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PubMedDate not supplied

Generalized occurrence of the broadly antiviral substance UTI beta in mammalian sera.

This study compares the characteristics of naturally occurring antiviral activities in nonhuman mammalian sera to UTI beta (University of Texas virus inhibitor beta), an innate, non-specific viral inhibitor found in human serum. The antiviral agent in sera from four different species appears to possess properties similar to those of UTI beta, e.g. molecular weight of 60 +/- 10 kDa, broad spectrum antiviral activity, glycoprotein structure with antiviral oligosaccharide moiety(s) attached to a carrier protein, and inhibition of most viruses by preventing their attachment to target cells. These findings suggest that UTI beta or UTI beta-like virus inhibitors are a normal component of the non-specific immune defenses of mammals.

Animals↗
PubMed1988

Efficacy and safety of ciprofloxacin in the treatment of UTIs and RTIs in patients affected by liver diseases.

The clinical efficacy and the safety of ciprofloxacin was studied in 92 patients (aged 26 to 83 years; mean 57.5 years) affected by urinary tract infections (UTI) and respiratory tract infections (RTI) suffering also with various liver diseases. Ciprofloxacin was given orally at different dose regimens: 500 mg b.i.d. (22 cases), 250 mg b.i.d. (20 cases), 500 mg s.i.d. (20 cases) for the treatment of UTIs; 500 mg b.i.d. (ten cases) and 250 mg b.i.d. (20 cases) for the treatment of RTIs. The doses were not correlated to the severity of the infections. Patients were treated for five to 15 days. All the bacteria isolated from sputum or urine before treatment were sensitive to ciprofloxacin (MIC range less than or equal to 0.015 mg/l to 8 mg/l). The clinical and bacteriological responses were favourable in a high percentage of patients both for RTIs and UTIs, irrespective of the dose. Side effects were infrequent (7%) and mild (nausea, gastralgia, oral candidosis), never requiring the interruption of the treatment. No change in the blood chemistry tests was observed at any dose.

Adult↗
PubMed1995

Clinical evaluation of the slide centrifuge (cytospin) gram's stained smear for the detection of bacteriuria and comparison with the FiltraCheck-UTI and UTIscreen.

The cytospin Gram's stained smear method for the detection of bacteriuria was compared with the FiltraCheck-UTI, the UTIscreen and culture of urine specimens from adult male and female inpatients and outpatients in a tertiary care medical institution. At a level of > or = 10(5) CFU/mL, the sensitivity of all three methods was at least 93% for organisms identified as potential pathogens. Investigation of false-negative screening tests by chart review demonstrated that only 5 of 10 combined misses in this category were clinically significant. At a level of > or = 10(4) CFU/mL, the sensitivity of the cytospin method remained essentially unchanged, whereas that of the FiltraCheck-UTI and the UTIscreen decreased to 89% and 85%, respectively. False positives were most frequent with the FiltraCheck-UTI, which was due in part to the presence of white blood cells in the urine. All three tests performed well in this population of patients.

Adult↗
PubMed1995

Tc-99m DMSA SPECT imaging in patients with acute symptoms or history of UTI. Comparison with ultrasonography.

Although planar cortical scintigraphy has been demonstrated to be a sensitive test for the detection of renal infection and scarring, one criticism has been radiation dose to the renal cortex. Recent studies of cortical SPECT suggest a sensitivity for detection of lesions equal to, or greater than, that of planar scans. The authors prospectively performed SPECT scans on 36 patients referred for recurrent urinary tract infection (UTI) (11 of 36), or recent onset of symptoms of UTI (25/36) after 30-40% of the standard 130 MBq (3.5 mCi) adult dose of Tc-99m DMSA was administered. Comparison was made with ultrasonography (US) performed at, or near, the same time. Of 67 kidneys evaluated, 34 (51%) demonstrated focal cortical loss on Tc-99m DMSA scintigraphy, 1 kidney was small in size, and 32 kidneys were normal. Abnormalities were noticed in only 13 (19%) of kidneys on US. Previously, US has been the primary imaging modality in the evaluation of the young patient with UTI. Triple-headed Tc-99m DMSA SPECT scintigraphy is a more sensitive, low-dose (12 mGy, 1.2 r) method of detecting renal cortical abnormalities. As such, it is a more appropriate test for identifying sites of cortical infection and scarring and for following patients on prophylactic therapy for evidence of asymptomatic break-through infections.

