Microbiology
Thomas Locke, Sally Keat, Andrew Walker, Rory Mackinnon in Microbiology and Infectious Diseases on the Move, 2013
For each of the following questions, please choose the single most likely bacterium responsible for the presenting conditions. Each option may be used once, more than once or not at all. 1) Chlamydia trachomatis 2) Neisseria gonorrhoeae 3) Neisseria meningitidis 4) Staphylococcus aureus 5) Staphylococcus epidermidis 6) Staphylococcus saprophyticus 7) Streptococcus agalactiae 8) Streptococcus pneumoniae 9) Streptococcus pyogenes 10) Viridans group streptococci Question 1 A 7-year-old girl presents to the Accident and Emergency Department with facial swelling, worse around the eyes. A urine sample on admission appears dark and frothy. The patient was treated with oral antibiotics from her GP for a sore throat 2 weeks prior to the onset of the current illness.
Clinical aspects of antimicrobial prophylaxis for invasive urological procedures
Published in Journal of Chemotherapy, 2014
The essential value of antimicrobial prophylaxis is to defend the patient undergoing invasive diagnostic procedures or surgery against infectious complications by reducing the bacterial load. Escherichia coli remains the predominant uropathogen (70–80%) isolated in acute community-acquired uncomplicated infections, followed by Staphylococcus saprophyticus (10 to 15%). Klebsiella, Enterobacter, Proteus species, and enterococci infrequently cause uncomplicated cystitis and pyelonephritis. The pathogens traditionally associated with UTI are altering many of their features, particularly because of antimicrobial resistance. Currently, only transurethral resection of prostate and prostate biopsy has been well studied and has high and moderately high levels of evidence in favor of using antibiotic prophylaxis. Other urological interventions have not been well studied. The moderate to low evidence suggests that there is no need for antibiotic prophylaxis in cystoscopy, urodynamic investigations, and extracorporeal shock-wave lithotripsy, whereas the low evidence favors the use of antibiotic prophylaxis for therapeutic ureterorenoscopy and percutaneous nephrolithotomy. The scarce data from studies on transurethral resection of bladder tumors cannot provide a definitive indication for antibiotic prophylaxis for this intervention.
Nalidixic Acid and Pivmecillinam for Treatment of Acute Lower Urinary Tract Infections
Published in Scandinavian Journal of Primary Health Care, 1985
Birgitta Hovelius, Per-Anders Mårdh, Lars Nygaard-Pedersen, Bjarne Wathne
Women, 15-45 years of age, with symptoms of lower urinary tract infection (UTI) were randomly treated with nalidixic acid (1 gx3) or pivmecillinam (200-400 mgx3) for three or seven days, respectively. Therapeutic failure, relapse, or reinfection occurred among 18% of 82 women, even though the isolated strains of gram-negative rods in these patients were susceptible in vitro to the antibiotics used. Therapeutic failure, i.e. no effect or at best only a minor effect on the symptoms, was registered in 10 of 13 cases of UTI caused by Staphylococcus saprophyticus and treated with nalidixic acid, which was consistent with the high minimum inhibitory concentrations (MIC) (128-512 μg/ml) of this antibiotic. S. saprophyticus was isolated in 9 of 12 patients during treatment with nalidixic acid. On the other hand, pivmecillinam therapy was clinically effective in 16 of 18 patients with UTI caused by S. saprophyticus, even though the MIC of mecillinam to these strains was considerably higher (8-64 μg/ml) than that vis-à-vis gram-negative rods. Thus the clinical effect of pivmecillinam was significantly better than that of nalidixic acid in cases of UTI caused by S. saprophyticus. The organism was not isolated from 14 patients receiving pivmecillinam therapy.
Symptomatic urinary tract infection in women in primary health care: Bacteriological, clinical and diagnostic aspects in relation to host response to infection
Published in Scandinavian Journal of Primary Health Care, 1996
Birgit Jellheden, Ragnar S. Norrby, Torsten Sandberg
Objective — To evaluate rapid diagnostic tests for bacteriuria in women with symptoms of urinary tract infection (UTI), and to analyse bacteriological and clinical findings in relation to host response to infection. Design — Prospective study of symptomatic UTI in women. Setting — Primary health care centres. Patients — 819 women with signs and symptoms suggestive of UTI. Main outcome measures — History of UTI and clinical findings were recorded. After randomization but before antibiotic treatment, urine specimens were analysed for pyuria by sediment microscopy and for nitrite using a test strip, and cultures were performed. The systemic inflammatory response was assessed by C-reactive protein (CRP), erythrocyte sedimentation rate, and total white blood cell count. Results — The combined use of tests for pyuria and nitrite resulted in a high sensitivity (0.93) and efficacy (0.85) when the prevalence of bacteriuria was 0.89. Escherichia coli and Staphylococcus saprophyticus accounted for 93% of the urinary isolates. Significantly more patients infected with S. saprophyticus than E. coli complained of dysuria (p
Related Knowledge Centers
- Gastrointestinal Tract
- Urinary Tract Infection
- Perineum
- Urethra
- Staphylococcus
- Staphylococcaceae
- Female Genital Tract