Objective To verify the relationship between catheter-related urinary tract infection(CAUTI)and stress hyperglycemia during catheter retention in stroke patients. Methods We used nosocomial infection monitoring system to track the status of CAUTI in stroke patients in a hospital.The study cohort was all the patients who received retention catheterization from January 2016 to March 2020.According to the nested case-control design,multivariate logistic regression analysis was performed to explore the relationship between stress hyperglycemia and CAUTI in stroke patients with indwelling catheter. Results A total of 322 cases of CAUTI and 644 cases of non-CAUTI were enrolled in this study.The length of stay in the case group was(20.68 ± 3.73)d,significantly longer than that[(13.00 ± 4.01)d]in the control group(t=29.473,P <0.001).Compared with non-stress hyperglycemia,stress hyperglycemia posed a higher risk of CAUTI in the stroke patients with indwelling catheter(OR=2.020,95% CI=1.447-2.821,P=0.000)and led to the higher incidence of CAUTI in one thousand days(P<0.001). Conclusion Stress hyperglycemia in the stroke patients with indwelling catheter can significantly increase the risk of CAUTI.
Catheter-Related Infections/epidemiology* ; Cross Infection/epidemiology* ; Humans ; Hyperglycemia/complications* ; Stroke/complications* ; Urinary Catheterization ; Urinary Tract Infections/epidemiology*

The quinolone class of antimicrobial agents is one of most widely used classes of antimicrobial agents in outpatient and inpatient treatment. However, quinolone resistance in gram-positive and gram-negative bacteria has emerged and increased globally. This resistance limits the usefulness of quinolones in clinical practice. The review summarizes mechanisms of quinolone resistance and its epidemiology and implications in the most common clinical settings, urinary tract infections, respiratory tract infections, intraabdominal infections, skin and skin structure infections, and sexually transmitted diseases.
Anti-Infective Agents ; Drug Resistance ; Epidemiology* ; Gram-Negative Bacteria ; Humans ; Inpatients ; Intraabdominal Infections ; Outpatients ; Quinolones ; Respiratory Tract Infections ; Sexually Transmitted Diseases ; Skin ; Urinary Tract Infections

Although asymptomatic bacteriuria, cystitis, and acute pyelonephritis (APN) have been categorized as urinary tract infections (UTIs), the immunopathogenesis of each disease is different. APN shows an age predilection; the majority of children (over 70-80%) with APN are under 1-2 years of age, with a male predominance. After 1-2 years of age, female predominance has been reported. This finding suggests that the immature immune state of infancy may be associated with the pathogenesis of APN. Escherichia coli is the most common etiologic agent; other uropathogens associated with UTIs originate from the host and comprise normal flora that are continuously altered by environmental factors. Therefore, uropathogens may have characteristics different from those of extraneous bacterial pathogens. Although antibiotic-resistant uropathogens, including extended-spectrum beta-lactamase-producing strains, are increasing in Korea and worldwide, treatment failure is rare in immune-competent children. The immunopathogenesis of APN remains unknown. Intact bacteria may not be the causative substances in renal cell injury; rather, smaller substances produced during bacterial replication may be responsible for renal cell injury and scarring. Moreover, substances from host cells such as proinflammatory cytokines may be involved in renal cell injury. A dimercaptosuccinic acid scan is used to detect the site of bacterial replication in the renal parenchyma, and may be influenced by the size of the focus and the stage of APN. Traditional aggressive studies used to identify vesicoureteral reflux after the first episode of APN have been modified because of rare cases of chronic kidney disease in patients with recurrent UTI.
Bacteria ; Bacteriuria ; Child* ; Cicatrix ; Cystitis ; Cytokines ; Epidemiology ; Escherichia coli ; Female ; Humans ; Korea ; Male ; Pyelonephritis ; Renal Insufficiency, Chronic ; Succimer ; Treatment Failure ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux

OBJECTIVETo explore the correlation of urinary stones and urinary tract infections.

METHODS300 cases with urinary tract stones received in our hospital from Feb. 2010 to Oct. 2013 were chosen as study samples. Urine routine index, situation of urine positivity and urinary tract infection after surgery were analyzed while, intraoperative cotton swabs were tested after being dipped in liquid near stones. Main components of stones in non-infected and infected stone group were analyzed and compared. Data on urolithiasis was collected.

RESULTS96 infected stones were found in 300 patients, accounting for 32%, which including 35 cases of E. coli (36.5%), 28 cases of Staphylococcus epidermidis (29.2%), and 15 cases of Proteus mirabilis (15.6%). Numbers of urine abnormalities, urine positivities, positive intraoperative cotton swabs and urinary tract infections in patients in the group with infected stones, were significantly higher than in the group without infected stones and the differences were statistically significant (χ² = 8.203, 73.99, 178.9, 24.26, P < 0.05). The incidence rates of hexahydrate magnesium ammonium phosphate, carbonate apatite and hydroxyapatite stones in the group with infected stones were significantly higher than those in the non-infected-rock group while the incidence rates of calcium oxalate and uric acid stones were found significantly lower than those in the non-infected-stone group, with differences statistically significant (χ² = 167.6, 21.00, 8.586, 73.17, 48.79, P < 0.05).

