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PubMed2000

Human myometrial cells in culture express specific binding sites for urinary trypsin inhibitor.

Urinary trypsin inhibitor (UTI), which is present in amniotic fluid, prevents uterine contractility during pregnancy possibly via specific binding protein mechanisms. To test for the presence of UTI binding sites on the cell surface, we prepared cultured myometrial cells obtained at biopsy from 12 pregnant women and performed binding, competition, and cross-linking experiments using a specific radiolabelled UTI as a ligand. We report for the first time two classes of binding sites of differing affinities. Scatchard analysis at 4 degrees C, using radioiodinated UTI, revealed that UTI binds to 35 000 high affinity binding sites/cell (K(d) = 9.1x10(-9) mol/l) and 450 000 lower affinity binding sites/cell (K(d) = 3.5x10(-7) mol/l) in cultured myometrial cells. It appears to be the low affinity site that is internalized, and this has been identified as a protein of approximately 45 kDa by cross-linking and immunoaffinity labelling studies. Monoclonal antibodies against the NH(2)-terminal fragment of UTI abrogated specific binding of this protein to the cells. Treatment of the cells with hyaluronidase resulted in >80% inhibition of the [(125)I]-labelled UTI binding to the cells. These data show that the UTI binding site, which is hyaluronidase sensitive, is expressed on the surface of human uterine myometrial cells to accumulate the UTI molecule during pregnancy.

Antibodies, Monoclonal↗
PubMed1995

First-time urinary tract infection and sexual behavior.

We studied the relation between sexual and health behaviors of women and first-time urinary tract infection (UTI). The study population was women using a university health service who were unmarried, had no UTI history, and who had engaged in sexual activity at least once. We found 86 cases of UTI, defined as one or more urinary symptoms and > or = 1,000 colony-forming units per ml urine of a known pathogen. We randomly sampled 288 controls from the student body. Vaginal intercourse increased the risk of UTI; this risk was further increased with condom use. After adjusting for vaginal intercourse with other birth control methods and recentness of current sexual partnership, a single sex act with a condom in the past 2 weeks increased UTI risk by 43%. Having a sex partner for less than 1 year vs 1 year or more, after adjustment for frequency of vaginal intercourse and birth control method, was associated with about twice the risk of UTI [odds ratio (OR) = 1.97; 95% confidence interval (CI) = 1.04-3.74]. After adjusting for frequency of vaginal intercourse, regular drinking of cranberry juice was protective against UTI (OR = 0.48; 95% CI = 0.19-1.02), whereas drinking carbonated soft drinks appeared to be associated with increased risk (OR = 2.37; 95% CI = 0.75-7.81). Using deodorant sanitary napkins or tampons was associated with a slight increase in risk of UTI (OR = 1.51; 95% CI = 0.74-3.06). Blacks had five times greater risk of UTI than whites after adjusting for frequency of vaginal intercourse (OR = 5.2; 95% CI = 1.89-24.63). We observed only modest differences in health behavior between racial groups.

Case-Control Studies↗
PubMed2000

Bacteremic urinary tract infection in children.

OBJECTIVE: To assess the clinical characteristics of bacteremic urinary tract infection (UTI) in children. DESIGN: Clinical data of Finnish children with bacteremic UTI (n = 134) from 1985 to 1994 were analyzed. Their symptoms, laboratory and imaging findings were compared with those of age- and sex-matched patients hospitalized for blood culture negative UTI. RESULTS: Generally, no major differences were seen in clinical findings between bacteremic and nonbacteremic patients. Bacteremic children had more frequent feeding problems (P = 0.02), and children > or =12 months of age tended more often to have abdominal pain and vomiting than did nonbacteremic patients. Fever was the major initial symptom in both study groups, but no significant difference occurred in the mean highest temperature or in the mean of duration of fever before admission to the hospital. The mean concentration of serum C-reactive protein on admission was significantly higher in bacteremic patients (116 vs. 76 mg/l; P < 0.01). After onset of antimicrobial treatment fever lasted significantly longer in bacteremic patients than in control patients (means, 2.3 vs. 1.1 days; P < 0.01). Anatomic or functional abnormalities in the urinary tract were detected in 51% vs. 46%, respectively. Obstruction of the urinary tract (9% vs. 1%, P < 0.01) and Grade 3 to 5 vesicoureteral reflux (30% vs. 16%, P = 0.02) were significantly more frequent in bacteremic patients with UTI. Obstruction or vesicoureteral reflux was found in 46% of children with bacteremic UTI caused by Escherichia coli vs. 89% of children with non-E. coli infection (P < 0.01). CONCLUSIONS: Clinical symptoms do not significantly distinguish bacteremic from nonbacteremic children with UTI. Outcome of bacteremic UTI was comparable with that of nonbacteremic UTI. Bacteremic children, especially those with non-E. coli UTI, more often had anatomical or functional abnormalities in the urinary tract.

