Displaying publications 1 - 20 of 88 in total

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  1. 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
  2. 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
  3. Ngoi ST, Teh CSJ, Chong CW, Abdul Jabar K, Tan SC, Yu LH, et al.
    Antibiotics (Basel), 2021 Feb 11;10(2).
    PMID: 33670224 DOI: 10.3390/antibiotics10020181
    The increasing prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae has greatly affected the clinical efficacy of β-lactam antibiotics in the management of urinary tract infections (UTIs). The limited treatment options have resulted in the increased use of carbapenem. However, flomoxef could be a potential carbapenem-sparing strategy for UTIs caused by ESBL-producers. Here, we compared the in vitro susceptibility of UTI-associated ESBL-producers to flomoxef and established β-lactam antibiotics. Fifty Escherichia coli and Klebsiella pneumoniae strains isolated from urine samples were subjected to broth microdilution assay, and the presence of ESBL genes was detected by polymerase chain reactions. High rates of resistance to amoxicillin-clavulanate (76-80%), ticarcillin-clavulanate (58-76%), and piperacillin-tazobactam (48-50%) were observed, indicated by high minimum inhibitory concentration (MIC) values (32 µg/mL to 128 µg/mL) for both species. The ESBL genes blaCTX-M and blaTEM were detected in both E. coli (58% and 54%, respectively) and K. pneumoniae (88% and 74%, respectively), whereas blaSHV was found only in K. pneumoniae (94%). Carbapenems remained as the most effective antibiotics against ESBL-producing E. coli and K. pneumoniae associated with UTIs, followed by flomoxef and cephamycins. In conclusion, flomoxef may be a potential alternative to carbapenem for UTIs caused by ESBL-producers in Malaysia.
    Matched MeSH terms: Urinary Tract Infections
  4. Rodríguez JY, Álvarez-Moreno CA, Cortés JA, Rodríguez GJ, Esquea K, Pinzón H, et al.
    Biomedica, 2019 05 01;39:10-18.
    PMID: 31529845 DOI: 10.7705/biomedica.v39i3.4534
    Melioidosis is an infectious disease caused by Burkholderia pseudomallei whose clinical diagnosis can be difficult due not only to its varied clinical presentation but also to the difficulties in the microbiological diagnosis.Thus, it may be necessary to use molecular techniques for its proper identification once it is suspected.
    There are few antibiotics available for the treatment of this disease, which must be used over a long period of time. Although it is known to be endemic in Thailand, Malaysia, Singapore, Vietnam, and Australia, in Colombia there are few reported cases.
    We describe a case of melioidosis in the northern region of Colombia. Additionally, we review its clinical characteristics and treatment and we describe the local epidemiology of this disease.
    Matched MeSH terms: Urinary Tract Infections/diagnosis; Urinary Tract Infections/drug therapy; Urinary Tract Infections/microbiology
  5. Al Fraijat B, Al-Tawarah NM, Khlaifat AM, Qaralleh H, Khleifat KM, M A, et al.
    Trop Biomed, 2019 Sep 01;36(3):620-629.
    PMID: 33597484
    Urinary Tract Infections (UTIs) consider as the most common infections worldwide, with higher risk in patients experienced Acute Appendicitis (AA). The purpose of this study was, to investigate the bacterial profile of UTIs in patients with non-ruptured AA postsurgically, and to assess age- and gender-related links of all AA cases in Karak region, Jordan. Urine samples obtained from 46 cases (32 male and 14 female) aged between 16-70 years were diagnosed as non-ruptured AA, following with isolation and characterization of isolated bacteria. Out of 46 AA cases, uropathogens isolated from 25 (54.3%) UTI cases. Out of these isolates; 42 (73.7%) were gram-negative isolates and 15 (26.3%) were gram-positive bacteria. The percentage of isolates were E. coli (26.3%), Enterobacter species (21%), Enterococcus faecalis and Klebsiella pneumoniea (10.5%) for each, Streptococcus saprophytics and Pseudomonas aeruginosa (7%) for each, Yersinia spp. and S. milleri (8.8%). Out of UTI cases, 20 cases (80%) possessed mixed culture, each of them had at least one of Enterobacterial species. i.e. Enterobacter spp. or E. coli or both. More precisely, out of all these positivecases, 2 cases had pure gram positive-bacterial infection (8%), while pure gram negative bacterial infection comprised 48% of them and the rest (44%) were mixed (gram-negative and gram-positive) bacterial infection. Moreover, study revealed a high prevalence rate of AA cases 24 (52.2%) in the ages of 16-22 years, then declining the rate with increasing the age, reaching the lowest rate (4.3%) in ages of 60-70. In addition to age factor, the males significantly more susceptible to AA cases than females by 2.2-fold. Antibiotic sensitivity test revealed high resistance capability of E. coli to the most used antibiotics except for nitrofurantoin. Bacterial isolates showing sensitivity against ciprofloxacin, trimethoprim/sulfamethoxazole, amoxicillin-Clavulanic acid and nitrofurantoin, with a superiority for the first two. Results demonstrate high prevalence rate of UTIs in patients with AA. For avoiding, the needless use of antibiotics through sticking to our accountability as healthcare provisioner to pursuit the antimicrobial management.
