scholarly journals Urinary Tract Infection Caused By Enterococcus Spp: Risk Factors And Mortality. An Observational Study.

2020 ◽  
Author(s):  
Elisa Alvarez-Artero ◽  
Amaia Campo Nuñez ◽  
Inmaculada Garcia Garcia ◽  
Moises Garcia Bravo ◽  
Olia Cores ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Antimicrobial Treatment ◽  
Empiric Antibiotic Therapy ◽  
Enterococcus Spp ◽  
Empiric Antibiotic ◽  
Patients At Risk ◽  
Severe Comorbidity ◽  
Predictive Risk ◽  
Tract Infections

Abstract Background Urinary tract infections (UTIs) are frequently caused by Enterococcus spp. We aim to define the risk factors involved in UTIs caused by Enterococcus. Determine the overall mortality and predictive risk factors. Methods A retrospective in-patients study was conducted with bacteriemic UTIs caused by Enterococcus spp. We compared bacteriemic UTIs caused by Enterococcus spp. vs. a random sample of 100 in-patients with bacteriemic UTIs caused by others enterobacteria. Results We found 106 in-patients with UTIs caused by Enterococcus spp., 51 of whom had concomitant positive blood cultures. Distribution by species was: 83% E. faecalis and 17% E. faecium, with a Charlson comorbidity index of 5.9 ± 2.9. When we compared bacteriemic UTIs caused by Enterococcus spp. vs. bacteriemic UTIs caused by others enterobacteria we found the following independent predictors of bacteriemic UTI by Enterococcus: male sex with an OR of 6.1 (95%CI 2.3–16.1), uropathy with an OR of 4.1 (1.6–10.1), nosocomial infection with an OR of 3.8 (1.4–10.3), urinary cancer with an OR of 6.4 (1.3–30.3) and previous antimicrobial treatment with an OR of 18 (5.2–62.1). Overall, in-patient mortality was 16.5%, which was associated with a higher Sequential Organ Failure Assessment (SOFA) score (> 4), severe comorbidity such as immunosuppression, malignant hemopathy and nephrostomy, or Enterococcus faecium species and its pattern or resistance to ampicillin or vancomycin (p < 0.05). Appropriate empiric antibiotic therapy was not associated with a better prognosis (p > 0.05). Conclusions Enterococcus spp. is a frequent cause of complicated UTI by a profile of risk factors. High mortality secondary to a severe clinical setting and high comorbidity may be sufficient reasons for implementing empiric treatment of patients at risk, although we did not show a higher survival rate in patients with this treatment strategy.

Urinary tract infection caused by enterococcus spp: risk factors and mortality.

2019 ◽  
Author(s):  
Elisa Alvarez Artero ◽  
Amaia Campo ◽  
Inmaculada Garcia Garcia ◽  
Moises Garcia Bravo ◽  
Olaia Cores ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Antimicrobial Treatment ◽  
Empiric Antibiotic Therapy ◽  
Enterococcus Spp ◽  
Empiric Antibiotic ◽  
Patients At Risk ◽  
Severe Comorbidity ◽  
Predictive Risk ◽  
Tract Infections

Abstract Purpose: Complicated urinary tract infections (UTIs) are frequently caused by Enterococcus spp. We aim to define the risk factors involved in UTIs caused by Enterococcus. Determine the overall mortality and predictive risk factors.Methods: A retrospective study was conducted. We compared the results with those of a random sample of patients with complicated UTIs infection caused by Escherichia coli.Results: We found 106 in-patients with UTIs caused by Enterococcus spp., 56 of whom had positive blood cultures. Distribution by species: 83% E. faecalis and 17% E. faecium, with a Charlson comorbidity index of 5.9±2.9. Only male sex with an OR of 2.8 (95%CI 1.2-6.4), nosocomial infection with an OR of 2.8 (95%CI 1.1-7), urinary catheter with an OR of 4.5 (95%CI 1.8-11.3), urinary cancer with an OR of 6.4 (2.1-19.4), and previous antimicrobial treatment with an OR of 4.3 (1.8-10.2) were independent predictors of Enterococcus infection. Overall, in-patient mortality was 16.5%, which was associated with a higher Sequential Organ Failure Assessment (SOFA) score (>4), severe comorbidity such as immunosuppression, malignant hemopathy and nephrostomy, or Enterococcus faecium species and its pattern or resistance to ampicillin or vancomycin (p<0.05). Appropriate empiric antibiotic therapy was not associated with a better prognosis (p >0.05).Conclusions: Enterococcus spp. is a frequent cause of complicated UTI by a profile of risk factors. High mortality secondary to a severe clinical setting and high comorbidity may be sufficient reasons for implementing empiric treatment of patients at risk, although we did not show a higher survival rate in patients with this treatment strategy.

scholarly journals Predictive Risk Factors of Urinary Tract Infection Following Semirigid Ureteroscopic Lithotripsy

