Impact of Antibiotic Resistance on the Development of Recurrent and Relapsing Symptomatic Urinary Tract Infection in Kidney Recipients

Abstract Background The role of antibiotics in preventing urinary tract infection (UTI) in older adults is unknown. We sought to quantify the benefits and risks of antibiotic prophylaxis among older adults. Methods We conducted a matched cohort study comparing older adults (≥66 years) receiving antibiotic prophylaxis, defined as antibiotic treatment for ≥30 days starting within 30 days of a positive culture, with patients with positive urine cultures who received antibiotic treatment but did not receive prophylaxis. We matched each prophylaxis recipient to 10 nonrecipients based on organism, number of positive cultures, and propensity score. Outcomes included (1) emergency department (ED) visit or hospitalization for UTI, sepsis, or bloodstream infection within 1 year; (2) acquisition of antibiotic resistance in urinary tract pathogens; and (3) antibiotic-related complications. Results Overall, 4.7% (151/3190) of UTI prophylaxis patients and 3.6% (n = 1092/30 542) of controls required an ED visit or hospitalization for UTI, sepsis, or bloodstream infection (hazard ratio [HR], 1.33; 95% confidence interval [CI], 1.12–1.57). Acquisition of antibiotic resistance to any urinary antibiotic (HR, 1.31; 95% CI, 1.18–1.44) and to the specific prophylaxis agent (HR, 2.01; 95% CI, 1.80–2.24) was higher in patients receiving prophylaxis. While the overall risk of antibiotic-related complications was similar between groups (HR, 1.08; 95% CI, .94–1.22), the risk of Clostridioides difficile and general medication adverse events was higher in prophylaxis recipients (HR [95% CI], 1.56 [1.05–2.23] and 1.62 [1.11–2.29], respectively). Conclusions Among older adults with UTI, the harms of long-term antibiotic prophylaxis may outweigh their benefits.

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Larger Numbers Needed

PEDIATRICS ◽

10.1542/peds.80.5.764 ◽

1987 ◽

Vol 80 (5) ◽

pp. 764-764

Author(s):

THOMAS E. WISWELL

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Urinary Tract Infections ◽

First Year ◽

Infection Rates ◽

Symptomatic Urinary Tract Infection ◽

Tract Infections ◽

First Year Of Life

In Reply.— Dr Altschul presents data on urinary tract infections during infancy and reports infection rates substantially lower than those we have previously reported.1,2 He then makes several conclusions based on these differences. His data indicate that the maximum infection rates would be 0.11% among girls and 0.02% and 0.12% among circumcised and uncircumcised boys, respectively. In contrast, from a population of 422,328 infants, we found the overall incidence of symptomatic urinary tract infection during the first year of life to be 0.57% in girls, 0.11% in circumcised boys, and 1.12% in uncircumcised boys.

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Nontypable Haemophilus influenzae Septicemia and Urinary Tract Infection Associated with Renal Stone Disease

The Open Microbiology Journal ◽

10.2174/1874285801812010243 ◽

2018 ◽

Vol 12 (1) ◽

pp. 243-247

Author(s):

Marianne Stærk ◽

Sara A. Tolouee ◽

Jens J. Christensen

Keyword(s):

Urinary Tract Infection ◽

Antibiotic Resistance ◽

Urinary Tract ◽

Tract Infection ◽

Haemophilus Influenzae ◽

Renal Stone ◽

Stone Disease ◽

Upper Respiratory Tract ◽

Renal Stone Disease ◽

Tract Infections

Introduction: Haemophilus influenzae commonly causes upper respiratory tract infections and has only rarely been reported etiology of urinary tract infections. Since the introduction of the Haemophilus influenzae b (Hib) vaccine, non-typable haemophilus species now cause the majority of invasive disease in Europe. Case Report: We report a case of an adult man with non-typable Haemophilus influenzae septicemia, urinary tract infection and bilateral renal stone disease. The patient presented with right sided flank pain and a CT scan showed bilateral renal stones and a right sided ureteral stone causing obstruction. Results and Discussion: Haemophilus influenzae was identified in blood and urine and despite a tendency of increasing antibiotic resistance among Haemophilus influenzae, our strain was susceptible to all antibiotics tested. Treatment consisted of 3 days of intravenous cefuroxime, insertion of a right sided JJ ureteric stent and 5 days of peroral ciprofloxacin after discharge. Physicians and microbiologists should be aware of Haemophilus influenzae as a possible urinary tract pathogen, especially when urinary tract abnormalities are present, and take the risk of antibiotic resistance into consideration at initial treatment.

