scholarly journals Utility of the blood culture in infection of the urinary tract with fever in the elderly

2021 ◽  
Author(s):  
Elisa Álvarez Artero ◽  
Amaia Campo Núñez ◽  
Moisés Garcia Bravo ◽  
Inmaculada García García ◽  
Moncef Belhassen Garcia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urine Culture ◽  
Urinary Infection ◽  
The Elderly ◽  
Blood Cultures ◽  
Febrile Urinary Tract Infection ◽  
Urinary Infections ◽  
Tract Infections ◽  
Overall Mortality

Introduction. Urinary tract infections are one of the most common community infections. The diagnosis of urinary infections in the elderly is complex because of its presentation and clinic. The aim of this article is to evaluate the usefulness of blood cultures in febrile urinary tract infection in elderly patients, risk factors, causes of discordance between urine and blood cultures, usefulness of biomarkers and mortality. Material and methods. Observational study of patients admitted over 65 years old, with urinary infections. Results. A total of 216 episodes with urinary infections and blood cultures performed. 70 (32,4%) cases with bacteremia. The most frequently detected isolates in blood cultures were: Escherichia coli 50 (71,4%) and Proteus spp. 6 (8,5%). Only septic shock was associated with a higher frequency of bacteraemia (OR=2,93, IC 95: 1,0-8,5; p=0,04). In 26 of the blood cultures a different isolation of the urine culture was detected. Overall mortality was 9.1%, with no association with the presence of bacteremia (p>0. 05). Conclusions. One third of elderly people hospitalized by tract urinary infection had bacteremia. Their detection was not associated with overall mortality. Disagree between blood and urine cultures in febrile is frequent, especially in patients with recent antibiotic treatment or recently hospitalized.

scholarly journals A study of risk factors for bacteremia caused by urinary tract infections

2018 ◽  
Vol 9 (5) ◽  
pp. 25-30
Author(s):  
Muralidhar Varma ◽  
Sravan Kumar Peravali ◽  
Vandana KE ◽  
Asha Kamath ◽  
Rahul Singh
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Tertiary Care ◽  
Blood Cultures ◽  
Medical Sciences ◽  
E Coli ◽  
Tract Infections ◽  
Control Study

Background: Urinary tract infections are not only one of the most common infections, but also one of the most common sources of bacteremia in both the general population and hospitalized patients.Aims and Objectives: The objective of this study was to identify risk factors for bacteremia caused by urinary tract infections.Materials and Methods: This was a prospective case control study conducted from October 2012 to July 2014in a tertiary care teaching hospital in southern India. Urinary tract infections were diagnosed based on the CDC criteria.Patients witha set of blood cultures and urine culture isolating same organism were grouped as cases while patients with urine culture alone isolating organism with sterile blood cultures were identified as controls.Results: Out of the 198 patientsin the study, 66 were cases while 132 were controls. E coli was the most organism isolated (81% of cases and 66% of controls). Risk factors for bacteremia based on univariate and multivariate analysis were diabetes mellitus with uncontrolled sugars (univariate: p=0.001; OR=5.250 [2.044-13.582]; and multivariate: p=0.01; OR= 6.023 [1.52-23.51]) and pyelonephritis (univariate: p=0.001; OR=6.56 [2.87-1.48]; and multivariate: p=0.047; OR=4.95 [1.02-24.12]).Conclusion: Upper UTI and complicated UTI patients should be evaluated for bacteremia since prompt and targeted treatment may be required.Asian Journal of Medical Sciences Vol.9(5) 2018 25-30

scholarly journals Managing Recurrent Urinary Tract Infections in Women

2005 ◽  
Vol 1 (1) ◽  
pp. 39-50
Author(s):  
Lindsay E Nicolle
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Bacterial Infection ◽  
Postmenopausal Women ◽  
Urinary Tract Infections ◽  
Urinary Infection ◽  
Management Strategies ◽  
Recurrent Urinary Tract Infections ◽  
Urinary Infections ◽  
Tract Infections

Recurrent urinary infections are a common problem for women of all ages. Risk factors for urinary infection differ for pre- and postmenopausal women. Management strategies are well established, and include treatment of the acute symptomatic episode, and decreasing the frequency of subsequent episodes. This update focuses on the management of acute uncomplicated urinary infection, the most common bacterial infection in women.

