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[PMID]: 29290000
[Au] Autor:Qiao LD; Chen S; Lin YH; Li JX; Hu WG; Hou JP; Cui L
[Ad] Address:Department of Urology, Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang, Dongcheng District, 100730, Beijing, China.
[Ti] Title:Evaluation of perioperative prophylaxis with fosfomycin tromethamine in ureteroscopic stone removal: an investigator-driven prospective, multicenter, randomized, controlled study.
[So] Source:Int Urol Nephrol;50(3):427-432, 2018 Mar.
[Is] ISSN:1573-2584
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:PURPOSE: To compare efficacy, safety, and cost-effectiveness of fosfomycin tromethamine with other standard-of-care antibiotics in patients undergoing ureteroscopic lithotripsy. METHODS: This study was a prospective, multicenter, randomized, controlled trial. Eligible patients scheduled for ureteroscopic lithotripsy were randomly assigned to receive either fosfomycin (fosfomycin group, N = 101 patients) or standard-of-care antibiotic therapy as prophylaxis (control group, N = 115 patients). The incidence of infectious complications and adverse events was analyzed between the two groups, as well as the cost-benefit analysis. RESULTS: The incidence of infections following lithotripsy was 3.0% in the fosfomycin group and 6.1% in the control group (p > 0.05). Only asymptomatic bacteriuria was reported in fosfomycin group. In the control group was reported asymptomatic bacteriuria (3.5%), fever (0.9%), bacteremia (0.9%), and genitourinary infection (0.9%). The rate of adverse events was very low, with no adverse event reported in the fosfomycin group and only one in the control group (forearm phlebitis). The average cost per patient of antibiotic therapy with fosfomycin was 151.45 ± 8.62 yuan (22.7 ± 1.3 USD), significantly lower compared to the average cost per patient of antibiotics used in the control group 305.10 ± 245.95 yuan (45.7 ± 36.9 USD; p < 0.001). CONCLUSIONS: Two oral doses of 3 g fosfomycin tromethamine showed good efficacy and safety and low cost in perioperative prophylaxis of infections following ureteroscopic stone removal.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:In-Process
[do] DOI:10.1007/s11255-017-1776-7

  2 / 9143 MEDLINE  
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[PMID]: 29379982
[Au] Autor:Li Y; Wang J; Wang W
[Ad] Address:Department of Orthopedics, the 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, Hunan, 410011, China.
[Ti] Title:Peri-operative antibiotic treatment of bacteriuria reduces early deep surgical site infections in geriatric patients with proximal femur fracture: is it related?
[So] Source:Int Orthop;42(3):719-720, 2018 Mar.
[Is] ISSN:1432-5195
[Cp] Country of publication:Germany
[La] Language:eng
[Pt] Publication type:LETTER
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Data-Review
[do] DOI:10.1007/s00264-018-3784-3

  3 / 9143 MEDLINE  
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[PMID]: 29368046
[Au] Autor:Wang C; Yin D; Shi W; Huang W; Zuo D; Lu Q
[Ad] Address:Faculty of Graduate Studies, Guangxi University of Chinese Medicine, No.179 Mingxiu Dong Road, Nanning, Guangxi Zhuang Autonomous Region, 530001, China.
[Ti] Title:Current evidence does not support systematic antibiotherapy prior to joint arthroplasty in patients with asymptomatic bacteriuria-a meta analysis.
[So] Source:Int Orthop;42(3):479-485, 2018 Mar.
[Is] ISSN:1432-5195
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:BACKGROUND: Many orthopaedic surgeons worry about asymptomatic bacteriuria (ASB) as a possible risk factor for prosthetic joint infection (PJI). However, available evidence establishing a direct link between ASB and PJI is limited. This meta-analysis aimed to investigate whether ASB is a factor for PJI and whether pre-operative antibiotic treatment shows benefit. METHOD: We systematically searched major databases such as PubMed, Web of Science, the Cochrane Library and EMBASE for studies. Risk ratio (RR) was calculated for included studies that reported raw counts with 95% confidence interval (CI). RESULTS: Five studies involved 3588 joint arthroplasties and 441 cases of ASB (overall incidence 12.3%). Compared with the control group, PJI was more common in both patients in the ASB group (RR = 2.87; 95% CI, 1.65-5.00). But in all five studies, the micro-organisms isolated from PJI and urine cultures were not the same. Three of the five studies reported that the antibiotic treated the ASB prior to joint arthroplasty and compared the untreated ASB group.There was no significant difference between groups (RR = 0.89; 95% CI, 0.36-2.20). DISCUSSION: PJI occurring via the haematogenous route from the genitourinary tract harbouring bacteria in ASB is impossible. Pre-operative antibiotic treatment has no benefit. A plausible explanation could be an indicator of frailty and increased susceptibility to infection. CONCLUSIONS: ASB increased the risk of PJI in the meta-analysis. However, current evidence does not support systematic antibiotherapy prior to joint arthroplasty and screening for ASB.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Data-Review
[do] DOI:10.1007/s00264-018-3765-6

