Objective: This study aimed to evaluate the antioxidant and antimicrobial capacities of extracts from Euphorbia hirta L. and Terminalia avicennioides GUILL & PERR. Methodology: The crude hydro-acetonic and aqueous...Objective: This study aimed to evaluate the antioxidant and antimicrobial capacities of extracts from Euphorbia hirta L. and Terminalia avicennioides GUILL & PERR. Methodology: The crude hydro-acetonic and aqueous extracts as well their fractionations were prepared. The total phenolic, flavonoids and tannins contents were assessed using the Folin-Ciocalteu, aluminum chloride and vanillin acid methods, respectively. The antioxidant and antibacterial activities were investigated using standard methods. Results: Euphorbia hirta showed significant contents of total phenolic and flavonoids in n-Butanol (145.14 ± 1.37 GAE/100mg extracts) and ethyl acetate (23.56 ± 0.68 mg QE/ 100mg extracts) fractions. Total tannins were high in hydro-acétonique extract (11.18 ± 0.31 mg TAE/100mg extracts) and aqueous fraction (11.12 ± 0.28 mg TAE/100mg extracts) of Terminalia avicennioides stem barks. Extracts and fractions of both plants demonstrated a strongly antioxidant capacity through the free radicals scavenging and the ferric ions reducing. Concerning antimicrobial screening the extracts of Terminalia avicennioides were effective against 16 causative pathogens of urinary tract infections. Bactericidal effect against Staphylococcus aureus ATCC 29213, Staphylococcus aureus and 2 methicillin-resistant Staphylococcus haemolyticus strains was found with aqueous fraction of Terminalia avicennioides leaves. This fraction also highlighted a synergetic effect with some antibiotics used against these bacterial strains. Conclusion: Terminalia avicennioides leaves could be recommended as an herbal drug formulation for the urinary infections management.展开更多
Introduction: Infection disease is a real publique health problem. The rise of resistance for modern antibiotic in infections treatment imposed us order alternatives. The study objective was to contribute in the knowl...Introduction: Infection disease is a real publique health problem. The rise of resistance for modern antibiotic in infections treatment imposed us order alternatives. The study objective was to contribute in the knowledge of medicinal plants uses in urinary infections treatment in N’Djamena (Chad) in view for amelioration the traditional medicine in future. Methodology: The study was conducted in the city of N’Djamena in the Republic of Chad that interviewed 60 traditherapists on using 11 plants for urinary tract infections treatment. The methodology of this study consisted of the knowledge of medicinal plants that used by traditherapists, and the plants identification was done in the laboratory of IRED at Farcha. Results: A total of 60 traditherapists was interrogated on the plants used in the treatment of urinary tract infections among the population of N’Djamena. The majority of traditherapists interrogated in this study were male with the rate of 61.67% against female with the rate of 38.33%. The age range of traditherapists was between 20 to 80 years, 25 (41.67%) from the age range between 30 - 50 years and 35 (58.33%) in age range from 50 to 70 years. For the origin of their knowledge, the study showed that 72% of traditherapists inherited the knowledge from their family, while 15% inherited from the family and from training. The ethnic groups of the traditherapists were Sara (16%), Maraba (12%) and Massa (11%). According to the results, 18.33% were illiterates, 49% attended primary school and 33.34% the secondary school. Our study found that 11 species of plants belonging to 11 families were used in the treatment of urinary tract infection and the Ziziphus spina-christi was the most represented. According to traditherapists the Ziziphus spina-christi, Cassia obovata and Euphorbia hirta were the most frequent plants used in the urinary tract infections treatment. The parts of plants used in the treatment were leaves and bark, grained leaves and entire plants with the proportion of 50%, 16.67 and 15% respectively. Conclusion: This study revealed that the medicinal plants are variously used in the treatment of infection urinary tract in the city of N’Djamena.展开更多
Obiective:To investigate whether"Fuzheng Qingretonglin"decoction can reduce urinary tract damage caused by complex urinary tract infection caused by drug resistant Escherichia coli by regulating Nod-like rec...Obiective:To investigate whether"Fuzheng Qingretonglin"decoction can reduce urinary tract damage caused by complex urinary tract infection caused by drug resistant Escherichia coli by regulating Nod-like receptor pyrin domain3 inflammasome,and to explore the feasibility of this decoction combined with levofloxacin in the treatment of complex urinary tract infection caused by drug resistant bacteria.Methods:SD rats were divided into five groups:sham group,model group,levofloxacin group(Lev group),levofloxacin+Fuzheng Qingre Tonglin decoction group(FZ+lev group),and Fuzheng Qingre Tonglin decoction group(FZQRTL group).After the experiment,urine was taken for bacterial culture to determine the urinary tract infection of rats in each group;HE staining was used to observe the pathological changes of kidney and bladder tissues in rats;The expression of NLRP3 in kidney and bladder tissues was detected by immunohistochemistry;The expression of IL-1βand IL-18 in serum of rats was detected by ELISA;The expressions of NLRP3,ASC and Caspase-1 were detected by Western blotting.Results:The positive rate of urine bacteria culture in the sham group was 0%,the positive rate of urine bacteria culture in the model group was 100%;and the positive rate of urine bacteria culture in the FZ+lev group was 37.50%,which was statistically different from that in the model group(P<0.05).A large number of inflammatory cells were observed in the kidney and bladder tissues of the model group by HE staining,while the number of inflammatory cells in the kidney and bladder tissues of the Lev group and FZQRTL group was significantly reduced compared with that of the model group.The FZ+lev group in the number and structure of inflammatory cells in kidney and bladder were similar to the sham group.The NLRP3 immunohistochemistry of kidney and bladder tissue in FZ+lev groups and FZQRTL groups was significantly different from that in model group(P<0.001).The levels of IL-1βand IL-18 in serum of Lev group,FZQRTL group and FZ+lev group were significantly decreased by ELISA compared with model group(P<0.001).The levels of IL-1βand IL-18 in the FZ+lev groups were significantly lower than in the Lev group and FZQRTL group,and the differences were statistically significant(P<0.05).The protein expressions of NLRP3,ASC and Caspase-1 in the Lev group,FZQRTL group and FZ+lev group were significantly lower than those in the model group(P<0.001).The protein expressions of NLRP3,ASC and Caspase-1 in the FZ+lev groups were significantly lower than in the Lev group and FZQRTL group,and the differences were statistically significant(P<0.05).Conclusions:"Fuzheng Qingretonglin"decoction may have a protective effect on the kidney and bladder of rats with complex urinary tract infection caused by drug-resistant Escherichia coli by inhibiting the activation of NLRP3 inflammatory bodies,and TCM combined with levofloxacin has a better therapeutic effect than TCM or levofloxacin alone.展开更多
[Objectives]To study the main active components,targets and related pathways of Ningmitai capsule for the treatment of urinary tract infections(UTIs)based on network pharmacology.[Methods]The chemical components of Ni...[Objectives]To study the main active components,targets and related pathways of Ningmitai capsule for the treatment of urinary tract infections(UTIs)based on network pharmacology.[Methods]The chemical components of Ningmitai capsule were collected through literature search,and the relevant target information of the components was sorted out.The UTIs-associated targets were also screened out using DisGeNET database and GeneCards database.Cytoscape 3.6.1 software and STRING platform were used to construct the protein-protein interaction(PPI)network,and MCODE plug-in in this software was used to analyze the action pathway and key targets of Ningmitai capsule for the treatment of UTIs.GO and KEGG pathway enrichment analysis of key targets was conducted using David database,and the component-target-pathway network diagram of Ningmitai capsule for the treatment of UTIs was established.[Results]A total of 37 active compounds,including salicylate,ferulic acid,baicalin,quercetin,apigenin and ellagic acid were screened from seven TCM components of Ningmitai capsule.There were 26 possible targets related to the treatment of UTIs,such as NFKB1,JUN,CTNNB1 and STAT3,which play an important role for the treatment of UTIs through prostate cancer,bladder cancer,pancreatic cancer and other signaling pathways.[Conclusions]The study provides a theoretical basis for the study of the mechanism of Ningmitai capsule in the treatment of UTIs.展开更多
Background and Aims: Urinary tract infections (UTIs) are common among pregnant women and major predisposing factors for pyelonephritis linked to obstetrical complications including preterm labour and low infants’ bir...Background and Aims: Urinary tract infections (UTIs) are common among pregnant women and major predisposing factors for pyelonephritis linked to obstetrical complications including preterm labour and low infants’ birth weights. This study sought to determine the relationship(s) between pregnancy trimesters, UTIs and changes in progesterone levels among pregnant women. Materials and Methods: The study was conducted in 2016 at Moi Teaching and Referral Hospital (MTRH) antenatal clinic which is a referral facility that attends to patients from most Counties in western region of Kenya. A cross-sectional study design was used to collect blood and urine specimens from 78 participants. Blood was used to determine progesterone levels using ELISA technique and urine cultures with bacterial colony counts ≥ 10<sup>5</sup> were appropriately identified to species level. Trimester periods and participants’ demographic information were obtained using a structured questionnaire. Results: Culture results showed that the most abundant bacterial species isolated in urine from the pregnant women was Escherechia coli (63.7%). The more affected age-group was women between 30 - 39 years during trimester three, suggesting that bacterial colonization of genital track occurred more frequently in older compared to the younger women. There was an exponential increase in progesterone levels among the pregnant women during trimester three compared to other trimesters, although these increases occurred independent of age. However, high levels of progesterone among pregnant women in third trimester corresponded with increased number of E. coli causing UTI. Conclusion: The results showed that progesterone levels increase with trimester and the most prevalent bacteria associated with this was E. coli even though age and increase in progesterone levels had no significant impact on E. coli infection.展开更多
