scholarly journals Pathogenic Mechanisms of Acute Obstructive Pyelonephritis

2021 ◽  
Vol 9 (F) ◽  
pp. 124-128
Author(s):  
Yerzhan Sharapatov ◽  
Yermek Turgunov ◽  
Alyena Lavrinenko
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Kidney Diseases ◽  
Adult Population ◽  
Complicated Urinary Tract Infection ◽  
Disease Development ◽  
Number Of Patients ◽  
The World ◽  
Urological Diseases ◽  
Obstructive Pyelonephritis

Among urological diseases, the most relevant is infection of the urinary tract. Pyelonephritis is on the 5th place in kidney diseases, and obstructive pyelonephritis occurs in 84% of all pyelonephritis. In the world, among the adult population, 100 people per 100,000 of the population suffer from pyelonephritis. In addition, from year to year, there is an increase in purulent forms of acute pyelonephritis by 4–5 times. This pathology is a separated manifestation of such an important urological problem as complicated urinary tract infection, which accounts for 84–86% of all infections. In acute obstructive pyelonephritis, more severe complications such as bacteriotoxic shock and urosepsis may develop. The mortality rate from these dangerous complications reaches 70–90%. In addition, the number of patients with urosepsis and bacteriotoxic shock has increased 4–6 times in recent years. The review presents current literature data on acute obstructive pyelonephritis. The main causes and pathogenetic mechanisms of the disease development are presented.

scholarly journals Risk factors for hospital readmission following complicated urinary tract infection

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.

scholarly journals MR-Proadrenomedullin as biomarker of renal damage in urinary tract infection in children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rafael Peñalver Penedo ◽  
Marta Rupérez Lucas ◽  
Luis Antonio Álvarez-Sala Walther ◽  
Alicia Torregrosa Benavent ◽  
María Luisa Casas Losada ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Adult Population ◽  
Roc Curves ◽  
Renal Scintigraphy ◽  
Reactive Protein ◽  
Sensitivity Specificity

Abstract Background Midregional-proadrenomedullin (MR-proADM) is a useful prognostic peptide in severe infectious pathologies in the adult population. However, there are no studies that analyze its utility in febrile urinary tract infection (fUTI) in children. An accurate biomarker would provide an early detection of patients with kidney damage, avoiding other invasive tests like renal scintigraphy scans. Our objective is to study the usefulness of MR-proADM as a biomarker of acute and chronic renal parenchymal damage in fUTI within the pediatric population. Methods A prospective cohort study was conducted in pediatric patients with fUTI between January 2015 and December 2018. Plasma and urine MR-proADM levels were measured at admission in addition to other laboratory parameters. After confirmation of fUTI, renal scintigraphy scans were performed during the acute and follow-up stages. A descriptive study has been carried out and sensitivity, specificity and ROC curves for MR-proADM, C-reactive protein, and procalcitonin were calculated. Results 62 pediatric patients (34 female) were enrolled. Scintigraphy showed acute pyelonephritis in 35 patients (56.5%). Of those patients, the median of plasmatic MR-proADM (P-MR-proADM) showed no differences compared to patients without pyelonephritis. 7 patients (11.3%) developed renal scars (RS). Their median P-MR-proADM levels were 1.07 nmol/L (IQR 0.66–1.59), while in patients without RS were 0.48 nmol/L (0.43–0.63) (p < 0.01). The AUC in this case was 0.92 (95% CI 0.77–0.99). We established an optimal cut-off point at 0.66 nmol/L with sensitivity 83.3% and specificity 81.8%. Conclusion MR-ProADM has demonstrated a poor ability to diagnose pyelonephritis in pediatric patients with fUTI. However, P-MR-proADM proved to be a very reliable biomarker for RS prediction.

