Clinical and Laboratory Characteristics of Acute Community-Acquired Urinary Tract Infections in Adult Hospitalised Patients

Abstract

Urinary tract infections (UTI) cause a great number of morbidity and mortality. These infections are serious complications in pregnancy, patients with diabetes, polycystic kidneys disease, sickle cell anaemia, kidney transplant and in patients with functional or structural anomalies of the urinary tract. The aim of this investigation was to determine a dominant causative agents of UTI and some of the clinical and laboratory characteristics of acute community-acquired UTI in adult hospitalised patients. We studied 200 adult patients with acute community-acquired UTI hospitalised in the Clinic for Infectious Diseases Tuzla from January 2006 to December 2007. The patients were divided into two groups: a group of patients with E. coli UTI (147) and a group of patients with non-E. coli UTI (53). In these two groups, the symptoms and signs of illness, blood test and urine analysis results were analysed. Our results have shown that the patients with E. coli UTI frequently had fever higher than 38,5 degrees C (p<0,0001), chills (p=0,0349), headache (p=0,0499), cloudy urine (p<0,0001), proteinuria (p=0,0011) and positive nitrite-test (p=0,0002). The patients with non-E. coli UTI frequently had fever lower than 38,5 degrees C (p<0,0001) and urine specific gravity <1015 (p=0,0012). There was no significant difference in blood test results between patients with E. coli and non-E. coli UTI. These clinical and laboratory findings can lead us to early etiological diagnosis of these UTI before urine culture detection of causative agents, which takes several days. Early etiological diagnosis of the E. coli and non-E. coli UTI is necessary for an urgent administration of appropriate empirical antibiotic treatment. This is very important in prevention of irreversible kidney damage, prolonged treatment, complications, as well as recidives and chronicity of the illness.

Can the Griess Nitrite Test and a Urinary Pus Cell Count of ≥5 Cells Per Micro Litre of Urine in Pregnant Women be Used for the Screening or the Early Detection of Urinary Tract Infections in Rural India?

“…The most common symptoms which were suggestive of UTI were burning micturition, an increased frequency of micturition of > 10/day and dysuria. These findings were consistent with those of Sharma et al, [21,22]. The symptoms are the best clinical predictors for the detection of UTI; however, these manifestations appear very late and in the mean time, the infection affects the maternal and the foetal health.…”

The correlation of crystalline and elemental composition of urinary stones with a history of bacterial infections: TXRF, XRPD and PCR-DGGE studies

“…The biophysical analyses in this study confirm that P. stuartii as an uropathogen with similar biochemical activity mainly to Proteus spp., might play an important role in urinary stone formation (O’Hara et al 2000). P. aeruginosa is a cause of urinary tract infection in 4.5–7.6% (Akkoyun et al 2008; Piljić et al 2009). In our study, Pseudomonas aeruginosa was identified only in the uric and mixed stones.…”

Urinary pathogens and drug susceptibility patterns of urinary tract infections among antenatal clinic attendees in Ibadan, Nigeria

“…In 2009, Piljic et al . reported Escherichia coli as the predominant organism, accounting for 73.5% in 200 subjects studied, 6 while a lesser percentage of the same organism was found in a Ghanaian study in 2007 7 . In Nigeria however, Staphylococcus aureus was reported to be the predominant pathogen 8…”

“…Characteristics of etiological agents of UTIs differ from one setting to the other and are also population specific 6 . Evaluation of these characteristics is the basis for empiric treatment of UTIs in pregnancy.…”

“…A UTI in pregnancy can either be symptomatic or asymptomatic. Characteristics of the etiological agents responsible for a UTI in pregnancy are specific for age, gestational age and region 6 . Evaluation of the predominant causative agent is the basis for empiric antimicrobial therapy and is necessary for timely and successful management of the disease in this high‐risk population.…”