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As infecções do trato urinário (ITU) são a segunda infecção mais comum em humanos, afetando milhões de pessoas anualmente. Além de sua alta prevalência, as ITUs estão associadas a elevadas taxas de morbidade, especialmente em mulheres, e representam um considerável impacto econômico devido à resistência antimicrobiana crescente. Este estudo tem como objetivo avaliar o perfil microbiológico de amostras de urocultura de pacientes atendidos em Maringá PR entre 2016 e 2022. Por meio de um estudo retrospectivo, foram analisados 167.426 laudos de urocultura, sendo 127.088 (75,9%) pertencentes ao sexo feminino. Um total de 34.467 (20,6%) amostras apresentaram crescimento bacteriano ou fúngico. Os resultados mostraram prevalência de Escherichia coli (66,97%), Klebsiella pneumoniae (11,7%) e Proteus mirabilis (4,67%), todas Gram-negativas. Foi observado predomínio de amostras positivas em todas as faixas etárias avaliadas na população do sexo feminino, com uma incidência total de 84,97% (n=29.288), especialmente em mulheres entre 20-39 anos (27,8%). A conclusão destaca a importância de estratégias de prevenção e tratamento adequadas para reduzir a incidência de ITUs e os custos relacionados ao tratamento, principalmente em populações de risco.
Urinary tract infections (UTIs) are the second most common infection in humans, affecting millions of people annually. In addition to their high prevalence, UTIs are associated with high morbidity rates, especially in women, and represent a considerable economic impact due to increasing antimicrobial resistance. This study aims to evaluate the microbiological profile of urine culture samples from patients treated in Maringá, Paraná, between 2016 and 2022. Through a retrospective study, 167,426 urine culture reports were analyzed, of which 127,088 (75.9%) belonged to females. A total of 34,467 (20.6%) samples showed bacterial or fungal growth. The results revealed a predominance of Escherichia coli (66.97%), followed by Klebsiella pneumoniae (11.7%) and Proteus mirabilis (4.67%), all of which are Gram-negative bacteria. A predominance of positive samples was observed across all age groups in the female population, with a total incidence of 84.97% (n=29,288), particularly in women aged 20-39 years (27.8%). The conclusion highlights the importance of appropriate prevention and treatment strategies to reduce the incidence of UTIs and the costs associated with treatment, especially in at-risk populations.
Las infecciones del tracto urinario (ITU) son la segunda infección más común en los seres humanos, afectando a millones de personas anualmente. Además de su alta prevalencia, las ITUs están asociadas a elevadas tasas de morbilidad, especialmente en mujeres, y representan un considerable impacto económico debido a la creciente resistencia antimicrobiana. Este estudio tiene como objetivo evaluar el perfil microbiológico de muestras de urocultivo de pacientes atendidos en Maringá PR entre 2016 y 2022. A través de un estudio retrospectivo, se analizaron 167.426 informes de urocultivo, de los cuales 127.088 (75,9%) pertenecían al sexo femenino. Un total de 34.467 (20,6%) muestras presentaron crecimiento de bacterias o hongos. Los resultados mostraron una prevalencia de Escherichia coli (66,97%), Klebsiella pneumoniae (11,7%) y Proteus mirabilis (4,67%), todas Gram-negativas. Se observó un predominio de muestras positivas en todos los grupos etarios evaluados en la población femenina, con una incidencia total de 84,97% (n=29.288), especialmente en mujeres entre 20 y 39 años (27,8%). La conclusión destaca la importancia de estrategias adecuadas de prevención y tratamiento.
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Objective To explore the clinical significance and antimicrobial resistance of group B Streptococcus(GBS)isolated from midstream urine culture,aiming to provide a basis for the diagnosis and treatment of clinical urinary tract infection(UTI).Methods Information about GBS strains isolated from midstream urine culture of in-patients and outpatient in a hospital in Nanjing from February 2020 to December 2022 were retrieved through labora-tory information system,strains with complete data were screened out.Case data,urine routine,and antimicrobial susceptibility testing results were reviewed.Results A total of 9 081 non-repetitive bacterial strains were detected from midstream urine culture,including 425 GBS strains,accounting for 4.7%,ranking sixth.Strains with incom-plete data were excluded,a total of 365 patients were included in the study.169(46.3%)were males and 196(53.7%)were females,with an average age of(55.4±15.2)years.365 patients who were detected GBS were from 17 de-partments,with the highest proportion being department of urology(n=237,64.9%).The underlying diseases of patients mainly included hypertension(n=136),diabetes(n=95),urolithiasis(n=120)and urinary tumors(n=98).211 patients underwent urological surgery,all were treated with antimicrobial agents before surgery,and 205 patients underwent indwelling urinary catheters after surgery;9 patients were detected GBS from urine during the middle and advanced stage of pregnancy.36.4%(n=133),38.9%(n=142)and 24.7%(n=90)patients had GBS colony count ≤104 CFU/mL,104-105 CFU/mL,and ≥105 CFU/mL,respectively.Patients with symptoms of UTI accounted for 24.9%(n=91),and asymptomatic bacteriuria accounted for 75.1%(n=274).The incidence of UTI symptoms in males was lower than that in females(19.5%vs 29.6%,P<0.05).As the GBS colony count in urine culture increased,the proportion of patients with symptoms of UTI showed an upward trend(P<0.05).On the day of urine culture,the positive rates of urine routine white blood cells,leukocyte esterase,and nitrite were 53.2%,50.1%,and 3.8%,respectively.The positive rates of urine occult blood,leukocyte esterase,white blood cells,and urine protein in patients with symptomatic UTI were all higher than those with asymptomatic bacteriuria patients(all P<0.05).No GBS were found to be resistant to penicillin,ampicillin,vancomycin,linezolid,and tigecycline.The resistance rate to levofloxacin and moxifloxacin was about 40%,and resistance rate to tetracycline and clindamycin was over 60%.Conclusion GBS isolated from urine is more common in non-pregnant adults,and only a small percentage have symptoms of UTI.The results of urine culture and urine routine should be comprehen-sively judged based on patient's clinical symptoms and signs.GBS in urine is susceptible to multiple antimicrobial agents,and clinical medication should be adopted rationally based on antimicrobial susceptibility testing result.
