Community-acquired enterococcal urinary tract infections

Bitsori, María; Maraki, Sofia; Raissaki, Maria; Bakantaki, Anna; Galanakis, Emmanouil

doi:10.1007/s00467-005-1976-8

Cited by 42 publications

(37 citation statements)

References 15 publications

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“…These observations have practical implications, as detailed below. The relative frequency of CA enterococcal UTIs found in our study, 6.2% of all episodes of UTI, is slightly higher than the rates reported by others, which ranged from 4.4 to 5.6% [24,26]. This difference may reflect the fact that the pediatric nephrology and pediatric urology services in our tertiary center receive referrals from a wide geographical area.…”

Section: Discussioncontrasting

confidence: 81%

“…Of the less common Gram-positive pediatric uropathogens, the main genus is Enterococcus, predominantly the species Enterococcus faecalis [10]. However, research on enterococcal UTIs in children is very limited, with most studies dealing with nosocomial infections [21][22][23][24]. Due to its unique antimicrobial susceptibility profile, Enterococcus spp.…”

Section: Introductionmentioning

confidence: 99%

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Community-acquired enterococcal urinary tract infections in hospitalized children

et al. 2011

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The objectives of this study were to characterize community-acquired (CA) enterococcal urinary tract infections (UTIs) in a tertiary pediatric center and to determine risk factors for their occurrence, their association with renal abnormalities, their antibiotic susceptibility profile, and the appropriateness of the empiric antibiotic treatment, in comparison to those of Gram-negative UTIs. In a 5-year prospective clinical and laboratory study, we found that enterococcal UTIs caused 6.2% (22/355) of culture-proven CA UTIs. Compared with Gram-negative UTI, enterococcal UTI was associated with male predominance, higher rates of underlying urinary abnormalities (70 vs. 43.7%; p = 0.03) and inappropriate empiric antibiotic therapy (22 vs. 5.6%; p = 0.02), and mainly vesicoureteral reflux (53% of cases). This study highlights the importance of early detection of CA enterococcal UTIs because of their association with underlying urinary abnormalities and a high rate of inappropriate empiric antibiotic therapy. Renal imaging is recommended for children with enterococcal UTIs; Gram stain is suggested in selected cases to detect Gram-positive cocci for early diagnosis of enterococcal UTIs and initiation of appropriate antibiotics.

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Section: Discussioncontrasting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Community-acquired enterococcal urinary tract infections in hospitalized children

et al. 2011

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“…Ashkenazi et al [3] showed that urinary tract malformation and urinary catheterization were associated with PA UTI in six children with communityacquired and 12 children with nosocomial infections. Bitsori et al [10] compared 13 children with community-acquired enterococcal (E. faecalis) UTI with 243 patients with gramnegative UTI (patients with PA UTI were not included in their control group). Similarly to our results, patients with enterococcal UTI had significantly more urinary tract abnormalities and urinary tract surgery.…”

Section: Discussionmentioning

confidence: 99%

Clinical features of community-acquired Pseudomonas aeruginosa urinary tract infections in children

et al. 2008

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This retrospective chart review sought to determine clinical, radiological, and gender-associated characteristics of community-acquired Pseudomonas aeruginosa (PA) urinary tract infections (UTIs) among children admitted to two medical centers. The records of 73 children with community-acquired PA UTIs were compared with records of 109 children with community-acquired UTIs caused by other pathogens. The mean age of both groups was similar. The PA UTI group included more boys. Features significantly more common in the PA UTI group were the number of patients who had undergone urinary tract surgery, patients with skeletal and/or neurological malformation, patients with >1 previous episode of UTI, patients on prophylactic antibiotic treatment on admission, and patients with pathological renal ultrasound and voiding cystourethrography (VCUG) findings. Multivariate logistic regression analysis revealed the following to be associated with PA UTI: >1 episode of UTI in the past [odds ratio (OR) = 35.5; 95% confidence interval (CI) 11.6-108.7], previous urinary tract surgery (OR = 34.1; 95% CI 7.00-166.2), and pathological VCUG results (OR = 2.62; 95% CI 0.96-7.15). In conclusion, PA UTI is associated with >1 previous UTI, urinary tract abnormalities, and past urinary tract surgery. We recommend that when UTI is suspected in children with these risk factors, a thorough radiologic investigation, including a VCUG, should be considered.

