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PubMed2004

Incidence of catheter-associated urinary tract infection among dogs in a small animal intensive care unit.

OBJECTIVE: To determine incidence of and possible risk factors for catheter-associated urinary tract infection (UTI) among dogs hospitalized in an intensive care unit and compare results of bacterial culture of urine samples with results of bacterial culture of catheter tips. DESIGN: Prospective study. ANIMALS: 39 dogs. PROCEDURE: A standard protocol for aseptic catheter placement and maintenance was used. Urine samples were obtained daily and submitted for bacterial culture. When possible, the urinary catheter tip was collected aseptically at the time of catheter removal and submitted for bacterial culture. Bacteria that were obtained were identified and tested for antimicrobial susceptibility. RESULTS: 4 of the 39 (10.3%) dogs developed a UTI. The probability of remaining free from UTI after 1 day in the intensive care unit was 94.9%, and the probability of remaining free from UTI after 4 days was 63.3%. Bacteria isolates were generally common urinary tract pathogens and were susceptible to most antimicrobials. Specific risk factors for catheter-associated UTI, beyond a lack of antimicrobial administration, were not identified. Positive predictive value of bacterial culture of urinary catheter tips was only 25%. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that placement of an indwelling urinary catheter in dogs is associated with a low risk of catheter-associated UTI during the first 3 days after catheter placement, provided that adequate precautions are taken for aseptic catheter placement and maintenance. Results of bacterial culture of urinary catheter tips should not be used to predict whether dogs developed catheter-associated UTI.

Animals↗
PubMed2004

Urinary tract infections. Does the smell really tell?

Asymptomatic bacteriuria is considered a transient and benign condition in the geriatric population. Before a diagnosis of a urinary tract infection (UTI) can be made, symptoms and significant bacteriuria must be present. One of these symptoms is malodorous urine. Other symptoms of a UTI, typical in the younger population, have been found to be absent or misleading in the older adult population. Though early detection of UTIs improves outcomes, unnecessary laboratory tests are costly and time-consuming, and may encourage inappropriate antibiotic therapy. The purpose of this study was to determine if urine odor is an accurate predictor of a UTI in the older adult incontinent nursing home population. Ninety-seven recently wet incontinence pads of residents in six Midwestern nursing homes were evaluated for odor within 1 hour of voiding. These results were compared to microscopy and culture results of clean-catch urine samples from these individuals. Defining a UTI as either bacteriuria or bacteriuria and pyuria, using urine odor to identify a UTI resulted in error in one third of cases. Results of this study indicate smell of urine in incontinence pads may be an absent or misleading symptom for UTIs in elderly nursing home residents.

Aged↗
PubMed1998

[Monitoring of interleukin-8 in urine and in serum of patients after kidney transplantation].

Neutrophil accumulation in the graft kidney is a feature of cellular rejection and bacterial infection. The cellular infiltration is mediated by the local production of chemoattractant factors. The aim of the study was to analyze levels of IL-8 in renal graft recipients during and after episodes of acute renal rejection and urinary tract infection (UTI). A total of 50 renal graft recipients, including 10 with acute graft rejection (Group I) and 20 with UTI (Group II) were studied. Urine and serum levels of IL-8 were determined in patients of Group I before and after 7 days of antirejection therapy and in patients of Group II before and after 2 weeks of antimicrobial therapy. Results were compared with group of 20 patients with stable renal function and a group of 25 healthy people. IL-8 was determined by ELISA technique. The level of IL-8 in urine (uIL-8) was elevated in patients with acute graft rejection and uIL-8 decreased after antirejection treatment (772 +/- 241 pg/mg cr. vs 140 +/- 50 pg/mg cr.; p < 0.01). In 13 patients UTI was asymptomatic and 6 patients had an acute pyelonephritis. The level of uIL-8 was elevated in all patients with UTI and decreased after antimicrobial therapy. Levels of uIL-8 during acute pyelonephritis were significantly higher (p < 0.01) than in patients with asymptomatic bacteriuria (2582 +/- 950 pg/mg cr. vs 804 +/- 225 pg/mg cr.) Urine levels of IL-8 were lower in patients infected by Gram-positive Cocci as compared to patients infected by Gram-negative organisms. Patients with higher concentrations of serum creatinine during UTI had high urine levels of IL-8. Serum levels of IL-8 in patients of Group I and Group II were comparable with patients with stable graft function although they were higher than in control group. Elevated urinary secretion of IL-8 in acute rejection and UTI suggests a role of IL-8-neutrophiles system in in the pathogenesis in both inflammatory complications after kidney transplantation. Urine level of IL-8 was correlated with clinical symptoms of UTI.

