Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 3.501
Filter
1.
Enferm. foco (Brasília) ; 11(2): 176-181, jul. 2020. tab
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1116005

ABSTRACT

Objetivo: Identificar os fatores associados ao desenvolvimento de Infecção do Trato Urinária Associada ao Cateter (ITU-AC) e mortalidade entre pacientes com cateter urinário. Metodologia: Estudo de coorte, prospectivo, com amostragem por conveniência envolvendo 790 pacientes com idade superior a 12 anos, em uso de cateter durante hospitalização. Os dados coletados do prontuário e fichas de notificação de infecção hospitalar foram analisados pelo programa SPSS. Resultados: Contribuíram para o desenvolvimento da ITU-AC a permanência com o cateter urinário por período >20 dias (OR 26,5; p<0,001), ser cateterizado mais de uma vez (OR 8,92; p<0,001) e hospitalização >30 dias (OR 26,8; p<0,001). Pacientes que desenvolveram ITU-AC apresentaram chance maior de mortalidade (OR 2,7; p<0,001). Conclusão:Frequência da inserção do dispositivo urinário, períodos prolongados de hospitalização e de permanência com o cateter contribuíram para o desenvolvimento de ITU-AC, e as chances de mortalidade foram aumentadas entre pacientes com essa infecção. (AU)


Objective: To identify factors associated with the development of Catheter-related Urinary Tract Infection (CR-UTI) and mortality among patients using urinary catheter. Methodology: Prospective cohort study in a convenience sample of 790 patients older than 12 years using catheter during hospitalization.[A1] The data collected from medical records and hospital infection notification were analyzed using the SPSS program. Results: Permanence with the urinary catheter >20 days (OR 26.5; p<0.001), being catheterized more than once (OR 8.92; p<0.001) and hospitalization >30 days (OR 26.8; p<0.001) contributed to the development of CR-UTI. Patients who developed CR-UTI presented a greater chance of mortality (OR 2.7; p<0.001). Conclusion: Frequency of urinary device insertion, prolonged periods of hospitalization and of permanence with the catheter contributed to the development of CR-UTI, and the chances of mortality were increased among patients with this infection. (AU)


Objetivo: Identificar los factores asociados con el desarrollo de Infección del Tracto Urinario Asociada con el Catéter (ITU-AC) y la mortalidad entre los pacientes que usan catéter urinario. Metodología: Estudio de cohorte, prospectivo con una muestra de conveniencia de 790 pacientes mayores de 12 años, que usan catéter durante su hospitalización. Los datos recopilados de los registros médicos y los formularios de notificación de infección nosocomial fueron analizados por el programa SPSS. Resultados: Contribuyendo al desarrollo de la (ITU-AC) la permanencia con el catéter urinario por un plazo >20 días (OR 26,5; p <0,001), tener recibido catéter más de una vez (OR 8,92; p<0,001) y hospitalización >30 días (OR 26,8; p<0,001). Los pacientes que desarrollaron (ITU-AC) presentaron una mayor posibilidad de mortalidad (OR 2,7; p<0,001). Conclusión: Frecuencia de inserción del dispositivo urinario, períodos prolongados de hospitalización y de permanencia con el catéter contribuyeron al desarrollo de (ITU-AC), y las posibilidades de mortalidad aumentaron entre los pacientes con esta infección. (AU)


Subject(s)
Urinary Tract Infections , Urinary Catheterization , Infection Control , Catheter-Related Infections , Nursing Care
2.
An. Fac. Cienc. Méd. (Asunción) ; 53(1): 31-40, 20200401.
Article in Spanish | LILACS (Americas) | ID: biblio-1095634

ABSTRACT

Introducción: El tipo de infección más común en las embarazadas es el de las vías urinarias (IVU), debido a varios factores que favorecen su desarrollo. Esto puede ocasionar distintas complicaciones en el feto y la madre. Objetivos: Determinar la prevalencia de IVU en embarazadas que acuden al Hospital Materno Infantil Santísima Trinidad. Materiales y Métodos: Estudio observacional, descriptivo, prospectivo de corte transversal en mujeres embarazadas que asistieron a controles prenatales al Hospital Materno Infantil Santísima Trinidad, en Asunción, Paraguay, de mayo a noviembre del año 2018. Se determinaron variables demográficas, clínicas y de laboratorio. Resultados: Se analizaron muestras de 202 pacientes, la edad media fue de 24±6 años. 83% presentó síntomas sugerentes de IVU, pero la prevalencia de dicha patología fue del 2%. Los agentes etiológicos aislados más comunes fueron: Escherichia coli y Staphylococcus saprophyticus. Todas las pacientes con IVU presentaron manifestaciones clínicas, principalmente nicturia, polaquiuria, dolor en flanco y orina oscura. Conclusión: Las manifestaciones de IVU pueden ser poco confiables durante la gestación debido al gran porcentaje de embarazadas que presentaron síntomas sugestivos, pero urocultivo negativo. La prueba diagnóstica definitiva de IVU es la presencia en el urocultivo de un solo germen en una cantidad igual o mayor a 105 UFC/mL.


Introduction: The most common type of infection in pregnant women affects the urinary tract (UTI), due to several factors that may contribute to its development. This can cause different complications in the fetus and mother. Objectives: To determine the prevalence of UTI in pregnant women who attend the Maternal Infant Hospital of Santísima Trinidad. Materials and Methods: Observational, descriptive, prospective cross-sectional study in pregnant women who attended prenatal controls at the Maternal Infant Hospital of Santísima Trinidad, in Asunción, Paraguay, from May to November of the year 2018. Demographic, clinical and laboratory variables were determined. Results: We analyzed samples of 202 patients, the mean age was 24 ± 6 years. 83% of them showed symptoms that suggested UTI but the prevalence was 2%. The most common etiological agents isolated were: Escherichia coli and Staphylococcus saprophyticus. All patients with UTI showed clinical manifestations, mostly nocturia, urinary frequency, flank pain and dark urine. Conclusion: UTI manifestations may be unreliable during pregnancy due to the large percentage of pregnant women who presented suggestive symptoms but negative urine culture. The definitive diagnostic test of UTI is the presence in the urine culture of a single germ in an amount equal to or greater than 105 CFU/mL.


