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Late onset group b beta-hemolytic streptococcus infection in a neonate manifesting as a urinary tract infection: a rare clinical presentation

Zurina Z, Rohani A, Neela V, Norlijah O

Southeast Asian J. Trop. Med. Public Health, 2012 Nov;43(6):1470-3.
PMID: 23413711

Group B beta-hemolytic streptococcus (GBS) sepsis is a serious bacterial infection in neonates, with significant morbidity and mortality. We report here a neonate with late onset GBS infection manifesting as a urinary tract infection (UTI) in an infant presenting with prolonged neonatal jaundice. The pathogenesis of this late onset is postulated.

Matched MeSH terms: Urinary Tract Infections/diagnosis*; Urinary Tract Infections/drug therapy; Urinary Tract Infections/microbiology
Fulltext Prevalence of lower urinary tract symptoms (LUTS) among young age medical population

Zalina, N., Aruku, N., Azura, N., Shahida, N., Akhmarina, N., Dian, F.

International Medical Journal Malaysia, 2011;10(1):7-15.
MyJurnal

Introduction: Frequency of lower urinary tract symptoms (LUTS) in young age women is not well studied. It is said to be common among female elderly and multiparous population. The aim of this study is to obtain the prevalence of LUTS among nulliparous students in relation to their personal hygiene. Materials and methods: This is a prospective cross-sectional study conducted among 200 nulliparous medical and nursing students aged between 18-28 years using standardized questionnaires. Urine samples were also collected from students to detect urinary tract infections. Results: The complete data sets of 146 students were analyzed. All of them were nulliparous, single and not sexually active. The prevalence of LUTS was 52.7% consist of over-active bladder, urinary incontinence (UI) and voiding difficulty respectively (51.3%, 34.9% and 45.2%). The most common type of UI was stress urinary incontinence which was 21.9% followed by 11.6% of urgency incontinence. Conclusion: The prevalence of LUTS among young age population is high at 52.7%. Public awareness regarding LUTS and availability of treatment is needed.

Matched MeSH terms: Urinary Tract Infections
Fulltext The value of positive nitrites in screening asymptomatic bacteriuria amongst Malaysian school children

Zainal D, Baba A

Southeast Asian J. Trop. Med. Public Health, 1996 Mar;27(1):184-8.
PMID: 9031425

It is important to diagnose and treat urinary tract infection in children before renal damage has taken place. Hence a new screening procedure will be of interest. This study was conducted to evaluate the efficacy of urinary nitrite in screening for asymptomatic bacteriuria among school children compared to a more traditional method. Of the 44,816 school children investigated 240 (0.54%) students were judged to have bacteriuria ie 82 (0.19%) in boys and 158 (0.35%) in girls. Escherichia coli was the commonest organism isolated (28.75%). Urine dipstick testing for nitrite was found to have a low sensitivity and positive predictive value. While urinalysis for pyuria was noted to have a sensitivity of 77.9%, a specificity of 95.8% and a negative predictive value of 99.9%.

Matched MeSH terms: Urinary Tract Infections
Surgical treatment of urinary tract infection in the male

Yong SL

Family Practitioner, 1974;1(3):19-20.

Matched MeSH terms: Urinary Tract Infections
Fulltext Purple urine bag syndrome: a startling phenomenon of purple urine in a urine drainage bag. A primary care approach and literature review

Wong, Y.W.E., Abdullah, N.

Malaysian Family Physician, 2018;13(2):42-44.
MyJurnal

Purple urine bag syndrome (PUBs) is a rare and startling phenomenon of purple discolouration
in the urine or urinary catheter and bag. It is reported in chronically debilitated elderly patients,
mostly in women on long-term urinary catheters. Its prevalence is strikingly more common in
nursing home residents. Several factors contribute to the formation of indigo (blue) and indirubin
(red) pigments from a breakdown of dietary tryptophan, which stains the urine purple. These
factors include constipation, dysmotility of the bowel, bowel bacterial overgrowth, dehydration, and
urinary tract infection. The presence of purple urine may cause undue alarm to both the patient and
the doctor. Thus, we present this case report on an 86-year-old woman, a nursing home resident
on a long-term urinary catheter, who presented to the primary care clinic. Her urine cleared
after antibiotic therapy, replacement of her urinary catheter, and supportive management, which
included hydration and nutrition. In addition to these measures, reducing the time between urinary
catheter changes was recommended to prevent recurrence of this condition.

