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1.
Rev. Assoc. Med. Bras. (1992) ; 68(1): 50-55, Jan. 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1360703

ABSTRACT

SUMMARY OBJECTIVE: We aimed to investigate the rate of urethral stricture development, predictor factors, and the reliability following bipolar transurethral resection of the prostate. METHODS: A total of 124 patients participated in this study. Patient data were retrospectively reviewed. The patients were divided into group 1 (those who developed urethral stricture) and group 2 (those who did not develop urethral stricture). Annual checkups were performed after the postoperative months 1 and 6. The patients were checked by uroflowmetry + post-voiding residue and international index of erectile function. We evaluated the complications that developed during the perioperative period according to the Clavien system. RESULTS: Urethral stricture developed in 10.5% (13/124) of the patients. It was found that patients who underwent transurethral resection of the prostate for the second time (p=0.007), patients with a preoperative catheter or history of catheter insertion (p=0.009), patients with high preoperative median white blood cell (103) counts (p=0.013), and patients with long postoperative catheterization time had a higher rate of urethral stricture after bipolar transurethral resection of the prostate (p=0.046). No grade 4 and grade 5 complications were observed according to the Clavien system in patients. CONCLUSION: Factors such as second transurethral resection of the prostate surgery, history of preoperative catheter insertion, high postoperative white blood cell count, and long postoperative catheterization time increase the risk of urethral stricture after bipolar transurethral resection of the prostate.

2.
Acta Paul. Enferm. (Online) ; 35: eAPE03751, 2022. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1364223

ABSTRACT

Resumo Objetivo Caracterizar os microrganismos e sua suscetibilidade antimicrobiana em uroculturas de idosos residentes de uma instituição de longa permanência. Métodos Estudo observacional transversal com 116 indivíduos de uma Instituição de Longa Permanência para Idosos de um município do sul da Bahia. O estudo foi aprovado por Comitê de Ética em Pesquisa e utilizou-se Termo de Consentimento Livre e Esclarecido. Foram realizadas coleta e análise laboratorial de urina tipo I e urocultura. Realizaram-se testes de sensibilidade a antimicrobianos conforme os critérios do European Committee on Antimicrobial Susceptibility Testing. Para o diagnóstico de infecção do trato urinário, foram utilizados os critérios de McGeer. A análise de dados se deu por estatística descritiva, com frequências absolutas e relativas. Resultados A prevalência de infecção do trato urinário foi de 33,62%, com predominância no sexo feminino e idade acima de 80 anos. Os uropatógenos foram: 69,2% Escherichia coli, 20,6% Klebsiella pneumoniae e 5,1% Providencia stuartii e Acinetobacter baumannii. As cepas de E. coli apresentaram suscetibilidade para a maior parte dos antimicrobianos; já nas de K. pneumoniae, a suscetibilidade foi variável. P. stuartii e A. baumannii não apresentaram resistência a carbapenêmicos e aos betalactâmicos aztreonam e piperacilina associados a tazobactam. Conclusão As cepas mais prevalentes e o perfil de suscetibilidade seguiram padrão próximo ao hospitalar, o que implica a necessidade de a instituição promover melhores estratégias de controle de infecção e envolver a equipe de enfermagem no gerenciamento dos casos e na qualificação da prescrição antimicrobiana, para reduzir a resistência bacteriana e efeitos adversos nos idosos.


Resumen Objetivo Caracterizar los microorganismos y su susceptibilidad antimicrobiana en urocultivos de adultos mayores residentes en una institución de larga estadía. Métodos Estudio observacional transversal con 116 individuos de una institución de larga estadía para adultos mayores de un municipio del sur del estado de Bahia. El estudio fue aprobado por el Comité de Ética de Investigación y se utilizó Consentimiento Informado. Se obtuvieron muestras de orina, con las cuales se realizó análisis de laboratorio tipo I y urocultivo. Se realizaron pruebas de sensibilidad a antimicrobianos según los criterios del European Committee on Antimicrobial Susceptibility Testing. Para el diagnóstico de infección del tracto urinario, se utilizaron los criterios de McGeer. El análisis de datos se obtuvo mediante estadística descriptiva, con frecuencias absolutas y relativas. Resultados La prevalencia de infección del tracto urinario fue del 33,62 %, con predominancia del sexo femenino y edad superior a 80 años. Los uropatógenos fueron: 69,2 % Escherichia coli, 20,6 % Klebsiella pneumoniae y 5,1 % Providencia stuartii y Acinetobacter baumannii. Las cepas de E. coli presentaron susceptibilidad en la mayor parte de los antimicrobianos, en las de K. pneumoniae, la susceptibilidad fue variable. P. stuartii y A. baumannii no presentaron resistencia a carbapenémicos ni a los betalactámicos aztreonam y piperacilina asociados a tazobactam. Conclusión Las cepas más prevalentes y el perfil de susceptibilidad presentaron un patrón parecido al hospitalario, lo que implica la necesidad de que la institución promueva mejores estrategias de control de infecciones e involucre al equipo de enfermería en la gestión de los casos y en la cualificación de la prescripción antimicrobiana para reducir la resistencia bacteriana y los efectos adversos en los adultos mayores.


Resumo Objetivo Caracterizar os microrganismos e sua suscetibilidade antimicrobiana em uroculturas de idosos residentes de uma instituição de longa permanência. Métodos Estudo observacional transversal com 116 indivíduos de uma Instituição de Longa Permanência para Idosos de um município do sul da Bahia. O estudo foi aprovado por Comitê de Ética em Pesquisa e utilizou-se Termo de Consentimento Livre e Esclarecido. Foram realizadas coleta e análise laboratorial de urina tipo I e urocultura. Realizaram-se testes de sensibilidade a antimicrobianos conforme os critérios do European Committee on Antimicrobial Susceptibility Testing. Para o diagnóstico de infecção do trato urinário, foram utilizados os critérios de McGeer. A análise de dados se deu por estatística descritiva, com frequências absolutas e relativas. Resultados A prevalência de infecção do trato urinário foi de 33,62%, com predominância no sexo feminino e idade acima de 80 anos. Os uropatógenos foram: 69,2% Escherichia coli, 20,6% Klebsiella pneumoniae e 5,1% Providencia stuartii e Acinetobacter baumannii. As cepas de E. coli apresentaram suscetibilidade para a maior parte dos antimicrobianos; já nas de K. pneumoniae, a suscetibilidade foi variável. P. stuartii e A. baumannii não apresentaram resistência a carbapenêmicos e aos betalactâmicos aztreonam e piperacilina associados a tazobactam. Conclusão As cepas mais prevalentes e o perfil de suscetibilidade seguiram padrão próximo ao hospitalar, o que implica a necessidade de a instituição promover melhores estratégias de controle de infecção e envolver a equipe de enfermagem no gerenciamento dos casos e na qualificação da prescrição antimicrobiana, para reduzir a resistência bacteriana e efeitos adversos nos idosos.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Urinary Tract Infections/epidemiology , Drug Resistance, Microbial , Drug Resistance, Bacterial , Cross-Sectional Studies , Infection Control , Observational Studies as Topic , Homes for the Aged
3.
Article in English | LILACS-Express | LILACS | ID: biblio-1354946

