A review on the prevalence and predisposing factors responsible for urinary tract infection among adults (original) (raw)
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Urinary Tract infection and its risk factors in Women: an Appraisal
A urinary tract infection (UTIs) is the one of the most common bacterial infection in women than in men, at a ratio of 8:1 and a major cause of morbidity. Approximately 50–60% of women report at least one UTI in their lifetime. UTI is caused by pathogenic invasion of the urinary tract which leads to an inflammatory response of the urothelium. The clinical manifestation of UTI depend upon the portion of the urinary tract involved, the etiologic organism, the severity of the infection and patients ability to mount an immune responds to it. Signs and symptoms include fever, dysuria, and urinary urgency, cloudy or malodorous urine. UTI is higher in women due to several clinical factors including anatomic differences, hormonal effects and behavioral pattern. Malnutrition, poor hygiene, low socioeconomic status is associated with UTI and these factors are rife in rural settings. UTI is mostly caused by gram negative aerobic bacilli found in GI tract. Included in this family are the Escherichia coli (E. coli), Klebsilla, Enterobactor, Citrobacter, Proteus and serratia species. Other common pathogens include Staphylococcus epidermidis, Staphylococcus saprophyticus and Enterococcus Species. E. coli is the most predominant organism. The aim of this review is to summarize the distribution, clinical sign and symptoms, laboratory profile and risk factor of urinary tract infection.
Urinary Tract Infection – A Review on Its Prevalence and Recent Advances
Journal of Pharmaceutical Research International
The Urinary Tract Infection (UTI) is a seasonal infection prevalent in coastal areas whose intensity varies among various age groups. Escherichia coli is one of the major causative organisms. The current study is to the frequency of UTI in the Coastal region; understand the recent advances in alternative treatment & their efficacy. The known medication for the UTI is quinolones and cephalosporin. Cranberry extract is the only medicine used from a plant source that is expensive and not native to India. The main cause of UTI to spread is a lack of hygiene, sexual intercourse, and inadequate consumption of water. Change in the pH of the urethra during puberty & menopause in women facilitates the growth of opportunistic Uropathogens. Innate immunity can also contribute to the resistance of the body but a recent study says that infection rate varies among individuals considering their age, immunity, and lifestyle. The pathogens causing UTI are developing resistance against multiple drugs...
Urinary tract infection in community: age and gender relationship
2016
This study was conducted to evaluate and determine the incidence of urinary tract infections (UTIs) in community and their relationship with the gender and age of the patients. To achieving this goal, midstream urine (MSU) specimens were collected from 325 patients with clinical symptoms suspected to be UTI. Specimens were cultured on MacConkey's ager and blood ager media, and then incubated aerobically overnight at 37°C. The identification of the isolated bacterial colonies was done by standard and conventional microbiological techniques, as well as the using of analytic profile index (API 20E) biochemical identification system. The antibiotic susceptibility testing was carried out by Kirby-Bauer's technique (disc diffusion method) using Muller-Hinton agar medium. Our results demonstrated that only 200 specimens exhibited positive urine cultures, and these specimens were belonged to patients, 85 (42.5 %) of them were males and 115 (57.5 %) were females. The mean age was 38.8 years, and the male to female ratio was 1:1.4. The highest rate of infection was recorded in patients aged between 27 to 46 years, 97 (48.5 %). Escherichia coli (E. coli) appear to be the most predominance bacterial causative agent of UTI with the highest number of isolates, 111 (55.5 %). All E. coli isolates were completely sensitive to imipenem and amikacin (100 %) for each, and (91 %) sensitivity toward nitrofurantoin, whereas (96 %) and (79 %) of the isolates were resistant to ampicillin and trimethoprim-sulfamethoxazole, respectively. We can conclude that UTI appears to be higher among the adults, with a significant incidence in females than males.