Acute Disease↗
PubMed1988

Evaluation of the modified Bac-T-Screen and FiltraCheck-UTI urine screening systems for detection of clinically significant bacteriuria.

Previous evaluations of the Bac-T-Screen system (Vitek Systems, Inc., Hazelwood, Mo.) demonstrated excellent sensitivity with specimens from patients with clinically significant bacteriuria (including infections with small numbers of uropathogens) but poor specificity with specimens from noninfected patients. In the study reported here, the sensitivity and specificity of the Bac-T-Screen system with a modified decolorizing reagent were evaluated. A manual filtration system, FiltraCheck-UTI (Vitek Systems), for screening urine specimens, Gram stains of mixed urine specimens, and quantitative cultures were also evaluated. The test sensitivity for clinically significant bacteriuria was greater than 96% with the original Bac-T-Screen system as well as the modified system and the manual system. In comparison, the sensitivities of the Gram stains and quantitative cultures (greater than or equal to 10(5) CFU/ml) were 82 and 77%, respectively. Of the 375 patients classified as noninfected by clinical parameters, 34% had positive screening tests with the original Bac-T-Screen system, as compared with 13 and 11% with the modified Bac-T-Screen and FiltraCheck-UTI systems, respectively. Thus, the modified Bac-T-Screen system and the manual FiltraCheck-UTI system have sensitives comparable to that of the original Bac-T-Screen system and markedly improved test specificities.

Bacteria↗
PubMed2000

UTI: diagnosis and evaluation in symptomatic pediatric patients.

We retrospectively reviewed data on 260 hospitalized pediatric patients with symptomatic urinary tract infection (UTI). To ascertain the colony-forming units (CFU)/mL compatible with the diagnosis of UTI, a culture from a catheterized urine specimen containing >1,000 CFU/mL was considered diagnostic of UTI and resulted in imaging by renal ultrasound, voiding cystourethrography, and renal nuclear scan with Tc99m dimercaptosuccinic acid (DMSA). A positive DMSA renal scan is indicative of pyelonephritis. We used logistic regression analysis to determine which patient characteristics were predictive of pyelonephritis. We determined that, in hospitalized pediatric patients, the colony count of the positive urine culture, the type of organism grown in culture, and the voiding cystourethrography (VCUG) result (positive or negative for vesicoureteral reflux) did not predict which patients had pyelonephritis. In females, advancing age of the patient and positive renal ultrasound results were predictive of which patients had pyelonephritis when we controlled for other factors. We feel this emphasizes the importance of a thorough evaluation of hospitalized symptomatic patients, including patients with colony counts of 1,000 to 50,000 CFU/mL, to locate the level of infection and plan appropriate therapy.

Age Factors↗
PubMed2001

Recognizing UTIs in infants and children. Early treatment prevents permanent damage.

The risk of irreversible renal scarring leading to hypertension and renal failure underscores the importance of expedient and accurate diagnoses of UTIs in infants and children. The selective use of invasive techniques to obtain urine for culture may reduce false-positive results that lead to unnecessary treatment. Subsequent management of UTIs depends on the age of the patient and the severity of the illness. Heightened awareness and prompt management of UTIs in infants and children can result in reduced morbidity and improved outcomes.

Age Factors↗
PubMed2000

The human UTY gene encodes a novel HLA-B8-restricted H-Y antigen.