Introduction: Urinary tract infection is one of the most frequent public health problems in the world and concerns all ages. Objective: To describe the epidemiological, clinical and biological profile of urinary tract...Introduction: Urinary tract infection is one of the most frequent public health problems in the world and concerns all ages. Objective: To describe the epidemiological, clinical and biological profile of urinary tract infection in the internal medicine unit of the Fousseyni Daou hospital in Kayes. Methodology: It was a descriptive and cross-sectional study with retrospective data collection which took place from January 1 to December 31, 2020 at the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes. It covered all outpatients and hospitalized patients presenting with a urinary tract infection during the study period. Results: We identified 79 cases of urinary tract infection out of 145 requests for ECBU, that is a positivity rate of 53.10% and out of a total of 1883 admissions that is a hospital prevalence of 4.19%. The age groups of 36 to 45 years and 46 to 55 years were more represented in 28 cases (35.44%) and 25 cases (31.64%) with an average age of 45 years ± 10. The female sex was predominant, 42 cases (53.16%) with a sex ratio of 0.88. Housewives were more represented 28 cases (34.44%). The majority of patients resided in rural areas 49 cases (62.03%). The history was dominated by the following pathologies: hypertension 48.10%, diabetes 36.70% and gastropathy 30.37%. The main clinical manifestations were: Urinary burning 67 cases (84.81%), Dysuria 65 cases (82.27%), Pelvic pain 59 cases (74.68%), Fever 57 cases (72.15%). The epidemiological profile of the isolated strains was dominated by enterobacteriaceae, followed by gram-positive cocci and gram-negative bacilli. The main bacteria responsible for urinary tract infections in order of frequency: Escherichia coli (45.56%), Klebsiella pneumoniae (11.39%), Pseudomonas aeruginosa (8.86%), Staphylococcus aureus (7.59%), Streptococcus sp (6.33%), Enterobacter cloacae (3.79%), Acinetobacter sp (3.79%). The study of the susceptibility and resistance profiles of the isolated strains showed significant sensitivity of enterobacteriaceae to colistin and resistance to amoxicillin and to the amoxicillin + clavulanic acid combination. Conclusion: Urinary tract infections are a major public health problem since they are responsible for significant morbidity and mortality and a high cost of care. Knowledge of the epidemiological-clinical and bacteriological profile of these infections is essential for efficient management.展开更多
Background: Urinary tract infection (UTI) is a bacterial infection affecting males and females but is more prevalent in expectant women. ESBLs are bacteria with enzymes that make them resistant to many antibiotics, po...Background: Urinary tract infection (UTI) is a bacterial infection affecting males and females but is more prevalent in expectant women. ESBLs are bacteria with enzymes that make them resistant to many antibiotics, posing a significant health challenge. This study aims to determine the characteristics of ESBL-producing bacteria causing UTIs in expectant women. Methodology: A self-administered survey was carried out;300 expectant women were recruited using a random sampling method. A questionnaire was used to collect socio-demographic information. Urine samples were collected in sterile universal bottles and processed at the JKUAT Zoology laboratory. Urine samples were analyzed using urinalysis, microscopy, culture, and sensitivity testing. ESBL-producing bacteria were identified phenotypically using the double-disc synergy test (DDST) and genotyped for specific resistant genes using PCR. Results: UTI prevalence was 32.7% (98/300). UTI was significantly associated with the history of previous UTI (OR = 0.84, p = 0.02) and multigravida (OR = 0.14 p = 0.01). UTI was common in women aged between 28-37 years in their second trimester. Bacteria isolated were E. coli 57.1% (56/98), S. aureus 21.4% (21/98) K. pneumonia 11.2% (11/98) and Proteus spp 10.4% (10/98). Bacteria antibiotic resistance patterns were E. coli-tetracycline (91.1%), sulfamethoxazole (55.4%), cefotaxime (53.4%) and augmentin (53.4%). S. aureus-sulfamethozaxole (100%) and augmentin (71.4%), K. pneumoniae-sulfame-thoxazole (72.2%) cefotaxime (63.6%), chloramphenicol and tetracycline (54.5%). Proteus spp: tetracycline (100%), nitrofurantoin (90%), cefotaxime and chloramphenicol (50%). The proportion of ESBLs bacterial producers was 37.6% (29/77) and 44.8% (13/29) possessed ESBLs resistant genes;Bla CTX-M 53.8% (7/13), Bla SHV and Bla TEM 23.1% (3/13) each, Bla OXA (0%) was not detected. Conclusion: The study revealed a high proportion of ESBLs producing bacteria responsible for UTI in expectant women. ESBLs screening, routine culture and sensitivity testing will guide on proper management and empirical treatment of UTI patients thus reducing multi-drug resistance.展开更多
Background: Urinary Tract Infection (UTI), a prevalent bacterial infection in adults, heavily relies on cytobacteriological examination of urine (CBEU) for diagnosis. However, in resource-limited countries, accessibil...Background: Urinary Tract Infection (UTI), a prevalent bacterial infection in adults, heavily relies on cytobacteriological examination of urine (CBEU) for diagnosis. However, in resource-limited countries, accessibility to CBEU remains hindered by cost and availability. This study aims to assess the utility of the Urinary Dipstick Test (UDT) in diagnosing UTIs among hospitalized patients in the context of limited resources. Methods: A cross-sectional study was conducted from February to May 2019, encompassing hospitalized patients who underwent CBEU at the bacteriology unit of Sour? Sanou University Hospital. UDT and CBEU were concurrently performed, and UDT’s analytical and diagnostic performance was evaluated against CBEU, considered the gold standard. Results: A total of 274 CBEU requests were registered, involving 274 patients (159 males) with a mean age of 45.8 ± 21.3 years (ranging from 1 to 90 years). UTI was confirmed in 90 patients, yielding a frequency of 32.85%. The UTI bacteriological profile was dominated by Enterobacteriaceae (75.23%), primarily Escherichia coli (60.55%). Nitrite and Leukocytes were positive in 54 (19.8%) and 157 (53.6%) of the samples tested. Among patients with confirmed UTI, Nitrite, and Leukocytes were positive in 30 (33%) and 71 (79%) patients respectively. UDT demonstrated variable performance based on nitrite and leukocyte combination: Sensitivity (57%-82%), Specificity (7%-98%), Positive Predictive Value (PPV) (43%-57%), Negative Predictive Value (NPV) (43%-67%). UDT performed slightly better in women (NPV = 88%) and inpatients without urinary catheters (NPV = 75% and PPV = 80%). Conclusion: This study underscores UDT’s potential utility in excluding UTIs among women, younger patients, and inpatients without urinary catheters, albeit with limited confidence. The UDT emerges as a complementary tool for UTI screening, particularly in resource-limited settings.展开更多
Background:Urinary tract infections(UTI),urolithiasis,and benign prostatic hyperplasia(BPH)are three of the most common nonmalignant conditions in urology.However,there is still a lack of comprehensive and updated epi...Background:Urinary tract infections(UTI),urolithiasis,and benign prostatic hyperplasia(BPH)are three of the most common nonmalignant conditions in urology.However,there is still a lack of comprehensive and updated epidemiological data.This study aimed to investigate the disease burden of UTI,urolithiasis,and BPH in 203 countries and territories from 1990 to 2019.Methods:Data were extracted from the Global Burden of Disease 2019,including incident cases,deaths,disabilityadjusted life-years(DALYs)and corresponding age-standardized rate(ASR)from 1990 to 2019.Estimated annual percentage changes(EAPC)were calculated to evaluate the trends of ASR.The associations between disease burden and social development degrees were analyzed using a sociodemographic index(SDI).Results:Compared with 1990,the incident cases of UTI,urolithiasis,and BPH increased by 60.40%,48.57%,and 105.70%in 2019,respectively.The age-standardized incidence rate(ASIR)of UTI increased(EAPC=0.08),while urolithiasis(EAPC=–0.83)and BPH(EAPC=–0.03)decreased from 1990 to 2019.In 2019,the age-standardized mortality rate(ASMR)of UTI and urolithiasis were 3.13/100,000 and 0.17/100,000,respectively.BPH had the largest increase(110.56%)in DALYs in the past three decades,followed by UTI(68.89%)and urolithiasis(16.95%).The burden of UTI was mainly concentrated in South Asia and Tropical Latin America,while the burden of urolithiasis and BPH was recorded in Asia and Eastern Europe.Moreover,the ASIR and SDI of urolithiasis in high-SDI regions from 1990to 2019 were negatively correlated,while the opposite trend was seen in low-SDI regions.In 2019,the ASIR of UTI in females was 3.59 times that of males,while the ASIR of urolithiasis in males was 1.96 times higher than that in females.The incidence was highest in the 30–34,55–59,and 65–69 age groups among the UTI,urolithiasis,and BPH groups,respectively.Conclusions:Over the past three decades,the disease burden has increased for UTI but decreased for urolithiasis and BPH.The allocation of medical resources should be based more on the epidemiological characteristics and geographical distribution of diseases.展开更多