Urinary Tract Infection (UTI) Still a Force to be Reckoned with
Journal of Biomedical Engineering and Medical Imaging
Burning pain ,frequent urge to urinate is the first sign of a UTI. It is due to bacteria in the urethra or bladder. Frequent urination is another red flag for an infection. Urine produces peculiar even foul odor and smoky, cloudy. Urine appears pinkish or reddish due to the presence of blood.Young women are commonly infected.Prostate hypertrophy is linked to male disease. It is affecting almost 4 million people in US alone. The chance of UTI is more in women.In females, it affects the bladder and urethra. Women who use diaphragms, spermicidal agents are more at risk. Menopause women are more vulnerable to infection. Infection of upper urinary tract,consisting of the kidney and pelvis ,is known as pyelonephritis.Infection of the lower tract may involve the bladder (Cystitis),urethra (Urethritis) or prostate (Prostatitis) Intercourse is common association of UTI. Catheters increase the risk.Obstruction of urinary flow increase the risk.Bacterial adherence favors persistence.Fever is usually absent.Enterobacteriaceae and gram positive bacteria appear with complications.Back and perirectal pain are the signs of UTI.Pyuria suggests UTI but not specific.Chronic disease is the source of cystitis.Kidney infection results in permanent kidney damage. Take plenty of water/fluids to flush out bacteria.Wipe front to back. This helps the spread of bacteria from the anus into the bladder. Decreased estrogen levels during menopause cause changes that make the urinary tract more susceptible to bacteria. Most patients with UTI have uncomplicated cystitis, which is one of the most common infections in the United States, especially in sexually active women. Escherichia coli is the most common cause of urinary tract infection. Staphylococcus saprophyticus is a frequent cause of cystitis in women, probably related to its occurrence as a part of normal vaginal flora. Klebsiella, Enterobacter, Proteus, and Serratia are the primary opportunistic and often nosocomial pathogens. Pseudomonas aeruginosa is an opportunistic pathogen and a major cause of hospital-acquired infections.
Indian Journal of Medical Microbiology, 2021
Background: Urinary tract infection (UTI) is an important cause of morbidity and mortality in the paediatric age group. The spectrum of etiologic agents causing UTI and their antimicrobial resistance pattern has been continuously changing over the years. It varies among geographical locations, hospitals and also in different age groups. Objective: The aim of this study was to find out the causative agents of UTI and their antibiotic sensitivity pattern in paediatric patients in CMH, Dhaka. Methodology: This is an observational cross sectional study. A total of 180 children aged 0 months to 15 years attending pediatric outpatient department or admitted in Department of Paediatrics CMH, Dhaka with suspected UTI were subjected for urine routine and microscopic examination between June 2015 to May 2016. Those having pyuria (n=120) were then sent for urine culture and sensitivity to the laboratory of Armed Forces Institute of Pathology (AFIP). Patients having significant growth of organism were enrolled as cases of confirmed UTI. After enrollment, relevant information such as age, sex, sociodemographic profile was obtained and recorded in case record form. Result: In the present study, urine routine microscopy was done in all 180 cases of suspected UTI. Among all urine analysis 67% had significant pyuria (n=120). Of the 120 cases with pyuria, 58 cases were having culture positive accounting 48.3% of the total sample studied. Occurrence of urinary tract infections was highest in the age group below 5 year (62.5%). UTI was more prevalent in girls (63.3%) with male to female ratio 1:1.7. E. coli was the commonest isolate (62.1%) followed by Enterococcus (19.2%) and Klebsiella (10.2%). E. coli was found to be most sensitive to Ciprofloxacin, Nitrofurantoin, Amikacin, and Levofloxacin in descending order. There was a generally high level of resistance of isolates to Cotrimoxazole, Amoxycillin, Aminoglycosides, Azythromycin and the Cephalosporins like Cefuroxime, Ceftazidime, Cefixime and Ceftriaxone compared to Ciprofloxacin, Nitrofurantoin and Levofloxacin. Conclusion: Based on our findings, Ciprofloxacin, Levofloxacin and Nitrofurantoin are appropriate for initial empirical therapy for UTI among Bangladeshi children.