Subject(s)
Urinary Tract Infections , Pregnant Women/ethnology
3.
Arch. argent. pediatr ; 118(1): e16-e21, 2020-02-00. tab
Article in English, Spanish | LILACS (Americas), BINACIS | ID: biblio-1095573

ABSTRACT

Introducción. El objetivo fue evaluar las características clínicas y la evolución del reflujo vesicoureteral (RVU) según el sexo y grado de RVU.Población y métodos. Se incluyeron pacientes con RVU vistos durante el seguimiento de rutina entre enero de 2014 y enero de 2015. Se registraron las características demográficas, la evolución, los laboratorios y las imágenes.Resultados. Se seleccionó a 220 pacientes, cuya media de edad del diagnóstico era 3,17 ± 3,08 años; en ese momento, los varones eran menores que las niñas (2,00 ± 2,59 vs. 3,81 ± 3,15, p < 0,001). La infección urinaria fue la presentación más frecuente, seguida de hidronefrosis prenatal (HNP). El 22 % de los pacientes tuvo reflujo de grado 1-2; el 51 %, de grado 3; y el 27 %, de grado 4-5. En el reflujo de grado 4-5, las ecografías y gammagrafías con ácido dimercaptosuccínico (DMSA) marcado con 99mTc presentaron más anomalías, y se realizaron más cirugías (p < 0,001). En los varones, fueron más comunes el reflujo de grado 4-5 (43,6 % vs. 18,3 %) y las anomalías ecográficas (77 % vs. 54 %) y en la DMSA (77 % vs. 59 %) (p < 0,05). En las niñas, hubo mayores tasas de infección urinaria, disfunción de las vías urinarias inferiores y resolución espontánea (p < 0,05).Conclusiones. A pesar de la menor edad al momento del diagnóstico, la resolución espontánea fue menor en los varones, y estos presentaron HNP, reflujo grave y anomalías radiológicas más frecuentemente.


Introduction. The aim of the study was to assess the clinical features and outcome parameters of children with vesicoureteral reflux (VUR) based on gender and VUR grade.Population and methods. Patients with VUR who were seen during routine follow-up visits at Ankara University Children's Hospital between January 2014-January 2015 were included in this retrospective study. Patient demographics, clinical course, laboratory investigations, imaging were noted.Results. Two hundred and twenty patients were recruited. Mean age at the time of diagnosis was 3,17 ± 3,08 years. Boys were diagnosed at younger ages as compared to girls (2.00 ± 2,59 vs. 3,81 ± 3.15, p < 0.001). Urinary tract infection (UTI) was the most common presentation. The second presentation form was antenatal hydronephrosis (AHN) which was more common in males (25.6 %, p < 0.001). Twenty-two percent of the patients had grade 1-2, 51 % grade 3 and 27 % grade 4-5 reflux. Patients with grade 4-5 reflux had more abnormal ultrasound (US) and Tech 99m dimercaptosuccinic acid scintigraphy (DMSA) findings and surgery was performed more frequently in this group (p < 0.001). In males, grade 4-5 reflux (43.6 % vs. 18.3 %), abnormal US (77 % vs. 54 %) and DMSA (77 % vs. 59 %) findings were more frequent (p < 0.05). In girls higher rates of UTIs, lower urinary tract dysfunction (LUTD) and spontaneous reflux resolution were seen (p < 0.05).Conclusions: Despite younger age at diagnosis, spontaneous resolution was found lower in boys and they had more frequent AHN, more severe reflux, and radiological abnormalities.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Urinary Tract Infections/diagnosis , Vesico-Ureteral Reflux/diagnosis , Signs and Symptoms , Turkey/epidemiology , Urinary Tract/abnormalities , Urinary Tract Infections/surgery , Vesico-Ureteral Reflux/surgery , Retrospective Studies , Demographic Data , Hydronephrosis
4.
Article in English | WPRIM (Western Pacific) | ID: wprim-782186

ABSTRACT

PURPOSE: Gastrointestinal symptoms are often related to antibiotic treatment. Their incidence, risk and protective conditions in children are not well defined and represent the aims of this study.METHODS: We prospectively enrolled inpatient children submitted to antibiotic treatment. Indication, type, dose and duration of treatment, probiotic supplementation and gastrointestinal symptoms were recorded at recruitment, after two and four weeks. Antibiotic-associated diarrhea (AAD) was defined as the presence of at least 3 loose/liquid stools within 14 days from antibiotic onset.RESULTS: AAD occurred in 59/289 (20.4%) of patients, with increased risk in children younger than 3 years (relative risk [RR]=4.25), in lower respiratory (RR=2.11) and urinary infections (RR=3.67), intravenous administration (RR=1.81) and previous AAD episodes (RR=1.87). Abdominal pain occurred in 27/289 (9.3%), particularly in children >6 years (RR=4.15), with previous abdominal pain (RR=7.2) or constipation (RR=4.06). Constipation was recorded in 23/289 (8.0%), with increased risk in children having surgery (RR=2.56) or previous constipation (RR=7.38). Probiotic supplementation significantly reduced AAD (RR=0.30) and abdominal pain (RR=0.36). Lactobacillus rhamnosus GG (LGG) and L. reuteri significantly reduced AAD (RR=0.37 and 0.35) and abdominal pain (RR=0.37 and 0.24).CONCLUSION: AAD occurred in 20.4% of children, with increased risk at younger age, lower respiratory and urinary tract infections, intravenous treatment and previous AAD. LGG and L. reuteri reduced both AAD and associated abdominal pain.


Subject(s)
Abdominal Pain , Administration, Intravenous , Anti-Bacterial Agents , Child , Constipation , Diarrhea , Humans , Incidence , Inpatients , Lactobacillus reuteri , Lactobacillus rhamnosus , Probiotics , Prospective Studies , Protective Factors , Urinary Tract Infections
5.
Article in English | WPRIM (Western Pacific) | ID: wprim-810966

ABSTRACT

BACKGROUND: Although the clinical importance of the immunological benefits of breastfeeding has been emphasized for decades, their direct relationship with acute pyelonephritis (APN) is still not clear. Our goal was to determine whether breastfeeding truly provides protection against APNs, while investigating the effects of other factors such as sex, age, mode of delivery, and birth weight on APN.METHODS: A total of 62 infants under 6 months of age who had both microbiologically and radiologically-confirmed APN were enrolled in the case group. Healthy infants (n = 178) who visited the hospital for scheduled vaccinations were enrolled in the control group. The following participant characteristics were compared between the case and control groups: age, sex, birth order among siblings, feeding methods, weight percentile by month, birth weight percentile by gestational age, gestational age at birth, and mode of delivery.RESULTS: Babies exclusively fed with manufactured infant formulae before 6 months of age had significantly higher risk for APN than breastfed or mixed-fed infants (odds ratio [OR], 3.4; 95% confidence interval [CI], 1.687–7.031; P = 0.001). Firstborn babies had lower risk for APN than 2nd- or 3rd-born babies (OR, 0.43; 95% CI, 0.210–0.919). Other factors that increased the risk for APN were low birth weight percentiles (OR, 8.33; 95% CI, 2.300–30.166) and birth via caesarean section (OR, 2.32; 95% CI, 1.097–4.887). There were more preterm births in the case group (10.9% vs. 1.7%; P = 0.002), but this did not increase the risk for APN (OR, 4.47; P = 0.063).CONCLUSION: Feeding exclusively with formula before 6 months of age was related to higher risk for APN, which demonstrates that breastfeeding has a protective effect against APN. The other risk factors for APN were birth order (≥ 2nd-born), low birth weight, and birth via caesarean section.


