Complicated urinary tract infections associated with diabetes mellitus: Pathogenesis, diagnosis and management

Abstract

Diabetes mellitus has a number of long-term effects on the genitourinary system. These effects predispose to bacterial urinary tract infections (UTIs) in the patient with diabetes mellitus. Complicated UTIs are also common and potentially life-threatening conditions. They include emphysematous pyelonephritis, emphysematous pyelitis/cystitis, xanthogranulomatous pyelonephritis, renal/perirenal abscess, and renal papillary necrosis. Improved outcomes of these entities may be achieved by early diagnosis, knowledge of common predisposing factors, appropriate clinical and radiological assessment, and prompt management. Herein we review complicated UTIs associated with diabetes mellitus in terms of pathogenesis, clinical manifestations, radiological features, and current management options.

Renal and perinephric abscesses in West China Hospital: 10-year retrospective-descriptive study

“…Consistent with previous studies, lithiasis (48.0%) and diabetes mellitus (33.7%) remained the pre dominant risk factors in the present study [3,8,9,12,16,22] . Diabetes mellitus accounts for 33.3%62.5% of all PNAs [2,7,23] 43.5%47% of RAs [7,16,17] and 28%50%…”

“…A similar result was found in the present study. A slight predominance in Table 5 The antibiotic resistance rate of causative pathogens isolated pain, flank mass, signs of sepsis, weight loss, fistula formation and urinary tract complaints [2,4,15,22] . However, patients with RA were more likely subjected to lethargy in this study.…”

“…Diagnosis of RA or PNA remains challenging because the symptoms can be insidious and obscure [1,2] . Patients with RA may present with fever, chills, flank or abdo minal pain, fatigue, nausea, decreased appetite, weight loss and even persistent hiccups [7,21,22] . In our study, fever was not always accompanied by chills and the high percentage of absent/lowgrade fever might be explained by prior antibiotic therapy.…”

Mass spectrometry and associated technologies delineate the advantageously biomedical capacity of siderophores in different pathogenic contexts

“…Siderophores have been observed to have higher expression in patients with acute pyelonephritis (Kashani & Eliott, 2013;Vandevelde & Stepanovic, 2014). IroA and IroN are receptors identified for iron uptake, and IroN is an important siderophore receptor in virulence formation of urinary tract infections (UTI) (Kamoun et al, 2013;Saleem & Shah, 2017). A recent study showed that Ent-Cipro, a synthetic siderophore-antibiotic conjugate based on the native Ent (enterobactin, a kind of siderophore) platform affords targeted antibacterial activity against Escherichia coli strains that express the pathogen-associated IroA gene cluster (Neumann et al, 2018).…”

Ultrasound Contribution to the Diagnosis of Emphysematous Cystitis

“…Most of times it is a urinary infection outcome attended with delay. Diabetes and urinary tract obstructions are risk factors [2]. The bacteria that are more commonly identified are Escherichia coli and Klebsiella pneumoniae.…”