European Journal of Cardiovascular Medicine

Background and Aims: One of the most common illnesses with high morbidity and death is urinary tract infections (UTIs). Even though a broad variety of medicines are available for the care of UTI, uropathogens have developed resistance, leading to a major treatment failure. In order to assess the rate of pathogen isolation as well as the pattern of antibiotic susceptibility of microorganisms causing UTI, the current investigation was conducted. Materials and Methods: 350 urine samples from individuals who had a UTI that was clinically suspected were processed between January and March 2019. The susceptibility of various antibiotics and UTI isolates were studied using the Kirby-Bauer disc diffusion method. Results: In this study, among the 350 samples, 195 (55.7%) samples showed microbial growth. Out of 195 isolates, 33 were Candida spp., and 162 were bacteria. E. coli (46.29%) was the predominant isolate, followed by E. faecalis (23.45%) as well as Klebsiella spp. (19.75%). E. coli was most susceptible to nitrofurantoin (96.29%), and Candida spp was most susceptible to Fluconazole (90.90%). Conclusion: The study outcome showed that E. coli is the major uropathogen responsible for UTI, and Nitrofurantoin is the superior antibiotic with a high susceptibly rate

Introduction: Nephrotic syndrome, characterized by presence of heavy proteinuria, hypoalbuminemia, edema and hyperlipidemia, is a common renal disorder in pediatric population and is most common in Asian child.

Aims & Objectives: To know the bacterial etiologies and their antibiogram in urinary samples of Pediatricnephrotic syndrome.

Materials And Methods:   This was a Cross sectional, Descriptive study conducted for a period of 6 months i.e., January 2022 – June 2022 in pediatric patients admitted in PICU’s of KING GEORGE HOSPITAL, VISAKHAPATNAM.  Urine samples are collected and transported to Department of Microbiology, ANDHRA MEDICAL COLLEGE, VISAKHAPATNAM.

Results: Out of 70 urine samples studied, 21(30%) have urinary tract infection, 13(62%) were asymptomatic and 8(38%) are symptomatic.  Majority of UTI caused by E.coli 8(38%) followed by klebsiella 6(29%), Proteus 4(19%), Staphylococcus aureus 2(10%), Acinetobacter 1(4%).

Gram negative bacilli were sensitive to Amikacin, Cefixime, Piperacillin plus Tazobactum, Nirofurantoin, Meropenem.

Gram positive cocci were sensitive to Amoxicillin, Vancomycin, Linezolid.

Conclusion: Children with nephrotic syndrome are frequently predisposed to UTI and in most cases, it is asymptomatic.  It is necessary to examine the patient and prevent the risk of complications by initiating appropriate antibiotic therapy

Lower urinary tract infections are accountable for a huge number of presentations in general practice and were treated with regular antibiotic prescriptions. But, they cause a significant financial burden while seeking treatment services. In our prospective study, that took place over 18 months at Katuri Medical College and Hospital, was done to determine the etiology and treatment modalities of lower urinary tract symptoms. Our Objectives were- 1. To assess various etiological factors causing lower urinary tract symptoms among patients attending the outpatient department at Katuri Medical College and Hospital. 2. To investigate the etiological factor causing lower urinary tract symptoms among the patients. 3. To evaluate various treatment options available for management of lower urinary tract symptoms. Results: A total of 87 patients who were screened and a sample size of 30 cases had been selected with objective evidence of LUTS on whom an surgical intervention is needed. It was found that the highest incidence of LUTS in males was in 7th decade, and then sixth and eight decade, meanwhile, the lowest incidence was seen in ninth decade. In this present study, major proportion i.e., 73.33% (22cases) were men and the remaining 2 6.67% (8 cases) are females. Patients presented with the following complaints. 1. Frequency and nocturia were found in highest number of cases i.e., 28 (76.67%). 2. Weak Stream was in the least number of patients i.e.,11 (36.67%). 3. Intermittency and Urgency were found to be suffered by 60% and the later was observed to be present in 70% of the study subjects. The most common cause was BPH which was observed in 53.33% followed by bladder stones (23.33%), carcinoma prostate (10%), Urethral stricture (10%) and bladder carcinoma (3.37%). Out of 30 cases of LUTS, 14 underwent TURP, 5 cases underwent cystolithotripsy, 1 underwent radical cystectomy and ileal conduit, 1 underwent VIU, 2 underwent urethroplasty, 5 underwent open prostatectomy, 2 underwent cystolithotomy.

