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https://www.readbyqxmd.com/read/29207766/successful-management-of-urosepsis-with-ceftriaxone-sulbactam-edta-a-case-report-of-penem-sparing-approach
#1
Amit Bery, Candy Sodhi, Rishu Bhanot
Over the past decade, the Anti-Microbial Resistance (AMR) among members of Enterobacteriaceae family is on rise mainly due to rapid spread of strains producing Extended-Spectrum Beta-Lactamases (ESBLs) and Metallo Beta-Lactamases (MBLs). Hence, the choice of drugs available for these resistant strains is diminishing and their treatment is becoming more challenging. This is a case of complicated Urinary Tract Infection (cUTI) due to ESBL producing E. coli leading to septic shock which was successfully managed with Antibiotic Adjuvant Entity (AAE), a combination of ceftriaxone+sulbactam+EDTA...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29181135/graves-disease-thyrotoxicosis-and-propylthiouracil-related-agranulocytosis-successfully-treated-with-therapeutic-plasma-exchange-and-g-csf-followed-by-total-thyroidectomy
#2
Anna Candoni, Federico De Marchi, Fabio Vescini, Sara Mauro, Cristina Rinaldi, Marco Piemonte, Nicholas Rabassi, Maria Vittoria Dubbini, Renato Fanin
Antithyroid drugs can be a rare cause of agranulocytosis (0.5% of treated patients). Suspension of these drugs is mandatory in these patients and may result in worsening hyperthyroidism. We report the case of a 27-year-old woman who is 3 months post-partum, breastfeeding, and suffering with Graves' disease hyperthyroidism treated first with methimazole and then with propylthiouracil due to a methimazole allergy. She was admitted for urosepsis and agranulocytosis. The patient was diagnosed with propylthiouracil related agranulocytosis, diffuse toxic goiter and thyro-gastric syndrome...
2017: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/29171624/-antimicrobial-susceptibility-of-bacteria-causing-urosepsis
#3
Manuel Catalán, Inés Cerón, Gastón Astroza
No abstract text is available yet for this article.
June 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/29151053/protocol-of-the-sepsivit-study-a-prospective-observational-study-to-determine-whether-continuous-heart-rate-variability-measurement-during-the-first-48-hours-of-hospitalisation-provides-an-early-warning-for-deterioration-in-patients-presenting-with-infection
#4
Vincent M Quinten, Matijs van Meurs, Maurits H Renes, Jack J M Ligtenberg, Jan C Ter Maaten
INTRODUCTION: One in five patients with sepsis deteriorates within 48 hours after hospital admission. Regrettably, a clear tool for the early detection of deterioration is still lacking. The SepsiVit study aims to determine whether continuous heart rate variability (HRV) measurement can provide an early warning for deterioration in patients presenting with suspected infection or sepsis to the emergency department (ED). METHODS AND ANALYSIS: The protocol of a prospective observational study in the ED...
November 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/29150394/efficacy-of-prostatic-artery-embolization-for-catheter-dependent-patients-with-large-prostate-sizes-and-high-comorbidity-scores
#5
Shivank Bhatia, Vishal K Sinha, Bruce R Kava, Christopher Gomez, Sardis Harward, Sanoj Punnen, Issam Kably, Jeffrey Miller, Dipen J Parekh
PURPOSE: To evaluate efficacy and safety of prostate artery embolization (PAE) in urinary catheter-dependent patients with large prostate volumes and high comorbidity scores. MATERIALS AND METHODS: A retrospective single-center review was conducted of 30 patients with urinary retention at time of PAE from November 2014 through February 2017. Mean (range) age was 73.1 years (48-94 y), age-adjusted Charlson comorbidity index was 4.5 (0-10), duration of urinary retention was 63...