Radical hysterectomy(RH) and pelvic lymphadenectomy are the main treatment methods for early cervical cancer and endometrial carcinoma.Effective care measures,however,can decrease the incidence of UTIs and complicatio...Radical hysterectomy(RH) and pelvic lymphadenectomy are the main treatment methods for early cervical cancer and endometrial carcinoma.Effective care measures,however,can decrease the incidence of UTIs and complications associated with RH and pelvic lymphadenectomy,as well as improve the therapeutic effects of administered drugs and patient prognosis.The writer refers to relevant literatures to analyze the reasons for postoperative UTIs and to provide a brief summary of the nursing methods for and progress in UTI prevention.展开更多
Objective:Urinary tract infection(UTI)is a common cause of morbidity and hospitalisation in the population worldwide.Upper UTI is indolent and causes subclinical acute kidney injury(AKI)resulting in preventable cause ...Objective:Urinary tract infection(UTI)is a common cause of morbidity and hospitalisation in the population worldwide.Upper UTI is indolent and causes subclinical acute kidney injury(AKI)resulting in preventable cause of scarring of renal parenchyma.We explored urinary and serum levels of kidney injury molecule-1(KIM-1),haematological parameters and quantitative urine microscopy parameters to predict kidney injury.Methods:Neutrophilelymphocyte ratio(NLR)is obtained by dividing absolute neutrophil count with absolute lymphocyte count.Quantitative urine sediment microscopy was performed and correlated with clinical,biochemical and haematological findings to predict AKI in patients with UTI.Quantitative ELISA was performed for serum and urine levels of KIM-1.Seventy two adult patients with UTI were enrolled,45 of whom had AKI while 27 were in the non-AKI group.Results:NLR(p=0.005)and renal tubular epithelial cell-granular cast score in quantitative urine microscopy(p=0.008)are strong predictors of AKI in patients with UTI while rest of quantitative urine microscopy parameters and serum and urinary levels of KIM-1 molecule were not found to be useful in prediction of AKI.Conclusion:NLR in haemogram is a novel and useful biomarker for predicting AKI in patients with UTI.展开更多
Urinary tract infection(UTI) is one of the most commonchildhood infections.Permanent renal cortical scarring may occur in affected children,especially with recurrent UTIs,leading to long-term complications such as hyp...Urinary tract infection(UTI) is one of the most commonchildhood infections.Permanent renal cortical scarring may occur in affected children,especially with recurrent UTIs,leading to long-term complications such as hypertension and chronic renal failure.To prevent such damage,several interventions to prevent UTI recurrences have been tried.The most established and accepted prevention at present is low dose long-term antibiotic prophylaxis.However it has a risk of break through infections,adverse drug reactions and also the risk of developing antibiotic resistance.The search is therefore on-going to find a safer,effective and acceptable alternative.A recent meta-analysis did not support routine circumcision for normal boys with no risk factors.Vaccinium Macrocarpon(cranberry),commonly used against UTI in adult women,is also effective in reducing the number of recurrences and related antimicrobial use in children.Sodium pentosanpolysulfate,which prevents bacterial adherence to the uroepithelial cells in animal models,has shown conflicting results in human trials.When combined with antibiotic,Lactobacillus acidophilus(LA-5) and Bifidobacterium,by blocking the in vitro attachment of uropathogenic bacteria to uroepithelial cells,significantly reduce in the incidence of febrile UTIs.Deliberate colonization of the human urinary tract of patients with recurrent UTI with Escherichia-coli(E.coli) 83972 has resulted in subjective benefit and less UTI requiring treatment.The non-pathogenic E.coli isolate NU14 DeltawaaL is a candidate to develop liveattenuated vaccine for the treatment and prevention of acute and recurrent UTI.Diagnosing and treating dysfunctional elimination syndromes decrease the incidence of recurrent UTI.A meta-analysis found the lack of robust prospective randomized controlled trials limited the strength of the established guidelines for surgical management of vesicoureteral reflux.In conclusion,several interventions,other than antibiotic prophylaxis,for the prevention of recurrent UTI have been tried and,although showing some promise,they do not provide so far a definitive effective answer.Finding suitable alternatives still requires further high quality research of those seemingly promising interventions.展开更多
<strong>Introduction:</strong> Urinary tract infections (UTI) are frequent and of polymorphous clinical symptomatology in elderly subjects both in and out of hospital. In Mali, to our knowledge, no study c...<strong>Introduction:</strong> Urinary tract infections (UTI) are frequent and of polymorphous clinical symptomatology in elderly subjects both in and out of hospital. In Mali, to our knowledge, no study concerning UTIs in the elderly has been conducted, hence the interest in this innovative work. <strong>Objectives:</strong> To determine the prevalence and clinical and paraclinical aspects of urinary tract infections in the elderly. <strong>Materials and Methods:</strong> This was a prospective descriptive and cross-sectional study from September 1, 2013 to August 31, 2014, <i>i.e. </i> duration of 12 months. All patients aged 65 years and over, hospitalized or ambulatory in the internal medicine department with a documented urinary tract infection were included. <strong>Results:</strong> We collected and examined 194 patients. The cytobacteriological study of urine (CBSU) was positive in 28 patients, <i>i.e. </i> a prevalence of 14.43%. The male sex represented 59.8% of the cases, the sex ratio was equal to 1.46. The age groups between 65 - 69 and 70 - 74 years were the most affected, respectively 28.57% and 39.28%. The main clinical signs were: asthenia, anorexia, dependence, fever, urinary burning, dysuria. Hospitalization was associated with urinary tract infection with P = 0.01. The group of enterobacteria were incriminated in 75% of cases. <i>Escherichia coli, Klebsiella pneumoniae</i> and <i>Pseudomonas aeruginosa</i> represented 39.28%, 14.28% and 10.71% of cases. Urinary tract infections were represented by pyelonephritis, acute prostatitis, orchi-epididymitis and simple cystitis. <strong>Conclusion:</strong> Urinary tract infection is frequent in the elderly, its clinical presentation is polymorphic and enterobacteria are the most incriminated group of bacteria.展开更多
<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Urinary tract infection (UTI) is common in pregnancy...<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Urinary tract infection (UTI) is common in pregnancy and accounts for a high burden of maternal and perinatal morbidity/mortality and </span><span style="font-family:Verdana;">health expenditure. The burden of this condition has been understudied in Came</span><span style="font-family:Verdana;">roon. We aimed to determine the uropathogens of urinary tract infection in pregnancy, and the maternal-fetal outcomes of UTI at the Douala Re</span><span><span style="font-family:Verdana;">ferral Hospital. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> We conducted an analytic matched case-control study </span></span><span style="font-family:Verdana;">of 206 pregnant wom</span><span style="font-family:Verdana;">en with evid</span><span style="font-family:Verdana;">ence of uri</span><span style="font-family:Verdana;">nary tract infectio</span><span style="font-family:Verdana;">n (103 cases)</span><span style="font-family:Verdana;"> an</span><span style="font-family:Verdana;">d </span><span style="font-family:Verdana;">those without (103 controls) who underwent antenatal care and gave birth at </span><span style="font-family:Verdana;">the DRH from January 2019 to April 2019. Socio-demographic, laboratory and</span> <span style="font-family:Verdana;">maternal-fetal outcome data were collected using a pre-tested structured questionnai</span><span style="font-family:Verdana;">re and analyzed with SPSS version 23. Statistical significance was set at </span><span><span style="font-family:Verdana;">p < 0.05. </span><b><span style="font-family:Verdana;">Results:</span></b> <i><span style="font-family:Verdana;">Escherichia coli</span></i><span style="font-family:Verdana;"> (51.5%), </span><i><span style="font-family:Verdana;">Proteus mirabilis</span></i><span style="font-family:Verdana;"> (15.5%), </span><i><span style="font-family:Verdana;">S</span></i></span><i><span style="font-family:Verdana;">taphylococcus aureus</span></i><span style="font-family:Verdana;"> (11.7%) and </span><i><span style="font-family:Verdana;">Klebsiella sp</span></i><span style="font-family:Verdana;">. (6.8%) were the predominant uropathogens of UTI. Maternal outcomes of UTI were puerperal pyelonephritis (AOR 3.1;95% CI: 1.11 - 3.55, p = 0.0023), preterm labor (AOR 4.4;95% CI: 1.0 - 2.7, p = 0.008) and preterm birth (AOR 4.6;95% CI 1.9 - 22.9, p = 0.05). Furthermore, low birth weight (AOR 2.1;95% CI: 0.8 - 5.6, p = 0.05), neonatal infection (AOR 13;95% CI: 0.9 - 191.6, p = 0.04) and neonatal intensive care unit admission (AOR 2.5;95% CI: 1.7 - 3.6, p = 0.003) were fetal outcomes of UTI. </span><b><span style="font-family:Verdana;">Conclusion:</span></b> <i><span style="font-family:Verdana;">Escherichia coli</span></i><span style="font-family:Verdana;"> was the main uropathogenic </span><span style="font-family:Verdana;">agent of UTI during pregnancy. Maternal outcomes of UTI were puerperal pyel</span><span style="font-family:Verdana;">onephritis, preterm labor and delivery while fetal outcomes include: low-birth </span><span style="font-family:Verdana;">weight, neonatal infection and neonatal intensive care admission. Prompt diagnosis of this condition is the cornerstone to avoid adverse outcomes.</span></span></span></span>展开更多