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Correlation between uropathogenic properties ofEscherichia colifrom urinary tract infections and the antibody-coated bacteria test and comparison with faecal strains

Journal of Hygiene ◽

10.1017/s0022172400069230 ◽

1981 ◽

Vol 87 (1) ◽

pp. 53-61 ◽

Cited By ~ 12

Author(s):

Heather J. L. Brooks ◽

Barbara A. Benseman ◽

Jayne Peck ◽

K. A. Bettelheim

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

World Literature ◽

Symptomatic Urinary Tract Infection ◽

E Coli ◽

High K ◽

Serotype 1 ◽

H Serotypes ◽

Tract Infections

SummaryStrains ofEscherichia coliisolated from adult females with symptomatic urinary tract infection were found to possess the following properties significantly more frequently than faecal strains: (i) high K-antigen titre; (ii) haemolysin; (iii) type 1 pili; (iv) mannose-resistant haemagglutination; (v) fermentation of dulcitol and salicin; (vi) O serotype 2, 6 and 75; (vii) H serotype 1.E. coliisolated from urine specimens containing significant numbers of antibody-coated bacteria were richer in these seven properties than strains from urines without detectable antibody-coated bacteria.The O and H serotypes ofE. coliobtained from patients with urinary tract infection in two New Zealand cities were compared with those reported in the world literature and found to be similar.

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Features of Antibiotic Resistance in Uncomplicated Urinary Tract Infection in Children and Effectiveness of Immunoprophylaxis

Clinical Immunology & Research ◽

10.33425/2639-8494.1022 ◽

2018 ◽

Vol 2 (2) ◽

Author(s):

Stoieva T.V ◽

Gruzievskyi O.A

Keyword(s):

Urinary Tract Infection ◽

Antibiotic Resistance ◽

Urinary Tract ◽

Tract Infection ◽

Uncomplicated Urinary Tract Infection

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Antibiotic Resistance in Children with Recurrent or Complicated Urinary Tract Infection

Journal of Nepal Medical Association ◽

10.31729/jnma.183 ◽

2009 ◽

Vol 48 (173) ◽

Author(s):

Nidal S Younish ◽

K Qual ◽

T Al-Awaisheh ◽

F Al-Awaisheh ◽

D Al-Kayed

Keyword(s):

Urinary Tract Infection ◽

Antibiotic Resistance ◽

Urinary Tract ◽

Tract Infection ◽

Recurrent Urinary Tract Infection ◽

Complicated Urinary Tract Infection ◽

Resistance Pattern ◽

Candida Spp ◽

Recurrent Uti ◽

Antibiotics Susceptibility

INTRODUCTION:Urinary tract infection is certainly one of the most common childhood infections. Emerging resistance to the antibiotics is not unusual. Current hospitalization for children with urinary tract infection is reserved for severe or complicated cases. The aim of the present study was to determine the antibiotic resistance pattern among children with recurrent or complicated urinary tract infection.METHODS:A retrospective study carried out at Prince Hashem hospital, Zarqa city, eastern Jordan and involved 336 episodes of culture proved urinary tract infection obtained from 121 patients with recurrent UTI, who used prophylactic antibiotics during the period from April 1, 2004 to December 31, 2006. The isolated microorganisms and there antibiotics susceptibility were studied.RESULTS:Seventy three patients (60.3%) were found to have some forms of urinary tract anomaly, significantly more prevalent among male children P<0.001. Vesicoureteral reflux being the most common (58.9%). Renal scars were significantly more prevalent among those with complicated rather than recurrent urinary tract infection (64.3% vs. 16.6%, P<0.001). Gram negative organisms were the most frequent isolates in patients with recurrent and complicated urinary tract infection. Proteus, Pseudomonas and Candida spp. were more prevalent in patients with complicated (P<0.001), and isolates in patients with UTA were significantly more resistant to most antibiotics tested.CONCLUSIONS:Pediatric urine culture isolates are becoming increasingly resistant to commonly used antibiotics. Empirical treatment with Trimethoprim-Sulfamethoxazole (TMP-SMX) or Cephalexin as the initial drug is ineffective. Nitrofurantoin and Nalidixic acid can be considered as the first line antibiotics for prophylaxis and or treatment of patients with recurrent UTI, while Meropenam and Ciprofloxacin can be used empirically in treating patients with complicated UTI.Key words: Antibiotic resistance, Complicated, Recurrent, Urinary tract infection

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An Intact Cell Bioluminescence-Based Assay for the Simple and Rapid Diagnosis of Urinary Tract Infection

International Journal of Molecular Sciences ◽

10.3390/ijms21145015 ◽

2020 ◽

Vol 21 (14) ◽

pp. 5015

Author(s):

Sherwin Reyes ◽

Nga Le ◽

Mary Denneth Fuentes ◽

Jonathan Upegui ◽

Emre Dikici ◽

...

