The ability of prior urinary cultures results to predict future culture results in neurogenic bladder patients

Clark, Roderick; Welk, Blayne

doi:10.1002/nau.23713

Cited by 10 publications

(5 citation statements)

References 16 publications

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“…In cases of complicated UTIs, a retrospective cohort found that empiric treatment based on culture results in the last 6 months was an inappropriate choice only 23% of the time and empiric therapy based on no prior culture results was inappropriate in choice 67% of the time, where the odds ratio of accurate treatment was 6.9 (95% CI 2.7 to 17.1) if prior culture data were used and 9.8 (95% CI 2.2 to 43.1) if subsequent culture was the same species [47]. For neurogenic patients in a single-arm retrospective study [52], there was 56% correspondence with the same organism and for antibiotic sensitivity correspondence was 77.3% for ciprofloxacin, 78.5% for nitrofurantoin, and 75% for TMP-SMX. Therefore, we advocate that past cultures, if available between recently and up to 1 year ago, should be used to guide therapy chosen over telemedicine visits regarding UTIs.…”

Section: Predicting Susceptibility By Past Culture Resultsmentioning

confidence: 99%

“…Twenty-three contributed to the narrative summary and are cited in the paper. These included 2 RCTs [36,37], 13 nonrandomized comparative studies [6,8,[38][39][40][41][42][43][44][45][46][47][48], and 7 single group studies [49][50][51][52][53][54][55], and the remaining articles [5,7,39,41,43,46,50,53, included consensus documents, cost-effectiveness analyses, and narrative reviews. Of note, most of our literature review and review of expert opinion was in line with the International Guidelines from the Infectious Disease Society of America (IDSA) and European Society for Microbiology and Infectious Disease (ESMID) recommendations, including choice of antibiotic for first-line therapy [84].…”

Section: Empiric Treatment Of Utimentioning

confidence: 99%

“…& The symptoms of dysuria, worsening frequency or urgency, gross hematuria, and lack of vaginal symptoms are significantly predictive of the presence of a UTI [44,61]. & Prior culture results within the past year correctly correspond to subsequent cultures and sensitivities and thus should be used to guide empiric therapy, even in neurogenic bladder patients [47,48,52,62].…”

Section: Empiric Treatment Of Utimentioning

confidence: 99%

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A guide for urogynecologic patient care utilizing telemedicine during the COVID-19 pandemic: review of existing evidence

et al. 2020

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Introduction and hypothesis The COVID-19 pandemic and the desire to "flatten the curve" of transmission have significantly affected the way providers care for patients. Female Pelvic Medicine and Reconstructive Surgeons (FPMRS) must provide high quality of care through remote access such as telemedicine. No clear guidelines exist on the use of telemedicine in FPMRS. Using expedited literature review methodology, we provide guidance regarding management of common outpatient urogynecology scenarios during the pandemic. Methods We grouped FPMRS conditions into those in which virtual management differs from direct in-person visits and conditions in which treatment would emphasize behavioral and conservative counseling but not deviate from current management paradigms. We conducted expedited literature review on four topics (telemedicine in FPMRS, pessary management, urinary tract infections, urinary retention) and addressed four other topics (urinary incontinence, prolapse, fecal incontinence, defecatory dysfunction) based on existing systematic reviews and guidelines. We further compiled expert consensus regarding management of FPMRS patients in the virtual setting, scenarios when in-person visits are necessary, symptoms that should alert providers, and specific considerations for FPMRS patients with suspected or confirmed COVID-19. Results Behavioral, medical, and conservative management will be valuable as first-line virtual treatments. Certain situations will require different treatments in the virtual setting while others will require an in-person visit despite the risks of COVID-19 transmission.Conclusions We have presented guidance for treating FPMRS conditions via telemedicine based on rapid literature review and expert consensus and presented it in a format that can be actively referenced.

