UTI can affect lower and sometimes both lower and upper urinary tracts. The term cystitis has been used to define the lower UTI infection and is
|
|
- Phillip Owen
- 5 years ago
- Views:
Transcription
1 1. INTRODUCTION Infectious disease is a clinically evident condition that results from a pathogenic agent which includes bacteria, fungi, virus, protozoa, multi-cellular parasites and aberrant proteins known as prions. Infectious pathologies (pathogens) are usually contagious diseases (also known as communicable diseases) due to their potential transmission from one species to another (Dorlands, 2007). The transmission of an infectious disease may occur through one or more diverse pathways that include physical contacts with infected person, through liquid, food, body fluids, contaminated objects, airborne inhalation or through vector (McGraw, 2005). Infectious diseases are the second largest cause of mortality in the world accounting for more than 13 million deaths annually (Cohen, 2000). In addition to causing deaths these diseases also disable millions of adults, diminishing their quality of life, decreasing productivity, and creating financial hardships for families (Breman, et al., 2004; UNAIDS and WHO, 2007). Many diseases are curable, others are manageable with treatment, and many are preventable with vaccines and other tools. However, getting these interventions to the people in order to prevent or control the disease has been challenging. Urinary tract infection (UTI) is one among them. UTI is the most common bacterial infectious disease in the community practice with a high rate of morbidity and financial cost. It has been estimated that 150 million people were infected with UTI per annum worldwide which cost global economy more than 6 billion US dollars (Stamm, 1993). Bacterial infections causing UTI can be symptomatic or asymptomatic. The symptomatic urinary tract infection can be uncomplicated or complicated. Uncomplicated symptomatic uinary tract infection is characterized by frequency, urgency, dysuria, or supra pubic pain in a woman with a normal genitourinary tract (Sampson, et al., 1999; Hooton, et al., 1997). Complicated symptomatic urinary infection in women is with functional or structural abnormalities of the genitourinary tract which involve either the bladder (cystitis) or kidneys (pyelonepritis) (Nicolle, 2001). The asymptomatic urinary tract infection is defined as a persistent, actively multiplying bacteria within the urinary tract without any symptoms of infection (Uncu, et al., 2002). 1
2 UTI can affect lower and sometimes both lower and upper urinary tracts. The term cystitis has been used to define the lower UTI infection and is characterized by symptoms such as dysuria, frequency, urgency, and suprapubic tenderness. The presence of the lower UTI symptoms does not exclude the upper UTI, which is often present in most of the complicated UTI cases (Sobel, et al., 2010). The treatment of UTI can be classified into uncomplicated and complicated on the basis of their choice of treatment (Sabra, et al., 2012). UTI is more common in females than in males, since the female urethra is structurally less effective for preventing the bacterial entry (Warren, et al., 1999). It may be due to the proximity of the genital tract and urethra (Schaeffer, et al., 2001) and adherence of urothelial mucosa to the mucopolysaccharide lining (Akortha, 2008). The other main factors which make females more prone to UTI are pregnancy and sexual activity (Arul, et al., 2012). In pregnancy, the physiological increase in plasma volume and decrease in urine concentration develop glycosuria in upto 70% women which ultimately leads to bacterial growth in urine (Lucas, et al., 1993). Also in the non pregnant state the uterus is situated over the bladder whereas, in the pregnant state the enlarged uterus affects the urinary tract (Warren, et al., 1982). Sexual activity in females also increases the risk of urethra contamination as the bacteria could be pushed into the urethra during sexual intercourse as well as bacteria being massaged up the urethra into the bladder during child birth (Ebie, et al., 2001: Kolawole, et al., 2009). The use of contraception, such as diaphragms also causes UTI as it pushes against the urethra and makes the urethra unable to empty the bladder completely and the small concentration of urine left in the bladder leads to the growth of bacteria which ultimately causes UTI (Okonko, et al., 2009). The prevalence is also markedly increased if women present certain pre-existing medical conditions, such as diabetes mellitus, sickle cell disease, immuno-deficiency states, urinary tract anatomic anomalies, spinal cord injuries and psychiatric illnesses (Ovalle, et al., 1989). During gestation, untreated UTIs can lead to several pregnancy complications, such as the low birth weight infants, premature delivery, and occasionally, stillbirth (Hill, et al., 2005). Prompt and efficacious treatment of symptomatic UTIs is warranted in pregnant women. Nevertheless, there is still some controversy regarding the screening and treatment of asymptomatic forms during gestation of 2
3 pregnancy (Lin and Brown, 2010; Lumbiganon, et al., 2010; Schmiemann, et al., 2010). The presence of ASB in pregnancy places patients at an increased risk for the development of cystitis and pyelonephritis with their respective morbidities. A critical meta-analysis by Romero and colleagues (1989) showed the relationship between ASB alone and preterm delivery and low birth weight infants. The risk of preterm delivery in women who had ASB during gestation was two fold greater than those who were never affected (Pfau, et al., 1992). Without treatment, ASB progresses to pyelonephritis in 20% to 40% of pregnant women. In contrast, progression to pyelonephritis in nonpregnant women is only 1% to 2%. Furthermore, the incidence of pyelonephritis in pregnant women without ASB complicating early pregnancy is less than 1%. With appropriate treatment in pregnancy, progression to pyelonephritis can be decreased to 3% (Wing, 1998). Bacteremia occurs in 15 to 20% of cases of pyelonephritis, the most common pathogen is E. coli. Endotoxin of Gram negative bacteria damages the capillary