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[PMID]:29443741
[Au] Autor:Zhang Q; Liu L; Sun W; Gao F; Cheng L; Li Z
[Ad] Endereço:Graduate School of Peking Union Medical College, China-Japan Friendship Institute of Clinical Medicine.
[Ti] Título:Research progress of asymptomatic bacteriuria before arthroplasty: A systematic review.
[So] Source:Medicine (Baltimore);97(7):e9810, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: A high prevalence of asymptomatic bacteriuria exists in patients prior to arthroplasty, and urinary tract infection is considered to be a source of postoperative superficial wound and prosthetic joint infections. There is no consensus whether to screen for and treat asymptomatic bacteriuria before arthroplasty. OBJECTIVE: To summarize the association between asymptomatic bacteriuria and complications after arthroplasty and to evaluate the clinical benefits of treating asymptomatic bacteriuria prior to arthroplasty. METHOD: We systematically searched PubMed, Embase, and the Cochrane Library to retrieve potentially eligible articles. By screening the titles and abstracts of retrieved records and then reading the full texts of the remaining papers, we finally included 8 English-language articles in this systematic review. RESULTS: Asymptomatic bacteriuria prior to arthroplasty is significantly associated with an increased occurrence of postoperative prosthetic joint and superficial wound infections. However, there is little evidence for direct or hematogenous seeding of urinary infections, and treating asymptomatic bacteriuria before arthroplasty did not decrease the incidence of postoperative infectious complications. CONCLUSION: Asymptomatic bacteriuria is not a contraindication for arthroplasty, and the practice of routine preoperative screening for and treatment of asymptomatic bacteriuria should not be continued.
[Mh] Termos MeSH primário: Artroplastia/efeitos adversos
Infecções Assintomáticas
Bacteriúria/complicações
Complicações Pós-Operatórias/microbiologia
[Mh] Termos MeSH secundário: Idoso
Bacteriúria/tratamento farmacológico
Feminino
Seres Humanos
Masculino
Meia-Idade
Período Pré-Operatório
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009810


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[PMID]:28463661
[Au] Autor:Pérez-Moreno MO; Picó-Plana E; Grande-Armas J; Centelles-Serrano MJ; Arasa-Subero M; Ochoa NC; Led By Mo Pérez-Moreno MOTSGG
[Ad] Endereço:2​Institud d'Investigació Sanitària Père Virgili, Tarragona, España.
[Ti] Título:Group B streptococcal bacteriuria during pregnancy as a risk factor for maternal intrapartum colonization: a prospective cohort study.
[So] Source:J Med Microbiol;66(4):454-460, 2017 Apr.
[Is] ISSN:1473-5644
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Current evidence is inconclusive regarding the intrapartum administration of chemoprophylaxis, merely based on the presence of group B streptococcal (GBS) bacteriuria of any colony count, in the prevention of early-onset neonatal GBS infection. The aim of this study was to assess whether GBS bacteriuria is a risk factor for intrapartum colonization (IPC) regardless of urinary concentration or the results of late third-trimester rectovaginal screening cultures (RVSCs). METHODOLOGY: Six hundred and eight pregnant women, with urine specimens cultured between May 2011 and May 2013, were enrolled in this prospective cohort study. RVSCs were available for 582 women and intrapartum rectovaginal cultures for 246. RESULTS: The prevalence of GBS bacteriuria and positive RVSCs was 10.8 and 16.5 %, respectively. The frequency of IPC was 15.9 % (39/246). Sensitivity, specificity, positive and negative predictive values of urine culture and of RVSC in predicting GBS IPC were 41, 94.7, 59.3 and 89.5 %, and 76.9, 95.4, 76.9 and 95.4 %, respectively. GBS bacteriuria was significantly associated with IPC, overall [relative risk (RR) 5.6] and in women with negative RVSC (RR 8.5), with bacteriuria <104 c.f.u. ml-1 (RR 5.9) or when both circumstances coexisted (RR 8.9). The urinary colony count was <104 c.f.u. ml-1 in 13 of the 16 women with GBS bacteriuria and IPC. CONCLUSION: GBS bacteriuria is a risk factor for IPC, irrespective of urinary GBS concentration or of colonization status at late gestation. Therefore, microbiology laboratories should search, and report, GBS of any colony count in urine from pregnant women, and not only in the presence of ≥104 c.f.u. ml-1 as the 2010 CDC guidelines recommend.