Matched MeSH terms: Urinary Tract Infections
Fulltext Purple urine bag syndrome: A startling phenomenon of purple urine in a urine drainage bag. A primary care approach and literature review

Wong Y, Abdullah N

Malays Fam Physician, 2018;13(2):42-44.
PMID: 30302185

Purple urine bag syndrome (PUBs) is a rare and startling phenomenon of purple discolouration in the urine or urinary catheter and bag. It is reported in chronically debilitated elderly patients, mostly in women on long-term urinary catheters. Its prevalence is strikingly more common in nursing home residents. Several factors contribute to the formation of indigo (blue) and indirubin (red) pigments from a breakdown of dietary tryptophan, which stains the urine purple. These factors include constipation, dysmotility of the bowel, bowel bacterial overgrowth, dehydration, and urinary tract infection. The presence of purple urine may cause undue alarm to both the patient and the doctor. Thus, we present this case report on an 86-year-old woman, a nursing home resident on a long-term urinary catheter, who presented to the primary care clinic. Her urine cleared after antibiotic therapy, replacement of her urinary catheter, and supportive management, which included hydration and nutrition. In addition to these measures, reducing the time between urinary catheter changes was recommended to prevent recurrence of this condition.

Matched MeSH terms: Urinary Tract Infections
Complete Genome Sequence of Proteus mirabilis Phage pPM_01 Isolated from Raw Sewage

Wirjon IA, Lau NS, Arip YM

Intervirology, 2016;59(5-6):243-253.
PMID: 28384626 DOI: 10.1159/000468987

OBJECTIVES: Phage pPM_01 was previously isolated from a raw sewage treatment facility located in Batu Maung, Penang, Malaysia, and it was highly lytic against Proteus mirabilis, which causes urinary tract infections in humans. In this paper, we characterize the biology and complete genome sequence of the phage.
METHODS AND RESULTS: Transmission electron microscopy revealed phage pPM_01 to be a siphovirus (the first reported virus to infect P. mirabilis), with its complete genome sequence successfully determined. The genome was sequenced using Illumina technology and the reads obtained were assembled using CLC Genomic Workbench v.7.0.3. The whole genome contains a total of 58,546 bp of linear double-stranded DNA with a G+C content of 46.9%. Seventy putative genes were identified and annotated using various bioinformatics tools including RAST, Geneious v.R7, National Center for Biotechnology Information (NCBI) BLAST, and tRNAscan-SE-v1.3 Search. Functional clusters of related potential genes were defined (structural, lytic, packaging, replication, modification, and modulatory). The whole genome sequence showed a low similarity to known phages (i.e., Enterobacter phage Enc34 and Enterobacteria phage Chi). Host range determination and SDS-PAGE analysis were also performed.
CONCLUSIONS: The inability to lysogenize a host, the absence of endotoxin genes in the annotated genome, and the lytic behavior suggest phage pPM_01 as a possible safe biological candidate to control P. mirabilis infection.

Matched MeSH terms: Urinary Tract Infections
Radiology and disease patterns in Malaysia

Wastie ML

Trop Geogr Med, 1975 Mar;27(1):17-24.
PMID: 1138449

The organisation of the radiological services in Malaysia is described and those diseases in which radiology plays an important part in diagnosis are discussed. As radiology embraces all specialities a pattern of diseases emerges which is different from that seen in the West. The control of infectious diseases, the general improvement in health care and the more sophisticated radiological investigations now available mean that in future radiology will play a much more important part in diagnosis and management of patients.

Matched MeSH terms: Urinary Tract Infections/radiography
Diagnosis of urinary tract infection

Wang F

Family Practitioner, 1974;1(3):12-15.

Matched MeSH terms: Urinary Tract Infections
Urinary tract infection in adults

Wang F

Family Practitioner, 1983;6:23-26.

