Postoperative urinary tract infection after ureteroscopic lithotripsy in patients with asymptomatic bacteriuria

Background/Aim. Postoperative urinary tract infection (UTI) is one of the most common infective complications of ureteroscopic lithotripsy. Preoperative asymptomatic bacteriuria is not a contraindication for performing ureteroscopic lithotripsy but it can be a significant risk factor for occurrence of severe forms of postoperative urinary infection. Methods. From January 2010 until December 2014 at the Urology Clinic of the Military Medical Academy in Belgrade, 389 patients undergoing ureteroscopic lithotripsy were analyzed, and their postoperative infective complications were monitored. From the group, the incidence of posteoperative urinary infection was analysed in 52 patients with preoperative asymptomatic bacteriuria. Results. Infective complications occured in 18.7% of patients, and postoperative UTI in 10% of patients. Out of 52 patients with preoperative asymptomatic bacteriuria, 36.5% had postoperative urinary tract infection (?2 = 46.773; p < 0.001). In these patients, we registered higher frequency of severe forms of postoperative UTI, systemic inflammatory response syndrome (SIRS) and sepsis. Conclusion. Preoperative asymptomatic bacteriuria represents a significant risk factor for developing postoperative UTI following ureteroscopic lithotripsy and is associated with increased risk for occurence of severe forms of SIRS and sepsis. It is desirable that every patient with indicated ureteroscopic lithotripsy has sterile urine culture, and if this is impossible to achieve, a special caution and an adequate antibiotic therapy and prophylaxis are needed before and during the surgical procedure

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Pathogenesis of urinary tract infection

10.1093/med/9780199659579.003.0001 ◽

2017 ◽

Author(s):

Ased Ali

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Urinary Infection ◽

Asymptomatic Bacteriuria ◽

Uropathogenic Escherichia Coli ◽

Systemic Sepsis ◽

Molecular Pattern ◽

Clinical Consequences ◽

Minor Infection

The realization of the harms resulting from indiscriminate use of antibiotics for minor infection has added impetus to the need to understand better the interaction between urogenital tract epithelium and invading bacteria during the initial stages of urinary tract infection (UTI). It is thought that uropathogenic Escherichia coli clones develop in the gut and migrate across the perineum to the urethra and up into the bladder. The response of the epithelium to bacterial adherence and the evolution of the invading bacteria will then govern the clinical consequences. These can vary between rapid invasion and further migration to produce systemic sepsis to tolerance of the bacteria in a planktonic state in asymptomatic bacteriuria. The key to these differences is the activation of epithelial pathogen-associated molecular pattern receptors by expressed proteins on the bacterial cell wall. Increased understanding of these interactions will lead to non-antibiotic-based strategies for clinical management of urinary infection.

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Urinary Tract Infection due to Extended-Spectrum Beta-Lactamase Producing Organisms is a Risk Factor for Acute Kidney Injury among Patients with Type 2 Diabetes Mellitus

Journal of Medicine ◽

10.3329/jom.v19i1.34840 ◽

2017 ◽

Vol 19 (1) ◽

pp. 40-43 ◽

Cited By ~ 1

Author(s):

Muhammad Abdur Rahim ◽

Palash Mitra ◽

Ariful Haque ◽

Shahana Zaman ◽

Tabassum Samad ◽

...

Keyword(s):

Acute Kidney Injury ◽

Urinary Tract Infection ◽

Risk Factor ◽

Urinary Tract ◽

Significant Risk ◽

Kidney Injury ◽

Significant Risk Factor ◽

Beta Lactamase ◽

Type 2 Diabetic

Background: Urinary tract infection (UTI) is common and diabetic patients are at increased risk for UTI. UTI may be complicated by acute kidney injury (AKI). This study was designed to evaluate whether UTI due to extend ed-spectrum beta-lactamase (ESBL) producing organisms should be considered as a risk factor for AKI in type 2 diabetic subjects.Methods: This case-control study was done in a tertiary care hospital in Dhaka, Bangladesh from April to June 2016. Type 2 diabetic subjects with culture proven UTI were evaluated. Patients with UTI complicated by AKI were cases and those without AKI were taken as controls. ESBL-positivity of the isolated organisms was evaluated as risk factor for AKI.Results: During the study period, a total of 131 (male to female ratio 1:2.6) type 2 diabetic subjects with culture proven UTI were enrolled. Mean age and mean duration of diabetes were 56.1±13.3 and 8.7±5.4 years respectively. Escherichia coli (82, 62.6%) was the commonest aetiological agent followed by Klebsiella pneumoniae(14, 10.7%). Two-thirds (55/82, 67.1%) of E. coli and two-fifths (6/14, 42.9%) of Klebsiellae were ESBL-positive. UTI in 64 (48.9%) patients were due to ESBL-positive organisms. Out of 131 UTI patients, 62 (47.3%) had AKI; 40 (40/64, 62.5%) among ESBL-positive and 22 (22/67, 32.8%) among non-ESBL organisms. There were no significant difference in relation to age (p=0.71), sex (p=0.26), duration of diabetes (p=0.37) and glycated haemoglobin (HbA1c) (p=0.69) between cases and controls. ESBL-positivity appeared as a significant risk factor for AKI among the study subjects (OR=3.4, 95% CI=1.66-6.99, p=0.008).Conclusions: Almost half of the type 2 diabetic subjects with UTI had ESBL-positive organisms as aetiological agents in this study. UTI due to ESBL-positive organisms was a significant risk factor for AKI.J MEDICINE Jan 2018; 19 (1) : 40-43

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Complicated Urinary Tract Infection in Adults

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2005/385768 ◽

2005 ◽

Vol 16 (6) ◽

pp. 349-360 ◽

Cited By ~ 121

Author(s):

