scholarly journals Predictive Risk Factors of Urinary Tract Infection Following Semirigid Ureteroscopic Lithotripsy

2020 ◽  
Author(s):  
Mehmet Çağlar Çakıcı ◽  
Özgür Kazan ◽  
Ayberk İplikçi ◽  
Muhammet Çiçek ◽  
Özgür Efiloğlu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Infectious Complications ◽  
Ureteral Stones ◽  
P Value ◽  
Ureteroscopic Lithotripsy ◽  
Increased Risk ◽  
Predictive Risk ◽  
Tract Infections ◽  
Residual Fragments

INTRODUCTION: The aim of this study is to determine the frequency and predictive factors of postoperative UTI in patients who underwent URS regarding ureteral stones. METHODS: Data from 425 patients undergoing semi-rigid ureteroscopic lithotripsy between December 2015 and December 2019 at a single center were reviewed to detect factors predicting postoperative urinary tract infections. RESULTS: Of the 425 patients, 35 were infective (8.2%). Proximal ureteral stones were the majority in infective group (48.5%); distal ureteral stones were the majority in non-infective group (42.6%)(p=0.026). Stone number and stone size were also higher in the postoperative infective group (p<0.05). UTI history and preoperative DJS insertion were higher in Group 1 (p <0.001, p = 0.001, respectively). Multivariate regression analyses revealed that history of UTI (OR=5.513, 95% CI; 2.622–11.591, p value <0.001) and presence of residual fragments (OR=4.274, 95% CI; 1.892–9.657, p value <0.001) were independent risk factors for infectious complications after URS. DISCUSSION AND CONCLUSION: Even if URS is considered an innocuous procedure, the probability of postoperative infectious complications is far from negligible. Our results showed that the presence of UTI history and residual fragments were associated with an increased risk of subsequent UTI after URS. These infectious complications also have significant morbidity, mortality and expenditure if not treated timely. Therefore, to avoid this preventable complication, all variables should be reviewed and more careful.

scholarly journals A study of risk factors for catheter associated urinary tract infection

2018 ◽  
Vol 5 (2) ◽  
pp. 334 ◽  
Author(s):  
Leelakrishna P. ◽  
Karthik Rao B.
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Closed System ◽  
Univariate Analysis ◽  
Significant Risk ◽  
P Value ◽  
Indwelling Catheters ◽  
Increased Risk ◽  
Catheter Size ◽  
Tract Infections

Background: Catheter associated urinary tract infections (CAUTIs) are the most common causes of UTIs in postoperative cases. Many risk factors are associated with its incidence. The present study was conducted with the aim to determine the related risk factors and to identify the causative agents contributing to the urinary tract infection.Methods: This prospective study was conducted on 210 patients meeting the requirements of inclusion criteria during September 2012 to February 2014. Detailed history of the patients was recorded. Urine culture was done at different time intervals to identify the causative agent suggestive to CAUTI. Univariate analyses of the association of each variable with CAUTI and multivariable logistic regression were done to predict CAUTI outcome.Results: The mean age of study participants was 51.61 years. Among them 141 were males and 69 were female patients. On univariate analysis purpose for urine catheterization, place of catheterization, breach in the closed system of drainage, duration of catheterization, hemoglobin value less than 10, raised renal parameters with serum creatinine more than 1.5 were all significantly associated with development of CAUTI (p value 0.000). Sex of the patient (p value 0.279) and catheter size (p value 0.279) was not found to have a significant correlation with increased risk of CAUTI. On multivariate analysis, age, catheter size, diabetes, duration of catheterization, a breach in the closed system of catheter drainage  and sex were found to be the significant risk factors associated with CAUTI (p<0.05).Conclusion: An understanding of the risk factors in development of CAUTI, significantly helps in reducing the additional burden on the health care system. Measures such as shortening the duration of catheterization, strict control of diabetes and sterile precautions in insertion and maintenance of indwelling catheters can help in prevention CAUTI.

scholarly journals Urinary Tract Infection Caused By Enterococcus Spp: Risk Factors And Mortality. An Observational Study.