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Background: Urinary tract infection (UTI) is a common problem in pediatric age group and is a significant risk factor for long term sequelae. The clinical signs and symptoms of UTI are nonspecific in the first 5 years of age.Methods: A cross-sectional study was conducted after obtaining institutional ethical clearance and informed consent from the parents, on 350 children aged 1 to 5 years admitted in with acute febrile illness.Results: Out of 350 children with acute febrile illness 23 had culture proved UTI. The frequency of occurrence of UTI was 6.5%. Majority 8 (34.7%) of children with UTI were between 1-2 yrs. There was female preponderance with male: female ratio of 1:2.3. Twelve children with UTI belonged to lower socioeconomic status. Fourteen (60.87%) had nonspecific symptoms. Seventeen (73.9%) children had a provisional diagnosis other than UTI. pyuria >10 WBC/HPF had higher specificity (98.5%) and positive predictive value (72.2%) than >5WBC/HPF. Combined bacteruria and pyuria had specificity of 98.8 %. The most common organism isolated from children with UTI was E. coli, most of the organisms (73.9%) were sensitive to ceftriaxone. Abnormal ultrasonographic features was found in 17.4 % of children with UTI.Conclusions: As the febrile children with UTI usually present with nonspecific signs and symptoms, urine culture should be considered as a part of diagnostic evaluation. Urine culture is the gold standard for diagnosis of UTI. However combined bacteruria and pyuria had specificity of 98.8% and can be used to start empirical antibiotic therapy awaiting culture reports.
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Background: Asymptomatic bacteriuria is a frequent pregnancy issue that, if left untreated, increases the risk of premature birth and pyelonephritis. Urine culture is the basis for the diagnosis. In the current study, 200 pregnant women are examined for severe asymptomatic bacteriuria to gain insight into its frequency in emerging nations, to re-evaluate some predisposing factors, and to test for the susceptibility of specific aetiological agents. The purpose of this study was to assess the prevalence of asymptomatic bacteriuria in pregnant women as well as to isolate, characterise, and establish the pathogens antibiotic susceptibility patterns. Methods: 200 pregnant women with asymptomatic bacteriuria are included in the study. By using traditional techniques, isolates were located, and their antibiotic susceptibility patterns were established. Results: Significant bacteriuria was detected in 102 individuals (51%) in total. The three most efficient antibiotics against the urine isolates were determined to be Piperacillin-Tazobactam, Amikacin, and Nitrofurantion. Escherichia coli was the most prevalent bacterium, followed by Klebsiella pneumoniae. Conclusions: In the group under study, prenatal patients frequently have asymptomatic bacteriuria. All prenatal patients should have routine urine cultural testing to detect any undetected infections. This action will significantly lessen pregnancy-related maternal and obstetric problems.
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【Objective】 To analyze the clinical characteristics of stone culture and preoperative urine culture of patients with renal calculi in Songjiang area of Shanghai and the relationship with postoperative infection. 【Methods】 The clinical data of 213 patients with kidney stones treated at our hospital during Jan.2020 and Jun.2022 were retrospectively analyzed. All patients underwent preoperative clean midcourse urine culture, drug sensitivity test and stone culture. The gender difference between male and female patients and the difference in postoperative infection between stone/bacterial culture positive and negative patients were analyzed. 【Results】 Among the 213 patients, 47(22.1%) had positive urine culture, and the most common bacterium was Escherichia coli (20 strains, 42.6%). The proportion of Escherichia coli was significantly higher in female patients than in male patients [12 strains (48.0%) vs.8 strains (36.4%), P<0.05], while the proportion of Klebsiella pneumoniae was significantly higher in male patients than in female patients [5 strains (22.7%) vs. 3 strains (12.0%), P<0.05]. Drug sensitivity results showed the main Gram-negative bacteria were highly resistant to ampicillin/sulbactam, cefazolin and cefuroxime, but sensitive to imipenem, kanamycin and piperacillin/tazobactam. The main Gram-positive bacteria were highly resistant to clindamycin, erythromycin and levofloxacin, but sensitive to vancomycin, teicoplanin and linezolid. Stone culture was positive in 31 cases (14.6%), and the most common bacterium was Proteus mirabilis (9 strains, 29.0%). However, there was no significant difference in the main bacterial spectrum between male and female patients. The positive rate of urine culture/stone culture in patients with postoperative fever/urosepsis was significantly higher than that in patients with negative urine culture/stone culture (P<0.05). 【Conclusion】 Escherichia coli is the main urinary spectrum of patients with kidney stones in Songjiang area, which is greatly different from the stone culture results. In clinical practice, etiological detection and antibiotics are necessary to reduce the occurrence of postoperative infection.