Abdominal Pain↗
PubMed2003

Protective effect of urinary trypsin inhibitor on myocardial mitochondria during hemorrhagic shock and reperfusion.

OBJECTIVE: To examine the mitochondrial function in the myocardium after hemorrhagic shock and reperfusion and to evaluate the protective effect of urinary trypsin inhibitor (UTI) on mitochondria. DESIGN: Animal experiment. SETTING: University research laboratory. SUBJECTS: Wistar rats receiving 50,000 units/kg/hr of UTI (n = 27; UTI group) and control rats (n = 26; control group). INTERVENTIONS: Rats were subjected to low-perfusion ischemia with the left ventricular systolic pressure maintained at 50 mm Hg for 60 mins by bleeding, followed by a 60-min reperfusion by transfusion of shed blood. UTI was infused continuously from 10 mins before bleeding. Cardiac function was measured before bleeding, after bleeding, and after transfusion; at each determination point, the myocardial contents of adenosine triphosphate (ATP), creatine phosphate (P-Cr), pyruvate (Pyr), and lactate (Lac) were measured enzymatically. The cytosolic phosphorylation potential (PP) as well as the redox potential of the oxidized form of nicotinamide adenine dinucleotide/reduced form of nicotinamide adenine dinucleotide couple in mitochondria (Eh(NAD+/NADH)) and change of Gibbs free energy in ATP hydrolysis (deltaG(ATP hydrolysis) energy) were calculated. MEASUREMENTS AND MAIN RESULTS: Cardiac function decreased during hemorrhagic shock but improved significantly in the UTI group after transfusion compared with the control group. Lac and the Lac/Pyr ratio were significantly lower in the UTI group than in the control group after transfusion. ATP and P-Cr were significantly higher in the UTI group than in the control group after transfusion. PP (x10(3) M-1), Eh(NAD+/NADH) (x - 1 mV), and deltaG(ATP hydrolysis) (x - 1 kcal/mol) were 1.9 +/- 0.4, 266 +/- 4, and 9.7 +/- 0.2, respectively, in the control group and 4.0 +/- 0.9, 274 +/- 5 and 13.0 +/- 0.2, respectively, in the UTI group after transfusion (p <.001, p <.001, and p <.001, respectively). CONCLUSIONS: In reperfusion after hemorrhagic shock, oxidative phosphorylation in myocardial mitochondria is impaired and energy production remains reduced, even after reperfusion. UTI contributed to the recovery of cardiac function after reperfusion, probably by reducing the severity of mitochondrial dysfunction during a state of shock and by maintaining energy production.

Adenosine Triphosphate↗
PubMed2003

The PIC cystogram: a novel approach to identify "occult" vesicoureteral reflux in children with febrile urinary tract infections.