Subject(s)
Birth Order , Birth Weight , Breast Feeding , Cesarean Section , Feeding Methods , Female , Gestational Age , Humans , Infant Formula , Infant , Infant, Low Birth Weight , Infant, Newborn , Parturition , Pregnancy , Premature Birth , Pyelonephritis , Reproductive History , Risk Factors , Siblings , Urinary Tract Infections , Vaccination
6.
Article in English | WPRIM (Western Pacific) | ID: wprim-785395

ABSTRACT

BACKGROUND: Pyuria seems to be common in chronic kidney disease (CKD), irrespective of urinary tract infection (UTI). It has been hypothesized that sterile pyuria occurs in CKD because of chronic renal parenchymal inflammation. However, there are limited data on whether CKD increases the rate of pyuria or how pyuria in CKD should be interpreted. We investigated the prevalence and characteristics of asymptomatic pyuria (ASP) in CKD via urinary white blood cell (WBC) analysis.METHODS: Urine examination was performed for all stable hemodialysis (HD) and non-dialysis CKD patients of the outpatient clinic (total N=298). Patients with infection symptoms or recent history of antibiotic use were excluded. Urine culture and WBC analysis were performed when urinalysis revealed pyuria.RESULTS: The prevalence of ASP was 30.5% (24.1% in non-dialysis CKD and 51.4% in HD patients). Over 70% of the pyuria cases were sterile. The majority of urinary WBCs were neutrophils, even in sterile pyuria. However, the percentage of neutrophils was significantly lower in sterile pyuria. In multivariate logistic regression analysis, the degree of pyuria, percentage of neutrophils, and presence of urinary nitrites remained independently associated with sterile pyuria.CONCLUSIONS: The prevalence of ASP was higher in CKD patients and increased according to CKD stage. Most ASP in CKD was sterile. Ascertaining the number and distribution of urinary WBCs may be helpful for interpreting ASP in CKD.


Subject(s)
Ambulatory Care Facilities , Humans , Inflammation , Leukocytes , Logistic Models , Neutrophils , Nitrites , Prevalence , Pyuria , Renal Dialysis , Renal Insufficiency, Chronic , Urinalysis , Urinary Tract Infections , Viperidae
8.
Diagn. tratamento ; 24(4): [135-142], out - dez. 2019. tab, graf
Article in Portuguese | LILACS (Americas) | ID: biblio-1049377

ABSTRACT

Introdução: A automedicação ocorre, em especial, por fatores sociais, econômicos e culturais, podendo refletir na eficácia do tratamento antibacteriano, devido à adaptação das bactérias aos antibióticos de primeira escolha. A resistência bacteriana é uma problemática mundial. Objetivo: Verificar a etiologia e o perfil de resistência de bactérias isoladas em uroculturas frente aos antibióticos comumente utilizados em um hospital no município de Macapá (AP), Brasil. Métodos: Trata-se de um estudo transversal com coleta de dados no sistema de registros cadastrais do Laboratório Central de Saúde Pública do Amapá, onde foram processadas as uroculturas oriundas do hospital-alvo deste estudo, no período de junho de 2016 a junho de 2018. Resultados: Os resultados demonstraram que, das 2.078 uroculturas, 289 (13,9%) eram positivas, sendo 55% de pacientes do sexo feminino. As infecções urinárias foram causadas, predominantemente, por enterobactérias Escherichia coli (50,4%) e Klebsiella pneumoniae (21%), sendo sensíveis ao meropenem e à amicacina, e respectivamente resistentes às quinolonas norfloxacina (63% e 66%) e ciprofloxacina (61% e 46,6%). Por outro lado, Staphylococcus aureus (1,4%) apresentou maior resistência à eritromicina (100%) e à oxacilina (50%). O Enterococcus faecalis (5%) foi mais resistente aos antibióticos ciprofloxacina, ampicilina e gentamicina, com 35,7%. Conclusão: Os uropatógenos foram mais frequentes no sexo feminino entre a faixa etária de 40 a 79 anos. Os microrganismos mais isolados foram as bactérias Escherichia coli e Klebsiella pneumoniae, que apresentaram perfil de resistência às quinolonas norfloxacina e ciprofloxacina, o que foi associado ao frequente uso empírico destes fármacos no tratamento de infecções do trato urinário. Verificou-se a existência de bactérias como Burkholderia cepacia e Stenotrophomonas maltophillia, que, por serem resistentes à maioria dos fármacos clinicamente utilizados, representam preocupação especial para os pacientes em condições de imunodepressão.


Subject(s)
Urinary Tract Infections , Cross Infection , Epidemiology , Clinical Laboratory Techniques , Anti-Bacterial Agents
9.
Rev. méd. (La Paz) ; 25(2): 10-18, Jul. Dic., 2019.
Article in Spanish | LILACS (Americas) | ID: biblio-1102519

ABSTRACT

Introducción. La Infección del Tracto Urinario (ITU) es la infección bacteriana que más se diagnostica en el mundo y su agente causal más frecuente es Escherichia coli (E. coli), bacteria que ha adquirido importancia por su capacidad de producir betalactamasa de espectro extendido (BLEE), lo cual dificulta su tratamiento y hace más frecuentes las infecciones recurrentes y recidivantes incluyendo sus complicaciones, sobretodo en pacientes inmunocomprometidos.Objetivo. Identificar pacientes con ITU producidas por E. coli productoras de BLEE y evaluar su espectro antibacteriano y molecular.Material y métodos. Estudio longitudinal y prospectivo realizado con muestras urinarias de 53 pacientes de la Caja Nacional de Salud en La Paz-Bolivia. Se aisló como agente causal a E. coli en el 72% de las muestras, de estas, 35 presentaron fenotipo BLEE sensibles a imipenem, gentamicina y nitrofurantoina (100%) y amikacina (94%). Los ensayos de fenotipificación reportaron predominio del tipo PhP-2 y los filogenéticos (PCR y secuenciación) identificaron predominio de bla CTX-M-15 asociada a bla TEM-1.Conclusión. Los fármacos de primera línea para el tratamiento de la ITU no son adecuados, haciendo a los pacientes más susceptibles a infecciones recurrentes y recidivantes. Se deben identificar precozmente y tratar eficazmente las ITU producidas por cepas de E. coli productoras de BLEE.