  4 / 9143 MEDLINE  
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[PMID]: 28459908
[Au] Autor:Meddings J; Saint S; Krein SL; Gaies E; Reichert H; Hickner A; McNamara S; Mann JD; Mody L
[Ad] Address:Department of Internal Medicine, Division of General Medicine, University of Michigan Medical School, Ann Arbor, MI; Department of Pediatrics and Communicable Diseases, Division of General Pediatrics, University of Michigan Medical School, Ann Arbor, MI; VA Ann Arbor Healthcare System, Ann Arbor, MI
[Ti] Title:Systematic Review of Interventions to Reduce Urinary Tract Infection in Nursing Home Residents.
[So] Source:J Hosp Med;12(5):356-368, 2017 May.
[Is] ISSN:1553-5606
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Urinary tract infections (UTIs) in nursing homes are common, costly, and morbid. PURPOSE: Systematic literature review of strategies to reduce UTIs in nursing home residents. DATA SOURCES: Ovid MEDLINE, Cochrane Library, CINAHL, Web of Science and Embase through June 22, 2015. STUDY SELECTION: Interventional studies with a comparison group reporting at least 1 outcome for: catheter-associated UTI (CAUTI), UTIs not identified as catheter-associated, bacteriuria, or urinary catheter use. DATA EXTRACTION: Two authors abstracted study design, participant and intervention details, outcomes, and quality measures. DATA SYNTHESIS: Of 5794 records retrieved, 20 records describing 19 interventions were included: 8 randomized controlled trials, 10 pre-post nonrandomized interventions, and 1 nonrandomized intervention with concurrent controls. Quality (range, 8-25; median, 15) and outcome definitions varied greatly. Thirteen studies employed strategies to reduce catheter use or improve catheter care; 9 studies employed general infection prevention strategies (eg, improving hand hygiene, surveillance, contact precautions, reducing antibiotics). The 19 studies reported 12 UTI outcomes, 9 CAUTI outcomes, 4 bacteriuria outcomes, and 5 catheter use outcomes. Five studies showed CAUTI reduction (1 significantly); 9 studies showed UTI reduction (none significantly); 2 studies showed bacteriuria reduction (none significantly). Four studies showed reduced catheter use (1 significantly). LIMITATIONS: Studies were often underpowered to assess statistical significance; none were pooled given variety of interventions and outcomes. CONCLUSIONS: Several practices, often implemented in bundles, such as improving hand hygiene, reducing and improving catheter use, managing incontinence without catheters, and enhanced barrier precautions, appear to reduce UTI or CAUTI in nursing home residents. Journal of Hospital Medicine 2017;12:356-368.
[Mh] MeSH terms primary: Catheter-Related Infections/prevention & control
Homes for the Aged
Infection Control/methods
Nursing Homes
Urinary Catheterization/adverse effects
Urinary Tract Infections/prevention & control
[Mh] MeSH terms secundary: Anti-Bacterial Agents/therapeutic use
Catheter-Related Infections/diagnosis
Catheter-Related Infections/epidemiology
Catheters, Indwelling/adverse effects
Catheters, Indwelling/microbiology
Homes for the Aged/standards
Humans
Infection Control/standards
Nursing Homes/standards
Randomized Controlled Trials as Topic/methods
Urinary Catheterization/standards
Urinary Tract Infections/diagnosis
Urinary Tract Infections/epidemiology
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Nm] Name of substance:0 (Anti-Bacterial Agents)
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[Js] Journal subset:IM
[Da] Date of entry for processing:170502
[St] Status:MEDLINE
[do] DOI:10.12788/jhm.2724

