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PubMed2002

Diagnosis, treatment, and long-term follow-up of bilateral, upper urinary tract infection (UTI) in a cat.

A case of bilateral, upper urinary tract infection caused by haemolytic E coli in a female Birman cat is presented. Ultrasonographic examination of the kidneys documented changes in size, outline, echogenicity and architecture. Ultrasound guided fine needle aspiration of fluid from the renal pelvis was used to make the diagnosis. Fluid was submitted for culture and sensitivity and based on the results, antimicrobial therapy was initiated. The treatment was monitored over a 406-day follow-up period. Despite extensive treatment with specific antibiotics and supportive therapy, recurrence of urinary tract infection occurred.

Animals↗
PubMed1994

USA resistance patterns among UTI pathogens.

The fluoroquinolones are a new, potent class of antimicrobials which are heavily prescribed in the United States. Resistance to these agents has developed primarily in organisms that are inherently less sensitive, such as Staphylococcus spp. and Pseudomonas spp., but also, in some centres, in more sensitive organisms, such as members of the Enterobacteriaceae. Because the fluoroquinolones are a valuable class of broad-spectrum antibiotics, it is desirable that their usefulness be conserved by adopting measures to prevent or minimize the development of resistance. One obvious approach to this is to restrict their use, preventing overuse or misuse. The therapy of urinary tract infections is a major area in which fluoroquinolone usage could be reduced or rationalized. Although these agents are highly efficacious in the therapy of urinary tract infections, so too are older, less expensive agents such as nitrofurantoin, co-trimoxazole, sulphonamides and amoxycillin. From considerations of both economy and minimizing the development of resistance there appears to be little justification for using fluoroquinolones routinely to treat urinary tract infections, except where other oral agents may not be well tolerated or are unlikely to be effective.

Anti-Infective Agents↗
PubMed2003

Antibiotic activity against urinary tract infection (UTI) isolates of vancomycin-resistant enterococci (VRE): results from the 2002 North American Vancomycin Resistant Enterococci Susceptibility Study (NAVRESS).

BACKGROUND: The purpose of this study was to assess the prevalence of vancomycin-resistant enterococci (VRE) in urinary isolates in North America, and the activity of various antibiotics against VRE. MATERIALS AND METHODS: Twenty-eight medical centres in the United States and 10 centres in Canada assessed the prevalence of VRE in urinary isolates in 2002. Each study site was asked to collect up to a maximum of 50 consecutive VRE (Enterococcus faecium, Enterococcus faecalis only) urinary isolates. Susceptibility was determined by NCCLS broth microdilution. The prevalence of vanA and vanB resistance genotypes was determined by multiplex PCR. RESULTS: From the 28 US medical centres, a total of 697 VRE (616 [88.4%] E. faecium and 81 [11.6%] E. faecalis) were received. Approximately 75% of all VRE (E. faecium and E. faecalis) isolates demonstrated a VanA phenotype (resistance to both vancomycin and teicoplanin). PCR detection of vanA and vanB resistance determinants showed that the vanA genotype was present in 584 of 697 (83.8%) VRE isolates, whereas 113 (16.2%) isolates possessed the vanB gene. The most active agents were linezolid, nitrofurantoin and chloramphenicol, with 0.3%, 0.6% and 2.4% resistance, respectively. The majority (77.8%) of vancomycin-resistant E. faecium isolates displayed the VanA phenotype, and 538 of these 616 (87.3%) isolates were PCR-positive for vanA; the vanB genotype was detected in 78 (12.7%) isolates. Resistance was lowest with linezolid, chloramphenicol and nitrofurantoin at 0.3%, 0.3% and 0.5%, respectively. Only three genetically indistinguishable vanA-positive E. faecium were isolated from the 10 Canadian medical centres. CONCLUSION: VRE urinary isolates are common in the United States, are primarily of the vanA genotype and are very susceptible to linezolid, nitrofurantoin and chloramphenicol. In Canada, VRE urinary isolates remain uncommon.

Anti-Bacterial Agents↗
PubMedDate not supplied

Management of UTIs during pregnancy.

This article summarizes the pathophysiology, patient presentation, diagnostic testing, and current treatment modalities for pregnant women presenting with urinary tract symptoms in pregnancy. Urinary tract infection is a common health problem, affecting millions of people each year. However, this seemingly benign condition may have serious consequences if it occurs during the course of a woman's pregnancy, and if untreated could lead to pyelonephritis, preterm labor, or Group B Streptococcal infection in the newborn. Thus, the prevention, early detection, and prompt treatment of urinary tract infections in pregnancy have become essential components of prenatal care.

Adult↗
PubMed2006

Clinical study of complicated urinary tract infection using 'The UTI Criteria (Draft Fourth Edition)': measurement methods for pyuria.

OBJECTIVE: To evaluate the influences the change of the measurement method of pyuria from conventional centrifuged sediment to microchamber uncentrifuged urine for the results of evaluation of antimicrobial agents in clinical study against complicated urinary tract infections. From the viewpoint of international harmonization of judgement criteria, the recent method for counting white blood cells (WBC) in urine has changed from using uncentrifuged urine to using a microchamber in all countries. METHODS: Targeted diseases were non-catheterized complicated urinary tract infection, and cefcapene pivoxil hydrochloride or levofloxacin were used as antimicrobial drug. Pyuria was examined using the counting chamber method, a quantitative method using uncentrifuged urine with a microchamber, and the sedimentation method. RESULTS: Overall clinical efficacy in early evaluation by the two methods in measuring pyuria was evaluated as different in eight patients (7.3%). It was rated excellent in 63 (52.9%), moderate in 32 patients (26.9%) and poor in 24 (20.2%) with an efficacy rate of 79.8% using the counting chamber method, and excellent in 68 (57.1%), moderate in 27 (22.7%) and poor in 24 (20.2%) with an efficacy rate of 79.8% using the conventional sedimentation method CONCLUSION: No significant difference was seen between the two methods of WBC count in urine.

Adult↗