    Matched MeSH terms: Urinary Tract Infections/microbiology; Urinary Tract Infections/epidemiology*
  6. Gondos AS, Al-Moyed KA, Al-Robasi AB, Al-Shamahy HA, Alyousefi NA
    PLoS One, 2015;10(12):e0144266.
    PMID: 26657128 DOI: 10.1371/journal.pone.0144266
    Urinary tract infection (UTI) is the most common complication following kidney transplantation (KT), which could result in losing the graft. This study aims to identify the prevalence of bacterial UTI among KT recipients in Yemen and to determine the predisposing factors associated with post renal transplantation UTI. A cross sectional study included of 150 patients, who underwent KT was conducted between June 2010 and January 2011. A Morning mid-stream urine specimen was collected for culture and antibiotic susceptibility test from each recipient. Bacterial UTI was found in 50 patients (33.3%). The prevalence among females 40.3% was higher than males 29%. The UTI was higher in the age group between 41-50 years with a percentage of 28% and this result was statistically significant. Predisposing factors as diabetes mellitus, vesicoureteral reflux, neurogenic bladder and polycystic kidney showed significant association. High relative risks were found for polycystic kidney = 13.5 and neurogenic bladder = 13.5. The most prevalent bacteria to cause UTI was Escherichia coli represent 44%, followed by Staphylococcus saprophyticus 34%. Amikacin was the most effective antibiotic against gram-negative isolates while Ciprofloxacin was the most effective antibiotic against Staphylococcus saprophyticus. In conclusion, there is high prevalence of bacterial UTI among KT recipients in Yemen. Diabetes mellitus, vesicoureteral reflux, neurogenic bladder, polycystic kidney and calculi were the main predisposing factors.
    Matched MeSH terms: Urinary Tract Infections/etiology*; Urinary Tract Infections/microbiology; Urinary Tract Infections/epidemiology
  7. Alrasheedy AA, Alsalloum MA, Almuqbil FA, Almuzaini MA, Aba Alkhayl BS, Albishri AS, et al.
    Expert Rev Anti Infect Ther, 2020 01;18(1):87-97.
    PMID: 31834825 DOI: 10.1080/14787210.2020.1705156
    Background: Dispensing of antibiotics without a prescription (DAwP) has been widely practised among community pharmacies in Saudi Arabia despite being illegal. However, in May 2018, the law and regulations were enforced alongside fines. Consequently, we wanted to evaluate the impact of these changes.Methods: A study was conducted among 116 community pharmacies in two phases. A pre-law enforcement phase between December 2017 and March 2018 and a post-law enforcement phase one year later. Each phase consisted of a cross-sectional questionnaire-based survey and a simulated client method (SCM) approach. In the SCM, clients presented with either pharyngitis or urinary tract infections (UTI). In SCM, for each phase, all 116 pharmacies were visited with one of the scenarios.Results: Before the law enforcement, 70.7% of community pharmacists reported that DAwP was common with 96.6% and 87.7% of participating pharmacies dispensed antibiotics without a prescription for pharyngitis and UTI respectively. After the law enforcement, only 12.9% reported that DAwP is still a common practice, with only 12.1% and 5.2% dispensing antibiotics without prescriptions for pharyngitis and UTI respectively.Conclusion: law enforcement was effective. However, there is still further scope for improvement. This could include further educational activities with pharmacists, physicians and the public.
    Matched MeSH terms: Urinary Tract Infections/drug therapy
  8. 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
  9. Siti Zulaikha Zakariah, Syafinaz Amin Nordin, Khairul Anuar Zainun, Asyraff Md Najib
    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
  10. Lim BK, Sivalingam N, Aza Mirandan AR
    Family Physician, 1996;8:11-14.
    A prospective case controlled study was conducted to determine the incidence of asymptomatic bacteriuria in pregnancy (ASB), causative organisms and fetal outcome. Out of 510 antenatal mothers screened, 46 (9%) had ASB. The main organisms isolated were E. coli (16%), Staphylococcus aureus (15%) and Beta-Haemolytic Streptococcus (11%). Oral Nitrofurantoin and Cefuroxime axetil achieved sensitivity levels of 96%. There was no significant difference in period of gestation at birth and birthweight between the control and study groups. The reasons for routine antimicrobial therapy for ASB are discussed.
