Infección del tracto urinario causada por Enterobacteriaceae y su relación con reflujo vésico-ureteral en recién nacidos

Álvarez, Manuel Díaz; Batista, Bárbara Acosta; Córdova, Rodolfo Pérez; Robledo, Ernesto Hernández

doi:10.1016/j.bmhimx.2016.10.011

Cited by 6 publications

(2 citation statements)

References 30 publications

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“…Recurrent UTIs were identified in patients with vesical/subvesical malformation (PUV, ano-rectal malformation) or high-grade VUR and bilateral hydronephrosis in our study. Results are comparable with previous studies that proved lower urinary tract disorder (LUTD) and VUR as risk factors in developing recurrent UTIs [ 5 , 16 , 21 , 23 ].…”

Section: Discussionsupporting

confidence: 89%

“…Hydronephrosis was the most frequent defect in our study group (83.51%) caused by PUJO, UVJO, or VUR, the latter being confirmed in 28.57% of cases. In the literature, VUR was associated with an increased risk of non- E. coli UTI development [ 23 ]. In our study, it could not be established VUR as a risk factor for non- E. coli UTI ( t -test p = 0.31), although 45.75% of all UTIs occurred in patients with VUR.…”

Section: Discussionmentioning

confidence: 99%

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Antibiotic Resistance Patterns of Uropathogens Causing Urinary Tract Infections in Children with Congenital Anomalies of Kidney and Urinary Tract

Isac

Basaca²,

Olariu

et al. 2021

Children

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Background: Urinary tract infections (UTI) are common in children worldwide. Congenital anomalies of kidney and urinary tract (CAKUT) increase the risk of UTI and consequently antibiotic resistance. Antibiotic resistance represents an important public health issue worldwide. We aimed to evaluate the local trend in terms of bacterial uropathogen resistance in the western part of Romania in children with CAKUT and UTI. Methods: 252 children with CAKUT were admitted to our hospital over a five-year period. Of them, 91 developed at least one UTI episode, with a total number of 260 positive urine cultures. We collected data about age at diagnosis of CAKUT, sex, origin environment, type and side of CAKUT, number of UTIs, type of uropathogen, and uropathogens antibiotic resistance. Results: Distribution of uropathogens was Escherichia coli (38.84%), Klebsiella spp. (21.15%), Enterococcus spp. (15.76%), Proteus spp. (8.07%), Pseudomonas spp. (8.07%), Enterobacter spp. (2.3%), other Gram-negative bacteria (2.3%), and other Gram-positive bacteria (3.45%). High antibiotic resistance was detected for ampicillin, amoxicillin, and second-generation cephalosporins. Escherichia coli presented high resistance for cefepime and ceftriaxone. Pseudomonas spp. remained susceptible to amikacin, quinolones, and colistin. Vancomycin, teicoplanin, linezolid, and piperacillin/tazobactam remained effective in treating Gram-positive UTI. Conclusions: High antibiotic resistance was identified for frequently used antibiotics. Lower antibiotic resistance was observed for some broad-spectrum antibiotics. Understanding uropathogens’ antibiotic resistance is important in creating treatment recommendations, based on international guidelines, local resistance patterns, and patient particularities.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Antibiotic Resistance Patterns of Uropathogens Causing Urinary Tract Infections in Children with Congenital Anomalies of Kidney and Urinary Tract

Isac

Basaca²,

Olariu

et al. 2021

Children

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Low yield from imaging after non-E. coliurine tract infections in children treated in primary care and emergency department

