Epidemiology, definition and treatment of complicated urinary tract infections

Wagenlehner, Florian M. E.; Johansen, Truls E. Bjerklund; Cai, Tommaso; Köves, B.; Kranz, Jennifer; Pilatz, Adrian; Tandoğdu, Zafer

doi:10.1038/s41585-020-0362-4

Cited by 186 publications

(184 citation statements)

References 102 publications

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“…Pyonephrosis (PN) refers to infected hydronephrosis with associated suppurative destruction of the kidney parenchyma, with partial or total loss of renal function, and it is defined as an accumulation of purulent debris and sediment in the renal pelvis and urinary collecting system. PN is associated with factors that compromise host defense, including immunosuppression, renal failure, renal transplantation [1,2], and it is associated with local factors that compromise the urinary tract, such as congenital uropathy, neurogenic bladder, pregnancy, presence of foreign bodies such as calculi, indwelling catheters or other drainage devices, or endoscopic maneuvers, and it is frequently associated with the obstruction of the collecting system (renal calculus disease, RCD) [2][3][4][5][6]. PN has also been reported in patients with urinary obstruction from tumors, such as in transitional cell carcinoma [7,8].…”

Section: Introductionmentioning

confidence: 99%

Pyonephrosis Ultrasound and Computed Tomography Features: A Pictorial Review

Tamburrini¹,

Lugarà²,

Iannuzzi³

et al. 2021

Diagnostics

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Urinary tract infections (UTIs) are the most frequent community-acquired and healthcare-associated bacterial infections. UTIs are heterogeneous and range from rather benign, uncomplicated infections to complicated UTIs (cUTIs), pyelonephritis and severe urosepsis, depending mostly on the host response. Ultrasound and computed tomography represent the imaging processes of choice in the diagnosis and staging of the pathology in emergency settings. The aim of this study is to describe the common ultrasound (US) and computed tomography (CT) features of pyonephrosis. US can make the diagnosis, demonstrating echogenic debris, fluid/fluid levels, and air in the collecting system. Although the diagnosis appears to be easily made with US, CT is necessary in non-diagnostic US examinations to confirm the diagnosis, to demonstrate the cause and moreover to stage the pathology, defining extrarenal complications. In emergency settings, US and CT are differently used in the diagnosis and staging of pyonephrosis.

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Section: Introductionmentioning

confidence: 99%

Pyonephrosis Ultrasound and Computed Tomography Features: A Pictorial Review

Tamburrini¹,

Lugarà²,

Iannuzzi³

et al. 2021

Diagnostics

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“…The cUTIs were defined as male with UTI, presence of anatomical abnormalities (obstruction, hydronephrosis, renalurinary tract calculi, etc. ), instrumentation-related UTIs, immunocompromised older adults, malignancy [16]. The patients were classified into the nonsurvivor group and the survivor group on the basis of all-cause mortality after visiting the ED.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of blood urea nitrogen and the neutrophil-to-lymphocyte ratio as predictors of mortality among elderly patients with genitourinary tract infections: A retrospective multicentre study

Park

Woo

Kim

et al. 2021

Journal of Infection and Chemotherapy

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Objectives: To investigate whether initial blood urea nitrogen (BUN) and the neutrophil-to-lymphocyte ratio (NLR) in the emergency department (ED) are associated with mortality in elderly patients with genitourinary tract infections. Methods: A total of 541 patients with genitourinary tract infections in 5 EDs between November 2016 and February 2017 were included and retrospectively reviewed. We assessed age, sex, comorbidities, vital signs, and initial laboratory results, including BUN, NLR and the SOFA criteria. The primary outcome was all-cause in-hospital mortality. Results: The nonsurvivor group included 32 (5.9%) elderly patients, and the mean arterial pressure (MAP), NLR and BUN were significantly higher in this group than in the survivor group (p < 0.001, p ¼ 0.003, p < 0.001). In multivariate analysis, MAP <70 mmHg, NLR 23.8 and BUN >28 mg/dl were shown to be independent risk factors for in-hospital mortality (OR 3.62, OR 2.51, OR 2.76: p ¼ 0.002, p ¼ 0.033, p ¼ 0.038, respectively). Additionally, NLR 23.8 and BUN >28 were shown to be independent risk factors for mortality in admitted elderly with complicated UTI (p ¼ 0.030, p ¼ 0.035). When BUN and NLR were combined with MAP, the area under the ROC curve (AUROC) value was 0.807 (0.771e0.839) for the prediction of mortality, the sensitivity was 87.5% (95% CI 71.0e96.5), and the specificity was 61.3% (95% CI 56.9e65.5%). Conclusion: The initial BUN and NLR values with the MAP were good predictors associated with all-cause in-hospital mortality among elderly genitourinary tract infections visiting the ED.

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“…Currently, urinary tract infections (UTIs) are seen as a global public health issue caused by E. coli strains and other bacteria including E. faecalis, Staphylococcus saprophyticus, Klebsiella, Citrobacter, Pseudomonas and Proteus mirabilis [46,47]. The high rates of occurrence of UTIs due to these pathogens and their increasing antibacterial resistance conducted to unfavorable outcomes, like complicated UTIs (cUTIs), pyelonephritis and severe urosepsis [48,49]. Thus, UTIs are infections needing the development of new therapeutic agents.…”

Section: Antibiotics and Bacteriocins Constitute Promising Synergistic Combinations For Medical Therapymentioning

confidence: 99%

Broadening and Enhancing Bacteriocins Activities by Association with Bioactive Substances

Zgheib

Drider

Belguesmia

2020

IJERPH

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Bacteriocins are antimicrobial peptides some of which are endowed with antiviral, anticancer and antibiofilm properties. These properties could be improved through synergistic interactions of these bacteriocins with other bioactive molecules such as antibiotics, phages, nanoparticles and essential oils. A number of studies are steadily reporting the effects of these combinations as new and potential therapeutic strategies in the future, as they may offer many incentives over existing therapies. In particular, bacteriocins can benefit from combination with nanoparticles which can improve their stability and solubility, and protect them from enzymatic degradation, reduce their interactions with other molecules and improve their bioavailability. Furthermore, the combination of bacteriocins with other antimicrobials is foreseen as a way to reduce the development of antibiotic resistance due to the involvement of several modes of action. Another relevant advantage of these synergistic combinations is that it decreases the concentration of each antimicrobial component, thereby reducing their side effects such as their toxicity. In addition, combination can extend the utility of bacteriocins as antiviral or anticancer agents. Thus, in this review, we report and discuss the synergistic effects of bacteriocin combinations as medicines, and also for other diverse applications including, antiviral, antispoilage, anticancer and antibiofilms.

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Epidemiology, definition and treatment of complicated urinary tract infections

Cited by 186 publications

References 102 publications

Pyonephrosis Ultrasound and Computed Tomography Features: A Pictorial Review

Pyonephrosis Ultrasound and Computed Tomography Features: A Pictorial Review

Efficacy of blood urea nitrogen and the neutrophil-to-lymphocyte ratio as predictors of mortality among elderly patients with genitourinary tract infections: A retrospective multicentre study

Broadening and Enhancing Bacteriocins Activities by Association with Bioactive Substances

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