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Complicated Acute pyelonephritis

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https://www.readbyqxmd.com/read/29747905/prospective-evaluation-of-the-management-of-urinary-tract-infections-in-134-french-nursing-homes
#1
L Lemoine, C Dupont, A Capron, E Cerf, M Yilmaz, D Verloop, K Blanckaert, E Senneville, S Alfandari
OBJECTIVE: Prospective assessment of the management of urinary tract infections (UTI) in the nursing homes of the Hauts-de-France region. PATIENTS AND METHODS: A 50-question form had to be filled in for up to five consecutive residents treated for UTI in each nursing home. If necessary, diagnoses were reclassified according to the 2014 French Infectious Diseases Society guidelines. Analyses were presented per supposed (reported) and reclassified diagnoses. RESULTS: Of 397 contacted facilities, 134 participated and informed 444 UTI episodes...
May 7, 2018: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/29692218/meropenem-vaborbactam-a-new-weapon-in-the-war-against-infections-due-to-resistant-gram-negative-bacteria
#2
Twisha S Patel, Jason M Pogue, John P Mills, Keith S Kaye
Meropenem-vaborbactam is a fixed-dose combination product of a carbapenem and a cyclic boronic acid β-lactamase inhibitor with potent in vitro activity against Klebsiella pneumoniae carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CRE). The efficacy of meropenem-vaborbactam for the treatment of complicated urinary tract infections and acute pyelonephritis was demonstrated in a Phase III trial (TANGO I). Preliminary data from TANGO II, a separate Phase III study, support the efficacy of meropenem-vaborbactam for the treatment of infections caused by CRE...
April 25, 2018: Future Microbiology
https://www.readbyqxmd.com/read/29684946/-indwelling-of-full-length-metallic-ureteral-stents-as-an-initial-treatment-for-patients-with-untreated-malignant-ureteral-obstruction
#3
Toshifumi Tsurusaki, Akihiro Asai, Yushi Imasato
To examine the efficacy and safety of a full-length metallic ureteral stent (MS), Resonance®, we retrospectively evaluated 16 cases (22 ureteral units) with indwelling MS as the initial treatment for patients with untreated malignant ureteral obstruction (MUO). All patients had undergone MS insertion by the retrograde approach without cystoscopy, with indirect stent placement under fluoroscopy, as a new method that can be performed even if the number of medical staff is one less than that required. Both serum creatinine and estimated glomerular filtration rate values in all cases improved significantly (p<0...
February 2018: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/29571291/factors-associated-to-prevalence-and-treatment-of-carbapenem-resistant-enterobacteriaceae-infections-a-seven-years-retrospective-study-in-three-tertiary-care-hospitals
#4
Feng Pang, Xiu-Qin Jia, Qi-Gang Zhao, Yi Zhang
BACKGROUND: The increasing incidence of carbapenem-resistant Enterobacteriaceae (CRE), has resulted in a difficult problem in the current clinical anti-infective treatment. We performed a retrospective analysis of prevalence and treatment for CRE infections patients. METHODS: This study was conducted in three tertiary care hospitals from January 1, 2010 to December 30, 2016. Baseline data, treatment, and outcomes were collected in patients with ventilator-associated bacterial pneumonia (VABP), bacteremia, complicated urinary tract infection (cUTI)/acute pyelonephritis (AP), hospital-acquired bacterial pneumonia (HABP), superficial wound infection (SWI), biliary tract infection (BTI), deep wound infection (DWI) and sterile body fluids infection (SBFI) due to CRE...
March 23, 2018: Annals of Clinical Microbiology and Antimicrobials
https://www.readbyqxmd.com/read/29486041/effect-of-meropenem-vaborbactam-vs-piperacillin-tazobactam-on-clinical-cure-or-improvement-and-microbial-eradication-in-complicated-urinary-tract-infection-the-tango-i-randomized-clinical-trial
#5
RANDOMIZED CONTROLLED TRIAL
Keith S Kaye, Tanaya Bhowmick, Symeon Metallidis, Susan C Bleasdale, Olexiy S Sagan, Viktor Stus, Jose Vazquez, Valerii Zaitsev, Mohamed Bidair, Erik Chorvat, Petru Octavian Dragoescu, Elena Fedosiuk, Juan P Horcajada, Claudia Murta, Yaroslav Sarychev, Ventsislav Stoev, Elizabeth Morgan, Karen Fusaro, David Griffith, Olga Lomovskaya, Elizabeth L Alexander, Jeffery Loutit, Michael N Dudley, Evangelos J Giamarellos-Bourboulis
Importance: Meropenem-vaborbactam is a combination carbapenem/beta-lactamase inhibitor and a potential treatment for severe drug-resistant gram-negative infections. Objective: To evaluate efficacy and adverse events of meropenem-vaborbactam in complicated urinary tract infection (UTI), including acute pyelonephritis. Design, Setting, and Participants: Phase 3, multicenter, multinational, randomized clinical trial (TANGO I) conducted November 2014 to April 2016 and enrolling patients (≥18 years) with complicated UTI, stratified by infection type and geographic region...
February 27, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29416285/a-rare-case-of-renal-vein-thrombosis-secondary-to-klebsiella-pneumoniae-pyelonephritis
#6
Kelly L Lurz, Dany N Hanna, Brian H McGreen, Francis J Schanne
Renal vein thrombosis (RVT) is most often an implication of nephrotic syndrome. Pyelonephritis has been associated at a much lower rate, with the incidence of Klebsiella pneumoniae causation being extremely rare. In our case, a 35-year-old female patient presented with right-sided K. pneumoniae -positive acute pyelonephritis complicated by perinephric abscess and renal vein thrombosis. She was successfully treated with anticoagulation and extended antibiotic therapy. The possibility of RVT in patients with K...
