Urinary Tract Infection: Diagnosis, Treatment and Management

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Diagnostic Microbiology and Infectious Disease".

Deadline for manuscript submissions: closed (31 July 2021) | Viewed by 72741

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Guest Editor
University North, University Centre Varazdin, Varazdin, Croatia; Clinical Microbiology and Parasitology Unit, Dr. Zora Profozic Polyclinic, Zagreb, Croatia
Interests: community and hospital acquired urinary tract infections; surveillance of urinary tract infections; antimicrobial resistance of uropathogens; human microbiome; epidemiology; public health
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Dear Colleagues,

Urinary tract infections (UTIs) represent one of the most common clinical entities in both community and health care settings; however, there is still a clear lack of practical clinical research to inform long-awaited clinical advances for improving UTI management strategies. Uncomplicated UTIs are usually self-limiting and generally considered benign, but untreated infections may progress to the upper urinary tract, resulting in pyelonephritis and kidney damage. The problem is additionally compounded by an increase of multiresistant uropathogens around the globe, which threatens our medical advances and has the potential to render our standard antibiotic treatment regimens ineffective.

As a result, swift and appropriate diagnosis is indispensable for timely treatment and UTI management. This Special Issue in the journal "Diagnostics" will focus on articles covering a range of topics including novel diagnostic approaches, the appropriateness of urine specimen collection, utilizing our available diagnostic armamentarium for surveillance, antimicrobial sensitivity/resistance patterns, as well as novel treatment and management approaches. Recently, there has also been a focus on the prevention of UTIs in hospitals and the community.

It is, therefore, my pleasure to invite submissions of high quality research-based or review papers related to the aforementioned topics to create a timely and highly relevant collection of articles tackling this pertinent medical problem.

Dr. Tomislav Mestrovic
Guest Editor

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Keywords

  • diagnostics of UTI
  • surveillance of UTI
  • antibiotic resistance in uropathogens
  • antimicrobial treatment of UTI
  • antibiotic stewardship principles for UTI
  • non-antimicrobial management of UTI
  • prevention of UTI.

Published Papers (3 papers)

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Research

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12 pages, 1051 KiB  
Article
Spectrum of Causative Pathogens and Resistance Rates to Antibacterial Agents in Bacterial Prostatitis
by Alberto Trinchieri, Khalid Mohammed Abdelrahman, Kamran Hassan Bhatti, Jibril O. Bello, Krishanu Das, Ognyan Gatsev, Ivanka Gergova, Vittorio Magri, Nikos Mourmouras, Panagiotis Mourmouris, Soni Murdeshwar, Gianpaolo Perletti, Iliya Saltirov, Idrissa Sissoko, Konstantinos Stamatiou and Noor Buchholz
Diagnostics 2021, 11(8), 1333; https://doi.org/10.3390/diagnostics11081333 - 25 Jul 2021
Cited by 8 | Viewed by 2193
Abstract
Objective: To evaluate spectrum and resistance rates to antibacterial agents in causative pathogens of bacterial prostatitis in patients from Southern Europe, the Middle East, and Africa. Materials: 1027 isolates from cultures of urine or expressed prostatic secretion, post-massage urine or seminal fluid, or [...] Read more.
Objective: To evaluate spectrum and resistance rates to antibacterial agents in causative pathogens of bacterial prostatitis in patients from Southern Europe, the Middle East, and Africa. Materials: 1027 isolates from cultures of urine or expressed prostatic secretion, post-massage urine or seminal fluid, or urethral samples were considered. Results: Escherichia coli (32%) and Enterococcus spp. (21%) were the most common isolates. Other Gram-negative, Gram-positive, and atypical pathogens accounted for 22%, 20%, and 5%, respectively. Resistance was <15% for piperacillin/tazobactam and carbapenems (both Gram-negative and -positive pathogens); <5% for glycopeptides against Gram-positive; 7%, 14%, and 20% for aminoglycosides, fosfomycin, and macrolides against Gram-negative pathogens, respectively; 10% for amoxicillin/clavulanate against Gram-positive pathogens; <20% for cephalosporins and fluoroquinolones against to Gram-negative pathogens (higher against Gram-positive pathogens); none for macrolides against atypical pathogens, but 20% and 27% for fluoroquinolones and tetracyclines. In West Africa, the resistance rates were generally higher, although the highest rates for ampicillin, cephalosporins, and fluoroquinolones were observed in the Gulf area. Lower rates were observed in Southeastern Europe. Conclusions: Resistance to antibiotics is a health problem requiring local health authorities to combat this phenomenon. Knowledge of the spectrum of pathogens and antibiotic resistance rates is crucial to assess local guidelines for the treatment of prostatitis. Full article
(This article belongs to the Special Issue Urinary Tract Infection: Diagnosis, Treatment and Management)
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Review