scholarly journals Infeções Urinárias Causadas por Enterobacteriaceae Produtoras de β-Lactamases de Espetro Expandido Adquiridas na Comunidade num Hospital de Nível III - Um Estudo Retrospetivo

2020 ◽  
Vol 33 (7-8) ◽  
pp. 466
Author(s):  
Ana Simões ◽  
Margarida Lima ◽  
Ana Brett ◽  
Carolina Queiroz ◽  
Catarina Chaves ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Retrospective Study ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Urinary Infection ◽  
Proteus Vulgaris ◽  
Paediatric Hospital ◽  
Urinary Infections ◽  
Tract Infections

Introduction: The emergence of β-lactamases producing bacteria is a problem worldwide, with increasing importance in communityacquired infections, especially in urinary tract infections. Data regarding the use of non-carbapenem antimicrobials in these infections are scarce. The aim of this study was to analyse the treatment and outcome of urinary tract infections caused by community-acquired β-lactamase-producing bacteria in children.Material and Methods: Retrospective study performed in a level III paediatric hospital, between June 2007 and December 2017. All children with β-lactamase-producing Enterobacteriaceae identified in aseptically collected urine culture were included.Results: A total of 175 urinary infections caused by β-lactamases producing bacteria were diagnosed, 34 (19%) were community-acquired: 25 Escherichia coli (74%), 4 Klebsiella pneumoniae (12%), 4 Proteus mirabilis (12%) and 1 Proteus vulgaris (3%). In 30 (88%) cases, it was the first urinary infection. After identification of the microorganism and antimicrobial susceptibility, 33 (97%) children were re-evaluated and 24 (71%) had a repeat urine culture, which was positive in three (13%). In six (18%) cases, antibiotic treatment was modified. Four (12%) children had another UTI in the following month. In 30 (88%) children, imaging was carried out, with no nephrourological malformations detected.Discussion: In the last decade, about 20% of urinary infections caused by β-lactamase-producing Enterobacteriaceae were community-acquired with a relatively stable number of cases over the years. No nephro-urological malformations were identified in these children.Conclusion: Although the number of cases is small, the clinical and microbiological outcomes showed that most were successfully treated with non-carbapenem antibiotics, with low recurrence of new episodes of urinary tract infections.

scholarly journals Urinary infection in dogs with chronic kidney disease: aetiology and resistance

2019 ◽  
Vol 40 (6Supl3) ◽  
pp. 3741
Author(s):  
Ariane Martins Fernandes ◽  
Alessandra Tammy Hayakawa Ito de Sousa ◽  
Luciana Auxiliadora Viebrantz da Conceição ◽  
Felipe Gomes da Silva ◽  
Mayara Aparecida Araújo Cayuela ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Bacterial Resistance ◽  
Antimicrobial Agents ◽  
Urine Culture ◽  
Urinary Infection ◽  
Clinical Routine ◽  
Disease Aetiology ◽  
Tract Infections ◽  
And Control

Infections of the genitourinary system are among the most frequent in the clinical routine of small animals. Treatment with the most appropriate antimicrobial therapy, according to the uropathogen susceptibility test, can avoid the spread of bacterial resistance to antimicrobials. A clinical study was performed in 32 canines, of both sexes and differing ages, who attended the Veterinary Teaching Hospital. Urine samples underwent culture, with the objective of evaluating urinary tract infection in dogs with renal disease, identifying the associated bacterial pathogens, and verifying their antimicrobial susceptibility in vitro. Urine culture was positive in 10 dogs, mostly males, with no predisposition for breed, and a mean age of 8.28 years. Most of the urinary tract infections (UTIs) were monobacterial, with the most common microorganisms being Pseudomonas sp. and Staphylococcus sp. The antimicrobials imipenem and meropenem had the best overall sensitivity profile, and ampicillin showed the highest resistance. The variation in epidemiological profiles, and susceptibility to uropathogens, reinforces the importance of the veterinarian in the prevention and control of infection, in addition to the need for further research to identify new antimicrobial agents.

scholarly journals PREVALÊNCIA DE INFECÇÃO URINÁRIA E DE Actinomyces suis EM PORCAS GESTANTES E SUA CORRELAÇÃO COM ALGUNS PARÂMETROS FÍSICOS E QUÍMICOS DA URINA

