scholarly journals Diagnosis of Urinary Tract Infection in the Neuropathic Bladder: Changing the Paradigm to Include the Microbiome

2019 ◽  
Vol 25 (3) ◽  
pp. 222-227 ◽  
Author(s):  
Catherine S. Forster ◽  
Hans Pohl
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Clinical Management ◽  
Significant Variation ◽  
Asymptomatic Bacteriuria ◽  
Specific Term ◽  
Variation In Care ◽  
Urinary Microbiome ◽  
Definition Of

Bacteriuria, a non-specific term that refers to the presence of bacteria in the urine, is common in people with neuropathic bladders. However, accurately determining when bacteriuria represents a urinary tract infection (UTI) as opposed to asymptomatic bacteriuria is difficult. There is currently no widely accepted definition of what constitutes a UTI in people with neuropathic bladders. As a result, there is significant variation in care, which likely leads to unnecessary use of antibiotics for bacteriuria. To improve the clinical management of people with neuropathic bladders, it is important to be able to accurately diagnose and treat UTIs. In this article, we review the difficulties associated with accurately diagnosing UTIs and then review proposed definitions. Finally, we discuss the emerging literature of the urinary microbiome and how this may assist in accurately diagnosing UTIs in people with neuropathic bladders.

scholarly journals Catheter-Associated Urinary Tract Infection Does Changing the Definition Change Quality?

2013 ◽  
Vol 34 (3) ◽  
pp. 313-315 ◽  
Author(s):  
Matthew J. Press ◽  
Joshua P. Metlay
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Disease Control ◽  
Asymptomatic Bacteriuria ◽  
Longitudinal Measurements ◽  
Control And Prevention ◽  
Centers For Disease Control ◽  
Definition Of

The Centers for Disease Control and Prevention (CDC) recently narrowed its definition of catheter-associated urinary tract infection (CAUTI) to exclude asymptomatic bacteriuria. Although CAUTI rates decreased after the definition was changed, rates of related measures remained relatively stagnant, which indicates that longitudinal measurements of CAUTI may be misleading and that the change in definition did not itself impact care.

scholarly journals Urinary Tract Infection and Asymptomatic Bacteriuria in Older Adults

2017 ◽  
Vol 31 (4) ◽  
pp. 673-688 ◽  
Author(s):  
Nicolas W. Cortes-Penfield ◽  
Barbara W. Trautner ◽  
Robin L.P. Jump
Keyword(s):  
Older Adults ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Asymptomatic Bacteriuria

Impact of an Antimicrobial Stewardship Care Bundle to Improve the Management of Patients with Suspected or Confirmed Urinary Tract Infection

2016 ◽  
Vol 37 (12) ◽  
pp. 1499-1501 ◽  
Author(s):  
Curtis D. Collins ◽  
Jared J. Kabara ◽  
Sarah M. Michienzi ◽  
Anurag N. Malani
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antimicrobial Stewardship ◽  
Asymptomatic Bacteriuria ◽  
Care Bundle ◽  
Antimicrobial Stewardship Program ◽  
Stewardship Program ◽  
Bundle Compliance ◽  
Tract Infections

Implementation of an antimicrobial stewardship program bundle for urinary tract infections among 92 patients led to a higher rate of discontinuation of therapy for asymptomatic bacteriuria (52.4% vs 12.5%; P =.004), more appropriate durations of therapy (88.7% vs 63.6%; P =.001), and significantly higher overall bundle compliance (75% vs 38.2%; P < .001).Infect Control Hosp Epidemiol 2016;1499–1501

Fever

2018 ◽  
pp. 217-220
Author(s):  
Glenn Patriquin
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Asymptomatic Bacteriuria ◽  
Common Causes ◽  
Criteria For Diagnosis ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Specific Symptoms ◽  
Growth Of Bacteria

This case illustrates one of the most common healthcare-associated infections (HAI) in a patient who is admitted to hospital. Catheter-associated urinary tract infections (CAUTI) can be prevented by eliminating unnecessary urinary catheter use. Furthermore, non-specific symptoms are frequently erroneously attributed to a presumed urinary tract infection (UTI) upon isolating bacteria from a urine sample. Except for a few specific circumstances, asymptomatic bacteriuria should not be treated with antibiotics. Without symptoms consistent with UTI, growth of bacteria from urine does not constitute an infection. Culturing urine without UTI symptoms can lead to misuse of antibiotics, which can increase adverse events and drive antimicrobial resistance. This case reviews common causes of UTIs and criteria for diagnosis.