ABSTRACT

Background: Antibiotic resistance is considered to be the next worldwide epidemic. Urinary tract infections (UTI) are the second most common cause of infection, which also has the highest resistance frequency. Nevertheless, in high Andean regions, little is known about the antibiotic resistance. Objectives: Determine the antimicrobial resistance patterns of the enterobacteriaceae family isolated from urinary tract infections of a Peruvian Andean region. Material and Methods: Aretrospective cross-sectional review of 1717 records from the microbiology service of a private health institution from Puno - Peru, was done between the years 2014 and 2017. Antibiotic resistance by uropathogens was studied among different age groups. Statistical analysis included Chi2 test with a p<0.05. Poisson regression was used to calculate the prevalence ratio (PR) with a 95% confidence interval. Results: There was a wide distribution of antibiotic resistance among all the antibiotics, mainly in Escherichia coli and Proteus spp. The elderly had the highest prevalence of antibiotic resistance. As age increased, resistance to all drugs also increased (p<0.01). Furthermore, the elderly had a risk probabilityofresistanceof1.22,1.42,1.20and1.32topenicillins, cephalosporins, quinolones and other antibiotics respectively. Conclusion: The antimicrobial resistance patterns of the Peruvian Andean region were lower than national and international patterns.


Introducción: La resistencia a antibióticos es considerada la próxima epidemia mundial. Las infecciones del tracto urinario (ITU) son la segunda causa más común de infecciones y la que presenta mayor frecuencia de resistencia. Sin embargo, poco se ha reportado en regiones altos-andinas. Objetivo: Evaluar los patrones de resistencia antimicrobiana de la familia enterobacteriaceae aisladas de infecciones del tracto urinario de pacientes ambulatorios de una región altoandina peruana y sus factores asociados. Material y Métodos: Estudio transversal analítico retrospectivo, a partir de 1717 registros del Servicio de Microbiología de una institución de salud en la región Puno ­ Perú, entre los años 2014 al 2017. Se estudió la resistencia a antibióticos según uropatógeno en diferentes grupos etarios. Se empleó la prueba de Chi2 de Pearson y un modelo de regresión de Poisson para calcular la razón de prevalencias (RP). En todos los análisis se consideró un valor de p<0.05 como significativo y se estimaron intervalos de confianza al 95%. Resultados: Se presentó una amplia distribución de resistencia en todos los fármacos evaluados, siendo mayor en Escherichia coli y Proteus spp. El grupo etario, ≥ 60 años, presentó la mayor prevalencia de resistencia bacteriana. A medida que la edad aumentaba, la resistencia a todos los fármacos estudiados también aumentó (p <0.01). Así mismo, los pacientes ≥ 60 años presentaron mayor probabilidad de presentar resistencia bacteriana a penicilinas, cefalosporinas y quinolonas. Conclusión: El patrón de resistencia a los antibióticos utilizados en ITUs en la zona altoandina peruana incrementa con la edad.

4.
Rev. enferm. Inst. Mex. Seguro Soc ; 29(3): 150-159, 04-oct-2021. tab
Article in Spanish | LILACS, BDENF | ID: biblio-1357925

ABSTRACT

Introducción: las infecciones de las vías urinarias relacionadas con la instalación de catéter vesical son de las infecciones asociadas a la atención sanitaria más comunes en México y el mundo. Representan un riesgo latente para el desarrollo de complicaciones y pueden ocasionar la muerte. Objetivo: analizar los factores de riesgo que se asocian directamente a la infección del tracto urinario en la instalación del catéter vesical. Metodología: estudio observacional, descriptivo y transversal, con muestra de 90 pacientes de un hospital de segundo nivel de atención en el que se identificaron los factores de riesgo de infección de vías urinarias asociadas a la instalación de sonda vesical. Resultados: se observó un tipo de cumplimiento de los indicadores de calidad durante la instalación de sonda vesical con frecuencia en el 52.22% de los participantes. Un tipo de cumplimiento con frecuencia en el 48.90% de los participantes durante el mantenimiento de la sonda vesical, y un tipo de cumplimiento con frecuencia del 47.78% al momento del retiro de la sonda. Los principales factores de riesgo identificados asociados a la infección del tracto urinario fueron: a) que la sonda sea instalada por un médico interno, b) una estancia mayor a 3 días en urgencias y c) que la sonda sea instalada por una enfermera general. Conclusiones: se encontraron indicadores de cumplimiento cercano al 50%, lo que se considera muy bajo en la medición de los indicadores de calidad durante la instalación, mantenimiento y retiro de la sonda vesical, incluso estos están por debajo del porcentaje nacional.


Introduction: Urinary tract infections related to the installation of a bladder catheter are the most common infections associated with health care in Mexico and the world. They represent a latent risk for the development of complications and can cause death. Objective: To analyze the risk factors that are directly associated with urinary tract infection in the installation of the bladder catheter. Methods: Observational, descriptive and cross-sectional study; with a sample of 90 patients from a second-level care hospital in which the risk factors for urinary tract infection associated with the installation of a urinary catheter were identified. Results: A type of compliance with the quality indicators was observed during the urinary catheter installation with a frequency of 52.22% of the participants. A type of compliance with a frequency of 48.90% of the participants during the maintenance of the urinary catheter, and a type of compli- ance with a frequency of 47.78% at the time of catheter removal. The main risk factors identified associated with urinary tract infection were: a) that the catheter is installed by an intern, b) a stay of more than 3 days in the emergency room, and c) that the catheter is installed by a general nurse. Conclusions: Compliance indicators were found close to 50%, which is considered very low in the measurement of quality indicators during the installation, maintenance and removal of the urinary catheter, even these are below the national percentage.


Subject(s)
Humans , Urinary Tract , Urinary Tract Infections , Cross-Sectional Studies , Urinary Catheters , Secondary Care , Mexico
5.
Int. braz. j. urol ; 47(4): 821-826, Jul.-Aug. 2021. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1286783

ABSTRACT

ABSTRACT Introduction: Symptomatic duplex kidneys usually present with recurrent urinary tract infection due to ureteral obstruction (megaureter, ureterocele or ectopic ureter) and/or vesicoureteral reflux. Upper-pole nephrectomy is a widely accepted procedure to correct symptomatic duplex systems with poor functioning moieties, also known as upper or proximal approach. The distal ureteral stump syndrome (DUSS) can be a late complication of this approach. There is no consensus upon the length of ureteral dissection and the better approach to symptomatic disease in duplex systems, so we aim to identify if extended ureteral dissection can prevent DUSS in top-down approach. Materials and Methods: Forty-four consecutive patients with symptomatic duplex system were retrospectively classified into two groups: those with limited ureteral excision after heminephrectomy (HN) (group-1) and those with extended ureterectomy after HN (group-2). Patients were followed-up for at least 36 months regarding outcomes of distal ureteral stump. Results: Overall complication was 20%. A total of 8 patients required unplanned further surgery in Group-1 (30%) whereas only 1 patient required unplanned surgery in group 2 (6%) (p=0.07). Subgroup analysis showed that Group-1 presented more DUSS requiring surgery during follow-up than group-2 (p=0.04). Factors possibly affecting complications incidence (such as ureterocele or ectopic ureter) did not differ between groups (p=0.72 and p=0.78). Conclusion: Upper pole nephrectomy should be performed with extended distal ureteral dissection to prevent ureteral stump complications.

