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Complicated Acute pyelonephritis

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https://www.readbyqxmd.com/read/29339393/early-clinical-assessment-of-the-antimicrobial-activity-of-finafloxacin-compared-to-ciprofloxacin-in-sub-sets-of-microbiologically-characterized-isolates
#1
Andreas Vente, Christine Bentley, Mark Lückermann, Paul Tambyah, Axel Dalhoff
INTRODUCTION: Two phase II studies were performed in patients with uncomplicated (uUTI) and complicated urinary tract infections or acute pyelonephritis (cUTI/PN) to compare finafloxacin (300 mg b.i.d, p.o. for uUTI 800 mg q.d., i.v. for cUTI/PN) and ciprofloxacin (250 mg b.i.d, p.o. for uUTI and 400 mg b.i.d., i.v. for cUTI/PN). The early response to the study medications was evaluated in the microbiological-intent-to treat population (mITT) at day 3. RESULTS: 21% of the isolates were ciprofloxacin-resistant, 13...
January 16, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29327131/renal-vein-thrombosis-complicating-severe-acute-pyelonephritis-with-renal-abscesses-and-associated-bacteraemia-caused-by-extended-spectrum-beta-lactamase-producing-escherichia-coli
#2
Stelios F Assimakopoulos, Pantelis Kraniotis, Charalambos Gogos, Markos Marangos
Acute pyelonephritis might be complicated by the formation of renal and perirenal abscesses and very rarely by renal vein thrombosis, which is a life-threatening condition. The main causative agents of acute pyelonephritis are enterobacteriaceae with the incidence of extended-spectrum beta-lactamase (ESBL)-producing strains increasing worldwide. We present the case of a 71-year-old Greek man with history of diabetes mellitus and recent hospitalization, who suffered from severe pyelonephritis with renal abscesses formation and associated bacteraemia caused by ESBL-producing Escherichia coli, complicated by extensive thrombosis of the ipsilateral renal vein and its branches, protruding also in the inferior venal cava...
January 11, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29320948/the-profiles-of-soluble-adhesion-molecules-in-the-great-obstetrical-syndromes
#3
Nikolina Docheva, Roberto Romero, Piya Chaemsaithong, Adi L Tarca, Gaurav Bhatti, Percy Pacora, Bogdan Panaitescu, Noppadol Chaiyasit, Tinnakorn Chaiworapongsa, Eli Maymon, Sonia S Hassan, Offer Erez
OBJECTIVE: The objective of this study was to determine the profiles of maternal plasma soluble adhesion molecules in patients with preeclampsia, small-for-gestational-age (SGA) fetuses, acute pyelonephritis, preterm labor with intact membranes (PTL), preterm prelabor rupture of the membranes (preterm PROM), and fetal death. MATERIALS AND METHODS: A cross-sectional study was conducted to determine maternal plasma concentrations of sE-selectin, sL-selectin, and sP-selectin as well as sICAM-1, sVCAM-1, and sPECAM-1 in patients with 1) an uncomplicated pregnancy (control, n = 100); 2) preeclampsia (n = 94); 3) SGA fetuses (in women without preeclampsia/hypertension, n = 45); 4) acute pyelonephritis (n = 25); 5) PTL (n = 53); 6) preterm PROM (n = 24); and 7) fetal death (n = 34)...
January 10, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29260318/the-utility-of-surveillance-biopsies-in-pediatric-kidney-transplantation
#4
Vikas R Dharnidharka, Neil Vyas, Joseph P Gaut, Leslie Walther, S Paul Hmiel
BACKGROUND: Surveillance biopsies (SBs) are performed in some pediatric kidney transplant programs, based on data obtained in earlier immunosuppressive eras that the treatment of subclinical acute rejection results in better graft survival. The benefit of SBs for patients on modern immunosuppression regimens is unclear. We have therefore evaluated the clinical utility of SBs in a population of children receiving a kidney transplant. METHODS: We have performed SBs at 3, 6 and 12 months post-transplantation as standard of care at our institution since 2013 in patients on a regimen of rabbit anti-thymocyte globulin, tacrolimus, mycophenolate and rapid steroid taper (RST; steroids maintained in some exceptions)...
