Infections

Infections

European Association of Urology Guidelines on Urological Infections: Summary of the 2024 Guidelines.

Urological infections significantly impact the wellbeing and quality of life of individuals owing to their widespread occurrence and diverse clinical manifestations. The objective of the guidelines panel was to provide evidence-based guidance on the diagnosis, treatment, and prevention of urinary tract infections (UTIs) and male accessory-gland infections, while addressing crucial public health aspects related to infection control and antimicrobial stewardship.

Urinalysis Is Predictive for Absence of Urinary Tract Infection in Men with and Without Catheters - Beyond the Abstract

The goal of the study was to determine predictive accuracy of a negative urinalysis for negative urine culture and the absence of urinary tract infection in men both with and without indwelling urinary catheters. Similar to our findings in women (PMID 36898589), when urinalysis was negative (LE, WBC, nitrite) in men, only 5% of urine cultures grew uropathogenic bacteria, and only 1% of negative urinalyses were associated with urinary tract infection.

Urinalysis is predictive for absence of urinary tract infection in men with and without catheters.

To determine accuracy of negative urinalysis (UA) for predicting negative urine culture and the absence of urinary tract infection (UTI), and optimal urine culture growth cutoff for UTI diagnosis in men with and without urinary catheters.

Antibiotic Prophylaxis for the Prevention of Urinary Tract Infections in Children: Guideline and Recommendations from the Emilia-Romagna Pediatric Urinary Tract Infections (UTI-Ped-ER) Study Group.

Background: Urinary tract infection (UTI) represents one of the most common infectious diseases and a major cause of antibiotic prescription in children. To prevent recurrent infections and long-term complications, low-dose continuous antibiotic prophylaxis (CAP) has been used.

Management of Urinary Tract Infection Symptoms in Older Women: A Survey of Practitioners

Importance: Urinary tract infection (UTI) is the most common bacterial infection for which empiric antibiotics are prescribed despite limited progression to urosepsis. More than half of antibiotics prescribed to older adults for a suspected UTI are considered unnecessary.

Objective: The aim of the study was to assess knowledge, attitudes, and practices regarding management of older women (>65 years) with symptoms attributed to UTIs among family and internal medicine providers.

Study design: This cross-sectional study surveyed 330 primary care providers in November 2021 regarding management of UTI symptoms. The primary outcome was the proportion of primary care providers who felt safe waiting for urine culture results before prescribing antibiotics in older women.

Results: The response rate was 43.0% (n = 142) with the majority of primary care providers practicing medicine more than 15 years (56.3%). For the primary outcome, 26.1% (n = 37) of primary care providers felt safe waiting for a urine culture result before prescribing antibiotics, while 62.0% (n = 88) felt delaying antibiotics depended on multiple factors, and 9.2% (n = 13) felt it was never safe to delay antibiotics. Primary care providers that either never felt it was safe to delay antibiotics or felt that "it depends" on a variety of factors, attributed their antibiotics administration to concern for progression to sepsis (n = 50, 49.5%) or progression of symptoms (n = 28, 27.7%). A higher proportion of primary care providers practicing more than 15 years felt safe delaying antibiotics compared with primary care providers with less experience (33.8% vs 18.3%, P = 0.04), and 70.3% of those who felt safe delaying antibiotics had more than 15 years of experience.

Conclusion: Primary care providers with more clinical experience have more comfort delaying antibiotics in older women with UTI symptoms.

Ashley Murillo, Selma Su, Halina Zyczynski, Megan Bradley

From the Division of Urogynecology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA.

Source: Murillo A, Su S, Zyczynski H, et al. Management of Urinary Tract Infection Symptoms in Older Women: A Survey of Practitioners. Urogynecology (Phila). 2024 Apr 1;30(4):452-456. doi: 10.1097/SPV.0000000000001416.

The REPAIR study: oral antibiotics to prevent infection and wound dehiscence after obstetric perineal tear-a double-blinded placebo controlled randomized trial.

Approximately 85% of women experience an obstetric tear at delivery and up to 25% subsequently experience wound dehiscence and/or infection. Previous publications suggest that intravenous antibiotics administrated during delivery reduces this risk.

Resident-, prescriber-, and facility-level factors associated with antibiotic use in long-term care facilities: a systematic review of quantitative studies.

Antimicrobial stewardship programmes are needed in long-term care facilities (LTCFs) to tackle antimicrobial resistance. We aimed to identify factors associated with antibiotic use in LTCFs. Such information would be useful to guide antimicrobial stewardship programmes.

The rationale for bladder washouts in children with neurogenic bladder.

