Urinary Tract Infections: The Current Scenario and Future Prospects

Mancuso, Giuseppe; Midiri, Angelina; Gerace, Elisabetta; Marra, Maria; Zummo, Sebastiana; Biondo, Carmelo

doi:10.3390/pathogens12040623

Cited by 100 publications

(56 citation statements)

References 112 publications

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“…The risk factors identi ed in the study, including female gender, prolonged Foley's catheterization, and urinary tract abnormalities, are well-established in the literature. [10,12,[16][17][18][19]27] These ndings emphasize the importance of identifying and closely monitoring high-risk patients to mitigate the risk of UTI development. Targeted preventive strategies, such as judicious use of catheterization, timely removal of urinary catheters, and prompt management of urinary tract abnormalities, may aid in reducing the burden of UTIs in this vulnerable population.…”

Section: Discussionmentioning

confidence: 99%

Spectrum Of Urinary Tract Infection Among Renal Allograft Recipients in a Tertiary Care Centre of Northeast India

Sharma,

Qanoongo,

Doley

et al. 2024

Preprint

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Background Urinary tract infection (UTI) poses a significant threat to renal allograft recipients, jeopardizing graft function and patient survival. This study aimed to investigate the incidence, clinical manifestations, microbiological profile, risk factors, and impact of UTI on renal allograft outcomes.Methods A retrospective cohort study was conducted at a tertiary care center in Assam, India, from July 2022 to January 2024, including 220 renal allograft recipients aged over 18 years. Detailed clinical, microbiological, and outcome data were collected and analyzed using SPSS. Multivariate logistic regression was performed to identify independent risk factors.Results The incidence of UTI was 25%, with a higher prevalence in females (58%). Asymptomatic bacteriuria (45%) and cystitis (35%) were the most common UTI types. Escherichia coli (44%) and Klebsiella pneumoniae (32%) were the predominant uropathogens, with 12% of isolates being multi-drug resistant (MDR) and 7% pan-drug resistant (PDR). Female gender (OR 6.73, 95% CI 4.53–12.65, p < 0.001), Prolonged Foley's catheterization (OR 3.92, 95% CI 2.95–4.88, p = 0.019), and Urinary tract abnormalities (OR 2.83, 95% CI 1.61–4.17, p = 0.027) emerged as significant independent risk factors. UTI led to graft failure in 54% of cases, and 3% underwent graft nephrectomy. However, 66% of patients with acute graft dysfunction due to UTI achieved complete recovery with management.Conclusions This study revealed a substantial 25% incidence of urinary tract infection among renal allograft recipients, with the highest risk observed in the early post-transplant period, especially within the first 3 months. Asymptomatic bacteriuria was the most common presentation, and Escherichia coli and Klebsiella pneumoniae were the predominant uropathogens, with a considerable proportion exhibiting multidrug and pan-drug resistance. Female gender, prolonged Foley's catheterization, and urinary tract abnormalities were identified as independent risk factors for UTI development. These findings emphasize the need for heightened vigilance, prompt diagnosis, tailored treatment approaches, and targeted preventive strategies to mitigate the burden of UTIs and combat antimicrobial resistance in this high-risk population.

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Section: Discussionmentioning

confidence: 99%

Spectrum Of Urinary Tract Infection Among Renal Allograft Recipients in a Tertiary Care Centre of Northeast India

Sharma,

Qanoongo,

Doley

et al. 2024

Preprint

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“…Indirect infection can also occur through colonisation of the urinary or gastrointestinal tracts. Endogenous infections can also result from translocation through the epithelium of the GI tract [ 97 , 98 , 99 , 100 , 102 , 103 ] ( Figure 3 ).…”

Section: Causes Of E Faecalis Bacteraemiamentioning

confidence: 99%

Current Knowledge of Enterococcal Endocarditis: A Disease Lurking in Plain Sight of Health Providers

Nappi

2024

Pathogens

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Enterococcus faecalis is a bacterial pathogen that can cause opportunistic infections. Studies indicate that initial biofilm formation plays a crucial regulatory role in these infections, as well as in colonising and maintaining the gastrointestinal tract as a commensal member of the microbiome of most land animals. It has long been thought that vegetation of endocarditis resulting from bacterial attachment to the endocardial endothelium requires some pre-existing tissue damage, and in animal models of experimental endocarditis, mechanical valve damage is typically induced by cardiac catheterisation preceding infection. This section reviews historical and contemporary animal model studies that demonstrate the ability of E. faecalis to colonise the undamaged endovascular endothelial surface directly and produce robust microcolony biofilms encapsulated within a bacterially derived extracellular matrix. This report reviews both previous and current animal model studies demonstrating the resilient capacity of E. faecalis to colonise the undamaged endovascular endothelial surface directly and produce robust microcolony biofilms encapsulated in a bacterially derived extracellular matrix. The article also considers the morphological similarities when these biofilms develop on different host sites, such as when E. faecalis colonises the gastrointestinal epithelium as a commensal member of the common vertebrate microbiome, lurking in plain sight and transmitting systemic infection. These phenotypes may enable the organism to survive as an unrecognised infection in asymptomatic subjects, providing an infectious resource for subsequent clinical process of endocarditis.

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“…A UTI may also progress to further complications: increasing the risk of urinary calculi development, UI, chronic prostatitis and affecting the upper urinary tract (pyelonephritis, kidney abscess, kidney failure) [36,37]. The pathophysiology of infectious UTI is beyond the scope of this review and can be found in some papers in this field [38][39][40]. However, UTI development may also result from the patient's pharmacotherapy.…”

Section: Urinary Tract Infectionsmentioning

confidence: 99%

Lower Urinary Tract Disorders as Adverse Drug Reactions—A Literature Review

Dobrek

2023

Pharmaceuticals

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A potential complication of pharmacotherapy for a given patient is the possibility of various side effects of drugs, which are manifested in many ways and constitute iatrogenic causes of diseases. Among the systemic side effects of drugs, there are also those involving the urinary tract, although these are less reported in the literature. The use of numerous drugs—especially of anticholinergics or drugs with anticholinergic potential, opioid analgesics, non-steroidal anti-inflammatory drugs, antidepressants, first-generation antipsychotics (classic neuroleptics) and selected cardiovascular drugs (beta-blockers, thiazides potassium-sparing diuretics, statins), as well as others—may increase the risk of developing urological disorders, such as urinary retention or incontinence, urinary tract infections, urolithiasis, erectile dysfunction in men and retroperitoneal fibrosis. The purpose of this paper is to characterise the abovementioned drug-induced disorders of the lower urinary tract on the basis of a non-systematic literature review.

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Urinary Tract Infections: The Current Scenario and Future Prospects

Cited by 100 publications

References 112 publications

Spectrum Of Urinary Tract Infection Among Renal Allograft Recipients in a Tertiary Care Centre of Northeast India

Spectrum Of Urinary Tract Infection Among Renal Allograft Recipients in a Tertiary Care Centre of Northeast India

Current Knowledge of Enterococcal Endocarditis: A Disease Lurking in Plain Sight of Health Providers

Lower Urinary Tract Disorders as Adverse Drug Reactions—A Literature Review

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