December 19, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29230684/imipenem-relebactam-and-meropenem-vaborbactam-two-novel-carbapenem-%C3%AE-lactamase-inhibitor-combinations
#5
REVIEW
George G Zhanel, Courtney K Lawrence, Heather Adam, Frank Schweizer, Sheryl Zelenitsky, Michael Zhanel, Philippe R S Lagacé-Wiens, Andrew Walkty, Andrew Denisuik, Alyssa Golden, Alfred S Gin, Daryl J Hoban, Joseph P Lynch, James A Karlowsky
Relebactam (formerly known as MK-7655) is a non-β-lactam, bicyclic diazabicyclooctane, β-lactamase inhibitor that is structurally related to avibactam, differing by the addition of a piperidine ring to the 2-position carbonyl group. Vaborbactam (formerly known as RPX7009) is a non-β-lactam, cyclic, boronic acid-based, β-lactamase inhibitor. The structure of vaborbactam is unlike any other currently marketed β-lactamase inhibitor. Both inhibitors display activity against Ambler class A [including extended-spectrum β-lactamases (ESBLs), Klebsiella pneumoniae carbapenemases (KPCs)] and class C β-lactamases (AmpC)...
December 12, 2017: Drugs
https://www.readbyqxmd.com/read/29187254/acute-disseminated-melioidosis-giving-rise-to-pneumonia-and-renal-abscesses-complicated-with-thrombotic-thrombocytopenic-purpura-in-a-post-partum-woman-a-case-report
#6
Piyumi Sachindra Alwis Wijewickrama, Rohini Weerakoon
BACKGROUND: Melioidosis is an established endemic infection in Sri Lanka, caused by Burkholderia pseudomallei, a gram negative bacterium distributed in saprophytes in soil and surface water. Main mode of transmission is via percutaneous inoculation. Pneumonia is the most common presentation in acute disease. CASE PRESENTATION: We report a 33 year old previously healthy Sinhalese female with an occupational exposure to surface water in paddy fields, who was on postpartum day 6 following an uncomplicated pregnancy and delivery via an elective caesarian section...
November 29, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29069028/factors-associated-with-severe-sepsis-or-septic-shock-in-complicated-pyelonephritis
#7
Juan D Ruiz-Mesa, Ignacio Marquez-Gomez, Gabriel Sena, Veronica A Buonaiuto, Juan Mora Ordoñez, Manuel Salido, Antonio Plata Ciézar, Lucía Valiente-De Santis, Concepción Mediavilla, Juan D Colmenero
Severe sepsis or septic shock are the main factors influencing the prognosis of acute pyelonephritis (APN). Our aim was to analyze factors associated with the development of severe sepsis or septic shock in a large sample of patients with acute complicated pyelonephritis (ACPN).This prospective observational study comprised 1507 consecutive patients aged 14 years or older who were admitted to a tertiary care hospital because of ACPN between 1997 and 2015. Covariates associated in univariate analysis with severe sepsis or septic shock were then analyzed by multivariate logistic regression...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29038272/population-pharmacokinetic-analysis-of-cefiderocol-a-parenteral-siderophore-cephalosporin-in-healthy-subjects-subjects-with-varying-renal-function-and-patients-with-complicated-urinary-tract-infection-or-acute-uncomplicated-pyelonephritis
#8
Nao Kawaguchi, Takayuki Katsube, Roger Echols, Toshihiro Wajima
Cefiderocol, a novel parenteral siderophore cephalosporin, exhibits potent efficacy against most Gram-negative bacteria including carbapenem-resistant strains. The aim of this study is to perform a population pharmacokinetic (PK) analysis based on plasma cefiderocol concentrations in healthy subjects, subjects with varying renal function, and patients with complicated urinary tract infection (cUTI) or acute uncomplicated pyelonephritis (AUP) caused by Gram-negative pathogens, and to calculate the fraction of time during the dosing interval where the free drug concentration in plasma exceeds the minimum inhibitory concentration (MIC) (fT>MIC)...
October 16, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29020720/pyelonephritis-can-lead-to-life-threatening-complications
#9
Declan B Keenan, Declan M O'Rourke, Aisling E Courtney
Acute pyelonephritis is suggested by the constellation of fever (temperature ≥ 38.5° C), flank pain (typically unilateral), nausea and vomiting, and costovertebral angle tenderness. Complaints typical of lower UTI are variably present. The severity of symptoms ranges from a mild pyrexial illness to life-threatening sepsis. The diagnosis of acute pyelonephritis should be suspected on the basis of the history and clinical examination. If the urine dipstick is negative for nitrites and leukocyte esterase this does not exclude the diagnosis, but it should prompt a re-evaluation of the clinical features and consideration of other potential diagnoses...