6.
Cambios rev. méd ; 20(1): 10-14, 30 junio 2021. tabs.
Article in Spanish | LILACS | ID: biblio-1292684

ABSTRACT

INTRODUCCIÓN. Las infecciones del tracto urinario son causa de mayor morbilidad en la población adulta y afectan con frecuencia a la mujer. Al ser un problema prevalente, fue fundamental realizar estudios sobre perfiles de susceptibilidad locales para establecer medidas de vigilancia y control de uso de antibióticos. OBJETIVO. Determinar el perfil de farmacorresistencia microbiana en adultos con infección del tracto urinario. MATERIALES Y MÉTODOS. Estudio descriptivo, transversal. La población fue de 437 urocultivos y una muestra de 176 positivos con su antibiograma, realizados en el laboratorio del Hospital Básico de Sangolquí entre enero de 2017 hasta abril de 2018. Los criterios de inclusión fueron: pacientes mayores de 15 años de edad de ambos sexos, ambulatorios y hospitalizados, que presentaron urocultivos positivos definidos por una cuenta mayor a 100 000 Unidades Formadoras de Colonia. RESULTADOS. Del 40,27% (176; 437) de urocultivos positivos, la bacteria aislada con frecuencia fue Escherichia coli. 69,31% (122; 176), con resistencia a ampicilina 77,97% (92; 118), trimetropim-sulfametoxazole 62,26% (66; 106), norfloxacino 37,50% (42; 112), ciprofloxacino 35,65 % (41; 115), ampicilina/sulbactam 32,20% (38; 118) y con susceptibilidad a: fosfomicina, ceftriaxona, amikacina y nitrofurantoina. CONCLUSIÓN. Se determinó el perfil de farmacorresistencia microbiana en adultos con infección del tracto urinario; donde Escherichia coli. fue aislada con frecuencia, con susceptibilidad favorable para nitrofurantoína y fosfomicina.


INTRODUCTION. Urinary tract infections are the cause of greater morbidity in the adult population and it often affects women. As it is a prevalent problem, it was essential to carry out studies on local susceptibility profiles to establish surveillance measures and control of antibiotic use. OBJECTIVE. To determine the microbial drug resistance profile in adults with urinary tract infection. MATERIALS AND METHODS. Descriptive, cross-sectional study. The population was 437 urine cultures and a sample of 176 positive with their antibiogram, carried out in the laboratory of the Hospital Básico de Sangolquí between january 2017 and april 2018. Inclusion criteria were: patients older than 15 years of age of both sexes, ambulatory and hospitalized, who presented positive urine cultures defined by a count greater than 100 000 Colony Forming Units. RESULTS. Of the 40,27% (176; 437) of positive urine cultures, the bacterium frequently isolated was Escherichia coli. 69,31% (122; 176), with resistance to ampicillin 77,97% (92; 118), trimethoprim-sulfamethoxazole 62,26% (66; 106), norfloxacin 37,50% (42; 112), ciprofloxacin 35,65% (41; 115), ampicillin / sulbactam 32,20% (38; 118) and with susceptibility to: fosfomycin, ceftriaxone, amikacin and nitrofurantoin. CONCLUSION. The microbial drug resistance profile was determined in adults with urinary tract infection; where Escherichia coli. was frequently isolated, with favorable susceptibility to nitrofurantoin and fosfomycin.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Urinary Tract , Urinary Tract Infections , Drug Resistance, Microbial , Anti-Bacterial Agents , Staphylococcus , Bacteriuria , Ampicillin Resistance , Microbial Sensitivity Tests , Drug Resistance, Bacterial , Escherichia coli
7.
Rev. Fac. Med. (Bogotá) ; 69(2): e201, Apr.-June 2021. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1287983

ABSTRACT

Abstract Introduction: Urinary tract infection (UTI) is the most common medical complication during pregnancy and is associated with adverse maternal and perinatal outcomes. Objectives: To determine the prevalence of UTI in socially vulnerable pregnant women in Bucaramanga, Colombia, and to characterize these cases. Also, to identify the factors associated with the development of this complication and the antibiotic resistance profile of the microorganisms causing the infection. Materials and methods: Secondary analysis of the data obtained in a main study conducted on 838 pregnant women treated by the public healthcare network of Bucaramanga. The prevalence of UTI was estimated considering the number of pregnant women with a urine culture report (n=648). A descriptive analysis of the sample characteristics and a bivariate analysis were performed to evaluate the differences in the diagnosis of UTI. Finally, factors associated with UTI were estimated using a binomial logistic regression model. Results: The prevalence of UTI during pregnancy was 14.51% (n=94). For each year that maternal age increased, a 6% reduction in the prevalence of UTI (PR: 0.94 95% CI: 0.90-0.98, p<0.001) was observed. Moreover, an association was found between having a history of UTI and developing this complication during pregnancy (PR: 3.6 95% CI: 1.81-7.08, p= 0.005). The most common pathogens isolated were E. Coli (75.53%) and Klebsiella spp (17.02%). Conclusion: About 15% of the participants had UTI, so it is necessary to implement health education strategies aimed at socially vulnerable pregnant women, mainly the youngest and those with a history of UTI, to reduce its occurrence and possible consequences for maternal-fetal health. Furthermore, the data reported herein may help develop public policies to improve prevention and care of UTI in this population.