PURPOSE: When the standard cystogram does not show vesicoureteral reflux in children who have experienced febrile urinary tract infections (UTIs), clinical management is controversial. We postulated that vesicoureteral reflux accounts for such UTIs but is "occult." We tested this hypothesis by using a novel method, PIC cystography (Positioning the Instillation of Contrast at the ureteral orifice) at the time of cystoscopy. MATERIALS AND METHODS: We performed PIC cystography with instillation of contrast medium at the ureteral orifice consecutively and prospectively in 57 children who underwent cystoscopy between November 1999 and February 2002 to evaluate febrile UTIs in 40 patients, dysfunctional voiding in 14 and hydronephrosis in 3. The control group (27 patients, 54 renal units) was used to assess the accuracy of PIC by comparing the results against those with the standard cystogram in children who did not have febrile infection and did not demonstrate vesicoureteral reflux (15 patients, 30 renal units), and in those who had febrile infection and vesicoureteral reflux (12 patients, 24 renal units). The study group (30 patients, 60 renal units) served to assess the incidence of "occult" vesicoureteral reflux in children who experienced febrile UTIs yet did not have vesicoureteral reflux on standard cystography. RESULTS CONTROL GROUP: In children without febrile UTIs all 30 ureteral orifices had a normal endoscopic appearance and no vesicoureteral reflux by PIC cystography. In children with febrile UTIs 15 ureteral orifices with known vesicoureteral reflux were lateral and/or patulous and demonstrated vesicoureteral reflux by PIC, 4 appeared normal and did not exhibit vesicoureteral reflux on standard cystography or by PIC, and 5 were lateral and/or patulous in appearance and did not display vesicoureteral reflux on standard cystography, but did show vesicoureteral reflux by PIC. These findings reveal that PIC cystography is 100% sensitive at demonstrating reflux already known by standard cystogram, is 87% specific as it showed reflux in 5 of 39 renal units not revealed by a standard cystogram and has an overall accuracy of 91%. STUDY GROUP: At cystoscopy all 30 children demonstrated an abnormal appearance of one or both ureteral orifices. PIC cystography showed vesicoureteral reflux in all 30 children (48 renal units, 12 unilateral and 18 bilateral). The remaining ureteral orifices (12), which appeared normal, did not permit vesicoureteral reflux. Children with vesicoureteral reflux by PIC were treated with antimicrobial prophylaxis (26) or ureteral reimplantation (4, 2 unilateral and 2 bilateral reimplantation) Postoperatively, these children did not experience a febrile UTI during followup (average 8 months). CONCLUSIONS: PIC cystography is simple to perform using routinely available operating room equipment and does not artifactually induce vesicoureteral reflux. The incidence of "occult" vesicoureteral reflux in children who experience febrile UTIs without vesicoureteral reflux on standard cystography is 100% by PIC cystography. PIC cystography should be done when vesicoureteral reflux is suspected in children who experience febrile UTIs but do not exhibit reflux on standard cystography.

Adolescent↗
PubMed2005

Management of urinary tract infections: historical perspective and current strategies: Part 1--Before antibiotics.

PURPOSE: Urinary tract infections (UTIs) have plagued mankind long before bacteria were recognized as the causative agents of disease and before urology became an established medical specialty. To our knowledge a comprehensive review of the recorded medical history of UTI from its first description in ancient Egyptian papyri through today has not been attempted until now. MATERIALS AND METHODS: Numerous resources were used to collect the information described in this review. Older textbooks from the school of medicine library at our institution were used to collect information on UTI in ancient times. Medical texts from the 19th century contains information regarding the treatment of UTI during that era. Early volumes of the Journal of Urology from the beginning of the 20th century are rich with information on the first attempts at chemotherapy for UTI. MEDLINE searches were used to collect appropriate information after 1969. RESULTS: The Ebers papyrus from ancient Egypt recommended herbal treatments to ameliorate urinary symptoms without providing insight into pathological mechanisms. Hippocrates believed that disease was caused by disharmony of the 4 humors and accordingly diagnosed urinary disorders. Roman medicine further expanded the conservative approach (bed rest, diet, narcotics and herbs) advocated by Greek physicians, while also improving invasive techniques (surgical lithotomy for stones and catheterization for retention). The Arabian physician Aetius refined uroscopy and created a detailed classification and interpretation of urinary disease based on this technique. During the Middle Ages no major advances occurred, although existing therapies were refined and treatments for gonococcal urethritis were well described. The early 19th century provided vivid and detailed descriptions of UTIs without the knowledge that they were caused by microorganisms. Management included hospitalization, bed rest, attention to diet, plasters, narcotics, herbal enemas and douches, judicious bleeding (direct bleeding, cupping and leeches), and surgery for stones, abscess and retention. The discovery of microorganisms as the etiological agents of infectious diseases in general and inflammation associated with urinary diseases in particular provided an impetus for physicians critically to examine management approaches and develop evidence based strategies for UTI treatment. Various antibacterial agents, such as hexamine, mercurochrome and others (hexylresorcinol, methylene blue, pyridium, acriflavin and mandelic acid), showed promise in laboratory studies but their efficacy in clinical investigations was disappointing. CONCLUSIONS: Treatments for UTI until the discovery of antibiotics were largely palliative because the bacterial origin of UTI was not recognized and no specific antimicrobial therapies were available.

China↗
PubMed2004

Urinary tract infections and genitourinary abnormalities in Cameroonian men.