Adult↗
PubMed2001

Urinary tract infections in men in a primary care population.

OBJECTIVE: There have been few studies on urinary tract infections (UTIs) in adult males. This study aimed to look at the clinical features of males presenting with urinary tract infections in a predominantly gay general practice population. METHOD: A retrospective audit and analysis was carried out of all male patients presenting with symptoms suggestive of a UTI and in whom a pathogen was cultured from urine. The subjects were drawn from two urban general practices in Melbourne. Subjects with known pre-existing urinary tract abnormalities, or in whom recent urinary tract instrumentation had been performed, were excluded, as were subjects in whom Neisseria gonorrhoeae was cultured from urine. RESULTS: Thirty-three subjects were identified, with a total of 47 presentations. Six subjects were excluded on the basis of pre-existing known factors which would predispose to UTIs, leaving 27 subjects, with 37 episodes of UTI. The mean age was 43 (range = 28-62) and 25 of the 27 identified as gay. Nine out of the 27 (33%) were HIV positive with a mean CD4 of 574/mm3 (range = 41-1812). The main presenting symptoms were dysuria/burning on micturition, urinary frequency, fever/sweats and haematuria. Urethral discharge occurred in two episodes. Multiple symptoms on presentation were common. The main organism cultured was E. coli. Fourteen subjects underwent further radiological investigation and two abnormalities were detected. CONCLUSION: Uncomplicated UTIs are uncommon in males presenting to general practice. The symptoms are similar to those in females with UTIs, though fever may be more common. Treatment with oral antibiotics in a primary care setting is generally curative. Further investigation of males with UTIs may be appropriate, but more studies are needed as to the cost-benefit of this.

Adult↗
PubMed2002

Relationship between vesicoureteral reflux and renal cortical scar development in Thai children: the significance of renal cortical scintigraphy and direct radionuclide cystography.

Relationship of vesicoureteral reflux (VUR), urinary tract infection (UTI) and subsequent renal scarring nowadays is still in question. This study aimed to determine 1) the incidence of cortical scarring in Thai children presenting with upper urinary tract infection, 2) the association between VUR with acute pyelonephritis and subsequent renal scarring, 3) the use of DMSA and direct radionuclide cystography (DRNC) scintigraphy in children with UTI. Sixty newly diagnosed UTI children underwent DRNC and Tc-99m DMSA renal cortical scintigraphy at the time of first UTI diagnosis and 6 months later. There were no significant differences of age, sex, type of antiobiotics and pathogens (E. coli vs non-E. coli) between those who did and did not develop scars (p>0.05). 58/98 of 1st DMSA abnormal kidneys (59.18%) developed scars. 60.20 per cent of 98 positive 1st DMSA had VUR while 80.33 per cent of 61 with VUR had positive 1st DMSA. 59.02 per cent of these 61 kidneys developed scars. Scar occurrence were 18.7 times in high grade VUR compared to low grades. In conclusion, there was a high incidence of acute pyelonephritis in the presence of VUR but acute pyelonephritis does not necessarily need VUR for its development. High grade reflux with upper UTI, is a strong indicator for renal scarring. Children presenting with UTI, irrespective of age, sex, or pathogen, should have both DMSA and DRNC scintigraphy performed to identify upper UTI and high risk patients who will develop subsequent renal scarring.

