scholarly journals Oral D mannose in the prevention and treatment of recurrent urinary tract infections: A review

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Daniele Porru ◽  
Annalisa De Silvestri ◽  
Edda Buffa ◽  
Catherine Klersy ◽  
Barbara Gardella ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Antibiotic Prophylaxis ◽  
Urinary Tract Infections ◽  
Resistant Bacteria ◽  
Control Groups ◽  
Recurrent Utis ◽  
Recurrent Urinary Tract Infections ◽  
Long Term Treatment ◽  
Significant Difference ◽  
Tract Infections

The results of several studies reveal that antibiotics may promote treatment resistance by causing alterations in the intestinal flora. The development of a gut reservoir of resistant bacteria promotes the development of UTIs through autoinfection. This review aims to address clinical reliability, efficacy and safety of long-term treatment with oral D mannose for the prevention of Recurrent Urinary Tract Infections (RUTI) in females. A comprehensive MEDLINE, Embase, Scopus and Cochrane search was performed for English language reports published before December 2018 using the term “recurrent urinary tract infections and D mannose” was carried out. We searched Medline, Embase, Scopus and the Cochrane Register of Controlled Trials from January 2010 to December 2018. Eligible studies did not include non-oral therapy, local (vaginal) treatment in women with recurrent UTIs. We identified eligible original articles. A few limitations of the review are the heterogeneity of the available studies, their different rational and aim, the assumption of D mannose for prophylaxis or treatment of recurrent UTIs. Oral D mannose performs well in the prevention of UTIs recurrences, significant improvement of urinary symptoms was observed, the disease- free time was longer in the groups of patients under prophylaxis with D mannose in comparison with control groups (no treatment, antibiotic prophylaxis, prophylaxis with Proanthocyanidin (PAC) etc. The review has limitations, as the studies are heterogeneous, the meta-analysis requires classifications that can also be arbitrary. Furthermore, single-arm studies are not included. Some of the authors found this evidence inconclusive, which results as a limitation of the study. D mannose prolonged the recurrence-free interval of recurrent UTIs, thus reducing the prolonged or cyclical use of antibiotics, improving clinical symptoms, with a significant difference between treatment and control groups (no treatment, antibiotic prophylaxis, prophylaxis with Proanthocyanidin). However, most clinical trials used an association of different substances commingled with D mannose, dosages and regimens of D mannose were different. For this reason, the evidence of the efficacy of D mannose remains low.

Vitamin D Status has no Influence on the Incidence of Recurrent Urinary Tract Infections after Kidney Transplantation

2014 ◽  
Vol 12 (2) ◽  
pp. 114-118 ◽  
Author(s):  
Jean Jeanov Filipov ◽  
Borelli Kirilov Zlatkov ◽  
Emil Paskalev Dimitrov ◽  
Dobrin A. Svinarov
Keyword(s):  
Vitamin D ◽  
Kidney Transplantation ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Pleiotropic Effects ◽  
Kidney Transplant Recipients ◽  
Recurrent Utis ◽  
Recurrent Urinary Tract Infections ◽  
Significant Difference ◽  
Tract Infections

AbstractIntroduction.Recurrent urinary tract infections (rUTIs) after kidney transplantation (KT) are associated with significant decrease in graft survival. There is a growing body of evidence for the pleiotropic effects of vitamin D (VD), including immunomodulatory and antibacterial effect. The number of studies on VD’s pleiotropic effects in kidney transplant recipients (KTRs) however is low. The aim of our study was to assess the influence of VD on the incidence of recurrent UTIs after KT.Methods. The KTRs were tested for 25-hydroxyvitamin D (25VD) between 1.05.2012 and 30.11.2012. Patients within 12 months of transplantation, performed parathyroidectomy, concomitant intake of calcineurin inhibittors and mTOR inhibitors, advanced liver disease and VD supplementation were excluded from the study. Recurrent UTIs were defined as more than 3 episodes of active UTI within the last 12 months of testing for 25VD. Statistical analysis was carried out with SPSS version 22.0 and included descriptive statistics, Mann-Whitney U test. Determination of total 25VD was performed by a validated LC-MS/MS method.Results.A total of 275 patients met the above-mentioned criteria (males 182, females 93). The mean 25VD in patients with rUTIs (n=14) was 51.41±25.17 nmol/L, whereas in the group without rUTIs (n=261) the level was 60.35±23.29 nmol/L. After matching the two groups for seasonal factors (sampling for 25VD in July, August, September) and gender 169 patients were selected, and 11 were with rUTIs. No significant difference was detected in the 25VD level in the two groups (53.30±18.37 vs 49.08±21.04 nmol/L), p=0.342.Conclusions.Despite the higher 25VD in the KTRs without rUTIs, the difference between the two groups remained insignificant.