OBJECTIVE: To compare the prevalence of genitourinary abnormalities in men diagnosed with urinary tract infection (UTI) in a Cameroonian hospital and those without. PATIENTS AND METHODS: Consecutive adult men aged 18-75 years, whose midstream urine samples were received for microscopy, culture and sensitivity at the microbiology laboratory of the Yaounde University Teaching Hospital, Cameroon, constituted the study population. Genitourinary abnormalities were diagnosed from history, physical examination, abdominal and transrectal ultrasonography, plain abdominal X-ray, and if indicated urethrocystoscopy and biopsy. RESULTS: Of the 206 patients who qualified, 179 completed the study and 63 (35.2%) were found to have UTI. A total of 41 (65.1%) patients with UTI (mean age 69.2 years) had at least one genitourinary abnormality, compared to 13 (11.2%) of those without UTI (mean age 61.9 years) (P < 0.001). The age-adjusted prevalence of genitourinary abnormalities was 59.4% in the UTI group and 12.1% in the non-UTI group (P < 0.001). The most frequent genitourinary abnormality in men with UTI was benign prostatic enlargement, followed by urethral stricture. The crude odds ratio (95% confidence intervals) for UTI associated with genitourinary abnormality was 14.77 (6.80-32.05), and the adjusted odds ratio 11.51 (7.08-29.46). CONCLUSION: Urological evaluation of Cameroonian men with UTI, using simple history taking, physical examination, ultrasound examination and plain abdominal X-ray, could have significant clinical benefits in this tropical African region.

Adolescent↗
PubMed2004

Prevention of recurrent bacterial cystitis by intravesical administration of hyaluronic acid: a pilot study.

OBJECTIVES: To assess the effect of bladder instillations of hyaluronic acid (HA) on the rate of recurrence of urinary tract infection (UTI). PATIENTS AND METHODS: Forty women (mean age 35 years) with a history of recurrent UTI received intravesical instillations of HA (40 mg in 50 mL phosphate-buffered saline) once weekly for 4 weeks then once monthly for 4 months. The UTI status was assessed over a prospective follow-up of 12.4 months and compared with the rates of UTI before instillation, determined by a retrospective review of patient charts covering 15.8 months. RESULTS: After HA treatment no patients had a UTI during the 5-month treatment phase and 28 (70%) were recurrence-free at the end of the follow-up. The mean (sd) rate of UTI per patient-year was 4.3 (1.55) before treatment and 0.3 (0.55) afterward (P < 0.001). The median time to recurrence after HA treatment was 498 days, compared with 96 days beforehand (P < 0.001). The tolerability was excellent, as side-effects were limited to nine patients who reported mild bladder irritation; no patient interrupted the treatment. CONCLUSIONS: In this preliminary study, bladder instillations of HA had a significant effect on the rate of UTI in women with a history of recurrent UTIs. The bladder instillation of HA is an acceptable and promising therapeutic alternative in patients with recurrent UTI. Expanded placebo controlled clinical trials examining this application of HA are currently underway.

Adjuvants, Immunologic↗
PubMed2000

Risk assessment of renal cortical scarring with urinary tract infection by clinical features and ultrasonography.

AIMS: To address some of the issues in the ongoing debate over the optimal diagnostic imaging following childhood urinary tract infection (UTI), by determining the risk of missing renal cortical scarring which would be detected on a technetium-99m dimercaptosuccinic acid (DMSA) gold standard if ultrasound alone were used, factoring for clinical features (upper or lower tract), UTI recurrence, and age group (infants, preschool, or school age). METHODS: Details of UTI clinical features and recurrence were recorded for 990 children with a proven UTI, and their DMSA and ultrasound results were compared for each kidney. RESULTS: The risks of missing DMSA scarring varied between 0.4% (school age children with solitary lower tract UTI) and 11.1% (infants with recurrent upper tract UTI). CONCLUSIONS: UTI clinical features are important in assessing the need for DMSA imaging. Current UK imaging guidelines are endorsed, although preschool children with solitary lower tract UTI remain a controversial group and more attention needs to focused on children with recurrent UTI.

Adolescent↗
PubMed2001

The significance of interleukin 8 in urine.