Children with a neurogenic bladder are at risk of developing recurrent urinary tract infections and long-term kidney failure. Due to an altered lower urinary tract, children may be overtreated for simple bacteriuria or undertreated for a potentially severe urinary tract infection.

Robotic simple cystectomy as a last resort for antibiotic-recalcitrant recurrent urinary tract infections in women.

To report a series of women with antibiotic-recalcitrant recurrent urinary tract infections (rUTI) managed with robotic simple cystectomy and ileal conduit urinary diversion.

Following Institutional Review Board approval, all female patients who underwent robotic cystectomy for rUTI between 2011-2021 were identified from a prospectively-maintained internal database at a tertiary care center.

Recurrent Urinary Tract Infection Genetic Risk: A Systematic Review and Gene Network Analysis - Beyond the Abstract

Recurrent urinary tract infections (UTIs) encompass a multifaceted interaction of genetic elements, microbiome composition, and environmental factors (Figure 1). Previous studies showed specific genetic variations linked to the susceptibility of recurrent UTIs, including alterations in the HLA-B gene region.¹ Our current study, entitled “Recurrent urinary tract infection genetic risk: a systematic review and gene network analysis,” aimed to investigate genetic factors related to recurrent UTIs and compile the findings of previous research efforts that have reported on gene expression differences between patients with recurrent UTIs and healthy individuals.²

Recurrent urinary tract infection genetic risk: a systematic review and gene network analysis.

The development of recurrent urinary tract infections (rUTIs) is not completely understood. This review is aimed at investigating the connection between genetics and rUTIs and summarizing the results of studies that have documented variations in gene expression among individuals with rUTIs compared with healthy individuals.

Systematic Review: Bacterial Colonisation of Conduits and Neobladders - When to Test, Watch, and Treat - Beyond the Abstract

Bacterial colonization of diverted urinary tracts remains an understudied area of research. Outdated guideline recommendations prompted the publication of our review, where we have summarised the most up-to-date evidence in patients with urinary diversions. Of note, we highlight the need for streamlined definitions of bacteriuria, the benefits of monitoring bacteriuria over time, as well as the role of short-term antimicrobial therapy as part of management. However, an important area that must be further clarified is the relationship between asymptomatic bacteriuria, and subsequent urinary tract infection (UTI), in patients with urinary diversions.

Characterization and Trend of Co-Infection with Neisseria gonorrhoeae and Chlamydia trachomatis from the Korean National Infectious Diseases Surveillance Database.

We analyzed the database from the Korean National Infectious Diseases Surveillance to reveal clinical characteristics of co-infection with Neisseria gonorrhoeae (NG) and Neisseria gonorrhoeae (CT).

Novel 3D organotypic urothelial cell culture model for identification of new therapeutic approaches in urological infections.

3D organotypic cell cultures offer the possibility to study cell growth in a more in vivo like situation. To our knowledge no 3D culture of primary urothelial cells has been established yet. BK Polyomavirus (BKPyV), replicating in urothelial cells, may cause haemorrhagic cystitis in immunocompromised patients.

Successful Endoscopic Management of a Renal Fungal Ball using Flexible Ureterorenoscopy.

Candida as a cause for urinary tract infection in healthy individuals is unusual. The extension of fungi into the urinary collecting system rarely leads to formation of bezoars or fungus balls. This can in turn lead to hydronephrosis, obstructive uropathy and sepsis.

Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by the Infectious Diseases Society of America.

Asymptomatic bacteriuria (ASB) is a common finding in many populations, including healthy women and persons with underlying urologic abnormalities. The 2005 guideline from the Infectious Diseases Society of America recommended that ASB should be screened for and treated only in pregnant women or in an individual prior to undergoing invasive urologic procedures.

Candida urinary tract infections in adults.

Candiduria is commonly seen in hospitalized patients and most of the patients are asymptomatic, but it may be due to cystitis, pyelonephritis, prostatitis, epididymo-orchitis or disseminated candidiasis.

Severe infectious complications of intravesical bacillus Calmette-Guérin: a case series of 10 patients.

To investigate severe infectious complications after intravesical treatment with bacillus Calmette-Guérin (BCG). We examine a retrospective case series of ten patients between 2006 and 2018 with severe cystitis or systemic infection after BCG.

Prostate abscess caused by Nocardia farcina.

Nocardia farcinica usually infects the respiratory tract and can sometimes cause central nervous system infections; however, it rarely infects the prostate. Here we report the first case of N. farcinica detected in the purulence specimen drained from a prostate abscess.

Current status of countermeasures for infectious diseases and resistant microbes in the field of urology.

A worldwide increase in antimicrobial-resistant microbes due to the improper use of antimicrobial agents, along with a lack of progress in developing new antimicrobials, is becoming a societal problem.

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