Approach to urinary tract infections
TLDR
The consensus conference convened by National Institute of Health added two more groups of patients, namely, chronic prostatitis/chronic pelvic pain syndrome and asymptomatic inflammatory prost atitis, in addition to acute and chronic bacterial prostatococcal infections.Abstract:
Urinary tract infection (UTI) is the most common infection experienced by humans after respiratory and gastro-intestinal infections, and also the most common cause of both community-acquired and nosocomial infections for patients admitted to hospitals. For better management and prognosis, it is mandatory to know the possible site of infection, whether the infection is uncomplicated or complicated, re-infection or relapse, or treatment failure and its pathogenesis and risk factors. Asymptomatic bacteriuria is common in certain age groups and has different connotations. It needs to be treated and completely cured in pregnant women and preschool children. Reflux nephropathy in children could result in chronic kidney disease; otherwise, urinary tract infections do not play a major role in the pathogenesis of end-stage renal disease. Symptomatic urinary tract infections occur most commonly in women of child-bearing age. Cystitis predominates, but needs to be distinguished from acute urethral syndrome that affects both sexes and has a different management plan than UTIs. The prostatitis symptoms are much more common than bacterial prostatic infections. The treatment needs to be prolonged in bacterial prostatitis and as cure rates are not very high and relapses are common, the classification of prostatitis needs to be understood. The consensus conference convened by National Institute of Health added two more groups of patients, namely, chronic prostatitis/chronic pelvic pain syndrome and asymptomatic inflammatory prostatitis, in addition to acute and chronic bacterial prostatitis. Although white blood cells in urine signify inflammation, they do not always signify UTI. Quantitative cultures of urine provide definitive evidence of UTI. Imaging studies should be done 3-6 weeks after cure of acute infection to identify abnormalities predisposing to infection or renal damage or which may affect management. Treatment of cystitis in women should be a three-day course and if symptoms are prolonged, then a seven day course of antibiotics should be given. Selected group of patients benefits from low-dose prophylactic therapy. Upper urinary tract infection may need in-patient treatment. Treatment of acute prostatitis is 30-day therapy of appropriate antibiotics and for chronic bacterial prostatitis a low dose therapy for 6-12 months may be required. It should be noted that no attempt should be made to eradicate infection unless foreign bodies such as stones and catheters are removed and correctable urological abnormalities are taken care of. Treatment under such circumstances can result only in the emergence of resistant organisms and complicate therapy further.read more
Citations
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Antimicrobial prophylaxis for children with vesicoureteral reflux.
Alejandro Hoberman,Saul P. Greenfield,Tej K. Mattoo,Ron Keren,Ranjiv Mathews,Hans G. Pohl,Bradley P. Kropp,Steven J. Skoog,Caleb P. Nelson,Marva Moxey-Mims,Russell W. Chesney,Myra A. Carpenter +11 more
TL;DR: Among children with vesicoureteral reflux after urinary tract infection, antimicrobial prophylaxis was associated with a substantially reduced risk of recurrence but not of renal scarring.
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Antimicrobial prophylaxis for children with vesicoureteral reflux.
TL;DR: It is concluded that antibiotic prophylaxis is useful to prevent repeat episodes of UTI in children with VUR and the prevalence of antibiotic resistance increased significantly with proPHylaxis.
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Recent advances in the treatment of pathogenic infections using antibiotics and nano-drug delivery vehicles.
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Cysteine capped gold nanoparticles for naked eye detection of E. coli bacteria in UTI patients
TL;DR: The method was successfully applied for the detection of E. coli 0157:H7 bacteria in patients suffering from urinary track infections and correlated well with the conventional method indicating that the method could potentially be used as a self screening method for the patients suspecting UTI, for warranting further medical attention.
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References
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Journal ArticleDOI
NIH consensus definition and classification of prostatitis
Journal ArticleDOI
Diagnosis and treatment of uncomplicated urinary tract infection
Thomas M. Hooton,Walter E. Stamm +1 more
TL;DR: The optimal treatment duration for acute uncomplicated pyelonephritis has not been established, but 10- to 14-day regimens are recommended, and patients prefer to use antimicrobials that attain high renal tissue levels, such as a fluoroquinolone, trimethoprim-sulfamethoxazole, or an aminoglycoside for pyel onephritis.
Journal ArticleDOI
Diagnosis of Coliform Infection in Acutely Dysuric Women
Walter E. Stamm,George W. Counts,Katherine Running,Stephen D Fihn,Marvin Turck,King K. Holmes +5 more
TL;DR: Clinicians and microbiologists should alter their approach to the diagnosis and treatment of women with acute symptomatic coliform infection of the lower urinary tract by finding the best diagnostic criterion to be greater than or equal to 10(2) bacteria per milliliter.
Journal ArticleDOI
Increasing antimicrobial resistance and the management of uncomplicated community-acquired urinary tract infections.
TL;DR: The problem of antimicrobial resistance in acute uncomplicated community-acquired UTI is highlighted, focusing on TMPSMX resistance, and the few available data regarding clinical outcomes associated with in vitro resistance are summarized.
Journal ArticleDOI
A Prospective Study of Risk Factors for Symptomatic Urinary Tract Infection in Young Women
Thomas M. Hooton,Delia Scholes,James P. Hughes,C. Winter,Pacita L. Roberts,Ann E. Stapleton,Andy Stergachis,Walter E. Stamm +7 more
TL;DR: Among sexually active young women the incidence of symptomatic urinary tract infection is high, and the risk is strongly and independently associated with recent sexual intercourse, recent use of a diaphragm with spermicide, and a history of recurrent urinary tract infections.