February 2017: Practitioner
https://www.readbyqxmd.com/read/28954556/an-update-on-new-antibiotic-prophylaxis-and-treatment-for-urinary-tract-infections-in-children
#10
Jean Daniel Delbet, Mathie Lorrot, Tim Ulinski
This review focuses on the treatment of urinary tract infections (UTI) in children and in particular its recent changes. Areas covered: Acute pyelonephritis, acute cystitis and asymptomatic bacteriuria or asymptomatic infections have to be clearly distinguished. Prompt treatment is required in pyelonephritis and cystitis, but not in asymptomatic bacteriuria or infection, in order to avoid selection of more virulent strains. This concept should be considered even in immunocompromised or bedridden children. In case of pyelonephritis, there should be no delay in beginning the antibiotic treatment in order to decrease the risk of long term complication, such as renal scars...
October 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28952688/-antimicrobial-resistance-of-uropathogens-in-patients-with-acute-obstructive-pyelonephritis
#11
Yu L Naboka, I A Gudima, E V Mitusova, S K Bedzhanyan, P P Morgun, M I Kogan, K T Dzhalagoniya, M A Akimenko
RELEVANCE: Acute pyelonephritis is known to be the most complicated and severe urinary tract infection occurring in all age groups and accounting for 14% of all kidney diseases. The generally recognized standard antibiotic therapy cannot completely prevent the progression of the disease to its chronic form after relief of its acute manifestations thus leading to a high incidence of relapses. The aim of our study was to investigate the spectrum of uropathogens and their antibiotic sensitivity in acute obstructive pyelonephritis...
September 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28951990/clinical-utility-of-fdg-pet-ct-in-acute-complicated-pyelonephritis-results-from-an-observational-study
#12
Chih-Hsing Wan, Jing-Ren Tseng, Ming-Hsun Lee, Lan-Yan Yang, Tzu-Chen Yen
BACKGROUND: Acute complicated pyelonephritis (ACP) is an upper urinary tract infection associated with coexisting urinary tract abnormalities or medical conditions that could predispose to serious outcomes or treatment failures. Although CT and magnetic resonance imaging (MRI) are frequently used in patients with ACP, the clinical value of (18)F-fluorodeoxyglucose positron emission tomography and computed tomography (FDG PET/CT) has not been systematically investigated. This single-center retrospective study was designed to evaluate the potential usefulness of FDG PET/CT in patients with ACP...
September 26, 2017: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28911880/pelvic-exenteration-for-gynecologic-malignancies-postoperative-complications-and-oncologic-outcomes
#13
A Romeo, M I Gonzalez, J Jaunarena, M E Zubieta, G Favre, J C Tejerizo
INTRODUCTION AND OBJECTIVE: To evaluate complications, morbidity and oncologic outcomes of pelvic exenteration as treatment for gynecologic malignancies. MATERIALS AND METHODS: Between 2008 and 2015, a total of 35 patients underwent pelvic exenteration, due to recurrence of gynecological cancer. Surgical outcomes, early and late postoperative complications, and recurrence/survival outcomes were assessed. RESULTS: Mean patient age was 53.8 years...
September 11, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28895201/long-term-kidney-transplant-survival-in-patients-with-continent-urinary-diversion
#14
Romain Fournier, Ricardo Codas-Duarte, Theresa Daily, Xavier Martin, Lionel Badet, Hakim Fassi-Fehri
OBJECTIVES: To report the long-term survival of transplanted kidneys in patients with a continent urinary diversion. METHODS: Between January 1987 and July 2015, 16 patients with a median age of 37 years (range 21-63 years) underwent kidney transplantation on a continent urinary diversion. A total of 14 patients presented irreversible dysfunction of the lower urinary tract, and two patients had required radical cystectomy because of bladder cancer. All continent urinary diversions were carried out before the transplantation...
November 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28868940/vigilance-on-use-of-drugs-herbal-products-and-food-supplements-during-pregnancy-focus-on-fosfomycin
#15
C Mannucci, G Dante, M Miroddi, F Facchinetti, R D'Anna, A Santamaria, M C Lenti, A Vannacci, F Calapai, M Perone, G Migliardi, A Alibrandi, M Navarra, G Calapai
PURPOSE: Urinary tract infection (UTI) is defined as a common bacterial infection that can lead to significant morbidity such as stricture, fistula, abscess formation, bacteremia, sepsis, pyelonephritis, and kidney dysfunction with a mortality rates reported of 1% in men and 3% in women because of development of pyelonephritis. UTIs are more common in women and the 33% of them require antimicrobials treatment for at least one episode by the age of 24 years. UTIs are the most common infections observed during pregnancy and up to 30% of mothers with not treated asymptomatic bacteriuria may develop acute pyelonephritis which consequently can be associated to adverse maternal and fetal outcomes...