AIMS: To assess the implications of detection of interleukin 8 (IL-8) in urine. METHODS: IL-8 was measured by immunoassay in all 305 urine samples from children aged 0-18.4 years received by our microbiology laboratory during four weeks, with a retrospective structured case note audit for all those in whom IL-8, white cells, or bacteria were detected. Patients were divided into three groups: urinary tract infection (UTI), at least one sample with >/=5 leucocytes x 10(9)/l and >/=10(5) cultured bacteria/ml; possible UTI, at least one sample with >/=5 leucocytes x 10(9)/l or >/=10(5) cultured bacteria/ml but not both; UTI unlikely, sample(s) with <5 leucocytes x 10(9)/l and <10(5) cultured bacteria/ml. Medical records were sought for all in groups 1 (14/14 found) and 2 (18/21 found) and those in group 3 (41/59 found) in whose urine any leucocytes, cultured bacteria, or IL-8 were detected. RESULTS: IL-8 was detected in 58/305 samples from 48/264 patients. IL-8 was detected in at least one urine sample from 13/14 patients with confirmed UTI (group 1); in 11/21 patients with possible UTI (group 2), of whom two were treated as UTI; and in 23/228 patients without UTI. Using a cut off of 200 pg/ml, urine IL-8 had a sensitivity of 93% and a specificity of 90% for diagnosing UTI. CONCLUSIONS: Urine IL-8 is a sensitive test for UTI, but is poorly specific as it is also present in a variety of other infectious and inflammatory disorders.

Adolescent↗
PubMed2002

Short compared with standard duration of antibiotic treatment for urinary tract infection: a systematic review of randomised controlled trials.

AIMS: To compare the effectiveness of short course (2-4 days) with standard duration oral antibiotic treatment (7-14 days) for urinary tract infection (UTI). METHODS: Meta-analysis of randomised controlled trials using a random effects model. Ten trials were eligible, involving 652 children with lower tract UTI recruited from outpatient or emergency departments. Main outcome measures were UTI at the end of treatment, UTI during follow up (recurrent UTI), and urinary pathogens resistant to the treating antibiotic. RESULTS: There was no significant difference in the frequency of positive urine cultures between the short (2-4 days) and standard duration therapy (7-14 days) for UTI in children at 0-7 days after treatment (eight studies: RR 1.06; 95% CI 0.64 to 1.76) and at 10 days to 15 months after treatment (10 studies: RR 1.01; 95% CI 0.77 to 1.33). There was no significant difference between short and standard duration therapy in the development of resistant organisms in UTI at the end of treatment (one study: RR 0.57, 95% CI 0.32 to 1.01) or in recurrent UTI (three studies: RR 0.39, 95% CI 0.12 to 1.29). CONCLUSION: A 2-4 day course of oral antibiotics is as effective as 7-14 days in eradicating lower tract UTI in children.

Adolescent↗
PubMed2005

Intensive care unit-acquired urinary tract infections in a regional critical care system.

INTRODUCTION: Few studies have evaluated urinary tract infections (UTIs) specifically acquired within intensive care units (ICUs), and the effect of such infections on patient outcome is unclear. The objectives of this study were to describe the occurrence, microbiology, and risk factors for acquiring UTIs in the ICU and to determine whether these infections independently increase mortality. METHODS: A surveillance cohort study was conducted among all adults admitted to multi-system and cardiovascular surgery ICUs in the Calgary Health Region (CHR, population about 1 million) between 1 January 2000 and 31 December 2002. RESULTS: During the 3 years, 4465 patients were admitted 4915 times to a CHR ICU for 48 hours or more. A total of 356 ICU-acquired UTIs (defined as at least 105 colony-forming units/ml of one or two organisms 48 hours or more after ICU admission) occurred among 290 (6.5%) patients, yielding an overall incidence density of ICU-acquired UTIs of 9.6 per 1000 ICU days. Four bacteremic/fungemic ICU-acquired UTIs occurred (0.1 per 1000 ICU days). Development of an ICU-acquired UTI was more common in women (relative risk [RR] 1.58; 95% confidence interval [CI] 1.43-1.75; P < 0.0001) and in medical (9%) compared with non-cardiac surgical (6%), and cardiac surgical patients (2%). The most common organisms isolated were Escherichia coli (23%), Candida albicans (20%), and Enterococcus species (15%). Antibiotic-resistant organisms were identified among 14% isolates. Although development of an ICU-acquired UTI was associated with significantly higher crude in-hospital mortality (86/290 [30%] vs. 862/4167 [21%]; RR = 1.43; 95% CI 1.19-1.73; P < 0.001); an ICU-acquired UTI was not an independent predictor for death. CONCLUSIONS: Development of an ICU-acquired UTI is common in critically ill patients. Although a marker of increased morbidity associated with critical illness, it is not a significant attributable cause of mortality.