2020 ◽  
Author(s):  
Elisa Alvarez-Artero ◽  
Amaia Campo Nuñez ◽  
Inmaculada Garcia Garcia ◽  
Moises Garcia Bravo ◽  
Olia Cores ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Antimicrobial Treatment ◽  
Empiric Antibiotic Therapy ◽  
Enterococcus Spp ◽  
Empiric Antibiotic ◽  
Patients At Risk ◽  
Severe Comorbidity ◽  
Predictive Risk ◽  
Tract Infections

Abstract Background Urinary tract infections (UTIs) are frequently caused by Enterococcus spp. We aim to define the risk factors involved in UTIs caused by Enterococcus. Determine the overall mortality and predictive risk factors. Methods A retrospective in-patients study was conducted with bacteriemic UTIs caused by Enterococcus spp. We compared bacteriemic UTIs caused by Enterococcus spp. vs. a random sample of 100 in-patients with bacteriemic UTIs caused by others enterobacteria. Results We found 106 in-patients with UTIs caused by Enterococcus spp., 51 of whom had concomitant positive blood cultures. Distribution by species was: 83% E. faecalis and 17% E. faecium, with a Charlson comorbidity index of 5.9 ± 2.9. When we compared bacteriemic UTIs caused by Enterococcus spp. vs. bacteriemic UTIs caused by others enterobacteria we found the following independent predictors of bacteriemic UTI by Enterococcus: male sex with an OR of 6.1 (95%CI 2.3–16.1), uropathy with an OR of 4.1 (1.6–10.1), nosocomial infection with an OR of 3.8 (1.4–10.3), urinary cancer with an OR of 6.4 (1.3–30.3) and previous antimicrobial treatment with an OR of 18 (5.2–62.1). Overall, in-patient mortality was 16.5%, which was associated with a higher Sequential Organ Failure Assessment (SOFA) score (> 4), severe comorbidity such as immunosuppression, malignant hemopathy and nephrostomy, or Enterococcus faecium species and its pattern or resistance to ampicillin or vancomycin (p < 0.05). Appropriate empiric antibiotic therapy was not associated with a better prognosis (p > 0.05). Conclusions Enterococcus spp. is a frequent cause of complicated UTI by a profile of risk factors. High mortality secondary to a severe clinical setting and high comorbidity may be sufficient reasons for implementing empiric treatment of patients at risk, although we did not show a higher survival rate in patients with this treatment strategy.

scholarly journals Subcapsular renal hematoma in patients underwent upper ureteroscopic lithotripsy

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
Y M Kotb ◽  
M K Abdelfattah ◽  
I M Saleh
Keyword(s):  
Risk Factors ◽  
Controlled Trial ◽  
Elevated Serum ◽  
Ureteral Stones ◽  
Ureteric Stone ◽  
Ureteroscopic Lithotripsy ◽  
Intravenous Contrast ◽  
Subcapsular Hematoma ◽  
Increased Risk ◽  
High Index Of Suspicion

Abstract Objective to demonstrate the risk factors of developing subcapsular renal hematoma ( SRH) in patients who underwent ureteroscopic lithotripsy for upper ureteric stones. Materials and Methods In a randomized controlled trial, 60 patients with an upper ureteric stone underwent URS lithotripsy either by laser or pneumatic. The inclusion criteria were age above 14 years old, of both sexes with an upper ureteric stone about 2 cm in diameter. Exclusion criteria were age below 14 years old, elevated serum creatinine level, patients with coagulopathies and pregnancy. The perioperative and postoperative outcomes were evaluated and postoperative pelvi-abdominal CT with intravenous contrast was done to detect if a subcapsular hematoma has been developed. Results There is no significant association between the formation of subcapsular renal hematoma and degree of hydronephrosis, chronic kidney disease (CKD), body mass index (BMI), diabetes mellitus (DM), hypertension (HTN) and preoperative bacteriuria as risk factors. Conclusions Subcapsular hematoma post-ureteroscopic lithotripsy (URSL) for impacted upper ureteric stones is a rare but potentially serious complication. A high index of suspicion is needed when patients present with significant loin pain and fever after ureteroscopic lithotripsy for obstructing proximal ureteral stones with thin renal cortices. Stone size, degree of hydronephrosis, operation duration, and perfusion pressure of hydraulic irrigation were associated with an increased risk of SRH formation. Management of post-URSL subcapsular hematomas needs to be customized for each patient.