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Introduction: Antimicrobial resistance is a global concern since infections by resistant pathogens are associated with higher mortality and morbidity. Objective: To assess the prevalence of Escherichia coli isolates producing extended-spectrum and AmpC beta-lactamase (ESBL) in urine samples from patients at the Hospital Metropolitano de Santiago in Dominican Republic. Methods: Pathogen identification and antibiogram were carried out by the automated systems BD Phoenix or Microscan®. General information and past medical history were gathered from patients with a positive urine culture for E. coli. Manual ESBL/AmpC screening was performed with the commercial ESBL+AmpC screen disc kit from Liofilchem Laboratory, Italy. Results: One or both of the studied phenotypes were present in 36% of the analyzed isolates. Among the risk factors for the detection of E. coli producing ESBL and/or AmpC in urine were male gender, advanced age, placement of urinary catheter, arterial hypertension, neoplasms, and coexistence of two or more comorbidities. Apart from cephalosporins resistance, isolates producing ESBL and/or AmpC also showed higher resistance to other antibiotics, such as gentamicin (66.7%), ciprofloxacin and levofloxacin (83.3%), and ampicillin (91.7%). Furthermore, 85% of the ESBL/AmpC producing samples were multidrug resistant (resistant to 1 or more drugs in at least 3 different antibiotic categories). Conclusions: The high prevalence of antimicrobial resistance found in this study highlights the importance of implementing national and global measures to tackle the problem, especially in developing countries such as the Dominican Republic, where resources are scarce.
Introducción: La resistencia antimicrobiana es un grave problema global, pues las infecciones causadas por patógenos resistentes están asociadas con una mayor mortalidad y morbilidad. Objetivos: Analizar la prevalencia de aislados de Escherichia coli productores de β-lactamasas de espectro extendido (BLEE) y tipo AmpC procedentes de muestras de orina de pacientes del Hospital Metropolitano de Santiago en la República Dominicana. Métodos: La identificación del patógeno y el antibiograma fueron llevados a cabo mediante los sistemas automáticos BD Phoenix o Microscan®. Se recolectó información general y la historia médica de pacientes con un cultivo de orina positivo para E. coli. La detección de BLEE/AmpC se realizó de manera manual con el estuche comercial ESBL+AmpC de Liofilchem Laboratory, de Italia. Resultados: Un 36 % de las muestras analizadas mostraron uno o ambos fenotipos estudiados. Como factores de riesgo para la detección en orina de E. coli productoras de BLEE o AmpC se encontraron: sexo masculino, edad avanzada, colocación de un catéter urinario, hipertensión, neoplasmas y coexistencia de comorbilidades. Además de resistencia a las cefalosporinas, los aislados productores de BLEE y AmpC revelaron también elevada resistencia a otros antibióticos como gentamicina (66,7 %), ciprofloxacina y levofloxacina (83,3 %), y ampicilina (91,7 %). Un 85,0 % de las muestras productoras de BLEE/AmpC fueron multidrogorresistentes. Conclusiones: La elevada prevalencia de resistencia antimicrobiana encontrada en este estudio refleja la importancia de tomar medidas nacionales y globales para contener el problema, especialmente en países en desarrollo como República Dominicana, donde los recursos son escasos.
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HumansABSTRACT
Objetivo: determinar la resistencia antibiótica de Echerichia coli, en urocultivos, según produccion de BLEE, en pacientes hospitalizados. El estudio: Diseño descriptivo - retrospectivo. La identificación bacteriana se hizo con VITEK XL, la susceptibilidad, con las pautas del CLSI M100. 30 edicion. Hallazgos. E. coli BLEE positivo, presento resistencia de 0% a: Meropenem, ertapenem, tigeciclina y colistina. Piperacilina/tazobactam, nitrofurantoina, imipenem, amicacina con 16.7%, 6.2%, 5% y 1% respectivamente. E. Coli BLEE negativo, presento resistencia de 0% a: cefotaxima, cefuroxime, tigeciclina y piperacilina/tazobactam. Ceftriaxona, cefepime, gentamicina, cefazolina, ceftazidima, nitrofurantoina, meropenem, amicacina, imipenem y ertapenem con 14.7%, 13%, 13%, 10.7%, 9.7%, 9.1%, 9.1%, 8%, 5%, 2.7%, respectivamente. Conclusion: Meropenen, ertapenem, tigeciclina, colestina, piperacilina/tazobactam, nitrofurantoina, amicacina y imipenem, con resistencia menor de 20%, fueron los mismos, para E. coli BLEE positivo, y E. coli, sin considerar la produccion de BLEE.
