asymptomatic bacteriuria
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Antibiotics ◽  
2022 ◽  
Vol 11 (1) ◽  
pp. 75
Author(s):  
Tessa M. Z. X. K. van Horrik ◽  
Bart J. Laan ◽  
Tamara N. Platteel ◽  
Suzanne E. Geerlings

Asymptomatic bacteriuria (ASB) is a common finding in certain populations. This study assessed general practitioners’ (GPs’) knowledge about ASB and their current clinical practice regarding urine testing. Methods: An online survey was used for GPs in the Netherlands from October to December 2020. Results: In total, 99 surveys were included in the analyses. All GPs strongly agreed with the statements about their knowledge and self-confidence regarding urine diagnostics and treatment of ASB. The median knowledge score was 4 out of 6 (IQR 2 to 6). Most GPs (64 of 92; 70%) followed the guideline for the choice of urine diagnostics and reported appropriate indications for urine testing. However, 71/94 (75.5%) GPs would treat patients for ASB if they have diabetes mellitus. Further, 34 (37%) of 92 participants would inappropriately repeat a urine test after a patient was treated for a urinary tract infection (UTI). One-third of the GPs responded that ASB was insufficiently addressed within the guidelines for UTI. Conclusion: These results indicate that knowledge about ASB could be improved in primary care in the Netherlands, mainly in diabetic patients that have ASB, as well as for follow-up tests after treatment for UTI.


2021 ◽  
Vol 11 (1) ◽  
pp. 226
Author(s):  
Jens Strohaeker ◽  
Victoria Aschke ◽  
Alfred Koenigsrainer ◽  
Silvio Nadalin ◽  
Robert Bachmann

(1) Background: Urinary tract infections (UTI) are the most common infections after kidney transplantation. Given the risk of urosepsis and the potential threat to the graft, the threshold for treating UTI and asymptomatic bacteriuria with broad spectrum antibiotics is low. Historically fluoroquinolones were prescription favorites for patients that underwent kidney transplantation (KT). After the recent recommendation to avoid them in these patients, however, alternative treatment strategies need to be investigated (2) Methods: We retrospectively analyzed the charts of 207 consecutive adult kidney transplantations that were performed at the department of General, Visceral and Transplantation Surgery of the University Hospital of Tuebingen between January 2015 and August 2020. All charts were screened for the diagnosis and treatment of asymptomatic bacteriuria (ASB) and urinary tract infections (UTI) and the patients’ clinical characteristics and outcomes were evaluated. (3) Results: Of the 207 patients, 68 patients suffered from urinary tract infections. Patients who developed UTI had worse graft function at discharge (p = 0.024) and at the 12 months follow-up (p < 0.001). The most commonly prescribed antibiotics were Ciprofloxacin and Piperacillin/Tazobactam. To both, bacterial resistance was more common in the study cohort than in the control group. (4) Conclusions: Urinary tract infections appear to be linked to worse graft functions. Thus, prevention and treatment should be accompanied by antibiotic stewardship teams.


Author(s):  
S. Roshini ◽  
R. Shruta Lakshanaa ◽  
M. Sivasankar ◽  
M. Griffin ◽  
T. Suhas ◽  
...  

Background: Asymptomatic bacteriuria is the presence of bacteria in the properly collected urine of a patient that has no signs and symptoms of urinary tract infection. Aim: This study was carried out to determine the incidence of asymptomatic bacteriuria in pregnant women in Saveetha medical college, Thandalam, Tamil Nadu. Materials and Methods: A total of 250 pregnant women attending antenatal clinic at civil hospital, Saveetha medical college, over a period of 3 months, with age groups between 18 to 30 years agreed to enter the study and were clinically evaluated. All these women were asked to submit clean catch midstream urine samples and it was examined under the microscope and by culture method. Results: A total of 250 pregnant women included in our study, with varying age groups between 18 to 30 years and the highest incidence was seen in between the 26 to 30 age group. Asymptomatic bacteriuria was seen in 27.2% of the pregnant women. The prevalence of Escherichia coli was among the most dominant organism, followed by Staphylococcus aureus ,klebsiella and proteus species. Conclusion: The study showed 27.2% of the pregnant women to have asymptomatic bacteriuria. This can be reduced by screening the mothers in first trimester and routine urine culture test must be carried out.