endothelium, diminished vascular resistance, and changes in cardiovascular output. When the active component of endotoxin lipid-a is released into the maternal circulation, it precipitates as a cascade response of proinflammatory cytokines, histamine, and bradykinins that may lead to the more serious complications of septic shock, disseminated intravascular coagulation, respiratory insufficiency, and adult respiratory distress syndrome (ARDS). Pyelonephritis is the most common cause of septic shock in pregnancy (Mabie, et al., 1997). The causative organisms that are isolated in asymptomatic Bacteriuria (ASB), cystitis, and pyelonephritis are similar in pregnant as well as in nonpregnant women. Most of the members of family Enterobacteriaceae encompass most of the colonizing organisms. Escherichia coli are the primary pathogen found in 80 to 90% of initial UTIs and 70 to 80% of recurrent infections. Other gram-negative pathogens include Klebsiella pneumoniae, Proteus mirabilis, Proteus vulgaris, Citrobacter sps, Enterobacter aerogenes, Pseudomonas aeruginosa and of the gram-positive organisms, Streptococcus agalacticae and Staphylococcus saphrophyticus (Ovalle, et al., 2001; Gilstrap, et al., 2001; Foxman, et al., 2003; Hooton, et al., 2003). Antibiotic resistance is now a linked global problem. Dispersion of the successful clones of multidrug resistant (MDR) bacteria is found to be common, the 3
4 importance of plasmids carrying multiple drug resistance (MDR) markers in Shigella sps and Escherichia coli was first described in the seminal work by Watanabe in Japan over 50 years ago (Watanabe, 1963). These plasmids are capable of self transfer (conjugation) between strains and species and have a mosaic structure that has arisen by recombination and transposition, which is responsible for the capture of different resistance genes, giving rise to the MDR phenotype (Leplae, 2006). Usually antibiotics are given empirically before the laboratory results of urine culture are available to ensure appropriate therapy. However, resistance to the commonly prescribed antibiotics is an expanding global health problem and various studies clearly demonstrate the increasing antibiotic resistance in uropathogens causing both community and nosocomially acquired UTIs (Tenvor and Hughes, 1996; Rahal, et al., 1997; Finch, 1998). Antimicrobial resistance among the Enterobacteriaceae, a group of highly pathogenic Gram negative organisms has increased dramatically in recent years against commonly used antimicrobials such as the tetracyclines, β-lactams, fluoroquinolones, aminoglycosides and co trimoxazole (Fritsch, et al., 2005). Therefore, it is recommended for physicians to obtain information about the local antibiotic resistant rate as stated by the Infectious Disease Society of America (Warren, et al., 1999). In addition, surveillance at the institutional and regional level is required to monitor the changes in susceptibility of uropathogens. Current knowledge of the organisms that cause urinary tract infection is mandatory (Gruneberg, 1982) and the detection of antibiotic resistance and ESβL producer may facilitate the implementation of effective therapy and control measures. Infections due to ESβL producers range from uncomplicated UTI to life threatening sepsis. It is well recognised that there can be marked variation in the incidence and or genotype of the ESβL s in hospitals close to one another, and certainly among countries (Bonnet, 2004). The ESβL enzymes are commonly found in the members of Enterobacteriaceae family and are of over 120 types. Extended-spectrum β-lactamases (ESβLs) are generally acquired by horizontal gene transfer and confer resistance to oxyiminocephalosporins, some being mutant derivatives of established plasmid-mediated β- lactamases (e.g. TEM/SHV) or mobilized from environmental bacteria (e.g. CTX- M) and these enzymes hydrolyze penicillins, broad-spectrum cephalosporins. and 4
5 monobactams. However, they do not affect cephamycins and carbapenems, and they are inhibited by clavulanic acid (Paterson et al., 2005). Currently, the emergence and rapid dissemination of CTX-M positive ESβL producing bacteria have caused a change in ESβL epidemiology (Paterson, et al., 2005; Livermore, et al., 2005; Pitout, et al., 2008). As these ESβL producing strains often exhibit a multidrug-resistance phenotype, the increase in community-acquired urinary tract infections (UTIs) caused by CTX-M ESβL producers poses significant challenges for the empiric treatment of these infections in the outpatient setting. Furthermore, the recent identification of ESβL producing isolates that have acquired carbapenemases has further limited the therapeutic options available for treatment of these multidrug resistant microorganisms (Nordmann, et al., 2011). The recognition of the importance of ESβL s as a major mechanism of β-lactam resistance throughout the region came with presentation of data from the SENTRY antimicrobial surveillance programme (Bell, et al., 2002). The incidence of ESβL production (no genotyping was undertaken) among E. coli isolates in the four Chinese sites varied from 13% to 35%. Rates >20% for the ESβL phenotype in Klebsiella pneumoniae in all participating mainland Chinese centres (one reaching 60%), in one each of three Japanese and Taiwanese centres, and in the single Singapore centre and Philippines centre, were confirmed. Such high rates had previously been reported only from South America, in a follow-up study ( ) lower rates were found in K. pneumoniae isolates from Australia and Japan (<10%), but that in China was 30% (Hirakata, 2005). The other area of Asia that is the Indian subcontinent high rates of ESβL production has been reported. One study reported a 68% prevalence of ESβL phenotypes among E. coli and K. pneumoniae isolates, one of the highest rates reported for any country worldwide (Mathai, et al., 2002). A number of other studies in India reported the incidence of ESβL producers to be 6.6 to 68%. In south India, Subha, et al., (2002) reported 6.6% ESβL producers whereas Babypadmini, et al., (2004) reported 40.3%. The ESβL production which was reported among gram negative bacteria by Mathur, et al., (2002) was 68% and Singhal, et al., (2005) detected ESβL in 64% isolates and Rodrigues, et al., (2004) reported 53% ESβL production. Other studies in India have also reported a very high prevalence of ESβL producing Enterobacteriaceae. Accordingly in North India 46% of uropathogens belonging to Enterobacteriaceae were found to be 5
