New Self-Reporting Questionnaire to Assess Urinary Tract Infections and Differential Diagnosis: Acute Cystitis Symptom Score

2014 ◽  
Vol 92 (2) ◽  
pp. 230-236 ◽  
Author(s):  
Jakhongir F. Alidjanov ◽  
Ulugbek A. Abdufattaev ◽  
Saidamin A. Makhsudov ◽  
Adrian Pilatz ◽  
Farkhad A. Akilov ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Urinary Tract ◽  
Symptom Score ◽  
Urinary Tract Infections ◽  
Acute Cystitis ◽  
Tract Infections ◽  
Self Reporting Questionnaire

scholarly journals Reevaluation of the Acute Cystitis Symptom Score, a Self-Reporting Questionnaire. Part I. Development, Diagnosis and Differential Diagnosis

Antibiotics ◽  
2018 ◽  
Vol 7 (1) ◽  
pp. 6 ◽  
Author(s):  
Jakhongir Alidjanov ◽  
Kurt Naber ◽  
Ulugbek Abdufattaev ◽  
Adrian Pilatz ◽  
Florian Wagenlehner
Keyword(s):  
Differential Diagnosis ◽  
Symptom Score ◽  
Acute Cystitis ◽  
Self Reporting Questionnaire

scholarly journals THE CURRENT STATE OF ANTIBIOTIC RESISTANCE AND THE COMPOSITION OF PATHOGENS OF URINARY TRACT INFECTIONS IN PREGNANT WOMEN

2018 ◽  
Vol 6 (2) ◽  
pp. 13-20 ◽  
Author(s):  
K. L. Lokshin ◽  
V. N. Shirshov ◽  
A. S. Popko ◽  
Yu. L. Demidko ◽  
N. D. Luchenkova
Keyword(s):  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Antibiotic Therapy ◽  
Pregnant Women ◽  
Urinary Tract Infections ◽  
Asymptomatic Bacteriuria ◽  
Resistance Rate ◽  
Acute Cystitis ◽  
E Coli ◽  
Tract Infections

Introduction.The main treatment component of asymptomatic bacteriuria, acute cystitis and pyelonephritis in pregnant women is antibiotic therapy, which in many patients is prescribed empirically. For successful selection of the drug, it is necessary to know both the structure of pathogens and the current profile of their antibiotic resistance.Purpose of research.The study of species composition and resistance to antibiotics of bacteria that cause urinary tract infections (UTIs) in pregnant women in the Moscow RegionMaterials and methods.The study included 104 pregnant women with uncomplicated UTIs who were observed and treated at the Lapino Clinical Hospital between 2016 and 2017. The material for bacteriological studies was the midstream portion of urine or urine collected by a catheter.Results.90 patients had asymptomatic bacteriuria, 10 had acute cystitis, and 4 had acute gestational pyelonephritis. The structure of the pathogens of UTI is presented: E. coli, Enterococcus faecalis, Klebsiella pneumoniae, Proteus spp., Staphylococcus spp., Streptococcus spp., Enterobacter cloacae. The most frequently detected pathogens were E. coli (67.3%) and E. faecalis (50%). Resistance rate of E.coli strains more than 20% was detected to ampicillin (36.4%), amoxicillin / clavulanate (23.2%), trimethoprim / sulfamethoxazole (27.4%), nalidixic acid (20.7%), cephalosporins 2 and 3 generation (respectively, 25.7% and 24.3%). Resistance rate more than 20% in Enterobacteriaceae family strains was detected to trimethoprim/sulfamethoxazole (24.4%), nalidixic acid (20.7%), cephalosporins 2 generations (21.7%). Antibiotic resistance of E.coli and other Enterobacteriaceae family taxons less than 10% was noted only with respect to carbapenems (0%) and fosfomycin (1.5% and 3.5%, respectively).Conclusions.It is expedient to use the obtained data on the composition and sensitivity profile of uropathogens in UTIs in pregnant women when choosing starting empirical antibiotic therapy. Disclosure: The study did not have sponsorship. The authors have declared no conflicts of interest.

scholarly journals Qualitative Analysis of Primary Care Provider Prescribing Decisions for Urinary Tract Infections

