Urinary tract infections (UTIs) caused by uropathogens are a significant public health problem, and their treatment primarily relies on antibiotic therapy. However, the increasing global development of antibiotic resi...Urinary tract infections (UTIs) caused by uropathogens are a significant public health problem, and their treatment primarily relies on antibiotic therapy. However, the increasing global development of antibiotic resistance necessitates updating diagnostic techniques to ensure higher sensitivity and specificity, especially with advancements in science and medicine. This study aimed to evaluate the prevalence of UTIs and antibiotic resistance profiles through urine culture, as well as to identify Klebsiella pneumoniae, Klebsiella oxytoca, and Acinetobacter spp. in urine samples using a molecular approach with multiplex real-time PCR. From May 3 to July 25, 2023, at the Pietro Annigoni Biomolecular Research Center (CERBA) and Saint Camille Hospital of Ouagadougou (HOSCO), 209 urine samples collected from patients with suspected UTIs were analyzed using both urine culture and multiplex real-time PCR. Among the 209 patients, 52.15% were male and 47.85% female, with an average age of 46.87 ± 21.33 years. Urine cultures revealed an overall UTI prevalence of 23.44%, with a prevalence of 8.13% in men versus 15.31% in women (P = 0.023). The bacterial prevalence rates were as follows: Escherichia coli (12.92%), Klebsiella spp. (7.18%), Enterobacter cloacae (1.44%), Staphylococcus aureus (0.96%), and other bacteria. Klebsiella spp. demonstrated 100% resistance to Amoxicillin and Amoxicillin/Clavulanic Acid, while Escherichia coli showed 96.2% and 65.4% resistance to Amoxicillin and Amoxicillin/Clavulanic Acid, respectively. PCR analysis of the target bacteria revealed mono-infection prevalence rates of Klebsiella pneumoniae (10.39%), Klebsiella oxytoca (7.79%), and Acinetobacter spp. (7.79%), along with a co-infection prevalence rate of Klebsiella pneumoniae/Acinetobacter spp. (1.30%). This study demonstrated that PCR, with its high sensitivity and specificity, could effectively distinguish Klebsiella pneumoniae from Klebsiella oxytoca and detect Acinetobacter spp. in less than 24 hours—something urine culture alone could not achieve. The relative ease of automating urine PCR testing, combined with its diagnostic accuracy and rapid turnaround time, makes it a valuable addition to modern medical practice for the laboratory diagnosis of UTIs.展开更多
Background:Urological guidelines assert that"urine culture should be obtained"before surgical management of ureteral or kidney stones.Thus,many surgeries are delayed by 1-3 days until the results of urine cu...Background:Urological guidelines assert that"urine culture should be obtained"before surgical management of ureteral or kidney stones.Thus,many surgeries are delayed by 1-3 days until the results of urine culture are available.During this time,the patient frequently experience pain and possible kidney damage.We investigated the hypothesis that it is possible to predict the results of urine culture in candidates for surgical intervention using parameters that are accessible immediately upon admission.Materials and methods:A database of 1000 patients who underwent either percutaneous nephrolithotomy(PCNL)or ureteroscopy/retrograde intrarenal surgery was analyzed.Eleven parameters potentially related to urinary infections and accessible to the clinician at the emergency department were correlated with the preoperative urine culture results.Results:Of the patients,234(23.4%)had positive cultures.On multivariate analysis,only sex,hydronephrosis grade,and history of previous nephrolithotomy were significantly associated with a positive preoperative urine culture.The risk of a positive culture can be easily determined from a simple table or an Excel-based calculator.This risk could be as low as 0.45%for a man without a history of PCNL and no hydronephrosis(4%in a woman with similar parameters)or as high as 79.5%in a man with a history of PCNL and hydronephrosis(85%in a woman with similar parameters).Conclusions:The risk of preoperative positive urine culture can be predicted using 3 parameters that are accessible upon admission.In low-risk cases,prompt surgical treatment can be provided,eliminating the anticipation time for urine culture results.展开更多
文摘Urinary tract infections (UTIs) caused by uropathogens are a significant public health problem, and their treatment primarily relies on antibiotic therapy. However, the increasing global development of antibiotic resistance necessitates updating diagnostic techniques to ensure higher sensitivity and specificity, especially with advancements in science and medicine. This study aimed to evaluate the prevalence of UTIs and antibiotic resistance profiles through urine culture, as well as to identify Klebsiella pneumoniae, Klebsiella oxytoca, and Acinetobacter spp. in urine samples using a molecular approach with multiplex real-time PCR. From May 3 to July 25, 2023, at the Pietro Annigoni Biomolecular Research Center (CERBA) and Saint Camille Hospital of Ouagadougou (HOSCO), 209 urine samples collected from patients with suspected UTIs were analyzed using both urine culture and multiplex real-time PCR. Among the 209 patients, 52.15% were male and 47.85% female, with an average age of 46.87 ± 21.33 years. Urine cultures revealed an overall UTI prevalence of 23.44%, with a prevalence of 8.13% in men versus 15.31% in women (P = 0.023). The bacterial prevalence rates were as follows: Escherichia coli (12.92%), Klebsiella spp. (7.18%), Enterobacter cloacae (1.44%), Staphylococcus aureus (0.96%), and other bacteria. Klebsiella spp. demonstrated 100% resistance to Amoxicillin and Amoxicillin/Clavulanic Acid, while Escherichia coli showed 96.2% and 65.4% resistance to Amoxicillin and Amoxicillin/Clavulanic Acid, respectively. PCR analysis of the target bacteria revealed mono-infection prevalence rates of Klebsiella pneumoniae (10.39%), Klebsiella oxytoca (7.79%), and Acinetobacter spp. (7.79%), along with a co-infection prevalence rate of Klebsiella pneumoniae/Acinetobacter spp. (1.30%). This study demonstrated that PCR, with its high sensitivity and specificity, could effectively distinguish Klebsiella pneumoniae from Klebsiella oxytoca and detect Acinetobacter spp. in less than 24 hours—something urine culture alone could not achieve. The relative ease of automating urine PCR testing, combined with its diagnostic accuracy and rapid turnaround time, makes it a valuable addition to modern medical practice for the laboratory diagnosis of UTIs.
文摘Background:Urological guidelines assert that"urine culture should be obtained"before surgical management of ureteral or kidney stones.Thus,many surgeries are delayed by 1-3 days until the results of urine culture are available.During this time,the patient frequently experience pain and possible kidney damage.We investigated the hypothesis that it is possible to predict the results of urine culture in candidates for surgical intervention using parameters that are accessible immediately upon admission.Materials and methods:A database of 1000 patients who underwent either percutaneous nephrolithotomy(PCNL)or ureteroscopy/retrograde intrarenal surgery was analyzed.Eleven parameters potentially related to urinary infections and accessible to the clinician at the emergency department were correlated with the preoperative urine culture results.Results:Of the patients,234(23.4%)had positive cultures.On multivariate analysis,only sex,hydronephrosis grade,and history of previous nephrolithotomy were significantly associated with a positive preoperative urine culture.The risk of a positive culture can be easily determined from a simple table or an Excel-based calculator.This risk could be as low as 0.45%for a man without a history of PCNL and no hydronephrosis(4%in a woman with similar parameters)or as high as 79.5%in a man with a history of PCNL and hydronephrosis(85%in a woman with similar parameters).Conclusions:The risk of preoperative positive urine culture can be predicted using 3 parameters that are accessible upon admission.In low-risk cases,prompt surgical treatment can be provided,eliminating the anticipation time for urine culture results.