  5 / 9143 MEDLINE  
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[PMID]: 29511075
[Au] Autor:Forsyth VS; Armbruster CE; Smith SN; Pirani A; Springman AC; Walters MS; Nielubowicz GR; Himpsl SD; Snitkin ES; Mobley HLT
[Ad] Address:Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, Michigan, USA.
[Ti] Title:Rapid Growth of Uropathogenic during Human Urinary Tract Infection.
[So] Source:MBio;9(2), 2018 Mar 06.
[Is] ISSN:2150-7511
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Uropathogenic (UPEC) strains cause most uncomplicated urinary tract infections (UTIs). These strains are a subgroup of extraintestinal pathogenic (ExPEC) strains that infect extraintestinal sites, including urinary tract, meninges, bloodstream, lungs, and surgical sites. Here, we hypothesize that UPEC isolates adapt to and grow more rapidly within the urinary tract than other isolates and survive in that niche. To date, there has not been a reliable method available to measure their growth rate Here we used two methods: segregation of nonreplicating plasmid pGTR902, and peak-to-trough ratio (PTR), a sequencing-based method that enumerates bacterial chromosomal replication forks present during cell division. In the murine model of UTI, UPEC strain growth was robust , matching or exceeding growth rates and only slowing after reaching high CFU counts at 24 and 30 h postinoculation (hpi). In contrast, asymptomatic bacteriuria (ABU) strains tended to maintain high growth rates at 6, 24, and 30 hpi, and population densities did not increase, suggesting that host responses or elimination limited population growth. Fecal strains displayed moderate growth rates at 6 hpi but did not survive to later times. By PTR, in urine of human patients with UTIs displayed extraordinarily rapid growth during active infection, with a mean doubling time of 22.4 min. Thus, in addition to traditional virulence determinants, including adhesins, toxins, iron acquisition, and motility, very high growth rates and resistance to the innate immune response appear to be critical phenotypes of UPEC strains. Uropathogenic (UPEC) strains cause most urinary tract infections in otherwise healthy women. While we understand numerous virulence factors are utilized by to colonize and persist within the urinary tract, these properties are inconsequential unless bacteria can divide rapidly and survive the host immune response. To determine the contribution of growth rate to successful colonization and persistence, we employed two methods: one involving the segregation of a nonreplicating plasmid in bacteria as they divide and the peak-to-trough ratio, a sequencing-based method that enumerates chromosomal replication forks present during cell division. We found that UPEC strains divide extraordinarily rapidly during human UTIs. These techniques will be broadly applicable to measure growth rates of other bacterial pathogens during host colonization.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Data-Review