Matched MeSH terms: Urinary Tract Infections
An Intriguing Case of Purple Urine Bag Syndrome

Wan Sulaiman WA, Hoo FK, Inche Mat LN

Am J Med Sci, 2017 May;353(5):e9.
PMID: 28502345 DOI: 10.1016/j.amjms.2016.11.022
Matched MeSH terms: Urinary Tract Infections/etiology*; Urinary Tract Infections/microbiology
Fulltext 24-hour discharge post Laparoscopic Ovarian Cystectomy: a feasibility study

Wan Ahmad Hazim, Nur Hidayah Aeshah Ng, Salleha Khalid

Pertanika Journal of Science & Technology, 2018;26(2):719-728.
MyJurnal

Minimally invasive surgery results in faster recovery. The objective of this study is to identify criteria for the feasibility of 24-hour discharge post laparoscopic ovarian cystectomy. This is a prospective cross-sectional study that was carried out at the Obstetrics and Gynaecology Department in Putrajaya Hospital between 1 January and 31 December, 2016. The inclusion criteria were: age between 15 and 45, no comorbidities, no family history of malignancy, BMI of less than 30, mass size less than 18 weeks, single uninoculated simple cyst and no ascites. The exclusion criteria were post-menopause women, known medical illness, family history of malignancy, mass size more than 18 weeks, multiloculated or bilateral ovarian cyst, presence of solid area within the cyst and ascites. The sample size was calculated to be 14. A total of 16 participants were identified. Results showed that using the Visual Analogue Score (VAS), the mean pain score post operatively in the first six hours, 24 hours, 48 hours, two weeks and three months were 3.67, 2.57, 0.5, 0 and 0, respectively. Two of the subjects experienced post-operative nausea and vomiting, one had urinary tract infection and one had minor bleeding from the surgical site. All the participants were discharged within 24 hours post-operatively. There was no readmission. In conclusion, 24-hour discharge post laparoscopic cystectomy is safe and feasible. Factors determining the success must be adhered to closely to ensure a good and satisfactory outcome. This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

Matched MeSH terms: Urinary Tract Infections
Fulltext Genotypic to Phenotypic Resistance Discrepancies Identified Involving β-Lactamase Genes, blaKPC, blaIMP, blaNDM-1, and blaVIM in Uropathogenic Klebsiella pneumoniae

Urmi UL, Nahar S, Rana M, Sultana F, Jahan N, Hossain B, et al.

Infect Drug Resist, 2020;13:2863-2875.
PMID: 32903880 DOI: 10.2147/IDR.S262493

Introduction: Klebsiella pneumoniae carbapenemase (KPC) belongs to the Group-A β-lactamases that incorporate serine at their active site and hydrolyze various penicillins, cephalosporins, and carbapenems. Metallo-beta-lactamases (MBLs) are group-B enzymes that contain one or two essential zinc ions in the active sites and hydrolyze almost all clinically available β-lactam antibiotics. Klebsiella pneumoniae remains the pathogen with the most antimicrobial resistance to KPC and MBLs.
Methods: This research investigated the blaKPC, and MBL genes, namely, blaIMP, blaVIM, and blaNDM-1 and their phenotypic resistance to K. pneumoniae isolated from urinary tract infections (UTI) in Bangladesh. Isolated UTI K. pneumoniae were identified by API-20E and 16s rDNA gene analysis. Their phenotypic antimicrobial resistance was examined by the Kirby-Bauer disc diffusion method, followed by minimal inhibitory concentration (MIC) determination. blaKPC, blaIMP, blaNDM-1, and blaVIM genes were evaluated by polymerase chain reactions (PCR) and confirmed by sequencing.
Results: Fifty-eight K. pneumoniae were identified from 142 acute UTI cases. Their phenotypic resistance to amoxycillin-clavulanic acid, cephalexin, cefuroxime, ceftriaxone, and imipenem were 98.3%, 100%, 96.5%, 91.4%, 75.1%, respectively. Over half (31/58) of the isolates contained either blaKPC or one of the MBL genes. Individual prevalence of blaKPC, blaIMP, blaNDM-1, and blaVIM were 15.5% (9), 10.3% (6), 22.4% (13), and 19% (11), respectively. Of these, eight isolates (25.8%, 8/31) were found to have two genes in four different combinations. The co-existence of the ESBL genes generated more resistance than each one individually. Some isolates appeared phenotypically susceptible to imipenem in the presence of blaKPC, blaIMP, blaVIM, and blaNDM-1 genes, singly or in combination.
Conclusion: The discrepancy of genotype and phenotype resistance has significant consequences for clinical bacteriology, precision in diagnosis, the prudent selection of antimicrobials, and rational prescribing. Heterogeneous phenotypes of antimicrobial susceptibility testing should be taken seriously to avoid inappropriate diagnostic and therapeutic decisions.

