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Complicated Acute pyelonephritis

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https://www.readbyqxmd.com/read/29069028/factors-associated-with-severe-sepsis-or-septic-shock-in-complicated-pyelonephritis
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/28509126/gram-negative-sepsis-following-biopsy-of-a-transplant-recipient-with-asymptomatic-allograft-pyelonephritis
#15
Hassan Al-Khayyat, Nigel Toussaint, Steve Holt, Peter Hughes
Pyelonephritis post-renal transplantation is common and in up to 50% of cases can be asymptomatic. Transplant pyelonephritis shares a lot of histopathological features with acute cellular rejection. We present a case of asymptomatic acute graft pyelonephritis where a renal biopsy was complicated by sepsis, and discuss the difficulties in interpretation of renal histology in the setting of transplant pyelonephritis where rejection may also be a possibility, but differentiation is challenging.
May 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28435791/emphysematous-pyelonephritis-with-renal-artery-pseudoaneurysm
#16
Kevin Koo, Elias S Hyams
Emphysematous pyelonephritis is an acute infection of the renal parenchyma and perinephric tissues caused by gas-forming microorganisms, resulting in the radiographic presence of gas in the kidney, collecting system, and surrounding spaces. Here we present a case of severe emphysematous pyelonephritis in the setting of Klebsiella urosepsis. Surgical exploration of the flank revealed infectious disintegration of the renal parenchyma into a large phlegmon. The post-operative course was complicated by renal artery pseudoaneurysm and cutaneous fistualization of a perinephric fluid collection...
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28430340/transurethral-contact-ureterolithotripsy-in-gas-%C3%B0-%C3%B0-2-medium
#17
Dmitry O Korolev, Peter V Glybochko, Leonid M Rapoport, Dmitry G Tsarichenko
BACKGROUND: Transurethral intracorporeal lithotripsy is the modality of choice for the endoscopic disintegration of large, long-standing, radiolucent or high-density stones. Despite several advantages and proven benefits of contact ureterolithotripsy/ureterolithoextraction (CULT), the application of irrigation carries significant risks of untoward perioperative events including retrograde stone migration and postoperative pyelonephritis. METHODS: We describe a new technique - endoscopic intracorporeal lithotripsy in the gas (СО2) medium...
April 14, 2017: Urologia
https://www.readbyqxmd.com/read/28394517/-technical-features-of-intestinal-ureteroplasty-art-6-simultaneous-ureteral-and-bladder-substitution
#18
B K Komyakov, A I Novikov, V A Ochelenko, B G Guliev, T Kh Al-Attar, M V Onoshko
AIM: To present the results and technical features of different methods of simultaneous ileal ureteral and bladder substitution. MATERIALS AND METHODS: From 2001 to 2016, 154 patients (mean age 52+/-9.2 years) underwent ileal and appendicular ureteroplasty. Of them, 70 (45.4%) were men and 84 (54.6%) women. Among them, 49 (31.8%) patients underwent ureteroplasty concurrently with orthotopic ileocystoplasty. The Studers ileal-ureter cystoplasty and Y-shaped bladder and ureteral reconstruction were performed in 38 (77...
April 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28338347/ceftazidime-avibactam-novel-antimicrobial-combination-for-the-treatment-of-complicated-urinary-tract-infections
#19
Jakhongir F Alidjanov, Moritz Fritzenwanker, Ivan Hoffman, Florian M Wagenlehner
Ceftazidime-avibactam is a combination of a third-generation cephalosporin and a novel non-beta-lactam beta-lactamase inhibitor. This combination was recently recommended for the treatment of complicated urinary tract infections, including acute pyelonephritis, in adults with limited or no alternative treatment options. The current review is aimed to determine activity, efficacy and safety of ceftazidime-avibactam in the treatment of patients with complicated urinary tract infections.
March 24, 2017: Future Microbiology
https://www.readbyqxmd.com/read/28248018/-diagnosis-and-treatment-of-cystitis-more-questions-than-answers
#20
E V Kulchavenya, S Yu Shevchenko, A G Cherednichenko
INTRODUCTION: Despite the prevalence of acute cystitis, there are still many unsolved problems of diagnosis and treatment of this disease. MATERIAL AND METHODS: To determine the nosological structure of dysuria, 126 female patients who sought medical attention for frequent painful urination were examined. To determine the incidence of outpatient visits to an urologist for patients with cystitis, medical records of 6753 patients of municipal outpatient clinic were analyzed...
November 2016: Urologii︠a︡
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