September 17, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28845939/-experience-in-ureteroscopy-for-managing-urolithiasis-in-one-clinic-when-does-quantity-transform-into-quality
#16
V Yu Ivanov, V A Malkhasyan, I V Semenyakin, D Yu Pushkar
INTRODUCTION: In recent years, there has been an increasing role of ureteroscopy in managing urinary tract calculi of various locations. Several studies have reported the relationship between the efficacy and safety of ureteroscopic interventions and surgeons skills and hospital caseload volume. The aim of our study was to assess the effectiveness of urethroscopic stone removal, the changes in treatment effectiveness, frequency and types of complications along with gaining experience in these interventions...
July 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28764263/acute-pyelonephritis-correlation-of-clinical-parameter-with-radiological-imaging-abnormalities
#17
Leelavathi Venkatesh, Ramalingiah Karadakere Hanumegowda
INTRODUCTION: Pyelonephritis (PN) is a suppurative infection of the kidney, most commonly due to bacterial infection and may be either acute or chronic. Acute PN (APN) subdivided into uncomplicated and complicated. Severity of PN cannot be assessed by clinical or laboratorial parameters alone, radiological imaging such as Ultrasound (USG) abdomen, Computed Tomography (CT) is required to know the nature, extent and severity of disease and for planning interventions. AIM: The aim of this study was to compare clinical and biochemical parameters with radiological findings (USG/CT) among patients diagnosed to have PN...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28584849/carbapenem-resistant-enterobacteriaceae-infections-results-from-a-retrospective-series-and-implications-for-the-design-of-prospective-clinical-trials
#18
Elizabeth L Alexander, Jeffery Loutit, Mario Tumbarello, Richard Wunderink, Tim Felton, George Daikos, Karen Fusaro, Dan White, Shu Zhang, Michael N Dudley
BACKGROUND: The increasing incidence of multidrug-resistant Gram negatives, such as carbapenem-resistant Enterobacteriaceae (CRE), has resulted in a critical need for new antimicrobials. Most studies of new antimicrobials have been performed in patients with nondrug-resistant pathogens. We performed a retrospective analysis of patients with CRE infections to inform the design of phase 3 clinical trials. METHODS: This was a retrospective study at 22 centers in 4 countries...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28577933/impact-of-selective-reporting-of-antibiotic-susceptibility-test-results-on-the-appropriateness-of-antibiotics-chosen-by-french-general-practitioners-in-urinary-tract-infections-a-randomised-controlled-case-vignette-study
#19
Loic Bourdellon, Nathalie Thilly, Sébastien Fougnot, Céline Pulcini, Sandrine Henard
Selective reporting of antibiotic susceptibility test (AST) results is a potential intervention for laboratory-based antibiotic stewardship. The aim of this study was to assess the impact of AST reporting on the appropriateness of antibiotics selected by French general practitioners for urinary tract infections (UTIs). A randomised controlled case-vignette study in a region of northeast France surveyed general practitioners between July and October 2015 on treatment of four clinical cases of community-acquired Escherichia coli UTIs (two cases of complicated cystitis, one of acute pyelonephritis and one male UTI)...
August 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28575389/prospective-randomized-double-blind-phase-2-dose-ranging-study-comparing-efficacy-and-safety-of-imipenem-cilastatin-plus-relebactam-with-imipenem-cilastatin-alone-in-patients-with-complicated-urinary-tract-infections
#20
Matthew Sims, Valeri Mariyanovski, Patrick McLeroth, Wayne Akers, Yu-Chieh Lee, Michelle L Brown, Jiejun Du, Alison Pedley, Nicholas A Kartsonis, Amanda Paschke
Objectives: The β-lactamase inhibitor relebactam can restore imipenem activity against imipenem non-susceptible pathogens. Methods: To explore relebactam's safety, tolerability and efficacy, we conducted a randomized (1:1:1), controlled, Phase 2 trial comparing imipenem/cilastatin+relebactam 250 mg, imipenem/cilastatin+relebactam 125 mg and imipenem/cilastatin alone in adults with complicated urinary tract infections (cUTI) or acute pyelonephritis, regardless of baseline pathogen susceptibility...
September 1, 2017: Journal of Antimicrobial Chemotherapy
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