scholarly journals Candiduria in Hospitalized Patients and Identification of Isolat-ed Candida Species by Morphological and Molecular Methods in Ilam, Iran

Author(s):  
Afagh FAZELI ◽  
Parivash KORDBACHEH ◽  
Ali NAZARI ◽  
Roshanak DAIE GHAZVINI ◽  
Hossein MIRHENDI ◽  
...  

Background: Candiduria in hospitalized patients may represent contamination, colonization, or urinary tract infections. On the other hand, candidemia and upper urinary tract infection could be the complications of candiduria. The aim of this study was to determine candiduria in hospitalized patients and identify isolated Candida species by conventional and molecular methods. Methods: This cross-sectional study was conducted on hospitalized patients in Imam Khomeini and Mostafa Khomeini hospitals in Ilam, western Iran from Jan to Dec 2016. Urine samples of hospitalized patients were collected during a period of 4 months for diagnosis of candiduria. Primary identification was done by conventional methods. PCR profile was carried out using phenol-chloroform method and confirmed using restriction fragment length polymorphism (PCR-RFLP) technique by MspI restriction enzyme. Results: Candiduria was diagnosed in 18 (9.2%) cases from a total of 195 patients. Isolated yeasts were identified as C. albicans (n: 13), C. glabrata (n: 5), and C. parapsilosis (n: 1) in the one case both C. albicans and C. glabrata were isolated from a urine sample. Conclusion: Candida urinary tract infection is becoming increasingly common in hospitalized patients but, differentiation fungal colonization from infection and identification of etiologic agents for optimal treatment is necessary.  

PEDIATRICS ◽  
1986 ◽  
Vol 78 (5) ◽  
pp. 871-878
Author(s):  
Candice E. Johnson ◽  
Baz P. DeBaz ◽  
Paul A. Shurin ◽  
Rose DeBartolomeo

Ultrasonography of the kidney may replace the intravenous pyelogram as the study of choice in identifying treatable abnormalities in children with urinary tract infection. In a series of 64 consecutive children with urinary tract infection in whom an intravenous pyelogram, renal ultrasound, and voiding cystogram were performed, only one treatable abnormality (calyceal dilation) was identified by intravenous pyelogram, and it was not detected by ultrasound. Eleven children showed vesicoureteral reflux on the cystogram. In an additional 43 children in whom intravenous pyelogram was done only if the ultrasound or cystogram were abnormal, there were five abnormal cystograms. Four treatable abnormalities were identified by ultrasound, and three were confirmed by the intravenous pyelogram. Ultrasound should replace the intravenous pyelogram in children with a normal cystogram because of its accuracy, safety, and high patient acceptance. We have also documented a significant volume increase with acute infection in one or both kidney(s) of those children having upper urinary tract infection. Fifteen of 18 children with upper urinary tract infection had volume increases of 30% on more in at least one kidney; whereas only four of 21 children with lower urinary tract infection had increases of greater than 30% (P < .005). Ultrasound volume measurements provide a new, noninvasive method for identifying the probable site of urinary tract infection.


