Effect of standard antibiotic prophylaxis versus enhanced prophylactic measures on rate of urinary tract infection after flexible ureteroscopy: A randomized clinical study

2021 ◽  
Author(s):  
El-Sayed I. El-Agamy ◽  
Mohamed A. Elhelaly. ◽  
Tamer A. Abouelgreed ◽  
Abdrabuh M. Abdrabuh ◽  
Mohamed F. Elebiary ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Tract Infection ◽  
Antibiotic Prophylaxis ◽  
Flexible Ureteroscopy ◽  
Treatment Groups ◽  
Prophylaxis Group ◽  
Randomized Clinical Study ◽  
Prophylactic Measures ◽  
Significant Difference ◽  
Tract Infections

Abstract BackgroundPrevention of urinary tract infections (UTIs) after flexible ureteroscopy (fURS) remains controversial. The present study aimed to compare the rate of post-procedural UTI in patients subjected to the standard antibiotic prophylaxis alone versus enhanced prophylactic measures.Methodsfrom August 2018 to September 2020, a total of 100 patients subjected to fURS for management of ureteral and/or renal stones were included in this study. Patients were equally and randomly divided to two treatment groups using randomly computer-generated allocation tables and concealed envelope technique. Treatment groups included standard antibiotic prophylaxis group and enhanced prophylaxis group. Patients in the standard antibiotic prophylaxis group IV, fluoroquinolone 1 hour preoperatively and oral antibiotics were used for 24h postoperatively. In the enhanced prophylaxis group, patients had urine culture 10 days before the procedure. In addition to the antibiotic prophylaxis, hydrophilic-coated ureteral access sheaths were systematically used.ResultsComparison between the baseline and operative characteristics of the studied groups revealed no statistically significant differences. Postoperatively, 8 patients (16.0 %) in the standard prophylaxis group were diagnosed with UTI in comparison to 2 patients (4.0 %) in the enhanced prophylaxis group expressing a statistically significant difference (p = 0.046). Using binary logistic regression analysis, female patients’ sex [OR (95% CI): 0.09 (0.018–0.46), operative time [OR (95%CI): 0.97 (0.94–0.99)] were significant predictors of postoperative UTI in univariate analysis. However, only female sex remained significant in multivariate analysis [OR (95% CI): 0.09 (0.017–0.49)].ConclusionsUrinary tract infection after fURS can be significantly reduced by using the suggested enhanced prophylactic approach.

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.

scholarly journals Oral D mannose in the prevention and treatment of recurrent urinary tract infections: A review

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Daniele Porru ◽  
Annalisa De Silvestri ◽  
Edda Buffa ◽  
Catherine Klersy ◽  
Barbara Gardella ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Antibiotic Prophylaxis ◽  
Urinary Tract Infections ◽  
Resistant Bacteria ◽  
Control Groups ◽  
Recurrent Utis ◽  
Recurrent Urinary Tract Infections ◽  
Long Term Treatment ◽  
Significant Difference ◽  
Tract Infections

The results of several studies reveal that antibiotics may promote treatment resistance by causing alterations in the intestinal flora. The development of a gut reservoir of resistant bacteria promotes the development of UTIs through autoinfection. This review aims to address clinical reliability, efficacy and safety of long-term treatment with oral D mannose for the prevention of Recurrent Urinary Tract Infections (RUTI) in females. A comprehensive MEDLINE, Embase, Scopus and Cochrane search was performed for English language reports published before December 2018 using the term “recurrent urinary tract infections and D mannose” was carried out. We searched Medline, Embase, Scopus and the Cochrane Register of Controlled Trials from January 2010 to December 2018. Eligible studies did not include non-oral therapy, local (vaginal) treatment in women with recurrent UTIs. We identified eligible original articles. A few limitations of the review are the heterogeneity of the available studies, their different rational and aim, the assumption of D mannose for prophylaxis or treatment of recurrent UTIs. Oral D mannose performs well in the prevention of UTIs recurrences, significant improvement of urinary symptoms was observed, the disease- free time was longer in the groups of patients under prophylaxis with D mannose in comparison with control groups (no treatment, antibiotic prophylaxis, prophylaxis with Proanthocyanidin (PAC) etc. The review has limitations, as the studies are heterogeneous, the meta-analysis requires classifications that can also be arbitrary. Furthermore, single-arm studies are not included. Some of the authors found this evidence inconclusive, which results as a limitation of the study. D mannose prolonged the recurrence-free interval of recurrent UTIs, thus reducing the prolonged or cyclical use of antibiotics, improving clinical symptoms, with a significant difference between treatment and control groups (no treatment, antibiotic prophylaxis, prophylaxis with Proanthocyanidin). However, most clinical trials used an association of different substances commingled with D mannose, dosages and regimens of D mannose were different. For this reason, the evidence of the efficacy of D mannose remains low.

scholarly journals Prevention of Recurrent Urinary Tract Infections in Postmenopausal Women