Adolescent↗
PubMed2002

[Comparative studies on activities on antimicrobial agents against causative organisms isolated from patients with urinary tract infections (2000). III. Secular changes in susceptibility].

The bacteria (Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, Klebsiella spp. and Pseudomonas aeruginosa) isolated from patients diagnosed as having urinary tract infections (UTIs) in 10 institutions in Japan were supplied between August 2000 and July 2001. Then, the susceptibilities of these bacteria to various antimicrobial agents were examined, and the results were compared with those obtained between 1992 and 1999. Comparison was made by classifying strains isolated from patients into those in uncomplicated UTIs and those in complicated UTIs (including with or without indwelling catheter). E. faecalis showed good susceptibility to ampicillin (ABPC) and imipenem (IPM), and the MIC90s were 2 micrograms/ml. Also, E. faecalis showed good susceptibility to vancomycin (VCM). However, the MIC90, which was 2 micrograms/ml between 1992 and 1999, rose to 4 micrograms/ml in patients with complicated UTIs because the strains inhibited at 4 micrograms/ml increased more than before. The low susceptibility of S. aureus to arbekacin (ABK) in complicated UTIs, as shown in 1998 and 1999, recovered in 2000, and no strains inhibited at > or = 4 micrograms/ml were detected. E. coli showed good susceptibility to CTM (MIC90: 0.25-0.5 microgram/ml) and CZOP (MIC90: < or = 0.125 microgram/ml) and was not resistant to those. E. coli also showed good susceptibility to the other drugs except to penicillins. Decreases in susceptibility of E. coli to quinolones, ciprofloxacin (CPFX), and sparfloxacin (SPFX) were observed in the patients with complicated UTIs. The susceptibility of Klebsiella spp. to all drugs did not significantly change in 2000 and was generally good except to penicillins. Although the susceptibility of P. aeruginosa to carbapenems was notable, the MIC90 went up from 4 micrograms/ml to 16 micrograms/ml in complicated UTIs compared with those observed in the previous year.

Anti-Infective Agents, Urinary↗
PubMed1976

[Significance of diagnostic parameters in recurrent urinary tract infection in children. I. The history (author's transl)].

Comparison of the history of 136 children with recurrent urinary tract infection (UTI) with their follow up in a special urologic service (260,6 patient years) showed marked differences in symptoms of recurrent UTI prior to follow up (769 "anamnestic" recurrent UTI) as compared to true significant bacteriuria (278 recurrent UTI during follow up). Therefore parents statements about time of first UTI and incidence of further recurrences should be considered with caution. Only 10% of the physicians proved their diagnosis "UTI" bacteriologically. Anamnestic data, however, are of great importance for the follow up of children with recurrent UTI: children with many recurrences in their history have a greater risk of further recurrences despite careful follow up, and tend to have more pathologic findings on first radiologic examinations.

Age Factors↗
PubMed2003

[Community acquired urinary tract infection among hospitalized children in northern Israel: pathogens, susceptibility patterns and urinary tract anomalies].