ABSTRAC Objective: to determine the antibiotic resistance of Echerichia coli, in urine cultures, according to ESBL production, in hospitalized patients. The study: Descriptive-retrospective design. Bacterial identification was done with VITEK XL, susceptibility, with the CLSI M100 guidelines. 30 edition. Findings: E. coli ESBL positive, presented 0% resistance to: Meropenem, ertapenem, tigecycline and colistin. Piperacillin/tazobactam, nitrofurantoin, imipenem, amikacin with 16.7%, 6.2%, 5% and 1% respectively. E. Coli ESBL negative, presented 0% resistance to: cefotaxime, cefuroxime, tigecycline and piperacillin/tazobactam. Ceftriaxone, cefepime, gentamicin, cefazolin, ceftazidime, nitrofurantoin, meropenem, amikacin, imipenem, and ertapenem with 14.7%, 13%, 13%, 10.7%, 9.7%, 9.1%, 9.1%, 8%, 5%, 2.7%, respectively. Conclusion: Meropenen, ertapenem, tigecycline, cholesterol, piperacillin/tazobactam, nitrofurantoin, amikacin and imipenem, with less than 20% resistance, were the same for ESBL-positive E. coli, and E. coli, without considering ESBL production.
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Objective:To investigate the characteristics of distribution and drug resistance of urinary bacteria in the mid-stream urine of patients with infectious stones.Methods:The retrospective study analyzed the clinical data of 254 patients with infectious stones in the First Affiliated Hospital of Guangzhou Medical University from September 2016 to September 2018. All patients were treated with PCNL. Overall, there were 101 male and 153 female patients, with the mean age of(51.5±12.3) years, and the mean stone burden of 1443.5(660.8, 2837.5) mm2. There were 58 (22.8%) patients with hypertension, 17(6.7%) patients with diabetes and 195(76.8%)with hydronephrosis. The mid-stream urine samples were obtained for bacterial culture and susceptibility test, and the results of urine culture and antimicrobial susceptibility were recorded and analyzed.Results:Of 254 patients involved in this study, 89(35.0%) were positive and 165 (65.0%) were negative for urinary bacterial culture of the mid-stream. The proportion of patients with positive urine bacterial culture of the mid-stream who had positive urine leucocytes, positive urine nitrite and postoperative pyrexia were 86.5%(77/89), 64.0%(57/89), 25.8%(23/89), respectively, which was higher than that of patients with negative urine bacterial culture of the mid-stream [50.3%(83/165), 14.5%(24/165), 14.5%(24/165), P<0.05]. Four teen kinds of bacteria were detected from the mid-stream urine, and the three bacteria with the highest detection rate in turn were Escherichia coli of 38.2%(34/89), Proteus mirabilis of 15.7%(14/89), and Pseudomonas aeruginosa of 11.2%(10/89). The results of this study showed that three common bacteria had high resistance to drug including Cefazolin, Cefuroxime, Cefuroxime ester, Ampicillin and Co-trimoxazole (all resistance rate>40%). The resistance rates of Escherichia coli and Pseudomonas aeruginosa to Ciprofloxacin and Levofloxacin were higher than or equal to 40%. The resistance rates of Escherichia coli and Proteus mirabilis to meropenem, imipenem, ertapenem, piperacillin/tazobactam and amikacin were all lower than 10%. In addition, the resistance rates of Escherichia coli to nitrofurantoin and tigecycline and Proteus mirabilis to tobramycin, aztreonam and cefoxitin were all less than 10%. The resistance rates of Pseudomonas aeruginosa to ceftazidime, cefepime, gentamicin and aztreonam were less than 10%. Conclusions:The highest detection rate of urinary bacteria in culture of the mid-stream with infectious stones are Escherichia coli, Proteus mirabilis and Pseudomonas aeruginosa, all of which showed high resistance to Ampicillin, Cotrimoxazole, and some cephalosporins. Escherichia coli and Pseudomonas aeruginosa showe high resistance to Ciprofloxacin and Levofloxacin, and all of the three bacteria have low resistance rates to some β-Lactamase inhibitor complex and carbapenems, suggesting a reference for clinical empirical medical treatment.
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Objetivo: describir la incidencia de tuberculosis urogenital (TBUG) en los dos centros de referencia diagnóstica del sistema de salud público del departamento de Cochabamba. Métodos: estudio transversal retrospectivo desde enero de 2013 a marzo de 2020; población de estudio: pacientes con sospecha de TBUG con solicitud de cultivo para BK. Recolección de datos: base de datos de los laboratorios y revisión de los expedientes clínicos. Resultados: se identificó a 2266 pacientes con sospecha clínica de TBUG a los que se les realizó cultivos de orina para TB; de los cuales 133 (5,87%) pacientes resultaron con cultivo positivo: 87 de sexo masculino (65,4%) y 46 de sexo femenino (34,6%); De estos, 115 pacientes no cuentan con un seguimiento completo clínico ni microbiológico, de los cuales el 83,3% tenía TB renal, 11,1% genital y 5,6% vesical; el 77,8 % presentaron síntomas del tracto urinario inferior, 33,3 % tenía algún tipo de comorbilidad y 1 requirió cirugía urológica. El tratamiento antituberculoso fue el estándar en el 100%, 1 presentó reacción adversa, pero ninguna resistencia ni defunciones asociadas al tratamiento. Discusión: la incidencia del 5,87% no es despreciable, debido a que se requiere un alto índice de sospecha y contar con el cultivo para el diagnóstico, seguimiento y finalización de la terapia y de este modo disminuir el daño irreversible que afectan la funcionalidad.
