scholarly journals Risk factors for treatment failure in women with uncomplicated lower urinary tract infection

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256464
Author(s):  
Romain Martischang ◽  
Maciek Godycki-Ćwirko ◽  
Anna Kowalczyk ◽  
Katarzyna Kosiek ◽  
Adi Turjeman ◽  
...  
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Risk Factor ◽  
Urinary Tract ◽  
Treatment Failure ◽  
Lower Urinary Tract ◽  
Independent Risk Factor ◽  
Lower Urinary Tract Infection ◽  
Tract Infections ◽  
Lower Urinary

Given rising antibiotic resistance and increasing use of delayed prescription for uncomplicated lower urinary tract infections (UTI), patients at risk for treatment failure should be identified early. We assessed risk factors for clinical and microbiological failure in women with lower UTI. This case-control study nested within a randomized clinical trial included all women in the per-protocol population (PPP), those in the PPP with microbiologically confirmed UTI, and those in the PPP with UTI due to Escherichia coli. Cases were women who experienced clinical and/or microbiologic failure; controls were those who did not. Risk factors for failure were assessed using multivariate logistic regression. In the PPP, there were 152 clinical cases for 307 controls. Among 340 women with microbiologically confirmed UTI, 126 and 102 cases with clinical and microbiological failure were considered with, respectively, 214 and 220 controls. Age ≥52 years was independently associated with clinical (adjusted OR 3.01; 95%CI 1.84–4.98) and microbiologic failure (aOR 2.55; 95%CI 1.54–4.25); treatment with fosfomycin was associated with clinical failure (aOR 2.35; 95%CI 1.47–3.80). The association with age persisted among all women, and women with E. coli-related UTI. Diabetes was not an independent risk factor, nor were other comorbidities. Postmenopausal age emerged as an independent risk factor for both clinical and microbiological treatment failure in women with lower UTI and should be considered to define women at-risk for non-spontaneous remission, and thus for delayed antibiotic therapy; diabetes mellitus was not associated with failure.

scholarly journals Adult Neurogenic Lower Urinary Tract Dysfunction and Intermittent Catheterisation in a Community Setting: Risk Factors Model for Urinary Tract Infections

2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Michael Kennelly ◽  
Nikesh Thiruchelvam ◽  
Márcio Augusto Averbeck ◽  
Charalampos Konstatinidis ◽  
Emmanuel Chartier-Kastler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Lower Urinary Tract ◽  
Cauda Equina ◽  
Lower Urinary Tract Dysfunction ◽  
Intermittent Catheterisation ◽  
Cord Injury ◽  
Tract Infections ◽  
Lower Urinary

A risk factor model for urinary tract infections in patients with adult neurogenic lower urinary tract dysfunction performing clean intermittent catheterisation was developed; it consists of four domains, namely, (1) general (systemic) conditions in the patient, (2) individual urinary tract conditions in the patient, (3) routine aspects related to the patient, and (4) factors related to intermittent catheters per se. The conceptual model primarily concerns patients with spinal cord injury, spina bifida, multiple sclerosis, or cauda equina where intermittent catheterisation is a normal part of the bladder management. On basis of several literature searches and author consensus in case of lacking evidence, the model intends to provide an overview of the risk factors involved in urinary tract infections, with specific emphasis to describe those that in daily practice can be handled and modified by the clinician and so come to the benefit of the individual catheter user in terms of fewer urinary tract infections.

scholarly journals Analysis of lower urinary tract disease of dogs

2017 ◽  
Vol 37 (11) ◽  
pp. 1275-1280 ◽  
Author(s):  
Claudia Iveth Mendóza-López ◽  
Javier Del-Angel-Caraza ◽  
Israel Alejandro Quijano-Hernández ◽  
Marco Antonio Barbosa-Mireles
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Clinical Laboratory ◽  
Imaging Studies ◽  
German Shepherd ◽  
Micturition Disorders ◽  
Tract Disease ◽  
Tract Infections ◽  
Lower Urinary

ABSTRACT: Lower urinary tract diseases (LUTD) include different conditions that affect the urinary bladder, urethra and prostate. The objective of this study was to determine the frequency of different related diseases, to characterize the population affected, and to determine risk factors in dogs. The clinical cases were diagnosed with LUTD through physical examination, and clinical laboratory and imaging studies. Male dogs had a greater predisposition to present a LUTD. Dogs from 3 months to 18 years with a median of 8 years were affected, and the most affected breeds were Poodle, Labrador, German shepherd, Schnauzer, Cocker Spaniel and Chihuahua. The LUTD presented with the following frequencies: bacterial urinary tract infection 34.02%; micturition disorders 22.68%; urolithiasis 20.61%; prostatic disease 14.43%; traumatic problems 8.24%. Sixty-seven per cent of the cases were specific diseases, such as uncomplicated and complicated bacterial urinary tract infections, urinary retention of neurologic origin and silica urolithiasis.

scholarly journals Treatment of lower urinary tract infections in women

2019 ◽  
pp. 184-191
Author(s):  
L. A. Sinyakova ◽  
I. V. Kosova ◽  
Y. I. Nezovibatko
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Social Problem ◽  
Lower Urinary Tract ◽  
Interdisciplinary Approach ◽  
Sexual Life ◽  
High Prevalence ◽  
Tract Infections ◽  
Lower Urinary

Lower urinary tract infections are currently an actual clinical and social problem due to the high prevalence, the need for an interdisciplinary approach to diagnosis and treatment, the severity of the combination of disorders of urination and dyspareunia, which leads to the rejection of sexual life, violations of childbearing function. Timely and adequate diagnosis of urinary disorders in women with the identification of risk factors, concomitant diseases, pathogens allow to select a rational, primarily necessary antibacterial therapy that contributes not only to the patient’s getting rid of symptoms of the disease, but also prevents the transition of the disease into a chronic form.