The mammalian Y chromosome encodes male-specific minor histocompatibility (H-Y) Ags that are recognized by female T cells in an MHC-restricted manner. Two human H-Y epitopes presented by HLA-A2 and HLA-B7, respectively, have been identified previously and both are derived from the SMCY gene. We previously isolated CD8+ CTL clones that recognized a male-specific minor histocompatibility Ag presented by HLA-B8. In contrast to the SMCY-encoded H-Y epitopes, the B8/H-Y Ag was not presented by fibroblasts from male donors, suggesting that it was encoded by a novel gene. We now report that the HLA-B8-restricted H-Y epitope is defined by the octameric peptide LPHNHTDL corresponding to aa residues 566-573 of the human UTY protein. Transcription of the UTY gene is detected in a wide range of human tissues, but presentation of the UTY-derived H-Y epitope to CTL by cultured human cells shows significant cell-type specificity. Identification of this CTL-defined H-Y epitope should facilitate analysis of its contribution to graft/host interactions following sex-mismatched organ and bone marrow transplantation.

Amino Acid Sequence↗
PubMed1999

Silver-coated catheter reduces hospital UTIs, associated costs.

IDEA BANK: Silver-coated catheter reduces hospital UTIs, associated costs. Catheter-associated UTI can extend a patient's hospital stay by 3.8 days, increasing costs significantly. Find out what new study says about a new catheter that decreased the incidence of UTIs in the study population.

Cost Savings↗
PubMed2001

Children's UTIs in the new millennium. Diagnosis, investigation, and treatment of childhood urinary tract infections in the year 2001.

OBJECTIVE: To provide an effective approach for family physicians treating children presenting with urinary tract infections (UTIs). QUALITY OF EVIDENCE: The information presented, and articles quoted, are drawn from both review of the literature and recent consensus guidelines. Data and recommendations come from prospective multicentre trials; retrospective reviews; expert consensus statements; and some smaller trials, commentaries, and editorials. MAIN MESSAGE: Urinary tract infections are often seen in family practice. Diagnosis requires suspicion and a realization that children, especially those younger than 2 years, often have very few, nonspecific signs of infection. Obtaining a proper urine sample is vital, because true infections require radiographic studies. Antibiotic prophylaxis is promoted because of the link between vesicoureteral reflux, recurrent UTIs, and renal scarring and hypertension. We generally provide prophylaxis until children are 3 or 4 years, when risk of damage from reflux is lessened and timely urine samples are easier to obtain for prompt therapy. Surgical opinion is sought only when medical management has failed. Failure is defined as either recurrent infections and pyelonephritis or poor renal growth. CONCLUSION: To diagnose UTIs in children, physicians must suspect them, obtain proper urine samples, order appropriate investigations to rule out underlying anatomic abnormalities, and treat with appropriate antibiotics considering both organism sensitivities and length of therapy.

Age Factors↗
PubMedDate not supplied

[Comparative study of the microbiological components in urinary infection (UTI)].

Hundred-six-fifty-one samples of urine obtained from external (460 samples) and hospitalized (191 samples) patients with suspected urinary tract infections (UTI) were analysed for bacterial flora isolation, identification of microorganisms and evaluation of their sensitivity to antimicrobial agents. 89 and 215 bacterial strains were identified in samples obtained respectively from external and hospitalized patients. E. coli was the dominant cause of community acquired UTI (68.59%), while the causative agents of UTI in hospitalized patients were Streptococcus faecalis (18.61%) and E. coli (13.96%).

Adult↗
PubMed1988

UTIs and two new antibiotics in the elderly.

Of the new antimicrobials available for the treatment of urinary tract infections (UTIs), aztreonam and imipenem/cilastatin represent two structurally unique, but distinct, classes of beta-lactam antibiotics. Aztreonam has a directed spectrum of activity covering gram-negative bacilli usually associated with UTIs. In comparative clinical trials of patients with complicated UTIs, aztreonam is well-tolerated and is as effective as conventional control regimens, including aminoglycosides. On the other hand, the antimicrobial spectrum of imipenem/cilastatin includes not only gram-negative bacilli but also gram-positive cocci and anaerobes. As such, this broad-spectrum antibiotic should be reserved for the treatment of mixed infections.