Matched MeSH terms: Urinary Tract Infections
Urinary tract infection

The Ambulatory PS

Family Physician, 1995;7:42-43.

Matched MeSH terms: Urinary Tract Infections
Fulltext Antibiotics for URTI and UTI -- prescribing in Malaysian primary care settings

Teng CL, Tong SF, Khoo EM, Lee V, Zailinawati AH, Mimi O, et al.

Aust Fam Physician, 2011 May;40(5):325-9.
PMID: 21597554

Background: Overprescription of antibiotics is a continuing problem in primary care. This study aims to assess the antibiotic prescribing rates and antibiotic choices for upper respiratory tract infections (URTI) and urinary tract infections (UTI) in Malaysian primary care.
Method: Antibiotic prescribing data for URTI and UTI was extracted from a morbidity survey of randomly selected primary care clinics in Malaysia.
Results: Analysis was performed of 1163 URTI and 105 UTI encounters. Antibiotic prescribing rates for URTI and UTI were 33.8% and 57.1% respectively. Antibiotic prescribing rates were higher in private clinics compared to public clinics for URTI, but not for UTI. In URTI encounters, the majority of antibiotics prescribed were penicillins and macrolides, but penicillin V was notably underused. In UTI encounters, the antibiotics prescribed were predominantly penicillins or cotrimoxazole.
Discussion: Greater effort is needed to bring about evidence based antibiotic prescribing in Malaysian primary care, especially for URTIs in private clinics.
Keywords: general practice, prescriptions, drug; upper respiratory tract infection; urinary tract infection; antibiotics, guideline; evidence based medicine
Study site: Klinik Kesihatan, Malaysia

Matched MeSH terms: Urinary Tract Infections/drug therapy*
The influence of antibiotic resistance gene carriage on biofilm formation by two Escherichia coli strains associated with urinary tract infections

Teh AH, Wang Y, Dykes GA

Can J Microbiol, 2014 Feb;60(2):105-11.
PMID: 24498987 DOI: 10.1139/cjm-2013-0633

Urinary tract infections (UTI) caused by uropathogenic Escherichia coli are one of the most common forms of human disease. In this study, the effect of the presence of newly acquired antibiotic resistance genes on biofilm formation of UTI-associated E. coli strains was examined. Two clinical UTI-associated E. coli strains (SMC18 and SMC20) carrying different combinations of virulence genes were transformed with pGEM-T, pGEM-T::KmΔAmp, or pGEM-T::Km to construct ampicillin-resistant (Km(S)Amp(R)), kanamycin-resistant (Km(R)Amp(S)), or ampicillin- and kanamycin-resistant (Km(R)Amp(R)) strains. Transformed and wild-type strains were characterized for biofilm formation, bacterial surface hydrophobicity, auto-aggregation, morphology, and attachment to abiotic surfaces. Transformation with a plasmid carrying an ampicillin resistance gene alone decreased (p < 0.05) biofilm formation by SMC18 (8 virulence marker genes) but increased (p < 0.05) biofilm formation by SMC20 (5 virulence marker genes). On the other hand, transformation with a plasmid carrying a kanamycin resistance gene alone or both ampicillin and kanamycin resistance genes resulted in a decrease (p < 0.05) in biofilm formation by SMC18 but did not affect (p > 0.05) the biofilm formation by SMC20. Our results suggest that transformation of UTI-associated E. coli with plasmids carrying different antibiotic resistance gene(s) had a significant impact on biofilm formation and that these effects were both strain dependent and varied between different antibiotics.