November 15, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29149963/urinary-tract-infections-in-the-first-year-post-kidney-transplantation-potential-benefits-of-treating-asymptomatic-bacteriuria
#6
P Kotagiri, D Chembolli, J Ryan, P D Hughes, N D Toussaint
BACKGROUND: Urinary tract infections (UTIs) are the commonest infectious complication in kidney transplant recipients (KTRs). No recommendations exist regarding treatment of asymptomatic bacteriuria. We aimed to identify potential risk factors and microbiological profile for UTIs, the role of treatment of asymptomatic bacteriuria, and effects on graft outcomes of bacteriuria within the first year post-transplantation. METHODS: We performed a retrospective analysis of UTIs in KTRs transplanted between January 2012 and December 2013 in 2 transplantation centers...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29124246/validation-of-apache-ii-scoring-system-at-24-hours-after-admission-as-a-prognostic-tool-in-urosepsis-a-prospective-observational-study
#7
Sundaramoorthy VijayGanapathy, VIlvapathy Senguttuvan Karthikeyan, Jayaram Sreenivas, Ashwin Mallya, Ramaiah Keshavamurthy
Purpose: Urosepsis implies clinically evident severe infection of urinary tract with features of systemic inflammatory response syndrome (SIRS). We validate the role of a single Acute Physiology and Chronic Health Evaluation II (APACHE II) score at 24 hours after admission in predicting mortality in urosepsis. Materials and Methods: A prospective observational study was done in 178 patients admitted with urosepsis in the Department of Urology, in a tertiary care institute from January 2015 to August 2016...
November 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/29123004/klebsiella-pneumoniae-renal-abscess-and-peritonitis-in-a-peritoneal-dialysis-patient-a-novel-route-of-infection
#8
Miten J Dhruve, Joanne M Bargman
We present a peritoneal dialysis (PD) patient who had a renal biopsy performed during an episode of urosepsis and subsequently presented with a renal abscess at the biopsy site along with concurrent peritonitis. Microbiology from the PD effluent and from the renal abscess were both positive for Klebsiella pneumoniae We propose that the PD peritonitis was the result of seeding of the peritoneal cavity with bacteria from the renal abscess. Successful treatment was achieved through drainage of the abscess and intraperitoneal antibiotics...
November 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29066548/genome-wide-discovery-of-genes-required-for-capsule-production-by-uropathogenic-escherichia-coli
#9
Kelvin G K Goh, Minh-Duy Phan, Brian M Forde, Teik Min Chong, Wai-Fong Yin, Kok-Gan Chan, Glen C Ulett, Matthew J Sweet, Scott A Beatson, Mark A Schembri
Uropathogenic Escherichia coli (UPEC) is a major cause of urinary tract and bloodstream infections and possesses an array of virulence factors for colonization, survival, and persistence. One such factor is the polysaccharide K capsule. Among the different K capsule types, the K1 serotype is strongly associated with UPEC infection. In this study, we completely sequenced the K1 UPEC urosepsis strain PA45B and employed a novel combination of a lytic K1 capsule-specific phage, saturated Tn5 transposon mutagenesis, and high-throughput transposon-directed insertion site sequencing (TraDIS) to identify the complement of genes required for capsule production...
October 24, 2017: MBio
https://www.readbyqxmd.com/read/29054953/vancomycin-associated-drug-reaction-with-eosinophilia-and-systemic-symptoms-dress-syndrome-masquerading-under-the-guise-of-sepsis
#10
Luke Maxfield, Toni Schlick, Angela Macri, James Thatcher
A patient presented with what appeared to be severe urosepsis. After admission and antibiotic administration, a newly developed rash and subsequent facial swelling appeared to be a reaction to penicillin class antibiotics. However, despite changing class of therapy with continued antimicrobial coverage, end organ damage continued, the rash worsened and facial oedema developed. Drug reaction with eosinophilia and systemic symptoms was ultimately diagnosed and was consistent with clinical and histopathological findings, as well as meeting all criteria for scoring systems...
