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BACKGROUND: Antibiotic resistance of Enterobacterales poses a major challenge in the treatment of urinary tract infections (UTIs). In low- and middle-income countries (LMICs), standard microbiological (i.e. urine culture and simple disk diffusion test) methods are considered the gold standard for bacterial identification and drug susceptibility testing, while PCR and DNA sequencing are less commonly used. In this study, we aimed to re-identifying Enterobacterales as the primary bacterial agents responsible for urinary tract infections (UTIs) by comparing the sensitivity and specificity of traditional microbiological methods with advanced molecular techniques for the detection of uropathogens in indigenous women from Otavalo, Ecuador. METHODS: A facility-based cross-sectional study was conducted from October 2021 to February 2022 among Kichwa-Otavalo women. Pathogens from urine samples were identified using culture and biochemical typing. Morphological identification was doble-checked through PCR and DNA sequencing of 16S, recA, and rpoB molecular barcodes. The isolates were subjected to antimicrobial susceptibility-testing using disk diffusion test. RESULTS: This study highlighted a 32% misidentification rate between biochemical and molecular identification. Using traditional methods, E. coli was 26.19% underrepresented meanwhile Klebsiella oxytoca was overrepresented by 92.86%. Furthermore, the genera Pseudomonas, Proteus, and Serratia were confirmed to be E. coli and Klebsiella spp. by molecular method, and one Klebsiella spp. was reidentified as Enterobacter spp. The susceptibility profile showed that 59% of the isolates were multidrug resistant strains and 31% produced extended spectrum beta-lactamases (ESBLs). Co-trimoxazole was the least effective antibiotic with 61% of the isolates resistant. Compared to previous reports, resistance to nitrofurantoin and fosfomycin showed an increase in resistance by 25% and 15%, respectively. CONCLUSIONS: Community-acquired UTIs in indigenous women in Otavalo were primarily caused by E. coli and Klebsiella spp. Molecular identification (16S/rpoB/recA) revealed a high rate of misidentification by standard biochemical and microbiological techniques, which could lead to incorrect antibiotic prescriptions. UTI isolates in this population displayed higher levels of resistance to commonly used antibiotics compared with non-indigenous groups. Accurate identification of pathogens causing UTIs and their antibiotic susceptibility in local populations is important for local antibiotic prescribing guidelines.

Background: Fetal complications can occur if pregnant women with urinary tract infection (UTI) are not treated. We aimed to determine the magnitude of UTI, drug resistance profile, and fetal outcomes among pregnant women in Adare General Hospital, Hawassa, Ethiopia. Methods: Facility‐based cross‐sectional study was conducted among 308 pregnant women using questionnaire and review of medical records. From 308 randomly selected pregnant women, clean catch midstream urine samples were collected, processed, and inoculated onto MacConkey and blood agars and after incubation, the colonies were further confirmed by using standard biochemical tests. A binary logistic regression model was used to compute the explanatory variables with the outcome variable. A p value less than 0.05 was considered statistically significant. Results: The overall prevalence of UTI was 13.6% with a 95% CI: 10–18. Out of 42 samples, 39 (92.8%) UTI infections in women between the ages of 15 and 34 were identified. The three most common bacterial isolates were Escherichia coli, Staphylococcus aureus, and Staphylococcus saprophyticus. The majority of the Gram‐negative bacteria isolates were resistant to ampicillin (96.2%) and trimethoprim‐sulfamethoxazole (39%), while the Gram‐positive bacteria were resistant to tetracycline (75%) and trimethoprim‐sulfamethoxazole (68.8%). Of the total 308 pregnant women who participated in the study, there were 51 (16.6%) poor fetal outcomes. In this study, the presence of bacteriuria had a significant association with poor fetal outcomes (p value = 0.001). The mother's age, gravidity, level of education, occupation, marital status, and previous UTI history were not associated with the current UTI status. Conclusions: Poor fetal outcomes are strongly associated with UTI during pregnancy. Early detection of UTI and treatment after culture and antibiotic susceptibility testing should be a priority for the management of UTIs in pregnancy to avoid poor fetal outcomes. [ABSTRACT FROM AUTHOR]

Background: Infection is a common complication in the acute phase after stroke; a systematic review in 2011 reported a post-stroke infection prevalence of 30%. Despite the plethora of primary data on post-stroke infections in recent times, a systematic review that synthesizes the data to provide comprehensive information to guide preventive, control, and management efforts is yet to be undertaken. This systematic review, therefore, aimed at bridging this gap by describing the epidemiology of post-stroke infections including the global prevalence and the associated mortality rates. Methodology: A comprehensive search was conducted in PubMed, SCOPUS, and Web of Science resulting in 2210 studies, of which 73 studies covering 32,109,574 stoke patients were included in the systematic review. Prevalence data on defined post-stroke infections were extracted for analysis in RStudio version 4.3.3. Results: The pooled prevalence of post-stroke infections and mortality rates were 9.14% and 15.91% respectively. The prevalence of post-stroke infections was highest for pneumonia (12.4%), followed by urinary tract infection (8.31%). Geographically, the prevalence of post-stroke infections for the various continents were Europe (10.41%), Africa (10.22%), South America (8.83%), North America (8.15%), Asia (8.09%), and Australia (7.88%). Common etiological agents of post-stroke infections included multidrug-resistant organisms particularly, Carbapenem-resistant Klebsiella pneumoniae (15.4-31.8%), Methicillin-resistant Staphylococcus aureus (9.8-15.4%), and Carbapenem-resistant Acinetobacter baumannii (38.5%). Conclusion: This systematic review indicates about a 3-fold decline in the global prevalence of post-stroke infections in the last decade. Pneumonia is the most common post-stroke infection. Europe and Africa have the highest prevalence of post-stroke infections. [ABSTRACT FROM AUTHOR]

Background: Congenital anomalies of the kidney and urinary tract (CAKUT) and urinary tract infections (UTIs) are significant clinical concerns in children. Children who have UTIs are also at risk of developing long-term complications, notably kidney disease and scarring UTIs. The purpose of this study was to assess the prevalence of urinary tract infection and its determinants among under-five children with congenital anomalies of kidney and urinary tract in Addis Ababa. Methods: A health institution-based retrospective cross-sectional study was employed on 389 randomly selected medical records of children with CAKUT, out of a total of 850 cases. The children were admitted to Tikur Anbesa and Menelik II Hospitals between January 1, 2018, and December 31, 2022. The study hospitals were purposively selected as they were the only referrals in the nation for CAKUT cases. Sociodemographic, clinical, and laboratory characteristics were captured using a data extraction sheet created in the Kobo Toolbox and transferred to SPSS for analysis. Binary logistic regression analysis was used to evaluate the associations of variables with a p-value of ≤ 0.05 and a confidence interval of 95%. Results: The majority of the study participants (336 [86.4%]) were males. A total of 194 (49.8%) children were older than 25 months, with a median age of 23 (95% CI: 22–27) months, and 117 (30.1%) (95% CI = 25.4–35.2) participants were positive for urinary tract infection (UTI). Forty were culture-positive out of 103 urine specimens tested, where, Escherichia coli (60%) was the most frequently isolated bacteria followed by Klebsiella pneumonia (20%), Enterobacter spp, (12.5%), and Staphylococci spp. (7.5%). Factors associated with UTI among CAKUT children were found to be being female (AOR = 4.3, 95% CI = (1.4–13.07), children having Posterior Ureteral Valve (PUV) (AOR = 4.8, 95% CI = (2.32–9.93), duration of hospitalization (> 4 days) (AOR = 3.08, 95% CI = (1.52–6.24), and children having fever (AOR = 5.8, 95% CI = (2.81–11.97). Conclusion: In this study, almost one-third of the children developed UTIs, and female sex, longer hospitalization, PUV, and fever were identified as independent risk factors of UTIs. This emphasizes special attention should be given to high-risk children. [ABSTRACT FROM AUTHOR]