6 ESβL producers (Akram, et al., 2007). Some reports have also described the molecular epidemiology of the ESβL producers (Ensor, et al., 2006; Lal, et al., 2007; Walsh, et al., 2007). One of the reasons contributing to the high prevalence of ESβL producers in India may be the crowded hospital conditions, including implementation of optimal hygienic practises, likely fuelled by unrestricted use of antimicrobials without doctor s prescription (Ray, et al., 2003). A recent study reported that the ESβL producing Enterobacteriaceae family were responsible for the onset of community infections in India (Gupta and Datta, 2007). CTX-M -15 is known to be having a peculiar association with the community onset of E. coli infections (Nicholas Chanoine, et al., 2008). It may therefore be speculated that, CTX-M-15 producing E. coli has already established in Indian community. The emergence of metallo-β-lactamases (MβLs) with activity against carbapenems (e.g. the VIM and IMP families of enzymes) has compromised the clinical utility of this class of antibiotics (Hawkey, et al., 2007; Walsh, 2008). Resistance to carbapenems may also be induced as a result of increased production of either AmpC or ESβL, coupled with a decrease in porin production or increased efflux (Walsh, 2008; Mena, et al., 2006). In India, the high rates of ESβL producers have recently increased the usage of carbapenem antibiotics, which may provide a selective pressure for the spread of strains producing carbapenemases in the near future. Though the presence of β-lactamases in Enterobacteriaceae have been reported in India, information on the molecular types of ESβL and MβL producers in uropathogens and that too in pregnant women from Karnataka is limited. Population of India standing at 1.2 billion, it surely represents the largest reservoirs of CTX-M ESβL genes in the world. ESβL producing Enterobacteriaceae in India are mostly detected by phenotypic methods. The present study was undertaken to identify the etiology of the uropathogens, prevalence of UTI and their antibiotic resistance profiles, incidence of β-lactamases produing uropathogens and ESβL genes from the isolates of urine samples collected from the pregnant women with suspected UTI from different parts of Karnataka. 6
URINARY TRACT INFECTIONS 3 rd Y Med Students. Prof. Dr. Asem Shehabi Faculty of Medicine, University of Jordan
URINARY TRACT INFECTIONS 3 rd Y Med Students Prof. Dr. Asem Shehabi Faculty of Medicine, University of Jordan Urinary Tract Infections-1 Normal urine is sterile.. It contains fluids, salts, and waste products,
More informationUTI IN ELDERLY. Zeinab Naderpour
UTI IN ELDERLY Zeinab Naderpour Urinary tract infection (UTI) is the most frequent bacterial infection in elderly populations. While urinary infection in the elderly person is usually asymptomatic, symptomatic
More informationMICHIGAN MEDICINE GUIDELINES FOR TREATMENT OF URINARY TRACT INFECTIONS IN ADULTS
When to Order a Urine Culture: Asymptomatic bacteriuria is often treated unnecessarily, and accounts for a substantial burden of unnecessary antimicrobial use. National guidelines recommend against testing
More informationURINARY TRACT INFECTIONS
URINARY TRACT INFECTIONS Learning Objectives Identify signs and symptoms that may indicate presence of UTI (both complicated and uncomplicated) List common causative organisms and risk factors for UTIs
More informationURINARY TRACT INFECTIONS 3 rd Y Med Students. Prof. Dr. Asem Shehabi Faculty of Medicine, University of Jordan
URINARY TRACT INFECTIONS 3 rd Y Med Students Prof. Dr. Asem Shehabi Faculty of Medicine, University of Jordan Urinary Tract Infections-1 Normal urine is sterile in urinary bladder.. It contains fluids,
More informationUrinary Tract Infections: From Simple to Complex. Adriane N Irwin, MS, PharmD, BCACP Clinical Assistant Professor Ambulatory Care October 25, 2014
Urinary Tract Infections: From Simple to Complex Adriane N Irwin, MS, PharmD, BCACP Clinical Assistant Professor Ambulatory Care October 25, 2014 Learning Objectives Develop empiric antimicrobial treatment
More informationORIGINAL ARTICLE SUSCEPTIBILITY PATTERNS IN GRAM NEGATIVE URINARY ISOLATES TO CIPROFLOXACIN, CO-TRIMOXAZOLE AND NITROFURANTOIN
SUSCEPTIBILITY PATTERNS IN GRAM NEGATIVE URINARY ISOLATES TO CIPROFLOXACIN, CO-TRIMOXAZOLE AND NITROFURANTOIN Anoop Sinha 1, Benny P V 2 HOW TO CITE THIS ARTICLE: Anoop Sinha, Benny PV. Susceptibility
More informationPrevalence of Extended Spectrum -Lactamases In E.coli and Klebsiella spp. in a Tertiary Care Hospital
ISSN: 2319-7706 Volume 3 Number 10 (2014) pp. 474-478 http://www.ijcmas.com Original Research Article Prevalence of Extended Spectrum -Lactamases In E.coli and Klebsiella spp. in a Tertiary Care Hospital
More informationWhen should UTIs be treated in the Elderly? Shelby L. Wentworth, MS4 University of Florida College of Medicine 29 AUG 2018
When should UTIs be treated in the Elderly? Shelby L. Wentworth, MS4 University of Florida College of Medicine 29 AUG 2018 UTIs in Patients >/ 65 yo - Most common infectious illness [1]. - Urinary tract
More informationUrinary tract infection. Mohamed Ahmed Fouad Lecturer of pediatrics Jazan faculty of medicine
Urinary tract infection Mohamed Ahmed Fouad Lecturer of pediatrics Jazan faculty of medicine Objectives To differentiate between types of urinary tract infections To recognize the epidemiology of UTI in
More informationLecture 1: Genito-urinary system. ISK
Urinary Tract Infections Lecture 1: Genito-urinary system. ISK 07 08 2009. Getting Clear on the Terminology UTI Cystitis Urosepsis Asymptomatic Bacteriuria Asymptomatic UTI Pyuria Symptomatic UTI Pylonephritis
More informationAnatomy kidney ureters bladder urethra upper lower
Urinary tract Anatomy The urinary tract consists of the kidney, ureters, bladder, and urethra. Urinary tract infections can be either: upper or lower based primarily on the anatomic location of the infection.