2021 ◽  
Author(s):  
◽  
Gerald Turyatunga

Background: A urinary tract infection (UTIs) is a common type of infection caused by bacteria that travel up the urethra to the bladder. Globally, it is reported that 150 million people are diagnosed with a UTI annually, costing the world economy over 6 million US dollars in treatment and work loss. Studies conducted in the in-patients pediatric ward of Muhimbili Hospital in Tanzania and Mulago National Referral Hospital in Uganda between five to ten years reported the prevalence of UTI to be 16.8% and 14.6% respectively. On average at Kam Medical Consult Clinic, patients who turn up in the laboratory are about 20%, and 50% of patients present with recurring UTIs clinically. Therefore,  there is a need to establish and investigate the prevalence of bacterial pathogens associated with UTI and multiple pathogens that are not known. Methodology: The cross-sectional study was carried out at Kam medical consult clinic (KMCC) located in Kafeero zone Mulago II Kawempe division. The study population was adults and children presenting with symptoms of urinary tract infection. 120 Midstream urine Samples were collected from patients presenting clinical signs of UTI. The diagnosis was done through macroscopy dry chemistry, microscopy, and culture. Results Among the sampled population, 33% of males had urinary tract infections while 67% of females had urinary tract infections.  88.5% were outpatients while 11.5 % were in-patients The overall prevalence of UTI among patients was 63.3% with children aged (1-10) having a prevalence of 5.8 %. Conclusion and recommendation: E.coli is an etiological agent causing UTIs in male and female patients presenting UTI at Kam Medical Consult Clinic. Other etiological agents included Klebsiella, Coliform, Enterococcus species, staphylococcus aureus, pseudomonas species, and candida species. There is a need to monitor the profile of etiological bacteria of UTI through culture and sensitivity regularly. 


2021 ◽  
Vol 8 (10) ◽  
pp. 522-526
Author(s):  
Bhavani Shankar Rokkam ◽  
Chowdary Babu Menni ◽  
Ramu Pedada ◽  
Deepak Kumar Alikana

BACKGROUND Urinary tract infections (UTI) constitute a common cause of morbidity in infants and children. When associated with abnormalities of urinary tract, they may lead to long-term complications including renal scarring, loss of function and hypertension. Most urinary tract infections remain undiagnosed if investigations are not routinely performed to detect them. Prompt detection and treatment of urinary tract infections and any complicating factors are important. The objective of the study is to know the clinical, epidemiological and bacteriological profile (i.e. clinical signs and symptoms, age, sex, family history, associated urinary tract abnormalities, & causative organisms) of urinary tract infections in febrile children with culture positive urinary tract infection. METHODS This descriptive, cross sectional observational study was conducted at outpatient clinics of our “child health clinics” between May 2016 and April 2017 (one year). All children aged 0 to 12 years with culture positive urinary tract infections were included in this study to evaluate the clinical, epidemiological and bacteriological profile. RESULTS A total of 69 children with culture positive urinary tract infections were included in this study. Out of 69 children included in this study, 36 (52.2 %) were females and 33 (47.8 %) were males. Overall female preponderance was seen and the M: F ratio was 0.9:1. But during first year of life in our study group we had more boys (10, 14.49 %) affected with urinary tract infection than girls. 49.3 % of urinary tract infections in the present study belonged to lower socio-economic status. Most common organism causing urinary tract infection in our group was E. coli (56.5 %). Fever (100 %), anorexia or refusal of feeds (52.2 %), dysuria (46.4 %), vomiting (46.4 %) and abdominal pain (39.1 %) were the predominant clinical manifestations observed in our study. CONCLUSIONS Urinary tract infection is a common medical problem in children and it should be considered as a potential cause of fever in children. As febrile children with urinary tract infection usually present with non-specific signs and symptoms, urine culture should be considered as a part of diagnostic evaluation. KEYWORDS Urinary Tract Infections (UTI), Febrile Children, Bacteriological Profile, Urine Culture


PEDIATRICS ◽  
1969 ◽  
Vol 44 (5) ◽  
pp. 677-684
Author(s):  
Duncan E. Govan ◽  
John M. Palmer

To study the influence of successful ureterovesicoplasty on incidence of recurrent urinary infection, two groups of infected children were compared in this regard before and after urologic evaluation. Of 280 new pediatric urologic hospital admissions, 55.6% had urinary tract infections. Sixty-six of these 156 infected children had vesicoureteral reflux. Bacteriologic localization of infection site was performed in both children with and without reflux at the time of diagnostic cystoscopy. Both groups were specifically treated with short-term antibiotic therapy and empiric urethral dilation. Operative vesicoureteroplasty was carried out in 62 children with reflux, with an overall cure rate of 83.8%. Distal urethral stenosis was not a contributing factor in this population nor did urethral caliber relate to the incidence of reflux. Only 3 of 35 children without reflux were found to have bacteriologically proved upper urinary tract infection. Similarly, only 32% of these children without reflux had clinical histories suggestive of recurrent pyelonephritis. In the children with reflux undergoing bacteriologic localization while infected, no nonrefluxing ureters were found infected, and only one third of the refluxing ureters so studied had proved upper urinary tract infection. Historical evidence for clinical pyelonephritis was present in 79% of the population with reflux; but, after successful cure of reflux, only 7% of these children continued to have pyelonephritic episodes. The long-term incidence of recurrent urinary tract infection was virtually identical, however, in the children undergoing successful antireflux surgery and the children without reflux following ureteral dilation. This relationship indicates that reflux plays little role in the etiology of bacteriunia but has a profound influence on urinary tract infection morbidity in children.