Urinary tract infection (UTI) is a pervasive, costly, and dangerous cause of morbidity and mortality worldwide, which can lead to further complications if they become recurrent or progress to urosepsis. Recurrent UTI is a particular concern among postmenopausal females because of increased risk factors and decreased estrogen levels, leading to changes in the urogenital epithelium and subsequently causing alterations in the urogenital microbiome. Prevention strategies for recurrent UTIs are often incorporated into patient-centered care plans, but finding the right management can be difficult for older women since many of the common treatment options have contraindications and adverse side effects. This review aims to describe the diagnosis, treatment, and special considerations for the treatment and prevention of recurrent UTIs in women over 65. Current prevention strategies include both antibiotic and nonantibiotic options. The antibiotic choice for older women presents a few unique challenges, including frequent allergy or intolerance of side effects, renal or liver dysfunction, and polypharmacy or drug interactions. Nonantibiotic options range from readily accessible drugstore remedies to experimental vaccines, which all are accompanied by certain advantages and disadvantages. Appropriate management plans can help to reduce symptoms and poor outcomes among older females. In addition, we hope future studies continue to investigate the proper dosing and routes for optimal management in this aging female population. [ABSTRACT FROM AUTHOR]

Background Urinary tract infections (UTIs) occur commonly and often recur. However, recent data on the epidemiology of recurrent UTI (rUTI) are scarce. Methods Between 1 January 2016 and 31 December 2020, index uncomplicated UTIs (uUTIs) from office, emergency department, hospital, and virtual care settings were identified from the electronic health records of women at Kaiser Permanente Southern California. We defined rUTI as ≥3 UTIs within 365 days or ≥2 UTIs within 180 days. We determined the proportion of women with cystitis index uUTI who had rUTI, and we examined factors associated with rUTIs using modified multivariable Poisson regression. Results Among 374 171 women with cystitis index uUTI, 54 318 (14.5%) had rUTI. A higher proportion of women with rUTI vs those without rUTI were aged 18 to 27 or ≥78 years at index uUTI (19.7% vs 18.7% and 9.0% vs 6.0%, respectively), were immunocompromised, or had a positive urine culture result at index uUTI. In multivariable analyses, characteristics associated with rUTI included younger or older age (48–57 vs 18–27 years: adjusted risk ratio [aRR], 0.83 [95% CI,.80–.85]; ≥78 vs 18–27 years: aRR, 1.07 [95% CI, 1.03–1.11]), Charlson Comorbidity Index (≥3 vs 0: aRR, 1.12 [95% CI, 1.08–1.17]), and diabetes mellitus (aRR, 1.07 [95% CI, 1.04–1.10]). More frequent prior-year outpatient and emergency department encounters, oral antibiotic and oral contraceptive prescriptions, positive culture result at index uUTI, and antibiotic-resistant organisms were also associated with increased risk of rUTI. Conclusions The high risk of rUTI among women with cystitis is concerning, especially given previous reports of increasing UTI incidence. Current assessment of the epidemiology of rUTI may guide the development of preventive interventions against UTI. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionUrinary tract infections (UTIs) are prevalent among patients carrying indwelling catheters in the intensive care unit (ICU). This study investigates antibiotic use and bacterial colonisation among ICU patients during the third wave of the COVID-19 pandemic, building on our prior discovery of increased Enterococcus colonisation associated with increased cephalosporin use in early COVID-19.Longitudinal urine samples from COVID-19 patients (n = 109) with transurethral catheterisation were analysed for bacterial prevalence, further identified via MALDI-TOF. Microbiological results were combined with clinical data obtained daily, assessed and compared with COVID-19 waves 1 and 2.Patients in wave 3 exhibited improved outcomes compared to those in waves 1 and 2, alongside a decrease in antibiotic use. Staphylococcus emerged as the primary bacterium and early colonizer of the urinary tract, potentially due to the absence of antibiotic treatment. Our results imply that length of stay (LOS) correlates solely with enteric pathogens and that antibiotic treatment correlates with colonisation by certain uropathogens, whereas the absence of antimicrobial therapy is associated with rapid colonisation of skin flora. Polymicrobial colonisation was common, predominantly involving Gram-positive bacteria.Our findings underscore the complexity of bacteriuria in ICU patients, advocating for targeted surveillance and tailored antibiotic approaches to mitigate UTI risk. Insights into antibiotic use and bacterial colonisation are vital for optimising stewardship practices, combating antimicrobial resistance, and enhancing ICU patient outcomes. [ABSTRACT FROM AUTHOR]

Objective: To determine prevalence of UTI in pregnant women and its associated risk factors at a tertiary care hospital. Study Design: Cross Sectional study. Setting: Department of Gynae & Obstetrics Independent University Hospital, Faisalabad. Period: 1-10-2022 to 31-3-2023. Methods: All pregnant patients visiting gynae OPD (5280) were enrolled for study. Mid-stream urine sample was taken and analyzed. UTI was diagnosed if >10 pus cells / HPF were seen. Inclusion Criteria: All pregnant females attending antenatal clinic during study period. Exclusion Criteria: Women with chronic renal disease. History of antibiotic treatment in last one week, Congenital renal abnormality. Patients on immuno suppressive therapy. Results: The prevalence of UTI in our study was 28%. In this study 593 patients (40%) were <20 years of age, 258(17%) were in 21-30 years age group, 246 (16%) were 31-40 years and 381(26%) were >40 years of age. In our study 526 (35%) were primigravidas, 249(17%) were G2, 272(18%) were G3 and 431 (29%) were G4 or above. In this study 698 (47%) patients were in first trimester, 320(22%) were in second trimester, 460(31%) in third trimester. Among risk factors 245 patients (16%) were anemic and 421(28%) were diabetic. Conclusion: The Prevalence of UTI in pregnant female of independent university hospital Faisalabad is quite high. Anemia and diabetes are major associated risk factors. Owing to its association with a number of complications, UTI needs to be diagnosed and treated promptly to lessen perinatal and maternal morbidity and mortality. [ABSTRACT FROM AUTHOR]

Diagnosis of urinary tract infections (UTI) is a routine part of medical work and yet is well recognised to be an area of high clinical uncertainty. Meanwhile, diagnosis of UTI is becoming increasingly important to policymakers globally due to concerns about antibiotic over‐prescription. Drawing on Mol's concept of ontological multiplicity in clinical work, I explore how diagnostic uncertainty is co‐ordinated into certainty by a UK national diagnostic algorithm for UTI. The diagnosis of UTI is produced or withheld as a post hoc rationalisation of a prior decision whether to prescribe antibiotics or not. Work in the sociology of diagnosis has already noted that diagnostic steps are often re‐ordered by health‐care professionals taking diverse actions in the best interest of their patients. This article contributes an argument that ordering diagnostic work around antimicrobial stewardship agendas has the effect of narrowing possible actions. Exploring the consequences and effects of doing diagnosis in this way for different groups, I argue that a greater creativity about what could be done to care for painful bladders could be found in a return to more clinical ways of working. [ABSTRACT FROM AUTHOR]