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14 pages, 1837 KiB  
Review
A New Gold Rush: A Review of Current and Developing Diagnostic Tools for Urinary Tract Infections
by Raymond Xu, Nicholas Deebel, Randy Casals, Rahul Dutta and Majid Mirzazadeh
Diagnostics 2021, 11(3), 479; https://doi.org/10.3390/diagnostics11030479 - 09 Mar 2021
Cited by 28 | Viewed by 11023
Abstract
Urinary tract infections (UTIs) are one of the most common infections in the United States and consequently are responsible for significant healthcare expenditure. The standard urine culture is the current gold standard for diagnosing urinary tract infections, however there are limitations of the [...] Read more.
Urinary tract infections (UTIs) are one of the most common infections in the United States and consequently are responsible for significant healthcare expenditure. The standard urine culture is the current gold standard for diagnosing urinary tract infections, however there are limitations of the test that directly contribute to increased healthcare costs. As a result, new and innovative techniques have been developed to address the inefficiencies of the current standard—it remains to be seen whether these tests should be performed adjunctly to, or perhaps even replace the urine culture. This review aims to analyze the advantages and disadvantages of the newer and emerging diagnostic techniques such as PCR, expanded quantitative urine culture (EQUC), and next generation sequencing (NGS). Full article
(This article belongs to the Special Issue Urinary Tract Infection: Diagnosis, Treatment and Management)
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Other

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10 pages, 554 KiB  
Guidelines
Guideline for Urine Culture and Biochemical Identification of Bacterial Urinary Pathogens in Low-Resource Settings
by Nabil Karah, Rayane Rafei, Wael Elamin, Anan Ghazy, Aula Abbara, Monzer Hamze and Bernt Eric Uhlin
Diagnostics 2020, 10(10), 832; https://doi.org/10.3390/diagnostics10100832 - 16 Oct 2020
Cited by 24 | Viewed by 58364
Abstract
Medical diagnosis in low-resource settings is confronted by the lack of suitable guidelines, protocols and checklists. Online-accessible procedural documents are difficult to find, might be mistranslated or interpreted and usually do not address the needs of developing countries. Urinalysis, one of the most [...] Read more.
Medical diagnosis in low-resource settings is confronted by the lack of suitable guidelines, protocols and checklists. Online-accessible procedural documents are difficult to find, might be mistranslated or interpreted and usually do not address the needs of developing countries. Urinalysis, one of the most frequently performed diagnostic examinations worldwide, involves a series of tests aiming to detect particular disorders, such as urinary tract infections, kidney disease and diabetes. In this guideline, we present an alternative approach for clinical laboratories with limited resources to identify common bacterial uropathogens. We propose dividing the identification plan into two levels. The implicated pathogen will first be assigned into a bacterial group, basic identification, against which a suitable panel of antimicrobial agents shall be selected for the antimicrobial susceptibility testing (AST). Characterization of the pathogen to the genus or species level, advanced identification, will then be performed to ensure correct reading of the AST results and determine the epidemiology of clinically significant pathogens. Most of the proposed steps in our guideline are tailored to meet the needs of clinical laboratories in low-resource settings. Such guidelines are needed to strengthen the capacity of regional pathology laboratories and to enhance international initiatives on antimicrobial resistance and health equity. Full article
(This article belongs to the Special Issue Urinary Tract Infection: Diagnosis, Treatment and Management)
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