2013 ◽  
Vol 53 (2) ◽  
pp. 70
Author(s):  
Meirina Daulay ◽  
Rosmayanti Siregar ◽  
Oke Rina Ramayani ◽  
Supriatmo Supriatmo ◽  
Rafita Ramayati ◽  
...  

Background Urinary tract infection (UTI) is the most commoncause of fever in children. Less frequent disposable diaper changingis thought to be a cause ofUTI in children. While wearing a diapei;the perinea! area becomes damp with urine allowing bacteria tomigrate from the anus to the external urethral orifice.Objective To assess for an association between the frequencyof disposable diaper changing and urinary tract infections inchildren.Methods This cross-sectional study was conducted in thechildren's outpatient clinic of Haji Adam Malik Hospital fromApril to June 2010. Urine culture was performed in children withsuspected UTI who wore disposable diapers every day. Subjects'ages ranged from 2 months to 2 years 6 months, with samplesmatched and collected by consecutive sampling. Diagnosis ofUTIwas based on urine cultures with bacterial count 2:: 105/mL. Eightychildren were followed in this study and divided into two groups:positive (n=40) and negative (n=40) urine cultures. Chi squaretest was use d to analyze the association between the frequency ofdaily disposable diapers changing during a one week period andthe urine culture results.Results The frequency of daily disposable diapers changing in80 subjects was as follows: < 4 times (22.5%), 4-5 times (40%),and 2::6 times (37.5%) . The frequency of daily disposable diaperchanging in children with positive urine culture was as fo llows:< 4 times (1 8 out of 40), 4-5 times (22 out of 40), and 2::6 times(O out of 40); (P < 0.0001). The most common bacterial speciesfound in urine cultures was Escherichia coli.Conclusion Lower frequency of daily disposable diaper changingis significantly associated with higher UTI incidence in children.


2020 ◽  
Vol 58 (221) ◽  
Author(s):  
Arun Giri ◽  
Raju Kafle ◽  
Ganesh Kumar` Singh ◽  
Niraj Niraula

Introduction: Urinary tract infection is one of the commonest causes of childhood morbidity. Earlydiagnosis and appropriate choice of antimicrobials is essential. Hence, this study aims to identify theprevalence of Escherichia coli in childhood urinary tract infections. Methods: This was a hospital based descriptive cross-sectional study conducted in Nobel MedicalCollege, Biratnagar over a period of one year. A total of 163 cases aged 1-15 years were included andclinical profile, laboratory reports including bacterial isolates in urine cultures and their sensitivitypatterns were documented. Results: The prevalence of Escherichia coli is 45 (53.57%) C.I. Escherichia coli was the most commonorganism isolated in bacterial cultures followed by Klebsiella 12 (14.29%), Enterococcus 10 (11.90%).Urinary tract infection was common among females with male: female ratio of 1:2.3. Fever 152(93.2%) and abdominal pain 113 (69.3%) were the most common presenting symptoms. Escherichiacoli was found most sensitive to Nitrofurantoin 43 (95.5%) followed by Ciprofloxacin 41 (91.1%) andAmikacin 40 (88.8%). Conclusions: Urinary tract infections in childhood require prompt attention and treatment to preventsignificant morbidity and mortality. From this study it can be concluded that Escherichia coli is oneof the most common isolates in urine culture and Aminoglycosides and Fluoroquinolones can beaccepted as empirical treatment regimens for childhood Urinary tract infections.


