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Sheela Swamy, William Barcella, Maria De Iorio, Kiren Gill, Rajvinder Khasriya, Anthony S Kupelian, Jennifer L Rohn, James Malone-Lee
PURPOSE: Lower urinary tract symptoms (LUTS) may be associated with chronic urinary tract infection (UTI) undetected by routine diagnostic tests. Antimicrobial therapy might confer benefit for these patients. MATERIALS AND METHODS: Over 10 years, we treated patients with chronic LUTS. Pyuria was adopted as the principal biomarker of infection. Urinary leucocyte counts were recorded from microscopy of fresh midstream urine (MSU) samples. Antibiotics were prescribed and the prescription adjusted to achieve a measurable clinical response and a reduction in pyuria...
March 20, 2018: International Urogynecology Journal
Jennifer Kranz, Stefanie Schmidt, Cordula Lebert, Laila Schneidewind, Falitsa Mandraka, Mirjam Kunze, Sina Helbig, Winfried Vahlensieck, Kurt Naber, Guido Schmiemann, Florian M Wagenlehner
BACKGROUND: We aimed to update the 2010 evidence- and consensus-based national clinical guideline on the diagnosis and management of uncomplicated urinary tract infections (UTIs) in adult patients. Results are published in 2 parts. Part 1 covers methods, the definition of patient groups, and diagnostics. This second publication focuses on treatment of acute episodes of cystitis and pyelonephritis as well as on prophylaxis of recurrent UTIs. MATERIALS AND METHODS: An interdisciplinary group consisting of 17 representatives of 12 medical societies and a patient representative was formed...
March 14, 2018: Urologia Internationalis
Mohd Rizwan, Mohd Akhtar, Abul Kalam Najmi, Kuldeep Singh
AIM: This study was carried out to record the sensitivity/resistance pattern of Escherichia coli and Klebsiella pneumoniae towards antimicrobial drugs prescribed to urinary tract infection (UTI) patients. MATERIALS AND METHODS: A total of 68 bacteriologically proven simple UTI patients were included in the study, based on inclusion and exclusion criteria. Subjects demographics, antibiotics prescribed, sensitivity pattern of antibiotics towards the urinary pathogens were recorded in drug utilization and documentation form...
March 12, 2018: Drug Research
Janelle Guirguis-Blake, Gina A Keppel, John Holmes, Rex W Force, William Kriegsman, Laura-Mae Baldwin
Background: Patients with chronic kidney disease (CKD) are at high risk for adverse drug events related to medication dosing errors and prescriptions for relatively contraindicated medications, such as non-steroidal anti-inflammatory drugs (NSAIDs). Objectives: To examine the scope of and variation in prescribing relatively contraindicated medications and medications above the recommended dose levels among patients with stage III/IV CKD in primary care practice...
February 26, 2018: Family Practice
Cliodna McNulty, Meredith Hawking, Donna Lecky, Leah Jones, Rebecca Owens, André Charlett, Chris Butler, Philippa Moore, Nick Francis
Objectives: To determine whether local trainer-led TARGET antibiotic interactive workshops improve antibiotic dispensing in general practice. Methods: Using a McNulty-Zelen-design randomized controlled trial within three regions of England, 152 general practices were stratified by clinical commissioning group, antibiotic dispensing rate and practice patient list size, then randomly allocated to intervention (offered TARGET workshop that incorporated a presentation, reflection on antibiotic data, promotion of patient and general practice (GP) staff resources, clinical scenarios and action planning, 73 practices) or control (usual practice, 79 practices)...
March 5, 2018: Journal of Antimicrobial Chemotherapy
Ana Verónica Martínez-Vázquez, Gildardo Rivera-Sánchez, Krystal Lira Méndez, Miguel Ángel Reyes-López, Virgilio Bocanegra-García
OBJECTIVE: The aim of this work was to determinate the prevalence of Escherichia coli and its resistance to antimicrobials and the presence of virulence genes in retail samples of beef and pork in several locations in Tamaulipas. METHODS: In this work, a total of 106 samples (beef and pork) collected from August 2013 to March 2014, were analyzed to detect Escherichia coli and then analyzed for virulence, antibiotic resistance gene detection, and tested for susceptibility to 16 antimicrobials...
