From Detection to Treatment: Navigating Urinary Tract Infections with Antibiotics

A special issue of Antibiotics (ISSN 2079-6382).

Deadline for manuscript submissions: 30 September 2024 | Viewed by 3308

Special Issue Editor


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Guest Editor
Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
Interests: fluorescence; rapid AST (antibiotic susceptibility testing); microbiology diagnostic; FCS (fluorescence correlation spectroscopy); biophysics; fast bacteriuria screening
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Special Issue Information

Dear Colleagues,

Urinary tract infections (UTIs) are a common and uncomfortable condition that affects millions of people worldwide. UTIs can range from mild discomfort to severe complications if left untreated. Antibiotics play a crucial role in the detection and treatment of UTIs, providing relief and preventing further complications.

A urinary tract infection occurs when bacteria enter the urinary system and multiply, leading to infection. Common symptoms include a strong, persistent urge to urinate, a burning sensation during urination, cloudy or bloody urine, and pelvic pain. It is essential to recognize these signs and seek medical attention promptly to prevent the infection from spreading to the kidneys or other parts of the body.

To diagnose a UTI, healthcare providers typically perform a physical examination and request a urine sample for analysis. This analysis involves a urine culture and sensitivity test, which identifies the type of bacteria causing the infection and determines the most effective antibiotic treatment. Prompt and accurate detection is crucial in initiating timely treatment and preventing complications.

The selection of an appropriate antibiotic for UTI treatment is based on several factors, including the type of bacteria identified, its susceptibility to different antibiotics, the patient's medical history, and any potential allergies. UTI treatment with antibiotics typically lasts from three to seven days, depending on the severity of the infection and the prescribed medication. It is crucial to complete the entire course of antibiotics, even if symptoms improve before completion. Skipping doses or stopping medication prematurely can lead to antibiotic resistance and recurrent infections.

While antibiotics are highly effective in treating UTIs, they can have side effects. In rare cases, individuals may develop antibiotic-resistant strains of bacteria. Responsible antibiotic use is essential to minimize the risk of antibiotic resistance.

Improving knowledge surrounding detection and treatment will help to increase patient well-being.

The present Special Issue is focused both on problems and new solutions related to diagnostics, exploring both clinical and pharmaceutical approaches related to UTI treatment.

Dr. Eleonora Nicolai
Guest Editor

Manuscript Submission Information

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Published Papers (2 papers)

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Research

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14 pages, 1454 KiB  
Article
Acidic Urine pH and Clinical Outcome of Lower Urinary Tract Infection in Kidney Transplant Recipients Treated with Ciprofloxacin and Fosfomycin
by Soraya Herrera-Espejo, Sara Fontserè, Carmen Infante, Alejandro Suárez-Benjumea, Marta Carretero-Ledesma, Marta Suñer-Poblet, Carmen González-Corvillo, Gabriel Bernal, Guillermo Martín-Gutiérrez, Juan Antonio Pérez-Cáceres, Jerónimo Pachón, María Eugenia Pachón-Ibáñez and Elisa Cordero
Antibiotics 2024, 13(2), 116; https://doi.org/10.3390/antibiotics13020116 - 24 Jan 2024
Viewed by 1190
Abstract
Different factors, including antimicrobial resistance, may diminish the effectiveness of antibiotic therapy, challenging the management of post-transplant urinary tract infection (UTI). The association of acidic urine pH with microbiological and clinical outcomes was evaluated after fosfomycin or ciprofloxacin therapy in 184 kidney transplant [...] Read more.
Different factors, including antimicrobial resistance, may diminish the effectiveness of antibiotic therapy, challenging the management of post-transplant urinary tract infection (UTI). The association of acidic urine pH with microbiological and clinical outcomes was evaluated after fosfomycin or ciprofloxacin therapy in 184 kidney transplant recipients (KTRs) with UTI episodes by Escherichia coli (N = 115) and Klebsiella pneumoniae (N = 69). Initial urine pH, antimicrobial therapy, and clinical and microbiological outcomes, and one- and six-month follow-up were assessed. Fosfomycin was prescribed in 88 (76.5%) E. coli and 46 (66.7%) K. pneumoniae UTI episodes in the total cohort. When the urine pH ≤ 6, fosfomycin was prescribed in 60 (52.2%) E. coli and 29 (42.0%) K. pneumoniae. Initial urine pH ≤ 6 in E. coli UTI was associated with symptomatic episodes (8/60 vs. 0/55, p = 0.04) at one-month follow-up, with a similar trend in those patients receiving fosfomycin (7/47 vs. 0/41, p = 0.09). Acidic urine pH was not associated with microbiological or clinical cure in K. pneumoniae UTI. At pH 5, the ciprofloxacin MIC90 increased from 8 to >8 mg/L in E. coli and from 4 to >8 mg/L in K. pneumoniae. At pH 5, the fosfomycin MIC90 decreased from 8 to 4 mg/L in E. coli and from 512 to 128 mg/L in K. pneumoniae. Acidic urine is not associated with the microbiological efficacy of fosfomycin and ciprofloxacin in KTRs with UTI, but it is associated with symptomatic UTI episodes at one-month follow-up in E. coli episodes. Full article
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Review

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17 pages, 1445 KiB  
Review
Novel Antimicrobial Approaches to Combat Bacterial Biofilms Associated with Urinary Tract Infections
by Giuseppe Mancuso, Marilena Trinchera, Angelina Midiri, Sebastiana Zummo, Giulia Vitale and Carmelo Biondo
Antibiotics 2024, 13(2), 154; https://doi.org/10.3390/antibiotics13020154 - 04 Feb 2024
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Abstract
Urinary tract infections (UTIs) are prevalent bacterial infections in both community and healthcare settings. They account for approximately 40% of all bacterial infections and require around 15% of all antibiotic prescriptions. Although antibiotics have traditionally been used to treat UTIs for several decades, [...] Read more.
Urinary tract infections (UTIs) are prevalent bacterial infections in both community and healthcare settings. They account for approximately 40% of all bacterial infections and require around 15% of all antibiotic prescriptions. Although antibiotics have traditionally been used to treat UTIs for several decades, the significant increase in antibiotic resistance in recent years has made many previously effective treatments ineffective. Biofilm on medical equipment in healthcare settings creates a reservoir of pathogens that can easily be transmitted to patients. Urinary catheter infections are frequently observed in hospitals and are caused by microbes that form a biofilm after a catheter is inserted into the bladder. Managing infections caused by biofilms is challenging due to the emergence of antibiotic resistance. Biofilms enable pathogens to evade the host’s innate immune defences, resulting in long-term persistence. The incidence of sepsis caused by UTIs that have spread to the bloodstream is increasing, and drug-resistant infections may be even more prevalent. While the availability of upcoming tests to identify the bacterial cause of infection and its resistance spectrum is critical, it alone will not solve the problem; innovative treatment approaches are also needed. This review analyses the main characteristics of biofilm formation and drug resistance in recurrent uropathogen-induced UTIs. The importance of innovative and alternative therapies for combatting biofilm-caused UTI is emphasised. Full article
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