Resumen Introducción. La infección del tracto urinario (ITU) es la complicación médica más frecuente durante el embarazo y se asocia con desenlaces materno-perinatales negativos. Objetivos. Determinar la prevalencia de ITU en gestantes en condiciones de vulnerabilidad social de Bucaramanga, Colombia, y realizar una caracterización de los casos de ITU. Además, identificar los factores asociados al desarrollo de esta complicación y el perfil de resistencia antibiótica de los microorganismos causantes de la infección. Materiales y métodos. Se llevó a cabo un análisis secundario de los datos obtenidos en un estudio principal que incluyó 838 gestantes atendidas en la red pública de atención de Bucaramanga. La prevalencia de ITU se estimó considerando el número de gestantes con reporte de urocultivo (n=648). Se realizó un análisis descriptivo de las características de la muestra y un análisis bivariado para evaluar las diferencias en el diagnóstico de ITU. Finalmente, se estimaron los factores asociados a ITU mediante un modelo de regresión log binomial. Resultados. La prevalencia de ITU durante el embarazo fue del 14.51% (n = 94). Se observó que por cada año de aumento en la edad materna hubo una reducción del 6% en la prevalencia de ITU (RP: 0.94, IC95%: 0.90-0.98, p=0.005); además, se encontró una asociación entre tener antecedentes de ITU y desarrollar esta complicación durante la gestación (RP: 3.6, IC95%: 1.81-7.08, p<0.001). Los patógenos aislados más frecuentes fueron Escherichia Coli (75.53%) y Klebsiella spp (17.02%). Conclusión. Cerca del 15% de las participantes tuvieron ITU, por lo que se requiere implementar estrategias de educación en salud dirigidas a las gestantes socialmente vulnerables, principalmente a las más jóvenes y aquellas con antecedentes de ITU, con el fin de reducir su ocurrencia y sus posibles consecuencias para la salud materno-fetal. Igualmente, los datos reportados aquí pueden ayudar al desarrollo de políticas públicas que busquen mejorar la prevención y atención de dicha complicación en esta población.

8.
Autops. Case Rep ; 11: e2020200, 2021. graf
Article in English | LILACS | ID: biblio-1142404

ABSTRACT

Xanthogranulomatous pyelonephritis (XGP) is a rare variant of chronic pyelonephritis. It is characterized by progressive parenchymal destruction caused by chronic renal obstruction due to calculus, stricture, or rarely tumor, resulting in kidney function loss. Herein, we describe the case of a 36-year-old female who presented with left loin pain, left lower limb pain, and dysuria. On contrast-enhanced computed tomography (CECT), multiple abscesses and an obstructive staghorn calculus were depicted in the left kidney with the classical appearance of "Bear Paw Sign." An abscess with calculi was also present within the left psoas muscle. Though psoas muscle abscess in association with XGP was described, a ureteric fistula and calculi within the psoas muscle have not yet been reported in the literature. Left nephrostomy was performed, which came out to be positive for E. coli on culture. The patient underwent left nephrectomy, and the histopathological report of the surgical specimen confirmed XGP.


Subject(s)
Humans , Female , Adult , Urinary Tract Infections , Pyelonephritis, Xanthogranulomatous/pathology , Psoas Muscles/abnormalities , Escherichia coli , Staghorn Calculi
9.
Braz. arch. biol. technol ; 64: e21200736, 2021. graf
Article in English | LILACS | ID: biblio-1345489

ABSTRACT

Abstract The effects of fluorodeoxyglucose conjugated iron oxide magnetic nanoparticles (FDGMNP) on macrophages are presented using a yeast substrate. Iron oxide magnetic nanoparticles (MNP) were synthesized by partially reducing FeCl3, then conjugated with (3-aminopropyl) triethoxysilane (APTES) after silication with tetraethyl orthosilicate. Silanated MMP nanoparticles were combined with fluorodeoxyglucose (FDG). Fluorodeoxyglucose iron oxide magnetic nanoparticles (FDGMNP) and its unconjugated control (MNP) were added (1mL) to the cells from the murine macrophage-like, Abelson murine leukemia virus transformed cell line RAW 264.7 (American Type Culture Collection number TIB-71) cell culture wells at different concentrations from 90-3.6 μg/mL. Cells were placed on the magnet plate for 30 min before incubating at 37°C, 5% CO2 overnight. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide tetrazolium) assay was performed to measure cell viability. Our results demonstrate that iron based nanoparticles can be linked to macrophages (elements of the immune system that attack bacteria) without the function of the macrophages being affected, ie no detrimental effects to the macrophages were evident in these experiments. We conclude that neither FDGMNP nor MNP had a detrimental effect on macrophage function.


Subject(s)
Urologic Diseases , Fluorodeoxyglucose F18 , Magnetic Iron Oxide Nanoparticles , Pilot Projects , Macrophages
10.
Rev. cienc. med. Pinar Rio ; 25(2): e4828, 2021. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1289122

ABSTRACT

RESUMEN Introducción: la litiasis vesical gigante es poco frecuente. Se diagnostica cuando el cálculo sobrepasa los 100 g de peso. Objetivo: comentar a la comunidad médica un nuevo caso de litiasis vesical gigante diagnosticado en un hombre de edad avanzada. Presentación del caso: paciente masculino de 72 años de edad, con antecedentes de infecciones urinarias a repetición, quien consultó por presentar dolor en bajo vientre y síntomas urinarios irritativos. Con el empleo de estudios de imagen se detectó un cálculo vesical de gran tamaño. Se utilizó anestesia regional espinal, se realizó adenomectomía y cistolitotomía convencional. Se extrajo un cálculo gigante con un peso de 460 g. Conclusiones: la litiasis vesical gigante es un padecimiento poco frecuente. Actualmente no representa un problema de salud en el territorio. La cistolitotomía convencional es la técnica de elección para la extracción de cálculos gigantes.


ABSTRACT Introduction: Giant bladder lithiasis is rare. It is diagnosed when the calculus exceeds 100g in weight. Objective: to comment to the medical community a new case of giant bladder lithiasis diagnosed in an elderly man. Case report: a 72-year-old male patient with a history of repeated urinary tract infections consulted for lower abdominal pain and irritative urinary symptoms. With the use of imaging studies a large bladder stone was discovered. Spinal regional anesthesia was applied, adenomectomy and conventional cystolithotomy were performed, and a giant stone weighing 460g was removed. Conclusions: giant bladder lithiasis is a rare entity. At present it does not represent a health problem in the territory. Conventional cystolithotomy is the technique of choice to remove giant stones.

11.
Article in English | LILACS | ID: biblio-1359846

ABSTRACT

Introduction: Urinary tract infections (UTI) are common in women and can cause systemic repercussions. In pregnant women, for example, the occurrence of UTI or asymptomatic bacteriuria (AB) can lead to premature birth and fetal death. The generalized immune depletion caused by HIV is related to the exacerbation of infections, and may be related to UTI. Objective: The objective of this review was to evaluate the characteristics of UTI in pregnant and non-pregnant HIV-positive women as well as the factors that interfere in its occurrence. Methods: By searching the databases PubMed, Web of Science, Scielo and Lilacs, we selected eleven articles that correlated UTI and HIV infection in women. Results: Our analysis showed that HIV-positive pregnant women have a higher predisposition to UTI than HIV-negative ones. The Viral Load (VL) is directly related to UTI and AB in HIV-positive nonpregnant women. TCD4 lymphocyte levels (TCD4) lower than 200 cells/mL and VL over 10,000 copies/mL are correlated with higher UTI and AB rates in HIV-positive pregnant women. There is a tendency for greater variability of pathogens in HIV-positive women and a predisposition to higher rates of antibiotic resistance in HIV-positive pregnant women. Conclusion: HIV-positive pregnant women have higher predisposition to urinary tract infection and its incidence is correlated with a high viral load and a low TCD4 count.