Predictive risk factors of urinary tract infection following flexible ureteroscopy despite preoperative precautions to avoid infectious complications

2019 ◽  
Vol 38 (5) ◽  
pp. 1253-1259 ◽  
Author(s):  
Michael Baboudjian ◽  
Bastien Gondran-Tellier ◽  
Rony Abdallah ◽  
Pierre Clement Sichez ◽  
Akram Akiki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Infectious Complications ◽  
Flexible Ureteroscopy ◽  
Predictive Risk

Urinary tract infection caused by enterococcus spp: risk factors and mortality.

2019 ◽  
Author(s):  
Elisa Alvarez Artero ◽  
Amaia Campo ◽  
Inmaculada Garcia Garcia ◽  
Moises Garcia Bravo ◽  
Olaia Cores ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Antimicrobial Treatment ◽  
Empiric Antibiotic Therapy ◽  
Enterococcus Spp ◽  
Empiric Antibiotic ◽  
Patients At Risk ◽  
Severe Comorbidity ◽  
Predictive Risk ◽  
Tract Infections

Abstract Purpose: Complicated urinary tract infections (UTIs) are frequently caused by Enterococcus spp. We aim to define the risk factors involved in UTIs caused by Enterococcus. Determine the overall mortality and predictive risk factors.Methods: A retrospective study was conducted. We compared the results with those of a random sample of patients with complicated UTIs infection caused by Escherichia coli.Results: We found 106 in-patients with UTIs caused by Enterococcus spp., 56 of whom had positive blood cultures. Distribution by species: 83% E. faecalis and 17% E. faecium, with a Charlson comorbidity index of 5.9±2.9. Only male sex with an OR of 2.8 (95%CI 1.2-6.4), nosocomial infection with an OR of 2.8 (95%CI 1.1-7), urinary catheter with an OR of 4.5 (95%CI 1.8-11.3), urinary cancer with an OR of 6.4 (2.1-19.4), and previous antimicrobial treatment with an OR of 4.3 (1.8-10.2) were independent predictors of Enterococcus infection. Overall, in-patient mortality was 16.5%, which was associated with a higher Sequential Organ Failure Assessment (SOFA) score (>4), severe comorbidity such as immunosuppression, malignant hemopathy and nephrostomy, or Enterococcus faecium species and its pattern or resistance to ampicillin or vancomycin (p<0.05). Appropriate empiric antibiotic therapy was not associated with a better prognosis (p >0.05).Conclusions: Enterococcus spp. is a frequent cause of complicated UTI by a profile of risk factors. High mortality secondary to a severe clinical setting and high comorbidity may be sufficient reasons for implementing empiric treatment of patients at risk, although we did not show a higher survival rate in patients with this treatment strategy.

