Only symptomatic urinary tract infections associated with indwelling catheters generally require antibacterial therapy

2006 ◽  
Vol 22 (8) ◽  
pp. 14-17
Author(s):  
&NA;
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antibacterial Therapy ◽  
Indwelling Catheters ◽  
Tract Infections

scholarly journals Urogenital tuberculosis, the cause of ineffective antibacterial therapy for urinary tract infections

2017 ◽  
Vol 10 (3) ◽  
pp. 95-101 ◽  
Author(s):  
Ekaterina Kulchavenya ◽  
Andrey Cherednichenko
Keyword(s):  
Drug Resistance ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antibacterial Therapy ◽  
Recurrent Utis ◽  
E Coli ◽  
Total Prevalence ◽  
Urogenital Tuberculosis ◽  
History Of ◽  
Tract Infections

Background: Urogenital tuberculosis (UGTB) is one of the great imitators; it is commonly masked by urinary tract infections (UTIs). We aimed to estimate how many UGTB patients were among patients with a long history of UTIs. Material and Methods: A total of 244 patients with recurrent UTIs and suspected UGTB were enrolled in an open, noncomparative prospective study. Their urine and expressed prostate secretion or ejaculate were cultured (a total of 1446 samples), and 421 isolates with growth of ⩾104 colony-forming units (CFU)/ml were investigated for drug resistance. Typically, UGTB diagnosis is made by individual case. Results: All 244 patients had a long history of recurrent UTIs (on average, 7.9 ± 3.4 years); all received at least five courses of antibacterial therapy without good result. UGTB was diagnosed in 63 (25.8%), and in 41 of these (65.1%), there was comorbidity of UTI and UGTB. Of 1446 samples investigated, 421 (29.1%) were positive, and 1025 were negative. Escherichia coli was found in 57.3% of gram-negative microflora and in 29.0% only among all uropathogens. E. coli was resistant to amoxicillin/clavulanate in 51.5–57.1%, to cefotaxime in 50.0–52.0%, to gentamycin in 33.3–59.5%, to ciprofloxacin in 63.2–66.7%, to levofloxacin in 54.8–45.2%, and to nitrofurantoin in 23.5–20.8% in 2015 and 2016, respectively. If, in 2015, all isolates of E. coli were susceptible to imipenem, in 2016, 7.1% of strains were resistant to this antibiotic. Level of drug-resistance was higher in 2016, excluding only levofloxacin and nitrofurantoin. Conclusions: Total prevalence of UGTB among UTI patients with poor results of antibacterial therapy was 25.8%. Comorbidity of UTI and UGTB was diagnosed in 65.1%.

Resistance to antibacterial therapy in pediatric febrile urinary tract infections—a single-center analysis

2020 ◽  
Vol 16 (1) ◽  
pp. 71-79
Author(s):  
Thomas Raupach ◽  
Jürgen Held ◽  
Hans-Ulrich Prokosch ◽  
Wolfgang Rascher ◽  
Jakob Zierk
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antibacterial Therapy ◽  
Single Center ◽  
Febrile Urinary Tract Infections ◽  
Tract Infections

scholarly journals Does cranberry have a role in catheter-associated urinary tract infections?

2017 ◽  
Vol 11 (11) ◽  
pp. E421-4 ◽  
Author(s):  
Dominique Thomas ◽  
Matthew Rutman ◽  
Kimberly Cooper ◽  
Andrew Abrams ◽  
Julia Finkelstein ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Bacterial Species ◽  
Signs And Symptoms ◽  
Urine Specimen ◽  
Indwelling Catheters ◽  
Resistance Patterns ◽  
Catheter Urine ◽  
Tract Infections

Introduction: Catheter-associated urinary tract infections (CA-UTIs) are a prevalent and costly condition, with very few therapeutic options. We sought to evaluate the efficacy of an oral cranberry supplement on CA-UTIs over a six-month period. Methods: Subjects with long-term indwelling catheters and recurrent symptomatic CA-UTIs were enrolled to take a once-daily oral cranberry supplement with 36 mg of the active ingredient proanthocyanidin (PACs). Primary outcome was reducing the number of symptomatic CA-UTIs. This was defined by ≥103 (cfu)/mL of ≥1 bacterial species in a single catheter urine specimen and signs and symptoms compatible with CA-UTI. Secondary outcomes included bacterial counts and resistance patterns to antibiotics.Results: Thirty-four patients were enrolled in the trial; 22 patients (mean age 77.22 years, 77.27% were men) completed the study. Cranberry was effective in reducing the number of symptomatic CA-UTIs in all patients (n=22). Resistance to antibiotics was reduced by 28%. Furthermore, colony counts were reduced by 58.65%. No subjects had adverse events while taking cranberry.Conclusions: The cranberry supplement reduced the number of symptomatic CA-UTIs, antibiotic resistances, and major causative organisms in this cohort. Larger, placebo-controlled studies are needed to further define the role of cranberry in CA-UTIs.