Antibiotics ◽  
2019 ◽  
Vol 8 (2) ◽  
pp. 84 ◽  
Author(s):  
Larissa Grigoryan ◽  
Susan Nash ◽  
Roger Zoorob ◽  
George J. Germanos ◽  
Matthew S. Horsfield ◽  
...  
Keyword(s):  
Primary Care ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Primary Care Providers ◽  
Effective Control ◽  
Antibiotic Prescribing ◽  
Care Providers ◽  
Sources Of Information ◽  
Acute Cystitis ◽  
Tract Infections

Inappropriate choices and durations of therapy for urinary tract infections (UTI) are a common and widespread problem. In this qualitative study, we sought to understand why primary care providers (PCPs) choose certain antibiotics or durations of treatment and the sources of information they rely upon to guide antibiotic-prescribing decisions. We conducted semi-structured interviews with 18 PCPs in two family medicine clinics focused on antibiotic-prescribing decisions for UTIs. Our interview guide focused on awareness and familiarity with guidelines (knowledge), acceptance and outcome expectancy (attitudes), and external barriers. We followed a six-phase approach to thematic analysis, finding that many PCPs believe that fluoroquinolones achieve more a rapid and effective control of UTI symptoms than trimethoprim-sulfamethoxazole or nitrofurantoin. Most providers were unfamiliar with fosfomycin as a possible first-line agent for the treatment of acute cystitis. PCPs may be misled by advanced patient age, diabetes, and recurrent UTIs to make inappropriate choices for the treatment of acute cystitis. For support in clinical decision making, few providers relied on guidelines, preferring instead to have decision support embedded in the electronic medical record. Knowing the PCPs’ knowledge gaps and preferred sources of information will guide the development of a primary care-specific antibiotic stewardship intervention for acute cystitis.

scholarly journals 1479. Clinical Efficacy and Safety Analysis Evaluating Oral Gepotidacin (GSK2140944) from a Phase IIa Study in the Treatment of Uncomplicated Urinary Tract Infections

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S539-S539
Author(s):  
J Scott Overcash ◽  
Etienne Dumont ◽  
Caroline R Perry ◽  
Courtney Tiffany ◽  
Nicole Scangarella-Oman ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Clinical Efficacy ◽  
Clinical Symptoms ◽  
Oral Treatment ◽  
Safety Data ◽  
Lower Abdominal Pain ◽  
Efficacy And Safety ◽  
Acute Cystitis ◽  
Tract Infections

Abstract Background Urinary tract infections (UTIs) are very common, with approximately 11% of women >18 years of age experiencing at least 1 episode of acute cystitis per year. Multidrug resistance, typically associated with nosocomial infections, has now emerged at the community level making treatment options for UTIs more difficult. Gepotidacin (GEP), a first-in-class, novel triazaacenaphthylene antibacterial has demonstrated in vitro activity against uropathogens including E. coli and provides high and sustained urine concentrations. It selectively inhibits bacterial DNA replication through a unique mechanism not utilized by any currently approved antibacterial. GEP presents an opportunity to address an unmet medical need and warrants study as a potential new and effective oral treatment for acute cystitis. Methods This Phase IIa single-center study was designed primarily to evaluate plasma and urine pharmacokinetics (PK) of gepotidacin in female participants with acute cystitis. Safety data and clinical and microbiological efficacy of gepotidacin were also assessed as secondary and exploratory endpoints. All participants received oral gepotidacin 1,500 mg BID for 5 days (total of 10 doses) during clinic confinement. Pretreatment and posttreatment PK collections were performed together with safety, efficacy, microbiological, and exploratory assessments throughout the study. Results Summary of Exploratory Endpoints (ITT Population). Clinical Efficacy: All subjects had significant improvement of clinical symptoms (dysuria, frequency, urgency, lower abdominal pain) within 24 to 48 hours of treatment. Most subjects, (20/22; 90.9%) achieved symptom resolution at test of cure (ToC) and follow-up (F/U). Microbiological eradication was achieved independent of baseline CFU’s (see microbiology abstract). Safety Endpoint: Most common AEs involved the GI tract (diarrhea (18/22 [82%] and nausea 17/22 [77%]). Per investigator observation, tolerance to nausea was observed with repeat dosing. No withdrawal due to AE. There were no clinically relevant trends in safety laboratories, ECG, or vital signs. Conclusion This first report of efficacy and safety in the treatment of acute cystitis supports further study of the clinical use of GEP in this indication. Disclosures All authors: No reported disclosures.