Bariatric Surgery and Perioperative Infections

2018 ◽  
Author(s):  
Mohammad Alsulaimy ◽  
Seyed Mohammad Kalantar Motamedi
Keyword(s):  
Bariatric Surgery ◽  
Urinary Tract ◽  
Respiratory Infections ◽  
Operative Procedure ◽  
Surgical Site Infections ◽  
Infectious Complications ◽  
Obese Patients ◽  
Preventative Measures ◽  
Increased Risk ◽  
Tract Infections

Morbid obesity is associated with an increased risk of infectious complications including surgical site, urinary tract, and pulmonary infections. Surgical site infections (SSI) are the most common, followed by urinary and respiratory infections. Various risk factors in obese patients including impaired immunity, and altered pulmonary and circulatory systems contribute to the increased susceptibility of morbid obese patients to infectious complications. Perioperative infections are defined to occur within 30 days of the initial operative procedure. Surgical site and urinary tract infections usually occur within 7–10 days post-operatively. Therefore, it is recommended that patients should be followed up between 7 to 10 days post-op to examine surgical sites, and to screen for possible urinary tract symptoms. This chapter will discuss the diagnosis, treatment, and possible preventative measures of the aforementioned infectious complications in the bariatric surgery population.

scholarly journals Risk factors for acquisition of multidrug-resistant Escherichia coli and development of community-acquired urinary tract infections

2017 ◽  
Vol 146 (1) ◽  
pp. 46-57 ◽  
Author(s):  
U. V. UKAH ◽  
M. GLASS ◽  
B. AVERY ◽  
D. DAIGNAULT ◽  
M. R. MULVEY ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Urinary Tract ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Health Concern ◽  
Drug Resistant ◽  
E Coli ◽  
Increased Risk ◽  
Tract Infections

SUMMARYWe examined risk factors associated with the intestinal acquisition of antimicrobial-resistant extraintestinal pathogenic Escherichia coli (ExPEC) and development of community-acquired urinary tract infection (UTI) in a case-control study of young women across Canada. A total of 399 women were recruited; 164 women had a UTI caused by E. coli resistant to ⩾1 antimicrobial classes and 98 had a UTI caused by E. coli resistant to ⩾3 antimicrobial classes. After adjustment for age, student health service (region of Canada) and either prior antibiotic use or UTI history, consumption of processed or ground chicken, cooked or raw shellfish, street foods and any organic fruit; as well as, contact with chickens, dogs and pet treats; and travel to Asia, were associated with an increased risk of UTI caused by antimicrobial resistant E. coli. A decreased risk of antimicrobial resistant UTI was associated with consumption of apples, nectarines, peppers, fresh herbs, peanuts and cooked beef. Drug-resistant UTI linked to foodborne and environmental exposures may be a significant public health concern and understanding the risk factors for intestinal acquisition of existing or newly emerging lineages of drug-resistant ExPEC is important for epidemiology, antimicrobial stewardship and prevention efforts.

Comparative Study between Tadalafil versus Tamsulosin versus Halphabarol with Terpenes Mixture as a Medical Expulsive Therapy for Lower Ureteric Stones

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
K A H Teama ◽  
A Y K Abdelsalam ◽  
M E A Elmenyawee
Keyword(s):  
Urinary Tract ◽  
Side Effects ◽  
Comparative Study ◽  
Ureteral Stones ◽  
P Value ◽  
Expulsion Rate ◽  
Once Daily ◽  
Medical Expulsive Therapy ◽  
Tract Infections