International Journal of Pharmacy and Pharmaceutical Sciences, 2022
Objective: To study the Prevalence of urinary tract infections and related risk factors and to study the Management of urinary tract infections. Methods: This was a prospective observational study conducted in General Medicine Department, Osmania General Hospital (OGH), a tertiary care teaching hospital in Telangana State, where patients presenting or highly suspicious of having UTIs were included in the study. Pregnant women, Children, Patients who are not willing to participate were excluded from the study. Data was collected in predesigned Data collection forms. Results: Over a period of 6 Mo a total of 75 UTI cases were observed in General Medicine Department of OGH, which included 33 Males, and 42 Females. High prevalence of UTI were observed in Females in the middle age group i.e. 31-45 y, whereas in Males, in senior adult group i.e.,>60 y. The age group 18-30 y have shown the dominance of Uncomplicated UTIs(19%) and Primary UTIs (17%) and the age group>60 y have shown the dominance of Complicated UTIs (25%) and Recurrent UTIs(23%). The most common causative organism was found to be E. coli (69.3%). It was confirmed that the most common risk factor was found to be Diabetes Mellitus, followed by Hypertension and Chronic Kidney Disease. The most common antibiotic prescribed for UTI was Piperacillin+Tazobactum and for fungal UTIs, an antifungal drug i.e., Fluconazole was prescribed. Conclusion: E. coli are the major cause of UTIs among patients It is discovered that UTI is common among females. Hospitalisation, married individuals, Diabetes mellitus, genitourinary tract abnormalities, congestive cardiac failure, hypertension, prostatitis and female gender are the most important risk factors of UTIs. Appropriate measures may help to reduce UTIs due to these associated factors.
Urinary Tract Infection in Adults
Brenner and Rector's The Kidney, 2012
Urinary tract infections (UTIs) are a frequent problem worldwide which are caused by microbial invasion to different tissues of the urinary tract. Urine is normally sterile, that is, free of bacteria, viruses, and fungi. A urinary tract infection is a condition in which one or more parts of the urinary system (the kidneys, ureters, bladder, and urethra) become infected. UTIs are one of the most common bacterial infections in the general population, with an estimated overall incidence rate of 18 per 1000 person per year. It is the most frequent bacterial infection recorded in older people [1]. In addition, UTIs are a major cause of hospital admissions and are associated with significant morbidity and mortality as well as a high economic burden [2]. In a study performed by Sammon et al. 10.8 million patients in the United States visited an Emergency Department (ED) for the treatment of a UTI between 2006 and 2009. The economic burden of utilizing the ED for the treatment of UTIs is estimated to be $2 billion US dollars annually [3]. UTIs can manifest in a wide clinical range from bacteriuria with limited clinical symptoms to sepsis [4].
Epidemiology, definition and treatment of complicated urinary tract infections
Nature Reviews Urology, 2020
UTIs are amongst the most frequent bacterial infections in the community, as well as in health-care systems in general, and they are seen in many specialties, such as internal medicine, gynaecology, urology and intensive care medicine 1. The clinical spectrum of UTI ranges from benign to life-threatening infections 2-5. For decades, UTIs have therefore been classified into uncomplicated UTIs and complicated UTIs (cUTIs), with the aim of distinguishing infections with a benign course from those with a higher probability of recurrence or progression to severe infection. However, the classification systems employed by regulatory authorities, scientific societies or guideline groups are not unified and UTI classification is continuously evolving and developing 6. Traditionally, uncomplicated UTIs referred to infections in non-pregnant, healthy women that resolve with antibiotic treatment, whereas all other UTIs were referred to as complicated, including cystitis in men. Some more recent definitions focus more on the relevance of complicating factors to cause a more complicated course of the infection and group healthy postmenopausal women or women with well-controlled diabetes mellitus amongst those with uncomplicated UTI. Infections can occur in any part of the urinary tract, including the urethra (urethritis), the bladder (cystitis), the ureters and the kidneys (pyelonephritis). Without treatment or in cases that are not resolved with antibiotics, in some patients with lower UTIs the infection can ascend