2020 ◽  
Author(s):  
Mehmet Çağlar Çakıcı ◽  
Özgür Kazan ◽  
Ayberk İplikçi ◽  
Muhammet Çiçek ◽  
Özgür Efiloğlu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Infectious Complications ◽  
Ureteral Stones ◽  
P Value ◽  
Ureteroscopic Lithotripsy ◽  
Increased Risk ◽  
Predictive Risk ◽  
Tract Infections ◽  
Residual Fragments

INTRODUCTION: The aim of this study is to determine the frequency and predictive factors of postoperative UTI in patients who underwent URS regarding ureteral stones. METHODS: Data from 425 patients undergoing semi-rigid ureteroscopic lithotripsy between December 2015 and December 2019 at a single center were reviewed to detect factors predicting postoperative urinary tract infections. RESULTS: Of the 425 patients, 35 were infective (8.2%). Proximal ureteral stones were the majority in infective group (48.5%); distal ureteral stones were the majority in non-infective group (42.6%)(p=0.026). Stone number and stone size were also higher in the postoperative infective group (p<0.05). UTI history and preoperative DJS insertion were higher in Group 1 (p <0.001, p = 0.001, respectively). Multivariate regression analyses revealed that history of UTI (OR=5.513, 95% CI; 2.622–11.591, p value <0.001) and presence of residual fragments (OR=4.274, 95% CI; 1.892–9.657, p value <0.001) were independent risk factors for infectious complications after URS. DISCUSSION AND CONCLUSION: Even if URS is considered an innocuous procedure, the probability of postoperative infectious complications is far from negligible. Our results showed that the presence of UTI history and residual fragments were associated with an increased risk of subsequent UTI after URS. These infectious complications also have significant morbidity, mortality and expenditure if not treated timely. Therefore, to avoid this preventable complication, all variables should be reviewed and more careful.

Recurrent Urinary Tract Infections

2020 ◽  
Author(s):  
Lauren N Siff
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Antimicrobial Prophylaxis ◽  
Antimicrobial Treatment ◽  
Ct Urography ◽  
Recurrent Uti ◽  
The Past ◽  
Treatment And Prevention ◽  
Tract Infections ◽  
Work Up

One in three women has had at least one urinary tract infection (UTI) treated with antibiotics by the age of 24 years, and half of all women experience a UTI in their lifetime with one in four developing recurrence. Recurrent UTI is defined by two or more symptomatic infections in the past 6 months or three or more symptomatic infections in the past 12 months where each UTI follows a complete resolution of the previous UTI. This review describes the risk factors, diagnosis, work-up and treatment, and prevention of recurrent UTIs. Prevention strategies can be divided into antimicrobial and nonantimicrobial strategies. Nonantimicrobial prevention with behavioral changes, cranberry products, or probiotics did not significantly reduce the occurrence of symptomatic UTIs. Compared with placebo, oral estrogens did not reduce UTIs. However, vaginal estrogens do play a role in prevention of recurrence, particularly in postmenopausal women. There are three main strategies for antibiotic prevention: (1) low-dose daily antimicrobial prophylaxis, (2) postcoital antimicrobial prophylaxis, and (3) patient-initiated antimicrobial treatment. All of these strategies decrease infections during prophylaxis period.The choice of regimen should be based on susceptibilities and antibiotic allergy. This review contains 1 figure, 7 tables and 37 references. Keywords: antimicrobial prophylaxis, continuous antibiotics, CT urography, cystoscopy, postcoital prophylaxis, recurrent UTI, risk factors, self-directed therapy, treatment and diagnosis

Utilizing the electronic health record to construct antibiograms for previously healthy children with urinary tract infections

2018 ◽  
Vol 39 (12) ◽  
pp. 1473-1475
Author(s):  
Yusuf Y. Chao ◽  
Larry K. Kociolek ◽  
Xiaotian T. Zheng ◽  
Tonya Scardina ◽  
Sameer J. Patel
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Empiric Antibiotic Therapy ◽  
Healthy Children ◽  
International Classification Of Disease ◽  
Empiric Antibiotic ◽  
Icd 10 ◽  
Data Elements ◽  
Tract Infections

AbstractTraditional antibiograms can guide empiric antibiotic therapy, but they may miss differences in resistance across patient subpopulations. In this retrospective descriptive study, we constructed and validated antibiograms using International Classification of Disease, Tenth Revision (ICD-10) codes and other discrete data elements to define a cohort of previously healthy children with urinary tract infections. Our results demonstrate increased antibiotic susceptibility. This methodology may be modified to create other syndrome-specific antibiograms.

Urinary tract infections to Enterococcus spp.: Risk factors and treatments

2019 ◽  
Vol 493 ◽  
pp. S559
Author(s):  
H. Roux ◽  
J. Lourtet ◽  
R. Garreau ◽  
B. Pilmis ◽  
A. Le Monnier
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Enterococcus Spp ◽  
Tract Infections
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