2000 ◽  
Vol 5 (1) ◽  
Author(s):  
G.C. ALBERTON ◽  
P.R. WERNER ◽  
J. SOBESTIANSKY ◽  
O.D. COSTA ◽  
W. BARIONI JÚNIOR
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urinary Infection ◽  
Urine Samples ◽  
Chemical Parameters ◽  
Presumptive Diagnosis ◽  
Urinary Infections ◽  
Physical And Chemical Parameters ◽  
Tract Infections ◽  
Physical And Chemical

O presente trabalho teve como objetivo determinar a prevalência de infecção urinária e da bactéria Actinomyces suis na urina de 1745 porcas gestantes da região Sul do Brasil e correlacionar essa prevalência com parâmetros físicos e químicos da urina. A prevalência de infecção urinária e de A. suis foi de 28,31% e 20,63%, respectivamente. Observou-se correlação negativa entre infecção urinária e A. suis, ou seja, as porcas que apresentaram infecção urinária tinham menor prevalência de A. suis (13,67%) do que as que não a apresentaram (23,12%). Da mesma forma, as porcas portadoras de A. suis, tinham menor prevalência de infecção urinária (17,43%) do que as não portadoras (28,62%). Apenas 3,60% das porcas examinadas eram positivas para infecção urinária e A. suis simultaneamente. A cor predominante da urina foi a amarelo claro, tanto para as porcas portadoras ou não portadoras de infecção urinária ou de A. suis. Constatou-se a presença de turbidez em 83,15% das amostras, sendo que em 96,18% das amostras turvas observou-se a presença de cristais. Finalmente, a cor, aspecto, densidade, pH e presença de cristais, foram considerados como parâmetros sem valor para o diagnóstico presuntivo de infecção urinária em porcas gestantes. Prevalence of urinary tract infections and of Actinomyces suis in urine from pregnant sows. Correlation with some urine’s physical and chemical parameters Abstract A survey has been carried out in urine samples from 1745 pregnant sows from Southern Brazil, in regard to the prevalence of urinary infections and of Actinomyces suis and its correlation with some of the urine physical and chemical parameters. Prevalence of urinary infections was of 28.31% and that of A. suis, 20.63%. However, a negative correlation has been found between the incidence of urinary infection and the presence of A. suis, the prevalence of the latter being lower in sows which are positive for urinary infections (13.67%) than in those without urinary infection (23.12%). At the same time, sows positive for A. suis display a lesser number of urinary infection (17.43%) than those negative for the bacteria (28.62%). Only in 3.60% of the sows, urinary infection and A. suis occurred simultaneously. Due to the presence of crystals, turbidity was frequently observed in sow’s urine (83.15%). Crystals were present in 96.18% of sow’s turbid urine samples. Furthermore, color, turbidity, density, pH and the presence of crystals were not considered of value for the presumptive diagnosis of urinary tract infections in pregnant sows.

scholarly journals Risk factors and treatment of urinary tract infections in elderly people

2014 ◽  
Vol 67 (suppl. 2) ◽  
pp. 9-13
Author(s):  
Radoslava Doder ◽  
Jelena Polovina ◽  
Nadica Kovacevic ◽  
Sinisa Sevic ◽  
Tomislav Preveden ◽  
...  
Keyword(s):  
Risk Factors ◽  
Infectious Diseases ◽  
Asymptomatic Bacteriuria ◽  
The Elderly ◽  
Lumbar Region ◽  
Associated Diseases ◽  
Urinary Infections ◽  
Therapeutic Procedures ◽  
Tract Infections ◽  
Novi Sad