Introdução: As infecções do trato urinário (ITU) são comuns em mulheres e podem causar repercussões sistêmicas. Em mulheres grávidas, por exemplo, a ocorrência de ITU ou bacteriúria assintomática (BA) pode levar ao nascimento prematuro e à morte fetal. A depleção imunológica generalizada causada pelo HIV está relacionada à exacerbação de infecções e pode estar relacionada à ITU. Objetivo: O objetivo desta revisão foi avaliar as características da ITU em gestantes e não gestantes HIV-positivas, bem como os fatores que interferem na sua ocorrência. Métodos: Por meio de busca nas bases de dados PubMed, Web of Science, SciELO e LILACS, foram selecionados 11 artigos que correlacionavam ITU a infecção pelo HIV em mulheres. Resultados: Nossa análise mostrou que gestantes soropositivas têm maior predisposição à ITU do que gestantes soronegativas. A carga viral está diretamente relacionada a ITU e BA em mulheres não grávidas HIV-positivas. Os níveis de linfócitos TCD4 (TCD4) abaixo de 200 células/mL e a carga viral acima de 10.000 cópias/mL estão correlacionados a maiores taxas de ITU e BA em mulheres grávidas HIV-positivas. Há uma tendência para maior variabilidade de patógenos em mulheres HIV-positivas e uma predisposição para maiores taxas de resistência a antibióticos em mulheres grávidas HIV-positivas. Conclusão: Gestantes HIVpositivas apresentam maior predisposição à infecção do trato urinário e sua incidência está correlacionada com alta carga viral e baixa contagem de TCD4.


Subject(s)
Humans , Urinary Tract Infections , Women , Pregnant Women , Urinary Tract , HIV , HIV Seropositivity
12.
Rev. bras. enferm ; 74(supl.2): e20200813, 2021. tab
Article in English | LILACS-Express | LILACS, BDENF | ID: biblio-1279986

ABSTRACT

ABSTRACT Objective: to analyze the factors associated with urinary tract infection occurrence in institutionalized elderly. Methods: this is a cross-sectional, analytical, quantitative study with 116 elderly people from a Nursing Home. Urinary tract infection diagnosis was carried out through urine culture and clinical assessment. Demographic data and associated factors were obtained from medical records. Statistical analysis included bivariate analysis and logistic regression models. Results: the factors associated with urinary tract infection (p<0.05) were being female; wheelchair user; diaper use; diuretic use; urinary and bowel incontinence; type 1 diabetes; benign prostatic hyperplasia; dehydration. Conclusion: this study revealed that it is important to consider non-modifiable factors such as sex and clinical comorbidities; however, dehydration, a modifiable factor, increased the chances of developing urinary tract infections by 40 times among institutionalized elderly and demands greater attention from the health team.


RESUMEN Objetivo: analizar los factores asociados a la ocurrencia de infección del tracto urinario en ancianos institucionalizados. Métodos: estudio transversal, analítico con abordaje cuantitativo, con 116 ancianos de um Hogar para Ancianos. El diagnóstico de infección del tracto urinario se realizó mediante urocultivo y evaluación clínica. Los datos demográficos y los factores asociados se obtuvieron de las historias clínicas. El análisis estadístico incluyó análisis bivariado y modelos de regresión logística. Resultados: los factores asociados a la infección del tracto urinario (p<0.05) fueron: mujeres; silla de ruedas; uso de pañales; uso de diuréticos; incontinencia urinaria y fecal; diabetes tipo 1; hiperplasia prostática benigna; deshidración. Conclusión: es importante considerar factores no modificables como el sexo y las comorbilidades clínicas, pero la presencia de deshidratación, un factor modificable, aumentó 40 veces la posibilidad de desarrollar infecciones del tracto urinario entre los ancianos institucionalizados y exige una mayor atención por parte del equipo de salud.


RESUMO Objetivo: analisar os fatores associados à ocorrência de infecção do trato urinário em idosos institucionalizados. Métodos: estudo transversal, analítico, de abordagem quantitativa, com 116 idosos de uma Instituição de Longa Permanência. O diagnóstico de infecção urinária foi por meio de urocultura e avaliação clínica. Os dados demográficos e fatores associados foram obtidos dos prontuários. A análise estatística compreendeu análise bivariada e modelos de regressão logística. Resultados: os fatores associados à infecção de trato urinário (p<0,05) foram: sexo feminino; cadeirante; uso de fraldas; uso de diuréticos; incontinência urinária e fecal; diabetes tipo 1; hiperplasia benigna de próstata; desidratação. Conclusão: o estudo revelou que é importante considerar os fatores não modificáveis como sexo e comorbidades clínicas, mas a presença de desidratação, um fator modificável, aumentou em 40 vezes a chance de desenvolver infecções de trato urinário entre os idosos institucionalizados e demanda maior atenção da equipe de saúde.

13.
Rev. bras. enferm ; 74(supl.2): e20200813, 2021. tab
Article in English | LILACS-Express | LILACS, BDENF | ID: biblio-1279995

ABSTRACT

ABSTRACT Objective: to analyze the factors associated with urinary tract infection occurrence in institutionalized elderly. Methods: this is a cross-sectional, analytical, quantitative study with 116 elderly people from a Nursing Home. Urinary tract infection diagnosis was carried out through urine culture and clinical assessment. Demographic data and associated factors were obtained from medical records. Statistical analysis included bivariate analysis and logistic regression models. Results: the factors associated with urinary tract infection (p<0.05) were being female; wheelchair user; diaper use; diuretic use; urinary and bowel incontinence; type 1 diabetes; benign prostatic hyperplasia; dehydration. Conclusion: this study revealed that it is important to consider non-modifiable factors such as sex and clinical comorbidities; however, dehydration, a modifiable factor, increased the chances of developing urinary tract infections by 40 times among institutionalized elderly and demands greater attention from the health team.


RESUMEN Objetivo: analizar los factores asociados a la ocurrencia de infección del tracto urinario en ancianos institucionalizados. Métodos: estudio transversal, analítico con abordaje cuantitativo, con 116 ancianos de um Hogar para Ancianos. El diagnóstico de infección del tracto urinario se realizó mediante urocultivo y evaluación clínica. Los datos demográficos y los factores asociados se obtuvieron de las historias clínicas. El análisis estadístico incluyó análisis bivariado y modelos de regresión logística. Resultados: los factores asociados a la infección del tracto urinario (p<0.05) fueron: mujeres; silla de ruedas; uso de pañales; uso de diuréticos; incontinencia urinaria y fecal; diabetes tipo 1; hiperplasia prostática benigna; deshidración. Conclusión: es importante considerar factores no modificables como el sexo y las comorbilidades clínicas, pero la presencia de deshidratación, un factor modificable, aumentó 40 veces la posibilidad de desarrollar infecciones del tracto urinario entre los ancianos institucionalizados y exige una mayor atención por parte del equipo de salud.