  6 / 9143 MEDLINE  
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[PMID]: 29390169
[Au] Autor:Coussement J; Scemla A; Abramowicz D; Nagler EV; Webster AC
[Ad] Address:Department of Infectious Diseases and Department of Microbiology, CUB-Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, Brussels, Belgium, 1070.
[Ti] Title:Antibiotics for asymptomatic bacteriuria in kidney transplant recipients.
[So] Source:Cochrane Database Syst Rev;2:CD011357, 2018 02 01.
[Is] ISSN:1469-493X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Asymptomatic bacteriuria, defined as bacteriuria without signs or symptoms of urinary tract infection (UTI), occurs in 17% to 51% of kidney transplant recipients and is thought to increase the risk for a subsequent UTI. No consensus exists on the role of antibiotics for asymptomatic bacteriuria in kidney transplantation. OBJECTIVES: To assess the benefits and harms of treating asymptomatic bacteriuria in kidney transplant recipients with antimicrobial agents to prevent symptomatic UTI, all-cause mortality and the indirect effects of UTI (acute rejection, graft loss, worsening of graft function). SEARCH METHODS: We searched the Cochrane Kidney and Transplant Register of Studies up to 1 September 2017 through contact with the Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Register (ICTRP) Search Portal, and ClinicalTrials.gov. SELECTION CRITERIA: All randomised controlled trials (RCTs) and quasi-RCTs in any language assessing treatment of asymptomatic bacteriuria in kidney transplant recipients at any time-point after transplantation. DATA COLLECTION AND ANALYSIS: Two authors independently determined study eligibility, assessed quality and extracted data. Primary outcomes were incidence of symptomatic UTI and incidence of antimicrobial resistance. Other outcomes included incidences of all-cause mortality, graft loss, graft rejection, graft function, hospitalisation for UTI, adverse reactions to antimicrobial agents and relapse or persistence of asymptomatic bacteriuria. We expressed dichotomous outcomes as absolute risk difference (RD) or risk ratio (RR) with 95% confidence intervals (CI) and continuous data as mean differences (MD) with 95% CI. Data were pooled using the random effects model. MAIN RESULTS: We included two studies (212 participants) comparing antibiotics versus no treatment, and identified three on-going studies. Overall, incidence of symptomatic UTI varied between 19% and 31% in the groups not treated for asymptomatic bacteriuria. Antibiotic treatment had uncertain effects on preventing symptomatic UTI (2 studies, 200 participants: RR 0.86, 95% CI 0.51 to 1.45). Risk for selecting multidrug-resistant organisms was uncertain with antibiotic treatment (1 study, 112 participants: RR 1.21, 95% CI 0.60 to 2.41). Persistence of asymptomatic bacteriuria was high regardless of treatment. Antibiotics also have uncertain effects on other important patient and graft outcomes, for instance on all-cause mortality (1 study, 112 participants: RR 2.23, 95% CI 0.21 to 23.86), graft loss (1 study, 112 participants: RR 1.11, 95% CI 0.07 to 17.36), acute rejection (1 study, 112 participants: RR 0.93, 95% CI 0.44 to 1.97), hospitalisation for UTI (1 study, 112 participants: RR 0.74, 95% CI 0.13 to 4.27), graft function (2 studies, 200 participants, MD in serum creatinine concentration -0.06 mg/dL, 95% CI -0.19 to 0.08) and adverse reactions (1 study, 112 participants: no severe adverse event attributable to the antibiotic treatment). Evidence quality was low for all outcomes. AUTHORS' CONCLUSIONS: Currently, there is insufficient evidence to support routinely treating kidney transplant recipients with antibiotics in case of asymptomatic bacteriuria after transplantation, but data are scarce. Further studies assessing routine antibiotic treatment would inform practice and we await the results of three ongoing randomised studies, which may help resolve existing uncertainties.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Process
[do] DOI:10.1002/14651858.CD011357.pub2

  7 / 9143 MEDLINE  
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[PMID]: 29504856
[Au] Autor:Cray M; Berent AC; Weisse CW; Bagley D
[Ti] Title:Treatment of pyonephrosis with a subcutaneous ureteral bypass device in four cats.
[So] Source:J Am Vet Med Assoc;252(6):744-753, 2018 Mar 15.
[Is] ISSN:1943-569X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:CASE DESCRIPTION 4 cats were examined because of ureteral obstruction. CLINICAL FINDINGS Clinical and clinicopathologic abnormalities were nonspecific and included anorexia, lethargy, weight loss, anemia, leukocytosis, neutrophilia, lymphopenia, and azotemia. A diagnosis of pyonephrosis was made in all cats. The presence of bacteriuria was confirmed by means of urinalysis in 2 cats, bacterial culture of a urine sample obtained by means of preoperative cystocentesis in 2 cats, and bacterial culture of samples obtained from the renal pelvis intraoperatively in 3 cats. Ureteral obstruction was caused by a urolith in 3 cats; ureteral stricture associated with a circumcaval ureter was identified in 1 cat. TREATMENT AND OUTCOME All 4 cats underwent renal pelvis lavage and placement of a subcutaneous ureteral bypass (SUB) device for treatment of obstructive pyonephrosis. Postoperatively, the cystostomy tube became occluded with purulent material in 1 cat, requiring exchange. The procedure was successful in relieving the obstruction and pyonephrosis in all cats. Three of 4 cats had documented resolution of urinary tract infection. One cat had persistent bacteriuria without clinical signs 1 month after SUB device placement. CLINICAL RELEVANCE Results of this small series suggested that renal pelvis lavage with placement of an SUB device may be a treatment option for cats with obstructive pyonephrosis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:In-Data-Review
[do] DOI:10.2460/javma.252.6.744