    Matched MeSH terms: Urinary Tract Infections
  11. Zainal D, Baba A
    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
  12. Forde BM, Ben Zakour NL, Stanton-Cook M, Phan MD, Totsika M, Peters KM, et al.
    PLoS One, 2014;9(8):e104400.
    PMID: 25126841 DOI: 10.1371/journal.pone.0104400
    Escherichia coli ST131 is now recognised as a leading contributor to urinary tract and bloodstream infections in both community and clinical settings. Here we present the complete, annotated genome of E. coli EC958, which was isolated from the urine of a patient presenting with a urinary tract infection in the Northwest region of England and represents the most well characterised ST131 strain. Sequencing was carried out using the Pacific Biosciences platform, which provided sufficient depth and read-length to produce a complete genome without the need for other technologies. The discovery of spurious contigs within the assembly that correspond to site-specific inversions in the tail fibre regions of prophages demonstrates the potential for this technology to reveal dynamic evolutionary mechanisms. E. coli EC958 belongs to the major subgroup of ST131 strains that produce the CTX-M-15 extended spectrum β-lactamase, are fluoroquinolone resistant and encode the fimH30 type 1 fimbrial adhesin. This subgroup includes the Indian strain NA114 and the North American strain JJ1886. A comparison of the genomes of EC958, JJ1886 and NA114 revealed that differences in the arrangement of genomic islands, prophages and other repetitive elements in the NA114 genome are not biologically relevant and are due to misassembly. The availability of a high quality uropathogenic E. coli ST131 genome provides a reference for understanding this multidrug resistant pathogen and will facilitate novel functional, comparative and clinical studies of the E. coli ST131 clonal lineage.
    Matched MeSH terms: Urinary Tract Infections/microbiology
  13. Forde BM, Phan MD, Gawthorne JA, Ashcroft MM, Stanton-Cook M, Sarkar S, et al.
    mBio, 2015 Nov 17;6(6):e01602-15.
    PMID: 26578678 DOI: 10.1128/mBio.01602-15
    Escherichia coli sequence type 131 (ST131) is a clone of uropathogenic E. coli that has emerged rapidly and disseminated globally in both clinical and community settings. Members of the ST131 lineage from across the globe have been comprehensively characterized in terms of antibiotic resistance, virulence potential, and pathogenicity, but to date nothing is known about the methylome of these important human pathogens. Here we used single-molecule real-time (SMRT) PacBio sequencing to determine the methylome of E. coli EC958, the most-well-characterized completely sequenced ST131 strain. Our analysis of 52,081 methylated adenines in the genome of EC958 discovered three (m6)A methylation motifs that have not been described previously. Subsequent SMRT sequencing of isogenic knockout mutants identified the two type I methyltransferases (MTases) and one type IIG MTase responsible for (m6)A methylation of novel recognition sites. Although both type I sites were rare, the type IIG sites accounted for more than 12% of all methylated adenines in EC958. Analysis of the distribution of MTase genes across 95 ST131 genomes revealed their prevalence is highly conserved within the ST131 lineage, with most variation due to the presence or absence of mobile genetic elements on which individual MTase genes are located.

    IMPORTANCE: DNA modification plays a crucial role in bacterial regulation. Despite several examples demonstrating the role of methyltransferase (MTase) enzymes in bacterial virulence, investigation of this phenomenon on a whole-genome scale has remained elusive until now. Here we used single-molecule real-time (SMRT) sequencing to determine the first complete methylome of a strain from the multidrug-resistant E. coli sequence type 131 (ST131) lineage. By interrogating the methylome computationally and with further SMRT sequencing of isogenic mutants representing previously uncharacterized MTase genes, we defined the target sequences of three novel ST131-specific MTases and determined the genomic distribution of all MTase target sequences. Using a large collection of 95 previously sequenced ST131 genomes, we identified mobile genetic elements as a major factor driving diversity in DNA methylation patterns. Overall, our analysis highlights the potential for DNA methylation to dramatically influence gene regulation at the transcriptional level within a well-defined E. coli clone.

    Matched MeSH terms: Urinary Tract Infections/microbiology; Urinary Tract Infections/epidemiology
  14. Forde BM, Roberts LW, Phan MD, Peters KM, Fleming BA, Russell CW, et al.
    Nat Commun, 2019 08 13;10(1):3643.
