ratio in children with febrile urinary tract infection

2017 ◽  
Vol 56 (03) ◽  
pp. 109-114 ◽  
Author(s):  
Jeong Won Lee ◽  
Joon Soo Park ◽  
Kyeong Bae Park ◽  
Gyeong Hee Yoo ◽  
Seung Soo Kim ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Neutrophil To Lymphocyte Ratio ◽  
Febrile Urinary Tract Infection ◽  
Lymphocyte Ratio ◽  
Cortical Defect ◽  
Febrile Uti ◽  
Dmsa Scan

SummaryAim: This study is aimed to evaluate the predictive value of the neutrophil-to-lymphocyte ratio (NLR) for cortical defect on initial and follow-up Tc-99m dimercaptosuccinic acid (DMSA) scan in children with the first febrile urinary tract infection (UTI). Methods: We retrospectively enrolled 179 children with the first febrile UTI who underwent DMSA scan and laboratory tests. In patients with abnormal DMSA scan findings, follow-up DMSA scan was performed at least 6 months after the initial scan. All DMSA scans were classified as negative and positive cortical defects. Multiple logistic regression analyses were performed to identify the risk factors for cortical defect on initial and follow-up DMSA scan. Results: Cortical defects on initial DMSA scan were noted in 133 patients. Vesicoureteral reflux (VUR), white blood cell count, absolute neutrophil count, NLR, and serum C-reactive protein level were independent predictive factors for positive cortical defect on initial DMSA scan (p < 0.050). On follow-up DMSA scan, 24 of the 133 patients showed persistent cortical defects, and only VUR was significantly associated with persistent cortical defect (p = 0.002). In 84 patients who showed cortical defect on initial scan and absence of VUR, only NLR was significantly associated with persistent cortical defect on follow-up scan (p = 0.025). Conclusion: NLR was significantly associated with persistent cortical defect on follow-up DMSA scan in patients without VUR, as well as positive cortical defect on initial scan.

scholarly journals The Role of Antegrade Irrigation via Percutaneous Nephrostomy on Surgical Outcomes in Semirigid Ureteroscopy among Patients with Upper Ureteral Stones

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Wonho Jung ◽  
Hye Jin Byun ◽  
Dong Sup Lee
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Operation Time ◽  
Percutaneous Nephrostomy ◽  
Stone Size ◽  
Stone Free Rate ◽  
Ureter Stones ◽  
Free Rate

Objective. We aimed to investigate the role of antegrade irrigation via percutaneous nephrostomy on surgical outcomes in retrograde ureteroscopy in patients with upper ureter stones. Materials and Methods. In this retrospective study, we analyzed 134 patients who underwent retrograde semirigid ureteroscopy for upper ureter stones between August 2012 and December 2017. Patients were divided into two groups: retrograde irrigation group (conventional URS) and antegrade irrigation group (using percutaneous nephrostomy). Operation time, postoperative hospital stay, complications, and stone-free rate were measured for each patient after ureteroscopy. Results. The mean age in the retrograde irrigation and antegrade irrigation groups was 53.3 and 60.7 years, respectively (p=0.007). The operation time was 60.8 min vs. 43.0 min (p=0.002), and stone-free rate was 82.0 % vs. 95.5 % (p=0.033). Stone size, laterality, the proportion of male patients, and urinary tract infection prevalence were comparable between the groups. In the subgroup analysis of stone size >10 mm, the antegrade irrigation group had a shorter operation time and a higher stone-free rate. For stone size of 5–10 mm, operation time in the antegrade irrigation group was shorter and the stone-free rate between the two groups was comparable. Conclusion. Antegrade irrigation via percutaneous nephrostomy during ureteroscopy has a higher stone-free rate with a shorter operation time without an increased urinary tract infection risk. Therefore, if percutaneous nephrostomy is necessary before ureteroscopy, antegrade irrigation of external fluid via percutaneous nephrostomy is strongly recommended.