More informationOutpatient treatment in women with acute pyelonephritis after visiting emergency department
LETTER TO THE EDITOR Korean J Intern Med 2017;32:369-373 Outpatient treatment in women with acute pyelonephritis after visiting emergency department Hee Kyoung Choi 1,*, Jin-Won Chung 2, Won Sup Oh 3,
More informationAsyntomatic bacteriuria, Urinary Tract Infection
Asyntomatic bacteriuria, Urinary Tract Infection C. Infectious Diseases Society of America Guidelines for the Diagnosis and Treatment of Asyntomatic Bacteriuria in Adults (2005) Pyuria accompanying asymptomatic
More information-Almost one third of cases admitted to medical centers are related to urinary tract infection
Urinary tract infections: -Almost one third of cases admitted to medical centers are related to urinary tract infection -Urinary tract infection and respiratory infection together encompass about fifty
More information11/15/2010. Asymptomatic Bacteriuria UTI. Symptomatic UTI. Asymptomatic UTI. Cystitis. Pylonephritis. Pyuria. Urosepsis
Urinary Tract Infections Renal vein Inferior vena cava Urinary bladder Urethra Renal artery Kidney Aorta Ureter Lecture 1: Genito-urinary system. 06 08 2010. (a) Sherwood Fig. 12-6a, p.530 An introduction
More informationDiagnostic approach and microorganism resistance pattern in UTI Yeva Rosana, Anis Karuniawati, Yulia Rosa, Budiman Bela
Diagnostic approach and microorganism resistance pattern in UTI Yeva Rosana, Anis Karuniawati, Yulia Rosa, Budiman Bela Microbiology Department Medical Faculty, University of Indonesia Urinary Tract Infection
More informationEMPIRICAL TREATMENT OF SELECT INFECTIONS ADULT GUIDELINES. Refer to VIHA Algorithm for the empiric treatment of Urinary Tract Infection
URINARY TRACT Refer to VIHA Algorithm for the empiric treatment of Urinary Tract Infection and Asymptomatic Bacteriuria on the VIHA Intranet: https://intranet.viha.ca/departments/pharmacy/clinical_pharmacy/pages/infec
More information1/21/2016. Overview. Significance
Asymptomatic Bacteriuria: Myths, Magic and Management Christopher Ohl MD Professor of Medicine, Section on Infectious Diseases Wake Forest School of Medicine, Winston Salem, NC Slide credits to Katie Wallace,
More informationTreatment Regimens for Bacterial Urinary Tract Infections. Characteristic Pathogen. E. coli, S.saprophyticus P.mirabilis, K.
HEALTHSPAN URINARY TRACT INFECTIONS (ADULT FEMALE) Methodology: Evidence-Based Issue Date: 1-98 Champion: Internal Medicine Most Recent Review: 4-10, 4-12, 4-14 Key Stakeholders: IM, Urology, Next Review:
More informationALERT. Clinical microbiology considerations related to the emergence of. New Delhi metallo beta lactamases (NDM 1) and Klebsiella
ALERT Clinical microbiology considerations related to the emergence of New Delhi metallo beta lactamases (NDM 1) and Klebsiella pneumoniae carbapenemases (KPC) amongst hospitalized patients in South Africa
More informationASPIRES Urinary Tract Infection Algorithm
ASPIRES Urinary Tract Infection Algorithm Dr. Jennifer Grant Dr. Tim Lau Donna Leung February 2013 VCH Antimicrobial Stewardship 1 Programme: Innovation, Research, Education & Safety KEY PRINCIPLES 1.
More informationURINARY TRACT INFECTIONS IN LONG TERM CARE. Tuesday, 8 November, 11
URINARY TRACT INFECTIONS IN LONG TERM CARE OBJECTIVES UNDERSTAND THE SCALE OF DISEASE IN LTC SETTINGS DEVELOP AN UNDERSTANDING OF THE DIFFERENT PRESENTATIONS OF UTIs IN THIS SETTING AND WORKUP BECOME AWARE
More information320 MBIO Microbial Diagnosis. Aljawharah F. Alabbad Noorah A. Alkubaisi 2017
320 MBIO Microbial Diagnosis Aljawharah F. Alabbad Noorah A. Alkubaisi 2017 Pathogens of the Urinary tract The urinary system is composed of organs that regulate the chemical composition and volume of
More informationKAISER PERMANENTE OHIO URINARY TRACT INFECTIONS (ADULT FEMALE)
KAISER PERMANENTE OHIO URINARY TRACT INFECTIONS (ADULT FEMALE) Methodology: Evidence-Based Issue Date: 1-98 Champion: Internal Medicine Most Recent Review: 4-10, 4-12 Key Stakeholders: IM, Urology, Next
More informationCarbapenemases in Enterobacteriaceae: Prof P. Nordmann Bicêtre hospital, South-Paris Med School
Carbapenemases in Enterobacteriaceae: 2012 Prof P. Nordmann Bicêtre hospital, South-Paris Med School March 21, 2012 Trends in Molecular Medecine NDM IMP OXA-48 KPC VIM ALERT VI M KPC KPC NDM I MP OXA-
More informationUTI are the most common genitourinary disease of childhood. The prevalence of UTI at all ages is girls and 1% of boys.