October 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29017505/study-protocol-patient-reported-outcomes-for-bladder-management-strategies-in-spinal-cord-injury
#11
Darshan P Patel, Sara M Lenherr, John T Stoffel, Sean P Elliott, Blayne Welk, Angela P Presson, Amitabh Jha, Jeffrey Rosenbluth, Jeremy B Myers
BACKGROUND: The majority of spinal cord injury (SCI) patients have urinary issues, such as incontinence, retention, and frequency. These problems place a significant burden on patients' physical health and quality of life (QoL). There are a wide variety of bladder management strategies available to patients with no clear guidelines on appropriate selection. Inappropriate bladder management can cause hospitalizations and serious complications, such as urosepsis and renal failure. Patients believe that both independence and ability to carry out daily activities are just as important as physical health in selecting the right bladder-management strategy but little is known about patient's QoL with different bladder managements...
October 10, 2017: BMC Urology
https://www.readbyqxmd.com/read/28973965/biofilm-formation-by-uropathogenic-escherichia-coli-is-favored-under-oxygen-conditions-that-mimic-the-bladder-environment
#12
Allison R Eberly, Kyle A Floyd, Connor J Beebout, Spencer J Colling, Madison J Fitzgerald, Charles W Stratton, Jonathan E Schmitz, Maria Hadjifrangiskou
One of the most common urologic problems afflicting millions of people worldwide is urinary tract infection (UTI). The severity of UTIs ranges from asymptomatic bacteriuria to acute cystitis, and in severe cases, pyelonephritis and urosepsis. The primary cause of UTIs is uropathogenic Escherichia coli (UPEC), for which current antibiotic therapies often fail. UPEC forms multicellular communities known as biofilms on urinary catheters, as well as on and within bladder epithelial cells. Biofilm formation protects UPEC from environmental conditions, antimicrobial therapy, and the host immune system...
September 30, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28969204/giant-pyonephrosis-due-to-ureteropelvic-junction-obstruction-a-case-report
#13
Rupesh Gupta, Sweta Gupta, Arpan Choudhary, Supriya Basu
Pyonephrosis is a suppurative infection of upper urinary tract due to obstruction of the ureter. It is usually associated with suppurative damage of renal parenchyma and renal function loss. Patients are mostly symptomatic but may remain asymptomatic in 15% of cases. Severe infection in pyonephrosis may lead to urosepsis and may endangered life, if timely not treated with surgical intervention. We hereby report a rare case of Giant Pyonephrosis (GP), contained 11 liters of pus, due to Ureteropelvic Junction (UPJ) obstruction presented with haematuria...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28967060/original-flow-chart-for-the-management-of-hydroureteronephrosis-caused-by-pessary-placement
#14
Matteo Balzarro, Emanuele Rubilotta, Antonio B Porcaro, Nicolò Trabacchin, Antonio D'Amico, Maria Angela Cerruto, Walter Artibani
INTRODUCTION: The use of a pessary to treat a pelvic organ prolapse (POP) is a valid non-invasive option. Severe complications are usually associated with neglected, oversized, or misplaced pessaries. Major complications include fistulas, bowel or bladder erosion, and hydroureteronephrosis (HUN). MATERIALS AND METHODS: We reviewed the literature and our experience in the management of HUN in the last decade, as a consequence of pessary placement. RESULTS: We used flow charts to take an accurate medical history of each patient...
October 25, 2017: Urologia
https://www.readbyqxmd.com/read/28923621/extended-spectrum-beta-lactamase-producing-enterobacteriaceae-related-urinary-tract-infection-in-kidney-transplant-recipients-risk-factors-treatment-and-long-term-outcome
#15
S Brakemeier, S I Taxeidi, B Zukunft, D Schmidt, J Gaedeke, M Dürr, S Hansen, K Budde
BACKGROUND: Prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) has risen in kidney transplant (KT) patients, with no long-term data so far on graft function or survival. METHODS: KT patients with ESBL-E-positive urine culture were retrospectively analyzed regarding initial adequate antimicrobial therapy, recurrent infection, transplant function, and survival compared with an ESBL-E-negative KT control cohort. RESULTS: ESBL-E-positive KT patients (n = 93) were older (55...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28876082/co-production-of-ndm-1-and-oxa-232-by-st16-klebsiella-pneumoniae-italy-2016
#16
Manuela Avolio, Carla Vignaroli, Massimo Crapis, Alessandro Camporese
Carbapenem-resistant Klebsiella pneumoniae strains, New Delhi metallo-β-lactamase-1 producers, are still rare in Italy, being endemic in Southeast Asiatic region. In October 2016, a multidrug-resistant K. pneumoniae was isolated from blood and urine of an Italian long-hospitalized patient with urosepsis without travel history abroad. To the best of our knowledge, this is the first report of bacteremia caused by an ST16 K. pneuomoniae New Delhi metallo-β-lactamase-1 and OXA-232 co-producing carbapenemase, in Italy...
