No abstract

It is challenging to provide with an exact frequency of UTIs. Both CAUTI and HAUTI frequency, pathogen spectrum and resistance rates vary according to geographical setting.

There is an urgent need for new strategies to reduce carbapenem consumption. Ceftazidime-avibactam was highly effective for empiric treatment of complicated urinary tract infection, including in patients with ceftazidime-nonsusceptible pathogens, and may offer an alternative to carbapenems in this setting.

No abstract

No abstract

Abbreviations & Acronyms aPTT = activated partial thromboplastin time ARDS = acute respiratory distress syndrome BLI = b-lactamase inhibitor HMGB1 = high-mobility group box 1 protein IL = interleukin INR = international normalized ratio MAP = mean arterial pressure PAF = platelet-activating factor PAMP = pathogen-associated molecular patterns PRR = pattern-recognition receptors SBP = systolic blood pressure SD = standard deviation SIRS = systemic inflammatory response syndrome TLR = Toll-like receptors TNF = tumor necrosis factor UTI = urinary tract infections WBC = white blood cells Abstract: Urosepsis is defined as sepsis caused by a urogenital tract infection. Urosepsis in adults comprises approximately 25% of all sepsis cases, and is in most cases due to complicated urinary tract infections. The urinary tract is the infection site of severe sepsis or septic shock in approximately 10-30% of cases. Severe sepsis and septic shock is a critical situation, with a reported mortality rate nowadays still ranging from 30% to 40%. Urosepsis is mainly a result of obstructed uropathy of the upper urinary tract, with ureterolithiasis being the most common cause. The complex pathogenesis of sepsis is initiated when pathogen or damage-associated molecular patterns recognized by pattern recognition receptors of the host innate immune system generate proinflammatory cytokines. A transition from the innate to the adaptive immune system follows until a T H2 anti-inflammatory response takes over, leading to immunosuppression. Treatment of urosepsis comprises four major aspects: (i) early diagnosis; (ii) early goal-directed therapy including optimal pharmacodynamic exposure to antimicrobials both in the plasma and in the urinary tract; (iii) identification and control of the complicating factor in the urinary tract; and (iv) specific sepsis therapy. Early adequate tissue oxygenation, adequate initial antibiotic therapy, and rapid identification and control of the septic focus in the urinary tract are critical steps in the successful management of a patient with urosepsis, which includes early imaging, and an optimal interdisciplinary approach encompassing emergency unit, urological and intensive-care medicine specialists.

Available data provide sufficient evidence that in men with alterations of the ejaculate, urogenital infections and inflammation have to be considered.

Our results indicate that recurrent UTIs have a significant impact on QoL of women in Europe.