Matched MeSH terms: Urinary Tract Infections/microbiology
Screening for urinary tract infection in women with hyperemesis gravidarum

Tan PC, King AS, Omar SZ

J Obstet Gynaecol Res, 2012 Jan;38(1):145-53.
PMID: 21955280 DOI: 10.1111/j.1447-0756.2011.01652.x

AIM: The aim of this study was to evaluate urine microscopy, dipstick analysis and urinary symptoms in screening for urinary tract infection (UTI) in hyperemesis gravidarum (HG).
MATERIALS AND METHODS: A prospective cross-sectional study was performed on women at first hospitalization for HG. A clean-catch mid-stream urine sample from each recruit was sent for microscopy (for bacteria, leucocytes and erythrocytes), dipstick analysis (for leukocyte esterase, nitrites, protein and hemoglobin) and microbiological culture. The presence of current urinary symptoms was elicited by questionnaire. UTI is defined as at least 10(5) colony-forming units/mL of a single uropathogen on culture. Screening test parameters were analyzed against UTI.
RESULTS: UTI was diagnosed in 15/292 subjects (5.1%). Receiver-operator characteristic curve analysis of microscopic urine leucocytes revealed area under the curve=0.64, 95% confidence interval (CI) 0.5-0.79, P=0.063 and erythrocytes area under the curve=0.53, 95%CI 0.39-0.67, P=0.67 for UTI indicating the limited screening utility of these parameters. Microscopic bacteriuria (likelihood ratio [LR] 1.1, 95%CI 0.7-1.5) and urine dipstick leukocyte esterase (LR 1.4, 95%CI 1.1-1.8), nitrites (LR 2.3, 95%CI 0.3-17.2), protein (LR 1.0, 95%CI 0.7-1.6) and hemoglobin (LR 0.8, 95%CI 0.4-1.5) were not useful screening tests for UTI in HG. Elicited symptoms were also not predictive of UTI.
CONCLUSION: Urine microscopy, dipstick analysis and urinary symptoms were not useful in screening for UTI in HG. UTI should be established by urine culture in HG before starting antibiotic treatment.

Matched MeSH terms: Urinary Tract Infections/complications; Urinary Tract Infections/diagnosis*; Urinary Tract Infections/microbiology; Urinary Tract Infections/urine
Intrauterine contraceptive device embedded in bladder wall with calculus formation removed successfully with open surgery

Tan JH, Lip H, Ong W, Omar S

Malays Fam Physician, 2019;14(2):29-31.
PMID: 31827733

An Intrauterine contraceptive devices (IUCD) is commonly inserted by the primary health care physician. It can migrate into pelvic or abdominal organs. When a pregnancy occurs following an insertion of an IUCD, there should be a high suspicion of uterine perforation or possible migration. A radiograph can be done in the primary health care clinic to search for a missing IUCD. Early referral to the urology service is warranted when a patient presents with recurrent urinary tract infections. Removal of an intravesical IUCD can be managed with cystoscopy, laparoscopy or open surgery. Herein, we report a case of IUCD migration into the bladder. This case will highlight the importance of proper technique, careful insertion and the role of ultrasound.

Matched MeSH terms: Urinary Tract Infections
Fulltext Post-partum invasive group b Streptococcus infection with fatal outcome: a case report

Siti Zulaikha Zakariah, Syafinaz Amin Nordin, Khairul Anuar Zainun, Asyraff Md Najib

Malaysian Journal of Medicine and Health Sciences, 2018;14(3):57-59.
MyJurnal

Group B streptococcus (GBS) is generally known to cause severe disease in the neonate and immunocompromised adults. GBS in the pregnant mother is rare and can potentially be fatal. Clinical presentation can be as mild as an uncomplicated urinary tract infection or serious invasive disease in the form of bacteremia, chorioamnionitis, endometritis and septic abortion. We report a case of a 46-year-old Para 3 lady, post-partum day 12, whom was found dead at home. Prior to her death, she had intermittent fever and abnormal lochia. Autopsy findings indicate GBS endometritis and bacteraemia. She was never screened for GBS. The cost-effectiveness of universal GBS screening needs to be explored to reduce maternal and neonatal morbidity due to GBS.

Matched MeSH terms: Urinary Tract Infections
Prophylactic antibiotics in children

Sinniah D

Med J Malaya, 1971 Dec;26(2):84-9.
PMID: 4260865
Matched MeSH terms: Urinary Tract Infections/prevention & control

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