BACKGROUND: Urinary tract infection (UTI) is one of the most common diseases in children. Vesicoureteral reflux (VUR) has been demonstrated in a substantial number of young children with UTI. Empiric antibacterial therapy is recommended before results of the urine culture are available in order to shorten the duration of the disease and prevent renal complications. OBJECTIVES: The aims of this study were to assess the prevalence and susceptibility patterns of UTI pathogens, and urinary anomalies in children admitted with UTI. METHODS: The study population included 151 children younger than 14 years admitted with first UTI. Renal ultrasound was performed in all the patients and voiding cystourethrography (VCUG) in children younger than 5 years. Dimercaptosuccinic acid (DMSA) scan was performed in children with vesicoureteral reflux. The data included age, sex, symptoms and signs, urinalysis, the pathogen and its sensitivity and the results of the imaging studies. RESULTS: A total of 119 patients (79%) were females. Gram negative rods caused 98% of the infections, of which Escherichia coli (87%) was the most prevalent pathogen, followed by Klebsiella pneumoniae (4%), and Proteus mirabilis (4%). The sensitivities to antibacterial agents were: Amikacin 100%, ceftazidime 97%, gentamicin 96%, ceftriaxone 96%, cefuroxime 95%, amoxicillin-clavulanate 84%, trimethoprim-sulfamethoxazole 63%, cephalexin 58%, and ampicillin 28%. Renal US showed minor abnormalities in 24/149 (16%) and VCUG demonstrated vesicoureteral reflux in 38/127 (30%) patients. DMSA revealed renal scars in 7/28 (25%) children with vesicoureteral reflux. CONCLUSIONS: Overall Gram negative rods cause 98% of the UTI in hospitalized children in our area. E. coli is the leading pathogen and aminoglycosides and second or third generation cephalosporins are the most suitable agents for empiric therapy in UTI. A high incidence of renal scars in young children with vesicoureteral reflux was found.

Adolescent↗
PubMed2003

Hospital-acquired urinary tract infection.

Nosocomial urinary tract infections (UTIs) account for up to 40% of all hospital-acquired infections. The associated morbidity and mortality are a major drain on hospital resources. Patients with indwelling urinary catheters, patients undergoing urological manipulations, long-stay elderly male patients and patients with debilitating diseases are at high risk of developing nosocomial UTIs. The organisms responsible usually originate from patients' endogenous intestinal flora, but occasionally from a moist site in the hospital environment. Nosocomial pathogens causing UTIs tend to have a higher antibiotic resistance than simple UTIs. Infection control policies are important in limiting the number of hospital-acquired UTIs. Other important points include catheterisation using an aseptic technique and sterile equipment and the use of closed drainage systems. UTIs should be treated only after a urine sample has been sent and the advice of a microbiologist sought. In the future catheters impregnated with antibiotics, and the use of newer materials, may lead to further reductions in the incidence of nosocomial UTIs.

Anti-Bacterial Agents↗
PubMed2003

[Urinary tract infections in children under three years of age].

Urinary tract infection (UTI) in infants and babies is still a challenging problem. The aim of the study was the clinical analysis of children under three years of age with UTI, hospitalised in The Department of Paediatrics, Medical University of Lodz in 2000-2001. The study included 91 children (45 girls and 46 boys), aged 1-36 months; 10 months on the average. Acute UTI was observed in 29% of children, recurrent UTI was diagnosed in 71% of patients. Voiding cystography was performed in 82% of children. Among 28/91 cases of vesicoureteral reflux, 36% were unilateral and 64% were bilateral. Vesicoureteral reflux grade 2 was most frequent (64%) in patients with UTI. The most common pathogen was Escherichia coli. The obtained results demonstrate the necessity of early imaging diagnosis of the urinary system in infants and babies with UTI. Patients under three years of age with UTI require hospitalisation and performance of early diagnostic examinations of the urinary tract.

Age Factors↗
PubMed1992

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1988). III. Secular changes in susceptibility].

Sensitivities to various antibacterial and antibiotic agents of strains of Escherichia coli, Klebsiella spp., Proteus spp., Citrobacter spp., Enterobacter spp., Serratia marcescens and Pseudomonas aeruginosa isolated from patients with urinary tract infections (UTIs) in 9 hospitals during June to November 1988 were compared with those in the same period of previous year according to a classification, uncomplicated UTIs, complicated UTIs without indwelling catheter, and complicated UTIs with indwelling catheter. No remarkable changes were found in sensitivities of E. coli, Proteus spp., Citrobacter spp. and S. marcescens. The sensitivity of Klebsiella spp. to cephems decreased in complicated UTI without indwelling catheter and increased in complicated UTI with indwelling catheter. The sensitivity of Enterobacter spp. to third generation cephems decreased in complicated UTI with indwelling catheter. Sensitivities of P. aeruginosa to aspoxicillin and cefsulodin increased. The number of resistant strains to new quinolones increased slightly.