[Mh] Termos MeSH primário: Bacteriúria/epidemiologia
Bacteriúria/microbiologia
Complicações Infecciosas na Gravidez/microbiologia
Infecções Estreptocócicas/microbiologia
Streptococcus agalactiae/isolamento & purificação
[Mh] Termos MeSH secundário: Adulto
Quimioprevenção
Estudos de Coortes
Feminino
Seres Humanos
Meia-Idade
Gravidez
Complicações Infecciosas na Gravidez/epidemiologia
Estudos Prospectivos
Fatores de Risco
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1099/jmm.0.000465


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[PMID]:28869004
[Au] Autor:Stefanovic A; Roscoe D; Ranasinghe R; Wong T; Bryce E; Porter C; Lim A; Grant J; Ng K; Pudek M
[Ad] Endereço:1​Division of Medical Microbiology, Department of Pathology and Laboratory Medicine, Vancouver General Hospital, BC, Canada 2​University of British Columbia, BC, Canada.
[Ti] Título:Performance assessment of urine flow cytometry (UFC) to screen urines to reflex to culture in immunocompetent and immunosuppressed hosts.
[So] Source:J Med Microbiol;66(9):1308-1315, 2017 Sep.
[Is] ISSN:1473-5644
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Urine flow cytometry (UFC) is an automated method to quantify bacterial and white blood cell (WBC) counts. We aimed to determine whether a threshold for these parameters can be set to use UFC as a sensitive screen to predict which urine samples will subsequently grow in culture. METHODOLOGY: Urines submitted to our microbiology laboratory at a tertiary care centre from 22 July 2015-17 February 2016 underwent UFC (Sysmex UF-1000i) analysis, regular urinalysis and urine culture. Positive urine cultures were defined as growth ≥104 c.f.u. ml-1 of organisms associated with urinary tract infections. The correlation of UFC bacterial and WBC counts with urine culture was assessed using receiver operating characteristics curves. The sensitivity (SN), specificity (SP), negative predictive values (NPVs), positive predictive values (PPVs) and false negative rate (FNR) were calculated at various thresholds in immunocompetent and immunosuppressed patients. RESULTS: A total of 15 046 urine specimens were submitted, of which 14 908 were analysable in the study. The average time to UFC result from receipt in the laboratory was 0.76 h (+/-1.04). The test performance at a set threshold of UFC bacteria ≥20 or WBC >5 was: SN=96.0 %, SP=39.2 %, PPV=47.0 %, NPV=94.5 % and FNR=4.0 %. This threshold eliminates 26 % of urine cultures. Immunosuppressed hosts had a lower sensitivity of 90.6 % and a higher FNR of 9.4 %. CONCLUSIONS: UFC is a rapid and sensitive method to screen out urine samples that will subsequently be negative and to reflex urines to culture that will subsequently grow. UFC results are available within 1 h from receipt and enable the elimination of culture when the set threshold is not met.
[Mh] Termos MeSH primário: Bacteriúria/diagnóstico
Citometria de Fluxo/métodos
Piúria/diagnóstico
Urinálise/métodos
Infecções Urinárias/diagnóstico
[Mh] Termos MeSH secundário: Bacteriúria/microbiologia
Feminino
Seres Humanos
Contagem de Leucócitos
Masculino
Programas de Rastreamento/métodos
Meia-Idade
Curva ROC
Infecções Urinárias/microbiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170905
[St] Status:MEDLINE
[do] DOI:10.1099/jmm.0.000572


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[PMID]:28845933
[Au] Autor:Kogan MI; Naboka YL; Bedzhanyan SK; Mitusova EV; Gudima IA; Morgun PP; Vasileva LI
[Ad] Endereço:RostSMU of Minzdrav of Russia, Rostov on Don, Russia.
[Ti] Título:[Is bacteriological testing of bladder urine informative in acute obstructive pyelo- nephritis?]
[So] Source:Urologiia;(3):10-15, 2017 Jul.