Introduction: Acute appendicitis is a common surgical emergency, with appendectomy being the gold standard treatment for this condition. Traditionally, early appendectomy has been advocated to prevent the potential complications associated with delayed intervention. However, recent studies have questioned the necessity of immediate surgical intervention and proposed a conservative approach with delayed appendectomy or even non-operative management. The debate between early versus delayed appendectomy in the treatment of acute appendicitis has gained significant attention among surgeons, researchers, and healthcare providers. This comparative study aims to provide a comprehensive analysis of the outcomes, efficacy, and safety of these two approaches. Aims and Objectives: This study aims to compare the morbidity, mortality, postoperative length of stay and 30 days readmission rate of acute appendicitis patients who had appendectomy within 8 hours of visiting the emergency room with those who had surgery after that period. Material and Methods: This study was conducted on 175 patients retrospectively who underwent appendectomy procedures from January 2021 to December 2021 at Adesh Medical College and Hospital, Shahabad, Kurukshetra, Haryana, India. The study population was divided into two groups based on the length of time before the intervention: early appendectomy (group 1), which included patients who underwent surgery within 8 hours, and delayed appendectomy (group 2), which included patients who underwent surgery after that time. The underlying characteristics of the two study groups were then compared, including demographic, clinical, radiological, and perioperative data. The 30 days readmission rate, postoperative length of stay, and mortality and morbidity were all regarded as outcome measures. Data were manually collected by reviewing patient charts in the electronic medical record. The Statistical Package for the Social Sciences (SPSS) 24.0 was used for the statistical analysis. Statistical significance was evaluated at p<0.05.  Results: A total of 175 patients met the inclusion requirements for the study population over the course of the twelve months of the trial period. Within 8 hours of their arrival at the emergency department, 100 patients (57.1%) underwent early appendectomy, while 75 patients (42.8%) did so after that time. The age was 43.8±11.85 years on average. A total of 54.28% (n = 95) of the population were male patients and the rest were females. Twenty patients (11.43%) overall experienced postoperative problems, including two postoperative hemorrhages (1.1%), five surgical site infections (2.86%), eight pneumonia (4.57%), one urinary tract infections (0.5%) and four patients (2.28%) who experienced multiple organ system failure. Within 30 days of surgery, six patients (3.4%) were readmitted. The 30‐day readmission rate (2% vs. 4%, p = 0.569) did not differ significantly between the two groups. The postoperative duration of stay did not differ significantly between the two groups: Median (IQR) 24.8 (11.2‐38.4) vs. 26.9 (11.6‐26.9) hours (p = 0.692). Conclusions: Our results concluded that eight hours delay in the appendectomy did not lead to longer postoperative stays, an increase in mortality or morbidity, or a higher 30‐day readmission rate, of patients with acute appendicitis. This comparative study investigated that early versus delayed emergency appendectomy in the treatment of acute appendicitis holds significant importance in guiding clinical decision-making. By critically analyzing the available evidence, this research aims to provide evidence-based recommendations to enhance patient care and optimize outcomes.

Introduction: UTI is a prevalent condition that affects approximately 40% of the adult population. Clinical Syndrome may be characterized as Asymptomatic Bacteriuria, Uncomplicated Cystitis, Pyelonephritis, Prostatitis, or complicated UTI. The goals of treatment of urinary tract infection are to eliminate the pathogen, to prevent Urosepsis, and to reduce the risk of renal scarring. Objective: To study the culture and sensitivity patterns of urinary tract infections in asymptomatic patients in a tertiary care hospital. Methods: A total of 120 samples were collected from January to June 2023. Identification was conducted by conventional biochemical tests. Antibiotic sensitivity test was analysed by disc diffusion method using different antibiotics and their zone of inhibition was measured. Results: Out of 120 subjects enrolled, 67 were males and 53 females The most common urinary pathogen isolated was E. Coli (64%) sensitive most often (82% sensitivity) to Amikacin. Overall sensitivity of different urinary isolates to amikacin was highest (82%).  Conclusion: Epidemiology and resistance patterns of bacterial pathogens in pediatrics urinary tract infection show large interregional variability, and rates of bacterial resistances are changing due to different antibiotic treatment. Knowledge of spectrum of pathogens and their patterns of drug resistance is indispensable for the empirical section of an effective therapeutic agent prior to availability of culture result.

Background: Urinary tract infections (UTIs) rank among the most prevalent bacterial infections in pediatric populations.¹ It is estimated that around 1% of boys and 3% of girls will experience UTIs in their first decade of life. The primary cause of this condition is typically due to an ascending infection from the urethra.

Objectives:

• To describe the clinical profile of infants and children hospitalized with urinary tract infections.
• To study the current antibiotic susceptibility patterns of the prevailing urinary pathogens.
• To study the treatment outcome of urinary tract infections in children.

Material & Methods: Study Design: Hospital-based descriptive study. Study area: The study was conducted in the Department of Paediatrics of a tertiary care hospital. Study Period: 1 year. Study population: Hospitalized Children aged between 0-18 years and diagnosed with urinary tract infection. Sample size: The study consisted of a total of 189 subjects.