Subject(s)
Urinary Tract Infections
10.
Rev. colomb. obstet. ginecol ; 70(4): 243-252, oct.-dic. 2019. tab, graf
Article in Spanish | LILACS (Americas) | ID: biblio-1093047

ABSTRACT

RESUMEN Objetivo: determinar la prevalencia de infección del tracto urinario (ITU), el perfil microbiológico y la resistencia a los antibióticos en mujeres gestantes con sospecha de infección del tracto urinario. Materiales y métodos: estudio de corte transversal. Ingresaron gestantes con sospecha de infección del tracto urinario adquirida en la comunidad, remitidas a consulta externa desde su control prenatal o atención por urgencias, y hospitalizadas entre agosto de 2013 y septiembre de 2015 en un hospital universitario de referencia ubicado en Medellín, Colombia. Se excluyeron gestantes que hubieran recibido antibióticos el día anterior a la admisión. Muestreo aleatorio simple. Variables medidas: sociodemográficas, clínicas y bacteriológicos. Se aplicó estadística descriptiva. Resultados: la prevalencia de infección del tracto urinario fue del 29 %. Predominaron los aislamientos de bacterias Gram negativas, principalmente E. coli y K. pneumoniae en un 57,7 y 11,4 % respectivamente. Se observó resistencia a trimetoprim-sulfametoxazol en el 19,5 % y ampicilina-sulbactam en el 17,5 % de los aislamientos. Conclusiones: se requieren estudios de base poblacional para una mejor aproximación a la resistencia de las bacterias causantes de la ITU en la comunidad. Por otra parte, la alta resistencia observada podría sugerir que algunos antibióticos expuestos no sean incluidos en las guías locales de manejo de la ITU.


ABSTRACT Objective: To determine the prevalence of urinary tract infections (UTIs), the microbiological profile and antibiotic resistance in pregnant women with suspected urinary tract infection. Materials and methods: Cross-sectional study of pregnant women with suspected community- acquired urinary tract infection referred to the outpatient clinic by prenatal care practitioners or seen in the emergency room, and hospitalized between August 2013 and September 2015 in a referral teaching hospital located in Medellin, Colombia. Pregnant women who had received antibiotics on the day before admission were excluded. Random sampling. Measured variables: sociodemographic, clinical and bacteriological. Descriptive statistics were applied. Results: The prevalence of urinary tract infections was 29%. Gram negative bacteria isolates were found predominantly, the main ones being E. coli and K. pneumoniae at 57.7 and 11.4%, respectively. Resistance to trimethoprim- sulfamethoxazole and to ampicillin-sulbactam was observed in 19.5% and 17.5% of isolates, respectively. Conclusions: Population-based studies are needed to provide a better approach to bacterial resistance in community-acquired UTIs. On the other hand, the high resistance observed may suggest that some of the exposed antibiotics might not be included in the local guidelines for the management of UTIs.


Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications, Infectious , Urinary Tract Infections , Urinalysis , Diagnostic Techniques, Urological
11.
Arch. med ; 19(2): 238-246, 2019/07/30.
Article in Spanish | LILACS (Americas) | ID: biblio-1022888

ABSTRACT

Objetivos: caracterizar la respuesta inmunometabólica en la orina de pacientes adultos mayores infectados con Escherichia coli uropatógena residentes en casas de reposo y determinar su frecuencia filogenética. Materiales y métodos: estudio observacional descriptivo, en el cual se enrolaron 24 pacientes con infección del tracto urinario y 17 pacientes sin infección del tracto urinario. Se cuantificó el hierro y el TNF ­ α en orina por métodos espectrofotométricos, la capacidad antioxidante por ensayo ABTS+* y la determinación filogenética de E. coli por el método de Clermont. Resultados: la concentración de hierro, TNF ­ α y la capacidad antioxidante en la orina en pacientes con infección del tracto urinario los valores fueron de 175,40 µg/L, 70,11 pg/mL y 1229,75 µg/mL eq-VitC, mientras que en pacientes sin infección fue de 67,4 µg/L (p = 0,001), 87,16 pg/mL (p = 0,08) y 1069,14 µg/mL eq-VitC (p = 0,61) respectivamente. Además, se encontraron 11 E.coli pertenecientes al grupo B2 y 13 agrupados en no - B2 (A, B1, D y E). Conclusiones: se evidencia una alta disponibilidad de hierro en la orina de los pacientes adulto mayores con infección del tracto urinario, lo cual estimula la proliferación bacteriana. Hay una elevada capacidad antioxidante en la orina de los pacientes con infección del tracto urinario y una mayor presencia clonal de E.coli de tipo no B2 en la orina de los pacientes residentes en casas de reposo..(AU)


Objectives: to characterize the immunometabolic response in the urine of elderly patients infected with uropathogenic Escherichia coli resident in elderly homes and determine its phylogenetic frequency. Materials and methods: descriptive and observational study in which 24 patients with urinary tract infection and 17 patients without urinary tract infection were enrolled. Were quantified Iron and TNF ­ α in urine by spectrophotometric methods, the antioxidant capacity by ABTS + * assay and the phylogenetic determination of E. coli by the Clermont method. Results: the concentration of iron, TNF - α and the antioxidant capacity in urine in patients with urinary tract infection were 175.40 µg / L, 70.11 pg / mL and 1229.75 µg / mL eq-VitC, while in patients without infection the values were of 67.4 µg / L (p = 0.001), 87.16 pg / mL (p = 0.08) and 1069.14 µg / mL eq-VitC (p = 0.61) respectively. In addition, 11 E. coli belonging to group B2 and 13 grouped in non - B2 (A, B1, D and E) were found. Conclusions: high availability of iron in the urine of elderly patients with urinary tract infection is evidenced, which stimulates bacterial proliferation. There is a high antioxidant capacity in the urine of patients with urinary tract infection and a greater clonal presence of non-B2 type E.coli in the urine of patients residing in elderly homes..(AU)