Urinary Tract Infections (UTIs) are among one of the most common infections in women, with uropathogenic E. coli (UPEC) being involved in 80% of cases. In addition, E. coli exhibits an increasing resistance to broad s...Urinary Tract Infections (UTIs) are among one of the most common infections in women, with uropathogenic E. coli (UPEC) being involved in 80% of cases. In addition, E. coli exhibits an increasing resistance to broad spectrum antimicrobial agents as well as the subsequent generations of these drugs. The genetic diversity and antibiotic resistance patterns of both clinical and environmental E. coli isolates were studied to predict the potential of transmission of organisms and genes for antibiotic resistance from three different major eco-habitats including the gut of iguanas’ fresh and marine waters and the human urinary tract. (GTG)<sub>5 </sub>and BOX-PCR extragenic DNA fingerprinting allowed for the tracking of the relatedness of four different ecotype groups. Both DNA fingerprinting methods targeted non-protein coding or exogenous palindromic DNA and demonstrated shared origin and intraspecies level of genomic diversity within the population of the studied bacteria. DNA fingerprinting based on BOX-PCR was less discriminating than the (GTG)<sub>5</sub>-PCR, and produced five major clades. BOX-PCR analysis indicated that 44% of the UTI E. coli isolates was comprised within a single clade, therefore it correlated better with ecotype distribution. The (GTG)<sub>5</sub> PCR based co-clustering analysis showed that the clinical isolates appeared to have a closer relationship to iguana E. coli isolates than to the fresh and marine water isolates. However, in accordance with the BOX PCR co-clustering analysis, the clinical isolates were most similar to the marine water isolates, followed by the freshwater and iguana E. coli isolates. Seventy two percent of antibiotic resistance patterns were shared by the UTI strains with E. coli isolated from freshwater, followed by iguana.展开更多
Background: Among the common morbid causes that are prevalent among all age groups, urinary tract infections top the list. In our country, most of the UTI patients visiting hospitals (OPD or IPD) are already on empiri...Background: Among the common morbid causes that are prevalent among all age groups, urinary tract infections top the list. In our country, most of the UTI patients visiting hospitals (OPD or IPD) are already on empirical antibiotics even before getting the sensitivity report in their hand. The purpose of this research was to examine the susceptibility patterns of commonly used antibiotics, particularly fosfomycin, against common uropathogens. Methodology: This was a prospective observational study conducted between January and March 2021 in four private tertiary hospitals in Dhaka, Bangladesh. All the urine samples referred to these four laboratories, obtained from patients of all ages and both genders, clinically diagnosed to have UTI, were included. Urine culture was performed by a semiquantitative method on blood agar media and MacConkey agar media. Following identification, antimicrobial sensitivity testing was performed using the modified Kirby Bauer disk diffusion method in accordance with CLSI standards. The data was put into Statistical Package for Social Sciences (SPSS) statistical software version 25 for the analysis. Results: A total of 5389 urine samples were received from four private hospitals in Dhaka over three months, and of these, 934 (17.33%) isolates were obtained from culture. About 95% of the isolates were gram-negative bacilli (GNBs). The most common isolate was Escherichia coli 615 (65.85%), followed by Klebsiella spp. 154 (16.49%), Pseudomonas spp. 64 (6.85%) and 51 (5.46%) isolates of Enterobacter. Among the gram-positive cocci, the most common were Enterococci fecalis 18 (1.93%) and Staphylococcus aureus 17 (1.82%). Of all the antibiotics tested, fosfomycin sensitivity was 98.4%, 88.88%, and 100% for Escherichia coli, Enterococci fecalis, and Staphylococcus aureus, respectively. All the isolates tested were susceptible to Meropenem (77% - 100%), Amoxiclav (78% - 100%) and Nitrofurantoin (45% - 94%). Sensitivity amongst all the uropathogens for ceftriaxone, ciprofloxacin, and cotrimoxazole was nearly 50% - 77%. Conclusion: The positivity of urinary isolates is 17.33%, with the most common pathogen being Escherichia coli. Common uropathogens show the highest in vitro susceptibility to fosfomycin. So, fosfomycin should be considered as a highly potent and promising alternative oral antibiotic treatment for UTI.展开更多
Urinary tract infections (UTIs) are one of the most prevalent extra-intestinal bacterial infections. It is a common disease encountered in medical practice affecting people of all ages, from neonate to geriatric age g...Urinary tract infections (UTIs) are one of the most prevalent extra-intestinal bacterial infections. It is a common disease encountered in medical practice affecting people of all ages, from neonate to geriatric age group. These infections are on the increase for outpatients attending Primary Health Centres in Anambra State, Nigeria, therefore the need for this study. The prevalence rate of urinary tract infection, age distribution and influence of sex were determined. Susceptibility pattern of the infectious organisms to antimicrobial agent were examined. Clean-catch midstream urine samples were collected and examined. Out of 3000 urine samples examined, 528 bacterial isolates were recovered and characterized. These include: Escherichia coli (24.2%), Klebsiella spp. (18.2%), Staphylococcus aureus (18.2%), Proteus mirabilis (9.1%), Pseudomonas aeruginosa (9.1%), Enterococcus faecalis (9.1%), Citrobacter intermedius (6.1%) and Staphylococcus saprophyticus (6.1%). More females (52%) were infected than males (48%) and in both sexes, the highest incidence was found amongst the age group, 26 - 38 years. Gram negative rods had the highest incidence in both sexes. Among the towns in Anambra state, Umunya in southern province was observed to have the highest incidence rate of UTI. Susceptibility test of the bacterial isolates to antimicrobial agents showed that Staphylococcus aureus was sensitive to Cephalexin, Penicillin V, Erythromycin and Gentamycin while Pseudomonas aeruginosa was resistant to all the antibiotics. Escherichia coli and Klebsiella spp. were resistant to all the antibiotics except Gentamycin while Citrobacter intermedius was resistant only to Cephalexin and Erythromycin. This study provides the evidence of urinary tract infections amongst outpatients of primary health centres and the drugs for their control.展开更多
BACKGROUND Urinary tract infection(UTI)is one of the most common bacterial infections.Acute pyelonephritis or upper urinary tract infection is often accompanied by bacteremia;however,bacteremia resolves in most cases ...BACKGROUND Urinary tract infection(UTI)is one of the most common bacterial infections.Acute pyelonephritis or upper urinary tract infection is often accompanied by bacteremia;however,bacteremia resolves in most cases without complication.Rarely,complications due to bacteremia occur.One of these is osteomyelitis.It mainly affects the lumbar vertebral bodies,and rarely affects other site.CASE SUMMARY An 80-year-old woman presented to the hospital with a two-month history of pain in both legs.Two months ago,she was admitted to the hospital for fever,flank pain,and urinary frequency and was diagnosed with bacteremic UTI.During hospitalization,she complained of pain in both legs;however,the pain resolved shortly after,and no abnormalities were observed on physical examination.Therefore,she was placed on 2-wk antibiotic therapy for UTI without further evaluation for leg pain.However,pain recurred after discharge and persisted;therefore,an imaging test was performed.Bone scan and magnetic resonance imaging suggested osseous infection in both femurs,tibiae and patellae.Surgical treatment was performed,and tissue-and bone cultures revealed Escherichia coli,a previously observed pathogen,which demonstrated same antibiotic sensitivities,as noted in previous UTI.She was diagnosed with disseminated osteomyelitis,as a complication of UTI,and was placed on an 8-wk antibiotic therapy.CONCLUSION Indication for osteomyelitis should be high regardless of bone pain at sites other than lumbar spine after or during UTI.展开更多
BACKGROUND Urinary tract infection(UTI)is a common disease.It often requires hospitalization,and severe presentations,including sepsis and other complications,have a mortality rate of 6.7%-8.7%.AIM To evaluate the pre...BACKGROUND Urinary tract infection(UTI)is a common disease.It often requires hospitalization,and severe presentations,including sepsis and other complications,have a mortality rate of 6.7%-8.7%.AIM To evaluate the predictive factors for early clinical response and effects of initial antibiotic therapy on early clinical response in community-onset Escherichia coli(E.coli)urinary tract infections(UTIs).METHODS This retrospective study was conducted at Wonkwang University Hospital in South Korea between January 2011 and December 2017.Hospitalized patients(aged>18 years)who were diagnosed with community-onset E.coli UTI were enrolled in this study.RESULTS A total of 511 hospitalized patients were included.66.1%of the patients had an early clinical response.The mean length of hospital stay in patients with an early clinical response were each 4.3 d shorter than in patients without an early clinical response.In the multiple regression analysis,initial appropriate antibiotic therapy(OR=2.449,P=0.006),extended-spectrum(3-lactamase(ESBL)-producing E.coli(OR=2.112,P=0.044),improper use of broad-spectrum antimicrobials(OR=0.411,P=0.006),and a stay in a healthcare facility before admission(OR=0.562,P=0.033)were the factors associated with an early clinical response.Initial broadspectrum antibiotic therapy was not associated with an early clinical response.CONCLUSION ESBL producing E.coli,and the type of residence before hospital admission were the factors associated with an early clinical response.Appropriateness of initial antibiotic therapy was a predictive factor for an early clinical response,but broadspectrum of initial antibiotic therapy did not impact early clinical response.展开更多