Abstract Background urolithiasis is a health problem of worldwide importance. Urolithiasis is the third most common urological disease affecting the urinary tract after urinary tract infections and prostatic diseases. Ureteral stones account for 20% of urolithiasis, and 70% of ureteral stones are located in the lower third of the ureter. Ureteric stones have great bearing on the health as well as quality of life of the patient. Aim of the Study to compare the efficacy of tadalafil (a phosphodiesterase-5 inhibitor), tamsulosin (an alpha-1blocker) and halphabarol (Proximol) with terpenes mixture (Rowatinex) as a medical expulsive therapy for lower ureteric stones. Patients and Methods this was a prospective randomized comparative study conducted on 60 patients between the ages of 20 and 40 years and complaining of unilateral single lower ureteric stone less than or equal to 8 mm presented through the outpatient clinics of Urology in Ain Shams University Hospitals and Damanhour Medical National Institute over a period of 10 months (from November 2017 to August 2018). The patients were randomly divided into 3 equal groups: Group A (20 patients were treated by tadalafil 5 mg once daily), Group B (20 patients were treated by tamsulosin 0.4 mg once daily) and Group C (20 patients were treated by Proximol with Rowatinex three times daily). Therapy was given for a maximum of 3 weeks. The patients were followed-up until stone passage or the end of the study period. Results the results of this study indicate that the stone expulsion rate was significantly higher in tadalafil group and tamsulosin group than Proximol with Rowatinex group (75% vs. 75% vs. 40%, P value = 0.030). Also, the mean stone expulsion time was significantly shorter in tadalafil group and tamsulosin group than Proximol with Rowatinex group (10.20 ± 3.91 days vs. 10.80 ± 3.64 days vs. 14.25 ± 3.28 days, P value = 0.046). The number of patients who experienced renal colic episodes, the number of colic episodes and the number of injectable analgesic uses were significantly lower in tadalafil group and tamsulosin group than Proximol with Rowatinex group (P value &lt; 0.05). The number of follow up ureteroscopic procedures was significantly lower in tadalafil group and tamsulosin group than Proximol with Rowatinex group (25% vs. 25% vs. 60%, P value = 0.030). Also, the drugs are safe with mild few side effects. Conclusion PDE5 inhibitors (tadalafil) are equally efficacious to alpha-1 adrenergic antagonists (tamsulosin) in expulsion of lower ureteric stones less than or equal to 8 mm without any serious side effects. Comparing to Proximol with Rowatinex, both tadalafil and tamsulosin increase significantly the stone expulsion rate, decrease significantly the stone expulsion time and provide significant control of renal colicky pain, significantly less analgesic requirements and significantly lower follow up ureteroscopic procedures.

Assessing known/common risk factors for urinary tract infections to which pupils are exposed to at Ndola primary school:cross section study (Preprint)

2019 ◽  
Author(s):  
Jotham Chibwaya
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Urinary Tract ◽  
Primary School ◽  
Urinary Tract Infections ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Common Risk Factors ◽  
Tract Infections

BACKGROUND : Urinary tract infection is an infection of any part of the urinary system starting from the kidneys up to the urethra. It is a common infection with a prevalence of about 33%. If left unattended to urinary tract infections can lead to serious complications. The objective of the study was to assess which of the known risk factors for urinary tract infections are more common among pupils at Ndola Primary School and also assess which age group and sex have more risks. OBJECTIVE Assessing known/common risk factors for urinary tract infections METHODS : The study was a cross-sectional study and targeted primary school pupils aged between 7 and 12 years of age. Simple semi-structured questionnaires and a data collection form were used to collect data. The study also reviewed what other studies regarding urinary tract infections have found in other regions of Africa and a few from outside Africa then compared them to our findings RESULTS : Findings revealed that Lack of deworming was the commonest risk factor amongst pupils with a prevalence of 84%. The least common risk factor is lack of circumcision among boys 37.1%. Ignoring the urge to void had a prevalence of 72.1% while inadequate water intake, constipation and wiping from back to front had 71.2%, 66.9% and 63.9, respectively. The study also revealed that there was no association between age/sex and the risk factors for urinary tract infections except voiding which had a P value of 0.045. Furthermore, water and sanitation conditions existing at the school are very poor and below standard. Pupil toilet ratio is 1:166 and 1:191 for boys and girls, respectively CONCLUSIONS The study showed that most pupils are exposed to the risks factors for urinary tract infections with the commonest risk being lack of deworming and the least being lack of circumcision. There is great need to enhance efforts to improve sensitization by coming up with strategies to reach as many pupils as possible and organize workshops and training programs to assist teachers involved in health education in schools. The number of toilets should be increased to improve hygiene conditions existing at the school.

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