Anti-Bacterial Agents↗
PubMed2004

The influence of prepartal bacteriuria on the reproductive performance of the sow.

UNLABELLED: In a Slowakian indoor pig production unit, with high prevalence of vaginal-vulval discharges, the sows were subjected one day prefarrowing to urine analysis. Sows suffering urinary tract infection (UTI) were assigned to an UTI group (group 1, n = 384), the remaining sows were classified as free of UTI and were assigned to group 2 (n = 1099). Total born litter size, liveborn litter size, weaning litter size and the occurrence of periparturient diseases, reasons for sow cullings at weaning, subsequent weaning to estrus intervals, conceptions- and farrowing rate, next total born- and lifeborn litter size and the occurrence of periparturient diseases were evaluated. UTI having sows had smaller (p < 0.05) total born litter size (11.71 +/- 1.11) when compared to the healthy animals (12.97 +/- 1.25). Liveborn litter size was significantly (p < 0.01) lower in group 1 (10.21 +/- 0.81 vs. group 2: 11.31 +/- 1.21). The occurrence of periparturient diseases revealed highly significant (p < 0.001) differences between the groups (group one 26.24% vs. group two 4.64%). Weaning litter size showed significant (p < 0.05) differences between group 1 (9.21 +/- 1.02) and 2 (10.11 +/- 0.37). More (p < 0.05) sows were culled post-weaning in the UTI group, compared to the healthy animals. Causes of post-weaning cullings differed between the groups: all sows of the group one had the pathological signs of swine urogenital disease at culling, while the majority of sows of the group 2 were culled due to locomotor problems and chronic mastitis. Subsequent weaning to estrus intervals, conceptions-, and farrowing rate and next total born litter size differed significantly (p < 0.05) between the groups, next lifeborn litter size (p < 0.01) and the occurrence of periparturient diseases (p < 0.001) were high significantly better in the healthy than in the UTI suffering group of sows. IMPLICATIONS: antepartal UTI might be the sign of swine urogenital disease and might negatively influence the sows reproductive performance.

Animals↗
PubMed2004

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (2002). III. Secular changes in susceptibility].

The bacteria (Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Klebsiella spp. and Pseudomonas aeruginosa) isolated from patients diagnosed as urinary tract infections (UTIs) in 13 institutions in Japan were supplied between August 2002 and July 2003. The susceptibilities of these bacteria to various antimicrobial agents were examined. The bacteria were divided into 2 groups consisting of uncomplicated UTIs and complicated UTIs (with and without indwelling catheter) based on their isolation origins. The results were compared with those obtained between 1993 and 2001. The drug sensitivity of S. aureus in this year was similar to those in up to the previous year and S. aureus showed the best susceptibility to vancomycin. The drug sensitivity of E. faecalis in this year also was similar to those in up to the previous year. The drug sensitivity of E. coli in this year was generally good except penicillins and was similar to those in up to the previous year. Among cephems, cefozopran (CZOP) and cefpirome (CPR) showed the highest potency (MIC90: < or = 0.125 microg/mL). An antibacterial activity of cefotiam (CTM) was similar to it in 10 years ago and was fine (MIC90: < or = 1 microg/mL). The sensitivity of E. coli to carbapenems and carumonam (CRMN) also was good like to CZOP. However, the sensitivity of the complicated UTIs group to quinolones decreased after 2000 and was suggested to develop the resistance to the drug. The drug sensitivity of Klebsiella spp. in this year also was similar to those in up to the previous year. The bacteria showed good susceptibility (MIC: < or = 0.125 microg/mL) to cefmenoxime (CMX), CPR, cefixime (CFIX), flomoxef (FMOX), and CZOP among cephems. The drug sensitivity of P. aeruginosa was generally low. Most of the bacteria were little sensitive to cephems except CZOP and ceftazidime (CAZ). The sensitive bacteria to CZOP and ceftazidime (CAZ) were observed to be 26.8% (15/56 strains) and 39.3% (22/56 strains) in complicated UTIs group, respectively. The sensitivity profile of P. aeruginosa to the other tested drugs was not much different from that in up to the previous year. However, the sensitivity of the bacteria to carbapenems tended to decrease after 2000, and the low sensitive strains (MIC: > or = 256 microg/mL) were detected at 22.2% (2/9 strains) in the uncomplicated UTIs group and 3.6% (2/56 strains) in the complicated UTIs group.