Objective: to determine the incidence of urogenital tuberculosis (UGTB) in the 2 diagnostic reference centers of Cochabamba. Methods: retrospective cross-sectional study from January 2013 to March 2020; Study population: patients with suspected UGTB with culture request for BK. Data collection: Laboratory database and review of clinical records. Results: 2266 patients with clinical suspicion of UGTB who had urine cultures for TB were identified; of which 133 (5.87%) patients were culture positive: 87 male (65.4%) and 46 female (34.6%); Of these, 115 patients do not have complete follow-up and only 18 patients were evaluated, of which 83.3% had renal TB, 11.1% genital and 5.6% bladder; 77.8% had lower urinary tract symptoms, 33.3% had some type of comorbidity and 1 required urological surgery. Antituberculosis treatment was standard in 100%, 1 presented adverse reaction, but no resistance or deaths associated with the treatment. Discussion: the incidence of 5.87% is not negligible, due to the fact that a high index of suspicion is required and to have the culture for diagnosis, follow-up and termination of therapy and thus reduce irreversible damage affecting functionality.
Subject(s)
UrologyABSTRACT
RESUMEN Introducción. La resistencia antimicrobiana incrementa la morbimortalidad y es un problema serio en el mundo. Objetivo: Describir la resistencia antibiótica de bacterias aisladas en hemocultivos y Urocultivos en niños hospitalizados menores de 15 años. Material y Métodos: Estudio descriptivo - retrospectivo. La identificación bacteriana se hizo con VITEK XL, la susceptibilidad antibiótica con el CLSI. Resultados: Hemocultivos: Staphylococcus hominis 12,5% resistente a la Vancomicina. El Staphylococcus epidermidis, tuvo 100% de resistencia a Oxacilina y 0% resistencia a Vancomicina. Urocultivos: Klebsiella pneumoniae 0% resistencia a Amikacina, Gentamicina y Nitrofurantoina. La Escherichia Coli, tuvo resistencia para Amikacina 1,96%, Nitrofurantoina 3,92%. Conclusiones: E, Coli, resistencia menor de 6,25% para Amikacina y Nitrofurantoina. La Klebsiella pneumoniae, 0% de resistencia para Amikacina y Gentamicina. Hemocultivos: Estafilococo epidermidis, cero resistencia a Vancomicina. El Staphylococcus hominis, resistencia menor de 12% para Vancomicina y Rifampicina.
ABSTRACT Introduction: Antimicrobial resistance increases morbidity and mortality and is a serious problem in the world. Objective: to describe the antibiotic resistance of bacteria isolated in blood and urine cultures in hospitalized children under 15 years of age. Material and Methods: Descriptive retrospective study. Bacterial identification was made with VITEK XL, antibiotic susceptibility with CLSI. Results: Blood cultures: Staphylococcus hominis 12.5% resistant to Vancomycin. Staphylococcus epidermidis had 100% resistance to Oxacillin and 0% resistance to Vancomycin. Urine cultures: Klebsiella pneumoniae 0% resistance to Amikacin, Gentamicin and Nitrofurantoin. Escherichia Coli, had resistance to Amikacin 1.96%, Nitrofurantoin 3.92%. Conclusions: E, Coli, resistance less than 6.25% for Amikacin and Nitrofurantoin. Klebsiella pneumoniae, 0% resistance for Amikacin and Gentamicin. Blood cultures: Staphylococcus epidermidis, zero resistance to Vancomycin. Staphylococcus hominis, resistance less than 12% for Vancomycin and Rifampicin.
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Introducción: La presencia de leucocituria nos orienta hacia la probabilidad de infección del tracto urinario en niños. Objetivo: Determinar si la leucocituria significativa es un marcador de infección urinaria aun sin cultivo de orina positivo. Métodos: Estudio descriptivo y retrospectivo en pacientes egresados de los Servicios de Neonatología y Nefrología del Hospital Pediátrico Universitario Juan Manuel Márquez, entre enero 2018-diciembre 2019, que incluyó 124 niños de 2 años de edad; un grupo con infección del tracto urinario confirmada (clínica, leucocituria mayor 10 000 leucocitos/ml y con urocultivos positivos) y otro sospechada (clínica, con leucocituria significativa de más 100 000 leucocitos/ml, pero sin cultivo de orina positivo). Se compararon variables clínicas, de laboratorio y de radioimagen. Resultados: En 78,6 por ciento de los niños se aisló Escherichia coli. La fiebre fue un hallazgo clínico frecuente. El reactante de fase aguda con mayor variación fue la velocidad de sedimentación globular (71,0 por ciento), presentaron alteraciones del ultrasonido (79,8 por ciento) y uretrocistografía miccional (50,0 por ciento). No hubo diferencias estadísticamente significativas al comparar las variables clínicas, de laboratorio y de radioimagen entre el grupo de pacientes con infección del tracto urinario confirmada por urocultivo positivo y el grupo sospechado por la clínica, con leucocituria significativa de más 100 000 leucocitos/ml, pero sin urocultivo positivo. Conclusiones: En los niños con manifestaciones clínicas de infección, con presencia de una leucocituria significativa (más 100 000 leucocitos/ml), aunque no cuenten con un resultado positivo del urocultivo, se les debe proporcionar la atención médica establecida para un paciente con infección del tracto urinario(AU)