2014 ◽  
pp. 55-60
Author(s):  
Darrell Fernando ◽  
Budi I Santoso
Keyword(s):  
Systematic Review ◽  
Urinary Tract ◽  
Postmenopausal Women ◽  
Urinary Tract Infections ◽  
Antimicrobial Prophylaxis ◽  
Prophylaxis Group ◽  
Research Article ◽  
Recurrent Urinary Tract Infections ◽  
Significant Difference ◽  
Tract Infections

Objective: To determine the most effective and applicable methods to reduce recurrence of urinary tract infections in postmenopausal women. Method: A search was conducted on Pubmed, NEJM, BMJ, and Google. After screening and selection, six articles were considered useful; comprising of two original research articles, one systematic review, and three society guidelines. Result: Society guidelines recommended continuous antimicrobial prophylaxis, with postcoital antimicrobial prophylaxis as an alternative. The first research article found similar results in continous antimicrobial prophylaxis group and intermittent antimicrobial prophylaxis group. The second research article found no significant difference in cranberry and trimethoprim group. The systematic review revealed vaginal estrogens are effective in preventing recurrent UTI, but the type of estrogen is less clear. Oral estrogens are not effective. Conclusion: Prevention of recurrent urinary tract infections in postmenopausal women include risk factor identification, non-antimicrobial prophylaxis with cranberry and vaginal estrogen preparations, and antimicrobial prophylaxis (continuous or intermittent). Keywords: postmenopausal, prevention, recurrent urinary tract infection.

Effect of Intrapartum Antibiotic Prophylaxis Against Group B Streptococcal Infection on Comparisons of Rates of Endometritis and Urinary Tract Infection in Multicenter Surveillance

2008 ◽  
Vol 29 (4) ◽  
pp. 327-332 ◽  
Author(s):  
Anne-Marie Dumas ◽  
Raphaëlle Girard ◽  
Louis Ayzac ◽  
Geneviève Beaumont ◽  
Emmanuelle Caillat-Vallet ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antibiotic Prophylaxis ◽  
Streptococcal Infection ◽  
Confounding Factor ◽  
Intrapartum Antibiotic Prophylaxis ◽  
Intrapartum Antibiotic ◽  
Group B ◽  
Tract Infections

Objective.To establish whether antibiotic prophylaxis against group B streptococcal infection may be a confounding factor in comparisons of rates of endometritis and urinary tract infection after vaginal delivery.Design.Prospective study.Setting.Maternity units at 48 hospitals in a regional surveillance network in France during 2001-2004.Methods.The maternity units used a common protocol to establish whether antibiotic prophylaxis was indicated. Risk factors for endometritis and urinary tract infections were evaluated using multiple logistic regression.Results.We analyzed 49,786 vaginal deliveries. The percentage of women receiving antibiotic prophylaxis varied widely and significantly among the maternity units (range, 4.4%-26.0%; median, 15.8%; 25th percentile, 12.1%; 75th percentile, 19.0%) (P < .001, by Mantel-Haenszel χ2 test). The incidence rate of endometritis was significantly reduced from 0.25% to 0.11% by antibiotic prophylaxis (P = .001). There was a decrease in the incidence of urinary tract infection from 0.37% to 0.32%, but it was not statistically significant (P = .251).Conclusions.A reduction in the incidence of endometritis was observed when intrapartum antibiotic prophylaxis against group B streptococcal infection was used. However, the proportion of women considered to be at risk of infection varied widely among institutions. Comparisons of rates of endometritis among maternity units, but not urinary tract infection rates, should take into account antibiotic prophylaxis as a significant confounding factor.

Comparative Trial of Two Sulfisoxazole Regimens in Acute Urinary Tract Infection

1981 ◽  
Vol 15 (11) ◽  
pp. 863-866
Author(s):  
Randall A. Prince ◽  
Deborah H. Cassel ◽  
Charles D. Hepler ◽  
James L. Wilson ◽  
Mark E. Jones ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Comparative Trial ◽  
Uncomplicated Urinary Tract Infection ◽  
Loading Dose ◽  
Presenting Symptoms ◽  
Significant Difference ◽  
Tract Infections ◽  
Acute Urinary Tract Infection

Traditionally, the therapeutic regimen of sulfisoxazole in acute urinary tract infection has included either a 2- or 4-g loading dose. However, the biopharmaceutical aspects of this drug indicate that a loading dose is unnecessary. The objective of this clinical study, therefore, was to compare a traditional regimen of sulfisoxazole to a regimen not utilizing a loading dose. Fifty adult female patients with acute, uncomplicated urinary tract infections were assigned to a ten-day course of sulfisoxazole 1 g po qid. Patients were randomly allocated to a 2-g loading dose or no loading dose regimen. Data were analyzed with regard to resolution of presenting symptoms and eradication of the infecting organism (i.e., cure). Statistical analysis demonstrated no significant difference for symptom resolution and cure. It appears that the convention of using an initial 2-g oral loading dose of sulfisoxazole in the treatment of acute, uncomplicated urinary tract infection is unwarranted.