UTI are the most common genitourinary disease of childhood. The prevalence of UTI at all ages is girls and 1% of boys. 1-3% of Below 1 yr. male: female ratio is 4:1 especially among uncircumcised males,
More informationRECURRENT URINARY TRACT INFECTIONS: WHAT AN INTERNIST
RECURRENT URINARY TRACT INFECTIONS: WHAT AN INTERNIST MUST KNOW PROF. MD. ENAMUL KARIM Professor of Medicine Green Life Medical College INTRODUCTION Urinary tract infection (UTI) is one of the commonest
More informationTMP/SMZ DS Ciprofloxacin Norfloxacin Ofloxacin Cefadroxil * 30 Amoxicilin 86* 19 25
Evidence-Based Evaluation and Treatment of UTI UTI Prevalence Leslee L. Subak, MD Associate Professor Obstetrics, Gynecology & RS Epidemiology & Biostatistics University of California, San Francisco 50%
More informationPrevalence and Distribution of Bacterial Pathogens Causing Urinary Tract Infections in Humans: A Study from Tertiary Care Hospital in AP, India
ISSN: 2319-7706 Volume 4 Number 2 (2015) pp. 251-257 http://www.ijcmas.com Original Research Article Prevalence and Distribution of Bacterial Pathogens Causing Urinary Tract Infections in Humans: A Study
More informationGUIDE TO INFECTION CONTROL IN THE HOSPITAL. Carbapenem-resistant Enterobacteriaceae
GUIDE TO INFECTION CONTROL IN THE HOSPITAL CHAPTER 47: Carbapenem-resistant Enterobacteriaceae Authors E-B Kruse, MD H. Wisplinghoff, MD Chapter Editor Michelle Doll, MD, MPH) Topic Outline Key Issue Known
More informationBacterial Infections of the Urinary System *
OpenStax-CNX module: m64804 1 Bacterial Infections of the Urinary System * Douglas Risser This work is produced by OpenStax-CNX and licensed under the Creative Commons Attribution License 4.0 1 Learning
More informationUrinary Tract Infection and Pattern of Antibiotic Sensitivity in Hospitalized Patients with Diabetes Mellitus in Myanmar
Volume 2 Issue 1 2018 Page 147 to 153 Research Article Archives of Endocrinology and Diabetes Care Urinary Tract Infection and Pattern of Antibiotic Sensitivity in Hospitalized Patients with Diabetes Mellitus
More informationIndex. urologic.theclinics.com. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Acinetobacter baumannii, carbapenem-resistant, 497 498 Adolescents, urinary tract infections in, 520 521 Aminoglycosides, for UTIs and
More informationInvestigators Meeting
Outcomes of Urinary Tract Infection Management by Pharmacists (R x OUTMAP) Investigators Meeting June 11, 2017 Overview 1. Introductions and Opening Remarks 2. Epidemiology and Definitions 3. UTI Assessment
More informationDiagnosis and Management of UTI s in Care Home Settings. To Dip or Not to Dip?
Diagnosis and Management of UTI s in Care Home Settings To Dip or Not to Dip? 1 Key Summary Points: Treat the patient NOT the urine In people 65 years, asymptomatic bacteriuria is common. Treating does
More informationOCTOBER 2017 DRUG ANTIBIOTICS. Presence of bacteria in the urine with no symptoms or clinical signs.
OCTOBER 2017 DRUG ANTIBIOTICS This optimal usage guide is mainly intended for primary care health professionnals. It is provided for information purposes only and should not replace the clinician s judgement.
More information10/4/16. mcr-1. Emerging Resistance Updates. Objectives. National Center for Emerging and Zoonotic Infectious Diseases. Alex Kallen, MD, MPH, FACP
National Center for Emerging and Zoonotic Infectious Diseases Emerging Resistance Updates Alex Kallen, MD, MPH, FACP Lead Antimicrobial Resistance and Emerging Pathogens Team Prevention and Response Branch
More informationGroup B Streptococcus
Group B Streptococcus (Invasive Disease) Infants Younger than 90 Days Old DISEASE REPORTABLE WITHIN 24 HOURS OF DIAGNOSIS Per N.J.A.C. 8:57, healthcare providers and administrators shall report by mail
More informationReducing Time to Result for Urinary Tract Pathogen Detection Utilizing Real-Time PCR Technology
Reducing Time to Result for Urinary Tract Pathogen Detection Utilizing Real-Time PCR Technology David A. Baunoch, Ph.D Chief Scientific Officer Pathnostics Evolving Picture of Urinary Tract Infections
More informationThe role of an AMR reference laboratory
The role of an AMR reference laboratory Professor Neil Woodford Antimicrobial Resistance & Healthcare Associated Infections (AMRHAI) Reference Unit Crown copyright Primary purpose: regional AMR threats
More informationUrinary tract infections
بسم رلاهللا Urinary tract infections This sheet will only contain extra notes said by the dr. UTIs: - is the second most common type of infections in community(second only to RTIs) - Incidence=20-30% of
More informationFeasibility of Remote Management of Uncomplicated Urinary Tract Infection: A Quality Improvement Project
Rhode Island College Digital Commons @ RIC Master's Theses, Dissertations, Graduate Research and Major Papers Overview Master's Theses, Dissertations, Graduate Research and Major Papers 5-2017 Feasibility
More informationEvidence Based Management of Urinary Tract Infections
Evidence Based Management of Urinary Tract Infections Urinary tract infection (UTI) is the most common bacterial infection in humans. They account for more than 8.6 million physician visits (84% by women)
More informationCATHETER-ASSOCIATED URINARY TRACT INFECTIONS
CATHETER-ASSOCIATED URINARY TRACT INFECTIONS Hamid Emadi M.D Associate professor of Infectious diseases Department Tehran university of medical science The most common nosocomial infection The urinary
More informationNo Need to Agonize! Tips for the Diagnosis and Treatment of Complicated UTIs
ASCENSION TEXAS No Need to Agonize! Tips for the Diagnosis and Treatment of Complicated UTIs Austin Area Society of Health-System Pharmacists April 26, 2018 Amy Carr, PharmD PGY-2 Infectious Diseases Pharmacy
More informationEmergence of non-kpc carbapenemases: NDM and more
Emergence of non-kpc carbapenemases: NDM and more --- David Livermore Health Protection Agency, UK The first acquired carbapenemase to be recognised in gram-negative bacteria was IMP-1, a metallo-type,
More informationUrinary tract infections, renal malformations and scarring
Urinary tract infections, renal malformations and scarring Yaacov Frishberg, MD Division of Pediatric Nephrology Shaare Zedek Medical Center Jerusalem, ISRAEL UTI - definitions UTI = growth of bacteria
More informationUrinary Tract Infections
Urinary Tract Infections Michelle Eslami, M.D., FACP Professor of Medicine Division of Geriatrics David Geffen SOM at UCLA Urinary Tract Infection (UTI) One of most common infections in outpatient and
More informationTreatment of MDR urinary tract infections with oral fosfomycin: a retrospective analysis
J Antimicrob Chemother 2016; 71: 2563 2568 doi:10.1093/jac/dkw178 Advance Access publication 30 May 2016 Treatment of MDR urinary tract infections with oral fosfomycin: a retrospective analysis Justin
More informationBacteriemia and sepsis
Bacteriemia and sepsis Case 1 An 80-year-old man is brought to the emergency room by his son, who noted that his father had become lethargic and has decreased urination over the past 4 days. The patient
More informationAsymptomatic Bacteriuria In Female Students Population Of A Nigerian University
ISPUB.COM The Internet Journal of Microbiology Volume 2 Number 2 Asymptomatic Bacteriuria In Female Students Population Of A Nigerian University J Olaitan Citation J Olaitan.. The Internet Journal of Microbiology.