Clinical Characteristics of Febrile Urinary Tract Infection and Application of Thai Guideline Imaging Recommendations Compared between Children Aged 2 Months to 2 Years and Children Aged 2 to 5 Years

2021 ◽  
Vol 104 (12) ◽  
pp. 1977-1983
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Imaging Study ◽  
Female Gender ◽  
Voiding Cystourethrography ◽  
Older Children ◽  
Febrile Urinary Tract Infection ◽  
Febrile Uti ◽  
Imaging Recommendations

Background: In 2014, the Thai Pediatric Nephrology Association (TPNA) launched a guideline for febrile urinary tract infection (UTI) in children aged two months to five years. Renal and bladder ultrasound (RBUS) is recommended for first febrile UTI, and voiding cystourethrography (VCUG) is recommended in patients with at least one of eight proposed risk factors. Objective: To compare characteristics of febrile urinary tract infection (UTI), compliance with the imaging study recommendation regarding to the TPNA guide, and kidney, ureter, and bladder (KUB) abnormality detections between children aged two months to two years and older than two years to five years. Materials and Methods: The present study was a retrospective study, reviewed children aged two months to five years presenting with first or recurrent episode of febrile UTI between 2014 and 2019 at Siriraj Hospital. Clinical parameters during febrile UTI, indications to perform VCUG, and kidney, ureter, and bladder (KUB) abnormality detections were compared between the younger group and the older group. RBUS and VCUG undergone according to the recommendation were accounted for the compliance. Results: The mean age of 259 younger and of 51 older age children was 8.2±5.6 and 40.0±10.9 months, respectively. Female gender (p=0.01), complaint of constipation (p=0.03), abnormal bladder emptying (p<0.01), and renal impairment (p=0.03) were more frequent in the older than the younger. Overall imaging study compliance was 73.9% and the KUB abnormality detection was 16.5%. High-grade vesicoureteral reflux (VUR) was more common than low-grade VUR. The rates of compliance (p=0.45) and KUB abnormality detections (p=0.54) between the younger and older children were not different. Conclusion: Female gender, and bladder and bowel dysfunction were associated to febrile UTI in older children. The TPNA febrile UTI guideline imaging recommendation was shown to be applicable in both younger and older children. Keywords: Clinical characteristics; Febrile urinary tract infection; Thai guideline imaging recommendations; Renal and bladder ultrasound; Voiding cystourethrography

scholarly journals Role of Leptin in Febrile Urinary Tract Infection

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Abolfazl Mahyar ◽  
Parviz Ayazi ◽  
Behnor Hanafizadeh ◽  
Banafsheh Arad ◽  
Reza Dalirani ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
C Reactive Protein ◽  
Febrile Urinary Tract Infection ◽  
Serum Leptin ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Significant Difference ◽  
Febrile Uti

Background: Leptin is a hormone that plays an important role in human health against infections. Some studies have reported that leptin acts as a reactant phase marker in some infectious diseases. The role of leptin in febrile urinary tract infection (UTI) has not been adequately evaluated. Objectives: This study was conducted to determine the role of serum leptin in febrile UTI in children. Methods: Thirty-nine febrile UTI patients were compared with 40 healthy children for the serum leptin level. Serum leptin was measured by the enzyme-linked immunosorbent assay method. The results were compared between the groups. Results: Median (IQR) of serum leptin in the case and control groups was 2 ng/mL and 0.6 ng/mL, respectively. A significant difference was observed between the groups in the serum leptin level (P = 0.001). No significant difference was observed between cystitis and acute pyelonephritis patients in the serum leptin level. The correlation analysis showed no significant association between the serum leptin level and acute-phase reactant markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) (r = -0.13 and P = 0.41; r = -0.15 and P = 0.36, respectively). Conclusions: The present study showed that although serum leptin increases in febrile UTI, this increase is not correlated with C-reactive protein and erythrocyte sedimentation rate. Also, this marker cannot discriminate between cystitis and acute pyelonephritis.

scholarly journals Influence of Febrile Urinary Tract Infection on Ultrasonic Measurements of Nonreflux Upper Urinary Tract Dilation in Infants

2021 ◽  
Author(s):  
Peiqiang Li ◽  
Fuyun Liu ◽  
Yan Huang
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Upper Urinary Tract ◽  
Febrile Urinary Tract Infection ◽  
Ureterovesical Junction ◽  
Febrile Uti ◽  
Ultrasonic Measurements ◽  
Tract Dilation ◽  
Urinary Tract Dilation