Objectives: Recurrent urinary tract infections (rUTIs) have a significant effect on a patient's quality of life and frequent use of antibiotics increases multi-drug resistance. Previous research on intravesical antibiotics suggests that this has a local effect on bacteria with reduced systemic absorption and associated side effects. We conducted a systematic review to assess the effectiveness and adverse effects of intravesical gentamicin treatment. Methods: Systematic review of all English published articles from January 2001 to October 2021 according to the Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Results: A total of 139 studies were identified, 20 full-text articles were screened and 6 subsequently included totalling 166 patients. All studies reported a decrease in the mean number of urinary tract infections (UTIs) with a significant reduction (p = 0.0025 and p < 0.004) in two studies. When the number of breakthrough UTIs on prophylactic gentamicin installations was assessed, 65% (n = 86/133) remained UTI free. Throughout treatment, 99% of serum gentamicin levels were <0.3 ng/dL, and reported instances of increased creatinine were low (2%). A decrease in the growth of multi-drug-resistant bacteria was reported in two papers (p = 0.065 and p = 0.04). Conclusion: Intravesical gentamicin seems to be an effective treatment in patients with symptomatic rUTIs. The evidence suggests it also reduces UTIs caused by multi-drug-resistant bacteria with no systemic absorption and minimal renal toxicity. Level of evidence: 2a [ABSTRACT FROM AUTHOR]

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Objective: The colistin-resistant Klebsiella pneumoniae causes complicated urinary tract infections (UTIs). Of them, 73% of strains of K. pneumoniae formed moderate to strong biofilm. Multidrug-resistant (MDR)/Pandrug-resistant (PDR) bacteria causing UTIs are very challenging to conventional antibiotic therapy. However, bacteriophages may be a promising alternative as they easily disrupt the biofilm and act on receptors unrelated to antibiotic resistance mechanisms. This preclinical study evaluated the efficacy of a phage cocktail with different routes and dosages (in quantity and frequency) to eradicate the K. pneumoniae-associated UTI in the mice model. Methods: The three lytic phages with the broadest spectrum activity (ΦKpnBHU1, ΦKpnBHU2 and ΦKpnBHU3) were meticulously characterized using SEM and sequencing. The cocktails were administered to mice through urethral, rectal, subcutaneous and oral routes after establishing the UTI with 1 × 108 colony-forming unit/mouse (CFU/mouse) of K. pneumoniae (KpnBHU09) resistant to both the drugs carbapenem and colistin. The efficacy of different routes with varying dosages and frequency of administration was thoroughly optimized. Results: We observed that two doses of a phage cocktail containing 1 × 105 Plaque-Forming Unit (PFU/mouse) and a single dose of 1 × 109 PFU/mouse per urethra could eradicate KpnBHU09. Intriguingly, the non-invasive administration through oral and rectal routes required higher concentration and many dosages of phages to eliminate KpnBHU09 at any stage of acute UTI. The subcutaneous route was found unsatisfactory in curing the infection. Conclusion: Bacteriophage cocktails administered through transurethral, oral and rectal routes may cure UTIs.

Sejal M Bhavsar,1 Nisha Polavarapu,2 Emery Haley,3 Natalie Luke,3 Mohit Mathur,4 Xiaofei Chen,5 Jim Havrilla,5 David Baunoch,6 Kenneth Lieberman7 1Department of Pediatric Infectious Disease, Hackensack University Medical Center, Hackensack, NJ, USA; 2Department of Pediatric Emergency Medicine, Hackensack University Medical Center, Hackensack, NJ, USA; 3Department of Clinical Research, Pathnostics, Irvine, CA, USA; 4Department of Medical Affairs, Pathnostics, Irvine, CA, USA; 5Department of Bioinformatics, Pathnostics, Irvine, CA, USA; 6Department of Research and Development, Pathnostics, Irvine, CA, USA; 7Department of Pediatric Nephrology, Hackensack University Medical Center, Hackensack, NJ, USACorrespondence: David Baunoch, Pathnostics, 15545 Sand Canyon Suite 100, Irvine, CA, 92618, USA, Tel +1-714-966-1221, Fax +1-714-966-1231, Email dbaunoch@pathnostics.comObjective: To establish the noninferiority of the rapid and sensitive multiplex polymerase chain reaction (M-PCR) method versus standard urine culture (SUC) in pediatric urinary tract infection (UTI) diagnostic testing.Methods: A United States of America (USA)-based single-center prospective observational study of 44 female and four male patients aged 3– 21 years old presenting to a Pediatric Emergency Department in New Jersey with clinically suspected UTI. Urine specimens were primarily collected via midstream voiding. Patients with antibiotic exposure within the week prior to presentation were excluded. Patient demographic data, clinical manifestations, and urinalysis results were recorded. Noninferiority testing comparing M-PCR and SUC was conducted using a method for paired binary data, with a noninferiority margin set at 5%. Noninferiority was concluded if the lower bound of the 95% confidence interval of the difference in detection rates between M-PCR and SUC lies entirely to the right of the value minus the noninferiority margin. All statistical calculations were performed using Python 3.10.12.Results: The two methods were concordant in two-thirds of cases. Of the 14 M-PCR-positive/SUC-negative discordant specimens, 13 (93%) contained a fastidious and/or emerging uropathogen (A. urinae, A. schaalii, G. vaginalis, C. riegelii, U. urealyticum, Viridans group Streptococci (VGS), and/or Coagulase-negative Staphylococci (CoNS)). Neither symptom presentation nor urinalysis results differed significantly between participants with concordant positive results for UTI diagnosis and those with concordant negative results (non-UTI group).Conclusion: In this pediatric population, similar to previous findings in an older adult population, M-PCR established not only noninferiority but also superiority over SUC in detecting microorganisms in the urine.Keywords: symptoms, urinalysis, UTI, SUC, M-PCR, Guidance UTI

Abstract Background Antibiotic resistance of Enterobacterales poses a major challenge in the treatment of urinary tract infections (UTIs). In low- and middle-income countries (LMICs), standard microbiological (i.e. urine culture and simple disk diffusion test) methods are considered the “gold standard” for bacterial identification and drug susceptibility testing, while PCR and DNA sequencing are less commonly used. In this study, we aimed to re-identifying Enterobacterales as the primary bacterial agents responsible for urinary tract infections (UTIs) by comparing the sensitivity and specificity of traditional microbiological methods with advanced molecular techniques for the detection of uropathogens in indigenous women from Otavalo, Ecuador. Methods A facility-based cross-sectional study was conducted from October 2021 to February 2022 among Kichwa-Otavalo women. Pathogens from urine samples were identified using culture and biochemical typing. Morphological identification was doble-checked through PCR and DNA sequencing of 16S, recA, and rpoB molecular barcodes. The isolates were subjected to antimicrobial susceptibility-testing using disk diffusion test. Results This study highlighted a 32% misidentification rate between biochemical and molecular identification. Using traditional methods, E. coli was 26.19% underrepresented meanwhile Klebsiella oxytoca was overrepresented by 92.86%. Furthermore, the genera Pseudomonas, Proteus, and Serratia were confirmed to be E. coli and Klebsiella spp. by molecular method, and one Klebsiella spp. was reidentified as Enterobacter spp. The susceptibility profile showed that 59% of the isolates were multidrug resistant strains and 31% produced extended spectrum beta-lactamases (ESBLs). Co-trimoxazole was the least effective antibiotic with 61% of the isolates resistant. Compared to previous reports, resistance to nitrofurantoin and fosfomycin showed an increase in resistance by 25% and 15%, respectively. Conclusions Community-acquired UTIs in indigenous women in Otavalo were primarily caused by E. coli and Klebsiella spp. Molecular identification (16S/rpoB/recA) revealed a high rate of misidentification by standard biochemical and microbiological techniques, which could lead to incorrect antibiotic prescriptions. UTI isolates in this population displayed higher levels of resistance to commonly used antibiotics compared with non-indigenous groups. Accurate identification of pathogens causing UTIs and their antibiotic susceptibility in local populations is important for local antibiotic prescribing guidelines.

