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Postpartum infections
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Treatment for urinary tract infection is similar to that for the nonpregnant woman. High rates of cure are achieved even with a short (3 days) course of therapy (113). The causative organism is E. coli in 80% to 90% of infections, but may be another coliform or staphylococcal or enterococcal species (3,113). Culture and susceptibility testing may guide therapy, especially in patients who have recently received antibiotics. Suprapubic aspiration from a full bladder or urethral catheterization may be necessary to obtain samples of urine, as clean-catch midstream collections are frequently (46–69%) contaminated (113).
Urinary tract infections
Published in Prem Puri, Newborn Surgery, 2017
In neonates less than 3 months old, a catheterized urinalysis or suprapubic bladder aspiration is part of the standard workup for fever. Suprapubic aspiration, although not usually necessary, is considered the gold standard method for obtaining urine. It is performed after cleaning the suprapubic area with antiseptic solution. A 21- to 25-gauge needle is inserted one fingerbreadth above the symphysis pubis perpendicularly while aspirating until urine is obtained. Although suprapubic aspiration is popular in some EDs, it is invasive and has variable success rates for obtaining urine because of the lack of urine in the bladder. Physical examination to palpate for a full bladder is sometimes limited if the child is very upset. US, if available, may be useful to check bladder fullness before aspiration. For males with phimosis or stricture, and for girls with severe labial adhesions, suprapubic aspiration may be the only method for obtaining clean urine.24 Although the probability of a true infection with a positive culture obtained via suprapubic aspiration is approximately 99%, this method is the most technically challenging and is associated with the lowest rate of success (23%–99%).4
Complications related to neurogenic bladder dysfunction I: Infection, lithiasis, and neoplasia
Published in Jacques Corcos, David Ginsberg, Gilles Karsenty, Textbook of the Neurogenic Bladder, 2015
Suprapubic aspiration of the bladder is the standard for diagnosing UTI, though it is not often used clinically. In SCI patients with indwelling catheter (urethral or suprapubic), the urine specimen should be obtained from a new freshly inserted catheter and not from the old catheter. In both sexes, the external urethral meatus must be exposed and cleaned by antiseptic solution. The first 50 mL urine is passed without collection. Afterward, approximately 50 mL midstream urine is collected in a sterile container. The urine should be cultured as soon as possible or kept refrigerated and cultured within 24 hours.7 To obtain a urine specimen from a patient with neurogenic bladder dysfunction (NBD), external stimulation (usually suprapubic percussion) can be used. If this is impossible, urine should be obtained by a single catheterization.
Catheter-obtained, Enterococcus and Proteus positive urine cultures may represent mostly contamination or asymptomatic bacteriuria in infants <90 days
Published in Infectious Diseases, 2021
Dvir Gatt, Idan Lendner, Shalom Ben-Shimol
According to the American Academy of Pediatrics Clinical Practice Guidelines for the diagnosis and management of UTI in febrile infants and young children, 2–24 months old [14], the diagnosis of UTI is made by the presence of an abnormal urine dipstick/microscopy with positive urine culture that had been obtained through suprapubic aspiration (SPA) or catheter. However, there are no acceptable guidelines for infants under 2 months of age. Notably, in young infants, in contrast to older children, urine samples are routinely cultured even if the urine dipstick is negative for leukocytes or nitrites. Thus, in young infants, while positive urine culture may indicate true UTI, it may also indicate contamination or asymptomatic bacteriuria, especially in negative dipstick and non-febrile episodes. Indeed, recently, there have been some attempts to examine the applicability of the American Academy of Pediatrics UTI Guidelines in neonates, with data supporting incorporation of pyuria as a diagnostic criteria for UTI in infants <2 months old [15].
Evaluation of the sysmex UF-5000 fluorescence flow cytometer as a screening platform for ruling out urinary tract infections in elderly patients presenting at the Emergency Department
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2021
Lasse Krogh Alenkaer, Lise Pedersen, Pal Bela Szecsi, Poul Jannik Bjerrum
The urine samples originated from 449 (40%) males and 621 (56%) females, and and a total of 49 (4%) children were below the age of 15 years. The mean age and standard deviation (SD) of the patients were 68 (22) years. All 1119 urine specimens (All Patient group) were evaluated by UF-5000, urine dipstick and urine culture. Some 790 of the obtained urine samples were mid-stream urine and 329 were obtained from catheters. Nephrostomy and suprapubic aspiration samples were not included. The average time from specimen collection to analysis on the UF-5000 was 5.2 h. The culture results are presented in Supplementary Table 1. The distribution of the bacterial (BACT) and leucocyte (WBC) counts by the UF-5000 to the colony count defined is presented in Figure 2.
Pharmacotherapeutic management of lower urinary tract symptoms in Multiple Sclerosis patients
Published in Expert Opinion on Pharmacotherapy, 2020
Aurora Zanghì, Sebastiano Cimino, Daniele Urzì, Salvatore Privitera, Francesco Zagari, Giuseppe Lanza, Francesco Patti, Emanuele D’Amico
Indeed, the gold standard for UTI diagnosis is urine culture. Urine specimens may be collected either as a clean-catch midstream sample, from an indwelling urethral catheter or a suprapubic aspiration from a suprapubic catheter [20].