scholarly journals Microbiological profile of symptomatic and asymptomatic bacteriuria recovered from female patients with urinary tract infection

2015 ◽  
Vol 3 (1) ◽  
pp. 34-37
Author(s):  
Una Jessica Sarker ◽  
Md Sakil Munna ◽  
Saurab Kishore Munshi
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Nalidixic Acid ◽  
Asymptomatic Bacteriuria ◽  
Female Patients ◽  
Medical College ◽  
Tract Infections ◽  
Dominant Bacteria ◽  
Klebsiella Spp

With the previous knowledge on the production of ?-lactamase by the bacterial pathogens causing urinary tract infection, present study further investigated the presence of symptomatic and asymptomatic bacteriuria in female patients admitted into the Delta Medical College with suspected urinary tract infections (UTIs). The manifestation of uropathogens and their responses against locally available antibiotics (amoxicillin, 10 ?g; cephradin, 30 ?g; ciprofloxacin, 5 ?g; cotrimoxazole, 23.8 ?g; gentamicin, 10 ?g; nalidixic acid, 30 ?g) were inquired by means of conventional cultural techniques and double-disc diffusion methods, respectively. Among 110 urine samples collected from the patients with suspected UTI, 34 were found to be culture positive. Symptomatic (64.7%) and asymptomatic (36.3%) bacteriuria were noticed inside the puss cell of the UTI positive cases. Escherichia coli (73.5%) was the dominant bacteria while Klebsiella spp. (26.5%) was also exultant. Around 96% uropathogens were found to be sensitive against imipenem, and 75% against amikacin. E. coli was found to be sensitive against all of the antibiotics used, whereas Klebsiella spp. was found to be 100% resistant against nalidixic acid and cotrimoxazole. DOI: http://dx.doi.org/10.3329/sjm.v3i1.22751 Stamford Journal of Microbiology, Vol.3(1) 2013: 34-37

scholarly journals Symptom-based diagnosis of overactive bladder: an overview

2013 ◽  
Vol 5 (5-S2) ◽  
pp. 135
Author(s):  
Alan Wein
Keyword(s):  
Bladder Cancer ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Overactive Bladder ◽  
Clinical Diagnosis ◽  
Urge Incontinence ◽  
Subjective Assessment ◽  
Current Definition ◽  
Definition Of

The current definition of overactive bladder (OAB) is “urgency,with or without urge incontinence, usually with frequency andnocturia in the absence of an underlying metabolic or pathologiccondition.” Urgency, in turn, is defined as a “sudden, compellingdesire to pass urine that is difficult to defer.” While these definitionsprovide the framework for making a clinical diagnosis ofOAB, they rely on subjective assessment of the symptoms by thepatient. As well, the symptoms of OAB can be similar to thoseseen in other conditions, such as urinary tract infection, benignprostatic enlargement and bladder cancer. These other potentialdiagnoses should be ruled out in a noninvasive manner beforemaking a diagnosis of OAB.

Pathogenesis of urinary tract infection

2017 ◽  
Author(s):  
Ased Ali
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Infection ◽  
Asymptomatic Bacteriuria ◽  
Uropathogenic Escherichia Coli ◽  
Systemic Sepsis ◽  
Molecular Pattern ◽  
Clinical Consequences ◽  
Minor Infection

The realization of the harms resulting from indiscriminate use of antibiotics for minor infection has added impetus to the need to understand better the interaction between urogenital tract epithelium and invading bacteria during the initial stages of urinary tract infection (UTI). It is thought that uropathogenic Escherichia coli clones develop in the gut and migrate across the perineum to the urethra and up into the bladder. The response of the epithelium to bacterial adherence and the evolution of the invading bacteria will then govern the clinical consequences. These can vary between rapid invasion and further migration to produce systemic sepsis to tolerance of the bacteria in a planktonic state in asymptomatic bacteriuria. The key to these differences is the activation of epithelial pathogen-associated molecular pattern receptors by expressed proteins on the bacterial cell wall. Increased understanding of these interactions will lead to non-antibiotic-based strategies for clinical management of urinary infection.

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