Abstract Background This research aimed to identify evidence-based protocols for the safe management of bladder infections and the prevention of UTIs in athletes who have spinal cord injuries (SCI), as they are constantly at high risk of developing UTIs again. Study design Scoping review Methodology Four databases were searched (PubMed, Scopus, Web of Science, and Science Direct) for pertinent literature. The non-randomized controlled studies (non-RCT) and randomized controlled trials (RCT) that described the application of any particular measure to properly manage bladder and avoid urinary tract infections (UTIs) in people with spinal cord injuries (SCIs) were chosen. Results Forty-nine articles were screened for the effectiveness of weekly oral cyclic antibiotics, bacterial interference, coated catheter types, and patient education in preventing UTIs in SCI were shown in 20 RCT and 29 non-RCT researches. Concerns were raised about cranberry supplements and low-dose antibiotic prophylaxis, which is unreliable and leads to the emergence of germs that are resistant to many drugs. Conclusion According to the scoping review, WOCA is the most effective antibiotic regimen. The proven methods for treating UTIs in SCI patients include coated catheters, bacterial interference, bladder irrigation, and patient education. Moreover, there is a great deal of variation in the research about the efficacy of cranberries. The best option for safe bladder management and preventing UTIs in SCIs is to use suprapubic and coated intermittent catheters (ICs). When a urine bag is full, it should be changed out for a fresh one, and patients should be told to employ spontaneous voiding if that's not an option.

Abstract Background Both long (> 30 days) and short-term (≤ 30 days) catheterisation has been associated with urinary tract infections (UTIs) due to the invasive nature of device insertion through the urethra. Catheter associated Urinary Tract Infections (CAUTIs) are common (prevalence of ~ 8.5%) infections which can be treated with antibiotics; however, CAUTIs are both expensive to treat and contributes to the antibiotic usage crisis. As catheters are unlikely be replaced for the management of patients’ urination, ways of reducing CAUTIs are sought out, using the catheter device itself. The aim of this review is to assess the incidence of CAUTI and the causative micro-organisms when different urinary catheter devices have been used by humans, as reported in published research articles. Methods A Systematic Literature Review was conducted in Ovid Medline, Web of Science and PubMed, to identify studies which investigated the incidence of UTI and the causative micro-organisms, in patients with different urinary catheter devices. The articles were selected based on a strict set of inclusion and exclusion criteria. The data regarding UTI incidence was extracted and calculated odds ratio were compared across studies and pooled when types of catheters were compared. CAUTI causative micro-organisms, if stated within the research pieces, were also gathered. Results A total of 890 articles were identified, but only 26 unique articles met the inclusion/exclusion criteria for this review. Amongst the large cohort there were catheters of materials silicone, latex and PVC and catheter modifications of silver nanoparticles and nitrofurantoin antibiotics. The meta-analysis did not provide a clear choice towards a single catheter against another although silver-based catheters, and silver alloy, appeared to statistically reduce the OR of developing CAUTIs. At genus level the three commonest bacteria identified across the cohort were E. coli, Enterococcus spp. and Pseudomonas spp. whilst considering only at the genus level, with E. coli, Klebsiella pneumonia and Enterococcus faecalis most common at the species-specific level. Conclusions There does not appear to be a catheter type, which can significantly reduce the incidence of CAUTI’s in patients requiring catheterisation. Ultimately, this warrants further research to identify and develop a catheter device material that will reduce the incidence for CAUTIs.

Abstract Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections are a major public health problem, requiring the use of last-resort antibiotics such as colistin. However, there is concern regarding the emergence of isolates resistant to this agent. The report describes two patients with urinary tract infection (UTI) and ventilator-associated pneumonia (VAP) infection caused by CRKP strains. The first case was a 23-year-old male with UTI caused by a strain of ST16 co-harboring bla CTX-M, bla TEM, bla SHV, bla NDM, bla OXA-48-like genes. The second case was a 39-year-old woman with VAP due to hypervirulent ST337-K2 co-harboring bla SHV, bla NDM, bla OXA-48-like, iucA, rmpA2 and rmpA . The patients’ general condition improved after combination therapy with colistin (plus meropenem and rifampin, respectively) and both of them recovered and were discharged from the hospital. This study highlights the necessary prevention and control steps to prevent the further spread of CRKP strains should be a priority in our hospital.

Background: This research aimed to identify evidence-based protocols for the safe management of bladder infections and the prevention of UTIs in athletes who have spinal cord injuries (SCI), as they are constantly at high risk of developing UTIs again. Study design: Scoping review Methodology: Four databases were searched (PubMed, Scopus, Web of Science, and Science Direct) for pertinent literature. The non-randomized controlled studies (non-RCT) and randomized controlled trials (RCT) that described the application of any particular measure to properly manage bladder and avoid urinary tract infections (UTIs) in people with spinal cord injuries (SCIs) were chosen. Results: Forty-nine articles were screened for the effectiveness of weekly oral cyclic antibiotics, bacterial interference, coated catheter types, and patient education in preventing UTIs in SCI were shown in 20 RCT and 29 non-RCT researches. Concerns were raised about cranberry supplements and low-dose antibiotic prophylaxis, which is unreliable and leads to the emergence of germs that are resistant to many drugs. Conclusion: According to the scoping review, WOCA is the most effective antibiotic regimen. The proven methods for treating UTIs in SCI patients include coated catheters, bacterial interference, bladder irrigation, and patient education. Moreover, there is a great deal of variation in the research about the efficacy of cranberries. The best option for safe bladder management and preventing UTIs in SCIs is to use suprapubic and coated intermittent catheters (ICs). When a urine bag is full, it should be changed out for a fresh one, and patients should be told to employ spontaneous voiding if that's not an option. [ABSTRACT FROM AUTHOR]

Background: Urinary tract infections (UTIs) occur in one out of every 3 females, with a significant recurrence rate that can lead to renal impairment (RI) and kidney damage. RI is a condition that diminishes quality of life and elevates mortality risk. The female vaginal region possesses its own flora. Excessive or improper genital hygiene methods will disturb this flora, facilitating the colonization and proliferation of infections. An increased risk of urogenital infection is associated with women's anatomy, specifically the short urethra and the close proximity of the urethral meatus to the anus and vagina. Objective: This study aimed to throw the light on the relation between genital hygiene behaviors in women and urinary tract infection in any period of life. Material and methods: We searched Google Scholar and PubMed, Science Direct, and other internet databases for Genital Hygiene Behaviors, Women genitalia and Urinary Tract Infection. Only the latest or comprehensive study from 2012 to January 2024 was included, while the authors additionally assessed references from pertinent literature. Languages other than English have been excluded because of the dearth of translation sources. Oral presentations, dissertations, conference abstracts, and unpublished articles were excluded since they did not pertain to significant scientific studies. Conclusion: Genital hygiene is a crucial practice for preventing genital infections and their potentially serious consequences. Personal hygiene practices are essential for the management of numerous infectious disorders. Genital hygiene is a crucial aspect of women's health and is essential for safeguarding reproductive health. Certain genital hygiene techniques employed by women may influence their vulnerability to sexually transmitted infections and the incidence of other reproductive health conditions. Vaginal douching, commonly employed for female genital cleanliness, alters the vaginal chemistry, disrupts the healthy flora, and elevates the possibility of infections. Urinary tract infections were more prevalent among individuals who regularly engaged in vaginal douching. There exists a substantial correlation between urinary tract infections and vaginal douching. However, alterations in vaginal flora diminish its resistance to pathogenic bacteria, facilitating their colonization. These colonizing bacteria induce urinary tract infections. The etiologies of urinary tract infections encompass recent utilization of antimicrobial agents, vaginal operations, and irregular administration of antibiotics following these interventions. [ABSTRACT FROM AUTHOR]