Aged↗
PubMed1982

[Age distribution of urinary tract infections (UTIs) and their severity grade in children (author's transl)].

Urinary tract infections in 339 children (77 boys and 262 girls) have been followed up. An excretory urography and a urethrocystography were done for all the children. The frequency of functional and anatomical abnormalities is given. The severity grade of UTI was determined according to the classification of Elo and Stenström. Almost all episodes of UTI among boys occurred during the first three years of life and were mostly severe. After the 3rd year of life the occurrence of UTI among the boys was sporadic. Among the girls the severe episodes dominates during the first three years of life, but after that the episodes tended to become milder in character becoming mostly asymptomatic. The peak of asymptomatic episodes among girls was at 10 years of age. After that age the number of episodes dropped abruptly. The classification used, based on the erythrocyte sedimentation rate (ESR) and on white blood cell count (WBC), has shown to be useful and makes it possible to differentiate between renal (pyelonephritic) episodes and the lower tract episodes.

Age Factors↗
PubMed1996

Can a Silent Kidney Infection or Genetic Predisposition Underlie Recurrent UTIs?

Complications resulting from persistent and repeated urinary tract infections (UTIs) account for nearly 1 million hospital admissions annually. Cystitis, a localized bladder infection occurring in the lower tract, is recognized by a symptom complex of dysuria, frequency, urgency, and suprapubic tenderness; pyelonephritis, which refers to upper tract infection of the kidneys, classically manifests with flank pain and systemic as well as cystitis signs. An empiric 3-day antibiotic regimen has been shown to be more than 95% effective in curing cystitis. But for a subgroup of patients, a relapse of "cystitis" within 4 weeks can signal a subclinical, "silent," pyelonephritis. A 14-day course of antibiotics is indicated to treat the recurrent UTI. Follow-up urinalysis and urine cultures are then repeated 2 and 4 weeks after therapy. If symptoms and/or bacteriuria are again documented with the same organism, subclinical pyelonephritis is presumed; a prolonged 6-week course of antibiotics is then warranted to prevent prolonged problems and complications associated with UTIs. When the problem is reinfection with a microorganism different from that responsible for the last infection, short-course therapy for 3 days may be prescribed for each episode. When reinfection occurs more frequently than 2 to 3 times a year, however, antibiotic prophylaxis to prevent reinfections is warranted.

Journal Article↗
PubMed1990

Single dose fosfomycin trometamol versus multiple dose norfloxacin over three days for uncomplicated UTI in general practice.

The aim of this study was to carry out a small-scale bacteriological comparison between a standard therapy with norfloxacin 400 mg twice daily, and fosfomycin trometamol (3 g) in single dose in uncomplicated urinary tract infections (UTI) in women. Only patients with UTI with cultures showing a bacterial count of 10(5) or more bacteria/ml were included in the study (n = 32; ages 16-75 years). After one week sterile cultures were obtained in 14 of 16 cases in the fosfomycin trometamol group, and in 14 of 16 cases in the norfloxacin group. After one month eradication was confirmed in 13 of 16 patients in the fosfomycin trometamol group, and in nine of 16 patients in the norfloxacin group. Recurrence was seen in one case in the fosfomycin trometamol group, and in five cases in the norfloxacin group. The reinfection and persistence rates were identical (1/16) in both groups. The main clinical symptoms disappeared very rapidly after initiating treatment, and the correlation with the bacteriological data after one week was excellent. Both drugs were well tolerated and the compliance for fosfomycin trometamol was 100%.

Adolescent↗
PubMed2002

Outcomes associated with trimethoprim/sulphamethoxazole (TMP/SMX) therapy in TMP/SMX resistant community-acquired UTI.