  8 / 9143 MEDLINE  
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[PMID]: 29500947
[Au] Autor:Khalil MR; Thorsen PB; Møller JK; Uldbjerg N
[Ad] Address:Department of Gynecology and Obstetrics, Lillebaelt Hospital, Kolding, Denmark. Electronic address: mohammed.khalil@rsyd.dk.
[Ti] Title:Number of colony forming units in urine at 35-37 weeks' gestation as predictor of the vaginal load of Group B Streptococci at birth.
[So] Source:Eur J Obstet Gynecol Reprod Biol;223:68-71, 2018 Feb 21.
[Is] ISSN:1872-7654
[Cp] Country of publication:Ireland
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To evaluate GBS colony numbers in the urine at 35-37 weeks' gestation to predict the load of GBS-colonization of the vagina at birth. STUDY DESIGN: In this prospective observational study, we included 902 unselected pregnant women. Exposure was GBS colony forming units (CFU) per mL urine at 35-37 weeks' gestation. Outcome was vaginal GBS colonization at birth as assessed by a semi-quantitative culture of a vaginal swab sample (negative, +1, +2, +3). RESULTS: Bacteriuria with GBS at 35-37 weeks' gestation performed with a sensitivity of 30% concerning any degree of vaginal GBS colonization at birth (31 of 104 cases); 19% for light (+1), 17% for medium (+2), and 52% for high load (+3) vaginal GBS colonization. The colony count in case of GBS bacteriuria at 35-37 weeks' gestation performed with positive predictive values of 35% for <10 CFU/mL, 70% for 10 CFU/mL, and 67% for >10 CFU/mL. CONCLUSION: Even though the urinary GBS CFU at 35-37 weeks' gestation is strongly associated with a high load of vaginal GBS colonization intrapartum, it may not perform satisfactorily as a standalone-screening marker for risk of early-onset GBS disease.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180303
[Lr] Last revision date:180303
[St] Status:Publisher

  9 / 9143 MEDLINE  
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[PMID]: 29361359
[Au] Autor:Cortés JA; Alzate JP
[Ad] Address:Department of Internal Medicine, Universidad Nacional de Colombia, Bogotá, Colombia; Infectious Diseases Research Group, Universidad Nacional de Colombia, Bogotá, Colombia. Electronic address: jacortesl@unal.edu.co.
[Ti] Title:Appropriate methods to define bacteriuria relationship with surgical site infection.
[So] Source:Am J Infect Control;46(3):360-361, 2018 Mar.
[Is] ISSN:1527-3296
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:LETTER
[Em] Entry month:1801
[Cu] Class update date: 180303
[Lr] Last revision date:180303
[St] Status:In-Data-Review

  10 / 9143 MEDLINE  
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[PMID]: 29254609
[Au] Autor:Safiri S; Ashrafi-Asgarabad A
[Ad] Address:Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
[Ti] Title:Bacteriuria is not associated with surgical site infection in patients undergoing cardiovascular surgery: Methodologic issues.
[So] Source:Am J Infect Control;46(3):360, 2018 Mar.
[Is] ISSN:1527-3296
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:LETTER
[Em] Entry month:1712
[Cu] Class update date: 180303
[Lr] Last revision date:180303
[St] Status:In-Data-Review


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