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A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
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A urine culture and sensitivity test is a diagnostic procedure used to identify urinary tract bacterial infections and determine the most effective antibiotics for treatment. This test is generally preferred when a patient shows manifestations of a urinary tract infection, such as frequent or painful urination, cloudy or foul-smelling urine, or lower abdominal pain.Purpose of the TestThe primary goals of a urine culture and sensitivity test are to:Determine the specific bacteria causing the...
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In managing urinary tract infections (UTIs) in nursing, a comprehensive assessment is essential. Begin by gathering subjective data, such as the patient’s complaints of dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and any lower abdominal discomfort. This information can be complemented by questions regarding previous UTIs, sexual activity, and personal hygiene practices, which can provide insight into risk factors. Objective assessment should focus on signs...
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Recurrent Escherichia coli Urinary Tract Infection Triggered by Gardnerella vaginalis Bladder Exposure in Mice
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Antimicrobial Resistance and Urinary Tract Infection Recurrence.

Caleb P Nelson1, Alejandro Hoberman2, Nader Shaikh2

  • 1Department of Urology, Boston Children's Hospital, Boston, Massachusetts; caleb.nelson@childrens.harvard.edu.

Pediatrics
|March 13, 2016
PubMed
Summary
This summary is machine-generated.

Recurrent urinary tract infections (rUTIs) with resistant organisms were more common in children receiving trimethoprim-sulfamethoxazole prophylaxis (TSP). However, TMP-SMX resistance decreased over time in the RIVUR trial.

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Area of Science:

  • Pediatric Urology
  • Infectious Diseases
  • Clinical Trials

Background:

  • The Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trial investigated recurrent urinary tract infections (rUTIs) in children.
  • Recurrent UTIs with resistant organisms were more frequent in the trimethoprim-sulfamethoxazole prophylaxis (TSP) group.

Purpose of the Study:

  • To identify factors associated with trimethoprim-sulfamethoxazole (TMP-SMX) resistance in rUTIs within the RIVUR trial.
  • To analyze the incidence and resistance patterns of UTIs in children with VUR receiving prophylactic antibiotics.

Main Methods:

  • Children aged 2 to 71 months with VUR and a first or second UTI were randomized to receive either TSP or a placebo for 2 years.
  • Factors associated with TMP-SMX-resistant rUTIs were evaluated using data from the RIVUR trial.

Main Results:

  • TMP-SMX-resistant organisms were found in 76% of rUTIs in the TSP arm versus 28% in the placebo arm (P < .001).
  • The proportion of TMP-SMX-resistant rUTIs decreased over time, with higher resistance in the initial 6 months compared to the final 6 months in both arms.
  • No significant difference in UTI recurrence was observed between children with TMP-SMX-resistant versus TMP-SMX-susceptible index UTIs in the TSP group.

Conclusions:

  • While TMP-SMX resistance was more prevalent in children on TSP, this resistance diminished over the study period.
  • The initial susceptibility of the index UTI to TMP-SMX did not significantly predict subsequent rUTI in children receiving TSP.