et al. 2023

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BackgroundImaging is recommended for selected children following urinary tract infections (UTIs) to look for actionable structural abnormalities. Non-E. coliis considered high risk in many national guidelines, but evidence is mainly drawn from small cohorts from tertiary centres.ObjectiveTo ascertain imaging yield from infants and children <12 years diagnosed with their first confirmed UTI (pure single growth >1 00 000 cfu) in primary care or an emergency department without admission stratified by bacteria type.Design, setting, patientsData were collected from an administrative database of a UK citywide direct access UTI service between 2000 and 2021. Imaging policy mandated renal tract ultrasound and Technetium-99m dimercaptosuccinic acid scans in all children, plus micturating cystourethrogram in infants <12 months.Results7730 children (79% girls, 16% aged <1 year, 55% 1–4 years) underwent imaging after first UTI diagnosed by primary care (81%) or emergency department without admission (13%).E. coliUTI yielded abnormal kidney imaging in 8.9% (566/6384).Enterococcusand KPP (Klebsiella,Proteus,Pseudomonas) yielded 5.6% (42/749) and 5.0% (24/483) with relative risks 0.63 (95% CI 0.47 to 0.86) and 0.56 (0.38 to 0.83)), respectively. No difference was found when stratified by age banding or imaging modality.ConclusionIn this largest published group of infants and children diagnosed in primary and emergency care not requiring admission, non-E. coliUTI was not associated with a higher yield from renal tract imaging.

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Determinants of urinary tract infection in hospitalized patients with acute ischemic stroke

Jitpratoom¹,

Boonyasiri

2023

BMC Neurol

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Background Stroke is a major cause of morbidity and mortality worldwide. Urinary tract infection (UTI) is a common post-acute ischemic stroke (AIS) complication. We assessed the incidence, determinant factors, infection characteristics, post-stroke complications, and outcomes of hospitalized AIS patients with UTI. Methods This retrospective cohort study included AIS patients admitted within 7 days of stroke onset. The patients were divided into the UTI group and the non-UTI (control) group. Clinical data were collected and compared between the groups. Results There were 342 AIS patients (31 with UTIs and 311 controls). The multivariate analysis showed that an initial National Institutes of Health Stroke Scale (NIHSS) score of ≥ 15 (odds ratio [OR] 5.00, 95% confidence interval [CI] 1.33–18.72) and Foley catheter retention (OR 14.10, 95% CI 3.25–61.28) were risk factors for UTI, whereas smoking (OR 0.08, 95% CI 0.01–0.50), an initial systolic blood pressure (SBP) of > 120 mmHg (OR 0.06, 95% CI 0.01–0.31), and statin use (OR 0.02, 95% CI 0.0006–0.42) were protective factors. Twenty cases (64.5%) were community-acquired and 11 cases (35.3%) were hospital-acquired. Ten patients (32.3%) had catheter-associated UTIs. The most common pathogen was Escherichia coli (13 patients, 41.9%). Post-stroke complications were significantly more common in the UTI group, including pneumonia, respiratory failure, sepsis, brain edema, seizure, symptomatic hemorrhagic transformation, congestive heart failure, atrial fibrillation with a rapid ventricular response, acute kidney injury, and hyponatremia. The median length of stay (LOS) in the UTI group was 12 days versus 3 days in the control group (p < 0.001). The median 3-month modified Rankin Scale score was higher (5 in UTI and 2 in control; p < 0.001) and the median 3-month Barthel Index was lower (0 in UTI and 100 in control; p < 0.001) in the UTI group than in the control group. Conclusions The risk factors for post-AIS UTI included severe stroke (NIHSS score ≥ 15) and urethral catheter indwelling. An initial SBP of > 120 mmHg and statin use were protective factors. The UTI group had significantly worse post-stroke complications, a longer LOS, and worse 3-month outcomes. Smoking was protective, which requires further investigation.

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Infección del tracto urinario causada por Enterobacteriaceae y su relación con reflujo vésico-ureteral en recién nacidos

Cited by 6 publications

References 30 publications

Antibiotic Resistance Patterns of Uropathogens Causing Urinary Tract Infections in Children with Congenital Anomalies of Kidney and Urinary Tract

Antibiotic Resistance Patterns of Uropathogens Causing Urinary Tract Infections in Children with Congenital Anomalies of Kidney and Urinary Tract

Low yield from imaging after non-E. coliurine tract infections in children treated in primary care and emergency department

Determinants of urinary tract infection in hospitalized patients with acute ischemic stroke

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