scholarly journals Urinary Tract Infections with Non-Escherichia coli Pathogens in Children: An Observational Study

2020 ◽  
Vol 12 (4) ◽  
Author(s):  
Mitra Naseri ◽  
Gholam Reza Sarvari ◽  
Niayesh Tafazoli ◽  
Nooshin Tafazoli

Background: Urinary tract infections (UTIs) with non-Escherichia coli (E. coli) species are associate with urological abnormalities. Objectives: To compare the prevalence of non-E. coli infections in patients with urological anomalies, neurogenic bladder dysfunction, and those with apparently normal urinary systems. Methods: Pediatric nephrology clinic at a tertiary-care center in east of Iran. Children affected by UTI enrolled from 2003 to 2016. The results of urine culture were noted at enrolment. Cases with nephrolithiasis who had normal voiding cystourethrogram were excluded. After the implementation of imaging and urodynamic examinations, 832 patients enrolled according to the following inclusion criteria: cases with vesicoureteral reflux, urinary obstruction, neurogenic bladder, and patients with apparently normal urinary tract. The prevalence of infections with E. coli vs. non-E. coli pathogens were compared between different groups of enrolled cases. Results: In this study, 62.26% of the subjects had a normal urinary system, while 33.77%, 3.97%, and 2.4% of whom had vesicoureteral reflux, neurogenic bladder, and obstruction, respectively. Non-E. coli pathogens were responsible for infections in 17.29%, 19.39%, 33.74%, and 17.15% of these cases, respectively. Infections with non-E. coli pathogens were significantly more prevalent in cases with neurogenic bladder (P = 0.003). Pseudomonas species were responsible for 4/125, 5/118, 5/28, and 0/6 episodes of non-E. coli infections in cases with apparently normal urinary system, patients with vesicoureteral reflux, cases with neurogenic bladder, and those with urinary obstruction, respectively (P = 0.004). Conclusions: Infections with non-E. coli and also Pseudomonas species are significantly more prevalent in patients with neurogenic bladder dysfunction rather than those with urological abnormalities and/or cases with apparently normal urinary system.

2012 ◽  
Vol 2012 ◽  
pp. 1-16 ◽  
Author(s):  
Peter T. Dorsher ◽  
Peter M. McIntosh

Congenital anomalies such as meningomyelocele and diseases/damage of the central, peripheral, or autonomic nervous systems may produce neurogenic bladder dysfunction, which untreated can result in progressive renal damage, adverse physical effects including decubiti and urinary tract infections, and psychological and social sequelae related to urinary incontinence. A comprehensive bladder-retraining program that incorporates appropriate education, training, medication, and surgical interventions can mitigate the adverse consequences of neurogenic bladder dysfunction and improve both quantity and quality of life. The goals of bladder retraining for neurogenic bladder dysfunction are prevention of urinary incontinence, urinary tract infections, detrusor overdistension, and progressive upper urinary tract damage due to chronic, excessive detrusor pressures. Understanding the physiology and pathophysiology of micturition is essential to select appropriate pharmacologic and surgical interventions to achieve these goals. Future perspectives on potential pharmacological, surgical, and regenerative medicine options for treating neurogenic bladder dysfunction are also presented.


2020 ◽  
Vol 34 (12) ◽  
pp. 1458-1464
Author(s):  
Derick T Wade ◽  
James Cooper ◽  
Nicholas Peckham ◽  
Maurizio Belci

Objective: To establish the feasibility of a randomized, placebo-controlled trial to investigate the effect of a specific immunotherapy bacterial lysate OM-89 (Uro-Vaxom®) in reducing the frequency of urinary tract infections in people with neurogenic bladder dysfunction. Design: A parallel-group, double-blind, randomized, placebo-controlled trial. Setting: Patients at home, recruited through out-patient contact, social media and patient support groups. Subjects: People with a spinal cord injury, multiple sclerosis, transverse myelitis or cauda equina syndrome who had suffered three or more clinically diagnosed urinary tract infections treated with antibiotics over the preceding 12 months. Interventions: All participants took one capsule of oral OM-89 immunotherapy (6 mg) or matching Placebo (randomisation ratio 1:1), once daily in the morning for 3 months. Main measures: The primary outcome was occurrence of a symptomatic urinary tract infection treated with an antibiotic, assessed at 3 and 6 months. Feasibility measures included recruitment, retention and practical difficulties. Results: Of 115 patients screened, 49 were recruited, one withdrew before randomization, and 23 were allocated to the control group receiving matching placebo. Six participants, all in the control group, discontinued the intervention; all participants provided full data at both follow-up times. Over 6 months, 18/25 active group patients had 55 infections, and 18/23 control group patients had 47 infections. Most research and clinical procedures were practical, and acceptable to participants. Conclusion: It is feasible to undertake a larger trial. We recommend broader inclusion criteria to increase eligibility and generalizability.


2021 ◽  
Vol 9 (2) ◽  
pp. 310
Author(s):  
Masayuki Hashimoto ◽  
Yi-Fen Ma ◽  
Sin-Tian Wang ◽  
Chang-Shi Chen ◽  
Ching-Hao Teng

Uropathogenic Escherichia coli (UPEC) is a major bacterial pathogen that causes urinary tract infections (UTIs). The mouse is an available UTI model for studying the pathogenicity; however, Caenorhabditis elegans represents as an alternative surrogate host with the capacity for high-throughput analysis. Then, we established a simple assay for a UPEC infection model with C. elegans for large-scale screening. A total of 133 clinically isolated E. coli strains, which included UTI-associated and fecal isolates, were applied to demonstrate the simple pathogenicity assay. From the screening, several virulence factors (VFs) involved with iron acquisition (chuA, fyuA, and irp2) were significantly associated with high pathogenicity. We then evaluated whether the VFs in UPEC were involved in the pathogenicity. Mutants of E. coli UTI89 with defective iron acquisition systems were applied to a solid killing assay with C. elegans. As a result, the survival rate of C. elegans fed with the mutants significantly increased compared to when fed with the parent strain. The results demonstrated, the simple assay with C. elegans was useful as a UPEC infectious model. To our knowledge, this is the first report of the involvement of iron acquisition in the pathogenicity of UPEC in a C. elegans model.


Viruses ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1348
Author(s):  
Lívia Slobodníková ◽  
Barbora Markusková ◽  
Michal Kajsík ◽  
Michal Andrezál ◽  
Marek Straka ◽  
...  

Urinary tract infections (UTIs) are among the events that most frequently need medical intervention. Uropathogenic Escherichia coli are frequently their causative agents and the infections are sometimes complicated by the presence of polyresistant nosocomial strains. Phage therapy is a tool that has good prospects for the treatment of these infections. In the present study, we isolated and characterized two bacteriophages with broad host specificity against a panel of local uropathogenic E. coli strains and combined them into a phage cocktail. According to genome sequencing, these phages were closely related and belonged to the Tequatrovirus genus. The newly isolated phages showed very good activity on a panel of local clinical E. coli strains from urinary tract infections. In the form of a two-phage cocktail, they were active on E. coli strains belonging to phylogroups B2 and D, with relatively lower activity in B1 and no response in phylogroup A. Our study is a preliminary step toward the establishment of a national phage bank containing local, well-characterized phages with therapeutic potential for patients in Slovakia.


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