More informationCustomary urine test is the dip stick and the mid-stream culture of voided urine. Up to 77% of cystitis cases are cultured
9 million visits/year! Customary urine test is the dip stick and the mid-stream culture of voided urine. Up to 77% of cystitis cases are cultured Interpretation of the culture result has been controversial-
More informationManagement of UTI. Disclosures. Uncomplicated UTI UTI CLASSIFICATION. Where do UTI bugs come from? Food Sex
Management of UTI Thomas M. Hooton, M.D. University of Miami Miami, Florida Disclosures Fimbrion a biotech company with mission to develop novel approaches to treat and prevent UTI Co-founder and shareholder
More informationUrinary tract infections Dr. Hala Al Daghistani
Urinary tract infections Dr. Hala Al Daghistani UTIs are considered to be one of the most common bacterial infections. Diagnosis depends on the symptoms, urinalysis, and urine culture. UTIs occur more
More informationUrinary Tract Infection
67 Urinary Tract Infection Dr Kawa Ahmad PhD Pharmaceutics 1 Introduction The term urinary tract infection (UTI) usually refers to the presence of organisms in the urinary tract together with symptoms,
More informationCONSIDERATIONS IN UTI DETECTION AND POTENTIAL IMPACT ON ANTIBIOTIC STEWARDSHIP
CONSIDERATIONS IN UTI DETECTION AND POTENTIAL IMPACT ON ANTIBIOTIC STEWARDSHIP ERIN H. GRAF, PHD, D(ABMM) Director, Infectious Disease Diagnostics Laboratory Assistant Professor, Clinical Pathology and
More informationFoundations in Microbiology
Foundations in Microbiology Fifth Edition Talaro Chapter 13 Microbe Human Interactions: Infection and Disease Chapter 13 2 3 Infection a condition in which pathogenic microbes penetrate host defenses,
More informationOriginal Article - Infection/Inflammation. Sungmin Song, Chulsung Kim, Donghoon Lim.
www.kjurology.org http://dx.doi.org/10.4111/kju.2014..4.20 Original Article - Infection/Inflammation http://crossmark.crossref.org/dialog/?doi=10.4111/kju.2014..4.20&domain=pdf&date_stamp=2014-04-1 Clinical
More informationEnterobacteriaceae with acquired carbapenemases, 2015
Enterobacteriaceae with acquired carbapenemases, 2015 Background The acquired or transferable (as opposed to chromosomally encoded) carbapenemases found in Enterobacteriaceae belong to three of the four
More informationDetermining the Optimal Carbapenem MIC that Distinguishes Carbapenemase-Producing
AAC Accepted Manuscript Posted Online 8 August 2016 Antimicrob. Agents Chemother. doi:10.1128/aac.00838-16 Copyright 2016, American Society for Microbiology. All Rights Reserved. 1 1 2 Determining the
More informationInfection Control Strategies to Avoid Carbapenam Resistance in Hospitals. Victor Lim International Medical University Malaysia
Infection Control Strategies to Avoid Carbapenam Resistance in Hospitals Victor Lim International Medical University Malaysia Outline of Lecture 1. Carbapenam resistance 2. Epidemiology of carbapenam resistance
More informationPreventing & Controlling the Spread of Infection
Preventing & Controlling the Spread of Infection Contributors: Alice Pong M.D., Hospital Epidemiologist Chris Abe, R.N., Senior Director Ancillary and Support Services Objectives Review the magnitude of
More informationOvercoming the PosESBLities of Enterobacteriaceae Resistance
Overcoming the PosESBLities of Enterobacteriaceae Resistance Review of current treatment options Jamie Reed, PharmD Pharmacy Grand Rounds August 28, 2018 Rochester, MN 2018 MFMER slide-1 Disclosure No
More informationNEONATAL SEPSIS. Dalima Ari Wahono Astrawinata Departemen Patologi Klinik, FKUI-RSCM
NEONATAL SEPSIS Dalima Ari Wahono Astrawinata Departemen Patologi Klinik, FKUI- Background Neonatal sepsis : Early-onset Late-onset Early-onset : mostly premature neonates Within 24 hours 85% 24-48 hours
More informationGlobal Epidemiology of Carbapenem- Resistant Enterobacteriaceae (CRE)
Global Epidemiology of Carbapenem- Resistant Enterobacteriaceae (CRE) Mitchell J. Schwaber, MD MSc Director, National Center for Infection Control Ministry of Health State of Israel November 27, 2012 1
More informationPublic Health Surveillance for Multi Drug Resistant Organisms in Orange County
Public Health Surveillance for Multi Drug Resistant Organisms in Orange County Matt Zahn, MD Medical Director Epidemiology and Assessment Orange County Public Health Antimicrobial Mechanisms of Action
More informationDiscussion points CLSI M100 S19 Update. #1 format of tables has changed. #2 non susceptible category
Discussion points 2009 CLSI M100 S19 Update Nebraska Public Health Laboratory Changes most important to routine antimicrobial susceptibility testing. Documents available Janet Hindler discussion slide
More informationTrends in Antimicrobial Resistance among Urinary Tract Infection Isolates of Escherichia coli from Female Outpatients in the United States
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Aug. 2002, p. 2540 2545 Vol. 46, No. 8 0066-4804/02/$04.00 0 DOI: 10.1128/AAC.46.8.2540 2545.2002 Copyright 2002, American Society for Microbiology. All Rights Reserved.