Urinary tract infections (UTIs) are one of the most common infectious disorders worldwide. The most frequent cause of UTIs is uropathogenic Escherichia coli (UPEC). The current study is designed to assess the resistance of antibiotics, the formation of biofilm, and the detection of adhesion genes in E. coli isolated from patients with UTIs. A hundred and fifty samples were collected from patients with confirmed UTIs in Baghdad province during the period of October 2022 to February 2023. Isolation and identification of E. coli were performed using cultural characteristics, gram staining, and biochemical examination, and the results indicated that 52 (35%) isolates were identified as E. coli. Eleven antibiotic discs were utilized to estimate the sensitivity of E. coli isolates. 98% of isolates were resistant to ampicillin, followed by 75.5% of isolates resistant to both trimethoprim/sulfamethoxazole and fosfomycin, followed by 73.5, 71.4, 67.3, 53.1, and 6.1% of isolates resistant to imipenem, ceftazidime, nitrofurantoin, cefepime, and amikacin. All isolates were sensitive to piperacillin-tazobactam, ciprofloxacin, and aztreonam at 100%, 100%, and 98%, respectively. The microtiter plate method was utilized to estimate the ability of E. coli to form biofilm. The majority of isolates (69.2%; n = 36) were moderate biofilm producers, while 19.2% (n = 10) and 11.5% (n = 6) of isolates were strong and weak biofilm producers, respectively. Polymerase Chain Reactions (PCR) were applied to determine the gene expression level of adhesion genes (fimH and fimA genes). Forty isolates harbored both fimH and fimA genes. [ABSTRACT FROM AUTHOR]

We describe the epidemiology and incidence of infections following gender-affirming vaginoplasty. Urinary tract and surgical site infections were the most common infections with incidences of 17.5% and 5.5%, respectively. We also identified a significant gap in human immunodeficiency virus screening and prescription of preexposure prophylaxis. [ABSTRACT FROM AUTHOR]

Escherichia coli can colonise the urogenital tract of individuals without causing symptoms of infection, in a condition referred to as asymptomatic bacteriuria (ABU). ABU isolates can protect the host against symptomatic urinary tract infections (UTIs) by bacterial interference against uropathogenic E. coli (UPEC). The aim of this study was to investigate the genotypic and phenotypic characteristics of five ABU isolates from midstream urine samples of adults. Comparative genomic and phenotypic analysis was conducted including an antibiotic resistance profile, pangenome analysis, and a putative virulence profile. Based on the genome analysis, the isolates consisted of one from phylogroup A, three from phylogroup B2, and one from phylogroup D. Two of the isolates, PUTS 58 and SK-106-1, were noted for their lack of antibiotic resistance and virulence genes compared to the prototypic ABU strain E. coli 83,972. This study provides insights into the genotypic and phenotypic profiles of uncharacterised ABU isolates, and how relevant fitness and virulence traits can impact their potential suitability for therapeutic bacterial interference. [ABSTRACT FROM AUTHOR]

Klebsiella pneumoniae is an important pathogen causing difficult-to-treat urinary tract infections (UTIs). Over 1.5 million women per year suffer from recurrent UTI, reducing quality of life and causing substantial morbidity and mortality, especially in the hospital setting. Uropathogenic E. coli (UPEC) is the most prevalent cause of UTI. Like UPEC, K. pneumoniae relies on type 1 pili, tipped with the mannose-binding adhesin FimH, to cause cystitis. However, K. pneumoniae FimH is a poor binder of mannose, despite a mannose-binding pocket identical to UPEC FimH. FimH is composed of two domains that are in an equilibrium between tense (low-affinity) and relaxed (high-affinity) conformations. Substantial interdomain interactions in the tense conformation yield a low-affinity, deformed mannose-binding pocket, while domain-domain interactions are broken in the relaxed state, resulting in a high-affinity binding pocket. Using crystallography, we identified the structural basis by which domain-domain interactions direct the conformational equilibrium of K. pneumoniae FimH, which is strongly shifted toward the low-affinity tense state. Removal of the pilin domain restores mannose binding to the lectin domain, thus showing that poor mannose binding by K. pneumoniae FimH is not an inherent feature of the mannose-binding pocket. Phylogenetic analyses of K. pneumoniae genomes found that FimH sequences are highly conserved. However, we surveyed a collection of K. pneumoniae isolates from patients with long-term indwelling catheters and identified isolates that possessed relaxed higher-binding FimH variants, which increased K. pneumoniae fitness in bladder infection models, suggesting that long-term residence within the urinary tract may select for higher-binding FimH variants. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is an autoimmune disease characterized by the demyelination of axons in the central nervous system (CNS). Urinary tract infection (UTI) affects millions of people each year. UTI is a common risk factor that worsens attacks in patients with MS. Aims: The commonest pseudo exacerbations in patients with MS is UTI, in addition to the influence of UTI on disease activity and development; therefore, the research aims to study the prevalence of urinary tract Methods: The current study included sixty MS patients aged 15-57 years from May 2023 to March 2024 in MS clinic at Imam Al- Hussein medical city in Kerbala, Saad Al-Witry Hospital for Neuroscience in Baghdad and MS clinic at Middle Euphrates center for Neuroscience in Najaf. Ten ml of urine samples were collected from MS patients, and a general urine examination (GUE) was done. The urine sample was inoculated into the culture media, after which VITEK diagnosed it. Results: The UTI prevalence in patients with MS was about 23%; E. coli was the most frequent, while other bacteria were less frequent, ranging between (15-7%). Discussion: UTI infection is a risk factor in autoimmune diseases. Conclusions: Multiple sclerosis patients are likely to have UTI. They are community- and hospital-acquired, especially because of E. coli. In addition to autoimmune diseases, it is a risk of systemic infections. [ABSTRACT FROM AUTHOR]

The current study was conducted the relationship between circumcision and urinary tract infection in children under five years. in total, 100 child were included from various hospitals in the city of samarraa, which included (Samarra General Hospital and alkhairi Hospital), for the period between 9/1/2022 and 4/15 /2023 The current study aimed to isolate Escherichia coli bacteria that cause urinary tract infections in children less than five years old and evaluate some risk factors. 100 samples were isolated from children suffering from urinary tract infections of both genders from various hospitals in the city of Samarra, for the period between 9/1/2022 and 4/15. /2023. The results of microscopic examination showed that 55% of the samples were accompanied by bacteriuria and pyuria, 12% with bacteriuria, 22% with pyuria, and 11% without both. Bacterial culture results showed that 67% of the samples showed bacterial growth, and 64.1% of the specimen were diagnosed as Escherichia coli and the rest of the percentage was distributed among other bacterial species. The results showed that all male samples that showed bacterial growth were from uncircumcised children. The isolates showed resistance to many antibiotics. and the blood test for males and females showed a decrease in the level of ferritin and a decrease in some blood parameters compared with the normal levels, especially hemoglobin. [ABSTRACT FROM AUTHOR]