Abstract Background To investigate the changes in ultrasonic measurements of nonreflux upper urinary tract dilation in infants with febrile urinary tract infection (UTI).Methods There were 28 cases of nonreflux upper urinary tract dilatation with febrile UTI: 14 cases of ureteropelvic junction obstruction (UPJO) (14 kidneys) and 14 cases of ureterovesical junction obstruction (UVJO) (16 kidneys). Changes in anteroposterior renal pelvic diameter (APD) and ureteral dilatation during infection and after infection were compared in UPJO and UVJO patients, respectively.Results In the UPJO with febrile UTI group, the APD was 24.1±10.0 mm at the time of UTI and 16.6±7.0 mm 1 week after infection recovery (P<0.001). In the UVJO with febrile UTI group, the APD was 19.3±8.5 mm at the time of UTI and 15.2±7.7 mm 1 week after infection recovery (P<0.001). In the UVJO with febrile UTI group, the ureteric diameter was 11.0±3.2 mm during UTI and 6.8±2.6 mm 1 week after infection recovery (P<0.001).Conclusions In UPJO patients, the APD decreased after febrile UTI treatment compared with that during infection. In UVJO patients, the APD and ureteric diameter decreased after febrile UTI treatment compared with that during infection.

scholarly journals Predictors of Acute Pyelonephritis in Infants Less Than 4 Months Old with Febrile Urinary Tract Infection

2020 ◽  
Vol 30 (5) ◽  
Author(s):  
Tung-Yu Lin ◽  
Chih-Chieh Yang ◽  
Nai-Wen Fang ◽  
Jenn-Tzong Chang ◽  
Hsiao-Ping Wang ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Acute Pyelonephritis ◽  
Multiple Logistic Regression Analysis ◽  
White Blood Cells ◽  
Age Group ◽  
Febrile Urinary Tract Infection ◽  
Neutrophil Lymphocyte Ratio ◽  
Young Infants

Background: Detecting early predictors of acute pyelonephritis (APN) is essential for the prognosis, but few studies have focused on young infants specifically. Objectives: The aim of our research was to determine the relationship between APN and laboratory parameters in the age group less than 4 months. Methods: This retrospective study included patients aged less than 4 months with first time febrile urinary tract infection (UTI) between January 2012 and December 2018. White blood cells (WBC), C-reactive protein (CRP), and blood neutrophil/lymphocyte ratio (NLR) were analyzed. Patients were divided into two groups according to the presence of renal defects on dimercaptosuccinic acid (DMSA) scans. Results: In total, 205 patients were screened; 107 patients were in the APN group, and 98 patients were in the non-APN group. Compared with the non-APN group, the APN group showed significant differences in therapeutic response time (TRT), CRP, and NLR (all P values < 0.001). Multiple logistic regression analysis revealed that CRP, NLR, and TRT were independent risk factors for APN (P ≤ 0.001, 0.003, and 0.004, respectively). The area under the receiver operating characteristic (ROC) curve was 0.774 for CRP (P < 0.001). The optimum cut-off value for CRP was 4.27 mg/dL, with the highest sensitivity and specificity (70.1% and 73.5%, respectively). Conclusions: In the age group less than 4 months, without the image diagnosis, we could treat the patients as APN for longer antibiotic duration if CRP ≥ 4.27 mg/dL.

scholarly journals Use of Intravenous Furosemide to Prevent Febrile UTI Following Flexible Ureterorenoscopic Laser Lithotripsy

2019 ◽  
Vol 2 (2) ◽  
pp. 49-52
Author(s):  
Robin Bahadur Basnet ◽  
Sanjay Bikram Shrestha ◽  
Jitendra Shrestha ◽  
Bipin Shrestha
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Statistical Significance ◽  
Prophylactic Antibiotic ◽  
Renal Stones ◽  
Laser Lithotripsy ◽  
Febrile Urinary Tract Infection ◽  
Holmium Laser Lithotripsy ◽  
Febrile Uti

Introduction: Flexible ureterorenoscopic laser lithotripsy is the preferred management option for renal stones less than 2 cm. However, flexible ureterorenoscopic laser lithotripsy is not without complications and urinary tract infection is the most common reported complication. Prophylactic antibiotic use, access sheath, low pressure irrigation are few methods to reduce incidence of urinary tract infection. We have studied whether routine use of intravenous furosemide reduces the incidence of febrile urinary tract infection. Methods: A total of 70 patients were randomized into two groups where one received intravenous furosemide at the beginning of the procedure and another did not. Flexible ureteroscopic holmium laser lithotripsy was done and patients were followed up for development of febrile urinary tract infection within one week of the procedure. Results: 14% of patients who received furosemide and 20% of patients who did not receive developed post- operative febrile urinary tract infection within one week. Two patients in each group had bacteriuria. Conclusions: Although the incidence of febrile UTI is lesser with routine use of intravenous furosemide during flexible ureterorensocopic laser lithotripsy, statistical significance could not be proved.

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

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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