More informationDifferentiation of Carbapenemase producing Enterobacteriaceae by Triple disc Test
Original article: Differentiation of Carbapenemase producing Enterobacteriaceae by Triple disc Test Manish Bansal 1, Nitya Vyas 2, Babita Sharma 3, R.K.Maheshwari 4 1PG Resident, 2 Professor, 3 Assistant
More informationANTIBIOTIC USE DURING ENDOUROLOGIC SURGERY
ANTIBIOTIC USE DURING ENDOUROLOGIC SURGERY Comprehensive Kidney Stone Center at Duke University Medical Center Durham, North Carolina Glenn M. Preminger LEADING EDGE UROLOGY 49th Annual Duke Urologic Assembly
More informationSHABNAM TEHRANI M.D., MPH ASSISTANT PROFESSOR OF INFECTIOUS DISEASESE &TROPICAL MEDICINE RESEARCH CENTER, SHAHID BEHESHTI UNIVERSITY OF MEDICAL
URINARY TRACT INFECTION SHABNAM TEHRANI M.D., MPH ASSISTANT PROFESSOR OF INFECTIOUS DISEASESE &TROPICAL MEDICINE RESEARCH CENTER, SHAHID BEHESHTI UNIVERSITY OF MEDICAL SCIENCES Definition inflammatory
More informationMHSAL Guidelines for the Prevention and Control of Antimicrobial Resistant Organisms (AROs) - Response to Questions
MHSAL Guidelines for the Prevention and Control of Antimicrobial Resistant Organisms (AROs) - Response to Questions Dr. Andrew Walkty Medical Microbiologist, Diagnostic Services Manitoba (DSM) June. 17,
More informationTreatment of febrile neutropenia in patients with neoplasia
Treatment of febrile neutropenia in patients with neoplasia George Samonis MD, PhD Medical Oncologist Infectious Diseases Specialist Professor of Medicine The University of Crete, Heraklion,, Crete, Greece
More informationIn-House Standardization of Carba NP Test for Carbapenemase Detection in Gram Negative Bacteria
International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 7 Number 01 (2018) Journal homepage: http://www.ijcmas.com Original Research Article https://doi.org/10.20546/ijcmas.2018.701.342
More informationUTI : Requiem for a Heavyweight. Tom Finucane Maryland ACP February 3, 2018
UTI : Requiem for a Heavyweight Tom Finucane Maryland ACP February 3, 2018 No relevant disclosures Objectives 1. Report an involuntary shudder and feeling of unease each time the phrase UTI is uttered.
More informationDisclosure. Objectives. Evolution of β Lactamases. Extended Spectrum β Lactamases: The New Normal. Prevalence of ESBL Mystic Program
47 th Annual Meeting August 2-4, 2013 Orlando, FL Extended Spectrum β Lactamases: The New Normal Disclosure I do have a vested interest in or affiliation with the following companies or organizations Triax
More informationCommunicable diseases. Gastrointestinal track infection. Sarkhell Araz MSc. Public health/epidemiology
Communicable diseases Gastrointestinal track infection Sarkhell Araz MSc. Public health/epidemiology Communicable diseases : Refer to diseases that can be transmitted and make people ill. They are caused
More informationLower Urinary Tract Infection (UTI) in Males
Lower Urinary Tract Infection (UTI) in Males Clinical presentation For patients in care homes see UTI in adults where IV Antibiotics in the community may be appropriate (under development) History and
More informationRegional Emergence of VIM producing carbapenem resistant Pseudomonas aeruginosa (VIM CRPA)
National Center for Emerging and Zoonotic Infectious Diseases Regional Emergence of VIM producing carbapenem resistant Pseudomonas aeruginosa (VIM CRPA) Chris Prestel, MD Epidemic Intelligence Service
More informationUrinary tract infections at Aga Khan University hospital Nairobi - a one year experience
May 2012 Ea s t Af r i c a n Me d i c a l Jo u r n a l 147 East African Medical Journal Vol. 89 No. 5 May 2012 URINARY TRACT INFECTIONS AT AGA KHAN UNIVERSITY HOSPITAL NAIROBI - A ONE YEAR EXPERIENCE N.
More informationPaediatrica Indonesiana. Urine dipstick test for diagnosing urinary tract infection
Paediatrica Indonesiana VOLUME 53 November NUMBER 6 Original Article Urine dipstick test for diagnosing urinary tract infection Syarifah Julinawati, Oke Rina, Rosmayanti, Rafita Ramayati, Rusdidjas Abstract
More informationYaarub Ibraheem Salih Dept. of Community Medicine, College of Medicine, Tikrit University.