Keyword(s):

Urinary Tract Infection ◽

Antibiotic Resistance ◽

Urinary Tract ◽

Tract Infection ◽

Intact Cell ◽

Point Of Care ◽

Photobacterium Leiognathi ◽

Artificial Urine ◽

Detection Window ◽

Tract Infections

Urinary tract infection (UTI) is one of the most common infections, accounting for a substantial portion of outpatient hospital and clinic visits. Standard diagnosis of UTI by culture and sensitivity can take at least 48 h, and improper diagnosis can lead to an increase in antibiotic resistance following therapy. To address these shortcomings, rapid bioluminescence assays were developed and evaluated for the detection of UTI using intact, viable cells of Photobacterium mandapamensis USTCMS 1132 or previously lyophilized cells of Photobacterium leiognathi ATCC 33981™. Two platform technologies—tube bioluminescence extinction technology urine (TuBETUr) and cellphone-based UTI bioluminescence extinction technology (CUBET)—were developed and standardized using artificial urine to detect four commonly isolated UTI pathogens—namely, Escherichia coli, Proteus mirabilis, Staphylococcus aureus, and Candida albicans. Besides detection, these assays could also provide information regarding pathogen concentration/level, helping guide treatment decisions. These technologies were able to detect microbes associated with UTI at less than 105 CFU/mL, which is usually the lower cut-off limit for a positive UTI diagnosis. Among the 29 positive UTI samples yielding 105–106 CFU/mL pathogen concentrations, a total of 29 urine specimens were correctly detected by TuBETUr as UTI-positive based on an 1119 s detection window. Similarly, the rapid CUBET method was able to discriminate UTIs from normal samples with high confidence (p ≤ 0.0001), using single-pot conditions and cell phone-based monitoring. These technologies could potentially address the need for point-of-care UTI detection while reducing the possibility of antibiotic resistance associated with misdiagnosed cases of urinary tract infections, especially in low-resource environments.

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Bacteriological profile, risk factors and antimicrobial susceptibility patterns of symptomatic urinary tract infection among students of Mekelle University, northern Ethiopia

BMC Infectious Diseases ◽

10.1186/s12879-019-4610-2 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Guesh Gebremariam ◽

Haftom Legese ◽

Yemane Woldu ◽

Tadele Araya ◽

Kiflom Hagos ◽

...

Keyword(s):

Risk Factors ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Antimicrobial Susceptibility ◽

Medical Attention ◽

Bacterial Isolates ◽

Symptomatic Urinary Tract Infection ◽

Mekelle University ◽

History Of

Abstract Background Bacterial infection of the urinary tract is among the common reasons for seeking medical attention in the community. Rapidly increasing antibiotic resistance of uropathogens is resulting in limited treatment options. Therefore, knowledge of the current uropathogens and their antibiotic susceptibility is important for better treatment of urinary tract infection. Methods A cross-sectional study design was conducted from February to September thirty, 2017 among students who came to Mekelle University student’s clinics with symptomatic urinary tract infection during the study period.. Mid-stream urine specimens were collected from 341individuals with suspected urinary tract infection for bacteriological identification and antimicrobial susceptibility testing. Data on socio-demographic, clinical and risk factors were also collected using a structured questionnaire. Results Among the 341 study participants, 72(21.1%) showed significant bacteriuria. Escherichia coli (48.6%), Coagulase-negative staphylococci (23%), Staphylococcus aureus (13.5%), and Klebsiella spp. (8.1%) were common bacterial isolates. Resistance to ampicillin (81–100%), amoxicillin/clavulanic acid (77–93.6%), co- trimoxazole (55 72.3%), nalidixic acid (57.4%) and tetracycline (46–55.5%) was seen by most isolates. Multidrug resistance was observed in 73% of the bacterial isolates, and 25.5% of the Gram-negative isolates were extended-spectrum beta-lactamase producers. Being female, a history of urinary tract infection, a history of catheterization and frequent sexual activity were found to be statistically associated with urinary tract infection. Conclusion Urinary tract infection is a problem among university students with a prevalence of 21.1%. All isolates have developed resistance to most of the commonly used antibiotics. Therefore, health education on the transmission and causes of urinary tract infection are recommended for the students.

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