Vestnik ◽  
2021 ◽  
pp. 75-80
Author(s):  
В.Н. Сон ◽  
М.Р. Рысулы ◽  
С.Т. Турсыналиев ◽  
М.Е. Рамазанов

Бессимптомная бактериурия определяется как присутствие бактерий в моче беременных без признаков или симптомов инфекции мочевыводящих путей (ИМП). Стандартное микробиологическое исследование образцов мочи проведено с июня 2019 года по декабрь 2020 года у 800 беременных по программам скрининга на наличие мочеполовой инфекции (ИМП) в поликлинике городской клинической больницы №7 г.Алматы. Образцы были протестированы микробиологически по стандартным методикам, рекомендованных CAESAR. Выбор антимикробных препаратов (АМП) для включения в исследование чувствительности, а также принципы интерпретации результатов проводились согласно рекомендации Европейского комитета по определению чувствительности к антибиотикам (EUCAST). Представлены результаты оценки резистенности и чувствительности к антимикробным препаратам 138 клинических изолятов Escherichia coli, выделенных из образцов мочи беременных пациенток поликлиники №35 ГКБ №7 УОЗ г.Алматы. Основными уропатогеном в 66,3% являются E. Coli, меньше - в 15,9% Staphylococcus aureus и в 8,2% Klebsiella pneumoniae. Чувствительность изолятов Escherihia coli была для левофлоксацина (76,6%), комбинации пиперациллин/тазобактаму (73,7%), ципрофлоксацину (71,5%), тетрациклину (74,4%), но низкой для пиперациллина (24.8%), цефураксима (38,6%), тобрамицина (40,9%), цефазилина (40,1%), цефепима (40,1%); цефтазидима (43%), комбинации триметоприм/сульфаметаксазол (43,8%). Чувствительность E. coli к карбапенемам - для имипенема (73%), меропенема (67,8%), эртапенема (76,6%), а устойчивость составляла для эртапенема (13,8%), меропенема (16%) и имипенема (3,6%). Asymptomatic bacteriuria is defined as the presence of bacteria in the urine of pregnant women without signs or symptoms of a urinary tract infection (UTI). A standard microbiological study of urine samples was carried out from June 2019 to December 2020 in 800 pregnant women under screening programs for the presence of urinary tract infection (UTI) in the ambulatory of the Almaty city clinical hospital № 7. The samples were tested microbiologically according to standard methods recommended by CAESAR. The choice of AMPs for inclusion in the susceptibility study, as well as the principles of interpretation of the results, were carried out according to the recommendation of the European Committee for the determination of antibiotic susceptibility (EUCAST). The sensitivity of Escherihia coli isolates was for levofloxacin (76.6%), piperacillin / tazobactam combination (73.7%), ciprofloxacin (71.5%), tetracycline (74.4%), but low for piperacillin (24.8%), cefuraxime (38.6%), tobramycin (40.9%), cefazilin (40.1%), cefepime (40.1%); ceftazidime (43%), trimethoprim / sulfametaxazole combination (43.8%). The sensitivity of Escherihia coli to carbapenems was for imipenem (73%), meropenem (67.8%), ertapenem (76.6%), and resistance was for ertapenem (13.8%), meropenem (16%) and imipenem (3,6%).