LE Nicolle

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Antimicrobial Therapy ◽

Current Knowledge ◽

Urinary Infection ◽

Asymptomatic Bacteriuria ◽

Complicated Urinary Tract Infection ◽

Urine Specimen ◽

Infecting Organisms

BACKGROUND: Complicated urinary tract infection occurs in individuals with functional or structural abnormalities of the genitourinary tract.OBJECTIVE: To review current knowledge relevant to complicated urinary tract infection, and to provide evidence-based recommendations for management.METHODS: The literature was reviewed through a PubMed search, and additional articles were identified by journal reference review. A draft guideline was prepared and critically reviewed by members of the Association of Medical Microbiology and Infectious Disease Canada Guidelines Committee, with modifications incorporated following the review.RESULTS: Many urological abnormalities may be associated with complicated urinary infection. There is a wide spectrum of potential infecting organisms, and isolated bacteria tend to be more resistant to antimicrobial therapy. Morbidity and infection outcomes in subjects with complicated urinary infection are principally determined by the underlying abnormality rather than the infection. Principles of management include uniform collection of a urine specimen for culture before antimicrobial therapy, characterization of the underlying genitourinary abnormality, and nontreatment of asymptomatic bacteriuria except before an invasive genitourinary procedure. The antimicrobial regimen is determined by clinical presentation, patient tolerance, renal function and known or anticipated infecting organisms. If the underlying abnormality contributing to the urinary infection cannot be corrected, then early post-treatment recurrence of infection is anticipated.CONCLUSIONS: The management of complicated urinary infection is individualized depending on patient variables and the infecting organism. Further clinical investigations are necessary to assist in determining optimal antimicrobial regimens.

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Urinary Tract Infections in Children

The Journal of Pediatric Academy ◽

10.51271/jpea-2021-0121 ◽

2021 ◽

pp. 1-8

Author(s):

Hakan M. Poyrazoğlu ◽

Sibel Yel

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Urinary Tract Infections ◽

Bacterial Infections ◽

Significant Risk ◽

Significant Risk Factor ◽

Appropriate Treatment ◽

Tract Infections ◽

Kidney Scarring

Urinary tract infections are one of the most common bacterial infections in children. It may cause severe complications in both acute and chronic periods. Escherichia coli is the most common microorganism that causes urinary tract infections in children. Recurrent urinary tract infection is a significant risk factor for kidney scarring. Early diagnosis and appropriate treatment of urinary tract infection, as well as determination of risk factors and prevention of recurrent urinary tract infections, should be the most critical goals in managing children with urinary tract infections.

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Reduced urinary excretion of neutrophil gelatinase-associated lipocalin as a risk factor for recurrence of febrile urinary tract infection in children

Pediatric Nephrology ◽

10.1007/s00467-020-04863-2 ◽

2021 ◽

Author(s):

Sohsaku Yamanouchi ◽

Takahisa Kimata ◽

Yuko Akagawa ◽

Shohei Akagawa ◽

Jiro Kino ◽

...

Keyword(s):

Urinary Tract Infection ◽

Risk Factor ◽

Urinary Tract ◽

Tract Infection ◽

Urinary Excretion ◽

Febrile Urinary Tract Infection ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Neutrophil Gelatinase ◽

Risk Factor For Recurrence

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Risk factors for hospital readmission following complicated urinary tract infection

Scientific Reports ◽

10.1038/s41598-021-86246-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Tanya Babich ◽

Noa Eliakim-Raz ◽

Adi Turjeman ◽

Miquel Pujol ◽

Jordi Carratalà ◽

...

Keyword(s):

Risk Factors ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Medical Condition ◽

Hospital Readmissions ◽

Multivariable Analysis ◽

Significant Risk ◽

Complicated Urinary Tract Infection ◽

Negative Influence

AbstractHospital readmissions following severe infections are a major economic burden on the health care system and have a negative influence on patients' quality of life. Understanding the risk factors for readmission, particularly the extent to which they could be prevented, is of a great importance. In this study we evaluated potentially preventable risk factors for 60-day readmission in patients surviving hospitalization for complicated urinary tract infection (cUTI). This was a multinational, multicentre retrospective cohort study conducted in Europe and the Middle East. Our cohort included survivors of hospitalization due to cUTI during the years 2013–2014. The primary outcome was 60-day readmission following index hospitalization. Patient characteristics that could have influenced readmission: demographics, infection presentation and management, microbiological and clinical data; were collected via computerized medical records from infection onset up to 60 days after hospital discharge. Overall, 742 patients were included. The cohort median age was 68 years (interquartile range, (IQR) 55–80) and 43.3% (321/742) of patients were males. The all-cause 60-day readmission rate was 20.1% (149/742) and more than half were readmitted for infection [57.1%, (80/140)]. Recurrent cUTI was the most frequent cause for readmission [46.4% (65/140)]. Statistically significant risk factors associated with 60-day readmission in multivariable analysis were: older age (odds ratio (OR) 1.02 for an one-year increment, confidence interval (CI) 1.005–1.03), diabetes mellitus (OR 1.63, 95% CI 1.04–2.55), cancer (OR 1.7, 95% CI 1.05–2.77), previous urinary tract infection (UTI) in the last year (OR 1.8, 95% CI: 1.14–2.83), insertion of an indwelling bladder catheter (OR 1.62, 95% CI 1.07–2.45) and insertion of percutaneous nephrostomy (OR 3.68, 95% CI 1.67–8.13). In conclusion, patients surviving hospitalization for cUTI are frequently re-hospitalized, mostly for recurrent urinary infections associated with a medical condition that necessitated urinary interventions. Interventions to avoid re-admissions should target these patients.

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