October 2017: Future Microbiology
https://www.readbyqxmd.com/read/28859205/acute-abdomen-syndrome-due-to-spontaneous-intraperitoneal-bladder-rupture-following-vaginal-delivery
#17
Dubravko Habek, Ingrid Marton, Ana Tikvica Luetic, Matija Prka, Zeljka Kuljak, Krešimir Živković, Mario Cenkovčan, Berislav Mazuran
We report a rare case of spontaneous intraperitoneal bladder rupture following normal vaginal delivery without concomitant uterine rupture. Key diagnostic clinical features were acute renal failure, new-onset ascites and bowel ileus with urosepsis. Laparotomy and bladder repair with omentum patch were performed with no adverse outcome reported.
August 31, 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/28814704/-clinical-evaluation-of-urosepsis-in-tane-general-hospital-clinical-utility-of-measurement-of-procalcitonin
#18
Yukinari Hosokawa, Takuto Shimizu, Takuya Owari, Kenji Otsuka, Yoshiki Hayashi, Kiyohide Fujimoto
We clinicaliye valuated 355 patients with urinarytract infections (UTI), suspected of having urosepsis at Tane General Hospital, and determined the usefulness of the biomarker procalcitonin (PCT) as an aid in predicting urosepsis. Clinical and microbiological data were collected. The logistic regression analysis was used to determine the risk factors of urosepsis. Of 355 patients, 169 patients (47.6%) were diagnosed with urosepsis. C-reactive protein (CRP) (OR 2. 633, p<0. 001), PCT (OR 2. 153, p=0. 003) and clinical diagnosis (calculous pyelonephritis OR 1...
July 2017: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/28806220/association-of-gender-with-outcome-and-host-response-in-critically-ill-sepsis-patients
#19
Lonneke A van Vught, Brendon P Scicluna, Maryse A Wiewel, Arie J Hoogendijk, Peter M C Klein Klouwenberg, David S Y Ong, Olaf L Cremer, Janneke Horn, Marek Franitza, Mohammad R Toliat, Peter Nürnberg, Marc M J Bonten, Marcus J Schultz, Tom van der Poll
OBJECTIVE: To determine the association of gender with the presentation, outcome, and host response in critically ill patients with sepsis. DESIGN AND SETTING: A prospective observational cohort study in the ICU of two tertiary hospitals between January 2011 and January 2014. PATIENTS: All consecutive critically ill patients admitted with sepsis, involving 1,815 admissions (1,533 patients). INTERVENTIONS: The host response was evaluated on ICU admission by measuring 19 plasma biomarkers reflecting organ systems implicated in sepsis pathogenesis (1,205 admissions) and by applying genome-wide blood gene expression profiling (582 admissions)...
November 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28794587/predictive-factors-for-fever-and-sepsis-following-percutaneous-nephrolithotomy-a-review-of-580-patients
#20
Sumit Suresh Bansal, Prakash Wamanrao Pawar, Ajit S Sawant, Ashwin Sunil Tamhankar, Sunil Raghunath Patil, Gaurav Vinod Kasat
AIMS: There has been much speculation and discussion about the infective complications of percutaneous nephrolithotomy (PCNL). While fever is common after PCNL, the incidence of it progressing to urosepsis is fortunately less. Which patient undergoing PCNL is at risk of developing urosepsis and in whom aggressive treatment of fever postoperatively may prevent the progression to severe sepsis becomes a very important question. This study aims to answer these vital questions. SETTINGS AND DESIGN: This is a single institutional, retrospective study over a period of 3 years...
July 2017: Urology Annals
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