Disease burden and long-term trends of urinary tract infections: A worldwide report

Yang, Xiaorong; Chen, Hui; Zheng, Yue; Qu, Sifeng; Wang, Hao; Fan, Yi

doi:10.3389/fpubh.2022.888205

Cited by 80 publications

(92 citation statements)

References 44 publications

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“…Urinary dysfunction was the most reported autonomic symptom in individuals with PD at every time-point, affecting 95–97% of patients over the 7-year period. Interestingly, 92–96% of HCs also reported symptoms within the urinary domain, suggesting that urinary symptoms are also common in healthy controls ( 22 ). However, mean SCOPA-AUT scores in the urinary domain at baseline were significantly higher in PD than controls, indicating greater dysfunction in PD.…”

Section: Discussionmentioning

confidence: 99%

The longitudinal progression of autonomic dysfunction in Parkinson's disease: A 7-year study

et al. 2023

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BackgroundAutonomic dysfunction, including gastrointestinal, cardiovascular, and urinary dysfunction, is often present in early Parkinson's Disease (PD). However, the knowledge of the longitudinal progression of these symptoms, and the connection between different autonomic domains, is limited. Furthermore, the relationship between the presence of autonomic symptoms in early-stage PD and olfactory dysfunction, a possible marker of central nervous system involvement, has not been fully investigated.ObjectivesWe aimed to investigate the occurrence and progression of autonomic dysfunction in recently diagnosed (< 2 years) untreated PD patients and determine any coexistence of symptoms in individual patients. We also investigated the relationship between autonomic symptoms, olfactory dysfunction, and motor impairment.MethodsData were obtained from the Parkinson's Progression Markers Initiative (PPMI) database. Autonomic dysfunction was measured using the Scales for Outcomes in Parkinson's Disease (SCOPA-AUT). Symptom frequency and mean scores over 7 years were determined. The simultaneous occurrence of different autonomic symptoms was also examined. Finally, the relationships between SCOPA-AUT scores, olfactory dysfunction, and motor impairment were investigated using the University of Pennsylvania Smell Identification Test (UPSIT) and the Movement Disorder Society—Unified Parkinson's Disease Rating Scale (MDS-UPDRS), respectively.ResultsFollow-up data were available for 7 years for 171 PD patients and for 5 years for 136 HCs. Mean SCOPA-AUT score increased significantly from baseline to the 7-year follow-up for each autonomic domain, except for female sexual dysfunction. Most patients reported three or more autonomic symptoms. Common clusters of symptoms were composed of combinations of gastrointestinal, urinary, thermoregulatory, and sexual dysfunction. At baseline, greater SCOPA-AUT total score was associated with lower UPSIT scores (r = −0.209, p = 0.006) and with greater total MDS-UDPRS III score (r = 0.218, p = 0.004).ConclusionsAutonomic dysfunction, often with coexistence of autonomic manifestations, is common in early PD and progressively worsens over the first 7 years of disease, suggesting that these symptoms should be addressed with appropriate treatments early in the disease. The association between greater autonomic dysfunction and greater olfactory impairment, coupled with the association with more severe motor scores at baseline, indicates that patients who show more severe autonomic dysfunction could also have more severe involvement of the central nervous system at the time of diagnosis.

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Section: Discussionmentioning

confidence: 99%

The longitudinal progression of autonomic dysfunction in Parkinson's disease: A 7-year study

et al. 2023

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“…Because of the risk of misuse of antimicrobials in URTIs, the proportion of URTI cases prescribed an antibiotic is a key WHO indicator of appropriate antibiotic use in health facilities 12. In addition, urinary tract infections (UTIs) are one of the leading causes of outpatient hospital visits and are associated with high antibiotic use and increased risk of AMR 15. Similar findings have been described in Uganda 16…”

Section: Introductionmentioning

confidence: 67%

Development and evaluation of a continuous quality improvement programme for antimicrobial stewardship in six hospitals in Uganda