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“…It is well-known that enterococcal-caused urinary tract infections are more frequent prior to 10 years of age and after 60 years of age when genitourinary anomalies and obstructive uropathy are more frequent [19]. Interestingly, Bitsori et al [20] studied community-acquired enterococcal urinary tract infection in children and reported a high rate of anatomical abnormalities of the urinary tract and a poorer prognosis with respect to renal scarring. These investigators concluded that enterococcal urinary tract infection in children is highly indicative of urinary tract abnormalities and related complications.…”

Section: Discussionmentioning

confidence: 99%

Enterococcal urinary tract infections in a university hospital: clinical studies

Barros¹,

Martinelli²,

Rocha³

2009

Braz J Infect Dis

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Although urinary tract infections (UTI) represent the most common infection caused by enterococci, some aspects remain to be fully clarified. The aim of this study was to determine the clinical characteristics present in UTI caused by Enterococcus spp. in patients followed up at the Prof. Edgard Santos Teaching Hospital of the Federal University of Bahia. All patients consecutively examined between 1997 and 2005, who received a diagnosis of UTI caused by Enterococcus spp. were included in the study. UTI was defined as the presence of ≥ ≥ ≥ ≥ ≥ 10 5 colony-forming units per mL of urine. Standard microbiological techniques were used. During the study period, 6.2% of the urine cultures were positive for Enterococcus spp. The mean age of the patients was 48.9 years and 57% were male. At initial evaluation, 13% of the patients had complaints suggestive of UTI. Nineteen patients had a history consistent with obstructive uropathy and 26 with neurogenic bladder. At final evaluation, UTI was the diagnosis in 48 patients. In 36 patients (29%), the primary diagnosis was related to urogenital diseases, consisting of obstructive uropathy in 23 of these cases, while in 32 patients (25.8%) primary diagnosis was related to neurologic diseases, frequently neurogenic bladder. UTI caused by Enterococcus spp. is not infrequent, is usually associated with few or no symptoms and occurs in sick patients who have anatomical or functional obstructive uropathy associated or not with urinary tract catheterization or instrumentation. The diagnosis of enterococcal UTI may indicate a urinary tract abnormality yet to be diagnosed. Key-Words: Enterococcal infections, urinary tract, teaching hospital, Bahia, Brazil.Urinary tract infection is one of the most common infectious conditions in clinical practice and an important cause of nosocomial infection [1]. E. coli, other Gram-negative rods and Staphylococcus saprophyticus are the most frequent infecting organisms of the urinary tract [1,2]. Enterococcus spp., although less common, has been recognized as an important uropathogen [1,3].Enterococci are Gram-positive cocci, frequently referred to as facultative anaerobes. The habitat of these organisms is the gastrointestinal tract where they form part of the normal intestinal flora in humans [4]. In the last few years, enterococcal infections have become frequent occurrences in hospital settings. Currently they are an important cause of nosocomial infections [4][5][6] with increasingly common isolates that are resistant to multiple antibiotics [6][7][8][9]. Urinary tract infections constitute the most common type of disease produced by Enterococcus spp. [4][5][6].In view of the increasing importance of enterococcal infections and the current scarcity of pertinent clinical data in the medical literature, the purpose of the present study was to analyze urinary tract infections caused by Enterococcus spp. in patients followed up at a general hospital. Material and MethodsAll patients with a diagnosis of urinary tract infection caused by Enterococcus...

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Community-acquired enterococcal urinary tract infections

Cited by 42 publications

References 15 publications

Community-acquired enterococcal urinary tract infections in hospitalized children

Community-acquired enterococcal urinary tract infections in hospitalized children

Clinical features of community-acquired Pseudomonas aeruginosa urinary tract infections in children

Enterococcal urinary tract infections in a university hospital: clinical studies

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