BACKGROUND Urinary tract infection(UTI)is a common type of postoperative infection following cytoreductive surgery for ovarian cancer,which severely impacts the prognosis and quality of life of patients.AIM To develop...BACKGROUND Urinary tract infection(UTI)is a common type of postoperative infection following cytoreductive surgery for ovarian cancer,which severely impacts the prognosis and quality of life of patients.AIM To develop a machine learning assistant model for the prevention and control of nosocomial infection.METHODS A total of 674 elderly patients with ovarian cancer who were treated at the Department of Gynaecology at Jingzhou Central Hospital between January 31,2016 and January 31,2022 and met the inclusion criteria of the study were selected as the research subjects.A retrospective analysis of the postoperative UTI and related factors was performed by reviewing the medical records.Five machine learning-assisted models were developed using two-step estimation methods from the candidate predictive variables.The robustness and clinical applicability of each model were assessed using the receiver operating characteristic curve,decision curve analysis and clinical impact curve.RESULTS A total of 12 candidate variables were eventually included in the UTI prediction model.Models constructed using the random forest classifier,support vector machine,extreme gradient boosting,and artificial neural network and decision tree had areas under the receiver operating characteristic curve ranging from 0.776 to 0.925.The random forest classifier model,which incorporated factors such as age,body mass index,catheter,catheter intubation times,blood loss,diabetes and hypoproteinaemia,had the highest predictive accuracy.CONCLUSION These findings demonstrate that the machine learning-based prediction model developed using the random forest classifier can be used to identify elderly patients with ovarian cancer who may have postoperative UTI.This can help with treatment decisions and enhance clinical outcomes.展开更多
文摘Objective: This study aimed to evaluate the antioxidant and antimicrobial capacities of extracts from Euphorbia hirta L. and Terminalia avicennioides GUILL & PERR. Methodology: The crude hydro-acetonic and aqueous extracts as well their fractionations were prepared. The total phenolic, flavonoids and tannins contents were assessed using the Folin-Ciocalteu, aluminum chloride and vanillin acid methods, respectively. The antioxidant and antibacterial activities were investigated using standard methods. Results: Euphorbia hirta showed significant contents of total phenolic and flavonoids in n-Butanol (145.14 ± 1.37 GAE/100mg extracts) and ethyl acetate (23.56 ± 0.68 mg QE/ 100mg extracts) fractions. Total tannins were high in hydro-acétonique extract (11.18 ± 0.31 mg TAE/100mg extracts) and aqueous fraction (11.12 ± 0.28 mg TAE/100mg extracts) of Terminalia avicennioides stem barks. Extracts and fractions of both plants demonstrated a strongly antioxidant capacity through the free radicals scavenging and the ferric ions reducing. Concerning antimicrobial screening the extracts of Terminalia avicennioides were effective against 16 causative pathogens of urinary tract infections. Bactericidal effect against Staphylococcus aureus ATCC 29213, Staphylococcus aureus and 2 methicillin-resistant Staphylococcus haemolyticus strains was found with aqueous fraction of Terminalia avicennioides leaves. This fraction also highlighted a synergetic effect with some antibiotics used against these bacterial strains. Conclusion: Terminalia avicennioides leaves could be recommended as an herbal drug formulation for the urinary infections management.
文摘Introduction: Infection disease is a real publique health problem. The rise of resistance for modern antibiotic in infections treatment imposed us order alternatives. The study objective was to contribute in the knowledge of medicinal plants uses in urinary infections treatment in N’Djamena (Chad) in view for amelioration the traditional medicine in future. Methodology: The study was conducted in the city of N’Djamena in the Republic of Chad that interviewed 60 traditherapists on using 11 plants for urinary tract infections treatment. The methodology of this study consisted of the knowledge of medicinal plants that used by traditherapists, and the plants identification was done in the laboratory of IRED at Farcha. Results: A total of 60 traditherapists was interrogated on the plants used in the treatment of urinary tract infections among the population of N’Djamena. The majority of traditherapists interrogated in this study were male with the rate of 61.67% against female with the rate of 38.33%. The age range of traditherapists was between 20 to 80 years, 25 (41.67%) from the age range between 30 - 50 years and 35 (58.33%) in age range from 50 to 70 years. For the origin of their knowledge, the study showed that 72% of traditherapists inherited the knowledge from their family, while 15% inherited from the family and from training. The ethnic groups of the traditherapists were Sara (16%), Maraba (12%) and Massa (11%). According to the results, 18.33% were illiterates, 49% attended primary school and 33.34% the secondary school. Our study found that 11 species of plants belonging to 11 families were used in the treatment of urinary tract infection and the Ziziphus spina-christi was the most represented. According to traditherapists the Ziziphus spina-christi, Cassia obovata and Euphorbia hirta were the most frequent plants used in the urinary tract infections treatment. The parts of plants used in the treatment were leaves and bark, grained leaves and entire plants with the proportion of 50%, 16.67 and 15% respectively. Conclusion: This study revealed that the medicinal plants are variously used in the treatment of infection urinary tract in the city of N’Djamena.
基金Luzhou People's Government-Science and technology Strategic Cooperation project of Southwest Medical University(2017LZXNYD-T09)。
文摘Obiective:To investigate whether"Fuzheng Qingretonglin"decoction can reduce urinary tract damage caused by complex urinary tract infection caused by drug resistant Escherichia coli by regulating Nod-like receptor pyrin domain3 inflammasome,and to explore the feasibility of this decoction combined with levofloxacin in the treatment of complex urinary tract infection caused by drug resistant bacteria.Methods:SD rats were divided into five groups:sham group,model group,levofloxacin group(Lev group),levofloxacin+Fuzheng Qingre Tonglin decoction group(FZ+lev group),and Fuzheng Qingre Tonglin decoction group(FZQRTL group).After the experiment,urine was taken for bacterial culture to determine the urinary tract infection of rats in each group;HE staining was used to observe the pathological changes of kidney and bladder tissues in rats;The expression of NLRP3 in kidney and bladder tissues was detected by immunohistochemistry;The expression of IL-1βand IL-18 in serum of rats was detected by ELISA;The expressions of NLRP3,ASC and Caspase-1 were detected by Western blotting.Results:The positive rate of urine bacteria culture in the sham group was 0%,the positive rate of urine bacteria culture in the model group was 100%;and the positive rate of urine bacteria culture in the FZ+lev group was 37.50%,which was statistically different from that in the model group(P<0.05).A large number of inflammatory cells were observed in the kidney and bladder tissues of the model group by HE staining,while the number of inflammatory cells in the kidney and bladder tissues of the Lev group and FZQRTL group was significantly reduced compared with that of the model group.The FZ+lev group in the number and structure of inflammatory cells in kidney and bladder were similar to the sham group.The NLRP3 immunohistochemistry of kidney and bladder tissue in FZ+lev groups and FZQRTL groups was significantly different from that in model group(P<0.001).The levels of IL-1βand IL-18 in serum of Lev group,FZQRTL group and FZ+lev group were significantly decreased by ELISA compared with model group(P<0.001).The levels of IL-1βand IL-18 in the FZ+lev groups were significantly lower than in the Lev group and FZQRTL group,and the differences were statistically significant(P<0.05).The protein expressions of NLRP3,ASC and Caspase-1 in the Lev group,FZQRTL group and FZ+lev group were significantly lower than those in the model group(P<0.001).The protein expressions of NLRP3,ASC and Caspase-1 in the FZ+lev groups were significantly lower than in the Lev group and FZQRTL group,and the differences were statistically significant(P<0.05).Conclusions:"Fuzheng Qingretonglin"decoction may have a protective effect on the kidney and bladder of rats with complex urinary tract infection caused by drug-resistant Escherichia coli by inhibiting the activation of NLRP3 inflammatory bodies,and TCM combined with levofloxacin has a better therapeutic effect than TCM or levofloxacin alone.
基金Supported by Science and Technology Planning Project of Guizhou Province(QKHJC-ZK[2022]362,QKZYD[2022]4028)Science and Technology Achievements Transfer and Transformation Project of Guizhou Provincial Department of Education([2022]064)+1 种基金Higher Education Institution Engineering Research Center of Guizhou Provincial Department of Education([2023]035)National Undergraduate Innovation Training Project(202210660131).
文摘[Objectives]To study the main active components,targets and related pathways of Ningmitai capsule for the treatment of urinary tract infections(UTIs)based on network pharmacology.[Methods]The chemical components of Ningmitai capsule were collected through literature search,and the relevant target information of the components was sorted out.The UTIs-associated targets were also screened out using DisGeNET database and GeneCards database.Cytoscape 3.6.1 software and STRING platform were used to construct the protein-protein interaction(PPI)network,and MCODE plug-in in this software was used to analyze the action pathway and key targets of Ningmitai capsule for the treatment of UTIs.GO and KEGG pathway enrichment analysis of key targets was conducted using David database,and the component-target-pathway network diagram of Ningmitai capsule for the treatment of UTIs was established.[Results]A total of 37 active compounds,including salicylate,ferulic acid,baicalin,quercetin,apigenin and ellagic acid were screened from seven TCM components of Ningmitai capsule.There were 26 possible targets related to the treatment of UTIs,such as NFKB1,JUN,CTNNB1 and STAT3,which play an important role for the treatment of UTIs through prostate cancer,bladder cancer,pancreatic cancer and other signaling pathways.[Conclusions]The study provides a theoretical basis for the study of the mechanism of Ningmitai capsule in the treatment of UTIs.