Introduction: The presence of leukocyturia guides towards the probability of urinary tract infection in children. Objective: Determine whether significant leukocyturia is a marker of urinary tract infection even without positive urine culture. Methods: Descriptive and retrospective study in patients discharged from the Neonatology and Nephrology Services of Juan Manuel Márquez University Pediatric Hospital, from January 2018 to December 2019, which included 124 children of 2 years of age; one group with confirmed urinary tract infection (clinical, leukocyturia of more than 10 000 leukocytes/ml and with positive urine cultures) and another group of suspected ones (clinical, with significant leukocyturia of more than 100 000 leukocytes/ml, but without positive urine culture). Clinical, laboratory and radioimaging variables were compared. Results: Escherichia coli was isolated in 78.6 percent of the children. Fever was a common clinical finding. The reactant acute phase with the greatest variation was the erythrocyte sedimentation rate (71.0 percent), there were ultrasound alterations (79.8 percent) and voiding urethrocystography (50.0 percent). There were no statistically significant differences when comparing clinical, laboratory and radioimaging variables between the group of patients with urine tract infection confirmed by positive urine culture and the group suspected by the clinic findings, with significant leukocyturia of more than 100 000 leukocytes/ml, but without positive urine culture. Conclusions: In children with clinical manifestations of infection, with the presence of significant leukocyturia (more than 100 000 leukocytes/ml), even if they do not have a positive urine culture result, they should be provided with the medical care established for a patient with urinary tract infection(AU)
Subject(s)
Humans , Infant , Child, Preschool , Urinary Tract Infections/microbiology , Vesico-Ureteral Reflux , Clinical Laboratory Techniques/methods , Fever , Urine Specimen Collection/methods , Indicators and Reagents/analysis , Leukocytes/microbiology , Epidemiology, Descriptive , Retrospective StudiesABSTRACT
Background: Asymptomatic bacteriuria in pregnancy should be screened and treated to reduce the risk of morbidity and mortality. Urine culture is the recommended test. In low resource setting with large patient load urine culture in all pregnant patients is not feasible. In this study authors have assessed the validity of urine microscopy in the screening of asymptomatic bacteriuria in pregnancy.Methods: Midstream clean catch urine specimen collected from 675 pregnant women was subjected to urine sediment microscopy and culture. It was considered screen positive if pus cells were >5/HPF. Asymptomatic bacteriuria was diagnosed if there were >/=100000 CFU of a single uropathogen per ml. Results obtained were statistically analysed for the prevalence of asymptomatic bacteriuria, sociodemographic and medical risk factors, causative organisms, antibiotic sensitivity and validity of urine sediment microscopy in detecting asymptomatic bacteriuria.Results: The incidence of asymptomatic bacteriuria in our study was 10.2%. The incidence was higher in the age group between 20-30 years, in gravida 3 and above, in upper lower and lower socioeconomic status, in women with hyperglycemia in pregnancy and anaemia. E. coli was the commonest bacterial isolate in culture positive cases. Bacterial isolates had poor sensitivity for Ampicillin, amoxicillin and nitrofurantoin and good sensitivity for cephalosporins and aminoglycosides. The sensitivity, specificity, positive and negative predictive values for urine microscopy was 43%, 85%, 25% and 93% respectively.Conclusions: This study shows poor sensitivity and positive predictive value and good specificity and negative predictive value.
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BACKGROUND: Ureteral stents have been extensively applied In the stenosis In the conjunction of the renal pelvis and ureter, the reconstruction of in situ urine flow, ureter or nephroscope lithotripsy, renal transplant, and tumors. However, the long-term retention of ureteral stents can induce catheter-associated urinary tract Infection complications. OBJECTIVE: To Investigate the morphological characteristics of bacterial blofilm on ureteral stent, and to analyze the features of pathogenic distribution and antimicrobial drug resistance to bacterial biofilm. METHODS: Specimens of ureteral stent were collected from 127 patients at Yongchuan Hospital, Chongqing Medical University between January and December 2016. The morphological characteristics of bacterial blofilm on the stent were observed under scanning electron microscope. Each specimen was divided Into three parts (renal pelvis, ureter and bladder) for screening biofilm-forming bacteria strains separately by Congo red medium. The urine was bacterially cultured. Drug susceptibility test was done with the collected biofilm-forming bacteria strains. The study was approved by the Ethics Committee of Yongchuan Hospital, Chongqing Medical University (approval No. 201422). RESULTS AND CONCLUSION: (1) Bacterial blofilm was observed on the surface of ureteral stents at 7,15 and 30 days of retention, with various numbers of inflammatory attachments or crystals. Bacteria on the bacterial biofilm were embraced by large amounts of fiber membranes. Patchy bacterial colonies were observed on the surface of the ureteral stent at 7 and 15 days of retention, which mainly focused on bacillus. Heap-shaped bacterial colonies were found on the surface of ureteral stents that were retained for 30 days, which mainly were bacillus and coccus. (2) A total of 106 bacterial blofilms were detected in the ureteral stent samples obtained from 127 patients. The positive rate was 83.5%, in which the bladder section had the highest positive rate, followed by the renal pelvis section and ureter section. There were 25 copies of positive urine culture, and the positive rate was 19.7%. The strains obtained from the bacterial biofilm on each section of the ureteral stents were significantly higher than that from the urine bacteria culture (P < 0.05). (3) A total of 227 strains were detected from 106 positive samples. Among these samples, the number of Gram-negative strains was significantly higher than that of Gram-positive strains (P < 0.05). Among culture bacteria of the bacterial biofilm on the ureteral stent and urine culture bacteria, colibacillus, pseudomonas aeruginosa, enterococcus faecalis and enterococcus faecium were the most common. (4) The biofilm-forming bacteria on the ureteral stent had a high drug resistance. (5) In summary, bacterial blofilm may be the important reason for catheter-associated urinary tract infection.
