scholarly journals Positive Urine Cultures: A Major Cause of Inappropriate Antimicrobial Use in Hospitals?

2009 ◽  
Vol 20 (4) ◽  
pp. 107-111 ◽  
Author(s):  
Samuel A Silver ◽  
Laura Baillie ◽  
Andrew E Simor
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Medical Records ◽  
Urine Culture ◽  
Asymptomatic Bacteriuria ◽  
Antimicrobial Use ◽  
Symptomatic Urinary Tract Infection ◽  
Positive Urine ◽  
Urine Specimens

INTRODUCTION: Urine specimens are among the most common samples submitted for culture to microbiology laboratories. The objectives of the present study were to describe the indications for obtaining urine cultures in a cohort of hospitalized patients, and to determine the appropriateness of antimicrobial therapy in response to urine culture results.METHODS: The study was performed at a teaching hospital with an adjoining long-term care facility from June 1 to July 31, 2006. The medical records of nonpregnant adult patients with and without bacteriuria were reviewed. A symptomatic urinary tract infection was defined as the presence of bacteriuria in a patient with fever or urinary symptoms; asymptomatic bacteriuria was defined as bacteriuria without urinary symptoms and no infection evident at another site.RESULTS: Medical records of 335 eligible patients (64% male; mean age 68 years) were reviewed, including all 137 with bacteriuria, and 198 with negative urine cultures. In total, 51% of the urine specimens were obtained from an indwelling urinary catheter, and 28% were voided urine samples. Confusion (57%) and fever (36%) were the most common indications noted for obtaining the urine cultures. Only 34 patients (25% of those with positive urine cultures) met the criteria for a symptomatic urinary tract infection; 67 (49%) had asymptomatic bacteriuria and 36 (26%) had infection at a nonurinary site. Of those with asymptomatic bacteriuria, 64% received antimicrobial therapy for a total of 347 days. Confused patients with asymptomatic bacteriuria were more likely to be treated than were bacteriuric patients without altered mental status (OR 1.8, 95% CI 1.2 to 4.1; P=0.03).CONCLUSIONS: Urine cultures are frequently obtained from hospitalizedpatients,evenintheabsenceofurinarysymptoms.Asymptomatic bacteriuria is often treated in these patients, and accounts for a substantial burden of inappropriate antimicrobial use in hospitals. Effective strategies to improve urine culture ordering and antimicrobial utilization in hospitals need to be implemented.

URINARY INFECTION AT DEPARTMENT OF UROLOGY OF HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2018 ◽  
pp. 100-108
Author(s):  
Dinh Khanh Le ◽  
Dinh Dam Le ◽  
Khoa Hung Nguyen ◽  
Xuan My Nguyen ◽  
Minh Nhat Vo ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
University Hospital ◽  
E Coli ◽  
Positive Urine ◽  
Tract Infections

Objectives: To investigate clinical characteristics, bacterial characteristics, drug resistance status in patients with urinary tract infections treated at Department of Urology, Hue University Hospital. Materials and Method: The study was conducted in 474 patients with urological disease treated at Department of Urology, Hue Universiry Hospital from July 2017 to April 2018. Urine culture was done in the patients with urine > 25 Leu/ul who have symptoms of urinary tract disease or infection symptoms. Patients with positive urine cultures were analyzed for clinical and bacterial characteristics. Results: 187/474 (39.5%) patients had symptoms associated with urinary tract infections. 85/474 (17.9%) patients were diagnosed with urinary tract infection. The positive urine culture rate was 45.5%. Symptoms of UTI were varied, and no prominent symptoms. E. coli accounts for the highest proportion (46.67%), followed by, Staphycoccus aureus (10.67%), Pseudomonas aeruginsa (8,0%), Streptococcus faecali and Proteus (2.67%). ESBL - producing E. coli was 69.23%, ESBL producing Enterobacter spp was 33.33%. Gram-negative bacteria are susceptible to meropenem, imipenem, amikacin while gram positive are vancomycin-sensitive. Conclusions: Clinical manifestations of urinary tract infections varied and its typical symptoms are unclear. E.coli is a common bacterium (46.67%). Isolated bacteria have a high rate of resistance to some common antibiotics especially the third generation cephalosporins and quinolones. Most bacteria are resistant to multiple antibiotics at the same time. Gram (+) bacteria are susceptible to vancomycin, and gram (-) bacteria are susceptible to cefoxitin, amikacin, and carbapenem. Key words: urinary tract infection

scholarly journals Incidence of Acute Pyelonephritis in Hospitalized Children under 5 Years Old with Positive Urine Culture