文摘Background and Aims: Urinary tract infections (UTIs) are common among pregnant women and major predisposing factors for pyelonephritis linked to obstetrical complications including preterm labour and low infants’ birth weights. This study sought to determine the relationship(s) between pregnancy trimesters, UTIs and changes in progesterone levels among pregnant women. Materials and Methods: The study was conducted in 2016 at Moi Teaching and Referral Hospital (MTRH) antenatal clinic which is a referral facility that attends to patients from most Counties in western region of Kenya. A cross-sectional study design was used to collect blood and urine specimens from 78 participants. Blood was used to determine progesterone levels using ELISA technique and urine cultures with bacterial colony counts ≥ 10<sup>5</sup> were appropriately identified to species level. Trimester periods and participants’ demographic information were obtained using a structured questionnaire. Results: Culture results showed that the most abundant bacterial species isolated in urine from the pregnant women was Escherechia coli (63.7%). The more affected age-group was women between 30 - 39 years during trimester three, suggesting that bacterial colonization of genital track occurred more frequently in older compared to the younger women. There was an exponential increase in progesterone levels among the pregnant women during trimester three compared to other trimesters, although these increases occurred independent of age. However, high levels of progesterone among pregnant women in third trimester corresponded with increased number of E. coli causing UTI. Conclusion: The results showed that progesterone levels increase with trimester and the most prevalent bacteria associated with this was E. coli even though age and increase in progesterone levels had no significant impact on E. coli infection.
文摘Introduction: Urinary tract infection is one of the most frequent public health problems in the world and concerns all ages. Objective: To describe the epidemiological, clinical and biological profile of urinary tract infection in the internal medicine unit of the Fousseyni Daou hospital in Kayes. Methodology: It was a descriptive and cross-sectional study with retrospective data collection which took place from January 1 to December 31, 2020 at the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes. It covered all outpatients and hospitalized patients presenting with a urinary tract infection during the study period. Results: We identified 79 cases of urinary tract infection out of 145 requests for ECBU, that is a positivity rate of 53.10% and out of a total of 1883 admissions that is a hospital prevalence of 4.19%. The age groups of 36 to 45 years and 46 to 55 years were more represented in 28 cases (35.44%) and 25 cases (31.64%) with an average age of 45 years ± 10. The female sex was predominant, 42 cases (53.16%) with a sex ratio of 0.88. Housewives were more represented 28 cases (34.44%). The majority of patients resided in rural areas 49 cases (62.03%). The history was dominated by the following pathologies: hypertension 48.10%, diabetes 36.70% and gastropathy 30.37%. The main clinical manifestations were: Urinary burning 67 cases (84.81%), Dysuria 65 cases (82.27%), Pelvic pain 59 cases (74.68%), Fever 57 cases (72.15%). The epidemiological profile of the isolated strains was dominated by enterobacteriaceae, followed by gram-positive cocci and gram-negative bacilli. The main bacteria responsible for urinary tract infections in order of frequency: Escherichia coli (45.56%), Klebsiella pneumoniae (11.39%), Pseudomonas aeruginosa (8.86%), Staphylococcus aureus (7.59%), Streptococcus sp (6.33%), Enterobacter cloacae (3.79%), Acinetobacter sp (3.79%). The study of the susceptibility and resistance profiles of the isolated strains showed significant sensitivity of enterobacteriaceae to colistin and resistance to amoxicillin and to the amoxicillin + clavulanic acid combination. Conclusion: Urinary tract infections are a major public health problem since they are responsible for significant morbidity and mortality and a high cost of care. Knowledge of the epidemiological-clinical and bacteriological profile of these infections is essential for efficient management.
文摘Background: Urinary tract infection (UTI) is a bacterial infection affecting males and females but is more prevalent in expectant women. ESBLs are bacteria with enzymes that make them resistant to many antibiotics, posing a significant health challenge. This study aims to determine the characteristics of ESBL-producing bacteria causing UTIs in expectant women. Methodology: A self-administered survey was carried out;300 expectant women were recruited using a random sampling method. A questionnaire was used to collect socio-demographic information. Urine samples were collected in sterile universal bottles and processed at the JKUAT Zoology laboratory. Urine samples were analyzed using urinalysis, microscopy, culture, and sensitivity testing. ESBL-producing bacteria were identified phenotypically using the double-disc synergy test (DDST) and genotyped for specific resistant genes using PCR. Results: UTI prevalence was 32.7% (98/300). UTI was significantly associated with the history of previous UTI (OR = 0.84, p = 0.02) and multigravida (OR = 0.14 p = 0.01). UTI was common in women aged between 28-37 years in their second trimester. Bacteria isolated were E. coli 57.1% (56/98), S. aureus 21.4% (21/98) K. pneumonia 11.2% (11/98) and Proteus spp 10.4% (10/98). Bacteria antibiotic resistance patterns were E. coli-tetracycline (91.1%), sulfamethoxazole (55.4%), cefotaxime (53.4%) and augmentin (53.4%). S. aureus-sulfamethozaxole (100%) and augmentin (71.4%), K. pneumoniae-sulfame-thoxazole (72.2%) cefotaxime (63.6%), chloramphenicol and tetracycline (54.5%). Proteus spp: tetracycline (100%), nitrofurantoin (90%), cefotaxime and chloramphenicol (50%). The proportion of ESBLs bacterial producers was 37.6% (29/77) and 44.8% (13/29) possessed ESBLs resistant genes;Bla CTX-M 53.8% (7/13), Bla SHV and Bla TEM 23.1% (3/13) each, Bla OXA (0%) was not detected. Conclusion: The study revealed a high proportion of ESBLs producing bacteria responsible for UTI in expectant women. ESBLs screening, routine culture and sensitivity testing will guide on proper management and empirical treatment of UTI patients thus reducing multi-drug resistance.
文摘Background: Urinary Tract Infection (UTI), a prevalent bacterial infection in adults, heavily relies on cytobacteriological examination of urine (CBEU) for diagnosis. However, in resource-limited countries, accessibility to CBEU remains hindered by cost and availability. This study aims to assess the utility of the Urinary Dipstick Test (UDT) in diagnosing UTIs among hospitalized patients in the context of limited resources. Methods: A cross-sectional study was conducted from February to May 2019, encompassing hospitalized patients who underwent CBEU at the bacteriology unit of Sour? Sanou University Hospital. UDT and CBEU were concurrently performed, and UDT’s analytical and diagnostic performance was evaluated against CBEU, considered the gold standard. Results: A total of 274 CBEU requests were registered, involving 274 patients (159 males) with a mean age of 45.8 ± 21.3 years (ranging from 1 to 90 years). UTI was confirmed in 90 patients, yielding a frequency of 32.85%. The UTI bacteriological profile was dominated by Enterobacteriaceae (75.23%), primarily Escherichia coli (60.55%). Nitrite and Leukocytes were positive in 54 (19.8%) and 157 (53.6%) of the samples tested. Among patients with confirmed UTI, Nitrite, and Leukocytes were positive in 30 (33%) and 71 (79%) patients respectively. UDT demonstrated variable performance based on nitrite and leukocyte combination: Sensitivity (57%-82%), Specificity (7%-98%), Positive Predictive Value (PPV) (43%-57%), Negative Predictive Value (NPV) (43%-67%). UDT performed slightly better in women (NPV = 88%) and inpatients without urinary catheters (NPV = 75% and PPV = 80%). Conclusion: This study underscores UDT’s potential utility in excluding UTIs among women, younger patients, and inpatients without urinary catheters, albeit with limited confidence. The UDT emerges as a complementary tool for UTI screening, particularly in resource-limited settings.
基金supported by the National Key Research and Development Plan of China(Technology helps Economy 2020)the Fundamental Research Funds for the Central Universities(2042020kf1081)+2 种基金the Nature Science Foundation of Hubei Province(2019CFB760)the Translational Medicine and Interdisciplinary Research Joint Fund of Zhongnan Hospital of Wuhan University(ZNJC201917)the Health Commission of the Hubei Province Scientific Research Project(WJ2019H035)。
文摘Background:Urinary tract infections(UTI),urolithiasis,and benign prostatic hyperplasia(BPH)are three of the most common nonmalignant conditions in urology.However,there is still a lack of comprehensive and updated epidemiological data.This study aimed to investigate the disease burden of UTI,urolithiasis,and BPH in 203 countries and territories from 1990 to 2019.Methods:Data were extracted from the Global Burden of Disease 2019,including incident cases,deaths,disabilityadjusted life-years(DALYs)and corresponding age-standardized rate(ASR)from 1990 to 2019.Estimated annual percentage changes(EAPC)were calculated to evaluate the trends of ASR.The associations between disease burden and social development degrees were analyzed using a sociodemographic index(SDI).Results:Compared with 1990,the incident cases of UTI,urolithiasis,and BPH increased by 60.40%,48.57%,and 105.70%in 2019,respectively.The age-standardized incidence rate(ASIR)of UTI increased(EAPC=0.08),while urolithiasis(EAPC=–0.83)and BPH(EAPC=–0.03)decreased from 1990 to 2019.In 2019,the age-standardized mortality rate(ASMR)of UTI and urolithiasis were 3.13/100,000 and 0.17/100,000,respectively.BPH had the largest increase(110.56%)in DALYs in the past three decades,followed by UTI(68.89%)and urolithiasis(16.95%).The burden of UTI was mainly concentrated in South Asia and Tropical Latin America,while the burden of urolithiasis and BPH was recorded in Asia and Eastern Europe.Moreover,the ASIR and SDI of urolithiasis in high-SDI regions from 1990to 2019 were negatively correlated,while the opposite trend was seen in low-SDI regions.In 2019,the ASIR of UTI in females was 3.59 times that of males,while the ASIR of urolithiasis in males was 1.96 times higher than that in females.The incidence was highest in the 30–34,55–59,and 65–69 age groups among the UTI,urolithiasis,and BPH groups,respectively.Conclusions:Over the past three decades,the disease burden has increased for UTI but decreased for urolithiasis and BPH.The allocation of medical resources should be based more on the epidemiological characteristics and geographical distribution of diseases.
