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At least 19 recordsLinked to original sources
PubMed1992

The dipstick test in the diagnosis of UTI and the effect of pretreatment catheter exchange in catheter-associated UTI.

We examined the value of the dipstick test for detecting pyuria and bacteriuria in the diagnosis of urinary tract infection (UTI). The dipstick esterase test could be quickly assessed and could easily detect leukocyte esterase in the urine. This was well correlated with the conventional sedimentation method. The dipstick nitrate reduction method for detecting bacteriuria, however, was not well correlated with the urine culture method. These findings suggested that the dipstick esterase test was a useful method for detecting pyuria in the diagnosis of UTI, but not the dipstick nitrate reduction method. Catheter-associated UTI is the most difficult category of UTI to treat and control. One of the reasons for this is the formation of biofilm around the indwelling catheter. We attempted to evaluate the effect of catheter exchange just before treatment of catheter-associated UTI with either 300 or 600 mg/day of levofloxacin, one of the newer quinolones. However, we are unable to find any apparent effect on the drug's efficacy.

Bacteriuria↗
PubMed1989

A proteoglycan related to the urinary trypsin inhibitor (UTI) links the two heavy chains of inter-alpha-trypsin inhibitor.

cDNA studies have suggested that inter-alpha-trypsin inhibitor (ITI) is a complex of several different peptide chains; the sequence of the inhibitory part of ITI is in excellent agreement with that of the urinary trypsin inhibitor (UTI). The present report demonstrates that a compound immunologically related to UTI is released by digestion with porcine pancreatic elastase or human leucocyte elastase. Since UTI has been shown to be a proteoglycan, ITI has been treated by chondroitinase. In these conditions, ITI is dissociated and gives rise to two heavy chains (78 and 85 kDa) and one light chain (26 kDa) immunologically related to UTI and which in PAGE moves close to UTIc (produced by chondroitinase treatment of UTI). We suggest that ITI is a non-covalent complex comprising two heavy chains and one light chain immunologically related to UTI and which is also a proteoglycan.

Alpha-Globulins↗
PubMed1990

UTI: managing the most common nursing home infection.

Urinary tract infections (UTIs) are the most common type of infection in nursing homes. Asymptomatic bacteriuria, the most common form, requires no treatment. Symptomatic UTI requires treatment, but symptoms (acute deterioration in functional ability or mental status) may be nonspecific. Complicated UTI is more common in nursing home residents than in other populations. Immobility and the use of bedpans instead of commodes contribute to decreased bladder emptying and an increased potential for UTI. Poor perineal hygiene in many females in nursing homes also increases the potential for UTI. For this reason, obtaining urine for culture by catheterization rather than voided specimen should be the norm for female nursing home patients.

Activities of Daily Living↗
PubMed1989

Bacteriuria testing by the ATP method as an integral part in the diagnosis and therapy of urinary tract infection (UTI).

Rapid tests for bacteriuria have the highest value, if the test result is available while the patient is with the doctor. At the bacteriological laboratory rapid testing of samples obtained by mail may be cost-effective but is of little clinical value. In a previous study performed at a health care centre using conventional urine culture as a reference the ATP test came out as the most reliable one among several rapid bacteriuria tests. The present study was performed to see how the ATP test could be fitted into the routine of the health care centre. Female patients with UTI symptoms were asked to deliver a urine sample to the health care centre laboratory and to wait for the result before seeing the doctor. After having the symptoms confirmed the doctor based the diagnosis on the ATP value. A low ATP value ruled out UTI and a high ATP value confirmed UTI. In patients with an intermediary ATP value (10-50 nmol/l) a positive nitrite test was used to confirm UTI. Only those patients with intermediary ATP values and negative nitrite test had to wait for conventional urine culture. Thus in most patients the decision on antibiotic therapy or not was based on clinical symptoms and ATP results only. Antibiotics (trimethoprim) were given as single dose or as a conventional 7-day regime in a double-blind comparison. The correlation between the ATP method and conventional culture was good.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Triphosphate↗
PubMed1987

FiltraCheck-UTI, a rapid, disposable system for detection of bacteriuria.

The initial evaluation of the FiltraCheck-UTI bacteriuria detection system is described. The colorimetric test, which utilizes a disposable filter disk and a stable reagent system, does not require instrumentation. The test procedure is simple and may be performed in less than 1 min. Results obtained with the FiltraCheck-UTI system were compared with those obtained by conventional semiquantitative culturing. Of 1,198 urine specimens evaluated, 202 (16.9%) were determined to be significant positives at greater than or equal to 10(5) CFU/ml by the culture method. The sensitivity and specificity of the FiltraCheck-UTI system were 96.5 and 79.7%, respectively, and the negative predictive value was 99.1%. The high sensitivity, rapidity, simplicity, and unique disposable format of the FiltraCheck-UTI system offer significant advantages over other commonly used screening methods.

Bacteria↗
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↗
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↗
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↗
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↗
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↗
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↗
PubMed1977

[The periurethral flora in female patients with recurrent urinary tract infection (UTI) (author's transl)].