scholarly journals 1480. Plasma and Urine Pharmacokinetic Analysis of Gepotidacin (GSK2140944) Following BID Oral Dosing in a Phase IIa Study for Treatment of Uncomplicated Urinary Tract Infections

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S539-S540
Author(s):  
Eric I Zimmerman ◽  
Etienne Dumont ◽  
Caroline R Perry ◽  
Courtney Tiffany ◽  
Nicole Scangarella-Oman ◽  
...  
Keyword(s):  
Steady State ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Oral Treatment ◽  
Pharmacokinetic Analysis ◽  
Acute Cystitis ◽  
Oral Dosing ◽  
E Coli ◽  
Tract Infections ◽  
Free Plasma

Abstract Background Uncomplicated urinary tract infections (uUTIs) are very common, with approximately 11% of women >18 years of age experiencing at least 1 episode of acute cystitis per year [Foxman, 2000]. Multidrug resistance has now emerged at the community level and has made treatment approaches for UTIs more difficult [Hooton, 2012; Flamm, 2014; Sanchez, 2016]. Gepotidacin (GEP), a first-in-class, novel triazaacenaphthylene antibacterial has demonstrated in vitro activity against uropathogens, including E. coli. With its unique ability to selectively inhibit bacterial DNA replication by a means not utilized by any currently approved human therapeutic agent, GEP warrants further study as a potential opportunity to address an unmet medical need by providing a new and effective oral treatment option for acute cystitis. Methods All participants received oral GEP 1500 mg BID for 5 days (total of 10 doses) and PK sampling was performed on Days 1–5. Results GEP was rapidly absorbed with median Tmax values of 1.50 to 1.92 hours. Steady-state was attained by Day 3 with moderate accumulation in plasma following BID dosing (1.4 fold), which is consistent with an effective elimination half-life of 6.6 hours. Steady-state urine trough levels were high and remained above an MIC of 4 µg/mL over 12 hours. Approximately 20% of the dose was excreted in urine over the 12-hour dosing interval on Day 1, which increased to 31% on Day 4. Urinary AUC24hr (11945 µg hours/mL) was higher than the free plasma AUC24hr (39.4 µg hours/mL). Slightly higher GEP plasma and urine exposures were observed in uUTI patients compared with Phase I healthy subjects. Conclusion Oral dosing of 1500 mg BID produces urine GEP exposures that exceed free plasma exposures by ~300-fold. Urine concentrations were also higher than the GEP MIC90 values for common UTI pathogens, such as E. coli (MIC90 = 4 µg/mL), suggesting that GEP warrants further clinical study for the treatment of uUTI. Disclosures All authors: No reported disclosures.

scholarly journals 21st All-Russian Science Education Forum “Mother & Child”. Urinary tract infections in women: what a gynecologist needs to know? (Post-release)

2020 ◽  
Vol 3 (4) ◽  
pp. 282-289
Author(s):  
L.G. Spivak ◽  
◽  
A.V. Zaitsev ◽  
I.A. Apolikhina ◽  
L.A. Khodyreva ◽  
...  
Keyword(s):  
Science Education ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Round Table ◽  
Russian Science ◽  
Acute Cystitis ◽  
Medical Specialties ◽  
Active Implementation ◽  
Tract Infections ◽  
And Child Health

A round table on the topic “Urinary tract infections in women: what a gynecologist needs to know?” was organized within the framework of the 21st All-Russian Science Education Forum “Mother & Child” that was held on September 28–30, 2020, in Moscow. The speakers reported on an increasing incidence of urinary tract infections (UTIs), in particular, cystitis. This is accounted for by the lack of a common diagnostic and treatment approach to this disease among various medical specialties and self-medicating with randomly chosen or low-dose antibiotics. Current recommendations for the prescribing of medications to reduce the symptoms of acute cystitis are addressed. The increase in the prevalence of antibiotic resistance is highlighted. The development and more active implementation of the approaches avoiding the use of antibiotics to prevent UTI recurrences are required. KEYWORDS: cystitis, urinary tract infections, recommendations, immune prophylaxis, cranberry, D-mannose, vitamin D. FOR CITATION: 21st All-Russian Science Education Forum “Mother & Child”. Urinary tract infections in women: what a gynecologist needs to know? (Post-release). Russian Journal of Woman and Child Health. 2020;3(4):282–288. DOI: 10.32364/2618-8430-2020-3-4-282-289.

