Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “UTIs”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources
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↗
PubMed2003

Why fosfomycin trometamol as first line therapy for uncomplicated UTI?

Uncomplicated urinary tract infection (UTI) is one of the most common conditions requiring diagnostic and therapeutic intervention. The aetiology and the treatment of these infectious diseases have changed little during last years of the 'antibiotic era'. Escherichia coli is the most prevalent uropathogen (85->90%) and treatment is aimed at eradicating the infection using shorter regimes that typically may employ a 3-day course with once-a-day dosing of a selected drug or a single dose of a particular efficacious antibiotic. Antibiotic resistance to commonly used agents, such as trimethoprim and ampicillin, often now exceeds 30-50%, while fosfomycin trometamol, despite many years of usage, continues to be characterized by an extremely low incidence of E. coli resistant strains (about 1%) worldwide. Many factors may have contributed to preserve fosfomycin trometamol antibacterial activity including single dose usage limited to urinary infections, very high and sustained urinary concentrations that rapidly kill bacteria reducing the opportunity for mutant selection. In addition there is no animal feed that contains the drug, resistance is most commonly acquired by chromosomal mutations that do not spread easily and the biological cost of these genetic modifications is high. To these parameters fosfomycin trometamol adds excellent tolerability and safety. Although nowadays, microbial resistance limits available resources and some drugs can no longer be recommended as reliable agents, fosfomycin trometamol, because of its properties, remains a drug of choice for the eradication of uncomplicated UTI.

Animals↗
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↗
PubMed2001

Reduced rates of hospital-acquired UTI in medical patients. Prevalence surveys indicate effect of active infection control programmes.

Prevalence surveys have been part of the Danish infection control programme since 1974. Nationwide surveys were carried out in 1978, 1979, 1980, 1991 and 1999. The results indicate a net reduction of approximately 25%, mainly due to a reduction of urinary tract infections (UTIs) in medical patients. Results from the nationwide surveys are validated by results of occasional independent surveys performed in regions or single hospitals. The reduction coincides with preventive programmes focused on catheter policy and UTI. We conclude that the prevalence survey is an important part of our strategic programme for infection control in hospitals.

Cross Infection↗
PubMed2004

Empiric treatment of uncomplicated UTI in women: wasting money when more is not better.

CONTEXT: Trimethoprim-sulfamethoxazole (TMP-SMX) and nitrofurantoin were until recently the two drugs recommended in clinical guidelines in Israel for empiric treatment of uncomplicated urinary tract infection (UTI) in women. OBJECTIVES: The objective of this study is to evaluate the economic impact of physician non-adherence to these recommendations. DESIGN SETTING AND PATIENTS: Data were derived from the electronic patient records of the Leumit Health Fund. Cases of women aged 18 to 75 with a diagnosis of acute cystitis or UTI that were empirically treated with antibiotics from January 2001 to June 2002 were identified. The final sample comprised 7738 physician-patient encounters. The proportion of cases treated with each individual drug was calculated, and the excess expenditure because of non-adherence to guidelines from the perspective of the Health Maintenance Organization (HMO) was evaluated using 5 days of therapy with nitrofurantoin as the reference treatment. RESULTS: TMP-SMX was the most frequently prescribed drug (25.81%), followed by nitrofurantoin (14.71%) representing a 40.52% rate of adherence to the guidelines. Drugs from the fluoroquinolone family were prescribed in 22.82% of cases. Cost of treatment in approximately 70% of the cases exceeded the expected cost of the guideline therapy. CONCLUSIONS: Suboptimal adherence to the guidelines resulted in a significant and avoidable waste of the health plan's resources in both drugs and money.

Adolescent↗
PubMed1991

Antimicrobial therapy for treatment of UTI in the elderly.

Patient age is an important factor when considering an antimicrobial agent for treatment of urinary tract infection (UTI). Specifically, elderly patients cannot be managed in the same way as younger patients because of the many physical changes that occur with aging and because of the concomitant pathologies that may be present. In addition, UTI in the elderly is very often due to two common urologic syndromes: obstructive uropathy and urinary incontinence. No antimicrobial therapy, whether oral or parenteral, may be effective if these syndromes are not resolved prior to instituting treatment. Characteristics of and criteria for antimicrobial agents are detailed and the role of new quinolones is emphasized.