2018 ◽  
Vol 59 (4) ◽  
pp. 1-5
Author(s):  
Alexandra Castaño González ◽  
Juan Gabriel Ruiz Peláez
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Acute Pyelonephritis ◽  
Urine Culture ◽  
Renal Scintigraphy ◽  
Hospitalized Children ◽  
Positive Urine Culture ◽  
Positive Urine ◽  
Urinary Culture

Introduction: Urinary tract infection is a major cause of child morbidity. The diagnosis of acute pyelonephritis is important to decide the treatment. Methods: Retrospective observational study. We collected information of urinalysis, urine Gram and urine culture of hospitalized children between 3 months and 5 years old, with suspected urinary tract infection between January 2008 and December 2010. In patients with positive urine culture, the results of renal scintigraphy (Gamma scan) were evaluated to estimate the incidence of acute pyelonephritis. Results: We identified 1,463 medical records. Urinary culture was obtained in 237 patients, of whom 54.4% were positive. Renal scintigraphy was obtained in 93 of these patients and 59.1% were positive. Conclusions: The incidence of acute pyelonephritis in patients with confirmed urinary tract infection was 59.1%.

scholarly journals Impact of Constipation in Children on Urinary Tract Infection (UTI)

1970 ◽  
Vol 34 (1) ◽  
pp. 17-20 ◽  
Author(s):  
Seikh Azimul Hoque ◽  
Md Tariqul Islam ◽  
Farid Ahmed ◽  
Mohammed Hanif ◽  
Shahnoor Islam ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urine Culture ◽  
Single Species ◽  
Control Group ◽  
Positive Urine Culture ◽  
Positive Urine ◽  
History Of ◽  
The Difference

Objectives: The study was done to find out the relationship between constipation andurinary tract infection (UTI) in children.Methods: The study was a case control study between two groups in a tertiary carechildren hospital in Dhaka city. In group-1 (n=45) those children having history ofconstipation and in group-2 (n=78) as a control group having no history of constipationwere included in this study. Growths of a single species of organism with colony countof >105/ml in a clean-catch midstream single urine sample was considered as evidenceof urinary tract infection.Results: Positive urine culture was found in 8.9% (4/45) cases in children who hadhistory of constipation and 1.3% (1/78) in children who had no history of constipation.Though the number of positive urine culture was seven times more in children withconstipation than those who were not constipated but the difference between the twogroups was not statistically significant (p=0.059) .Conclusion: Culture documented UTI in children with constipation is seven timesmore than without constipation showing impact of constipation on urinary tract infection(UTI) in children.Key words: Urinary tract infection (UTI); constipation.DOI: 10.3329/bjch.v34i1.5697Bangladesh Journal of Child Health 2010; Vol.34(1): 17-20

scholarly journals Clinical, Etiological and Antibiotic Susceptibility Profiles of Community-Acquired Urinary Tract Infection in a Western Hemisphere of Baghdad

2015 ◽  
Vol 14 (4) ◽  
pp. 352-358
Author(s):  
Naser S Hussein
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Clinical Presentation ◽  
Urine Culture ◽  
Medical Science ◽  
Antibiotic Sensitivity ◽  
Western Hemisphere ◽  
Positive Urine Culture ◽  
Positive Urine