scholarly journals A Retrospective Study of Immunotherapy Treatment with Uro-Vaxom (OM-89®) for Prophylaxis of Recurrent Urinary Tract Infections

2020 ◽  
Vol 14 (3) ◽  
pp. 130-134
Author(s):  
Andrew Brodie ◽  
Omar El-Taji ◽  
Ibrahim Jour ◽  
Charlotte Foley ◽  
Damian Hanbury
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Primary Outcome Measure ◽  
Effective Treatment Option ◽  
Recurrent Utis ◽  
Recurrent Uti ◽  
Recurrent Urinary Tract Infections ◽  
Pre Treatment ◽  
The Uk ◽  
Tract Infections

<b><i>Objectives</i></b>: To present our experience with the long-term preventive effect of immunotherapy with Uro-Vaxom® on recurrent urinary tract infections (UTI) in adult patients. <b><i>Materials and Methods</i></b>: Retrospective analysis of 79 patients with recurrent UTI treated with Uro-Vaxom. Recurrent UTIs were defined as ≥ 2 infections in 6 months or ≥ 3 in 12 months. Patients received a 6 mg Uro-Vaxom capsule daily for 90 days followed by discontinuation for 3 months and then administration for the first 10 days of subsequent months 7, 8 and 9 as a ‘booster' regime. The primary outcome measure was the number of UTIs encountered in the 12 months pre-treatment compared to 12 months post-treatment. <b><i>Results</i></b>: There was a significant decrease in the mean number of UTIs in the year following initiation of Uro-Vaxom® compared to the year preceding administration 3.14 versus 1.53 (p < 0.05) respectively. <b><i>Conclusion</i></b>: Uro-Vaxom represents a safe and effective treatment option for prophylaxis of recurrent UTIs. In the UK, Uro-Vaxom is currently unlicensed. This study adds to a growing body of evidence in favor of non-antibiotic immune-prophylaxis for recurrent UTI.

scholarly journals The Urinary Microbiome in Postmenopausal Women with Recurrent Urinary Tract Infections

2020 ◽  
Author(s):  
Monique H. Vaughan ◽  
Jialiang Mao ◽  
Lisa A. Karstens ◽  
Li Ma ◽  
Cindy L. Amundsen ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Recurrent Utis ◽  
Recurrent Urinary Tract Infections ◽  
Vaginal Estrogen ◽  
Menopausal Women ◽  
Culture Independent ◽  
Urinary Microbiome ◽  
Tract Infections ◽  
Phenotypic Groups

ABSTRACTRecurrent urinary tract infections (UTI) are highly prevalent in postmenopausal women, where vaginal estrogen and prophylactic antibiotics are used for treatment. The etiology of recurrent UTIs is not completely known, but the urinary microbiome is thought to be implicated. Thus, we aimed to compare the “steady state” urinary microbiome in three groups of menopausal women who were all using topically-applied vaginal estrogen: 1) women with recurrent UTIs on daily antibiotic prophylaxis; 2) women with recurrent UTIs not on antibiotic prophylaxis; and 3) age-matched controls without recurrent UTIs. Here we present a cross-sectional analysis of baseline data from 64 women enrolled in a longitudinal cohort study. Catheterized urine samples were collected > 4 weeks after last treatment for UTI. Samples were evaluated using expanded quantitative urine culture (EQUC) and 16S rRNA gene sequencing. With EQUC techniques, there were no significant differences in the median numbers of microbial species isolated among groups (p=0.96), even when considering Lactobacilli (p=0.72). However, there were trends towards different Lactobacillus species between groups. With sequencing the overwhelming majority of urinary samples contained Lactobacilli, with non-significant trends in relative abundance of Lactobacilli among groups. Using a Bayesian regression analysis for compositional data, we identified significant differences in anaerobic taxa that were associated with phenotypic groups. Most of these differences centered on Bacteroidales and the family Prevotellaceae, though differences were also noted in Actinobacteria and certain genera of Clostridiales. Associations between anaerobes within the urinary microbiome and recurrent UTI warrants further investigation.IMPORTANCEIn menopausal women with recurrent urinary tract infections (UTIs) compared to those without, the abundance of Lactobacillus within the urinary microbiome is not significantly different when vaginal estrogen is regularly used. In this population, Lactobacillaceae were identified in 97% of urine samples using culture-independent techniques. However, with expanded urine cultures, women with recurrent UTIs taking daily antibiotics had a disproportionately low amount of L. gasseri/L. acidophilus compared to the other phenotypic groups. These findings support the theory that certain Lactobacillus species may be more important than others in the pathophysiology of postmenopausal recurrent UTIs. Furthermore, when using culture-independent techniques to explore urinary microbiota across phenotypic groups, we identified differences in multiple anaerobic taxa. Taken together, these results suggest that altered ratios of anaerobes and certain Lactobacillus species within the urinary microbiome may be implicated in postmenopausal recurrent UTI.