Cefoxitin sodium in complicated urinary tract infection

1978 ◽  
Vol 4 (suppl B) ◽  
pp. 255-256
Author(s):  
P. J. Little ◽  
B. A. Peddie ◽  
S. Pearson
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Complicated Urinary Tract Infection

scholarly journals EVALUATION OF THE MICROBIAL PROFILE AND ANTIBIOTIC RESISTANCE OF BACTERIA CAUSING URINARY TRACT INFECTION IN THE CHILDREN OF KYIV REGION

2016 ◽  
pp. 43-49
Author(s):  
О. Lavrenchuk ◽  
І. Bagdasarova
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Acquired Resistance ◽  
High Sensitivity ◽  
E Coli ◽  
Microbial Profile ◽  
Number Of Patients ◽  
Causative Agents ◽  
Resistance To Penicillin

The rapid growth of the acquired resistance of bacteria to antibacterial agents requires a revision of the selection ofempirical antimicrobial therapy in children with urinary tract infection (UTI). The aim of this work was to investigate the etiological structure of uropathogen flora and its sensitivity to nitrofurantoin and antibacterial drugs ofother classes in children with UTI in Kyiv and region. Materials and methods. Were examined in 95 children aged 3 to 17years in the aediatric Nephrology Department of, Institute of Nephrology NAMS of Ukraine” on the basis of clinical hospital №7 Kyiv city in 2015-2016. The disease duration ofthepatients rangedfrom 3 months to 4years. Results.The microbial spectrum of the urine depended on theform of pyelonephritis, but all patients were dominated by enterobacteria E. coli and Kl. pneumoniae. The greatest number of patients was resistant to ampicillin, co-trimoxazol and cefuroxime – 10.5% of patients with acute and 17.2% with chronic pyelonephritis. The highest sensitivity was preserved in all patients before medications meronem and gentamicin – 100% and 94.7%, respectively. Most children in Kyiv and Kyiv region showed a high sensitivity to nitrofurantoin:furamag – 78.9-75.8%,furagin - 63.8-65.5%. Comparative analysis of therapeutic efficiency of drugsfuramag and co-trimoxazol, demonstrated greater therapeutic efficacy of nitro- furans in the absence of recurrences, compared with co-trimoxazol (Oto 1.68withp=0.021). Conclusions. Among the causative agents of UTI in children of the city of Kyiv and Kyiv region was dominated by gram-negativeflora - E. coli and Kl. pneumoniae. High sensitivity to nitrofurantoin drugs, especiallyfuramag, cephalosporins, and gentamicin and meronem was documented. High rates of resistance to penicillin and co-trimoxazol was revealed. The use of the drugfuramag contributed to a more rapid, complete andpersistent normalization ofclinical and laboratory parameters in children with UTI.

scholarly journals Antibacterial data synthesis challenges: a systematic review of treatments for complicated gram-negative urinary tract infections

2021 ◽  
Author(s):  
Ryan Dillon ◽  
Jennifer Uyei ◽  
Rajpal Singh ◽  
Eilish McCann
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Meta Analysis ◽  
Complicated Urinary Tract Infection ◽  
Clinical Trial Data ◽  
Patient Characteristics ◽  
Heterogeneous Data ◽  
Eligibility Criteria ◽  
Tract Infections

Aim: To determine the suitability of network meta-analysis (NMA) using antibacterial treatment evidence in complicated urinary tract infection. Materials & methods: We conducted a systematic literature review to identify published clinical trial data for complicated urinary tract infection treatments. We performed a feasibility assessment to determine whether the available evidence would support the creation of a robust NMA, considering key assumptions of homogeneity, similarity and consistency. Results: Twenty-five trials met eligibility criteria. Risk of bias was low, and individual studies met their primary end point(s). Assumptions central to the conduct of a robust NMA were not met. Heterogeneity was ubiquitous, including baseline pathogen, treatment and patient characteristics. Conclusion: Limited and heterogeneous data identified make the use of NMA to compare novel antibacterial agents impractical and likely unreliable.

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