Background: In majority of community-acquired urinary tract infection (CA-UTI) cases, physicians can prescribe empirical therapy without a pretreatment urine culture especially in resource poor settings, where the cost of urine culture is more than cost of treatment itself. Objective: With growing problem of drug resistance globally as well as data on CA-UTI in Iraq are scare. We conduct this study to analyze clinical presentation, etiology and antibiotic sensitivity of bacteria causing community acquired urinary tract infection (CA-UTI). Material and Methods: Outpatients urine cultures and clinical presentations were collected from April 2012 to October 2012. A positive urine culture was defined as growth of a single bacteria with colony count of more than 100,000 CFU/ml and disk diffusion technique was performed to determine antibiotics susceptibility of isolated bacteria species. Clinical symptoms, causative uropathogens and their antibiotic sensitivity were recorded. Results: Of 299 urine cultures processed, a positive urine culture was detected in 100 subjects. Dysuria and bladder irritability (frequency and urgency) were the most common clinical presentation. 39% of isolated bacteria was Escherichia coli and Staphylococcus strains (30%). The isolated uropathogens showed a substantial sensitivity reduction to most of test antibiotics. Conclusion: Clinical presentation had a minor role in diagnosis of CA-UTI and this study revealed that E. coli and Staphylococcus strains were most prevalent isolated uropathogens. Susceptibility test showed there was a high sensitivity to nitrofurantoin, amikacin and imipenem.Bangladesh Journal of Medical Science Vol.14(4) 2015 p.352-358

scholarly journals Assessment of Rapid Dipstick Test for Diagnosis of Urinary Tract Infection in Asymptomatic Pregnant Female

2016 ◽  
Vol 5 (1) ◽  
pp. 965
Author(s):  
Ashish Khanna ◽  
Menka Khanna
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Gold Standard ◽  
Urine Culture ◽  
Asymptomatic Bacteriuria ◽  
Culture Method ◽  
Premature Delivery ◽  
Dipstick Test ◽  
In Pregnancy

<strong>Background:</strong>Bacteriuria during pregnancy has been known to cause many complications like low birth weight and premature delivery.<p><strong>Objective</strong>: This study was done to evaluate the diagnostic accuracy of rapid dipstick test to predict urinary tract infection in pregnancy against the gold standard urine culture.</p><p><strong>Material&amp;Methods:</strong> A total of 200 mid stream urine samples were collected from asymptomatic pregnant females. These specimens were cultured in blood agar and MacConkey's agar by using the standard loop technique and incubated aerobically at 37°C overnight. The criterion for clinically significant bacteriuria was either a pure or predominant culture of &gt;10<sup>5</sup> colony forming units (CFU)/ml. All the specimens were also examined microscopically for pyuria and bacteriuria.</p><p><strong>Results:</strong> The prevalence of asymptomatic bacteriuria in pregnancy was 15 % in our study. The sensitivity and the specificity for leucocyte esterase were 85.7% and 74.4% and for nitrites, they were 64.2% and 72%.</p><p><strong>Conclusion:</strong> The study revealed that use of either leukocyte esterase or nitrite for screening of asymptomatic bacteriuria in pregnancy was associated with many false positive and negative results when compared with the gold standard urine culture method. By using their combination maximum negative predictive value of .98 was achieved.</p>

scholarly journals Análise da Revisão Cochrane: Antibióticos Destinados ao Tratamento da Bacteriúria Assintomática. Cochrane Database Syst Rev. 2015;4:CD009534.

2018 ◽  
Vol 31 (2) ◽  
pp. 76
Author(s):  
Miguel Bigotte Vieira ◽  
Mariana Alves ◽  
João Costa ◽  
António Vaz-Carneiro
Keyword(s):  
Systematic Review ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Adverse Events ◽  
Kidney Function ◽  
Antibiotic Treatment ◽  
Asymptomatic Bacteriuria ◽  
Controlled Trials ◽  
Symptomatic Urinary Tract Infection

Asymptomatic bacteriuria is frequently detected in women aged up to 60 years, patients with diabetes and elderly patients. The benefit of antibiotic treatment for this condition is controversial. The objective of this Cochrane systematic review was to assess the effectiveness and safety of antibiotic treatment for asymptomatic bacteriuria in adults. A systematic review of the literature up to 24 February 2015 was performed using the Cochrane Renal Group’s Specialised Register. Randomised controlled trials (RCTs) and quasirandomised controlled trials comparing antibiotics to placebo or no treatment for asymptomatic bacteriuria in adults were included. The outcomes of interest were the development of symptomatic urinary tract infection, complications, death, adverse events, development of antibiotic resistance, bacteriological cure, and decline in kidney function. Nine studies (1614 participants) were included in this review. The incidence of symptomatic urinary tract infection, complications or death was similar between groups. Antibiotic use was significantly associated with bacteriological cure and an increase in minor adverse events. No decline in kidney function was observed with any one of the treatments. According to the results of the studies included in this revision, authors have concluded that there is no clinical benefit in treating asymptomatic bacteriuria in adults.