RESUMO Objetivo: analisar os fatores associados à ocorrência de infecção do trato urinário em idosos institucionalizados. Métodos: estudo transversal, analítico, de abordagem quantitativa, com 116 idosos de uma Instituição de Longa Permanência. O diagnóstico de infecção urinária foi por meio de urocultura e avaliação clínica. Os dados demográficos e fatores associados foram obtidos dos prontuários. A análise estatística compreendeu análise bivariada e modelos de regressão logística. Resultados: os fatores associados à infecção de trato urinário (p<0,05) foram: sexo feminino; cadeirante; uso de fraldas; uso de diuréticos; incontinência urinária e fecal; diabetes tipo 1; hiperplasia benigna de próstata; desidratação. Conclusão: o estudo revelou que é importante considerar os fatores não modificáveis como sexo e comorbidades clínicas, mas a presença de desidratação, um fator modificável, aumentou em 40 vezes a chance de desenvolver infecções de trato urinário entre os idosos institucionalizados e demanda maior atenção da equipe de saúde.

14.
Chinese Journal of Dermatology ; (12): 924-927, 2021.
Article in Chinese | WPRIM | ID: wpr-911533

ABSTRACT

The emergence of a large number of drug-resistant bacteria has brought severe challenges to clinical anti-infection treatment. Phage therapy is considered to be a very promising method to cope with this dilemma, which has been explored and applied in many disciplines. Its efficacy has also been confirmed in clearing skin and mucous membrane infections, and it has become a hot spot in international research. The use of phage cocktails, phage lysozymes and phage proteins has shown good efficacy in the treatment of drug-resistant Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Klebsiella, Bacillus proteus, etc. This review summarizes the background, characteristics, development of phage therapy, and its application and prospects in skin and genitourinary tract infections.

15.
Chinese Journal of Urology ; (12): 869-870, 2021.
Article in Chinese | WPRIM | ID: wpr-911137

ABSTRACT

Renal subcapsular abscess(RSA) is a rare disease with unknown etiology and pathogenesis. CT is an important assistant examination for the diagnosis. In this study, we reported 2 cases of RSA. One case achieved good therapeutic effect by timely debridement and surgery drainage, and the other case refused to perform debridement and drainage, which lead to the death. This kind of disease develops quickly and progresses rapidly. The adequate debridement and surgery drainage are important in treating this disease.

16.
Article in Chinese | WPRIM | ID: wpr-909275

ABSTRACT

Objective:To compare serum procalcitonin and fibrinogen degradation product levels between type 2 diabetes mellitus patients with Escherichia coli bloodstream and urinary tract infections. Methods:The clinical data of 82 type 2 diabetes mellitus patients with Escherichia coli infections who received treatment between December 2014 and December 2019 in the First Affiliated Hospital of Datong University (The Fifth People's Hospital of Datong) were retrospectively analyzed. These patients were assigned to bloodstream infection ( n = 40) and urinary tract infection ( n = 42) according to the way of Escherichia coli infection. Serum procalcitonin and fibrinogen degradation product levels, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, C-reactive protein, white blood cell count, D-Dimer level, antithrombin III activity, and electrolytes were determined and compared between the two groups. Correlation between procalcitonin and other variables was analyzed. Multiple linear regression analysis was performed with procalcitonin level as a dependent variable and other relevant indexes as independent variables. Results:Body temperature, white blood cell count, neutrophil count, monocyte count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, procalcitonin level, C-reactive protein level, fibrinogen degradation product level, and D-Dimer level in the bloodstream injection group were (39.49 ± 0.64) ℃, (14.92 ± 11.78) × 10 9/L, (13.39 ± 11.60) × 10 9/L, (0.72 ± 0.36) ×10 9/L, (14.86 ± 10.52), (199.15 ± 160.69), (22.81 ± 17.86) μg/L, (133.44 ± 63.63) mg/L, (49.71 ± 41.44) mg/L, (16.56 ± 12.20) mg/L, respectively, which were significantly higher than those in the urinary tract infection group [(37.12 ± 1.20) ℃, (9.04 ± 3.95) × 10 9/L, (6.25 ± 4.02) × 10 9/L, (0.42 ± 0.29) × 10 9/L, (3.67 ± 3.34), (120.01 ± 44.08), (4.46 ± 8.69) μg/L, (39.22 ± 22.16) mg/L, (3.81 ± 3.41) mg/L, (0.84 ± 0.75) mg/L), t = 7.356, 2.578, 3.162, 2.958, 5.538, 2.591, 2.810, 4.825, 2.902, 2.375, all P < 0.05]. Platelet count, lymphocyte count, blood sodium level and antithrombin Ⅲ activity in the bloodstream infection group were (167.50 ± 104.93) × 10 9/L, (1.06 ± 0.58) × 10 9/L, (130.89 ± 6.50) mmol/L, (57.88 ± 16.28)% , which were significantly lower than those in the urinary tract infection group [(239.40 ± 82.52)× 10 9/L, (2.14 ± 0.71) × 10 9/L, (138.46 ± 5.96) mmol/L, (90.11 ± 8.90)%, t = -2.853, -6.313, -4.046, -7.350, all P < 0.05]. Correlation analysis revealed that serum procalcitonin level was positively correlated with body temperature ( r = 0.387), white blood cell count ( r = 0.355), neutrophil count ( r = 0.368), C-reactive protein ( r = 0.605), fibrinogen degradation product level ( r = 0.616), D-Dimer level ( r = 0.486) (all P < 0.05), and it was negatively correlated with sodium level ( r = -0.319) and antithrombin Ⅲ activity ( r = -0.465) (both P < 0.05). Multiple linear regression analysis results revealed that fibrinogen degradation product level and body temperature were greatly correlated with procalcitonin level. Conclusion:Inflammatory indicators procalcitonin level, body temperature, white blood cell count, neutrophil count, C-reactive protein, fibrinogen degradation product level and D-Dimer level were remarkably higher in type 2 diabetes mellitus patients with Escherichia coli bloodstream infection than those in type 2 diabetes mellitus patients with Escherichia coli urinary tract infection. Procalcitonin level was greatly correlated with body temperature and fibrinogen degradation product level.