scholarly journals Prevention of Recurrent Urinary Tract Infections in Postmenopausal Women

2014 ◽  
pp. 55-60
Author(s):  
Darrell Fernando ◽  
Budi I Santoso
Keyword(s):  
Systematic Review ◽  
Urinary Tract ◽  
Postmenopausal Women ◽  
Urinary Tract Infections ◽  
Antimicrobial Prophylaxis ◽  
Prophylaxis Group ◽  
Research Article ◽  
Recurrent Urinary Tract Infections ◽  
Significant Difference ◽  
Tract Infections

Objective: To determine the most effective and applicable methods to reduce recurrence of urinary tract infections in postmenopausal women. Method: A search was conducted on Pubmed, NEJM, BMJ, and Google. After screening and selection, six articles were considered useful; comprising of two original research articles, one systematic review, and three society guidelines. Result: Society guidelines recommended continuous antimicrobial prophylaxis, with postcoital antimicrobial prophylaxis as an alternative. The first research article found similar results in continous antimicrobial prophylaxis group and intermittent antimicrobial prophylaxis group. The second research article found no significant difference in cranberry and trimethoprim group. The systematic review revealed vaginal estrogens are effective in preventing recurrent UTI, but the type of estrogen is less clear. Oral estrogens are not effective. Conclusion: Prevention of recurrent urinary tract infections in postmenopausal women include risk factor identification, non-antimicrobial prophylaxis with cranberry and vaginal estrogen preparations, and antimicrobial prophylaxis (continuous or intermittent). Keywords: postmenopausal, prevention, recurrent urinary tract infection.

Intravesical Gentamicin Treatment for Recurrent Urinary Tract Infections Caused by Multidrug Resistant Bacteria

2019 ◽  
Vol 201 (3) ◽  
pp. 549-555 ◽  
Author(s):  
Janneke E. Stalenhoef ◽  
Cees van Nieuwkoop ◽  
Petra H. Menken ◽  
Sandra T. Bernards ◽  
Henk W. Elzevier ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Multidrug Resistant Bacteria ◽  
Recurrent Urinary Tract Infections ◽  
Gentamicin Treatment ◽  
Tract Infections

scholarly journals Incidence of Breakthrough Urinary Tract Infection in Hospitalized Infants Receiving Antibiotic Prophylaxis

2016 ◽  
Vol 56 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Jessica C. Lloyd ◽  
Christoph P. Hornik ◽  
Daniel K. Benjamin ◽  
Reese H. Clark ◽  
Jonathan C. Routh ◽  
...  
Keyword(s):  
Intensive Care ◽  
Urinary Tract ◽  
Antibiotic Prophylaxis ◽  
Urinary Tract Infections ◽  
Neonatal Intensive Care ◽  
Cox Regression ◽  
Prophylactic Antibiotic ◽  
Neonatal Intensive Care Units ◽  
Significant Difference ◽  
Tract Infections

Urinary tract infections (UTIs) are a source of substantial morbidity in children in the neonatal intensive care unit. The incidence of UTIs that occur in critically ill infants during a course of antibiotic prophylaxis (i.e., breakthrough urinary tract infections [BUTIs]) is not known. We investigated the incidence of BUTI in a cohort of infants hospitalized on prophylactic antibiotics in neonatal intensive care units. Predictors of BUTI were evaluated using multivariable Cox regression. Out of 716 787 infants, 631 (0.09%) were prescribed 821 courses of antibiotic prophylaxis. Among this cohort, 60 infants (9.5%) suffered a total of 65 BUTIs. Of all prophylactic antibiotic courses, 65/821 (7.9%) were complicated by BUTI. Klebsiella, Enterobacter, and Escherichia coli species were the most common causes of BUTI. There was no statistically significant difference ( P = .78) in BUTI incidence among the 4 antibiotics assessed (amoxicillin, cephalexin, nitrofurantoin, or trimethoprim-sulfamethoxazole).

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