Author(s):  
David Hernández-Hernández ◽  
Bárbara Padilla-Fernández ◽  
María Yanira Ortega-González ◽  
David Manuel Castro-Díaz

2021 ◽  
Vol 36 (12) ◽  
pp. 681-686
Author(s):  
Alicia DeRosa ◽  
Bethany A. Wattengel ◽  
Michael T. Carter ◽  
John A. Sellick ◽  
Alan J. Lesse ◽  
...  

Objective To examine mortality and hospital readmission rates in male veterans with dementia diagnosed with urinary tract infection (UTI) compared with patients without dementia. Design Retrospective cohort study. Setting Veterans Healthcare Systems (VA). Participants Male inpatients with a diagnosis of UTI who were treated at any VA Healthcare Center from January 1, 2009, to December 31, 2018. Interventions None. Main Outcome Measures Mortality and hospital readmission for patients with and without dementia at 30, 60, and 90 days from UTI diagnosis. Results 262,515 veterans admitted with UTI were analyzed, and 58,940 (22.5%) had dementia. The mean age for veterans with dementia was 80.0 +/- 9.7 years. Veterans with dementia experienced less mortality than patients without dementia at 30 days (8.3% vs 8.5%; P < 0.001), but more mortality at 60-day (4.9% vs 4.7%; P < 0.001) and 90-day (3.6% vs 3.3%; P < 0.001) intervals. Death was 20% less likely at 30 days in patients with dementia. Veterans with dementia were readmitted more than those without dementia at 30-day (18.4% vs 16.0%), 60-day (4.5% vs 2.8%), and 90-day (3.4% vs 2.5%) intervals; P < 0.0001. Conclusion Though patients with dementia are at an increased risk for death long-term, risk of death is less than those without dementia shortly following UTI diagnosis. This highlights the possibility that veterans with dementia may be hospitalized and diagnosed with UTIs when in actuality they have asymptomatic bacteriuria. Patients with dementia and UTI therefore represent an important group of geriatric patients that could benefit from the oversight of a senior care pharmacist to help prevent unnecessary treatment of asymptomatic bacteriuria.


2021 ◽  
Vol 8 (12) ◽  
Author(s):  
Grace C Mortrude ◽  
Mary T Rehs ◽  
Katherine A Sherman ◽  
Nathan D Gundacker ◽  
Claire E Dysart

Abstract Background Outpatient antimicrobial prescribing is an important target for antimicrobial stewardship (AMS) interventions to decrease antimicrobial resistance. The objective of this study was to design, implement, and evaluate the impact of AMS interventions focused on asymptomatic bacteriuria (ASB) and acute respiratory infections (ARIs) in the primary care setting. Methods This stepped-wedge trial evaluated the impact of multifaceted educational interventions to providers on adult patients presenting to primary care clinics for ARIs and ASB. The primary outcome was percentage of overall antibiotic prescriptions as a composite of prescriptions for ASB, acute bronchitis, upper respiratory infection not otherwise specified, uncomplicated sinusitis, and uncomplicated pharyngitis. Secondary outcomes were the individual components of the primary outcome; a composite safety endpoint of related hospital, emergency department, or primary care visits within 4 weeks; antibiotic selection appropriateness; and patient satisfaction surveys. Results A total of 887 patients were included (405 preintervention and 482 postintervention). After controlling for type I error using Bonferroni correction, the primary outcome was not significantly different between groups (56% vs 49%). There was a statistically significant decrease in prescriptions for acute bronchitis (20.99% vs 12.66%; P = .0003). Appropriateness of antibiotic prescriptions for uncomplicated sinusitis (odds ratio [OR], 4.96 [95% confidence interval {CI}, 1.79–13.75]; P = .0021) and pharyngitis (OR, 5.36 [95% CI, 1.93–14.90]; P = .0013) was improved in the postintervention vs the preintervention group. The composite safety outcome and patient satisfaction surveys did not differ between groups. Conclusions Multifaceted educational interventions targeting providers can improve antibiotic prescribing for indications rarely requiring antimicrobials without increasing re-visits or patient satisfaction surveys.


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