[Is] ISSN:1728-2985
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:The problem of the etiology and pathogenesis of acute obstructive pyelonephritis (OOP) remains one of the challenging issues of modern urology. Etiological agents of pyelonephritis can be both gram-negative and gram-positive opportunistic bacteria mostly belonging to the normal flora in humans. The generally accepted diagnostic work-up involves a bacteriological testing of not pelvic urine, but of bladder urine collected by a transurethral catheter or midstream specimens of urine collected from the patients. The aim of our study was to compare the microbiota of bladder and pelvic urine in patients with OOP. MATERIALS AND METHODS: The study comprised 72 sequentially selected patients (12 men and 60 women) with OOP associated with ureteral stones. Mean age of patients was 53.7+/-0.5 years. All patients underwent bacteriological examination of the bladder urine collected by a transurethral catheter and pelvic urine obtained after relieving stone-related ureteral obstruction. Urinary diversion was performed using j-j stent and PCN in 64 and 8 patients, respectively. Preoperative prophylactic antibiotics were administered routinely. Bacteriological testing of urine was carried out using an extended set (9-10) of culture media. Empirical antibiotic therapy was initiated only after the restoration of urine outflow from the kidney and continued for 5-6 days until the availability of bacteriological testing results. RESULTS: Levels of bacteriuria with Enterobacteria, gram-positive pathogens and NAB in two urine samples did not differ significantly (p>0.05). There was a wide range of bacteriuria from 101 to 106 CFU/ml of most microorganisms except @Proteus spp., S. aureus. In bladder urine, the rates of bacteriuria of more or equal 104 CFU/ml for E. coli, Klebsiella spp. and Proteus spp. were 90.9%, 72.7% and 100.0%, respectively. For the remaining microorganisms, predominant bacteriuria was less or equal 103 CFU/ml. In pelvic urine, the rates of bacteriuria of more or equal 104 CFU/ml for E. coli, Klebsiella spp. and Proteus spp. was 71.8%, 40.0% and 66.7%, respectively. Other uropathogens in the pelvic urine mainly had a bacterial count of less or equal 103 CFU/ml. Only the concentration of Corynebacterium spp. in the pelvic urine significantly (p=0.023) differed from that of the bladder urine. There were no significant differences between microbiota of bladder and pelvic urine depending on duration of OOP except higher rates of Corynebacterium spp. in the bladder urine.
[Mh] Termos MeSH primário: Pielonefrite/urina
Infecções Urinárias/urina
Urina/microbiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Antibacterianos/administração & dosagem
Bacteriúria/prevenção & controle
Bacteriúria/urina
Corynebacterium/isolamento & purificação
Escherichia coli/isolamento & purificação
Feminino
Seres Humanos
Klebsiella/isolamento & purificação
Masculino
Meia-Idade
Proteus/isolamento & purificação
Pielonefrite/prevenção & controle
Infecções Urinárias/prevenção & controle
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170829
[St] Status:MEDLINE


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[PMID]:28819490
[Au] Autor:Izuchukwu KE; Oranu EO; Bassey G; Orazulike NC
[Ad] Endereço:Department of Obstetrics and Gynaecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
[Ti] Título:Maternofetal outcome of asymptomatic bacteriuria among pregnant women in a Nigerian Teaching Hospital.
[So] Source:Pan Afr Med J;27:69, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Asymptomatic bacteriuria has been reported to be associated with adverse pregnancy outcome. This study sought to determine the prevalence and complications of asymptomatic bacteriuria amongst parturient in the University of Port Harcourt Teaching Hospital (UPTH). METHODS: The study was a prospective cohort study involving 220 eligible antenatal attendees. Urine culture and sensitivity was conducted for each participant and the fetomaternal outcome between affected and unaffected women were compared and p value <0.05 was considered significant. RESULTS: Sixty-five of the participants had asymptomatic bacteriuria giving a prevalence of 29.5%. Twenty-three (35.4%) cultures yielded while Fifty-eight (89%) of the cultured organisms were sensitive to Nitrofurantoin. There was no statistical difference in the rate of prelabour rupture of membranes, preeclampsia, preterm delivery, birth asphyxia and low birth weight between affected and unaffected women. CONCLUSION: Contrary to widely held view, there was no significant increase in adverse pregnancy outcome amongst affected women.