Subject(s)
Aged , Urinary Tract Infections , Escherichia coli
12.
Salud(i)ciencia (Impresa) ; 23(5): 444-448, jun. 2019.
Article in Spanish | LILACS (Americas), BINACIS | ID: biblio-1025365

ABSTRACT

Ammonium is an important source of nitrogen for amino acid synthesis and is necessary for normal acid base balance. When ammonium concentrations are high it becomes a toxic compound. Hyperammonemia is a metabolic emergency. When underdiagnosed and not treated appropriately, it produces severe neurological sequelae and/or death. The clinical presentation of hyperammonemic encephalopathy varies, and includes from personality disorders, psychiatric disorders, confusion, irritability, lethargy, seizures to coma. Hyperammonemia occurs with an increase in ammonium production, as in intestinal hemorrhage, or with a decrease in the elimination of ammonium, such as in congenital metabolic errors, hepatic insufficiency or drug intoxication. As we can see, it may have multiple origins, but congenital errors of metabolism are always suspected as one of the causes. However, there are less frequent causes, such as urinary tract infection, especially in predisposing conditions. We describe the case of a 2-year-old boy with a history of horseshoe kidney and right ureterohydronephrosis, surgical correction of imperforate anus and rectal bladder fistula. This patient presented hyperammonemia with encephalopathy (Glasgow 7/15) while undergoing a urinary infection with Corynebacterium riegelii. Hyperammonemia is the result of the production in the dilated urinary tract of large amounts of ammonium due to bacterial urease and its subsequent reabsorption in the systemic circulation. The patient improved clinically (Glasgow 15/15) after parenteral antibiotic therapy and urinary tract clearance


El amonio es una fuente importante de nitrógeno para la síntesis de aminoácidos y necesario para el balance ácido base; si se encuentra elevado, se convierte en un compuesto tóxico. La hiperamoniemia es una urgencia metabólica; cuando no es diagnosticada y tratada de manera oportuna, produce graves secuelas de tipo neurológico o la muerte. La presentación clínica de la encefalopatía hiperamoniémica es variable, pudiéndose observar trastornos en la personalidad, trastornos psiquiátricos, confusión e irritabilidad, letargia, convulsión y coma. La hiperamoniemia se presenta por aumento en la producción de amonio, como en la hemorragia intestinal, o por disminución de la eliminación del mismo, como ocurre en los errores congénitos del metabolismo, en la insuficiencia hepática o en la intoxicación por fármacos. Puede tener múltiples orígenes, pero los errores congénitos del metabolismo son una de las causas que siempre se sospechan. Sin embargo, existen causas menos frecuentes, como la infección del tracto urinario (sobre todo en condiciones que predispongan a las mismas). Describimos aquí el caso de un niño de 2 años, con antecedentes de riñón en herradura y ureterohidronefrosis derecha, corrección quirúrgica de ano imperforado y fistula recto vesical. Este paciente presentó hiperamoniemia con encefalopatía (Glasgow 7/15) mientras cursaba una infección urinaria por Corynebacterium riegelii. La hiperamoniemia es el resultado de la producción en el tracto urinario dilatado de grandes cantidades de amonio, debido a la ureasa bacteriana y su posterior reabsorción en la circulación sistémica. El paciente mejoró clínicamente (Glasgow 15/15) después de la terapia antibiótica parenteral y desobstrucción de tracto urinario


Subject(s)
Humans , Male , Child, Preschool , Urinary Tract Infections , Brain Diseases , Corynebacterium , Hyperammonemia
14.
Rev. enferm. Inst. Mex. Seguro Soc ; 27(2): 73-79, Abr-Jun 2019.
Article in Spanish | LILACS (Americas), BDENF | ID: biblio-1015112

ABSTRACT

Introducción: según la incidencia que presenta el indicador Prevención de infecciones de vías urinarias, 80% de estas son ocasionadas en las unidades de salud por el uso de una sonda vesical. Con la finalidad de disminuir este problema, se implementó el indicador de calidad de los servicios de enfermería. Objetivo: identificar el cumplimiento de los criterios del indicador Prevención de infecciones de vías urinarias en pacientes con sonda vesical instalada en una unidad de tercer nivel. Métodos: estudio observacional, descriptivo, prospectivo, transversal del tipo sistemas de salud, en el que participaron 74 pacientes, en el periodo de septiembre a octubre del 2017, con un muestreo por conveniencia mediante observación al personal de enfermería que atiende pacientes con sonda vesical instalada durante el periodo de recolección de datos en los turnos matutino y vespertino, con el formato de sistema INDICAS (F1-PIVUPSVI/12). Se hizo el análisis mediante estadística descriptiva. Resultados: en relación con el nivel del cumplimiento del indicador Prevención de infecciones de vías urinarias en pacientes con sonda vesical instalada, este arrojó un 89.1% en rojo (66), equivalente a 70% o menos, y 18.9% en amarillo (8), que equivale al nivel del cumplimiento en un rango que va de 71 a 90%. Conclusiones: de acuerdo con datos estadísticos, se encuentra el indicador en rojo, con base en el sistema INDICAS de la Secretaría de Salud.


Introduction: According to the incidence showed by the Prevention of urinary tract infections in patients with a bladder catheter indicator, 80% of these infections is caused by the use of a bladder catheter. In order to reduce this problem, it was implemented the nursing service quality indicator. Objective: To identify compliance with the criteria of the indicator Prevention of urinary tract infections in patients with a bladder catheter in a third level unit. Methods: Observational, descriptive, prospective, cross-sectional, health systems sort of study, which included 74 patients from September to October of 2017, with a convenience sample by observation to the nursing staff that takes care of patients with bladder catheter installed during the period of data collection in the morning and afternoon shifts with INDICAS system format (F1-PIVUPSVI/12). Analysis was performed with descriptive statistics. Results: The level of compliance with the Prevention of urinary tract infections in patients with a bladder catheter indicator resulted in 89.1% in red (66), equivalent to 70% or less, and 18.9% in yellow (8), equivalent to a level of compliance ranging from 71 to 90%. Conclusions: According to statistical data, the indicator is in red, based on the Secretaría de Salud (Health Secretary) INDICAS system.


