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Urinary tract disorders
Published in Henry J. Woodford, Essential Geriatrics, 2022
Given the high rate of ASB, urine culture is also an unreliable way to diagnose UTI in older adults. A negative urine culture, taken prior to receiving antibiotics, can exclude UTI.10 Additionally, urine culture is helpful for obtaining sensitivities of organisms to guide treatment in patients diagnosed with UTI by other criteria, especially in older adults where atypical organisms are common. Empiric therapy can be commenced pending culture results. In people with an indwelling catheter, a change of catheter prior to treatment has been found to result in more rapid symptom resolution and lower rates of treatment failure.41 This is also an opportunity to obtain a sample of urine from within the bladder, which may be a more reliable guide than a catheter bag specimen, to determine antibiotic sensitivities. A catheter change is probably not necessary if it was just inserted within the last week.
Inflammation and Infection
Published in Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple, Basic Urological Sciences, 2021
Judith Hall, Christopher K. Harding
Segmented urine culture:Aims to localise bacteria to the specific area of the urinary tract.Not universally undertaken since low diagnostic yield may be due to preceding antibiotic treatment.Alternative is the 2-glass test (Nickel):Pre- and post-prostate massage urine samples.Positive post-prostate massage urine indicates CP/CPPS.
Urinary tract infections in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
To speed up diagnosis and treatment while awaiting the urine culture results, microscopic examination of uncentrifuged urine can be performed. One bacterium per high power field indicates a bacterial concentration of at least 105/mL. One or more white blood cells per high power field will also usually be seen in pyelonephritis. Although indicative of a UTI, none of these findings are specific for pyelonephritis. If the diagnosis of pyelonephritis is suspected, blood cultures may also be obtained before antibiotic treatment is begun. However, the additional cost of blood cultures may not be substantiated by clinical benefit, as the blood culture results of the patients with pyelonephritis who develop bacteremia usually parallel the urine culture results; MacMillan and Grimes changed antibiotic treatment based on blood cultures in only 2% of pregnant patients with pyelonephritis (54).
Does snake envenoming cause chronic kidney disease? A cohort study in rural Sri Lanka
Published in Clinical Toxicology, 2023
Subodha Waiddyanatha, Anjana Silva, Kosala Weerakoon, Sisira Siribaddana, Geoffrey K. Isbister
During the review visit, a serum creatinine, microalbuminuria, and a urine report that includes physical properties (colour, appearance, specific gravity), biochemical analysis (pH, protein, glucose, ketone bodies, bilirubin, urobilinogen), and centrifuged deposits (white cells, red cells, epithelial cells, casts, and crystals) were undertaken on blood and urine collected. Any abnormal urine reports were repeated with urine culture within two weeks. For both the acute stage and the review, the eGFR was calculated using the CKD Epidemiology Collaboration (CKD-EPI) creatinine 2021 equation [34]. eGFR <60mL/min/1.73m2 and/or urinary albumin/creatinine ratio ≥30 ug/L/mg/L were considered abnormal [30]. Elevated serum creatinine and/or abnormal microalbuminuria were repeated after three months.
Revisiting approaches to and considerations for urinalysis and urine culture reflexive testing
Published in Critical Reviews in Clinical Laboratory Sciences, 2022
Allison B. Chambliss, Tam T. Van
Urinalysis (UA) is considered the world’s oldest laboratory test. As far back as 4000 BC, Sumerian and Babylonian physicians recorded their assessment of urine on clay tablets [1]. Today, UA represents an invaluable tool in the diagnosis and monitoring of many conditions, including kidney disorders, diabetes mellitus, liver disease, malignancy, and urinary tract infections [2]. Modern UA consists of several components that may or may not be performed simultaneously or on all urine samples. These components include macroscopic evaluation (e.g. color, clarity), physical evaluation (e.g. specific gravity, volume for timed collections), chemical or dipstick testing (e.g. ketones, protein, glucose, blood, bilirubin, pH, urobilinogen, leukocyte esterase, nitrite), and microscopic assessment (e.g. red blood cells [RBC], white blood cells [WBC], bacteria, yeast, casts, crystals). A urine culture may also be performed to evaluate urinary tract infection (UTI). Thus, UA is multidisciplinary due to the various methodologies that are employed and the various environments in which testing takes place (core laboratories, microbiology laboratories, and/or as the point of care testing).
Efficiency of topical rifampin on infection in open neural tube defects: a randomized controlled trial
Published in International Journal of Neuroscience, 2021
Ibrahim Deger, Murat Başaranoğlu, Nihat Demir, Abdurrahman Aycan, Oğuz Tuncer
Urinary tract infection is a common problem of patients with neurogenic bladder operated for myelomeningocele using clean intermittent catheters and bacterial colonization is observed in the urinary tract of most patients, often with growth in urinalysis and urine culture (31). Patients with symptoms of UTI should be evaluated and treated based on urine culture. One study has shown urinary sepsis to be the second most common cause of death after meningocele operations (5). Another study revealed that the most common cause of mortality in patients with spina bifida was urinary tract disorders at 17.3%, with UTI having the highest rate of 33.4% among these (33). Here, the rate of UTI in the control group was 16.7%, but it was not detected in the case group. A remarkable finding was that none of the patients who were given rifampin had urinary tract infections. We believe this is associated with Rifampin, which may have reduced UTI by accelerating wound healing.