The microbiological causes of urinary tract infection among women attending medical institutions Yaarub Ibraheem Salih Dept. of Community Medicine, College of Medicine, Tikrit University. Abstract Urinary
More informationAdenium Biotech. Management: - Peter Nordkild, MD, CEO, ex Novo Nordisk, Ferring, Egalet - Søren Neve, PhD, project director, ex Lundbeck, Novozymes
Adenium Biotech Management: - Peter Nordkild, MD, CEO, ex Novo Nordisk, Ferring, Egalet - Søren Neve, PhD, project director, ex Lundbeck, Novozymes Board of Directors: - Stephan Christgau, PhD, chairman,
More informationImproving the prevention, diagnosis and clinical management of sepsis
SEVENTIETH WORLD HEALTH ASSEMBLY A70/13 Provisional agenda item 12.2 13 April 2017 Improving the prevention, diagnosis and clinical management of sepsis Report by the Secretariat 1. The Executive Board
More informationEnterobacteriaceae with acquired carbapenemases, 2016
Enterobacteriaceae with acquired carbapenemases, 2016 Background The acquired or transferable (as opposed to chromosomally encoded) carbapenemases found in Enterobacteriaceae belong to three of the four
More informationUrinary Tract Infections in Hospitalized Patients
Urinary Tract Infections in Hospitalized Patients Puerto Rico Chapter Annual Meeting Daniel C. DeSimone, MD March 9, 2019 2017 MFMER slide-1 Disclosures for speaker: Date of presentation: 3/9/2019 No relevant
More informationScreening of Carbapenem Resistant Enterobacteriaceae among Nosocomial Isolates: A Study from South India
International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 6 Number 4 (2017) pp. 460-465 Journal homepage: http://www.ijcmas.com Original Research Article https://doi.org/10.20546/ijcmas.2017.604.053
More informationThe Antibiotic Resistance Laboratory Network
The Antibiotic Resistance Laboratory Network 1 Antibiotic Resistance in the United States Sickens >2 million people per year Kills at least 23,000 people each year Plus 15,000 each year from C. difficile
More informationPediatric urinary tract infection. Dr. Nariman Fahmi Pediatrics/2013
Pediatric urinary tract infection Dr. Nariman Fahmi Pediatrics/2013 objectives EPIDEMIOLOGY CAUSATIVE PATHOGENS PATHOGENESIS CATEGORIES OF URINARY TRACT INFECTIONS AND CLINICAL MANIFESTATIONS IN pediatrics
More informationStudy of Ciprofloxacin Resistant Escherichia coli (CREC) in Type 2 Diabetic Patients with Symptomatic Urinary Tract Infections
Study of Ciprofloxacin Resistant Escherichia coli (CREC) in Type 2 Diabetic Patients with Symptomatic Urinary Tract Infections MSc Abstract: Background: Type 2 diabetes is the most common form of diabetes
More information(Facility Name and Address) (1D) Surveillance of Urinary Tract Infections in the Long-Term Care Setting
Policy Number: 1D Date: 4/16/14 Version: 1 (1D) Surveillance of Urinary Tract Infections in the Long-Term Care Setting Introduction: One-quarter of the older adult population in the United States will
More informationThe antibiogram types of Escherichia Coli isolated from suspected urinary tract infection samples
Journal of Microbiology and Biotechnology Research Scholars Research Library J. Microbiol. Biotech. Res., 2011, 1 (3): 57-65 (http://scholarsresearchlibrary.com/archive.html) ISSN : 2231 3168 CODEN (USA)
More informationNational Center for Emerging and Zoonotic Infectious Diseases The Biggest Antibiotic Resistance Threats
National Center for Emerging and Zoonotic Infectious Diseases The Biggest Antibiotic Resistance Threats Jean B. Patel, PhD, D(ABMM) Science Lead, Antibiotic Resistance and Coordination Unit Centers for
More informationGuidance on screening and confirmation of carbapenem resistant Enterobacteriacae (CRE) December 12, 2011
Guidance on screening and confirmation of carbapenem resistant Enterobacteriacae (CRE) December 12, 2011 Objectives: To discuss the guidelines for detection of CRE in the laboratory setting. To review
More informationStill Feelin the Burn? You Might Have a Urinary Tract Infection
Still Feelin the Burn? You Might Have a Urinary Tract Infection Jason Alegro, Pharm.D. BCPS Assistant Professor of Clinical Sciences, Roosevelt University Infectious Diseases Clinical Pharmacy Specialist,
More informationStill Feelin the Burn? You Might Have a Urinary Tract Infection
Still Feelin the Burn? You Might Have a Urinary Tract Infection Jason Alegro, Pharm.D. BCPS Assistant Professor of Clinical Sciences, Roosevelt University Infectious Diseases Clinical Pharmacy Specialist,
More informationExpert rules. for Gram-negatives
Academic Perspective in Expert rules Emerging Issues of Resistance in Gram-ve Bacteria for Gram-negatives Trevor Winstanley Sheffield Teaching Hospitals Presented on behalf of David Livermore University
More informationAntimicrobial resistance Fact sheet N 194 Updated April 2014
Antimicrobial resistance Fact sheet N 194 Updated April 2014 Key facts Antimicrobial resistance (AMR) threatens the effective prevention and treatment of an ever-increasing range of infections caused by
More informationTHE EFFECT OF DIABETES MELLITUS ON THE CLINICAL AND MICRO-BIOLOGICAL OUTCOMES IN PATIENTS WITH ACUTE PYELONEPHRITIS
American Journal of Infectious Diseases 10 (2): 71-76, 2014 ISSN: 1553-6203 2014 Science Publication doi:10.3844/ajidsp.2014.71.76 Published Online 10 (2) 2014 (http://www.thescipub.com/ajid.toc) THE EFFECT
More information