The Risk of Preterm Birth in Low Risk Pregnant Women with Urinary Tract Infections

2021 ◽  
Author(s):  
Dominique E. Werter ◽  
Caroline Schneeberger ◽  
Ben Willem J. Mol ◽  
Christianne J.M. de Groot ◽  
Eva Pajkrt ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Preterm Birth ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Lower Urinary Tract ◽  
Spontaneous Preterm Birth ◽  
Lower Urinary Tract Infection ◽  
Increased Risk ◽  
Tract Infections ◽  
Lower Urinary

Objective Urinary tract infections are among the most common infections during pregnancy. The association between symptomatic lower urinary tract infections during pregnancy and fetal and maternal complications such as preterm birth and low birthweight remains unclear. The aim of this research is to evaluate the association between urinary tract infections during pregnancy and maternal and neonatal outcomes, especially preterm birth. Study Design This study is a secondary analysis of a multicenter prospective cohort study, which included patients between October 2011 and June 2013. The population consists of women with low risk singleton pregnancies. We divided the cohort into women with and without a symptomatic lower urinary tract infection after 20 weeks of gestation. Baseline characteristics and maternal and neonatal outcomes were compared between the two groups. Multivariable logistic regression analysis was used to correct for confounders. The main outcome was spontaneous preterm birth at <37 weeks. Results We identified 4,918 pregnant women eligible for enrollment, of whom 9.4% had a symptomatic lower urinary tract infection during their pregnancy. Women with symptomatic lower urinary tract infections were at increased risk for both preterm birth in general (12 vs. 5.1%, adjusted OR 2.5; 95% CI 1.7–3.5) as well as a spontaneous preterm birth at <37 weeks (8.2 vs. 3.7%, adjusted OR 2.3; 95% CI 1.5–3.5). This association was also present for early preterm birth at <34 weeks. Women with symptomatic lower urinary tract infections during pregnancy are also at increased risk of endometritis (8.9 vs. 1.8%, adjusted OR 5.3; 95% CI 1.4–20) and mastitis (7.8 vs. 1.8%, adjusted OR 4.0; 95% CI 1.6–10) postpartum. Conclusion Low risk women with symptomatic lower urinary tract infections during pregnancy are at increased risk of spontaneous preterm birth. In addition, an increased risk for endometritis and mastitis postpartum was found in women with symptomatic lower urinary tract infection during pregnancy. Key Points

scholarly journals Pivmecillinam for Uncomplicated Lower Urinary Tract Infections Caused by Staphylococcus saprophyticus—Cumulative Observational Data from Four Recent Clinical Studies

Antibiotics ◽  
2019 ◽  
Vol 8 (2) ◽  
pp. 57 ◽  
Author(s):  
Filip Jansåker ◽  
Marianne Bollestad ◽  
Ingvild Vik ◽  
Morten Lindbæk ◽  
Lars Bjerrum ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Clinical Effect ◽  
Susceptibility Testing ◽  
Lower Urinary Tract Infection ◽  
Staphylococcus Saprophyticus ◽  
Days Of Therapy ◽  
Long Term Follow Up ◽  
Tract Infections ◽  
Lower Urinary

Objectives: To investigate pivmecillinam´s efficacy in uncomplicated lower urinary tract infection (UTI) caused by Staphylococcus saprophyticus—considered non-susceptible to mecillinam. Methods: Participants with confirmed UTIs caused by S. saprophyticus from four randomized controlled trials, where pivmecillinam was empirically given to females with symptoms of UTIs. The primary outcome was defined as a cumulative clinical effect—symptom resolution during the first eight days of therapy, without a recurrence of UTI symptoms in the long-term follow-up (approximately four weeks). Secondary outcomes included the bacteriological effect—elimination of the causative agent, with or without new uropathogenic bacteria present in the first control urine sample. Significant bacteriuria was defined as ≥103 bacteria/mL. The antibiotic susceptibility testing was done by disc diffusion methodology, according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST). Results: Seventy-four females (18–55 years) were empirically treated with pivmecillinam for UTIs caused by S. saphrophyticus (mean age 25 years; standard deviation (SD) 5.8). The cumulative clinical effect was 53/74 (72%), and the bacteriological effect was 51/59 (86%). Conclusion: Pivmecillinam showed a high clinical and bacteriological effect in UTIs caused by S. saprophyticus in these four clinical trials. The characterization of non-susceptibility for mecillinam regarding the treatment of UTIs caused by this common pathogen may need to be revised.

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