[Mh] Termos MeSH primário: Infecções Assintomáticas/epidemiologia
Bacteriúria/epidemiologia
Complicações Infecciosas na Gravidez/epidemiologia
Resultado da Gravidez
[Mh] Termos MeSH secundário: Adulto
Antibacterianos/farmacologia
Bactérias/efeitos dos fármacos
Bactérias/isolamento & purificação
Bacteriúria/complicações
Estudos de Coortes
Feminino
Hospitais de Ensino
Seres Humanos
Recém-Nascido
Testes de Sensibilidade Microbiana
Nigéria/epidemiologia
Nitrofurantoína/farmacologia
Gravidez
Complicações Infecciosas na Gravidez/microbiologia
Estudos Prospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 927AH8112L (Nitrofurantoin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170819
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.69.10492


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[PMID]:28641715
[Au] Autor:Gorelik Y; Paul M; Geffen Y; Khamaisi M
[Ad] Endereço:Division of Internal Medicine, Rambam Health Care Campus, Haifa, Israel. Electronic address: yurigorelik@gmail.com.
[Ti] Título:Urinary Tract Infections Due to Nontyphoidal Salmonella.
[So] Source:Am J Med Sci;353(6):529-532, 2017 Jun.
[Is] ISSN:1538-2990
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: We sought to establish the characteristics of symptomatic nontyphoidal Salmonella (NTS) urinary tract infection (UTI) without concomitant gastroenteritis (GE) as a separate clinical entity. MATERIALS AND METHODS: We conducted a retrospective cohort single-center study and reviewed all cases of NTS bacteriuria between 1995 and 2016. Patients were assigned to a group according to their clinical presentation, namely, symptomatic NTS UTI without GE, GE with NTS bacteriuria or isolated asymptomatic NTS bacteriuria. We compared the characteristics of patients in the NTS UTI group to those of the latter 2 groups. RESULTS: NTS bacteriuria was found in 77 patients, of which 61 had records available for review. Twenty-one patients (including 17 adults) presented with NTS UTI, 30 patients presented with features of GE with NTS bacteriuria and 10 patients had asymptomatic NTS bacteriuria. NTS UTI was not significantly associated with older age, male sex, diabetes, immunosuppressive states or urologic abnormalities. There was a significant difference in the proportion of patients with an underlying urologic malignancy in the NTS UTI group (4 of 17 patients [23.5%]) as compared to those in the other groups (0 of 24 patients), P = 0.023. CONCLUSIONS: A unique group of patients with symptomatic NTS UTI without GE was identified. A significant association with urologic malignancies was demonstrated in patients with NTS UTI compared to those with GE and NTS bacteriuria or asymptomatic NTS bacteriuria.
[Mh] Termos MeSH primário: Bacteriúria/urina
Infecções por Salmonella/urina
Salmonella/isolamento & purificação
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Bacteriúria/microbiologia
Criança
Pré-Escolar
Estudos de Coortes
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Salmonella/classificação
Infecções por Salmonella/microbiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170628
[Lr] Data última revisão:
170628
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170624
[St] Status:MEDLINE


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[PMID]:28634287
[Au] Autor:Al-Wali W
[Ad] Endereço:Rotherham NHS Foundation Trust, Rotherham S60 2UD, UK.
[Ti] Título:Antibiotics for urinary tract infection in pregnant women.
[So] Source:BMJ;357:j2934, 2017 06 20.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Antibacterianos
Infecções Urinárias
[Mh] Termos MeSH secundário: Bacteriúria
Feminino
Seres Humanos
Gravidez
Complicações Infecciosas na Gravidez
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170622
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j2934


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[PMID]:28566074
[Au] Autor:Mete E; Kaleli I; Cevahir N; Demir M; Akkaya Y; Kiris Satilmis Ö
[Ad] Endereço:Pamukkale University Faculty of Medicine, Department of Medical Microbiology, Denizli, Turkey. ergunmete@pau.edu.tr.
[Ti] Título:[Evaluation of virulence factors in enterococcus species].
[Ti] Título:Enterokok türlerinin virulans faktörlerinin arastirilmasi..
[So] Source:Mikrobiyol Bul;51(2):101-114, 2017 Apr.