February 28, 2018: Journal of Global Antimicrobial Resistance
Desmond Hsu, Mark Melzer
BACKGROUND AND AIM: In 2017, National Health Service Improvement set a 10% reduction target for Escherichia coli bacteraemia by 2018, followed by a 50% reduction in healthcare-associated Gram-negative bacteraemias by 2022. We analysed consecutive cases of E. coli bacteraemia and devised a strategy to achieve these targets. METHODS: From December 2012 to November 2013, demographic, clinical and microbiological data were prospectively collected on all patients with bacteraemia at the Royal London Hospital in East London, UK...
February 20, 2018: Postgraduate Medical Journal
Victoria Gordon, Ratul Adhikary, Victoria Appleby, Debasis Das, James Day, Toby Delahooke, Selena Dixon, David Elphick, Claire Hardie, Barbara Hoeroldt, Patricia Hooper, John Hutchinson, Rebecca Jones, Faisal Khan, Guruprasad P Aithal, John McGonigle, Andrew Nelson, Alick Nkhoma, Stavroula Pelitari, Martin Prince, Annell Prosser, Vinay Sathanarayana, Sophia Savva, Naina Shah, Sushma Saksena, Sreedhari Thayalasekaran, Deven Vani, Andrew Yeoman, Dermot Gleeson
BACKGROUND AND AIMS: There is limited information regarding patients with AIH outside relatively few large centres. We describe here the presenting features of patients with AIH, collected as part of an audit involving 28 UK hospitals. METHODS: Patients (incident since 1/1/2007 or prevalent since 1/1/2000) were >18 years and either met 1999 International AIH Group (IAIHG) diagnostic criteria (n=1164), or received immunosuppressive therapy for clinically diagnosed AIH (n=103)...
February 17, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
David E Lewandowski, David Pierce, Anne Barnett, Emmanuel Sampene, Nasia Safdar, Michael E Field, Jennifer M Wright
PURPOSE: Urinary catheter placement is common during atrial fibrillation (AF) ablation when performed under general anesthesia. Whether patients undergoing AF ablation would benefit from prophylactic antibiotics is unknown. METHODS: Patients undergoing AF ablation in a single center from December 2011 until June 2016 were included. All patients received urinary catheters and general anesthesia. After June 2014, patients received antibiotic prophylaxis with a single dose of oral nitrofurantoin and a catheter insertion checklist performed prior to urinary catheter placement...
February 14, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Maniya Arshadi, Mahmood Mahmoudi, Moloud Sadat Motahar, Saber Soltani, Mohammad Reza Pourmand
Background: This study aimed to investigate the incidence of antibiotic-resistance and virulence genes in vancomycin-resistant Enterococcus faecium isolated from different sources in southwest Iran from Mar to Sep 2015. Methods: Overall, 120 E. faecium isolates (80 VRE and 40 vancomycin-susceptible enterococci [VSE] isolates) were obtained from four hospitals. The resistance of the VRE isolates was determined by disk diffusion method. Multiplex PCR was performed to detect the virulence genes carried by the E...
February 2018: Iranian Journal of Public Health
Elizabeth Crellin, Kathryn E Mansfield, Clémence Leyrat, Dorothea Nitsch, Ian J Douglas, Adrian Root, Elizabeth Williamson, Liam Smeeth, Laurie A Tomlinson
OBJECTIVE: To determine if trimethoprim use for urinary tract infection (UTI) is associated with an increased risk of acute kidney injury, hyperkalaemia, or sudden death in the general population. DESIGN: Cohort study. SETTING: UK electronic primary care records from practices contributing to the Clinical Practice Research Datalink linked to the Hospital Episode Statistics database. PARTICIPANTS: Adults aged 65 and over with a prescription for trimethoprim, amoxicillin, cefalexin, ciprofloxacin, or nitrofurantoin prescribed up to three days after a primary care diagnosis of UTI between April 1997 and September 2015...
February 9, 2018: BMJ: British Medical Journal
B Erol, M Culpan, H Caskurlu, U Sari, Y Cag, H Vahaboglu, S H Özumut, M I Karaman, T Caskurlu
PURPOSE: To determine changes in antimicrobial resistance and demographics of UTIs in pediatric patients in a single institution over a 6-year period. MATERIALS AND METHODS: The current study examined outpatient urinary isolates from patients aged <18 years. A retrospective cross-sectional analysis of bacteria isolated from children with UTI was performed between 2009 and 2014. The most common bacterial pathogens were determined in the following four age groups: <2 years; 2-5 years; 6-12 years; and 13-17 years...