CONCLUSIONBacteria could cause urinary tract stones, and infected stones were always associated with urinary tract infections. Bacteria detection in patients with urinary calculi was particularly important to avoid the urinary tract infections.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Urinary Calculi ; epidemiology ; microbiology ; Urinary Tract Infections ; epidemiology ; microbiology ; Young Adult

BACKGROUND: To determine whether multiple short-term surveillances are as effective as long-term surveillance for estimating the incidence rates of nosocomial infections (NIs), we prospectively performed 9-month surveillance in four intensive care units (ICUs). METHODS: NI surveillance was performed prospectively from November 2002 through July 2003, with long-term surveillance performed over the 9-month period, and short-term surveillance performed during the middle 3 weeks of each calendar quarter. The incidence rate of NIs or device-associated infections was calculated as the number of infections per 1,000 patient-days or device-days. RESULTS: We observed no significant differences between the incidence rates of total NIs determined from these two methods (9.6 [CI95 8.2-11.3] vs 10.4 [CI95 7.5-14.4], P=.66). In addition, these two methods did not differ significantly in estimating the rates of ventilator-associated pneumonia (5.1 [CI95 3.4-7.6] vs 7.5 [CI95 3.8-15.0], P=.35), catheter-associated urinary tract infection (2.4 [CI95 1.7-3.4] vs 1.7 [CI95 0.7-4.1], P=.47), and central line-associated bloodstream infection (2.2 [CI95 1.4-3.4] vs 3.7 [CI95 1.9-7.4], P=.21). Plotting of the NI rates showed that the trends in multiple short-term surveillances were similar to those in long-term surveillance, except in one ICU. CONCLUSION: Our findings suggest that multiple short-term surveillances could replace long-term surveillance in estimating the baseline incidence rates of NIs in the circumstances of the relatively large number of patients in the ICUs, which would be especially useful in countries with limited resources.
Cross Infection* ; Epidemiology ; Humans ; Incidence ; Infection Control ; Intensive Care Units ; Pneumonia, Ventilator-Associated ; Prospective Studies ; Urinary Tract Infections

No abstract available.
Dextrans/*therapeutic use ; Female ; Humans ; Hyaluronic Acid/*therapeutic use ; Male ; Urinary Tract Infections/*epidemiology ; Vesico-Ureteral Reflux/*drug therapy

Adolescent ; Age Factors ; Child ; Child, Preschool ; Female ; Humans ; Incidence ; Infant ; Male ; Urinary Tract Infections ; etiology ; Vesico-Ureteral Reflux ; complications ; epidemiology

BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae are main pathogens of bloodstream infection. We compared the epidemiology of ESBL-producing E. coli and K. pneumoniae. METHODS: From January 2003 through March 2007, we retrospectively investigated the clinical characteristics and comorbidities of patients with bloodstream infection by ESBL-producing E. coli and K. pneumoniae. RESULTS: During the study period, 79 patients (54 with E. coli and 25 with K. pneumoniae) with blood cultures positive for ESBL-producing E. coli or K. pneumoniae were studied. When comparing the source of bloodstream infections, urinary tract infections (UTIs) were more commonly caused by E. coli (24% vs. 0; P=0.007), and respiratory tract and soft tissue infection (36% vs. 15%; P=0.04, 12% vs. 0; P=0.03, respectively) were more commonly associated with K. pneumoniae. Among hospital-acquired bloodstream infection, third-generation cephalosporin was more commonly used in patients with E. coli than patients with K. pneumoniae (81% vs. 24%, P<0.001). Medical devices (central venous catheter and urinary catheter) were more commonly used in patients with K. pneumoniae. CONCLUSION: ESBL-producing E. coli bloodstream infection is more common in urinary tract infections. ESBL-producing K. pneumoniae is more common in respiratory tract infections and in skin and soft tissue infections. In hospital-acquired infections, ESBL-producing E. coli bloodstream infection is more common in biliary tract infection. ESBL-producing E. coli was more commonly associated with prior frequent antibiotics use and K. pneumoniae was more commonly associated with use of medical devices.
Anti-Bacterial Agents ; beta-Lactamases ; Biliary Tract ; Catheters ; Comorbidity ; Epidemiology* ; Escherichia coli* ; Humans ; Klebsiella pneumoniae* ; Pneumonia ; Respiratory System ; Respiratory Tract Infections ; Retrospective Studies ; Skin ; Soft Tissue Infections ; Urinary Tract Infections

Catheter-Related Infections ; diagnosis ; epidemiology ; Critical Care ; Cross Infection ; diagnosis ; epidemiology ; Electronic Health Records ; Hospitalization ; Hospitals ; Humans ; Intensive Care Units ; Length of Stay ; Singapore ; Urinary Catheterization ; adverse effects ; Urinary Tract Infections ; diagnosis ; epidemiology

Physicians need to be prepared with basic understandings of enuresis and practical tips to diagnose and treat the patients properly. The knowledge about the natural history, epidemiology, and etiology of enuresis, not to mention multiple treatment modalities available, are essential, Medical consultation and treatment of enuresis begins at the age of 5. Evaluation should include history taking, physical examination, and laboratory investigations. A checklist may be provided for quick evaluation in busy clinics. The two main treatment modalities are behavioral modification with an alarm system and pharmacotherapy with desmopressin or imipramine, or oxybutinin. The response to treatment is evaluated after a 1-to 3-months' period of treatment. further evaluation and individualized treatment are needed in poor responders. Normalization of a small functional bladder capacity may help to cure enuresis and treatment of enuresis with antibiotics is effective in children with urinary tract infection, bacteriuria, or cystitis cystica.
Anti-Bacterial Agents ; Bacteriuria ; Checklist ; Child ; Cystitis ; Deamino Arginine Vasopressin ; Drug Therapy ; Enuresis* ; Epidemiology ; Humans ; Imipramine ; Natural History ; Physical Examination ; Urinary Bladder ; Urinary Tract Infections