scholarly journals Effect of a Herbal Therapy on Clinical Symptoms of Acute Lower Uncomplicated Urinary Tract Infections in Women: Secondary Analysis from a Randomized Controlled Trial

Antibiotics ◽  
2019 ◽  
Vol 8 (4) ◽  
pp. 256
Author(s):  
Winfried Vahlensieck ◽  
Horst Lorenz ◽  
Anne Schumacher-Stimpfl ◽  
Roland Fischer ◽  
Kurt Naber
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Fixed Combination ◽  
Controlled Trial ◽  
Symptom Relief ◽  
Secondary Analysis ◽  
Herbal Preparation ◽  
Acute Cystitis ◽  
Randomized Controlled ◽  
Tract Infections

Background: Antibiotics are commonly used as first-line treatment for acute lower uncomplicated urinary tract infections (uUTIs). However, antimicrobial resistance is a growing global problem and efficacious nonantibiotic treatment options are urgently needed. Methods: A secondary analysis was conducted with data from a randomized, controlled, double-blind trial comparing a fixed combination of extracts of restharrow root, Java tea, and goldenrod herb (Aqualibra®) to placebo in 200 women with acute lower uUTI. Symptom scores reported in the original trial were reanalyzed and adjusted to the definitions of the Acute Cystitis Symptom Score (ACSS). Results: Based on a subgroup of patients with evaluable microbiologic data (n = 122), the decrease of the mean sum-score of three typical ACSS-adjusted symptoms showed significant superiority of the herbal preparation over placebo already after one day of treatment (p = 0.0086); on Day 7, the average difference was −1.9 score points (p < 0.0001). The superior efficacy of the herbal preparation on Day 1 was mainly driven by a difference in response rates of the symptom ‘dysuria’ (group difference: −29.4%, p = 0.0042). Furthermore, significantly fewer patients in the verum group required antibiotic therapy (15.3% vs. 49.2%, p = 0.0001). These results were confirmed in the intention-to-treat (ITT) population (n = 200). Conclusions: A fixed combination of extracts of restharrow root, Java tea, and goldenrod herb was superior to placebo regarding symptom relief and prevention of antibiotic use in women with lower uUTI. Trial registration: ClinicalTrials.gov: NCT04032574.

scholarly journals Urinary tract infections in culled sows from Greek herds: prevalence and associations between findings of histopathology, bacteriology and urinalysis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mihaela Cernat ◽  
Vassilis Skampardonis ◽  
Georgios A. Papadopoulos ◽  
Fotios Kroustallas ◽  
Sofia Chalvatzi ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Bladder ◽  
Urinary Tract Infections ◽  
Urine Ph ◽  
Urine Sediment ◽  
Acute Cystitis ◽  
Positive Urine ◽  
Unit Increase ◽  
Environmental Bacteria ◽  
Tract Infections

