Tag Archives: urinary tract infection

New Insights in Treatment Options in Pediatric Urinary Tract Infection

Carmen Duicu1, Iulia Armean2, Cornel Aldea3

1. University of Medicine, Pharmacy, Sciences and Technology of Târgu Mureș, Târgu Mureș, Romania
2. Pediatric Clinic 1, Emergency County Hospital Târgu Mureș, Romania
3. Pediatric Nephrology Department, Emergency Clinical Hospital for Children Cluj-Napoca, Romania

DOI: 10.2478/amma-2019-0002

Urinary tract infection (UTI) represents one of the most frequent infections with bacterial etiology during childhood. In infants and toddlers with fever without source UTI’ investigation should be carried out, since signs and symptoms are nonspecific. However, obtaining uncontaminated urine samples from these patients can be challenging and time consuming; all current collection methods (clean-catch, plastic collection bag, catheterization, etc) have disadvantages. Criteria for UTI definition are represented by the presence of significant number of a single uropathogen, this number being different depending on the collection method: at least 1000 colony-forming unit (CFU/ml) for catheter samples and at least 100.000 CFU/ml from midstream clean-catch samples or 50.000 CFU/ml and significant pyuria in a symptomatic or febrile child. Accurate diagnosis of UTI is essential to avoid any antibiotic overuse and expensive investigations. UTI caused by resistant bacterial strains has an increasing prevalence in children. In pediatric population, extended spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) represent the etiology of around 15% of UTIs. Because of limited therapeutic options the reintroduction of some old antimicrobial agents is necessary, therefore Nitrofurantoin and Fosfomycin, can represent alternatives for oral treatment and prophylaxis of UTIs in children or in case of resistance suspicion to other drug classes. It is important to recognize patients at risk, such as children with recurrent UTIs, kidney abnormalities, like vesicoureteral reflux and previous antibiotherapy, in order to recommend adequate empiric treatment, especially against resistant bacteria.

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Bacteriological Study of Urinary Stones

Tudor Bianca1, Toma Felicia1, Boja R.2, Oşan V.2, Cigir Teodora3, Szavuj J.1, Man A.1

1 Discipline of Microbiology, University of Medicine and Pharmacy Tîrgu Mureş
2 Discipline of Urology, University of Medicine and Pharmacy Tîrgu Mureş
3 Laboratory, Mures County Clinical Emergency Hospital, Tîrgu Mureş

Background: Despite modern antibiotic therapy and technological advances in lithotripsy, the presence of infection in patients with urinary stones, as well as with infectious stones is still a significant cause of morbidity and mortality. Recent findings lend more theories as to how infection leads to stone formation.
Aim: The bacteriological study of urine and stone samples from patients with urinary tract infections (UTI) and the correlation of the bacteriological analysis results of stones and urine culture.
Method: We enrolled patients admitted to the urology department of Mures Emergency Hospital, from December 2008 to March 2009; all 50 patients who were diagnosed by the urologist as having urinary stones were included in this study. Bacteriological study was conducted on pre-operative urine and operated renal stones. Pre-operative urine sam¬ples were collected aseptically for macroscopic and micro¬scopic examination. Both pre-operative urine and operated renal stones were processed for bacteriological culture. The isolated microorganisms were identified by standard techniques.
Results: From the 50 patients included in this study, 20 had both infected stones and UTI. While correlating the results of bacteriologi¬cal analysis of stones and urine culture, the same microorganisms from urine culture and stone culture were isolated in 12 (60%) out of 20 cases, but different microorganisms in 8 (40%). The bacteriological study of urine and stone samples revealed that the most common pathogens were E.coli, Pseudomonas aeruginosa.
Conclusion: The incidence of infectious urinary stones in patients with UTI was higher than in the sterile ones. The preponderant identified microorganisms were E. coli, followed by Pseudomonas aeruginosa. In more than half of the cases, the same microorganisms were found both in UTI and within the urinary stones.

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Research Concerning the Correlations Between Urinary Tract Infections and Congenital Malformations of the Renourinary System

Moréh Zsuzsanna, Voicu Lucia Sanda

Department of Pediatry 2, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

DOI: 10.2478/amma-2013-0006

Introduction: Congenital malformations of the urinary system are risk factors for the development of urinary tract infections (UTI). Besides the severity of the malformation, urinary infection is always associated with poor prognosis for these patients. Late discovery of the malformation background, after several urinary tract infection episodes, contributes to the development of chronic pyelonephritis that may lead to chronic renal failure.
Material and method: The study involved patients with renal and urinary tract congenital malformations treated at the Pediatric Nephrology Department from Tîrgu Mureș over a period of 6 years, who associated urinary tract infection.
Results: Out of the total of 432 patients with congenital malformations of the urinary system, 270 had had at least one or several episode(s) of urinary tract infections in their medical history. Vesico-ureteral reflux and obstructive lesions of the urinary tract were most frequently associated with urinary infections. During the time when no ultrasound screening had been performed, the malformation background was usually diagnosed at the time of the first urinary infection episodes.
onclusions: The incidence of urinary tract infections in patients with renal and urinary tract congenital malformations depends on the type of the underlying malformation, and the time of diagnosis of the malformation background. Prevention of irreversible complications requires early diagnosis of the urinary system malformations that can be performed through ultrasound screening in the neonatal period.

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