Results: Among the Escherichia coli isolates, high resistance was observed for Ampicillin (87.9%) and Nalidixic acid (88.6%) followed by Cotrimoxazole (67.5%), Cefotaxime (66.9%), Ceftriaxone (66.9%), Cefixime (64.4%), Aztreonam (64.4%) Norfloxacin (64.2%), Cefipime (57.2%), Gentamicin (53.9%), Amoxicillin-Clavulunate (47.8%).

Conclusion: This study highlights the significant burden of urinary tract infections (UTIs) in children, particularly those under 5 years of age. The emergence of antibiotic-resistant bacteria, such as ESBL and carbapenemase-producing Enterobacteriaceae, poses a major challenge in treating these infections.

Asymptomatic bacteriuria (ASB) is a prevalent condition in Type-2 Diabetes Mellitus (T2DM) patients, often exacerbated by the chronic inflammatory milieu associated with diabetes. This study aims to evaluate and compare the levels of key inflammatory biomarkers—Interleukin-6 (IL-6), Tumor Necrosis Factor-alpha (TNF-α), C-reactive protein (CRP), and Hemoglobin A1c (HbA1c)—in T2DM patients with and without ASB in Northern Andhra Pradesh. IL-6 and TNF-α are pivotal pro-inflammatory cytokines that contribute to both the pathogenesis of insulin resistance and the inflammatory response during bacterial infections. Elevated IL-6 and TNF-α levels are associated with poor glycemic control and increased susceptibility to infections, including urinary tract infections. CRP, an acute-phase reactant, is commonly elevated in systemic inflammation and serves as a reliable marker for infection and inflammation, which is critical in assessing the risk of ASB in diabetic patients. HbA1c, reflecting long-term blood glucose control, is also implicated in chronic inflammation, with poorly controlled diabetes being linked to higher inflammation and infection rates. By assessing these biomarkers, this study aims to elucidate the relationship between systemic inflammation, glycemic control, and the incidence of ASB in T2DM.

Background: Urinary tract infections (UTIs) are common in elderly patients and pose significant health risks. This study aimed to assess the prevalence, risk factors, microbial isolates, and antibiotic resistance patterns of UTIs in elderly patients. Methods: A cross-sectional study was conducted involving 100 elderly patients. Demographic characteristics, prevalence of UTIs, associated risk factors, microbial isolates, and antibiotic resistance patterns were analyzed. The study used descriptive statistics and chi-square tests for analysis. Results: The mean age of participants was 72.4 years (SD = 6.8), with 52% female and 48% male. The overall prevalence of UTI was 24%, with a higher incidence in females (66.7%) compared to males (33.3%). UTI was most common in the age group 70-79 years (45.8%). Significant risk factors included female gender (p = 0.05), diabetes mellitus (p = 0.02), urinary incontinence (p = 0.04), catheterization history (p = 0.01), and immunocompromised status (p = 0.03). The most common microbial pathogen was Escherichia coli (58.3%), followed by Klebsiella pneumoniae (20.8%) and Enterococcus faecalis (12.5%). Antibiotic resistance was notably high, with Escherichia coli, Klebsiella pneumoniae, and Enterococcus faecalis exhibiting a 42.9% resistance rate to tested antibiotics. Conclusion: UTIs are prevalent among elderly patients, with several risk factors contributing to their development. High antibiotic resistance among common microbial pathogens calls for improved management strategies and appropriate antibiotic use in this vulnerable population.

Background: Urinary tract infections (UTIs) are among the most common bacterial infections in Pediatric patients. The emergence of antibiotic-resistant uropathogens has complicated empirical treatment strategies, necessitating continuous surveillance of resistance patterns.  Objectives: To evaluate the distribution of uropathogens and their antibiotic resistance profiles in pediatric UTIs over a 12-month period. Methods: A longitudinal observational study was conducted over one year in a tertiary care hospital. A total of 100 pediatric patients (aged 1 month to 12 years) clinically diagnosed with UTI were enrolled. Midstream urine samples were collected and processed for culture and sensitivity. The isolated organisms were identified, and antibiotic susceptibility testing was performed using the Kirby-Bauer disk diffusion method according to CLSI guidelines. Multidrug resistance (MDR) was defined as resistance to three or more antibiotic classes. Results: Escherichia coli was the most common isolate (66%), followed by Klebsiella pneumoniae (14%), Proteus mirabilis (8%), Enterococcus faecalis (6%), and Pseudomonas aeruginosa (4%). High resistance rates were observed for ampicillin (84.8% in E. coli, 92.9% in Klebsiella), cotrimoxazole, and ciprofloxacin. Nitrofurantoin and imipenem retained better sensitivity. Overall, 38% of isolates exhibited multidrug resistance. A rising trend in resistance to ampicillin and cotrimoxazole was noted over the study period.  Conclusion: This study highlights the alarming prevalence of antimicrobial resistance in pediatric UTIs, particularly among Gram-negative organisms. Regular monitoring of resistance patterns is essential to guide empirical therapy and limit the spread of MDR pathogens.