January 2018: Urology Annals
https://www.readbyqxmd.com/read/29402148/urinary-tract-infection-during-pregnancy-current-concepts-on-a-common-multifaceted-problem
#7
Kallirhoe Kalinderi, Dimitrios Delkos, Michail Kalinderis, Apostolos Athanasiadis, Ioannis Kalogiannidis
Urinary tract infections (UTIs) are the most common bacterial infection in pregnancy, increasing the risk of maternal and neonatal morbidity and mortality. Urinary tract infections may present as asymptomatic bacteriuria, acute cystitis or pyelonephritis. Escherichia coli is the most common pathogen associated with both symptomatic and asymptomatic bacteriuria. If asymptomatic bacteriuria is untreated, up to 30% of mothers develop acute pyelonephritis, with an increased risk of multiple maternal and neonatal complications, such as preeclampsia, preterm birth, intrauterine growth restriction and low birth weight...
February 6, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29387559/inadvertent-placement-of-a-urinary-catheter-into-the-ureter-a-report-of-3-cases-and-review-of-the-literature
#8
Rui Luo, Song Liang Lee, Foo Cheong Ng, Li-Tsa Koh
We describe three cases of inadvertent placement of the urinary catheter into the ureter. An 85-year-old gentleman on long-term indwelling catheter (IDC) for neurogenic bladder presented with fever and right flank pain. CT of abdomen and pelvis demonstrated the tip of the IDC to be located within the right vesicoureteric junction with acute right hydronephrosis and acute pyelonephritis. A 74-year-old woman, on long-term IDC for neurogenic bladder was found to have hydronephrosis on ultrasound imaging. Contrast-enhanced CT intravenous pyelography done subsequently showed the IDC was in the right distal ureter...
October 2017: Asian Journal of Urology
https://www.readbyqxmd.com/read/29379541/vitamin-d-deficiency-is-associated-with-urinary-tract-infection-in-children
#9
Sherein Abdelhamid Shalaby, Nesrein Mosad Handoka, Rasha Emad Amin
Introduction: In humans, vitamin D has been shown to play a role in infectious diseases, but its association with acquisition and a complicated course of febrile urinary tract infections (UTIs) has not been investigated. We aimed to investigate the association between 25-hydroxyvitamin D (25(OH)D3 ) levels and the risk of first time febrile UTI in children. Material and methods: This prospective case-control study included 50 children with first febrile UTI, with no risk factors for UTI, and 50 age- and sex-matched healthy siblings as controls...
January 2018: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29378708/a-multicenter-randomized-double-blind-phase-2-study-of-the-efficacy-and-safety-of-plazomicin-compared-with-levofloxacin-in-the-treatment-of-complicated-urinary-tract-infection-and-acute-pyelonephritis
#10
Lynn E Connolly, Valerie Riddle, Deborah Cebrik, Eliana S Armstrong, Loren G Miller
Increasing antimicrobial resistance among uropathogens limits treatment options for patients with complicated urinary tract infection (cUTI). Plazomicin, a new aminoglycoside, has in vitro activity against multidrug-resistant Enterobacteriaceae , including isolates resistant to currently available aminoglycosides, as well as extended-spectrum β-lactamase-producing and carbapenem-resistant Enterobacteriaceae We evaluated the efficacy and safety of plazomicin in a double-blind, comparator-controlled, phase 2 study in adults with cUTI or acute pyelonephritis...
April 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29376597/-experience-of-157-vesikoscopic-operations-in-children
#11
A V Pirogov, V V Sizonov, M I Kogan
AIM: Recent advances in the field of minimally invasive surgical technologies in children and adolescents have led to the development of vesicoscopic (transvesical, pneumoscopic) access (VA). Current limitations in using VA emphasize the need for further studies investigating surgical options for the management of various pathological conditions of the bladder and ureterovesical junction, the features of surgical techniques and the course of the early postoperative period when used in pediatric urological practice...
December 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/29339393/early-clinical-assessment-of-the-antimicrobial-activity-of-finafloxacin-compared-to-ciprofloxacin-in-subsets-of-microbiologically-characterized-isolates
#12
Andreas Vente, Christine Bentley, Mark Lückermann, Paul Tambyah, Axel Dalhoff
Two phase II studies were performed with patients with uncomplicated urinary tract infections (uUTIs) and complicated urinary tract infections (cUTIs) or acute pyelonephritis (PN) to compare finafloxacin (300 mg twice a day [b.i.d.] orally for uUTI and 800 mg once a day [q.d.] intravenously [i.v.] for cUTI/PN) and ciprofloxacin (250 mg b.i.d. orally 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...
April 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
#13
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...
May 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29320948/the-profiles-of-soluble-adhesion-molecules-in-the-great-obstetrical-syndromes
#14
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)...
February 1, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29260318/the-utility-of-surveillance-biopsies-in-pediatric-kidney-transplantation
#15
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)...
May 2018: 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
#16
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)...
January 2018: 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
#17
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
#18
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-various-degrees-of-renal-function-and-patients-with-complicated-urinary-tract-infection-or-acute-uncomplicated-pyelonephritis
#19
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 was to perform a population pharmacokinetic (PK) analysis based on plasma cefiderocol concentrations in healthy subjects, subjects with various degrees of 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 the time during the dosing interval where the free drug concentration in plasma exceeds the MIC ( fT MIC )...
February 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29020720/pyelonephritis-can-lead-to-life-threatening-complications
#20
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
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