scholarly journals Incidence of Breakthrough Urinary Tract Infection in Hospitalized Infants Receiving Antibiotic Prophylaxis

2016 ◽  
Vol 56 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Jessica C. Lloyd ◽  
Christoph P. Hornik ◽  
Daniel K. Benjamin ◽  
Reese H. Clark ◽  
Jonathan C. Routh ◽  
...  
Keyword(s):  
Intensive Care ◽  
Urinary Tract ◽  
Antibiotic Prophylaxis ◽  
Urinary Tract Infections ◽  
Neonatal Intensive Care ◽  
Cox Regression ◽  
Prophylactic Antibiotic ◽  
Neonatal Intensive Care Units ◽  
Significant Difference ◽  
Tract Infections

Urinary tract infections (UTIs) are a source of substantial morbidity in children in the neonatal intensive care unit. The incidence of UTIs that occur in critically ill infants during a course of antibiotic prophylaxis (i.e., breakthrough urinary tract infections [BUTIs]) is not known. We investigated the incidence of BUTI in a cohort of infants hospitalized on prophylactic antibiotics in neonatal intensive care units. Predictors of BUTI were evaluated using multivariable Cox regression. Out of 716 787 infants, 631 (0.09%) were prescribed 821 courses of antibiotic prophylaxis. Among this cohort, 60 infants (9.5%) suffered a total of 65 BUTIs. Of all prophylactic antibiotic courses, 65/821 (7.9%) were complicated by BUTI. Klebsiella, Enterobacter, and Escherichia coli species were the most common causes of BUTI. There was no statistically significant difference ( P = .78) in BUTI incidence among the 4 antibiotics assessed (amoxicillin, cephalexin, nitrofurantoin, or trimethoprim-sulfamethoxazole).

Antimicrobial Prophylaxis for Children With Vesicoureteral Reflux

2021 ◽  
pp. 257-262
Author(s):  
Philipp Dahm ◽  
Jane M. Lewis
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antibiotic Prophylaxis ◽  
Vesicoureteral Reflux ◽  
Antimicrobial Prophylaxis ◽  
Renal Scarring ◽  
Symptomatic Urinary Tract Infection ◽  
Randomized Intervention ◽  
Tract Infections

This chapter summarizes the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trial, a landmark trial that randomized children with vesicoureteral reflux diagnosed after a first or second febrile or symptomatic urinary tract infection to receive trimethoprim–sulfamethoxazole (TMP-SMX) prophylaxis versus placebo. It found that antibiotic prophylaxis reduced the incidence of recurrent febrile or symptomatic urinary tract infection but had little effect on renal scarring. Recurrent febrile or symptomatic urinary tract infections resistant pathogens were increased. This study provides the underpinning for guidelines that advocate for low-dose antibiotic prophylaxis for the first year of life; however, this remains an area of considerable controversy.

Trimethoprim/Sulfamethoxazole and Ampicillin in the Treatment of Acute Urinary Tract Infections in Children: A Double-Blind Study

PEDIATRICS ◽  
1977 ◽  
Vol 60 (2) ◽  
pp. 245-247
Author(s):  
N. S. Ellerstein ◽  
T. D. Sullivan ◽  
T. Baliah ◽  
E. Neter
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Side Effects ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Double Blind Study ◽  
Double Blind ◽  
Treatment Groups ◽  
Tract Infections ◽  
Acute Urinary Tract Infection

Trimethoprim/sulfamethoxazole and ampicillin therapy in children with acute urinary tract infection, whose microorganisms were susceptible to both drugs, proved to be of similar effectiveness. Side effects did not differ significantly between the two treatment groups.

Detection of tox A gene in Pseudomonas aeruginosa that isolates from different clinical cases by using PCR.

2018 ◽  
pp. 26
Author(s):  
Rana M. Abdullah Al-Shwaikh ◽  
Abbas Falih Alornaaouti
Keyword(s):  
Molecular Weight ◽  
Pseudomonas Aeruginosa ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Otitis Media ◽  
Urinary Tract Infections ◽  
Gel Electrophoresis ◽  
Wound Infections ◽  
Tract Infections

       Current study obtained (75) isolate of Pseudomonas aeruginosa collected from different cases included : 28 isolates from otitis media, 23 isolates from burn infections, 10 isolates from wound infections, 8 isolates from urinary tract infections and 6 isolates from blood, during the period between 1/9/2014 to 1/11/2014        The result revealed that the tox A gene was present in 54 isolates (72%) of Pseudomonas aeruginosa. The gel electrophoresis showed that the molecular weight of tox A gene was 352 bp. The result shows 17 isolates (60.71%) from otitis media has tox A gene, 18 isolates (78.26%) from burn followed by 8 isolate (80%) from wound infection and 5 isolates (62.5%) from urinary tract infection , finally 6 isolates (100%) from blood have this gene.

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