scholarly journals Asymptomatic Bacteriuria among Pregnant Women Attending Antenatal Clinic at the Akuapem North District of the Eastern Region of Ghana

2021 ◽  
Vol 9 (3) ◽  
pp. 24-34
Author(s):  
Aquel Rene Lopez
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Pregnant Women ◽  
Urine Culture ◽  
Multiple Pregnancy ◽  
Asymptomatic Bacteriuria ◽  
Health Care Facilities ◽  
Bivariate Analysis ◽  
Eastern Region

Asymptomatic bacteriuria is a condition in which urine culture reveals the presence of more than 105 bacteria per millilitre but without the patient showing signs and symptoms of urinary tract infection (UTI). In many of the health care facilities in Ghana, routine screening for ASB among pregnant woman is not done despite overwhelming evidence clearly demonstrating its benefits in preventing UTI and the associated adverse pregnancy outcome. It is a common problem in pregnant women, which usually results in maternal and fetal complications. The majority of the participant were in the age range of 25 years to 34 years, and all the participants had basic education. Out of the 134 sterile urine samples cultured, 11 of the participants had bacteria isolated from their urine, given a prevalence of 8.2%. Escherichia coli were 63.6%, Nitrofurantoin was 81.8% sensitive to all bacteria isolated, and Cotrimoxazole was the most resistant antibiotic with 72.7%. Factors associated with ASB in Akuapem North District were toilet facility, multiple pregnancy, and any medical condition, which were statistically significant at the bivariate analysis level. After adjusting these factors with the multiple logistics regression, only multiple pregnancy was statistically significant. The study revealed an 8.2% prevalence of ASB among pregnant women with E. coli, the predominate bacteria with 63.6%. Nitrofurantoin, 81.8% sensitive, and Cotrimoxazole was the most resistant antibiotics with 72.7%. Multiple pregnancy was associated with Asymptomatic bacteriuria among pregnant women at Akuapem North District. Keywords: Asymptomatic Bacteriuria, Pregnant Women, Urine Culture, Urinary Tract Infection.

Urinary Tract Infections

PEDIATRICS ◽  
1991 ◽  
Vol 87 (5) ◽  
pp. 746-746
Author(s):  
ELLEN F. CRAIN ◽  
JEFFREY C. GERSHEL
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Incidental Finding ◽  
Asymptomatic Bacteriuria ◽  
Positive Urine ◽  
Tract Infections

In Reply.— Dr Roscelli calls attention to the 16 infants in our sample with positive urine cultures but negative urinalyses and admission diagnoses other than urinary tract infection (UTI). These patients, Dr Roscelli suggests, could have had asymptomatic bacteriuria with a different source for their fever. Although we doubt that these infants had asymptomatic bacteriuria, in theory it is possible that the bacteriuria was not the cause of the fever. However, as Dr Roscelli states, "at this time there no way to determine if the bacteriuria is causing the patient's fever or is simply an incidental finding."

Importance of Urinary Tract Infection to Antibiotic Use Among Hospitalized Patients

2009 ◽  
Vol 30 (2) ◽  
pp. 193-195 ◽  
Author(s):  
Tejal Gandhi ◽  
Scott A. Flanders ◽  
Erica Markovitz ◽  
Sanjay Saint ◽  
Daniel R. Kaul
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Broad Spectrum ◽  
Urine Culture ◽  
Asymptomatic Bacteriuria ◽  
Antibiotic Use ◽  
Hospitalized Patients ◽  
Broad Spectrum Antibiotics

Many patients with asymptomatic bacteriuria receive extended courses of broad-spectrum antibiotics. Antibiotic use was analyzed in patients admitted to the hospital with urinary tract infection. Strategies to optimize antibiotic use for such patients are discussed and include implementing a process whereby a urine culture is automatically performed if a urinalysis result suggests infection.

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