In 52 girls and 38 women with recurrent nonobstructive UTI 529 bacterial samples were obtained from the periurethral area under the following conditions: no bacteriuria and no chemotherapy for at least 3 weeks before the examination. In 225 samples we found E. coli and enterococci as the most frequent potentially uropathogenic bacteria. In the periurethral region these were found approximately twice as frequently as in urologically normal persons. 36 (40%) of the patients had no further recurrences during the follow-up, though 107 (44%) of the swabs showed an abnormal bacterial colonization. 54 (60%) of the patients, many of them with very frequent recurrences, in only 118 (41%) of the obtained samples showed an abnormal periurethral flora. The findings suggest that the periurethral flora is not the most important factor in the pathogenesis of UTI.

Adolescent↗
PubMed1987

Development of nosocomial and iatrogenic urinary tract infections (UTI) following urological interventions. A prospective clinical study.

Development of nosocomial and iatrogenic UTI was investigated over 3 months period of time. Included were 140 patients following 228 instrumentations or endoscopical or surgical interventions. Of these 84 were carried out under antimicrobial medication. 30 UTIs developed 1-8 days after the various procedures (= 13.2%): 10% after TUR-B, 14% after TUR-P and ureteral instrumentation, 16% following cystoscopy and catheterisation. No significant difference was observed between: Males and females, patients with or without antimicrobial medication, younger and older patients and after long or short procedures. Indwelling catheters remain sterile for 3 days. Though antimicrobial prophylaxis did not significantly influence the generally low rate of infection it appeared as a trend that the elderly patient who requires repeated interventions and who suffers from additional diseases as diabetes, consuming tumours and renal insufficiency may benefit from medication.

Adult↗
PubMed1987

Cefuroxime axetil in the treatment of uncomplicated UTI: a comparison with cefaclor and augmentin.

Cefuroxime axetil (CAE) is an acetoxyethyl ester prodrug of cefuroxime. The efficacy and safety of cefuroxime axetil was studied in a randomized general practice trial in urological infections where cefuroxime axetil 250 mg b.d. was compared with amoxycillin/clavulanate (Augmentin, AUG) 375 mg t.d.s. A randomized trial was then performed in hospital outpatients, who received cefuroxime axetil 250 mg b.d. or cefaclor (CCL) 250 mg t.d.s. Of 140 clinically assessable patients, 108 were cured and 28 improved on cefuroxime axetil (97% success) compared with 75 cured and 13 improved out of 89 on Augmentin (99% success) and 31 cured and 7 improved out of 38 patients treated with cefaclor (97% success). Bacteriology was assessable in 101 patients given cefuroxime axetil (72% cleared), 61 of those given Augmentin (70% cleared) and 27 out of 28 (96%) given cefaclor. As expected, the predominant pathogen was E. coli, accounting for 61% of isolates overall. Drug-related adverse events occurred in 10% of patients given cefuroxime axetil, including diarrhoea in 4%. Eleven percent of patients given Augmentin suffered adverse events (5% diarrhoea) and 5% of those given cefaclor. Superinfections occurred in 4 cefaclor patients (2 Pseudomonas aeruginosa, 1 Candida, 1 E. coli) compared with 2 on cefuroxime axetil (1 Candida, 1 E. coli). Uncomplicated UTI accounted for 92% of cases in the G.P. trial and 82% of cases in the hospital trial. Cefuroxime axetil may be used safely and effectively to treat uncomplicated UTI at a dose of 250 mg b.d.

Adolescent↗
PubMed1992

Assessment of the UTI criteria for bacterial prostatitis in Japan.

A clinical study of a new oral fluoroquinolone was conducted in bacterial prostatitis for the assessment of the UTI criteria in Japan. It is concluded that evaluation of efficacy is possible after seven-day administration in acute bacterial prostatitis (ABP), and after 14-day administration in chronic bacterial prostatitis (CBP). In ABP, the cure evaluation can be done 14 days after the treatment period. Further studies on the pathogenicity of coagulase-negative Staphylococcus were found to be necessary. When isolates from expressed prostatic secretion (EPS) are employed before administration, isolation from VB3 should not be used for evaluation of efficacy.

Acute Disease↗
PubMed1990

Fosfomycin trometamol (Monuril) versus norfloxacin in single dose for adult female uncomplicated UTIs. Multicenter randomized, double-blind study.

The efficacy, tolerability and side effects of a 'single-dose' therapy for acute female lower UTIs in general practice with fosfomycin trometamol (3 g) or norfloxacin (800 mg) were compared in a randomized double-blind study. 89 patients were included in the trial; however, 36 (40.4%) did not present significant bacteriuria and were assessed mainly for tolerability. Of the 53, 28 patients in the fosfomycin trometamol group and 25 patients in the norfloxacin group, 21 (75%) had no bacteriuria at immediate follow-up after treatment with fosfomycin trometamol and 20 (84%) with norfloxacin. The tolerability of both drugs in single dose was absolute.

Adolescent↗
PubMedDate not supplied

[Evaluation of a new method (Filtrachek-UTI) for the detection of bacteriuria].

The diagnostic effectiveness of a new test for the detection of bacteriuria (Filtrachek-UTI) was compared with Gram stain and semiquantitative culture in 955 urine samples. 276 of these were from inpatients (108 males and 168 females), and 677 from outpatients (206 males and 471 females). Overall 229 positive cultures were obtained. Taking the sample culture as the standard, the statistical parameters obtained were very low, particularly the sensitivity and the negative predictive value (75-89% sensitivity and 80-91% NPV in inpatients, and 67-92% sensitivity and 79-98% NPV in outpatients). Other problems of the method are the subjective interpretation, choluria or filter obliteration by the urine, high cost and an approximate false negative rate of 16%.

Adult↗