Anti-Bacterial Agents↗
PubMed2005

Antioxidative role of urinary trypsin inhibitor in acute lung injury induced by lipopolysaccharide.

We have previously demonstrated the protective role of urinary trypsin inhibitor (UTI) against acute inflammatory lung injury induced by lipopolysaccharide (LPS) using UTI-deficient (-/-) mice and corresponding wild-type (WT) mice. The protection was mediated, at least partly, through inhibition of the enhanced local expression of proinflammatory cytokines, chemokines, and intercellular adhesion molecule-1. In the present study, we addressed whether UTI regulates oxidative stress generated by LPS challenge in the lung. UTI (-/-) and WT mice were treated intratracheally with vehicle or LPS (125 microg/kg). After LPS challenge in both genotypes of mice, the lung levels of mRNA for inducible nitric oxide synthase and hemo oxygenase-1 were elevated, but to a greater extent in UTI (-/-) mice than in WT mice. Immunohistochemistry showed that the formations of 8-hydroxy-2'-deoxyguanosine and nitrotyrosine in the lung were more intense in UTI (-/-) mice than in WT mice after LPS challenge. These results indicate that endogenous UTI is protective against acute lung injury induced by bacterial endotoxin, at least partly, via the antioxidative properties.

8-Hydroxy-2'-Deoxyguanosine↗
PubMed1989

[Clinical evaluation of cefixime (CFIX) in the treatment of urinary tract infection].

Cefixime (CFIX, Cefspan), a new oral cephem, was used in the treatment of urinary tract infections, and was evaluated for its therapeutic effectiveness and safety at the Department of Urology, Osaka University Hospital and 16 affiliated hospitals. A total of 238 patients were administered daily doses of 200 or 400 mg. Clinical efficacy was assessed on 92 female patients with acute uncomplicated cystitis and 42 patients with complicated UTI according to the Criteria for Clinical Evaluation of Antimicrobial Agents in UTI (3rd ed.) recommended by the Japan UTI Committee, to which we added our own minimum modification. Clinical efficacy was evaluated as excellent in 57 of the acute uncomplicated cystitis cases, moderate in 33 and poor in 2, with an overall clinical effectiveness rate of 98%. Clinical efficacy was evaluated as excellent in 12 of the complicated UTI cases moderate in 12 and poor in 18, with an overall clinical effectiveness rate of 57%. In one case of uncomplicated pyelonephritis, CFIX showed an excellent efficacy. Of the total of 102 bacterial strains isolated from uncomplicated UTIs, 95 (93%) were eradicated by CFIX, while 36 (72%) eradicated in 50 strains isolated from complicated UTIs. Subjective adverse reactions were seen in 4 cases (1.7%) of the 236 patients, as generalized pruritus and upper gastrointestinal discomforts. Abnormal laboratory findings were recorded in 6 out of 141 cases. They were increases in serum GPT, GOT, alkaline phosphatases, total bilirubin, as well as increases in peripheral leukocytes. These adverse symptoms and abnormal laboratory findings disappeared after the termination of CFIX administration. CFIX might therefore be considered as a clinically useful oral antibiotic in the treatment of UTI.

