scholarly journals 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

2017 ◽  
Vol 19 (1) ◽  
pp. 40-43 ◽  
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

scholarly journals Urinary Tract Infection due to Extended-spectrum Beta-lactamase Producing Organisms is a Risk Factor for Bacteraemia Among Patients with Type 2 Diabetes Mellitus

2019 ◽  
Vol 31 (1) ◽  
pp. 9-12
Author(s):  
Muhammad Abdur Rahim ◽  
Shahana Zaman ◽  
Ishrat Jahan ◽  
Samira Humaira Habib ◽  
Tabassum Samad ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Urinary Tract Infection ◽  
Risk Factor ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Type 2 Diabetic

Introduction: Urinary tract infection (UTI) is common among patients with diabetes mellitus and the aetiological agents are often extended-spectrum beta-lactamase (ESBL) producing bacteria. Diabetic patients with UTI are sometimes complicated by bacteraemia. This study was designed to evaluate whether UTI due to ESBL-positive organisms is a risk factor for bacteraemia among patients with type 2 diabetes mellitus. Methods: This was a cross-sectional analytical study, done in BIRDEM General Hospital, Dhaka, Bangladesh from January to April 2016. Adult (e”18 years) type 2 diabetic subjects of either sex with culture proven UTI were included in this study. All study participants were subjected to undergo blood cultures as well. ESBL-positivity of the infective organisms for UTI was evaluated as possible risk factor for bacteraemia. Results: Total patients were 145 including 119 (82%) females. Eshcerichia coli (112, 77.2%) was the most common aetiological agents followed by Klebsiella pneumoniae (28, 19.3%). In 54 (37.2%) patients UTI was due to ESBL-positive organisms. Ten (6.9%) patients were complicated by bacteraemia [7 (7/ 54, 13%) among patients with UTI due to ESBL-positive organisms and 3 (3/91, 3.3%) among patients with UTI due to non-ESBL organisms]. UTI due to ESBL-positive organisms appeared as a significant risk factor for bacteraemia (OR 4.37, 95% CI 1.08-17.38, p 0.03). Conclusion: Nearly two-fifths of UTI cases were due to ESBL-positive organisms in this study. ESBLpositivity of the causative organisms was a significant risk factor for bacteraemia among type 2 diabetic subjects. Bangladesh J Medicine Jan 2020; 31(1) : 9-12

scholarly journals Urolithiasis Is a Risk Factor for Uroseptic Shock and Acute Kidney Injury in Patients With Urinary Tract Infection

2019 ◽  
Vol 6 ◽  
Author(s):  
Chih-Yen Hsiao ◽  
Tsung-Hsien Chen ◽  
Yi-Chien Lee ◽  
Meng-Chang Hsiao ◽  
Peir-Haur Hung ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Urinary Tract Infection ◽  
Risk Factor ◽  
Urinary Tract ◽  
Tract Infection ◽  
Kidney Injury

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

2020 ◽  
Vol 77 (9) ◽  
pp. 917-922
Author(s):  
Mirko Jovanovic ◽  
Vesna Suljagic ◽  
Vladimir Bancevic
Keyword(s):  
Urinary Tract Infection ◽  
Risk Factor ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Infection ◽  
Asymptomatic Bacteriuria ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Ureteroscopic Lithotripsy ◽  
Infective Complications

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

scholarly journals Community- versus hospital-acquired acute kidney injury in hospitalised COVID-19 patients

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jack S Bell ◽  
Benjamin D James ◽  
Saif Al-Chalabi ◽  
Lynne Sykes ◽  
Philip A Kalra ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Acute Kidney Injury ◽  
Risk Factor ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Significant Risk ◽  
Kidney Injury ◽  
Significant Risk Factor ◽  
Hospital Acquired

Abstract Background Acute kidney injury (AKI) is a recognised complication of coronavirus disease 2019 (COVID-19), yet the reported incidence varies widely and the associated risk factors are poorly understood. Methods Data was collected on all adult patients who returned a positive COVID-19 swab while hospitalised at a large UK teaching hospital between 1st March 2020 and 3rd June 2020. Patients were stratified into community- and hospital-acquired AKI based on the timing of AKI onset. Results Out of the 448 eligible patients with COVID-19, 118 (26.3 %) recorded an AKI during their admission. Significant independent risk factors for community-acquired AKI were chronic kidney disease (CKD), diabetes, clinical frailty score and admission C-reactive protein (CRP), systolic blood pressure and respiratory rate. Similar risk factors were significant for hospital-acquired AKI including CKD and trough systolic blood pressure, peak heart rate, peak CRP and trough lymphocytes during admission. In addition, invasive mechanical ventilation was the most significant risk factor for hospital-acquired AKI (adjusted odds ratio 9.1, p < 0.0001) while atrial fibrillation conferred a protective effect (adjusted odds ratio 0.29, p < 0.0209). Mortality was significantly higher for patients who had an AKI compared to those who didn’t have an AKI (54.3 % vs. 29.4 % respectively, p < 0.0001). On Cox regression, hospital-acquired AKI was significantly associated with mortality (adjusted hazard ratio 4.64, p < 0.0001) while community-acquired AKI was not. Conclusions AKI occurred in over a quarter of our hospitalised COVID-19 patients. Community- and hospital-acquired AKI have many shared risk factors which appear to converge on a pre-renal mechanism of injury. Hospital- but not community acquired AKI was a significant risk factor for death.

scholarly journals Ureteral stone with hydronephrosis and urolithiasis alone are risk factors for acute kidney injury in patients with urinary tract infection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chih-Yen Hsiao ◽  
Tsung-Hsien Chen ◽  
Yi-Chien Lee ◽  
Ming-Cheng Wang
Keyword(s):  
Acute Kidney Injury ◽  
Urinary Tract Infection ◽  
Risk Factor ◽  
Urinary Tract ◽  
Tract Infection ◽  
Care Setting ◽  
Ureteral Stone ◽  
Multivariate Logistic Regression Analysis ◽  
Kidney Injury ◽  
Increased Risk

AbstractTo identify whether urolithiasis with or without hydronephrosis has an impact on acute kidney injury (AKI) in patients with urinary tract infection (UTI). This study aimed to identify whether urolithiasis with or without hydronephrosis has an impact on AKI in patients with UTI. This retrospective study enrolled hospitalized UTI patients who underwent imaging in an acute care setting from January 2006 to April 2019. Of the 1113 participants enrolled, 191 (17.2%) had urolithiasis and 76 (6.8%) had ureteral stone complicated with hydronephrosis. Multivariate logistic regression analysis showed that in UTI patients with urolithiasis, the presence of ureteral stone with concomitant hydronephrosis was an independent risk factor for AKI (odds ratio [OR] 2.299, 95% confidence interval [CI] 1.112–4.755, P = 0.025). In addition, urolithiasis was associated with an increased risk for AKI (OR 2.451, 95% CI 1.369–4.389, P = 0.003) in UTI patients without hydronephrosis. The presence of ureteral stone with hydronephrosis increases the risk for AKI of UTI patients with urolithiasis, and urolithiasis remains a risk factor of AKI in UTI patients without hydronephrosis.

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