2021 ◽  
Vol 9 (2) ◽  
pp. 131-137
Author(s):  
Putra Rahmadea Utami

 Urinary tract infection (UTI) is the second largest infection after respiratory infection and can cause sepsis. Urinary tract infections occur due to the entry of microorganisms in the urinary tract. The urinary tract that is usually infected is the urethra (urethritis), bladder (cystisis), ureter (ureteristis), kidney tissue (pyelonephritis). This study aims to determine the sensitivity and specificity of the diagnostic test of nitrite examination with urine culture in suspected urinary tract infections. The method of this study is a descriptive-analytical study with a cross-sectional retrospective approach, conducted in the STIKes field laboratory with the population studied in this study were all patients diagnosed with urinary tract infection with a sample size of 50 samples. The results of this study showed positive nitrite results as many as 17 people, 34% percentage, and negative nitrite results as many as 33 people with a percentage of 66% and on urine culture examination obtained positive results as many as 17 people with a percentage of 34%, which results in growth of bacterial colonies on cultures> 100,000 CFU / mL and negative results of 33 people with a percentage of 66%. Sensitivity Results 82%, Specificity 90.9%. The conclusion of this study is the value of sensitivity, high specificity so that the nitrite test with urine culture can be applied to help diagnose UTI.


Author(s):  
George G. Zhanel ◽  
Michael A. Zhanel ◽  
James A. Karlowsky

Oral fosfomycin is approved in Canada for the treatment of acute uncomplicated cystitis. Several studies have reported “off label” use of oral fosfomycin in the treatment of patients with complicated lower urinary tract infection (cLUTI). This review summarizes the available literature describing the use of oral fosfomycin in the treatment of patients with cLUTI. Collectively, these studies support the use of a regimen of 3 grams of oral fosfomycin administered once every 48 or 72 hours for a total of 3 doses for patients who have previously failed treatment with another agent, are infected with a multidrug-resistant (MDR) pathogen, or cannot tolerate first-line treatment due to intolerance or adverse effects. Additionally, a Phase 2/3 clinical trial, known as the ZEUS study, assessed the efficacy and safety of intravenous (IV) fosfomycin versus piperacillin-tazobactam in the treatment of patients with complicated upper urinary tract infection (cUUTI) or acute pyelonephritis (AP) including in patients with concomitant bacteremia. IV fosfomycin was reported to be noninferior to piperacillin-tazobactam in treating patients with cUUTI and AP; however, when outcomes were independently evaluated according to baseline diagnosis (i.e., cUUTI versus AP), IV fosfomycin was superior to piperacillin-tazobactam in the treatment of patients with cUUTI and demonstrated superior microbiological eradication rates, across all resistant phenotypes including extended-spectrum β-lactamase- (ESBL-) producing Escherichia coli and Klebsiella spp. and carbapenem-resistant (CRE), aminoglycoside-resistant, and MDR Gram-negative bacilli (primarily Enterobacterales). Based on the ZEUS study, IV fosfomycin dosed at 6 grams every 8 hours for 7 days (14 days in patients with concurrent bacteremia) appears to be a safe and effective therapeutic option in treating patients with upper urinary tract infections, particularly those with cUUTI caused by antimicrobial-resistant Enterobacterales.