Introduction - Preterm labour refers to the initiation of labour prior to 37 weeks and after 28 weeks of gestation, characterised by consistent uterine contractions that result in gradual cervical modifications. Urinary tract infection (UTI) is one of the several causes of preterm labour. The aim of this study is to evaluate first trimester urinary tract infection and risk of preterm labour pain. Material and methods- The present cross-sectional hospital based study was conducted at department of obstetrics and gynecology among 100 women with preterm labour pain during the study period of one year. Midstream urine samples were collected from all and culture test was performed. Results were analyzed using SPSS version 25.0 Results- Maximum patients were in the age group of 25 to 29 years (50%). 92% of them live in rural area. 70% of patients had normal urine examination and 30% were suffering from UTI. 3% of women had pyleonephritis and 97% had no complications. Organisms isolated from urine culture and sensitivity were : E.coli (68%), cogaulase negative staph (11%), S.aureus (10%), Klebsiella (6%) and GBS (5%). Conclusion – Untreated urinary tract infection (UTI) can be linked to obstetric problems and lead to preterm birth. The predominant bacterial illness that occurs during pregnancy is urinary tract infections (UTIs). It is recommended that all women undergo screening for urinary tract infections (UTIs) during their initial antenatal appointment. Upon diagnosis, it is crucial to rapidly administer an appropriate antibiotic that is both effective and safe. [ABSTRACT FROM AUTHOR]

Background: Gastroschisis is a birth defect with the greatest risk among women <20 years of age. Methods: Pregnant women attending the University of Utah's Maternal‐Fetal Medicine Diagnostic Center between 2011 and 2017 for either their routine diagnostic ultrasound or referral were recruited (cases: pregnant women with fetal gastroschisis, n = 53 participated/57, 93%; controls: pregnant women without fetal abnormalities, n = 102 participated/120, 85%). A clinic coordinator consented and interviewed women and obtained a blood sample and prenatal medical records. We evaluated self‐reported maternal characteristics, risk factors, and infections. To assess pathogen seropositivity we used Serimmune's Serum Epitope Repertoire Analysis validated 35 pathogen panels and Chlamydia trachomatis and compared seropositivity to self‐report and prenatal medical record screening to assess sensitivity. Results: Cases were more likely to report a younger age at sexual debut (p = <0.01), more sexual partners (p = 0.02), being unmarried (p < 0.01), changing partners between pregnancies (p = <0.01), smoking cigarettes (<0.01), and a recent sexually transmitted infection (STI) (p = 0.02). No differences were observed for self‐report of illicit drug use or periconceptional urinary tract infections. Cases had a higher seropositivity for cytomegalovirus (p = 0.01). No differences were observed for herpes simplex I, II, or Epstein–Barr. Though based on small numbers, C. trachomatis seropositivity was highest in cases (17%) compared to controls (8.8%) with the highest proportion observed in case women <20 years of age (cases 33%; controls 0%). Any STI (self‐report or seropositivity) was also highest among cases <20 years of age (cases 47%; controls 0%). Among C. trachomatis seropositive women, self‐report and prenatal medical record sensitivity was 27.8% and 3%, respectively. Conclusions: Cases were more likely to engage in behaviors that can increase their risk of exposure to sexually transmitted pathogens. Case women <20 years of age had the highest proportion of C. trachomatis seropositivity and any STI. Prenatal medical records and self‐report were inadequate to identify a recent chlamydial infection whereas, the SERA assay is a novel approach for evaluating subclinical infections that may impact the developing embryo. [ABSTRACT FROM AUTHOR]

Background: Childhood urinary tract infections (UTIs) are among the most prevalent diseases. In recent years, the overuse of common antibiotics has increased antibiotic resistance among urinary tract pathogens worldwide, with changes in the pattern of microbial resistance varying by geographical area and time. Objectives: This study aims to investigate the pattern of microbial resistance of UTI pathogens in pediatric patients. Methods: In this cross-sectional study, children aged < 13 years with UTI and positive urine cultures, who were admitted to Bahrami Hospital in Tehran, Iran, between 2015 and 2019, were evaluated. The pathogens' frequency, their antimicrobial resistance, and clinical and demographic information were extracted from the patients' files. Statistical relationships between clinical and demographic data and antibiotic resistance were analyzed using appropriate statistical tests. Results: The files of 202 patients were evaluated. The majority of patients were female (79.2%). UTI was more common among the 12 - 60 months age group (36.3%) in females and the 1 - 12 months age group (50%) in males. The most common UTI pathogen was Escherichia coli (85.1%). The lowest rates of microbial resistance were related to Meropenem (0% resistance), Gentamicin (9.2%), and Amikacin (10.8%). Conversely, the highest resistance rates were observed for Cotrimoxazole (74.6%), Ampicillin (74.5%), and Cephalothin (64.9%). Conclusions: UTI is more common in females aged 1 to 60 months. E. coli is the most common cause of UTI. Microbial resistance to antibiotics used for empirical treatment, such as ceftriaxone, is high and changes over time. It is recommended to use alternative antibiotics and avoid the inappropriate administration of antibiotics. [ABSTRACT FROM AUTHOR]

Background: Both long (> 30 days) and short-term (≤ 30 days) catheterisation has been associated with urinary tract infections (UTIs) due to the invasive nature of device insertion through the urethra. Catheter associated Urinary Tract Infections (CAUTIs) are common (prevalence of ~ 8.5%) infections which can be treated with antibiotics; however, CAUTIs are both expensive to treat and contributes to the antibiotic usage crisis. As catheters are unlikely be replaced for the management of patients' urination, ways of reducing CAUTIs are sought out, using the catheter device itself. The aim of this review is to assess the incidence of CAUTI and the causative micro-organisms when different urinary catheter devices have been used by humans, as reported in published research articles. Methods: A Systematic Literature Review was conducted in Ovid Medline, Web of Science and PubMed, to identify studies which investigated the incidence of UTI and the causative micro-organisms, in patients with different urinary catheter devices. The articles were selected based on a strict set of inclusion and exclusion criteria. The data regarding UTI incidence was extracted and calculated odds ratio were compared across studies and pooled when types of catheters were compared. CAUTI causative micro-organisms, if stated within the research pieces, were also gathered. Results: A total of 890 articles were identified, but only 26 unique articles met the inclusion/exclusion criteria for this review. Amongst the large cohort there were catheters of materials silicone, latex and PVC and catheter modifications of silver nanoparticles and nitrofurantoin antibiotics. The meta-analysis did not provide a clear choice towards a single catheter against another although silver-based catheters, and silver alloy, appeared to statistically reduce the OR of developing CAUTIs. At genus level the three commonest bacteria identified across the cohort were E. coli, Enterococcus spp. and Pseudomonas spp. whilst considering only at the genus level, with E. coli, Klebsiella pneumonia and Enterococcus faecalis most common at the species-specific level. Conclusions: There does not appear to be a catheter type, which can significantly reduce the incidence of CAUTI's in patients requiring catheterisation. Ultimately, this warrants further research to identify and develop a catheter device material that will reduce the incidence for CAUTIs. [ABSTRACT FROM AUTHOR]

Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections are a major public health problem, requiring the use of last-resort antibiotics such as colistin. However, there is concern regarding the emergence of isolates resistant to this agent. The report describes two patients with urinary tract infection (UTI) and ventilator-associated pneumonia (VAP) infection caused by CRKP strains. The first case was a 23-year-old male with UTI caused by a strain of ST16 co-harboring blaCTX-M, blaTEM, blaSHV, blaNDM, blaOXA-48-like genes. The second case was a 39-year-old woman with VAP due to hypervirulent ST337-K2 co-harboring blaSHV, blaNDM, blaOXA-48-like,iucA, rmpA2 and rmpA. The patients' general condition improved after combination therapy with colistin (plus meropenem and rifampin, respectively) and both of them recovered and were discharged from the hospital. This study highlights the necessary prevention and control steps to prevent the further spread of CRKP strains should be a priority in our hospital. [ABSTRACT FROM AUTHOR]

In this second episode of the Microbiologist in the Clinic series, clinicians and laboratory scientists share their perspectives about a 75-year-old woman who was diagnosed with asymptomatic bacteriuria based on positive urine cultures. The patient and her GP are concerned about this laboratory finding as the patient will become immunosuppressed with planned chemotherapy. The patient has had an overactive bladder (OAB) for approximately 20 years, with good control of her urinary urgency and frequency (no incontinence) with a stable dose of OAB medication. The challenges of this clinical presentation are discussed, with evidence for evaluation and treatment. [ABSTRACT FROM AUTHOR]

Isolated renal tuberculosis is a rare form of extrapulmonary TB, especially in immunocompetent individuals. This case report details the diagnosis and management of a 14-year-old male who presented with massive hydronephrosis of unknown cause. Initial investigations, including urine cultures, were inconclusive. However, percutaneous nephrostomy provided a key diagnostic opportunity. This case highlights the importance of considering TB in the differential diagnosis of patients with unexplained urinary tract abnormalities, even in immunocompetent patients.