Introduction. The aim of the retrospective part of this research was to present the risk factors, etiology, clinical picture, therapy and outcome of urinary infections in elderly patients treated at the Department of Infectious Diseases in Novi Sad. The prospective part was aimed at establishing the most common risk factors for urinary infections among users in the Gerontology Center "Novi Sad? and determining the appropriate preventive measures by using an assessment questionnaire. Material and Methods. The retrospective research included 81 patients diagnosed with urinary infection. The patients were over 65 years of age and were treated at the Department of Infectious Diseases in the period from 2010 to September 2012. Within the prospective part of research, a poll was conducted among users of Gerontology Center ?Novi Sad? by applying an "Urination Disorder Test? questionnaire. Results. The average age of participants was 75.47 years (min 65, max 96, SD 6.86), and the female patients predominated in the patient population (F:M = 58%:42%). Associated diseases were recorded in 53 (65.4%) patients, and 24 (29.6%) of them had hypertension history. Escherichia coli were isolated in 12 (46.2%) patients. The majority of patients had preserved consciousness at admission whereas febrility and signs of intoxication were recorded in 60 (75.95%) and 33 (41.8%) patients, respectively. The patients reported the following problems: dysuria - 23 (29.1%) patients, pollakiuria - 9 (11.4%), suprapubic pain - 8 (10.1%) and pain in the lumbar region - 7 (8.9%) patients. Antibiotic therapy included ceftiaxone and ciprofloxacin, which were administered to 43 (56.6%) and 33 (43.3%) patients, respectively. Favorable disease outcome was recorded in 79 (97.5%) patients, whereas lethal outcome occurred in 2 (2.5%) patients and was associated with severe comorbidity. Frequent urinary infections, nocturia and incontinence, being the most frequent diseases among the users of Gerontology Center, were reported by 9 (22.5%), 25 (62.5%) and 16 (40%) users, respectively. The most frequent associated diseases were diabetes mellitus and therapeutic procedures on the prostate and bladder in 7 (17.5%) and stroke in 5 (12.5%) participants. Conclusion. Urinary infections in the elderly remain a highly challenging issue from both diagnostics and treatment standpoint. An update of guidelines to the relevant antimicrobial therapy is a prerequisite in order to decrease the uncritical administration of antibiotics in asymptomatic bacteriuria and to prevent the spreading of multiresistant organisms.

Urinary tract infections in older patients

2003 ◽  
Vol 13 (2) ◽  
pp. 119-127 ◽  
Author(s):  
WJ MacLennon
Keyword(s):  
Urinary Tract ◽  
Old Age ◽  
Urinary Tract Infections ◽  
B Lymphocyte ◽  
Cell Function ◽  
Urinary Infection ◽  
Bladder Control ◽  
Urinary Infections ◽  
Oestrogen Level ◽  
Tract Infections

Factors increasing the risk of urinary tract infections in old age include reduced T lymphocyte regulation, decreased B lymphocyte antibody synthesis, impaired killer T cell function and slowed neutrophil chemotaxis. More practical causes for a high incidence of urinary infections are multiple pathology and poor nutrition. In women, a low oestrogen level increases the intravaginal pH, resulting in the lactobacillus being replaced by a pathogenic agent. Faecal stasis may also increase the risk of a urinary infection. The presentation and severity of a urinary infection are affected by intercurrent disorders such as diabetes mellitus, poor bladder control, concurrent medication and cognitive impairment. Other relevant but less common disorders are bladder calculi and tumours. Common signs of pyouria in old age are urinary incontinence, anorexia, lethargy and confusion. The infection may even be asymptomatic and this is discussed later.

scholarly journals INFECÇÃO URINÁRIA: DO DIAGNÓSTICO AO TRATAMENTO

2013 ◽  
Vol 5 (1) ◽  
pp. 59-67
Author(s):  
Marcel Rangel ◽  
Yáscara Tressa ◽  
Sueli Schadeck Zago
Keyword(s):  
Urinary Tract ◽  
Urine Analysis ◽  
Urine Culture ◽  
The Elderly ◽  
Relevant Information ◽  
Microbial Colonization ◽  
Renal Diseases ◽  
Relieve Pain ◽  
Negative Urine Culture ◽  
Tract Infections

A urinary tract infection (UTI) is a common condition in all ages, from newborns to the elderly, being more frequent in females. This study aims to analyze the main causes of urinary tract infections, assessing its complications, its diagnostic tests and therapeutics. The UTI consists of microbial colonization of the urine that can develop into a tissue invasion of any structure of the urinary tract. Urine analysis is a simple cheap and easy to obtain thesample, yet provides relevant information on renal and urinary tract, as well as some extra-renal diseases, being considered a routine examination. Among the tests performed for confirmation and monitoring of urinary infection are reagent strips ("dipstick"), especially used to screen cases of suspected acute UTI. The downside would be the use of some medications that can alter the outcome of laboratory tests using pharmacological mechanisms, physical, chemical and metabolic, as being a very commonplace infection, people end up self-medicating in order to relieve pain and if there is no improvement in symptoms, only to decide later laboratory examination, thus controlling this interference plays an important role in our laboratory. After completion of the urine culture and getting a positive result, the antibiogram will be made to check the most effective drug. However due to this indiscriminate use, exams can end up suffering changes in the results and sometimes even a negative urine culture.