January 9, 2018: Journal of Pediatric Urology
Menyfah Q Alanazi, Fulwah Y Alqahtani, Fadilah S Aleanizy
BACKGROUND: Urinary tract infection (UTIS) is a common infectious disease in which level of antimicrobial resistance are alarming worldwide. Therefore, this study aims to describe the prevalence and the resistance pattern of the main bacteria responsible for UTIS Escherichia coli (E. coli). METHODS: Retrospective chart review for patients admitted to emergency department and diagnosed with UTIS at KAMC, in Riyadh, Saudi Arabia between January to March 2008 was performed...
February 9, 2018: Annals of Clinical Microbiology and Antimicrobials
Kristen L Bunnell, Eric Wenzler, Amanda T Harrington, Larry H Danziger
Breakpoint changes may impact cephalosporin susceptibility rates in uncomplicated urinary tract infections (uUTIs). Applying the ≤16-mg/L breakpoint to urine cultures from adult women in an academic health system resulted in cefazolin being the most active uUTI antimicrobial, with 86.9% susceptibility, compared to levofloxacin (80%), nitrofurantoin (76.5%), and sulfamethoxazole-trimethoprim (72.6%).
December 16, 2017: Diagnostic Microbiology and Infectious Disease
Koen B Pouwels, Rachel Freeman, Berit Muller-Pebody, Graeme Rooney, Katherine L Henderson, Julie V Robotham, Timo Smieszek
Objectives: To evaluate the association between use of different antibiotics and trimethoprim resistance at the population level. Methods: Monthly primary care prescribing data were obtained from NHS Digital. Positive Enterobacteriaceae records from urine samples from patients between April 2014 and January 2016 in England were extracted from PHE's Second Generation Surveillance System (SGSS). Elastic net regularization and generalized boosted regression models were used to evaluate associations between antibiotic prescribing and trimethoprim resistance, both measured at Clinical Commission Group level...
January 31, 2018: Journal of Antimicrobial Chemotherapy
Ashley Bryce, Céire Costelloe, Mandy Wootton, Christopher C Butler, Alastair D Hay
Background: All-cause antibiotic prescribing affects bowel flora antimicrobial susceptibility, and may increase risk of urinary autoinoculation with antibiotic-resistant microbes. However, little is known about relative prevalence of, or risk factors for, antimicrobial resistance among potentially pathogenic microbes thought to be contaminating and infecting urine. Methods: Secondary analysis of 824 children under 5 years of age consulting in primary care for an acute illness and their Escherichia coli isolates cultured at ≥103 cfu/mL from the Diagnosis of Urinary Tract infection in Young children (DUTY) study...
January 29, 2018: Journal of Antimicrobial Chemotherapy
David Garrido, Santiago Garrido, Miguel Gutiérrez, Leonel Calvopiña, Amani Sunday Harrison, Michelle Fuseau, Ramiro Salazar Irigoyen
BACKGROUND: Urinary tract infections (UTI) are among the most common infections in pediatric patients. The main etiopathogenic agent is Escherichia coli. The purpose of this study was to determine the antimicrobial resistance pattern of E. coli in pediatric patients and to understand their main clinical and laboratory manifestations. METHODS: Fifty-nine patients were included in the study and classified into two groups: hospitalization (H) and external consultation (EC)...
July 2017: Boletín Médico del Hospital Infantil de México
Florian Hitzenbichler, Michaela Simon, Thomas Holzmann, Michael Iberer, Markus Zimmermann, Bernd Salzberger, Frank Hanses
PURPOSE: Escherichia coli urine isolates from patients presenting to the emergency department at a German tertiary care hospital were retrospectively analyzed from January 2015-March 2017 to determine antibiotic resistance patterns and patient risk factors for resistance. METHODS: Uncomplicated urinary tract infection (UTI) was defined as UTI in the otherwise healthy patient without relevant co-morbidities and complications. Patients were assumed to have UTI if diagnosis was made by the attending physician with conclusive dipstick results...
January 24, 2018: Infection
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