Subject(s)
Humans , Preventive Health Services , Urinary Tract Infections , Administration, Intravesical , Cross Infection , Epidemiology, Descriptive , Cross-Sectional Studies , Data Collection , Prospective Studies , Health Status Indicators , Probe , Federal Government , Secondary Prevention , Observational Study , Hospitals, Special , Nursing Staff , Mexico
16.
Univ. salud ; 21(1): 72-87, ene.-abr. 2019. tab
Article in Spanish | LILACS (Americas), COLNAL | ID: biblio-986197

ABSTRACT

Resumen Introducción: Se estima que el 86% de los pacientes receptores de un trasplante renal presentan una infección por microorganismos multirresistentes, principalmente de vías urinarias (IVU) en el postrasplante, lo cual se asocia a un mal pronóstico del injerto y del paciente. Objetivo: Describir los principales mecanismos de resistencia que se encuentran en la colonización de las vías urinarias, luego de ser sometido un paciente a un trasplante renal y algunos factores de riesgo que aumentan la probabilidad de complicaciones de este postoperatorio. Materiales y métodos: Se realizó una revisión de la literatura en bases de datos como Medline, Embase y Science Direct, empleando palabras claves validadas entre los años 2007 a 2017. Resultados: Los factores de riesgo asociados a la adquisición de IVU luego de un trasplante renal son sexo femenino, diabetes mellitus, anomalías de la vía urinaria e instrumentación de la uretra, los microorganismos asociados al trasplante renal son SARM (Staphylococcus aureus resistente a Meticilina) en un 20% en salas de nefrología y Escherichia coli y Klebsiella pneumoniae tipo BLEE en un 30% y 28%. Conclusiones: Los mecanismos de resistencia de mayor prevalencia en trasplantes son causados por bacterias productoras de BLEE, asociados a la profilaxis postrasplante que se realiza.


Abstract Introduction: It is estimated that 86% of patients receiving a renal transplant have an infection by multiresistant microorganisms, mainly urinary tract (UTI) in post-transplant, which is associated with poor prognosis of the graft and patient. Objective: To describe the main mechanisms of resistance found in the colonization of the urinary tract from a patient after being submitted to a renal transplant and some risk factors that increase the likelihood of complications of this postoperative. Materials and methods: A review of literature in databases such as Medline, Embase and Science Direct was conducted, using key words validated from 2007 to 2017. Results: The risk factors associated with the acquisition of UTI after a renal transplant are female sex, diabetes mellitus, urinary tract anomalies and instrumentation of the urethra. The microorganisms associated with renal transplantation are MRSA (Methicillin-resistant Staphylococcus aureus) in 20% in rooms of nephrology and Escherichia coli and Klebsiella pneumoniae type ESBL in 30% and 28% respectively. Conclusions: The mechanisms of resistance of higher prevalence in transplants are caused by bacteria producing ESBL, associated with the post-transplant prophylaxis performed.


Subject(s)
Humans , Bacterial Infections , Kidney Transplantation , Urinary Tract Infections , Drug Resistance, Microbial , Risk Factors , Antibiotic Prophylaxis
17.
Rev. Hosp. Ital. B. Aires (2004) ; 39(1): 19-21, mar. 2019. ilus., graf.
Article in Spanish | LILACS (Americas) | ID: biblio-1022121

ABSTRACT

La policitemia primaria es producida por una mutación adquirida o heredada en las células progenitoras de los glóbulos rojos, mientras que la poliglobulia secundaria está relacionada con un aumento de la eritropoyetina sérica como respuesta a la hipoxia tisular o a la producción autónoma tumoral. Hace más de medio siglo que se conoce que la hidronefrosis puede actuar como una rara causa de eritrocitosis debido al aumento de producción de eritropoyetina por un riñón que censa una disminución de oxígeno, mecanismo también observado en la estenosis de la arteria renal y en los quistes renales. Se describe a continuación el caso de un paciente de 38 años con poliglobulia atendido en el Hospital Italiano de San Justo (Argentina), que presenta como hallazgo una hidronefrosis unilateral severa y cuya resolución quirúrgica a través de una nefrectomía revierte el cuadro hematológico de base. (AU)


Primary polycythemia is produced by an acquired or inherited mutation in progenitor cells of red blood cells, while secondary polyglobulia is related to an increase in serum erythropoietin in response to tissue hypoxia or autonomous tumor production. Since the middle of the twentieth century, the hydronephrosis is known to be a rare etiology of secondary polycythemia, with increased erythropoietin production caused by diminished oxygen sensing by the kidney, also seen in renal artery stenosis and kidney cysts. We describe a case of a 38 year old patient with polycythemia studied in the "Hospital Italiano de San Justo" (Argentina) that presented an incidental severe unilateral hydronephrosis, and nephrectomy was carried out as a final resolution of the hematological disorder. (AU)


Subject(s)
Humans , Animals , Male , Adult , Middle Aged , Polycythemia/diagnosis , Pyelonephritis/diagnosis , Urinary Tract Infections/complications , Erythropoietin/blood , Hydronephrosis/diagnosis , Nephrectomy/trends , Polycythemia/complications , Polycythemia/etiology , Pyelonephritis/blood , Renal Artery Obstruction/pathology , Low Back Pain , Hypoxia-Ischemia, Brain/pathology , Erythrocytes/physiology , Kidney Diseases, Cystic/pathology , Dysuria , Fever , Hydronephrosis/surgery , Hydronephrosis/complications , Anemia , Nephrectomy/methods
18.
Rev. bras. ter. intensiva ; 31(1): 47-56, jan.-mar. 2019. tab, graf
Article in Spanish | LILACS (Americas) | ID: biblio-1003621

ABSTRACT

RESUMEN Objetivo: Determinar en pacientes con sepsis admitidos en el servicio de urgencias la asociación entre el foco infeccioso principal y la mortalidad intrahospitalaria como desenlace principal o requerimiento de ingreso a unidad de cuidados intensivos como desenlace secundario. Métodos: Análisis secundario de cohorte prospectiva multicéntrica. Se incluyeron pacientes mayores de 18 años con diagnóstico de sepsis grave o choque séptico atendidos en las salas de urgencias de 3 hospitales de alta complejidad. De 5022 elegibles, se incluyeron 2510 participantes. Análisis de regresión logística múltiple para mortalidad. Resultados: El sitio de infección más frecuente fue tracto urinario, presente en el 27,8% de los casos, seguido de neumonía en el 27,5% y foco intraabdominal en el 10,8%. En el 5,4% de los casos no se identificó foco claro al ingreso. Mediante regresión logística se encontró asociación significativa entre los siguientes sitios de infección y mortalidad intrahospitalaria al tomar como referencia el grupo de infección urinaria: neumonía (OR 3,4; IC95%, 2,2 - 5,2; p < 0,001), piel y tejidos blandos (OR 2,6; IC95%, 1,4 - 5,0; p = 0,003), torrente sanguíneo (OR 2,0; IC95%, 1,1 - 3,6; p = 0,018), sin foco claro (OR 2,0; IC95%, 1,1 - 3,8; p = 0,028), e intraabdominal (OR 1,9; IC95%, 1,1 - 3,3; p = 0,024). Conclusiones: Existe una asociación significativa entre los diferentes sitios de infección y la mortalidad intrahospitalaria o requerimiento de unidad de cuidados intensivos en pacientes con sepsis o choque séptico, siendo la infección de vías urinarias la que confiere el menor riesgo, lo que se deberá tener en cuenta en los modelos pronósticos de estas condiciones.