17.
Medicina (B.Aires) ; 80(6): 611-621, dic. 2020. graf
Article in English | LILACS | ID: biblio-1250283

ABSTRACT

Abstract Infections are frequent complications of kidney transplants. We aimed at determining the frequency and type of infections that occur in renal transplant recipients during the early (0-1 month), intermediate (1-6 months) and late (6-12 months) post-transplant period and analyzing the risk factors for infection. To this aim, we conducted a retrospective cohort study on 1-year post-transplant follow-up in two third-level university hospitals in Cordoba city. All consecutive recipients of renal transplants performed between 2009 and 2015 were included, except those with multiple solid organ transplantation and pediatric patients. We included 375 recipients, of which 235 (62.7%) had at least one episode of infection during follow-up. There were 504 episodes of infection, of which 131 (26%) occurred in the early, 272 (53.9%) in the intermediate, and 101 (20.1%) in the late post-transplant period. The most frequent infections in all periods were caused by bacteria (mainly urinary tract infections), and the most frequent viral infection was caused by Cytomegalovirus (mainly in the second and third period). In the multivariate analysis, infection risk factors were: age > 60 years (adjusted odds ratio [aOR] = 1.92; 95% CI = 1.05-3.49), organ transplantation from deceased donor (aOR = 8.19; 95% CI = 2.32-28.9), use of pigtail catheter for urinary tract drainage (aOR = 4.06; 95% CI = 1.27-12.9), and number of days in hospital after transplant (aOR = 1.05; 95% CI = 1.01-1.11). In conclusion, infections in renal transplant recipients represent a very frequent health problem in our hospitals. Understanding the local epidemiology of infection and the potential risk factors for infection acquires utmost importance.


Resumen Las infecciones son complicaciones frecuentes de los trasplantes renales. Los objetivos del estudio fueron determinar la frecuencia y el tipo de infecciones que ocurren en el período post-trasplante temprano (0-1 mes), intermedio (1-6 meses) y tardío (6-12 meses) en nuestro medio y analizar los factores de riesgo de infección. Se realizó un estudio de cohorte retrospectivo que incluyó todos los pacientes con trasplantes renales realizados entre 2009 y 2015 en dos hospitales universitarios de tercer nivel de la ciudad de Córdoba, excluidos los receptores de trasplante simultáneo de múltiples órganos sólidos y los menores de 18 años. Fueron incluidos 375 pacientes, de los cuales 235 (62.7%) tuvieron al menos un episodio de infección. Hubo 504 episodios de infección: 131 (26%) ocurrieron en el período temprano, 272 (53.9%) en el intermedio y 101 (20.1%) en el tardío. La mayoría de las infecciones fueron de origen bacteriano (principalmente del tracto urinario). La mayoría de las infecciones virales ocurrieron en el segundo y el tercer período y Citomegalovirus fue el responsable más frecuente. En el análisis multivariado, los factores de riesgo de infección post-transplante renal fueron: edad > 60 años (odds ratio ajustado [aOR] 1.92; IC95% 1.05-3.49), donante cadavérico (aOR 8.19; IC95% 2.32-28.9), uso de catéter pigtail (aOR 4.06; IC95% 1.27-12.9) y número de días internado postrasplante (aOR 1.05; IC95% 1.01-1.11). En conclusión, confirmamos que las infecciones en pacientes con trasplante renal son muy frecuentes en nuestro medio, por lo cual es importante conocer la epidemiología local y los factores de riesgo.


Subject(s)
Humans , Child , Urinary Tract Infections , Kidney Transplantation/adverse effects , Tissue Donors , Retrospective Studies , Risk Factors
18.
Arch. pediatr. Urug ; 91(supl.2): 24-33, dic. 2020. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1142241

ABSTRACT

Resumen: Introducción: fosfomicina trometamol (FT) representa una alternativa al tratamiento de la infección del tracto urinario (ITU) baja. Uruguay no dispone de información acerca de su uso en niños. Objetivo: describir la evolución clínica y microbiológica de una cohorte de niños mayores de 6 años con ITU baja tratados con FT. Material y método: se incluyeron niños mayores de 6 años con ITU baja de dos prestadores de salud de Montevideo, entre 1/2/2018 - 30/6/2019. A todos se indicó FT 2 g monodosis y urocultivo de control. Se realizó seguimiento telefónico. Se evaluó: clínica, antecedentes de ITU, microorganismo, susceptibilidad antimicrobiana y evolución: tiempo de resolución clínica, resolución microbiológica, efectos adversos, recurrencia en los primeros tres meses. Resultados: se incluyeron 46 niños, mediana de edad 9,4 años, antecedentes de ITU 13. Presentaron disuria 44, tenesmo 33, polaquiuria 31. Microorganismo aislado: E. coli 43, S. saprophyticus 2, Proteus sp 1. Todos susceptibles a FT, excepto S. saprophyticus naturalmente resistente. Resolución clínica en 48 horas: 42. Se obtuvo urocultivo de control en 31/46 niños: resolución microbiológica 22, no resolución 5 y contaminado 4. Presentaron efectos adversos 9: vómitos 1, diarrea 8 y cefalea 1. Seguimiento telefónico a 40/46 pacientes: reinfecciones al mes de tratamiento: 6. Conclusiones: no se registró resistencia adquirida en los microorganismos. Se observó resolución clínica en las primeras 48 horas en la mayoría de los casos. Los efectos adversos fueron leves. Ocurrieron reinfecciones en una proporción pequeña. Los resultados avalan a FT como alternativa terapéutica para ITU baja en mayores de 6 años.


Summary: Introduction: fosfomycin tromethamine (FT) is an alternative to the treatment of low urinary tract infection (UTI). Uruguay does not have information about its use in children. Objective: to describe the clinical and microbiological evolution of a cohort of children older than 6 years of age with low UTI treated with FT. Materials and methods: we included children of over 6 years of age with low UTI from two health providers in Montevideo between 2/1/2018 and 6/30/2019. We prescribed a single dose of FT 2 g and a control urine culture to all patients. We carried out a telephone follow-up and assessed their clinical record, history of UTI, microorganisms, antimicrobial susceptibility and evolution: time of clinical resolution, microbiological resolution, adverse effects, and recurrence during the first 3 months. Results: 46 children were included, median age 9.4 years, history of UTI 13. 44 presented dysuria, 33 tenesmus, 31 pollakiuria. Isolated microorganism: E. coli 43, S. saprophyticus 2, Proteus sp 1. All susceptible to FT, except S. saprophyticus, naturally resistant. Clinical resolution in 48 hours: 42. Control urine culture was obtained in 31/46 children: microbiological resolution 22, no resolution 5 and contaminated 4. Adverse effects 9: vomiting 1, diarrhea 8, and headache 1. Telephone follow-up carried out for 40 / 46 patients: reinfections after one month of treatment: 6. Conclusions: microorganisms had not acquired resistance. Most cases showed clinical resolution during the first 48 hours. Adverse effects were mild. Reinfections occurred in a small proportion. The results support FT as a therapeutic alternative for low UTI for the case of children of over 6 years of age.