Author(s):  
Seyed Reza Aghili ◽  
Mahdi Abastabar ◽  
Ameneh Soleimani ◽  
Iman Haghani ◽  
Soheil Azizi

Background and Purpose: Heart failure is a leading cause of hospitalization, and asymptomatic candiduria is common in hospitalized patients with low morbidity. However, in most patients, it is resolved spontaneously on the removal of the catheter. Despite the publication of guidelines, there are still controversies over the diagnosis and management of candiduria. However, in hospitalized patients with heart failure, the decision to treat candiduria is especially important since the nosocomial infections are associated with an increase in morbidity, mortality, length of hospital stay, and healthcare costs. Some species of Candida, such as Candida glabrata, are increasingly resistant to the first-line and second-line antifungal medications. The present study aimed to investigate the incidence of asymptomatic Candida urinary tract infection due to C. glabrata and antifungal susceptibility of Candida isolates in hospitalized patients with heart failure. Materials and Methods: In total, 305 hospitalized patients with heart failure were studied to identify asymptomatic nosocomial candiduria during 2016-17 in one private hospital in the north of Iran. The Sabouraud’s dextrose agar culture plates with a colony count of >104 colony-forming unit/ml of urine sample were considered as Candida urinary tract infection. Candida species were identified based on the morphology of CHROMagar Candida (manufactured by CHROMagar, France) and PCR-RFLP method with MspI restriction enzyme. Antifungal susceptibility testing of the isolates was performed using five mediations, including itraconazole, voriconazole, fluconazole, amphotericin B, and caspofungin by broth microdilution method according to CLSI M27-S4. Results: In this study, the rate of asymptomatic Candida urinary tract infection was 18.8%, which was more common in people above 51 years old and females (70%). In addition to the urinary and intravascular catheter, the occurrence of candiduria in hospitalized patients had significant relationships with a history of surgical intervention, diastolic heart failure, and use of systemic antibiotics (P>0.05). Among Candida spp., non-albicans Candida species was the most common infectious agent (59.7%). Moreover, C. glabrata (n=27, 40.3%) (alone or with other species) and Candida albicans (n=27, 40.3%) were the most common agents isolated in Candida urinary tract infection. Based on the results of the in vitro susceptibility test, the C. glabrata isolates were 15%, 59%, 70%, 74%, and 85% susceptible to caspofungin, amphotericin B, itraconazole, voriconazole, and fluconazole, respectively. Conclusion: According to the findings, there was a high prevalence of asymptomatic Candida urinary tract infection in hospitalized patients with heart failure. Besides, it was suggested that there was a shift towards non-albicans Candida, especially C. glabrata, in these patients. Therefore, asymptomatic candiduria in hospitalized patients with heart failure should be considered significant. Furthermore, the identification of Candida species along with antifungal susceptibility is essential and helps the clinicians to select the appropriate antifungal agent for better management of such cases.


Author(s):  
Vinoth M. ◽  
Prabagaravarthanan R. ◽  
Bhaskar M.

Background: Catheter-associated urinary tract infection (CAUTI) is an important cause of morbidity and mortality in Indian subjects, affecting all age groups. Bacteriuria orcandiduria is almost inevitable in nearly half of the patients who require an indwelling urinary catheter for more than 5 days. The objective of this study was to find the prevalence of CAUTI infection and to determine their antibiotic profileMethods: The present cross-sectional study included 50 patients admitted to medicine and surgery wards in our hospital. The urine from catheter is collected from each patient and subjected to culture and antibiotic susceptibility testing.Results: The prevalence of catheter associated urinary tract infection in our hospital is about 20% and asymptomatic bacterial colonization is 50% which is nearequal to Danchaivijitr S et al study. The common pathogens found in this study are Escherichia coli (22%), Klebsiella (18%), Enterobacter (8%), Staph. aureus (6%) which include MRSA (4%), Pseudomonas (6%), Enterococcus (4%), Candida sps. (4%) Andproteus (2%).Conclusions: CAUTI has low prevalence 20% and asymptomatic colonisation 50% in our hospital with common pathogen being Escherichia coli. It is one of the important notable pathogen causing nosocomial infection among admitted patients. The patients present mainly as asymptomatic bacterial colonisation and risk of CAUTI increases with longer duration of catheterisation. All patients those who had catheter for more than 6 days, aged 60 and above, should be checked for UTI symptoms. And their urine should be cultured regularly in order to diagnose and prevent CAUTI and its complications which are very dangerous and difficult to treat.


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