The increase in resistance rates to TMP/SMX among E. coli causing community-acquired UTI has resulted in consideration of alternative agents as first line therapy for these infections. However, there has been little study of the clinical significance of the in vitro trends in resistance which have been reported. We review studies that address the correlation between in vitro resistance to TMP/SMX and clinical outcome in uncomplicated UTI. From these data, it is clear that in vitro resistance does translate into therapeutic failure for 50-60% of patients with a TMP/SMX resistant uropathogen. Thus, it is reasonable to consider an agent other than TMP/SMX when the TMP/SMX resistance prevalence reaches 20%.

Anti-Infective Agents, Urinary↗
PubMed1999

Ciprofloxacin once versus twice daily in the treatment of complicated urinary tract infections. German Ciprofloxacin UTI Study Group.

Ciprofloxacin is considered to be the standard treatment for patients with complicated urinary tract infections (UTI). This multicentre, randomized clinical study was designed to compare a once-daily regimen with 500 mg to the usual twice-daily regimen with 250 mg orally for 7-20 days. A total of 215 patients with significant bacteriuria (> or = 10(5) c.f.u./ml for females and > or = 10(4) c.f.u./ml for males) were included in the study. Eradication of bacteriuria was shown in 84.0% of patients treated with 500 mg q.i.d. and in 90.9% of patients treated with 250 mg b.i.d. Clinical cure or improvement was achieved in 97.3% of those treated with 500 mg q.i.d. versus 95.5% of those treated with 250 mg b.i.d. More superinfections occurred in patients treated with 500 mg q.i.d., mostly caused by gram-positive cocci. The statistical analysis concerning the elimination of bacteriuria using the 95% confidence interval showed a difference of up to 18.4% between the two treatment groups in favour of the 250-mg b.i.d. regimen. Ciprofloxacin was well tolerated with only mild to moderate side-effects (mostly gastrointestinal) in 8% of the patients. When using ciprofloxacin in patients with complicated UTI, its administration in two divided doses can be further recommended as a standard regimen.

Anti-Infective Agents↗
PubMed1998

Post traumatic paraplegics living in Athens: the impact of pressure sores and UTIs on everyday life activities.

This paper contains the findings of a scientific research which was done on post-traumatic paraplegics who live in the area of Athens. Greece, and measured the impact of pressure sores and UTIs on their everyday life activities. The target population was 127 individuals out of which 98 were observed and interviewed. A semi-structured questionnaire which consisted of two parts used; the first part of the questionnaire included general questions whereas the second contained the Sarno Functional Life Scale (SFLS) which is a tool measuring the level of independence of disabled people. Sixty-two per cent of the population was male. The mean age of the sample population at the time they had the accident which caused the paraplegia was 31.5, while the median was 28.5. The majority of the subjects comes from the lower socioeconomic class. Traffic accidents accounted for the 55% of the occurrences of paraplegia, falls for 37%, surgical complication for 4% and athletic activities for the remaining 4%. Forty-nine percent of the sample had been hospitalised in a rehabilitation centre. However, the multiple regressions used did not reveal any statistically significant relation between the hospitalisation in a rehabilitation centre and the paraplegic's scores in any of the Sarno Functional Life Scale's (SFLS) variables. Instead, the multiple regressions employed yielded paraplegics' scores in the SFLS's everyday life activities that were negatively related to age (P = 0.004) and pressure sores (P = 0.021). The paraplegics' scores on the SFLS's indoors activities are positively related to the years since injury (P = 0.048) and health education on daily fluid consumption (P = 0.003). The scores of the subjects on the SFLS's outdoor activities are positively related to the years of education (P = 0.008), the years since injury (P = 0.011), while are negatively related to pressure sores (P = 0.034) and UTIs (0.044). The subjects' scores on the SFLS variables regarding social relations had a negative relation to sex, (female) (P = 0.0001), age (P = 0.001) and pressure sores (P = 0.019), while they have a positive relation with the years since injury (P = 0.024).

Activities of Daily Living↗