Resumo: Introdução: A fosfomicina trometamina (FT) é uma alternativa ao tratamento da infecção do trato urinário baixo (ITU). O Uruguai não possui informações sobre seu uso em crianças. Objetivo: Descrever a evolução clínica e microbiológica de uma coorte de crianças maiores de 6 anos de idade com ITU baixa tratada com TF. Materiais e métodos: Foram incluídas crianças maiores de 6 anos de com ITU baixa de dois provedores de saúde em Montevidéu; no período 1/2 / 2018 e 30/06/2019. Todos os pacientes receberam indicação de FT 2 g em dose única, cultura de urina e controle. Realizou-se um rastreamento por telefone. Se avaliou: prontuário clínico, história de ITU, microrganismos, suscetibilidade a antimicrobianos e evolução: tempo de resolução clínica, resolução microbiológica, efeitos adversos, recorrência nos primeiros 3 meses. Resultados: Incluíram-se 46 crianças, mediana de idade 9,4 anos, história de ITU 13. 44 delas apresentaram disúria, tenesmo 33, polaciúria 31. Microrgoanismo isolado: E. coli 43, S. saprophyticus 2, Proteus sp 1. Todas suscetíveis a FT, exceto S. saprophyticus, naturalmente resistente. Resolução clínica em 48 horas: 42. Obtivemos cultura de urina controle em 31/46 crianças: resolução microbiológica 22, sem resolução 5 e contaminada 4. 9 delas apresentaram efeitos adversos 9: vômito 1, diarreia 8 e dor de cabeça 1. Realizamos acompanhamento telefônico em 40 / 46 pacientes: reinfecções um mês após tratamento, 6. Conclusões: Os microrganismos não adquiriram resistência. Na maioria dos casos observou-se resolução clínica nas primeiras 48 horas. Os efeitos adversos foram leves. As reinfecções ocorreram em pequena proporção. Os resultados apoiam o TF como uma alternativa terapêutica para ITU baixa para casos de crianças maiores de 6 anos de idade.

19.
Iatreia ; 33(4): 360-369, oct.-dic. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1143088

ABSTRACT

RESUMEN La tuberculosis es una enfermedad infecciosa y frecuente en países en vía de desarrollo. Esta puede causar una amplia variedad de complicaciones y presentaciones atípicas con alta morbimortalidad. De la forma genitourinaria se sospechada muy poco, razón por la cual su diagnóstico se hace, usualmente, de forma tardía o no se realiza. Esto conlleva a consecuencias muy graves en los pacientes, por ejemplo, la enfermedad renal crónica terminal. A continuación, se presenta un reporte de caso de una paciente con la anterior enfermedad, secundaria a una tuberculosis renal bilateral diagnosticada tardíamente y se realiza una revisión de la literatura sobre este tema.


SUMMARY Tuberculosis is a common infectious disease in developing countries, which can cause a variety of complications and atypical manifestations with high morbidity and mortality. The urogenital form is rarely suspected, resulting in delayed diagnosis or even no diagnosis, which can have serious consequences for the patients, such as chronic end-stage renal disease. We report on a patient with chronic end-stage renal failure caused by a delayed diagnosis of bilateral renal tuberculosis and a literature review on this topic.


Subject(s)
Humans , Tuberculosis, Urogenital , Kidney Failure, Chronic
20.
Rev. colomb. nefrol. (En línea) ; 7(2): 78-84, jul.-dic. 2020. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1251567

ABSTRACT

Resumen Introducción: las infecciones del tracto urinario (ITU) son frecuentes en pacientes con enfermedad renal crónica (ERC). Una opción de tratamiento cuando estas infecciones son recurrentes es la vacunación bacteriana sublingual. Objetivo: determinar la respuesta a la vacunación bacteriana sublingual en pacientes nefrológicos con ITU recurrente. Materiales y métodos: estudio cuasi experimental en el que se evaluó la evolución en 15 meses de los pacientes con ITU recurrente que asistieron a consulta externa de nefrología. Tras recibir tratamiento antibiótico según antibiograma para cada ITU, los participantes tomaron un ciclo de la vacuna sublingual bacteriana Uromune® durante tres meses. Se recogieron datos sociodemográficos y sobre factores de riesgo asociados, análisis de sangre y orina, episodios de ITU en los seis meses previos y posteriores, microorganismos causantes, tratamiento antibiótico concomitante, respuesta al tratamiento y resolución de la ITU. Resultados: se incluyeron 26 pacientes (80,8 % mujeres) con una media de edad de 61,9±18,4 años, de los cuales el 46,2 % tenía diabetes y el 47,7 %, afectación de la función renal. La media de ITU fue 3,62±1,77 (rango: 1 -7) antes de la vacuna y de 1,69±1,77 (rango: 0-5) después. Se recogieron 184 urocultivos: 74,9 % positivos, 16,9 % negativos y 8,2 % contaminados. Las bacterias más frecuentes fueron Escherichia coli (55,4 %), Enterococcus faecalis (6 %) y Enterobacter cloacae (2,7 %). El 50 % de los participan- tes presentó síndrome miccional, que se asoció inversamente con la edad (p<0,05). El 26,9 % no volvió a tener ITU y el 73,1 % tuvo menos episodios. Los pacientes con ERC avanzada (estadios IV-V) respondieron peor a la vacuna (92,9 % vs 50 %, p=0,025). Conclusiones: la vacunación bacteriana sublingual es una buena opción de tratamiento para la ITU recurrente de pacientes con ERC, siendo más eficaz en los que presentan mejor función renal.


Abstract Introduction: Urinary tract infections (UTIs) are common in patients with chronic kidney disease. A treatment option in recurrent UTI is sublingual bacterial vaccination. The objective of this study was to determine the response to vaccination in nephrologic patients with recurrent UTI. Method: Quasi-experimental study before-after (15 months) in patients with recurrent UTI from the outpatient nephrology consultation. After receiving antibiotic treatment for each UTI, patients took one cycle of the sublingual bacterial vaccine Uromune? for three months. Sociodemographic data, associated risk factors, analysis, UTI in the previous and subsequent six months, microorganisms, concomitant antibiotic treatment, response to treatment and resolution of UTI were collected. Results: Twenty-six patients (80.8% female) of 61.9 ±18.4 years, 46.2% with diabetes and 47.7% with impaired renal function were included. The episodes of UTI were 3.62 ±1.77 (1-7) before and 1.69 ± 1.77 (0-5) after vaccination. In total, 184 urine cultures were collected: 74.9% positive, 16.9% negative and 8.2% contaminated. The most frequent bacteria were Escherichia coli (55.4%), Enterococcus faecalis (6%) and Enterobacter cloacae (2.7%). Fifty percent had voiding syndrome, which was inversely associated with age (p < 0.05); 26.9% did not have a UTI again and 73.1% had fewer episodes. Patients with advanced chronic disease (stages 4-5) reponded worse to the vaccine (92.9% vs 50%, p =0.025). Conclusions: Sublingual bacterial vaccination is a good treatment option in recurrent UTI of nephrologic patients, being more effective in those with better renal function.


Subject(s)
Humans , Male , Female , Bacterial Vaccines , Patients , Spain , Urinary Tract Infections , Renal Insufficiency, Chronic , Nephrology
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