and cause pyelonephritis or male genital infections, such as prostatitis or epididymo-orchitis, or can progress to severe, life-threatening urosepsis. Incidence and prevalence rates vary substantially according to the UTI location, the medical specialist dealing with the patient, and patient sex and comorbidities, amongst others. Self-reported incidence rates for cystitis were 12.6% per year for women and 3.0% for men in the USA in the 2000 (ref. 7). In 2000, hospitalization rates for pyelonephritis were 11.7 per 10,000 women and 2.4 per 10,000 men in the USA 8. The Global Prevalence Study on Infections in Urology (GPIU) estimates that 1,866 of 19,756 (9.4%) urological patients hospitalized between 2005 and 2017 developed a cUTI during their hospital stay 9. A wide variety of important medical aspects are intimately linked with UTIs, such as morbidity, mortality, long-term sequelae, antimicrobial administration and antimicrobial resistance, and costs. Morbidity rates for recurrent cystitis were assessed in the GESPRIT study 10 , which reported a mean of
Prevalence of UTI in Different Age Groups and Antimicrobial Susceptibility Pattern of Isolates
International Journal of Medical and Allied Health Sciences
Background: Urinary tract infection (UTI) has become major infection mainly caused by bacteria. It is second most common reason for empirical antibiotic treatment. About 150 million population is suffering from UTI worldwide annually. Distribution and susceptibility of uropathogens changes according to living conditions, hygiene status of affected people, morphology, place and sometimes environmental conditions. Aim: This study aimed to find out occurrence of UTI in among age groups of rural population and to find out antimicrobial susceptibility pattern of isolates. Materials and Methods: During this study total 422 patients of age ranging from 2- 86 years from different wards of the Rama medical college, Hospital and Research Center, Hapur, Uttar Pradesh, India, was observed from January to June 2021. Morphology, Staining, Motility, Biochemical test and antimicrobial susceptibility test were performed. Result: It was observed that about 18.48% patients were found positive with UTI...
Moroccan Journal of Biology, 2021
Urinary tract infection (UTI) is one among the foremost prevalent diseases affecting people of both genders and all age groups. The management of UTI relies on the likely etiology of UTI and knowledge of their antimicrobial susceptibility patterns. Extensive application of antibiotics has led to the emergence of resistant microorganisms. This study was conducted to research the prevalence rate of UTI among patients of different age groups and to analyze the recent antibiotic susceptibility pattern of uropathogen in UTI because the antibiogram of the microorganisms is repeatedly changing. In a prospective study undertaken at Al-Hera General Hospital, Sadar, Sirajganj over a 9 month period, 159 samples from patients suspected of having UTI were analyzed, of which 57 were culture positive. Identification of the isolated bacteria was performed by standard tests, and antibiotic susceptibility was measured by disc diffusion method. The total predominance of UTI was 35.8% of which 78.9% were females and 21.1% were from males. Greater prevalence was detected in females as compared to males. The overall prevalence in females was high in the age range of 21-60 yr (57.8%), followed by 1-20 yr (22.2%) and > 60 yr (20%). In males the frequency is high in 21-40 yr (41.7%); both the age range of 41-60 yr and > 60 yr was 50%, and the rest of 8.3% for the age group of 1-20 yr. From the total 57 uropathogens, E. coli was estimated for 63.1% of all the isolate, followed by Pseudomonas spp. (7%), Proteus spp. (5.2%), Klebsiella pneumoniae (5.2%), Staphylococcus saprophyticus (5.2%), Salmonella spp. (3.5%), Serratia spp. (3.5%), Citrobacter frundii (5.2%), and Candida albicans (1.8%). In the present study, the most potent antibiotics were Amikacin, Imipenem, Nitrofurantoin, Meropenem, and Amoxiclav, while on the contrary higher resistance was observed among the commonly used drugs like Cephradine, Amoxicillin, Cotrimoxazole, and Ceftazidime. UTI may be a serious health problem if untreated. Initial diagnosis and immediate treatment will prevent the probabilities of developing further complication of UTI. Both the patient's age and gender can increase accuracy in defining the causative agents and providing a useful guideline to treat UTI. As the drug resistance pattern of the bacterial pathogens of UTI is greatly varied with time, regular surveillance and monitoring are vital for giving updated information to the physician for effective management of UTI.