The factors affecting inadequate empirical antimicrobial therapy and clinical course in upper urinary tract infections of the elderly patients

Infection is the most common complication during pregnancy and the postpartum period. Choices are limited for antibiotic therapy are limited. One must take into account the effect of pregnancy on serum levels, distribution of antibiotics, placental transfer, the fetus, the newborn, excretion in milk, the breast-feeding infant. Antimicrobial therapy is selected on the basis of experience and guidelines. Diagnosis and treatment of urinary tract infections, bacterial vaginosis, preterm labor, preterm rupture of membranes, intra-amniotic infection, and major perinatal and puerperal infections are reviewed.

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Evidence-Informed Practice: Diagnostic Questions in Urinary Tract Infections in the Elderly

Western Journal of Emergency Medicine ◽

10.5811/westjem.2019.5.42096 ◽

2019 ◽

Vol 20 (4) ◽

pp. 573-577 ◽

Cited By ~ 2

Author(s):

Richard Pescatore ◽

Joshua Niforatos ◽

Salim Rezaie ◽

Anand Swaminathan

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

The Elderly ◽

Tract Infections

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Increased community-acquired upper urinary tract infections caused by extended-spectrum beta-lactamase-producing Escherichia coli in children and the efficacy of flomoxef and cefmetazole

Clinical and Experimental Nephrology ◽

10.1007/s10157-019-01775-w ◽

2019 ◽

Vol 23 (11) ◽

pp. 1306-1314 ◽

Cited By ~ 3

Author(s):

Akiyoshi Horie ◽

Akiyoshi Nariai ◽

Fumihide Katou ◽

Yasuhiro Abe ◽

Yuya Saito ◽

...

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Upper Urinary Tract ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

Extended Spectrum ◽

Tract Infections

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Increased human pathogenic potential of Escherichia coli from polymicrobial urinary tract infections in comparison to isolates from monomicrobial culture samples

Journal of Medical Microbiology ◽

10.1099/jmm.0.020602-0 ◽

2011 ◽

Vol 60 (1) ◽

pp. 102-109 ◽

Cited By ~ 37

Author(s):

Gemma Croxall ◽

Vivienne Weston ◽

Susan Joseph ◽

Georgina Manning ◽

Phil Cheetham ◽

...

Keyword(s):

Urinary Tract ◽

Elderly Patients ◽

Urinary Tract Infections ◽

Standard Procedure ◽

Bacterial Species ◽

Cell Infection ◽

Pathogenic Potential ◽

Increased Risk ◽

Tract Infections

The current diagnostic standard procedure outlined by the Health Protection Agency for urinary tract infections (UTIs) in clinical laboratories does not report bacteria isolated from samples containing three or more different bacterial species. As a result many UTIs go unreported and untreated, particularly in elderly patients, where polymicrobial UTI samples are especially prevalent. This study reports the presence of the major uropathogenic species in mixed culture urine samples from elderly patients, and of resistance to front-line antibiotics, with potentially increased levels of resistance to ciprofloxacin and trimethoprim. Most importantly, the study highlights that Escherichia coli present in polymicrobial UTI samples are statistically more invasive (P<0.001) in in vitro epithelial cell infection assays than those isolated from monomicrobial culture samples. In summary, the results of this study suggest that the current diagnostic standard procedure for polymicrobial UTI samples needs to be reassessed, and that E. coli present in polymicrobial UTI samples may pose an increased risk to human health.

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