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Background: Children with fever comprise a major proportion of our practice in outpatient department of Paediatric. Among the fever cases Urinary tract infection is the third most common cause of febrile illness in children. The emphasis on identification of urinary tract infections in febrile children is minimal. Very often, children receive antibiotics empirically, without any adequate evaluation for urinary tract infection. The objective of our study is to determine the prevalence of urinary tract infection in all febrile children from 1months to 5 years of age.Methods: A prospective study was undertaken in the department of Pediatrics, Government medical college, Srikakulam. Urine was collected from enrolled febrile patients and sent for routine microscopic examination as well as for culture and sensitivity.Results: The study included 500 children. Females were 256(51.2%) and males were 244(48.8%). The total prevalence of UTI cases were 6%. The incidence in <1 year was 7.05%, 1-2 years was 5.97 % and >2 years was 5.35%. The prevalence of UTI was higher among females (7.68%) than males (4.68%). Apart from fever, the commonest symptoms were dysuria, abdominal pain, vomiting, chills and rigors and loss of appetite. Urine culture shows E. coli followed by Klebsiella were found to contribute the maximum number of cases.Conclusions: Possibility of Urinary Tract Infection must be considered in all febrile children and urine culture specimen must be collected as a part of diagnostic evaluation.
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Background: Dengue fever is an important tropical disease which is endemic in around 110 countries. It infects 50-100 million people worldwide per year. In India case fatality rate is 1-5% for severe Dengue. Between 2015-2017, 790 deaths have been recorded according to NVBDCP data. Global burden of Dengue has increased at least fourfold over last three decades and now 2.5 billion people at risk of disease. This study aims at determining sterile pyuria as a manifestation in patients presenting with Dengue fever, as patients may present with similar symptoms as that of urinary tract infection, thereby preventing unnecessary use of antibiotics.Methods: It is a Cross sectional observational study conducted on 100 consecutive patients with serologically proven Dengue fever. Patients satisfying inclusion and exclusion criteria underwent relevant investigations and in patients with urine routine showing pyuria, urine culture and sensitivity was done to rule out urinary tract infection and look for sterile pyuria.Results: Among 100 patients of dengue studied, age distribution being 18years to 70years, mean age was 33.27±13.2 years of them 78 were male and 22 were female. 41% patients showed pyuria in urine. 25 % patients were culture positive most common being E. coli and 16% patients had sterile pyuria.Conclusions: Sterile pyuria is not a well-recognized entity in Dengue fever and is often missed. This study shows that sterile pyuria is quite common manifestation in dengue fever which resembles urinary tract infection and therefore does not require any empirical antibiotic treatment.
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INTRODUCTION: Urinary Tract Infection (UTI) is a common bacterial infection in children with variable symptomatology. Urinary tract infection is the third most common bacterial infection in children in developing countries after those of gastrointestinal and respiratory tract MATERIALAND METHODS: This hospital based observational study was conducted prospectively for one and half years between March 2017and Sep 2018 at government general hospital, pediatric ward, srikakulam. RESULT:Atotal number of 312 febrile children fulfilling the inclusion criteria (n=312). In the study group, 65 children were diagnosed to have UTI, on basis of a positive culture test. There were 121 male children and 191 female children in the study group. There were 65 cases of UTI accounting for an overall prevalence of 20.83%. Out of 121 male children 23 had culture positivity (19%) whereas out of 191 female children 42 had culture positivity (21.98%). In the age group of 1-5 years 27 [19.85%] cases were culture positive. Among 6-12years 38 cases were positive [21.59%]. This difference is not statistically significant with p value 0.86. CONCLUSIONS :The prevalence of culture positive UTI in febrile children presenting with a clinical features other than urinary tract symptoms is 16.28%, which represents a high yield .Most of the organisms isolated are sensitive to cefotaxime {75.38%}, amikacin{73.84%}, gentamycin{64.61%},ciprofloxacin{63.07%}.
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Background: The current study aims to identify the prevalence of asymptomatic bacteriuria among low-risk pregnant women attending the antenatal care clinic of tertiary University Hospital and to detect the most common causative organisms.Methods: A prospective cross-sectional study conducted at a tertiary University Hospital in the period between 1st November 2017 and 31st June 2018. All eligible women attending the outpatient clinic for antenatal care were approached to participate in the study. The recruited women were assessed through detailed history and clinical examination. Urine samples were taken for culture and sensitivity within two hours, in order to avoid bacterial multiplication. Urine culture and antibiotic sensitivity test were done.Results: The study included 250 women. The mean age of included women was 25.89±5.49 (18-42 years). The urine analysis results showed that 32% of cases had pus cells >5 per high power field and 10.4% of cases have protein (+). Casts were present in 0.8% of cases. RBCs >5 per high power field were present in 4.8% of cases. ASB is defined as urine culture with more than 100,000 colony forming unit; this was present in 30 cases. This indicates that the prevalence of ASB among studied cases was 12%. Enterococcus was the most prevalent organism as it was present in 36.7% among positive cases. Antibiotic sensitivity test was performed to the growing organisms indicated that teicoplanin, imipenem, cefoxitin, cefotaxime + clavulanic acid, Entrapenem, and trimethoprim + sulfamethoxazole are the most effective antibiotics against the most common organisms causing asymptomatic bacteriuria.Conclusions: The prevalence of asymptomatic bacteriuria among low-risk pregnant women is about 12%. Urine culture for asymptomatic bacteriuria should be the standard of care for evaluation of pregnant patient during antenatal care as regard presence or absence of UTI.