[Is] ISSN:0374-9096
[Cp] País de publicação:Turkey
[La] Idioma:tur
[Ab] Resumo:Enterococci have recently become important due to their increased isolation rates in community-based and nosocomial infections and resistance to many antibiotics, including glycopeptides. The aim of this study was to evaluate the antimicrobial susceptible patterns and virulence factors of various clinical specimens; urine (n= 149), blood (n= 38), wound (n= 17), stool (n= 13), and other (n= 12) with a total of 229 enterococci including 138 E.faecalis and 91 E.faecium isolates. Aggregation factor (AF), enterococcus surface protein (esp), cytolysins and gelatinase encoding genes (asa1, esp, cylM, cylBcyl A, cylll, cylls, gelE, respectively) were investigated by molecular methods. Haemolysin production and gelatinase were studied phenotypically. A total of 30 isolates, 29 of E.faecium and one of E.faecalis isolates were resistant to vancomycin. High-level gentamicin and high-level streptomycin resistance in E.faecalis were 40.7% and 63.7% however, they were 47.1% and 55.8% in E.faecalis isolates. All strains were susceptible to linezolid. Ampicillin, penicillin and vancomycin resistance in E.faecium isolates were found to be higher than E.faecalis isolates (p= 0.001, p= 0.008 and p< 0.001). Asa1 (p< 0.001), cylll (p= 0.002) and cylls (p< 0.001) as well as gelatinase activity in isolates of E.faecalis were significantly higher than the isolates of E.faecium (p< 0.001). The most common virulence genes in our study were asa1 gene (45%), cyLs gene (33.2%) and esp gene (32.3%). Ciprofloxacin resistance in cylLL and cyLs gene positive isolates of E.faecalis were significantly higher compared to isolates that do not contain these genes (p= 0.035 and p= 0.047). Likewise, haemolysin producing E.faecium isolates were significantly more resistant to vancomycin compared to isolates that do not produce hemolysin (p< 0.001). When the virulence factors of vancomycin resistant and susceptible isolates were compared, the esp gene level in VRE E.faecium isolates was found to be 24.1%, while no esp gene was found in VRE E.faecalis isolates. The existence of asa1was negative in both VRE E.faecium and VRE E.faecalis isolates. The activity of hemolysin was found 42.3% for E.faecalis and 19.3% for E.faecium. In vancomycin-sensitive enterococcus (VSE) species, esp gene activity was 35.1% for E.faecalis, 29.4% for E.faecium, asa1 gene activity was 60.8% for E.faecalis and 47.1% for E.faecium, hemolysin activity was 52.8% for E.faecalis and 23.5% for E.faecium. In our study, it was found that VSE isolates have more virulence genes than VRE isolates. It should be kept in mind that VRE can causeinfections which are difficult-to-treat especially in hospitalized patients and VSE have significant virulence factors that can cause severe infections.
[Mh] Termos MeSH primário: Enterococcus faecalis/patogenicidade
Enterococcus faecium/patogenicidade
Infecções por Bactérias Gram-Positivas/microbiologia
Fatores de Virulência/análise
[Mh] Termos MeSH secundário: Antibacterianos/farmacologia
Bacteriemia/microbiologia
Bacteriúria/microbiologia
Farmacorresistência Bacteriana/genética
Enterococcus faecalis/efeitos dos fármacos
Enterococcus faecalis/genética
Enterococcus faecium/efeitos dos fármacos
Enterococcus faecium/genética
Fezes/microbiologia
Seres Humanos
Resistência a Vancomicina/genética
Fatores de Virulência/genética
Infecção dos Ferimentos/microbiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Virulence Factors)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170602
[St] Status:MEDLINE


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[PMID]:28542707
[Au] Autor:Finucane TE
[Ad] Endereço:Johns Hopkins Bayview Medical Center, Baltimore, Maryland.
[Ti] Título:"Urinary Tract Infection"-Requiem for a Heavyweight.
[So] Source:J Am Geriatr Soc;65(8):1650-1655, 2017 Aug.