scholarly journals 5 Improving Diagnosis and Management of Urinary Tract Infections for Elderly Patients

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i1-i8
Author(s):  
L Al-makdase ◽  
P Ioannou ◽  
Z Y Tew ◽  
M Khan ◽  
M Debnath ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Elderly Population ◽  
Urine Culture ◽  
Asymptomatic Bacteriuria ◽  
Signs And Symptoms ◽  
The Elderly ◽  
Clinical Indication ◽  
Royal Infirmary ◽  
Urine Dipstick ◽  
Tract Infections

Abstract Introduction Diagnosis of urinary tract infection (UTI) in the elderly population is challenging as they commonly present with atypical signs and symptoms. Prevalence of asymptomatic bacteriuria in the elderly population is high. Hence, urine dipstick and urine culture are no longer diagnostic tests. UTI is over-diagnosed and overtreated in the elderly, resulting in poor antimicrobial stewardship. This project was carried out to assess and improve the current practices in the diagnosis and treatment of UTI in the Department of Medicine of the Elderly. Methods We reviewed current Scottish Intercollegiate Guidelines Network (SIGN) and National Institute for health and Care Excellence (NICE) guidelines on management of UTI and defined indications for performing urine dipstick and sending urine culture. We then collected and assessed data on all urine dipsticks performed, urine cultures sent, and use of antibiotics in treating UTI and asymptomatic bacteriuria in three Medicine of the Elderly wards in Aberdeen Royal Infirmary. We carried out intervention by means of presenting and discussing findings of Plan-Do-Study-Act (PDSA) cycles in departmental multi-disciplinary Quality Improvement (QI) meetings followed by educational sessions. Results Our baseline data showed 77% of urine dipsticks were performed without clinical indication and 18% of patients had urine cultures sent without clinical indication. After presenting our initial findings and carrying out an educational intervention session, 25% of patients had urine dipstick done without clinical indication, and 0% of patients had urine cultures sent without clinical indication. However, over the course of four subsequent PDSA cycles, practices in investigation of UTI fluctuated but were overall consistently better than the initial practice with further interventions. In all PDSA cycles, no patients were treated for asymptomatic bacteriuria. Conclusions Multidisciplinary team involvement in discussion of this QI project findings and educational sessions proved to be an effective form of intervention for improving current practice.

scholarly journals Urinary infection by Morganella morganii in a young dog affected by ectopic ureter

2016 ◽  
Vol 10 (3) ◽  
pp. 273
Author(s):  
Juliana De Abreu Pereira ◽  
Mário Mendes Bonci ◽  
Rita de Cássia Campbell Machado Botteon ◽  
Miliane Moreira Soares De Souza ◽  
Cristiano Chaves Pessoa Da Veiga ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Clinical Improvement ◽  
Clinical Medicine ◽  
Urinary Infection ◽  
Young Animal ◽  
Companion Animals ◽  
Ectopic Ureter ◽  
Morganella Morganii ◽  
Urinary Infections ◽  
Tract Infections

Urinary tract infections (UTI) are frequent diseases in the routine of clinical medicine of companion animals and bacterial cystitis is the most common cause of UTI in dogs and cats. The bad-formations of the urinary tract, as the ectopic ureter, may predispose the affected animals to recurrent urinary infections caused by the same or different pathogens. Morganella morganii is a bacterium with rare isolation from urinary infections in dogs, and it is considered an opportunistic agent in infectious processes, both in pets as in men. This report aimed to describe the clinical diagnosis, as microbiological diagnosis of this infrequent isolation of this microorganism in a young animal carrier of ectopic ureter. Despite of previous treatments of cystitis, the patient had no clinical improvement due to the lack of correction of the baseline cause, or ectopic ureter; which favored recurrent infections. Even being warned about the diseases and its aggravating, the owner left the treatment of the patient, despite the partial clinical improvement with antibiotic therapy according to the susceptibility profile. The results obtained in this case report confirm the importance of culture and sensitivity test for treatment of UTIs; and the search for baseline causes of infectious processes of the urinary tract. Although it’s rare isolation, Morganella morganii should be considered as an important causative agent of UTI in animals as in humans, since the anatomical deformities favor the rise of pathogens, especially Gram negative inhabitants of the gastrointestinal tract of animals.

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