Urinary Tract Infection Research Today is a free monthly online journal that collates and summarizes the latest research about Urinary Tract Infection, including details on uti, causes, prevention, diet, treatment.

Bacteriuria in patients with an orthotopic ileal neobladder: urinary tract infection or asymptomatic bacteriuria?

Suriano F, Gallucci M, Flammia GP, Musco S, Alcini A, Imbalzano G, Dicuonzo G

Department of Urology, Campus Bio-Medico, Rome, Italy. fracbm@yahoo.it

OBJECTIVE: To investigate the prevalence of asymptomatic bacteriuria (ABU) and urinary tract infection (UTI), and the local and systemic inflammatory response, in patients with ileal neobladder. PATIENTS AND METHODS: The study included 40 patients who had a radical cystectomy and ileal neobladder. Two urine samples, one for chemical and physical analysis, and cytofluorimetry, and one for urine culture, were collected every 3 months for 9 months after surgery. RESULTS: Of 119 urine cultures, 69 (57%) were positive for bacteria. Only nine of the 40 patients had no bacteriuria on urine culture. Escherichia coli strains were cultured from eight of 10 patients with persistently positive urine. The incidence of bacteriuria was different according to gender. There was a high concentration of leukocytes (0-6 microL) in 118 of 119 samples. The mean concentration of leukocytes in sterile urine culture was 1181/microL, while in patients with ABU the mean was 491 (P < 0.05). CONCLUSION: A positive urine culture is a very common finding in patients with an orthotopic bladder. The most interesting results was the absence of elevated inflammatory indices and/or symptoms, even in those patients with high levels of bacteriuria. Probably this is due to the completely different inflammatory response of ileal mucosa against bacteria than has bladder mucosa. Indeed, the leukocyte concentration detected in urinary sediment was inversely association with bacterial growth in urine cultures. These findings suggest a redefinition of ABU and UTI in patients with an orthotopic neobladder.

Published 20 May 2008 in BJU Int, 101(12): 1576-9.
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Articles on Urinary Tract Infection published 12 May 2008:

Incidence of urinary tract infections in children after successful ureteral reimplantation versus endoscopic dextranomer/hyaluronic acid implantation.   J Urol, 179(6): 2364-7; discussion 2367-8.

PURPOSE: Endoscopic implantation of dextranomer/hyaluronic acid has proved to be an effective minimally invasive technique for correcting vesicoureteral reflux in children. There is some evidence suggesting that in addition to being less invasive, successful dextranomer/hyaluronic acid implantation compared to successful antireflux surgery is associated with fewer febrile and nonfebrile urinary tract infections. We review the clinical outcomes of 2 groups of children cured of reflux with open ... [Abstract] [Full-text]

Articles on Urinary Tract Infection published 5 May 2008:

Residual urine as a risk factor for lower urinary tract infection: a 1-year follow-up study in nursing homes.   J Am Geriatr Soc, 56(5): 871-4.

OBJECTIVES: To determine whether postvoid urine is a risk factor for the development of lower urinary tract infections (UTIs) in nursing home residents. DESIGN: Prospective surveillance with a follow-up period of 1 year. SETTING: Six Norwegian nursing homes. PARTICIPANTS: One hundred fifty nursing home residents. METHODS: Postvoid residual (PVR) urine volumes were measured using a portable ultrasound. UTIs were registered prospectively for 1 year. RESULTS: Ninety-eight residents (65.3%) had a ... [Abstract] [Full-text]

Articles on Urinary Tract Infection published 30 April 2008:

Intervening with urinary tract infections using anti-adhesives based on the crystal structure of the FimH-oligomannose-3 complex.   PLoS ONE, 3(4): e2040.

BACKGROUND: Escherichia coli strains adhere to the normally sterile human uroepithelium using type 1 pili, that are long, hairy surface organelles exposing a mannose-binding FimH adhesin at the tip. A small percentage of adhered bacteria can successfully invade bladder cells, presumably via pathways mediated by the high-mannosylated uroplakin-Ia and alpha3beta1 integrins found throughout the uroepithelium. Invaded bacteria replicate and mature into dense, biofilm-like inclusions in preparation ... [Abstract] [Full-text]

Articles on Urinary Tract Infection published 29 April 2008:

Vesicoureteral reflux.   J Am Soc Nephrol, 19(5): 847-62.

Vesicoureteral reflux (VUR), the retrograde flow of urine from the bladder toward the kidney, is common in young children. About 30% of children with urinary tract infections will be diagnosed with VUR after a voiding cystourethrogram. For most, VUR will resolve spontaneously; 20% to 30% will have further infections, but few will experience long-term renal sequelae. Developmentally, VUR arises from disruption of complex signaling pathways and cellular differentiation. These mechanisms are ... [Abstract] [Full-text]

Articles on Urinary Tract Infection published 22 April 2008:

Sexual intercourse and risk of symptomatic urinary tract infection in post-menopausal women.   J Gen Intern Med, 23(5): 595-9.

BACKGROUND: Sexual intercourse increases the risk of symptomatic urinary tract infections (UTI) in young women, but its role among post-menopausal women is unclear. OBJECTIVE: To determine whether recent sexual intercourse, as documented by daily diaries, is associated with an increased risk of symptomatic UTI in post-menopausal women. DESIGN: A 2-year prospective cohort study conducted from 1998 to 2002. PARTICIPANTS: One thousand and seventeen randomly selected post-menopausal women enrolled ... [Abstract] [Full-text]

Articles on Urinary Tract Infection published 14 April 2008:

Urinary tract infection following successful dextranomer/hyaluronic acid injection for vesicoureteral reflux.   J Urol, 179(5): 1966-9.

PURPOSE: The incidence of symptomatic urinary tract infection following reflux resolution by endoscopic injection is unclear. We determined the occurrence of febrile and nonfebrile urinary tract infections, and factors relating to development of infection after reflux correction with dextranomer/hyaluronic acid injection. MATERIALS AND METHODS: We identified 175 patients with more than 6 months of followup after successful dextranomer/hyaluronic acid injection by one of us (WS) to resolve ... [Abstract] [Full-text]

Articles on Urinary Tract Infection published 4 April 2008:

Rapid antimicrobial susceptibility determination of uropathogens in clinical urine specimens by use of ATP bioluminescence.   J Clin Microbiol, 46(4): 1213-9.

We describe the first direct testing of the antimicrobial susceptibilities of bacterial pathogens in human clinical fluid samples by the use of ATP bioluminescence. We developed an ATP bioluminescence assay that eliminates somatic sources of ATP to selectively quantify the bacterial load in clinical urine specimens with a sensitivity of <1,000 CFU per milliliter. There was a log-log relationship between light emission and the numbers of CFU in clinical urine specimens. A clinical study was ... [Abstract] [Full-text]

Articles on Urinary Tract Infection published 1 April 2008:

Discordance between perception and treatment practices associated with intensive care unit-acquired bacteriuria and funguria: a Canadian physician survey.   Crit Care Med, 36(4): 1158-67.

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