Kiggundu,

Waswa,

Nakambale

et al. 2023

BMJ Open Qual

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BackgroundAppropriate antimicrobial use is essential for antimicrobial stewardship (AMS). Ugandan hospitals are making efforts to improve antibiotic use, but improvements have not been sufficiently documented and evaluated.MethodsSix Ugandan hospitals implemented AMS interventions between June 2019 and July 2022. We used the WHO AMS toolkit to set-up hospital AMS programmes and implemented interventions using continuous quality improvement (CQI) techniques and targeting conditions commonly associated with antibiotic misuse, that is, urinary tract infections (UTIs), upper respiratory tract infections (URTIs) and surgical antibiotic prophylaxis (SAP). The interventions included training, mentorship and provision of clinical guidelines to support clinical decision-making. Quarterly antibiotic use surveys were conducted.ResultsData were collected for 7037 patients diagnosed with UTIs. There was an increase in the proportion of patients receiving one antibiotic for the treatment of UTI from 48% during the pre-intervention to 73.2%, p<0.01. There was a 19.2% reduction in the number of antimicrobials per patient treated for UTI p<0.01. There was an increase in use of nitrofurantoin, the first-line drug for the management of UTI. There was an increase in the use of Access antibiotics for managing UTIs from 50.4% to 53.8%. The proportion of patients receiving no antimicrobials for URTI increased from 26.3% at pre-intervention compared with 53.4% at intervention phase, p<0.01. There was a 20.7% reduction in the mean number of antimicrobials per patient for URTI from the pre-intervention to the intervention phase, from 0.8 to 0.6, respectively, p<0.001 and reduction in the number of treatment days, p=0.0163. Among patients undergoing surgery, 49.5% (2212) received SAP during the pre-intervention versus 50.5% (2169) during the intervention.ConclusionsUsing CQI approaches to focus on specific causes of inappropriate antibiotic use led to desirable overall reductions in antibiotic use for URTI and UTI.

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“…In conclusion, the results of our study and the sequencing of increasing numbers of E. coli isolates reflect a paradigm shift in our understanding of pColV plasmids: from being confined to APEC and NMEC, to their dissemination within new STs or even new E. coli pathotypes. Given the ageing of the population and the increase in comorbidities and complex medical procedures such as the use of transplants or immunosuppressive drugs, the frequency and severity of UTIs is likely to increase [58].…”

Section: Hlyf and Pcolv Plasmid As Virulence And Antimicrobial Resist...mentioning

confidence: 99%

HlyF, an underestimated virulence factor of uropathogenicEscherichia coli

Chagneau

Payros

Goman

et al. 2023

Preprint

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Urinary tract infections (UTIs) are predominantly caused by uropathogenicEscherichia coli(UPEC). By analysing a representative collection of UPEC strains from community-acquired infections, we showed that 20 % of these strains had the ability to produce the protein HlyF. ThesehlyF+ UPEC strains were the most virulent, mostly responsible for pyelonephritis, often with bloodstream infections. Using a mouse model of UTI, we showed that HlyF was associated with the ability of UPEC to develop a urosepsis, with the presence of bacteria in the spleen and an exacerbated inflammatory response. In contrast to archetypical UPEC strains,hlyF+ UPEC strains are not restricted to phylogroup B2 and harbor a specific repertoire of virulence factors reflecting the fact that HlyF is encoded by conjugative ColV-like plasmids. These plasmids also carry antimicrobial resistance genes, which may facilitate their selection and spreading amongst people receiving antimicrobial therapy. Overall, our data suggest that HlyF is a virulence factor in UPEC and spreading of ColV-like plasmids encodinghlyFwarrants further investigation.

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Disease burden and long-term trends of urinary tract infections: A worldwide report

Cited by 80 publications

References 44 publications

The longitudinal progression of autonomic dysfunction in Parkinson's disease: A 7-year study

The longitudinal progression of autonomic dysfunction in Parkinson's disease: A 7-year study

Development and evaluation of a continuous quality improvement programme for antimicrobial stewardship in six hospitals in Uganda

HlyF, an underestimated virulence factor of uropathogenicEscherichia coli

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