文摘Radical hysterectomy(RH) and pelvic lymphadenectomy are the main treatment methods for early cervical cancer and endometrial carcinoma.Effective care measures,however,can decrease the incidence of UTIs and complications associated with RH and pelvic lymphadenectomy,as well as improve the therapeutic effects of administered drugs and patient prognosis.The writer refers to relevant literatures to analyze the reasons for postoperative UTIs and to provide a brief summary of the nursing methods for and progress in UTI prevention.
基金an Insitutte of National Importance under Ministry of Health and Family Welfare,Government of India,for the Intramural funding for the research study.Project No.95/JIP/Res/Intra-MSc/Phase 2/Grant 3/2016-2017 dated 07.01.2017.
文摘Objective:Urinary tract infection(UTI)is a common cause of morbidity and hospitalisation in the population worldwide.Upper UTI is indolent and causes subclinical acute kidney injury(AKI)resulting in preventable cause of scarring of renal parenchyma.We explored urinary and serum levels of kidney injury molecule-1(KIM-1),haematological parameters and quantitative urine microscopy parameters to predict kidney injury.Methods:Neutrophilelymphocyte ratio(NLR)is obtained by dividing absolute neutrophil count with absolute lymphocyte count.Quantitative urine sediment microscopy was performed and correlated with clinical,biochemical and haematological findings to predict AKI in patients with UTI.Quantitative ELISA was performed for serum and urine levels of KIM-1.Seventy two adult patients with UTI were enrolled,45 of whom had AKI while 27 were in the non-AKI group.Results:NLR(p=0.005)and renal tubular epithelial cell-granular cast score in quantitative urine microscopy(p=0.008)are strong predictors of AKI in patients with UTI while rest of quantitative urine microscopy parameters and serum and urinary levels of KIM-1 molecule were not found to be useful in prediction of AKI.Conclusion:NLR in haemogram is a novel and useful biomarker for predicting AKI in patients with UTI.
文摘Urinary tract infection(UTI) is one of the most commonchildhood infections.Permanent renal cortical scarring may occur in affected children,especially with recurrent UTIs,leading to long-term complications such as hypertension and chronic renal failure.To prevent such damage,several interventions to prevent UTI recurrences have been tried.The most established and accepted prevention at present is low dose long-term antibiotic prophylaxis.However it has a risk of break through infections,adverse drug reactions and also the risk of developing antibiotic resistance.The search is therefore on-going to find a safer,effective and acceptable alternative.A recent meta-analysis did not support routine circumcision for normal boys with no risk factors.Vaccinium Macrocarpon(cranberry),commonly used against UTI in adult women,is also effective in reducing the number of recurrences and related antimicrobial use in children.Sodium pentosanpolysulfate,which prevents bacterial adherence to the uroepithelial cells in animal models,has shown conflicting results in human trials.When combined with antibiotic,Lactobacillus acidophilus(LA-5) and Bifidobacterium,by blocking the in vitro attachment of uropathogenic bacteria to uroepithelial cells,significantly reduce in the incidence of febrile UTIs.Deliberate colonization of the human urinary tract of patients with recurrent UTI with Escherichia-coli(E.coli) 83972 has resulted in subjective benefit and less UTI requiring treatment.The non-pathogenic E.coli isolate NU14 DeltawaaL is a candidate to develop liveattenuated vaccine for the treatment and prevention of acute and recurrent UTI.Diagnosing and treating dysfunctional elimination syndromes decrease the incidence of recurrent UTI.A meta-analysis found the lack of robust prospective randomized controlled trials limited the strength of the established guidelines for surgical management of vesicoureteral reflux.In conclusion,several interventions,other than antibiotic prophylaxis,for the prevention of recurrent UTI have been tried and,although showing some promise,they do not provide so far a definitive effective answer.Finding suitable alternatives still requires further high quality research of those seemingly promising interventions.
文摘<strong>Introduction:</strong> Urinary tract infections (UTI) are frequent and of polymorphous clinical symptomatology in elderly subjects both in and out of hospital. In Mali, to our knowledge, no study concerning UTIs in the elderly has been conducted, hence the interest in this innovative work. <strong>Objectives:</strong> To determine the prevalence and clinical and paraclinical aspects of urinary tract infections in the elderly. <strong>Materials and Methods:</strong> This was a prospective descriptive and cross-sectional study from September 1, 2013 to August 31, 2014, <i>i.e. </i> duration of 12 months. All patients aged 65 years and over, hospitalized or ambulatory in the internal medicine department with a documented urinary tract infection were included. <strong>Results:</strong> We collected and examined 194 patients. The cytobacteriological study of urine (CBSU) was positive in 28 patients, <i>i.e. </i> a prevalence of 14.43%. The male sex represented 59.8% of the cases, the sex ratio was equal to 1.46. The age groups between 65 - 69 and 70 - 74 years were the most affected, respectively 28.57% and 39.28%. The main clinical signs were: asthenia, anorexia, dependence, fever, urinary burning, dysuria. Hospitalization was associated with urinary tract infection with P = 0.01. The group of enterobacteria were incriminated in 75% of cases. <i>Escherichia coli, Klebsiella pneumoniae</i> and <i>Pseudomonas aeruginosa</i> represented 39.28%, 14.28% and 10.71% of cases. Urinary tract infections were represented by pyelonephritis, acute prostatitis, orchi-epididymitis and simple cystitis. <strong>Conclusion:</strong> Urinary tract infection is frequent in the elderly, its clinical presentation is polymorphic and enterobacteria are the most incriminated group of bacteria.
文摘<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Urinary tract infection (UTI) is common in pregnancy and accounts for a high burden of maternal and perinatal morbidity/mortality and </span><span style="font-family:Verdana;">health expenditure. The burden of this condition has been understudied in Came</span><span style="font-family:Verdana;">roon. We aimed to determine the uropathogens of urinary tract infection in pregnancy, and the maternal-fetal outcomes of UTI at the Douala Re</span><span><span style="font-family:Verdana;">ferral Hospital. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> We conducted an analytic matched case-control study </span></span><span style="font-family:Verdana;">of 206 pregnant wom</span><span style="font-family:Verdana;">en with evid</span><span style="font-family:Verdana;">ence of uri</span><span style="font-family:Verdana;">nary tract infectio</span><span style="font-family:Verdana;">n (103 cases)</span><span style="font-family:Verdana;"> an</span><span style="font-family:Verdana;">d </span><span style="font-family:Verdana;">those without (103 controls) who underwent antenatal care and gave birth at </span><span style="font-family:Verdana;">the DRH from January 2019 to April 2019. Socio-demographic, laboratory and</span> <span style="font-family:Verdana;">maternal-fetal outcome data were collected using a pre-tested structured questionnai</span><span style="font-family:Verdana;">re and analyzed with SPSS version 23. Statistical significance was set at </span><span><span style="font-family:Verdana;">p < 0.05. </span><b><span style="font-family:Verdana;">Results:</span></b> <i><span style="font-family:Verdana;">Escherichia coli</span></i><span style="font-family:Verdana;"> (51.5%), </span><i><span style="font-family:Verdana;">Proteus mirabilis</span></i><span style="font-family:Verdana;"> (15.5%), </span><i><span style="font-family:Verdana;">S</span></i></span><i><span style="font-family:Verdana;">taphylococcus aureus</span></i><span style="font-family:Verdana;"> (11.7%) and </span><i><span style="font-family:Verdana;">Klebsiella sp</span></i><span style="font-family:Verdana;">. (6.8%) were the predominant uropathogens of UTI. Maternal outcomes of UTI were puerperal pyelonephritis (AOR 3.1;95% CI: 1.11 - 3.55, p = 0.0023), preterm labor (AOR 4.4;95% CI: 1.0 - 2.7, p = 0.008) and preterm birth (AOR 4.6;95% CI 1.9 - 22.9, p = 0.05). Furthermore, low birth weight (AOR 2.1;95% CI: 0.8 - 5.6, p = 0.05), neonatal infection (AOR 13;95% CI: 0.9 - 191.6, p = 0.04) and neonatal intensive care unit admission (AOR 2.5;95% CI: 1.7 - 3.6, p = 0.003) were fetal outcomes of UTI. </span><b><span style="font-family:Verdana;">Conclusion:</span></b> <i><span style="font-family:Verdana;">Escherichia coli</span></i><span style="font-family:Verdana;"> was the main uropathogenic </span><span style="font-family:Verdana;">agent of UTI during pregnancy. Maternal outcomes of UTI were puerperal pyel</span><span style="font-family:Verdana;">onephritis, preterm labor and delivery while fetal outcomes include: low-birth </span><span style="font-family:Verdana;">weight, neonatal infection and neonatal intensive care admission. Prompt diagnosis of this condition is the cornerstone to avoid adverse outcomes.</span></span></span></span>
文摘Urinary Tract Infections (UTIs) are among one of the most common infections in women, with uropathogenic E. coli (UPEC) being involved in 80% of cases. In addition, E. coli exhibits an increasing resistance to broad spectrum antimicrobial agents as well as the subsequent generations of these drugs. The genetic diversity and antibiotic resistance patterns of both clinical and environmental E. coli isolates were studied to predict the potential of transmission of organisms and genes for antibiotic resistance from three different major eco-habitats including the gut of iguanas’ fresh and marine waters and the human urinary tract. (GTG)<sub>5 </sub>and BOX-PCR extragenic DNA fingerprinting allowed for the tracking of the relatedness of four different ecotype groups. Both DNA fingerprinting methods targeted non-protein coding or exogenous palindromic DNA and demonstrated shared origin and intraspecies level of genomic diversity within the population of the studied bacteria. DNA fingerprinting based on BOX-PCR was less discriminating than the (GTG)<sub>5</sub>-PCR, and produced five major clades. BOX-PCR analysis indicated that 44% of the UTI E. coli isolates was comprised within a single clade, therefore it correlated better with ecotype distribution. The (GTG)<sub>5</sub> PCR based co-clustering analysis showed that the clinical isolates appeared to have a closer relationship to iguana E. coli isolates than to the fresh and marine water isolates. However, in accordance with the BOX PCR co-clustering analysis, the clinical isolates were most similar to the marine water isolates, followed by the freshwater and iguana E. coli isolates. Seventy two percent of antibiotic resistance patterns were shared by the UTI strains with E. coli isolated from freshwater, followed by iguana.