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Section: Predicting Susceptibility By Past Culture Resultsmentioning

confidence: 99%

Section: Empiric Treatment Of Utimentioning

confidence: 99%

Section: Empiric Treatment Of Utimentioning

confidence: 99%

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A guide for urogynecologic patient care utilizing telemedicine during the COVID-19 pandemic: review of existing evidence

et al. 2020

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“…The patientreported outcome of antibiotic treatment should be followed up, but repeated urine cultures are not indicated if symptoms have diminished or ceased. In individual patients with recurring symptoms, the history of previous bacterial cultures, resistance patterns and antibiotic treatments may be informative [29].…”

Section: Discussionmentioning

confidence: 99%

The Stockholm Spinal Cord Uro Study: 2. Urinary tract infections in a regional prevalence group: frequency, symptoms and treatment strategies

Farrelly

Lindbo

Wijkström

et al. 2020

Scandinavian Journal of Urology

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Objective: To examine symptomatic urinary tract infections (UTI) in a regional prevalence group of patients with traumatic spinal cord injury (SCI), to assess risk factors for recurring infections and to identify a high-risk sub-population for frequently recurring and severe febrile UTIs. Materials and Methods: Four hundred and twelve patients who attended a yearly checkup at the Spinalis SCI clinic were included. A regional programme for neurogenic bladder dysfunction was applied, including S-creatinine and S-cystatin-C, urine culture, residual urine, ultrasound of kidneys, urodynamic studies and a questionnaire regarding complications during the preceding year. Descriptive statistics and regression analysis were used to estimate risk factors. Results: Nearly half of all patients reported 1 UTI during the preceding year with a mean number of 3.6. Persons who use normal voiding had the lowest frequency, while those with catheter-assisted voiding reported the highest numbers. A subgroup of patients had more frequent and severe UTIs. They were characterized by a cervical or thoracic neurological level lesion and a more severe injury and the presence of SCI-related complications such as spasticity, neuropathic pain and autonomic dysreflexia. The most common signs and symptoms of UTI were smelly and cloudy urine, feelings of malaise and increased spasticity. Conclusions: Risk profiles for recurring and severe UTIs were catheter-assisted voiding, cervical or thoracic levels and more complete neurological lesions and the coexistence of other SCI-related complications. There is a need for an increased understanding of the special symptoms of UTI in this patient group and a strategy to avoid unspecific antibiotic treatment.

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Section: Empiric Treatment Of Utimentioning

confidence: 99%

A Guide for Urogynecologic Patient Care Utilizing Telemedicine During the COVID-19 Pandemic: Review of Existing Evidence

Grimes

Balk

Crisp

et al. 2020

Obstetrical &Amp; Gynecological Survey

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Introduction and hypothesisThe COVID-19 pandemic and the desire to "flatten the curve" of transmission have significantly affected the way providers care for patients. Female Pelvic Medicine and Reconstructive Surgeons (FPMRS) must provide high quality of care through remote access such as telemedicine. No clear guidelines exist on the use of telemedicine in FPMRS. Using expedited literature review methodology, we provide guidance regarding management of common outpatient urogynecology scenarios during the pandemic. Methods We grouped FPMRS conditions into those in which virtual management differs from direct in-person visits and conditions in which treatment would emphasize behavioral and conservative counseling but not deviate from current management paradigms. We conducted expedited literature review on four topics (telemedicine in FPMRS, pessary management, urinary tract infections, urinary retention) and addressed four other topics (urinary incontinence, prolapse, fecal incontinence, defecatory dysfunction) based on existing systematic reviews and guidelines. We further compiled expert consensus regarding management of FPMRS patients in the virtual setting, scenarios when in-person visits are necessary, symptoms that should alert providers, and specific considerations for FPMRS patients with suspected or confirmed COVID-19. Results Behavioral, medical, and conservative management will be valuable as first-line virtual treatments. Certain situations will require different treatments in the virtual setting while others will require an in-person visit despite the risks of COVID-19 transmission. Conclusions We have presented guidance for treating FPMRS conditions via telemedicine based on rapid literature review and expert consensus and presented it in a format that can be actively referenced.

show abstract

The ability of prior urinary cultures results to predict future culture results in neurogenic bladder patients

Cited by 10 publications

References 16 publications

A guide for urogynecologic patient care utilizing telemedicine during the COVID-19 pandemic: review of existing evidence

A guide for urogynecologic patient care utilizing telemedicine during the COVID-19 pandemic: review of existing evidence

The Stockholm Spinal Cord Uro Study: 2. Urinary tract infections in a regional prevalence group: frequency, symptoms and treatment strategies

A Guide for Urogynecologic Patient Care Utilizing Telemedicine During the COVID-19 Pandemic: Review of Existing Evidence

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