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Acute Pyelonephritis II: Diagnostic Studies and Management

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...

Urine Studies II: Urine Culture and Sensitivity Test

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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...

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

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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...

Urinary Tract Infection II: Pathophysiology

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The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...

Urinary Tract Infection I: Introduction

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Urinary tract infections (UTIs) impact various parts of the urinary system, including the kidneys, ureters, bladder, and urethra. These infections are generally bacterial, with Escherichia coli being the most common causative agent, often originating from the gastrointestinal tract. However, other bacteria, such as Staphylococcus saprophyticus, Klebsiella pneumoniae, and Proteus mirabilis, are also known to cause UTIs. The type, location, and underlying complexity of the UTI guide both...

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A Case-Control Study Evaluating Risk Factors and Outcomes of Hospitalized Children With ESBL-UTI.

Sophia Hassor¹, Veronica Etinger¹, Diana Sofia Villacis¹

¹Nicklaus Children's Hospital, Miami, FL, USA.

Clinical Pediatrics

|July 27, 2022

Summary

This study identified risk factors for extended-spectrum beta-lactamase-producing (ESBL) urinary tract infections (UTIs) in children. Many children with ESBL-UTI responded to antibiotics, but longer hospital stays and IV antibiotic use were noted.

Keywords:

extended-spectrum beta-lactamase organisms hospital medicine infectious diseases risk factors urinary tract infection

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Area of Science:

Pediatric infectious diseases
Microbiology
Clinical epidemiology

Background:

Urinary tract infections (UTIs) are a common cause of pediatric hospitalization.
There is a growing concern regarding the prevalence of extended-spectrum beta-lactamase-producing (ESBL) organisms in pediatric UTIs.

Purpose of the Study:

To identify risk factors associated with ESBL-UTI in hospitalized children.
To evaluate treatment outcomes for children diagnosed with ESBL-UTI.

Main Methods:

A retrospective case-control study was conducted between July 2014 and December 2017.
Medical records of hospitalized children with positive urine cultures were reviewed.
Cases were defined as ESBL-UTI, and controls as non-ESBL-UTI.

Main Results:

Identified risk factors for ESBL-UTI include previous UTI, recent antibiotic use, urinary tract abnormalities, recent hospitalization, and nonrenal comorbidities.
The majority of children with ESBL-UTI showed positive responses to discordant antibiotics.
Patients with ESBL-UTI experienced longer hospital stays and required more prolonged intravenous antibiotic therapy.

Conclusions:

Specific risk factors predispose children to ESBL-UTI.
While treatment with discordant antibiotics can be effective, ESBL-UTI is associated with increased healthcare resource utilization.