The Global Prevalence of Infections in Urology Study: A Long-Term, Worldwide Surveillance Study on Urological Infections

Wagenlehner, Florian M. E.; Tandoğdu, Zafer; Bartoletti, Riccardo; Cai, Tommaso; Çek, Mete; Kulchavenya, Ekaterina; Köves, Béla; Naber, Kurt G.; Перепанова, Т С; Tenke, Péter; Wullt, Björn; Bogenhard, Florian; Johansen, Truls E. Bjerklund

doi:10.3390/pathogens5010010

Cited by 79 publications

(53 citation statements)

References 10 publications

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“…The global prevalence of UTI/HAI in Europe was 10% [5]. The study Global Prevalence of Infections in Urology analysed 70 countries registering HAI/UTI global incidence of 9.4% [7, 8]. …”

Section: Discussionmentioning

confidence: 99%

Healthcare-Associated Infections after Lower Urinary Tract Endoscopic Surgery: Analysis of Risk Factors, Associated Microorganisms and Patterns of Antibiotic Resistance

et al. 2018

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Objectives: To review the incidence of healthcare-associated infections/urinary tract infection (UTI), risk factors, microorganisms isolated and antibiotic resistances in patients who underwent lower urinary tract endoscopic surgery (LUTES) in a tertiary care hospital. Methods: A prospective observational study was carried out including 1,498 patients who undergo LUTES. Patients with and without UTI after surgery were compared. We analysed infection incidence, risk factors, microorganisms isolated and antibiotic resistances. Results: Postoperative UTI incidence was 4.7%. Risk factors found: higher American Society of Anesthesiologists classification (OR 2.82; 95% CI 1.8–4.5; p < 0.00), immunosuppression (OR 2.89; 95% CI 1.2–7.2; p = 0.01), indwelling urinary catheter prior admission (OR 2.6; 95% CI 1.6–4.2; p < 0.00) and postoperative catheterization longer than 2 days (OR 1.74; 95% CI 1.7–4.3; p < 0.00). Transurethral resection of the bladder (TURB) had the highest infection rates (5.5%). Microorganisms isolated were Pseudomonas aeruginosa (23.5%), Escherichia coli (17.6%), Klebsiella pneumoniae and Enterococcus spp (11.8%). Resistance rates for flourquinolones varied between 28 and 80%, and Carbapenem-resistant Enterobacteriaceae rose up 20%. Conclusions: Low percentage of UTI after endoscopic surgery was registered. TURB was the procedure with highest infection rate. Pseudomonas aeruginosa stands out as the most frequently isolated microorganism. Patient comorbidities, previous urinary catheter and postoperative catheter were identified as risk factors.

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“…The global prevalence of UTI/HAI in Europe was 10% [5]. The study Global Prevalence of Infections in Urology analysed 70 countries registering HAI/UTI global incidence of 9.4% [7, 8]. …”

Section: Discussionmentioning

confidence: 99%

Healthcare-Associated Infections after Lower Urinary Tract Endoscopic Surgery: Analysis of Risk Factors, Associated Microorganisms and Patterns of Antibiotic Resistance

et al. 2018

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“…Urinary tract infection (UTI) is a common infectious disease for in-and outpatients worldwide. [14]. Treatment guidelines distinguish between a lower and upper urinary tract infection, as this determines the choice of antibiotic treatment [15,16].…”

Section: Urinary Tract Infectionmentioning

confidence: 99%

A clinical decision support system improves antibiotic therapy for upper urinary tract infection in a randomized single-blinded study