Abstract Background Urinary tract infections (UTI) of sows characterized by cystitis, which may progress to ureteritis and pyelonephritis, can affect their productivity, longevity and welfare. In this study, we determined the prevalence of UTI by histopathology and bacteriology. Furthermore, we investigated possible associations between histologically confirmed cystitis and the results of urinalysis and urine cultures in culled sows from three farrow-to-finish herds in Greece. Materials and methods One hundred eighty-five routinely culled sows were included in the study. Their urinary bladder was collected from abattoirs and subjected to histopathology. Furthermore, urinalysis and urine cultures were performed on urine samples aseptically collected from the bladders. Results Histologically confirmed cystitis was evident in 85/185 (45.94%) culled sows. Among those, 44 (51.76%) suffered from acute and 41 (48.24%) from chronic inflammation. The majority of positive urine cultures were due to colonization of the urinary tract with E.coli, which accounted for 55.81% of the total cases, followed by Staphylococcus spp. which accounted for 18.60% of detected infections. Evidence of cystitis was associated with bacteriuria and sows with bacteriuria were 2.30 (P = 0.03, 95% CI: 1.10–4.83) times more likely to have histologically confirmed cystitis compared to sows with negative urine cultures. Bacteriuria was associated with proteinuria (P < 0.01, OR = 9.72, 2.63–35.88), increased urine pH (P < 0.01, 3.40, 1.10–10.56) and presence of sediment (P < 0.01, 6.00, 1.50–23.76) in urine. Sows with proteinuria had 9.72 (P < 0.01, 2.63–35.88) times higher odds of bacteriuria than those without. Histologically defined cystitis was associated with proteinuria (P < 0.01, 2.03–13.20) and decreased urine pH (P < 0.01, 0.13–0.72). Sows with proteinuria were 5.18 (P < 0.01, 2.03–13.2) times more likely to have histological lesions consistent with cystitis, than those without. For one unit increase in pH, it was 3.20 (P = 0.006, 1.39–7.69) times less likely for a sow to have chronic or acute cystitis compared to absence of cystitis. Conclusion In the studied population, UTI affected almost one out of two culled sows. Bacteriuria, which was more common among sows with UTI than those without, was mainly ascribed to members of the intestinal and environmental bacteria. Proteinuria and the existence of urine sediment which were associated with UTI, could be used as proxy traits for UTI in live sows.

scholarly journals Susceptibility Trends of Urinary Tract Infections Over a 15 Year Period on a University Campus

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S346-S347
Author(s):  
Wesley Hoffmann ◽  
Monica Donnelley ◽  
Thomas Ferguson
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Acute Cystitis ◽  
E Coli ◽  
First Line Therapy ◽  
Time Period ◽  
Prescribing Trends ◽  
Tract Infections

Abstract Background Acute uncomplicated cystitis (AUC) is one of the most common infections for which antimicrobials are prescribed. Despite IDSA AUC guideline recommendations, prescribing practices are varied throughout the US. Per IDSA recommendations, nitrofurantoin (NTF), fosfomycin, and trimethoprim/sulfamethoxazole (TMP/SMX) are all considered first line therapy for AUC, however there is concern of resistance to some of these agents. Quality improvement activity at the University of California, Davis Student Health Center (UCDSHC) has made prescribing NTF preferred for acute cystitis since 2001 as TMP/SMX has community resistance rates of ~20%. Ciprofloxacin is the second line agent at UCDSHC. Methods UCDSHC reviewed all urine cultures and susceptibilities for clinical and epidemiologic purposes. Susceptibility results were gathered from the UCDSHC microbiology laboratory from 2001–2016. Prescribing data was obtained from UCDSHC under diagnosis codes consistent with cystitis or UTI to demonstrate antibiotic prescribing trends. Susceptibilities were evaluated over the 15-year time period (2001–2016). TMP/SMX, FQ’s, and NTF were the primary agents evaluated in this study. Results From 2001–2016, 3,831 E. coli and 296 S. saprophyticus isolates were evaluated, accounting for 88% of the total number of organisms. E. coli susceptibilities to NTF remained &gt;98% from 2001–2016. E. coli susceptibilities to FQ’s trended down from 99% in 2001 to 88% in 2016. E. coli susceptibilities to TMP/SMX remained stable around 80% from 2001–2016. S. saprophyticusremained highly susceptible to NTF, FQ’s, and TMP/SMX (95%, 97%, and 100% respectively at the end of the study period). In total, 12,298 prescriptions were written from 2008–20016. Eighty percent (9,875) were NTF and 17% (2,016) were FQ’s. The remaining 1% and 2% were TMP/SMX and ‘Other’, respectively. Conclusion After changes in prescribing practice in 2001, NTF was used in 80% of cystitis cases over 15 years and retained excellent activity against common urinary pathogens. FQ’s retained acceptable activity for empiric use for urinary tract infections, but susceptibilities trended down notably despite limited FQ use. TMP/SMX did not regain increased activity over the time period. Disclosures All authors: No reported disclosures.

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