ABSTRACT Objective: To determine the association between the primary site of infection and in-hospital mortality as the main outcome, or the need for admission to the intensive care unit as a secondary outcome, in patients with sepsis admitted to the emergency department. Methods: This was a secondary analysis of a multicenter prospective cohort. Patients included in the study were older than 18 years with a diagnosis of severe sepsis or septic shock who were admitted to the emergency departments of three tertiary care hospitals. Of the 5022 eligible participants, 2510 were included. Multiple logistic regression analysis was performed for mortality. Results: The most common site of infection was the urinary tract, present in 27.8% of the cases, followed by pneumonia (27.5%) and intra-abdominal focus (10.8%). In 5.4% of the cases, no definite site of infection was identified on admission. Logistic regression revealed a significant association between the following sites of infection and in-hospital mortality when using the urinary infection group as a reference: pneumonia (OR 3.4; 95%CI, 2.2 - 5.2; p < 0.001), skin and soft tissues (OR 2.6; 95%CI, 1.4 - 5.0; p = 0.003), bloodstream (OR 2.0; 95%CI, 1.1 - 3.6; p = 0.018), without specific focus (OR 2.0; 95%CI, 1.1 - 3.8; p = 0.028), and intra-abdominal focus (OR 1.9; 95%CI, 1.1 - 3.3; p = 0.024). Conclusions: There is a significant association between the different sites of infection and in-hospital mortality or the need for admission to an intensive care unit in patients with sepsis or septic shock. Urinary tract infection shows the lowest risk, which should be considered in prognostic models of these conditions.


Subject(s)
Humans , Male , Female , Adult , Aged , Shock, Septic/epidemiology , Hospital Mortality , Sepsis/epidemiology , Emergency Service, Hospital , Pneumonia/complications , Pneumonia/epidemiology , Prognosis , Shock, Septic/metabolism , Urinary Tract Infections/complications , Urinary Tract Infections/epidemiology , Prospective Studies , Cohort Studies , Colombia , Sepsis/mortality , Tertiary Care Centers , Intensive Care Units , Middle Aged
19.
REME rev. min. enferm ; 23: e-1263, jan.2019.
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1047867

ABSTRACT

As infecções do trato urinário relacionadas ao cateterismo urinário de demora estão entre as mais frequentes em hospitais. Existem várias recomendações para a prevenção de infecções, porém ainda se questiona a necessidade de utilizar antissépticos para a limpeza periuretral. Objetivo: este estudo objetivou analisar as evidências, na literatura, acerca do tema. Método: foi realizada revisão sistemática utilizando-se as bases de dados Biblioteca Virtual em Saúde, Medline, Embase, Web of Science e Cumulative Index to Nursing & Allied Health Literature. Foram incluídos ensaios clínicos que avaliaram as taxas de infecção do trato urinário/bacteriúria e que utilizaram soluções antissépticas e água na limpeza periuretral. Resultados: de 211 estudos, três foram considerados metodologicamente adequados de acordo com a Escala de Jadad. Todos os estudos mostraram que não há diferenças significativas nas taxas de ITU/ bacteriúria quando comparado o uso de água com antisséptico (clorexidina ou povidona-iodo). Conclusão: concluiu-se que o uso de água na limpeza periuretral parece não aumentar o risco de adquirir infecção/bacteriúria.(AU)


Urinary tract infections related to indwelling urinary catheterization are among the most frequent in hospitals. There are many recommendations for the prevention of infections, but the need to use antiseptics for periurethral cleaning is still questioned. Objective: This study aimed to analyze the evidence on the theme in the literature. Method: A systematic review was performed using the following databases: Biblioteca Virtual em Saúde, Medline, Embase, Web of Science and Cumulative Index to Nursing & Allied Health Literature. Clinical trials were included which assessed the infection rates of the urinary tract/bacteriuria and which used antiseptic solutions and water in the periurethral cleaning. Results: Of 211 studies, three were considered as methodologically adequate according to the Jadad Scale. All of the studies showed that there is no significant difference in the rates of UTI/bacteriuria when compared to the use of water with antiseptic (chlorhexidine or povidone-iodine). Conclusion: It was concluded that the use of water in the periurethral cleaning seems not to augment the risk of acquiring infections/bacteriuria.(AU)


Las infecciones del tracto urinario relacionadas con el cateterismo urinario permanente se encuentran entre las infecciones hospitalarias más comunes. Existen recomendaciones para la prevención de infecciones, pero aún se cuestiona la necesidad de usar antisépticos para la limpieza periuretral. Objetivo: analizar la evidencia en la literatura sobre el tema. Método: se realizó una revisión sistemática utilizando las bases de datos de la Biblioteca Virtual de Salud, Medline, Embase, Web of Science y Cumulative Index to Nursing & Allied Health Literature. Se incluyeron ensayos clínicos que evaluaron las tasas de infección urinaria / bacteriuria y el uso de soluciones antisépticas y agua para la limpieza periuretral. Resultados: de 211 estudios, tres se consideraron metodológicamente adecuados según la escala de Jadad. Todos los estudios mostraron que no hay diferencias significativas en las tasas de infección urinaria / bacteriuria en comparación con el uso de agua antiséptica (clorhexidina o povidona yodada). Conclusión: el uso de agua para la limpieza periuretral no parece aumentar el riesgo de contraer infección / bacteriuria.(AU)


Subject(s)
Urinary Tract Infections , Urinary Catheterization , Anti-Infective Agents, Urinary , Povidone-Iodine , Water , Chlorhexidine
20.
Rev. nefrol. diál. traspl ; 39(1): 15-25, ene. 2019. tab
Article in Spanish | LILACS (Americas) | ID: biblio-1007057