Neugebauer

Ebert

Vogelmann

2020

BMC Health Serv Res

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Background: Due to increasing bacterial resistance rates choosing a correct empiric antibiotic therapy is getting more and more complex. Often medical doctors use information tools to make the right treatment choice. Methods: One hundred sixty six participants (77 medical doctors and 89 medical students) were asked to provide a diagnosis and antibiotic therapy in a simple fictive paper case of upper urinary tract infection (UTI) in a randomized single-blinded study. Participants were randomized to one of four information tools they were allowed to use in the study or control: 1. free internet access, 2. pharmaceutical pocket guide, 3. pocket guide antibiotic therapy, 4. clinical decision support system (CDSS), and control (no information tool). The CDSS was designed for the study. The adherence to the national German UTI guideline was evaluated.Results: Only 27.1% (n = 45/166) provided a correct diagnosis of upper UTI and 19.4% (n = 32/166) an antibiotic treatment recommended by national German treatment guidelines indicating their need for information tools. This result was not significantly different between medical doctors and medical students, residents and medical specialists or level of working experience. Using CDSS improved results significantly compared to conventional tools (diagnosis 57.1%; treatment recommendation 40.5%; p < 0,01). Processing time was not different between the use of CDSS and conventional information tools. CDSS users based their decision making on their assigned information tool more than users of conventional tools (73.8% vs. 48.0%; p < 0.01). Using CDSS improved the confidence of participants in their recommendation significantly compared to conventional tools (p < 0.01). Conclusions: Our study suggests that medical professionals require information tools in diagnosing and treating a simple case of upper UTI correctly. CDSS appears to be superior to conventional tools as an information source.

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“…For clinicians, it is essential to know the most common etiological agents for UTI and antibiotic resistance rates in the related geographical area, since resistance rates in different geographical regions can vary [4]. Uropathogens do not respect geographical borders, which has resulted in increasing global antimicrobial resistance to pathogens [5].…”

Section: Introductionmentioning

confidence: 99%

Changes in Antimicrobial Resistance of Urinary Tract Infections in Adult Patients over a 5-Year Period

et al. 2020

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Objectives: We aimed to determine the most common bac teria that cause urinary tract infections (UTIs), the rate of an tibiotic resistance of these uropathogens, and the changes in resistance rates over the years for adult patients diag nosed with UTIs. Methods: We retrospectively reviewed urine cultures and antibiotic susceptibility results of patients > 17 years of age from our outpatient clinic between 2014 and 2018. The most common uropathogens and their anti biotic resistance rates were identified in different age groups (18-39, 40-59, and ≥60 years) and with respect to gender and date of admission. In addition, the change in antibiotic resistance of Escherichia coli between 2014 and 2018 was also examined. Results: A total of 9,556 positive urine cul tures were included. The most common uropathogen was E. coli, and its prevalence was higher in females than males (70.6 vs. 53.4%, respectively). The majority of isolates were from patients ≥60 years of age. E. coli resistance was most pronounced for ampicillin (61.56%), followed by trimeth oprimsulfamethoxazole (49.80%), amoxicillinclavulanic acid (34.69%), and cefazolin (30.72%). E. coli resistance to am picillin, nitrofurantoin, cefepime, ciprofloxacin, fosfomycin, and amoxicillinclavulanic acid increased significantly with time (all p = 0.001). For E. coli, resistance to ciprofloxacin, one of the most commonly used antibiotics for UTI, increased from 17 to 43% from 2014 to 2018. Conclusion: Most of the uropathogens displayed high resistance to ampicillin, tri methoprimsulfamethoxazole, and amoxicillinclavulanic acid, and were susceptible to meropenem, ertapenem, and imipenem. Fosfomycin and cefepime were useful in the em pirical treatment of communityacquired UTIs. A surprisingly high increase was observed in the resistance of E. coli to an timicrobial agents from 2014 to 2018.

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The Global Prevalence of Infections in Urology Study: A Long-Term, Worldwide Surveillance Study on Urological Infections

Cited by 79 publications

References 10 publications

Healthcare-Associated Infections after Lower Urinary Tract Endoscopic Surgery: Analysis of Risk Factors, Associated Microorganisms and Patterns of Antibiotic Resistance

Healthcare-Associated Infections after Lower Urinary Tract Endoscopic Surgery: Analysis of Risk Factors, Associated Microorganisms and Patterns of Antibiotic Resistance

A clinical decision support system improves antibiotic therapy for upper urinary tract infection in a randomized single-blinded study

Changes in Antimicrobial Resistance of Urinary Tract Infections in Adult Patients over a 5-Year Period

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