Background:Infertile men aged 18 to 40 with urogenital bacterial infections can be assessed for the presence of pus cells in their sperm or urine using direct microscopy, urine culture, and sperm culture techniques. Objectives:To examine the impact of microbial infections on the male genitourinary system and assess the probability of male sterility resulting from these conditions. Materials and Methods:Microorganisms including Escherichia coli, Proteus mirabilis, coagulase-negative Staphylococci, Staphylococcus aureus, and Klebsiella species, as well as Neisseria gonorrhoeae, Pseudomonas aeruginosa, and Enterococcus faecalis, were identified in samples obtained from semen and urine. Results:The correlation (Cor = 0.1) between isolates found in sperm and urine samples was demonstrated. This correlation indicates the potential for infections originating in the urinary tract to migrate to the spermatic tract. Antibiotics such as gentamicin, ciprofloxacin, rifampicin, ceftriaxone (amoxicillin and clavulanic acid), and augmentin have proven effective in treating severe infections. The broad spectrum of activity exhibited by these potent antibiotics underscores their efficacy in addressing various diseases and conditions caused by infections, as evidenced by their effectiveness against isolated pathogens. Among the patients assessed, 37 individuals were diagnosed with azoospermia, representing 28% of the total; 80 patients exhibited oligospermia, constituting 62% of the cohort; while 13 patients demonstrated sperm counts within the normal range, accounting for 10% of the sample. Conclusion:According to the findings of this prospective study, the occurrence of an infection in the male reproductive system should be regarded as a potential contributing feature to male sterility. This revelation enhances the aggregate body of indication that underscores the significance of considering various factors in assessing male infertility.

Background: Urinary tract infection (UTI) is one of the serious bacterial infections in febrile young children, which may cause chronic morbidities. Studies from different parts of Nigeria have shown varying pattern in its bacteriology and antibiotic sensitivities. Antimicrobial resistance rate among uropathogens is an increasing problem limiting therapeutic options, and underscores the need to determine local bacteriological pattern that will guide empiric antibiotic choices. Objectives: To identify the bacterial pathogens responsible for UTI in febrile under-five children in Enugu as well as their antibiotic sensitivity patterns. Methods: A cross-sectional descriptive hospital based study of eligible febrile children aged one to 59 months. Urine samples were collected using mid-stream and suprapubic aspiration methods. Standard laboratory procedures were used to culture the urine specimens, identify the bacterial pathogens as well as their antibiotic sensitivity patterns. Descriptive statistics were used to analyse the outcome. Results: Significant bacteriuria occurred in 22 (11%) of the 200 samples. Escherichia coli isolates were the most common organisms in 7(31.8%) of the 22 positive samples. Others were Staphylococcus aureus, Klebsiella spp and Streptococcus faecalis isolated in 5 (22.7%), 3(13.6%), and 3(13.6%) of the positive samples respectively. Most of the isolates were sensitive to ofloxacin (90.9%), ciprofloxacin (81.8%), nitrofurantoin (77.3%) and ceftriaxone (72.7%). High levels of resistance to ampicillin, cotrimoxazole, amoxicillin, nalidixic acid and clavulanate-potentiated amoxicillin were observed. Conclusion: Escherichia coli is the most common cause of UTI in febrile under-five children studied. Ciprofloxacin and ceftriaxone showed better sensitivities are advocated for the empiric treatment of febrile UTI in Enugu.

Background: Febrile illness in children remains the most common cause of emergency room visit. In many tropical countries where malaria is endemic, children presenting with fever are treated for malaria resumptuously. Current evidence suggests however that malarial parasitaemia in febrile children is declining and the prevalence of other causes of fever apparently on the increase. Therefore, highlighting such causes of fever as urinary tract infection (UTI) is indispensable. This is much so as UTI not only is common in younger children and often neglected but also associated with long term complications Methods: Children aged 6- 59months with fever of less than 2weeks were consecutively recruited. Each child had both clinicalevaluation and preliminary laboratory assessment such as dipstick urinalysis. Further microbiological and radiological evaluations were performed where necessary: blood film for malarial parasite identification and count, cerebrospinal fluid (CSF) analysis and chest X-ray. Results: Of the 303 children 180 (59.4%) were males and 123 were females (40.6%). The mean age was 21.7±14.0months, 54.5% were less than 24months. ARI accounted for 44.6% (mainly tonsillitis, 61%, pneumonia, 27% and otitis media, 12%), while malaria and UTI were observed in 38.3% and 4.6% respectively. Five (35.7%) patients with UTI were males while 9 (64.3%) were females. Their combined mean age was 25.4±18.6months, 57% of these children were less than 24 months old. In 3(21.4%), UTI coexisted with malaria. Conclusions: Acute respiratory infection, malaria and UTI are the three leading causes of fever in children under 5 years.

Abstract Background Urinary tract infection is one of the most common infections in humans, affecting women in more proportion. The bladder was considered sterile, but it has a urinary microbiome. Moreover, intracellular bacteria (IB) were observed in uroepithelial cells from children and women with urinary tract infections (UTIs). Here, we evaluated the presence of IB in urine from healthy people and patients with UTI symptoms. Methods Midstream urine was self-collected from 141 donors, 77 females and 64 males; 72 belonged to the asymptomatic group and 69 were symptomatic. IB was characterized by a culture-dependent technique and visualized by confocal microscopy. Urine was also subjected to the classical uroculture and isolated bacteria were identified by MALDI-TOF. Results One-hundred and fifteen uroculture were positive. A significant association was observed between the presence of symptoms and IB (P = 0.007). Moreover, a significant association between the presence of IB, symptoms and being female was observed (P = 0.03). From the cases with IB, Escherichia coli was the most frequent microorganism identified (34.7%), followed by Stenotrophomonas maltophilia (14.2%), Staphylococcus spp (14.2%), and Enterococcus faecalis (10.7%). Intracellular E. coli was associated with the symptomatic group (P = 0.02). Most of the intracellular Staphylococcus spp. were recovered from the asymptomatic group (P = 0.006). Conclusions Intracellular bacteria are present in patients with UTI but also in asymptomatic people. Here, we report for the first time, the presence of S. maltophilia, Staphylococcus spp., and Enterobacter cloacae as intracellular bacteria in uroepithelial cells. These findings open new insights into the comprehension of urinary tract infections, urinary microbiome and future therapies. Uroculture as the gold standard could not be enough for an accurate diagnosis in recurrent or complicated cases.