APACHE↗
PubMed2006

Urinary tract infections in children with congenital adrenal hyperplasia.

OBJECTIVE: To investigate the incidence of urinary tract infections (UTIs) in children with congenital adrenal hyperplasia (CAH), and to determine whether there was a correlation between UTIs and the timing and type of genital surgery in girls. STUDY DESIGN: Medical records of patients with CAH < or = 15 years were reviewed. A parent questionnaire regarding history of UTIs was completed. RESULTS: Seventy-one patients with classic CAH (41 girls, 30 boys) aged 8.3 +/- 4.2 years were identified. Thirty-five (85%) girls had undergone feminizing genitoplasty at 1.1 +/- 0.8 years, while six (15%) had not. History of UTI was reported in nine (12.6%) patients (one boy, eight girls). In seven of the eight girls, genital surgery had been performed and all UTIs occurred after surgery. One UTI was reported in a girl who had not undergone surgery. No correlation was found between UTIs and the type of genital surgery. CONCLUSION: The incidence of UTIs in children with CAH is similar to that in the general population. Although preliminary, our results do not suggest an increased risk of UTIs if surgery is delayed.

Adolescent↗
PubMed2004

Antibiotic treatment for urinary tract infections: pharmacokinetic/pharmacodynamic principles.

Bacterial urinary tract infections (UTIs) frequently occur in the outpatient as well as in the nosocomial setting. The stratification into uncomplicated and complicated UTIs has proven to be clinically useful. Bacterial virulence factors on the one hand, and the integrity of the host defense mechanisms on the other, determine the course of the infection. Late complications or sequelae might ensue if the defense mechanisms are disturbed, either by a genetic or an acquired cause. Escherichia coli is the most prevalent organism in uncomplicated UTIs, whereas the bacterial spectrum is much broader in complicated UTIs, including Gram-negative and -positive, and often multiresistant organisms. Therapy for uncomplicated UTIs is almost exclusively antibacterial, whereas in complicated UTIs the complicating factors need to be treated as well. The success of antibiotic therapy of UTIs in a population can be estimated by four parameters: the minimal inhibitory concentrations of the clinical isolates, the pharmacokinetic and pharmacodynamic profiles, and the protein binding of the treatment drug. In uncomplicated UTIs, antimicrobial therapy is usually empiric, whereas in complicated UTIs antibiotic therapy should be more individualized; tailored to the individual patient.

Anti-Infective Agents, Urinary↗
PubMedDate not supplied

Retrospective evaluation of urinary tract infection in 42 dogs with hyperadrenocorticism or diabetes mellitus or both.

A retrospective study was performed to determine the proportion of dogs with hyperadrenocorticism or diabetes mellitus or both that had urinary tract infection (UTI) and to describe clinical and laboratory findings. Dogs with these endocrine disorders were included if results of quantitative urine culture were available and dogs were not receiving antimicrobials. Dogs with positive urine cultures were considered to have UTI and dogs with negative urine cultures were used as controls. Information including history, clinical signs, physical examination findings, and results of laboratory tests and urine culture was extracted from all records. Findings in dogs with UTI were compared with control dogs. There were 101 dogs with hyperadrenocorticism or diabetes mellitus or both that met inclusion criteria; 42 (41.6%) had UTI and 59 (58.4%) did not. UTI was present in 46% of dogs with hyperadrenocorticism, 37% of dogs with diabetes mellitus, and 50% of dogs with both endocrine disorders. There was no association between endocrine group and occurrence of UTI. Escherichia coli was the most common bacteria isolated, and cultures from 29 dogs (69%) showed growth of this organism. Of dogs with UTI, <5% had stranguria, pollakiuria, or discolored urine, whereas 60% had pyuria and 69% had bacteriuria. We conclude that UTIs are common in dogs with hyperadrenocorticism, diabetes mellitus, or both diseases. Clinical signs of UTI, however, are uncommon and results of urinalysis may be normal. Therefore, it is appropriate to recommend urine culture as part of the evaluation of dogs with these endocrine disorders.

Adrenocortical Hyperfunction↗
PubMed1985

Epidemiology of urinary tract infection: I. Diaphragm use and sexual intercourse.