    PMID: 31409795 DOI: 10.1038/s41467-019-11571-5
    Recurrent urinary tract infections (rUTIs) are extremely common, with ~ 25% of all women experiencing a recurrence within 1 year of their original infection. Escherichia coli ST131 is a globally dominant multidrug resistant clone associated with high rates of rUTI. Here, we show the dynamics of an ST131 population over a 5-year period from one elderly woman with rUTI since the 1970s. Using whole genome sequencing, we identify an indigenous clonal lineage (P1A) linked to rUTI and persistence in the fecal flora, providing compelling evidence of an intestinal reservoir of rUTI. We also show that the P1A lineage possesses substantial plasmid diversity, resulting in the coexistence of antibiotic resistant and sensitive intestinal isolates despite frequent treatment. Our longitudinal study provides a unique comprehensive genomic analysis of a clonal lineage within a single individual and suggests a population-wide resistance mechanism enabling rapid adaptation to fluctuating antibiotic exposure.
    Matched MeSH terms: Urinary Tract Infections/microbiology*
  15. Chong Vh VH, Sharif F, Bickle I
    Med J Malaysia, 2014 Dec;69(6):257-60.
    PMID: 25934955 MyJurnal
    INTRODUCTION: Melioidosis is endemic to the tropical regions, in particular Thailand and Northern Australia. Any organ can be affected by melioidosis. Involvement of the urogenital system is common in Northern Australia, but is less common in other regions. This study assesses the characteristics of melioidosis affecting the urogenital system treated in a tertiary referral centre in Brunei Darussalam.

    MATERIAL AND METHODS: All patients treated for melioidosis of the urogenital system were identified and retrospectively reviewed.

    RESULTS: There were 9 patients with 11 episodes of urogenital infections treated over 13 years. The median age at diagnosis was 38 years old (range 29 - 63) with men predominantly affected. The major risk factor was underlying diabetes mellitus (n=9), including three patients diagnosed at the time of diagnosis of melioidosis. The median glycosylated haemoglobin (HbA1c) was 12.8% (range 6.4 to 16.6%). One patient's risk factor was only moderate alcohol consumption. Common symptoms included; fever, lethargy, rigor and anorexia. Dysuria was reported by two patients. The median duration of symptoms before presentation was 7 days (range 2 to 21 days) and the median number of sites involved were 3 (range of 2 to 6). Urogenital involvement included prostate (n=6), kidney (n=8), seminal vesicles (n=1) and testis (n=1). Radiological imaging showed that large prostate abscesses (>4.5cm) were common, and in some patients, the kidney abscess had the 'honeycomb' previously described as typical for melioidosis liver abscess. All patients were successfully treated for melioidosis and at a median follow up of 34 months (range 1 - 97), there was one death from complications of diabetes mellitus.

    CONCLUSION: Urogenital melioidosis only accounted for a small proportion of all melioidosis involvement, with prostate and kidney most commonly affected. Concomitant involvement of other sites were common. The major risk factor was poorly controlled diabetes mellitus.
    Matched MeSH terms: Urinary Tract Infections
  16. Chelvanayagam D
    Family Practitioner, 1974;1(3):21-24.
    Matched MeSH terms: Urinary Tract Infections
  17. Cheong I
    Family Practitioner, 1988;11:92-93.
    5% of hospital admissions in Malaysia each year consist of patients suffering from renal diseases; from these 600 new cases of chronic renal failure will be diagnosed. The common causes of chronic renal failure in Malaysia in order of frequency are chronic glomerulonephritis, diabetic nephropathy, obstructive uropathy, malignant hypertension, chronic pyelonephritis, SLE nephritis and gouty nephropathy. Prevention of renal diseases require good control of the underlying conditions.
    Matched MeSH terms: Urinary Tract Infections
  18. Cheung HS
    Australas Radiol, 1992 Feb;36(1):23-6.
    PMID: 1632740
    The results of radiological investigations performed on 81 children with urinary tract infection (UTI) were reviewed. Investigations included 91 voiding cystourethrograms (VCU), 59 intravenous urograms (IVU) and 36 ultrasonograms (US). The aim was to study the local spectrum of renal tract abnormalities in childhood UTI and to compare the diagnostic yield of combining US and VCU against IVU and VCU. Renal tract abnormalities were detected in 37%. Vesico-ureteric reflux (VUR) was the commonest, detected in 26%, with renal scarring found in 9% of refluxing units. Ultrasound should replace IVU in the initial diagnostic work-up of these children.
    Matched MeSH terms: Urinary Tract Infections/radiography*
  19. Onn LV, Bickle I, Chua HB, Telisinghe PU, Chong CF, Chong VH
    Malays Fam Physician, 2017;12(3):33-36.
    PMID: 29527279
    Urinary tract infection (UTI) is one of the most common presentations in general practice and, in most instances, occurs in a single episode and is easily treated with a course of anti-microbial therapy. In the case of recurrent urinary tract infections, it is important to consider evaluation for any underlying causes. We report the case of a 32 year old female who had recurrent UTIs; this was a case of recurrent UTI secondary to xanthogranulomatous pyelonephritis from renal stones with resultant reno-colic fistula formation.
    Matched MeSH terms: Urinary Tract Infections
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