Aged↗
PubMed1999

Newer quinolones in the long term prophylaxis of recurrent urinary tract infections (UTI).

Up to 10% of premenopausal women experience recurrent symptomatic urinary tract infection (UTI), mainly due to reinfection from the faecal flora. The recently introduced fluoroquinolones possess a wide spectrum of activity against most uropathogens and achieve high urinary concentrations for extended time periods. Our initial study, conducted between 1993 and 1995, was designed to compare the efficacy and safety of oral pefloxacin 800mg once weekly with oral ciprofloxacin 125mg once daily, over a 12-month prophylactic course in women with recurrent UTI. A 12-month reinfection-free period was achieved in 83.3% of pefloxacin patients and in 78.9% of ciprofloxacin patients. The present study, which commenced in 1996, was designed to compare pefloxacin 400mg with oral fleroxacin 400mg once weekly. Prophylaxis was maintained for 12 months. There are no statistically significant differences between the 2 regimens in terms of efficacy and safety. The most frequently isolated pathogens causing breakthrough reinfections were Escherichia coli and Enterococcus spp. Adverse effects observed were mostly neuropsychic (insomnia) and gastrointestinal. In both studies, there was no evidence of emergence of quinolone-resistant organisms in the urine or rectal flora, even after 12 months of chemoprophylaxis.

4-Quinolones↗
PubMed2000

Complicated UTI. Effective treatment in the long-term care setting.

Diagnosis and treatment of complicated urinary tract infection (UTI) in older persons in the long-term care setting presents practitioners with special clinical challenges and is a more complex proposition than management of UTIs that commonly arise in younger persons. Effective care is a function of consideration and understanding of several key issues relating to urinalysis, antibiotic therapy, duration of therapy, and the route of drug administration. Typical diagnostic and management hurdles include collecting a clean specimen; dealing effectively with asymptomatic bacteriuria, a benign condition that often precipitates unnecessary treatment; and appreciation that diagnosis should not be made based solely on a positive culture result.

Aged↗
PubMed2000

UTY gene codes for an HLA-B60-restricted human male-specific minor histocompatibility antigen involved in stem cell graft rejection: characterization of the critical polymorphic amino acid residues for T-cell recognition.

Rejection of a graft after human leukocyte antigen (HLA)-identical stem cell transplantation (SCT) can be caused by recipient's immunocompetent T lymphocytes recognizing minor histocompatibility antigens on donor stem cells. During rejection of a male stem cell graft by a female recipient, 2 male (H-Y)-specific cytotoxic T lymphocyte (CTL) clones were isolated from peripheral blood. One CTL clone recognized an HLA-A2-restricted H-Y antigen, encoded by the SMCY gene. Another CTL clone recognized an HLA-B60-restricted H-Y antigen. In this study UTY was identified as the gene coding for the HLA-B60-restricted H-Y antigen. The UTY-derived H-Y antigen was characterized as a 10-amino acid residue peptide, RESEEESVSL. Although the epitope differed by 3 amino acids from its X-homologue, UTX, only 2 polymorphisms were essential for recognition by the CTL clone HLA-B60 HY. These results illustrate that CTLs against several H-Y antigens derived from different proteins can contribute simultaneously to graft rejection after HLA-identical, sex-mismatched SCT. Moreover, RESEEESVSL-specific T cells could be isolated from a female HLA-B60+ patient with myelodysplastic syndrome who has been treated with multiple blood transfusions, but not from control healthy HLA-B60+ female donors. This may indicate that RESEEESVSL-reactive T cells are more common in sensitized patients.

Base Sequence↗
PubMed1989

Meeting the challenge of geriatric UTIs.

Urinary tract infections (UTIs) are common, and the geriatric population, because of multiple risk factors, is particularly susceptible. The diagnosis may be difficult and requires consideration in the appropriate clinical settings. Many antimicrobial agents provide effective initial therapy for UTIs. Recurrence is a problem that mandates urine culture and antibiotic sensitivity studies; urologic evaluation may also be necessary. The patient with a chronic indwelling bladder catheter and bacteriuria presents a unique challenge to the practicing physician.

Aged↗