In the present case-control study of college-aged women, we examined the associations of sexual intercourse and diaphragm use with primary and secondary urinary tract infection (UTI), and measured the treatment and functional costs of primary, secondary, and recurrent UTI. All of the cases but only half of the controls had engaged in sexual intercourse during the past four weeks. When compared to using oral contraceptives, diaphragm use was associated with both first attack UTI (when compared with controls) and second attack UTI (when compared to women with primary UTI) even after controlling for frequency of sexual intercourse (Primary UTI: RRMH = 3.5; 95% CI: 0.9, 13.0; Secondary UTI: RRMH = 2.2; 95% CI: 0.3, 15.4). Women with all types of UTI reported 6.1 symptom days, 2.4 restricted-activity days, 1.6 office visits and laboratory tests, and spent $62 for treatment of UTI, based on prices of a subsidized student health service.

Adolescent↗
PubMed2002

Diabetes and the risk of acute urinary tract infection among postmenopausal women.

OBJECTIVE: To examine whether the presence of diabetes alters the risk of acute urinary tract infection (UTI) in postmenopausal women. RESEARCH DESIGN AND METHODS: A case-control study of the Group Health Cooperative of Puget Sound (GHC), a staff-model nonprofit health maintenance organization in Washington State, was conducted. Subjects were women aged 55-75 years who had been members of GHC for at least 1 year and who had had an acute symptomatic UTI within the preceding month. Laboratory files were used to identify women with a urine culture that grew > or =10(5) colonies of a urinary pathogen. Medical records were reviewed to confirm the presence of acute, clinically symptomatic UTI. Control subjects were randomly selected from the GHC enrollment file, screened to remove women with recent UTI, and frequency matched to cases by age within 2 years. An interviewer ascertained self-reported clinician-diagnosed diabetes. Diagnosis of diabetes was confirmed by the GHC diabetes registry. A subsample of women underwent measurement of postvoid residual bladder volume (n = 748) and culture of vaginal flora (n = 454). RESULTS: Of the 901 case and 913 control subjects, diabetes was reported in 13.1 and 6.8%, respectively. The health plan diabetes registry confirmed the diagnosis in 92% of women who self-reported the condition. The age-adjusted odds ratio (OR) for UTI in relation to self-reported clinician-diagnosed diabetes was 2.2 (95% CI 1.6-3.0). Adjustment for frequency of sexual intercourse and history of UTI had little effect on this estimate. Compared with nondiabetic women, higher UTI odds were seen in subjects who used oral hypoglycemic agents (OR 2.9 [95% CI 1.7-5.1]) and insulin (2.6 [1.5-4.6]) but not in subjects with untreated diabetes or diabetes treated by lifestyle changes (1.3 [0.7-2.3]). No significant difference was seen in the OR for UTI in diabetic women with disease of shorter duration (<10 years, OR 1.9) or longer duration (> or =10 years, OR 2.6) or in relation to HbA(1c) level. Similar microbiologic pathogens were seen in diabetic and nondiabetic women. No significant differences were seen by diabetes status in mean postvoid residual bladder volume or vaginal flora. CONCLUSIONS: Diabetes under pharmacologic treatment is associated with increased risk of clinically apparent UTI in postmenopausal women.

Aged↗
PubMed1993

[The importance of the host nutritional and immune status on the prognosis of urinary tract infection in the elderly].

This study was performed to evaluate the role of the nutritional and immune status on the prognosis of urinary tract infections (UTI) in the elderly. 192 patients among the 790 inpatients were diagnosed as UTI. Age-related increase in the prevalence of UTI was accompanied with poor prognosis in the patients with hypoalbuminemia (< 2.6 g/dl) and lymphocytopenia (< 700/mm3). To study the immunologic basis for susceptibility to UTI in the aged further, we compared the T-cell functions between outpatients without serious disease and inpatients with chronic UTI. The absolute numbers of lymphocyte, OKT3 (pan T-cell marker), OKT4 (Helper/Inducer marker) and Interleukin (IL)-2 as well as serum albumin concentration were decreased in the patients with UTI. A prospective study was done to confirm that these nutritional and immunological changes become risk factors in the prognosis of UTI with long-term and low-dose chemotherapy. In the patients continued with bacteriuria (Non-responders, n = 6), serum albumin concentration and IL-2 production were significantly lower than the patients who became free from bacteriuria (Responders, n = 7). These results suggest that poor nutrition-related immune dysfunction contributes to the vulnerability of elderly patients to UTI and becomes risks for he prognosis of UTI.

Adult↗