ABSTRACT

INTRODUCCIÓN: En la actualidad existe un crecimiento de infecciones urinarias en trasplantados renales, por organismos multirresistentes (OMR) que se han convertido en un desafío médico.OBJETIVO: Describir la prevalencia de infección urinaria (ITU) por OMR en pacientes trasplantados renales (PTxR) hospitalizados, sus factores de riesgo, el tratamiento y la evolución a 1 año. MATERIAL Y MÉTODOS: Se revisaron las historias clínicas y los cultivos de PTxR internados infectados con OMR en el período entre el 1/1/2016 y el 31/12/2017. Se evaluaron los factores de riesgo como: género, edad avanzada, presencia prolongada de catéter doble J, complicaciones quirúrgicas e internación prolongada y la función renal al momento de la internación, al alta y al año y la aparición de rechazos al año. RESULTADOS: La presencia de gérmenes multirresistentes se encontró en 58 PTxR (31,18%) que presentaron 105 episodios de ITU, 36 tuvieron una sola infección y 22 P sufrieron más de una. El 55,17% (32) fueron hombres y la edad promedio fue 50,52 ±14,24 años. Del total de pacientes 43 (74,15%) tenían factores de riesgo tales como: extracción tardía del catéter doble J en 8 (13,8%), complicaciones quirúrgicas en 11 (18,9%), internación prolongada en 12 (20,7%) y 18 (31,03%) eran mayores de 60 años. En la evolución, 9 requirieron diálisis, de los cuales 4 recuperaron la función renal. La creatinina al momento de la internación en los pacientes que no necesitaron diálisis fue de 1.8 (1.39 ­ 3.01) mg/dl; al alta 1.5 (1.1 ­ 2.1) mg/dl (p=0.025) y al año fue de 1.5 (1.18 ­ 2.1) mg/dl sin diferencia significativa con respecto a la del alta. (p=0.089). En el seguimiento anual 5 pacientes fallecieron y 5 perdieron el injerto. La incidencia de rechazo fue del 15,51%. Los gérmenes rescatados fueron 13 A. baumanii cpx. (ABA) (11,92%), E. Coli (ECO) 24 (22,01%), Enterobacter spp. 4 (3,66%), Enterococcus spp. 3 (2,75%), Klebsiella spp. 58 (53,21%), Serratia spp. 5 (4,58%), Proteus spp. 1 (0,91%) y Pseudomonas aeruginosa (PAE) (0,91). De los 105 episodios de ITU, 79 se trataron con monoterapia: 57 con carbapenem (54,28%), 10 con Colistin (9,51%), 4 con Linezolid (3.8%), 4 con Piperacilina + Tazobactan (3.8%), 3 con Ciprofloxacina (2.85%) y 1 con Nitrofurantoína (0,95%). En 26 episodios se utilizó terapias combinadas de Carbapenem en 21 casos, colistin en 14, amikacina en 13, fosfomicina en 2 y en 1 oportunidad se utilizó tigeciclina y en otra ciprofloxacina. CONCLUSIÓN:Las ITUs por ORM fueron frecuentes y semejantes a las descritas en otras series. No se encontraron diferencias en la evolución de la función renal, en los rechazos, en la mortalidad en las ITUs por OMR con o sin factores de riesgo asociados, tampoco se observó influencia de las ITUs recurrentes ni de las recidivantes. Son necesarios estudios ulteriores con mayor número de pacientes para evaluar pronóstico y evolución de los pacientes con estas infecciones


INTRODUCTION: There exists a current growth of urinary tract infections in kidney transplant recipients caused by multidrug-resistant organisms (MRO), which has become a medical challenge. Objective: To describe the prevalence of urinary tract infection (UTI) from MRO in hospitalized kidney transplant recipients (KTR), their risk factors, treatment and evolution at 1 year. METHODS: Clinical records and cultures of hospitalized KTR infected by MRO were reviewed between January 1st 2016 and Dec. 31st 2017. The following risk factors were evaluated: gender, advanced age, prolonged presence of double-J stent, surgical complications and long-term hospitalization, renal function at the time of admission, at discharge and at one year, and the appearance of any rejection after one year. RESULTS: The presence of multiresistant germs was found in 58 KTR (31.18%), who presented 105 episodes of UTI; 36 of them had a single infection and 22 suffered more than one. 55.17% (32) were men and the average age was 50.52 ± 14.24 years. Of the total of patients, 43 (74.15%) had these risk factors: late extraction of double-J stent in 8 patients (13.8%), surgical complications in 11 (18.9%), long-term hospitalization in 12 (20, 7%) and 18 (31.03%) were older than 60. During evolution, 9 patients required dialysis, 4 of which recovered their renal function. The creatinine at the time of admission of the patients who did not need dialysis was 1.8 (1.39 - 3.01) mg/dL; at discharge it was 1.5 (1.1 - 2.1) mg/dL (p = 0.025) and after one year it was 1.5 (1.18 - 2.1) mg/dL without significant difference with respect to discharge (p = 0.089). In the annual follow-up, 5 patients died and 5 lost the transplant. The incidence of rejection was 15.51%. The presence of risk factors and recurrent and / or recurrent ITUs did not result in significant differences in renal function at follow-up, nor in patient and graft survival. The following germs were found: 13 A. baumannii cpx. (ABA) (11.92%); 24 E. Coli (ECO) (22.01%); 4 Enterobacter spp. (3.66%), 3 Enterococcus spp. (2.75%); 58 Klebsiella spp. (53.21%); 5 Serratia spp. (4.58%); 1 Proteus spp.(0.91%), and 1 Pseudomonas aeruginosa (PAE) (0.91%). Of the 105 episodes of UTI, 79 were treated with monotherapy: 57 with carbapenem (54.28%), 10 with colistin (9.51%), 4 with linezolid (3.8%), 4 with piperacillin + tazobactan (3.8%), 3 with ciprofloxacin (2.85%) and 1 with nitrofurantoin (0.95%). In 26 episodes, combined therapies of carbapenem were used in 21 cases; colistin in 14; amikacin in 13; fosfomycin in 2, and on one occasion tigecycline was used and in another, ciprofloxacin. CONCLUSION: The urinary tract infections caused by MRO were frequent and similar to those described in other series. No differences were found in the evolution of renal function, in rejections, in mortality in UTI due to MOR with or without associated risk factors, neither of recurrent UTIs influence or relapsing observed were found. Further studies with a larger number of patients are necessary to evaluate the prognosis and evolution of patients with these infections


Subject(s)
Humans , Male , Female , Urinary Tract Infections , Kidney Transplantation , Drug Resistance
SELECTION OF CITATIONS
SEARCH DETAIL