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Background: Urinary tract infection is the second most common bacterial infection seen during pregnancy and is due to the morphological and physiological changes that take place in the genitourinary tract. The pregnant women are two times more commonly affected than age matched non pregnant females and it may lead to less favorable pregnancy outcomes and complications such as premature birth, low birth weight, pyelonephritis, preeclampsia and anemia.Methods: This hospital based cross sectional study was conducted on 350 pregnant women, falling into the inclusion criteria of the study, who attended the antenatal clinic in the Department of Obstetrics and Gynecology at PCMS and RC, Bhopal, irrespective of the gestational age of the cases. The cases found to have asymptomatic bacteriuria were followed till delivery and any adverse antenatal or perinatal outcome was noted.Results: The study was conducted with the aim to know the prevalence of asymptomatic bacteriuria and the obstetrical outcome in pregnant women. The prevalence of asymptomatic bacteriuria was 13% and it was common in the age group of 21-25 years, in primigravidas and with period of gestation less than 12 weeks. E. coli was found to be the commonest causative organism. Asymptomatic bacteriuria was found significantly associated with the presence of anemia. Maternal morbidity in terms of pre term labour was higher in cases with asymptomatic bacteriuria.Conclusions: Urine culture and sensitivity should be done as a routine investigation to screen the patients for asymptomatic bacteriuria and to prevent adverse maternal and fetal outcomes.
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Background: Urinary tract infection is diagnosed by the growth of many organisms of a single specimen in the urine with presence of many symptoms. bacteriuria is defined as growth with a colony of >105/ml of a single species in a midstream clean catch urine sample.Methods: A cross sectional study was undertaken in febrile children with urinary tract infection attending Department of Paediatrics, tertiary care hospital, Bangalore during the period January 2017 to December 2017.Results: Out of the 200 children studied, 93 children belonged to the age group of 6 year to 12 year and 57 children belong to 1 year to 6-year age group and 50 children belongs to 12 year to 18-year age group. 97 children showed significant pyuria in centrifuged urine sample of which 49 were males and 48 were females. Majority 45 children were belonging to age group of 6 year to 12 year. Out of 97 children showed significant pyuria in centrifuged urine sample of which 46 children 5-10 cells/HPF and 27 children showed > 10 cells/HPF and 24 cases showed < 5cells / HPF. Out of 200 children, in 29 cases urine culture showed E. coli growth and 51 cases showed no growth.Conclusions: Urinary tract infections are common in childhood. Nearly all UTIs are caused by bacteria that enter the opening of the urethra and move upward to the urinary bladder and sometimes the kidneys.
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Objective To evaluate the consistency among the results of preoperative midstream urine culture (PMUC), renal pelvis urine culture (RPUC) and renal stone (RSC) culture in patients undergoing percutaneous nephrolithotomy (PNL) and their relationship with postoperative infection. Methods This was a multicenter prospective study. From September 2014 to November 2017, 115 patients undergoing standard channel PNL or microchannel PNL in the First Affiliated Hospital of Soochow University and Yancheng Hospital of Traditional Chinese Medicine were selected. The PMUC, RPUC and RSC were detected. Samples for RPUC and RSC were obtained during PNL. The clinical data, stone configuration, stone burden and results of cultures were recorded. Results In the 115 patients, PMUC positive was in 4 cases (3.5%), RPUC positive was in 17 cases (14.8%), and RSC positive was in 16 cases (13.9% ); both RPUC and RSC positive were in 7 cases (6.1% ), among whom consistent pathogenic bacterium was in 6 cases, and inconsistent pathogenic bacterium was in 1 case; all the 3 cultures were positive in 1 case, but the types of pathogenic bacterium of PMUC were totally different with RPUC and RSC. At least one positive of the 3 cultures was in 29 cases (25.2% ). The types of pathogenic bacterium of PMUC were multidrug susceptible Escherichia coli and Staphylococcus aureus , and the types of pathogenic bacterium of RPUC and RSC were multidrug resistant pathogens and/or fungus. The consistency of pathogenic bacterium between PMUC and RPUC, RSC was very low; while the consistency of pathogenic bacterium between RPUC and RSC was very high (6/7). Postoperative infection occurred in 8 of 115 patients (7.0% , 5 cases of infective fever and 3 cases of urinary sepsis). In the 8 patients, PMUC was negative, PRUC positive in 4 cases, RSC positive in 7 cases, and both PRUC and RSC positive were in 3 cases. Conclusions PMUC can not accurately reflect the true situation of upper urinary tract renal calculi and pyelo-urine pathogenic bacterium. In patients with PNL postoperative infectious complications, the result of PMUC is often negative, but the results of RPUC and RSC are mostly positive. RPUC and RSC are helpful to detecting pathogenic bacterium in time, guiding the application of sensitive antibiotics, preventing and treating PNL postoperative infection.