[Is] ISSN:1532-5415
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:"Urinary tract infection" ("UTI") is an ambiguous, expansive, overused diagnosis that can lead to marked, harmful antibiotic overtreatment. "Significant bacteriuria," central to most definitions of "UTI," has little significance in identifying individuals who will benefit from treatment. "Urinary symptoms" are similarly uninformative. Neither criterion is well defined. Bacteriuria and symptoms remit and recur spontaneously. Treatment is standard for acute uncomplicated cystitis and common for asymptomatic bacteriuria, but definite benefits are few. Treatment for "UTI" in older adults with delirium and bacteriuria is widespread but no evidence supports the practice, and expert opinion opposes it. Sensitive diagnostic tests now demonstrate that healthy urinary tracts host a ubiquitous, complex microbial community. Recognition of this microbiome, largely undetectable using standard agar-based cultures, offers a new perspective on "UTI." Everyone is bacteriuric. From this perspective, most people who are treated for a "UTI" would probably be better off without treatment. Elderly adults, little studied in this regard, face particular risk. Invasive bacterial diseases such as pyelonephritis and bacteremic bacteriuria are also "UTIs." Mindful decisions about antibiotic use will require a far better understanding of how pathogenicity arises within microbial communities. It is likely that public education and meaningful informed-consent discussions about antibiotic treatment of bacteriuria, emphasizing potential harms and uncertain benefits, would reduce overtreatment. Emphasizing the microbiome's significance and using the term "urinary tract dysbiosis" instead of "UTI" might also help and might encourage mindful study of the relationships among host, aging, microbiome, disease, and antibiotic treatment.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Bacteriúria/tratamento farmacológico
Infecções Urinárias/tratamento farmacológico
[Mh] Termos MeSH secundário: Doença Aguda
Envelhecimento
Bacteriúria/diagnóstico
Cistite/tratamento farmacológico
Seres Humanos
Uso Excessivo de Produtos e Serviços de Saúde/prevenção & controle
Infecções Urinárias/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170526
[St] Status:MEDLINE
[do] DOI:10.1111/jgs.14907


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[PMID]:28533857
[Au] Autor:Derbie A; Hailu D; Mekonnen D; Abera B; Yitayew G
[Ad] Endereço:Department of Medical Microbiology, Immunology and Parasitology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
[Ti] Título:Antibiogram profile of uropathogens isolated at Bahir Dar Regional Health Research Laboratory Centre, Northwest Ethiopia.
[So] Source:Pan Afr Med J;26:134, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Antimicrobial resistance among bacteria that cause urinary tract infection (UTI) has been increasing since the introduction of chemotherapy. This study was aimed to assess the types of isolates from patients with UTI and to determine their current antimicrobial susceptibility profile. METHODS: A record based retrospective analysis of bacterial uropathogens processed in the period of January 2012 to December 2014 at Bahir Dar Health Research Laboratory Center (BRHRLC) was determined. According to standard microbiological procedures, midstream urine samples were collected and processed with conventional culture and biochemical tests. Isolates were tested against commonly used antibiotics by Kirby-Bauer disc diffusion methods. Chi-square test was calculated to compare the proportion of bacterial isolates between sex and age and statistical significance was set at p value < 0.05. RESULTS: Out of 446 patients, female constituted at 299 (67%). Significant bacteriuria was reported on 30.5% (95% CI: 26.4-34.9%) cultures. Of these, 78% (95% CI: 71.0-84.7%) were from females. Age and sex were found associated with significant bacteriuria at p=0.046 and p=0.001 respectively. The most commonly identified isolates were , at 72 (49 %) followed by at 20 (13.6%) and at 11 (7.5%). The overall antimicrobial susceptibility profile showed that Trimetoprim-sulphamethoxazole, amoxicillin/clavulanate and ampicillin revealed high level of resistance, at 84(66.7%), 61(79.2%), 106(91.4% respectively. Conversely, 64.2-100% sensitivity rate was documented for ciprofloxacin, gentamycin and pepracillin. CONCLUSION: UTI associated with multiple drug resistant bacteria is an important health concern of the study population. Therefore, ongoing surveillance of the types of uropathogens and their up-to-date antimicrobial resistance profile is crucial for better management of patients.
[Mh] Termos MeSH primário: Antibacterianos/farmacologia
Bactérias/efeitos dos fármacos
Bacteriúria/epidemiologia
Infecções Urinárias/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Bactérias/isolamento & purificação
Bacteriúria/microbiologia
Criança
Pré-Escolar
Farmacorresistência Bacteriana Múltipla
Etiópia/epidemiologia
Feminino
Seres Humanos
Lactente
Masculino
Testes de Sensibilidade Microbiana
Meia-Idade
Estudos Retrospectivos
Fatores Sexuais
Infecções Urinárias/microbiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170613
[Lr] Data última revisão:
170613
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170524
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.26.134.7827



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