Administration, Oral↗
PubMed1986

[Bacterial adhesiveness and recurrent urinary infections in children].

Bacterial adhesivity test to epithelial cells in vitro was studied, in order to investigate whether urinary, and buccal cells, from children prone to recurrent urinary tract infections (UTI) are better adhered to by uropathogen Escherichia coli (E. coli), as compared to cells from control children, non-prone to recurrent UTI. Cells were withdrawn from 75 children, divided into 3 groups: with recurrent UTI without uropathy, with recurrent UTI and uropathy, and controls, without recurrent UTI and without uropathy. Values obtained showed that most of the children, prone or not to recurrent UTI, have cells allowing good adhesivity of the 2 uropathogen E. coli used and that there is no significant difference among these results and no relation with the 3 described groups. Bacterial adhesivity appears dependent on individual genetic variations of cell donors, presumably related to membrane receptors. Studies on in vitro bacterial adhesivity do not seem to be able to explain pathogenesis of recurrent UTI.

Adolescent↗
PubMed1984

[Clinical studies of antimicrobial prophylaxis of recurrent urinary infection in women. Long-term, low-dose pipemidic acid for prophylaxis].

The prophylactic efficacy of long-term, low-dose antimicrobial treatment in urinary tract infection (UTI) was studied. Fifty-eight female adult patients with a history of at least two recurrent episodes of UTI in the past year were entered into this study, and the prophylactic regimen was not started until the existing UTI had been eradicated. Patients took 250 mg of pipemidic acid (PPA) daily at bedtime after voiding for 6 consecutive months. Incidence of recurrence of UTI in 48 patients with uncomplicated UTI and 10 patients with complicated UTI decreased to 0.15 and 0.29 per year, respectively, during the treatment compared with 3.5 per year before the treatment. At the end of the 6 months of prophylactic treatment, the patients were divided into two groups by the envelope method. Seventeen patients were treated for a further 6 months and 11 patients were followed up without further medication. Prophylactic efficacy of UTI was obtained in both groups, and there was no significant difference in the incidence of recurrence between the two groups. These findings suggest that the 6-month period of prophylaxis might be sufficient. Examination of the periurethral swab showed that E. coli and Klebsiella sp. were decreased during the treatment. This prophylactic treatment produced no resistant strains. Urinary levels of PPA in the morning urine of patients administered 250 mg of PPA at bedtime averaged 513 micrograms/ml. These values were about 2 times higher than those found in the evening urine after administration of the same dose in the morning.

Drug Evaluation↗
PubMed1995

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1989). III. Secular changes in susceptibility].

Susceptibilities of Citrobacter spp., Enterobacter spp., Escherichia coli, Klebsiella spp., Proteus mirabilis, Pseudomonas aeruginosa, Serratia spp. isolated from patients with urinary tract infections (UTIs) in 10 hospitals during June 1989 to May 1990 to various antimicrobial agents were compared with those in the same period of previous years according to a classification, uncomplicated UTIs, complicated UTIs without indwelling catheter, and complicated UTIs with indwelling catheter. As for Citrobacter spp., P. mirabilis and Serratia spp., which were detected very few in 1989, their susceptibilities were not observed an obvious change. As for Enterobacter spp., the susceptible strains to flomoxef, cefixime, cefuzonam and ceftazidime increased in complicated UTIs with indwelling catheter. The susceptibilities of E. coli to penicillins increased slightly in complicated UTIs with indwelling catheter. Against Klebsiella spp., a good activity of minocycline or cephems was found. The susceptibilities of P. aeruginosa to ciprofloxacin and new quinolones increased in uncomplicated UTIs. These data should be considered in clinical treatment of various urinary tract infections.

Anti-Bacterial Agents↗