Background:Klebsiella pneumoniae and Pseudomonas aeruginosa are the most common causes of nosocomial urinary tract infections (UTIs), and in recent years, these bacteria have become significantly more resistant to antibiotics.Objective:The objective of the study was to determine the frequency of uropathogenic K. pneumoniae and P. aeruginosa in clinical urine samples from patients with UTIs in Wasit Province.Materials and Methods:Initially, 100 clinical urine samples were taken for this investigation from (October 1 to December 1, 2022), and the isolates were initially identified using culture, microscopic analysis, and biochemical assays.Results:The findings of the biochemical results revealed that 16/100 isolates had a 16% positive response for K. pneumonia, and 13/100 isolates had a 13% positive response for P. aeruginosa. When DNA was recovered from the isolates, the nucleic acid purity was diverse from 1.8 to 2.0, and the concentration fluctuated from 50 to 360 mg/µL. By using molecular techniques, including the 16S rRNA gene, for confirmation of the diagnosis. These findings were validated by the polymerase chain reaction method used to detect the virulence genes fimH gene, where 4/16 (25%) and mrkA gene, where result 7/16 (43.75%) were positive in recovered K. pneumoniae isolated. And RNA polymerase subunit B (rpoB) gene where results 10/13 (76.92%) were positive in recovered P. aeruginosa isolated.Conclusion:In conclusion, the outcomes of this study presented a significant increase in biofilm-forming and multidrug-resistant K. pneumoniae isolates, which also harbor a wide range of virulence genes and used rpoB as high molecular identification properties to confirm the P. aeruginosa, the most efficient antibiotics for its treatment were Impinem and Nitrofurantoin for both K. pneumonia and P. aeruginosa.

Background: Vitamin D insufficiency was seen in kids with various infections. Aim: This study aimed to assess the influence of vit D insufficiency on UTI in kids. Patients and methods: This case-control investigation involved ninety kids between one and twelve years in the Outpatient and Inpatient of the Pediatric Department, Suez Canal University Hospital. Results: There was significant variance among vit D level in the two study groups (p<0.001). Fever was the most frequent sign in the case group (80%), while dysuria was the most frequent symptoms (60%). The most common organisms identified in the urine culture was E. coli (75.6%). In the urine analysis, the study showed one quarter of the patients had 20-50 pus cells whereas more than 85% of the controls had pus cells below 10 (p<0.001). Linear regression analysis revealed that there was a decrease by 14.26 units in the vitamin D level of patients suffering from UTI compared to healthy controls. Conclusion: We found that concentration of vit D was lesser in kids with UTI than without, also there was correlation among concentration of Vit D and development of UTI manifestations, and moreover there was a decrease by 14.26 units in the concentration of vit D of cases suffering UTI compared to healthy controls. [ABSTRACT FROM AUTHOR]

Uropathogenic Escherichia coli (UPEC) is the most common causative agent of urinary tract infections, and strains that are resistant to antibiotics are a major problem in treating these infections. Phage therapy is a promising alternative approach that can be used to treat infections caused by polyresistant bacterial strains. In the present study, 16 bacteriophages isolated from sewage and surface water were investigated. Phage host specificity was tested on a collection of 77 UPEC strains. The phages infected 2–44 strains, and 80% of the strains were infected by at least one phage. The susceptible E. coli strains belonged predominantly to the B2 phylogenetic group, including strains of two clones, CC131 and CC73, that have a worldwide distribution. All of the phages belonged to class Caudoviricetes and were identified as members of the families Straboviridae, Autographiviridae, and Drexlerviridae and the genera Kagunavirus, Justusliebigvirus, and Murrayvirus. A phage cocktail composed of six phages – four members of the family Straboviridae and two members of the family Autographiviridae – was prepared, and its antibacterial activity was tested in liquid medium. Complete suppression of bacterial growth was observed after 5–22 hours of cultivation, followed by partial regrowth. At 24 hours postinfection, the cocktail suppressed bacterial growth to 43–92% of control values. Similar results were obtained when testing the activity of the phage cocktail in LB and in artificial urine medium. The results indicate that our phage cocktail has potential to inhibit bacterial growth during infection, and they will therefore be preserved in the national phage bank, serving as valuable resources for therapeutic applications. [ABSTRACT FROM AUTHOR]

Background: Urinary tract infections (UTI) constitute a major public health problem, especially in developing countries such as Burkina Faso. They are commonly encountered in hospitals, particularly in patients suffering from chronic kidney disease whose management requires special measures to avoid treatment failures which are frequent. The objective of this study is to determine the microbial profiles of urinary tract infections (UTIs) in these patients. Methodology: This was a cross-sectional study of hospitalized patients with UTIs in the nephrology-haemodialysis department of the CHUB from August 1 to November 31, 2020. Socio-demographic and clinical data of selected patients were collected by a well-designed data collection form. Cytobacteriological analysis of urine (CBAU) was carried out on voided or catheter-urine sample of each patient using standard microbiological technique. The disc diffusion method in agar medium modified according to the recommendations of the 2020 CA-SFM-EUCAST was used to determine the antibiotic susceptibility of each isolate. Data were processed and analyzed using Excel 2013, IBM SPSS Statistics 25.0 and CSpro 7.5 software. Results: Urine samples were collected from a total of 77 eligible participants, 49 (63.6%) of which were CBAU positive, with 56 microbial pathogens isolated. Enterobacterales represented 58.9% (n=33), including 39.4% Escherichia coli (n=13) and 36.4% Klebsiella spp (n=12). Non-fermentative Gram-negative bacilli represented 7.1% (n=4) including Acinetobacter baumannii (n=3) and Pseudomonas aeruginosa (n=1). Staphylococcus aureus was isolated in 5.4% (n=3) and Candida spp in 28.6% (n=16). The most active antimicrobials in vitro against the bacterial pathogens were amikacin and imipenem, and clotrimazole and nystatin against the Candida spp. A total 35.7% (n=20) were multi-drug resistant bacteria with 32.1% by ESBL in Gram-negative bacteria and 66.7% (2/3) by MRSA in Grampositive bacteria. Conclusion: The high resistance of pathogens to antimicrobials, resulting in therapeutic failures, constitutes a significant challenge in the management of urinary tract infection, especially in people with chronic kidney disease. It is therefore necessary to put in place urgent measures aimed at the rational use of antimicrobials and strict compliance with good hospital hygiene practices. [ABSTRACT FROM AUTHOR]

Urinary tract infections are widely recognized as prevalent bacterial infections frequently encountered in both hospital and community settings. The most common gram-negative bacterial pathogen in humans, extra-intestinal pathogenic Escherichia coli, causes these diseases. A retrospective cross-sectional study in Karachi, Pakistan examined Escherichia coli's susceptibility to doxycycline, nalidixic acid and meropenem. One hundred isolates of Escherichia coli from urine samples of patients were collected. The Kirby Bauer disc diffusion testing method was used following CLSI guidelines. The results showed variability because of differences in patient's gender and age. 84 out of 100 samples were of females and 16 samples were of males. Infection prevalence by age showed that 15% of isolates were from children (0-12 years), 2% from adolescents (13-18 years), 52% from adults (19-59 years) and 31% from seniors. This study concluded that females and adults (aged 19-59 years) are at highest risk of prevalence. Meropenem is a potential antibiotic choice for urinary tract infections due to its demonstrated 100% susceptibility. However, in light of increasing resistance trends, the administration of doxycycline and nalidixic acid should be reserved until antimicrobial susceptibility testing has been conducted. The study ensures that antibiotics are used judiciously and effectively in combating urinary tract infections while minimizing the risk of further antimicrobial resistance development. [ABSTRACT FROM AUTHOR]

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Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)