文摘Background: Among the common morbid causes that are prevalent among all age groups, urinary tract infections top the list. In our country, most of the UTI patients visiting hospitals (OPD or IPD) are already on empirical antibiotics even before getting the sensitivity report in their hand. The purpose of this research was to examine the susceptibility patterns of commonly used antibiotics, particularly fosfomycin, against common uropathogens. Methodology: This was a prospective observational study conducted between January and March 2021 in four private tertiary hospitals in Dhaka, Bangladesh. All the urine samples referred to these four laboratories, obtained from patients of all ages and both genders, clinically diagnosed to have UTI, were included. Urine culture was performed by a semiquantitative method on blood agar media and MacConkey agar media. Following identification, antimicrobial sensitivity testing was performed using the modified Kirby Bauer disk diffusion method in accordance with CLSI standards. The data was put into Statistical Package for Social Sciences (SPSS) statistical software version 25 for the analysis. Results: A total of 5389 urine samples were received from four private hospitals in Dhaka over three months, and of these, 934 (17.33%) isolates were obtained from culture. About 95% of the isolates were gram-negative bacilli (GNBs). The most common isolate was Escherichia coli 615 (65.85%), followed by Klebsiella spp. 154 (16.49%), Pseudomonas spp. 64 (6.85%) and 51 (5.46%) isolates of Enterobacter. Among the gram-positive cocci, the most common were Enterococci fecalis 18 (1.93%) and Staphylococcus aureus 17 (1.82%). Of all the antibiotics tested, fosfomycin sensitivity was 98.4%, 88.88%, and 100% for Escherichia coli, Enterococci fecalis, and Staphylococcus aureus, respectively. All the isolates tested were susceptible to Meropenem (77% - 100%), Amoxiclav (78% - 100%) and Nitrofurantoin (45% - 94%). Sensitivity amongst all the uropathogens for ceftriaxone, ciprofloxacin, and cotrimoxazole was nearly 50% - 77%. Conclusion: The positivity of urinary isolates is 17.33%, with the most common pathogen being Escherichia coli. Common uropathogens show the highest in vitro susceptibility to fosfomycin. So, fosfomycin should be considered as a highly potent and promising alternative oral antibiotic treatment for UTI.
文摘Urinary tract infections (UTIs) are one of the most prevalent extra-intestinal bacterial infections. It is a common disease encountered in medical practice affecting people of all ages, from neonate to geriatric age group. These infections are on the increase for outpatients attending Primary Health Centres in Anambra State, Nigeria, therefore the need for this study. The prevalence rate of urinary tract infection, age distribution and influence of sex were determined. Susceptibility pattern of the infectious organisms to antimicrobial agent were examined. Clean-catch midstream urine samples were collected and examined. Out of 3000 urine samples examined, 528 bacterial isolates were recovered and characterized. These include: Escherichia coli (24.2%), Klebsiella spp. (18.2%), Staphylococcus aureus (18.2%), Proteus mirabilis (9.1%), Pseudomonas aeruginosa (9.1%), Enterococcus faecalis (9.1%), Citrobacter intermedius (6.1%) and Staphylococcus saprophyticus (6.1%). More females (52%) were infected than males (48%) and in both sexes, the highest incidence was found amongst the age group, 26 - 38 years. Gram negative rods had the highest incidence in both sexes. Among the towns in Anambra state, Umunya in southern province was observed to have the highest incidence rate of UTI. Susceptibility test of the bacterial isolates to antimicrobial agents showed that Staphylococcus aureus was sensitive to Cephalexin, Penicillin V, Erythromycin and Gentamycin while Pseudomonas aeruginosa was resistant to all the antibiotics. Escherichia coli and Klebsiella spp. were resistant to all the antibiotics except Gentamycin while Citrobacter intermedius was resistant only to Cephalexin and Erythromycin. This study provides the evidence of urinary tract infections amongst outpatients of primary health centres and the drugs for their control.
文摘BACKGROUND Urinary tract infection(UTI)is one of the most common bacterial infections.Acute pyelonephritis or upper urinary tract infection is often accompanied by bacteremia;however,bacteremia resolves in most cases without complication.Rarely,complications due to bacteremia occur.One of these is osteomyelitis.It mainly affects the lumbar vertebral bodies,and rarely affects other site.CASE SUMMARY An 80-year-old woman presented to the hospital with a two-month history of pain in both legs.Two months ago,she was admitted to the hospital for fever,flank pain,and urinary frequency and was diagnosed with bacteremic UTI.During hospitalization,she complained of pain in both legs;however,the pain resolved shortly after,and no abnormalities were observed on physical examination.Therefore,she was placed on 2-wk antibiotic therapy for UTI without further evaluation for leg pain.However,pain recurred after discharge and persisted;therefore,an imaging test was performed.Bone scan and magnetic resonance imaging suggested osseous infection in both femurs,tibiae and patellae.Surgical treatment was performed,and tissue-and bone cultures revealed Escherichia coli,a previously observed pathogen,which demonstrated same antibiotic sensitivities,as noted in previous UTI.She was diagnosed with disseminated osteomyelitis,as a complication of UTI,and was placed on an 8-wk antibiotic therapy.CONCLUSION Indication for osteomyelitis should be high regardless of bone pain at sites other than lumbar spine after or during UTI.
文摘BACKGROUND Urinary tract infection(UTI)is a common disease.It often requires hospitalization,and severe presentations,including sepsis and other complications,have a mortality rate of 6.7%-8.7%.AIM To evaluate the predictive factors for early clinical response and effects of initial antibiotic therapy on early clinical response in community-onset Escherichia coli(E.coli)urinary tract infections(UTIs).METHODS This retrospective study was conducted at Wonkwang University Hospital in South Korea between January 2011 and December 2017.Hospitalized patients(aged>18 years)who were diagnosed with community-onset E.coli UTI were enrolled in this study.RESULTS A total of 511 hospitalized patients were included.66.1%of the patients had an early clinical response.The mean length of hospital stay in patients with an early clinical response were each 4.3 d shorter than in patients without an early clinical response.In the multiple regression analysis,initial appropriate antibiotic therapy(OR=2.449,P=0.006),extended-spectrum(3-lactamase(ESBL)-producing E.coli(OR=2.112,P=0.044),improper use of broad-spectrum antimicrobials(OR=0.411,P=0.006),and a stay in a healthcare facility before admission(OR=0.562,P=0.033)were the factors associated with an early clinical response.Initial broadspectrum antibiotic therapy was not associated with an early clinical response.CONCLUSION ESBL producing E.coli,and the type of residence before hospital admission were the factors associated with an early clinical response.Appropriateness of initial antibiotic therapy was a predictive factor for an early clinical response,but broadspectrum of initial antibiotic therapy did not impact early clinical response.
文摘BACKGROUND Urinary tract infection(UTI)is a common type of postoperative infection following cytoreductive surgery for ovarian cancer,which severely impacts the prognosis and quality of life of patients.AIM To develop a machine learning assistant model for the prevention and control of nosocomial infection.METHODS A total of 674 elderly patients with ovarian cancer who were treated at the Department of Gynaecology at Jingzhou Central Hospital between January 31,2016 and January 31,2022 and met the inclusion criteria of the study were selected as the research subjects.A retrospective analysis of the postoperative UTI and related factors was performed by reviewing the medical records.Five machine learning-assisted models were developed using two-step estimation methods from the candidate predictive variables.The robustness and clinical applicability of each model were assessed using the receiver operating characteristic curve,decision curve analysis and clinical impact curve.RESULTS A total of 12 candidate variables were eventually included in the UTI prediction model.Models constructed using the random forest classifier,support vector machine,extreme gradient boosting,and artificial neural network and decision tree had areas under the receiver operating characteristic curve ranging from 0.776 to 0.925.The random forest classifier model,which incorporated factors such as age,body mass index,catheter,catheter intubation times,blood loss,diabetes and hypoproteinaemia,had the highest predictive accuracy.CONCLUSION These findings demonstrate that the machine learning-based prediction model developed using the random forest classifier can be used to identify elderly patients with ovarian cancer who may have postoperative UTI.This can help with treatment decisions and enhance clinical outcomes.