scholarly journals Outcomes of Urinary Tract Infection Management by Pharmacists (RxOUTMAP): A study of pharmacist prescribing and care in patients with uncomplicated urinary tract infections in the community

2018 ◽  
Vol 151 (5) ◽  
pp. 305-314 ◽  
Author(s):  
Nathan P. Beahm ◽  
Daniel J. Smyth ◽  
Ross T. Tsuyuki
Keyword(s):  
Patient Satisfaction ◽  
Urinary Tract ◽  
Adverse Events ◽  
Urinary Tract Infections ◽  
Antibacterial Therapy ◽  
Clinical Cure ◽  
Pharmacist Prescribing ◽  
Complicating Factors ◽  
Tract Infections ◽  
Very High

Background: Pharmacists have the authorization to prescribe medications for the treatment of uncomplicated urinary tract infections (UTI) in some provinces. However, there are limited data on the outcomes of this care by pharmacists. Our objective was to evaluate the effectiveness, safety and patient satisfaction with pharmacist prescribing and care in patients with uncomplicated UTI. Methods: We conducted a prospective registry trial in 39 community pharmacies in the Canadian province of New Brunswick. Adult patients were enrolled if they presented to the pharmacy with either symptoms of UTI with no current antibacterial treatment (Pharmacist-Initial Arm) or if they presented with a prescription for an antibacterial to treat UTI from another health care provider (Physician-Initial Arm). Pharmacists assessed patients and if they had complicating factors or red flags for systemic illness or pyelonephritis, they were excluded from the study. Pharmacists either prescribed antibacterial therapy, modified antibacterial therapy, provided education only or referred to physician, as appropriate. The primary outcome was clinical cure at 2 weeks and the secondary outcomes included adverse events and patient satisfaction. Results: A total of 750 patients were enrolled (87.4% in the Pharmacist-Initial Arm), average age was 40.9 (SD 16.0) years. Clinical cure was achieved in 88.9% of patients. Of those that did not have sustained symptom resolution, most (5.5% overall) had symptom recurrence after completion of therapy. Adverse events were reported by 7.2% of patients and 88.9% of those continued their medication. Most adverse events were gastrointestinal-related and transient. The patient satisfaction survey reflected very high levels of satisfaction for the care they received, as well as for trust and accessibility of the pharmacist. Conclusion: Pharmacist management of uncomplicated UTI is effective, safe, and patient satisfaction appears very high.

scholarly journals Enterococcal Biofilm Formation and Virulence in an Optimized Murine Model of Foreign Body-Associated Urinary Tract Infections

2010 ◽  
Vol 78 (10) ◽  
pp. 4166-4175 ◽  
Author(s):  
Pascale S. Guiton ◽  
Chia S. Hung ◽  
Lynn E. Hancock ◽  
Michael G. Caparon ◽  
Scott J. Hultgren
Keyword(s):  
Urinary Tract ◽  
Foreign Body ◽  
Urinary Tract Infections ◽  
Murine Model ◽  
Biofilm Formation ◽  
Significant Advance ◽  
Virulence Determinants ◽  
Indwelling Catheters ◽  
Tract Infections

ABSTRACT Catheter-associated urinary tract infections (CAUTIs) constitute the majority of nosocomial UTIs and pose significant clinical challenges. Enterococcal species are among the predominant causative agents of CAUTIs. However, very little is known about the pathophysiology of Enterococcus-mediated UTIs. We optimized a murine model of foreign body-associated UTI in order to mimic conditions of indwelling catheters in patients. In this model, the presence of a foreign body elicits major histological changes and induces the expression of several proinflammatory cytokines in the bladder. In addition, in contrast to naïve mice, infection of catheter-implanted mice with Enterococcus faecalis induced the specific expression of interleukin 1β (IL-1β) and macrophage inflammatory protein 1α (MIP-1α) in the bladder. These responses resulted in a favorable niche for the development of persistent E. faecalis infections in the murine bladders and kidneys. Furthermore, biofilm formation on the catheter implant in vivo correlated with persistent infections. However, the enterococcal autolytic factors GelE and Atn (also known as AtlA), which are important in biofilm formation in vitro, are dispensable in vivo. In contrast, the housekeeping sortase A (SrtA) is critical for biofilm formation and virulence in CAUTIs. Overall, this murine model represents a significant advance in the understanding of CAUTIs and underscores the importance of urinary catheterization during E. faecalis uropathogenesis. This model is also a valuable tool for the identification of virulence determinants that can serve as potential antimicrobial targets for the treatment of enterococcal infections.

scholarly journals Antibacterial therapy of the urinary tract infections: Pharmacoeconomic aspect

2015 ◽  
Vol 65 (1) ◽  
pp. 47-57
Author(s):  
Dragana Lakic ◽  
Ivana Tadic ◽  
Marina Odalovic ◽  
Svetlana Kolundzic
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antibacterial Therapy ◽  
Tract Infections
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