exudates and Urinary-Tract-Infections

Complications associated with cerclage that are commonly described in the existing published reports include injuries to the cervix or bladder, premature rupture of membranes, chorioamnionitis and bleeding. We report an unusual complication of a ureterovaginal fistula formation after the insertion of a McDonald suture.

Topics: Adult; Anti-Bacterial Agents; Cerclage, Cervical; Cesarean Section, Repeat; Diagnosis, Differential; Drug Therapy, Combination; Female; Fetal Membranes, Premature Rupture; Humans; Infusions, Intravenous; Malaysia; Nephrostomy, Percutaneous; Postoperative Complications; Pregnancy; Pregnancy Complications, Infectious; Singapore; Treatment Outcome; Urinary Fistula; Urinary Tract Infections; Vaginal Fistula

The impact of bladder care and urinary complications on quality of life in persons with spinal cord injury who have neurogenic lower urinary tract dysfunction has not been elucidated, especially in those living in low-resource countries.. This multinational cross-sectional survey was conducted in rehabilitation facilities in Malaysia, Indonesia, and Thailand. Community-dwelling adults with traumatic or nontraumatic spinal cord injury participating in the International Spinal Cord Injury Community Survey from 2017 to 2018 were enrolled. Data regarding bladder management/care, presence of bladder dysfunction, urinary tract infection, and quality of life score were extracted from the International Spinal Cord Injury Community Survey questionnaire. The impact of bladder care and urinary complications on quality of life was determined using univariable and multivariable regression analysis.. Questionnaires from 770 adults were recruited for analysis. After adjusting for all demographic and spinal cord injury-related data, secondary conditions, as well as activity and participation factors, urinary tract infection was an independent negative predictive factor of quality of life score ( P = 0.007, unstandardized coefficients = -4.563, multivariable linear regression analysis, enter method).. Among bladder care and urinary complication factors, urinary tract infection is the only factor negatively impacting quality of life. These results address the importance of proper bladder management and urinary tract infection prevention in persons with spinal cord injury to improve their quality of life.

Topics: Adult; Cross-Sectional Studies; Humans; Indonesia; Malaysia; Quality of Life; Spinal Cord Injuries; Thailand; Urinary Bladder; Urinary Bladder, Neurogenic; Urinary Tract Infections

Diagnosis and management of urinary tract infection (UTI) are complex, and do not always follow guidelines. The aim of this study was to determine adherence to the 2014 Malaysian Ministry of Health guidelines for managing suspected UTI in a Malaysian primary care setting.. We retrospectively reviewed computerized medical records of adults with suspected UTI between July-December 2016. Excluded were consultations misclassified by the search engine, duplicated records of the same patient, consultations for follow-up of suspected UTI, patients who were pregnant, catheterised, or who had a renal transplant. Records were reviewed by two primary care physicians and a clinical microbiologist.. From 852 records, 366 consultations were a fresh episode of possible UTI. Most subjects were female (78.2%) with median age of 61.5 years. The major co-morbidities were hypertension (37.1%), prostatic enlargement in males (35.5%) and impaired renal function (31.1%). Symptoms were reported in 349 (95.4%) consultations. Antibiotics were prescribed in 307 (83.9%) consultations, which was appropriate in 227/307 (73.9%), where the subject had at least one symptom, and leucocytes were raised in urine full examination and microscopic examination (UFEME). In 73 (23.8%) consultations antibiotics were prescribed inappropriately, as the subjects were asymptomatic (14,4.6%), urine was clear (17,5.5%), or UFEME did not show raised leucocytes (42,13.7%). In 7 (2.3%) consultations appropriateness of antibiotics could not be determined as UFEME was not available.. Several pitfalls contributed to suboptimal adherence to guidelines for diagnosis and management of suspected UTI. This illustrates the complexity of managing suspected UTI in older subjects with multiple co-morbidities.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Infective Agents; Catheter-Related Infections; Diagnostic Tests, Routine; Disease Management; Female; Guideline Adherence; Humans; Malaysia; Male; Middle Aged; Primary Health Care; Retrospective Studies; Urban Population; Urinary Tract Infections; Young Adult

This is a retrospective audit of all patients admitted to the surgical unit for urosepsis from June 2014 to June 2015 at the General Surgery Unit of Hospital Sultan Ismail, Malaysia. Demographics, comorbidities, presenting symptoms, length of stay (LOS), mortality, and associated risk factors were recorded. There were 35 patients treated for urosepsis with a male preponderance of 21/35 patients. Hypertension (n=18) and diabetes (n=10) were the two most common comorbidities. There were five deaths (mortality rate=14.3%) and the main bacterium cultured was Escherichia coli. Age >65, presence of underlying comorbid disease, presence of cancer, urine and blood culture positivity had higher incidence of death but were not statistically significant for urosepsis mortality. However, this result is limited by the small sample size and single centre retrospective data.

Topics: Aged; Clinical Audit; Cohort Studies; Disease Progression; Female; Hospital Mortality; Humans; Incidence; Malaysia; Male; Middle Aged; Prognosis; Retrospective Studies; Risk Assessment; Sepsis; Surgery Department, Hospital; Survival Rate; Treatment Outcome; Urinary Tract Infections

Uropathogenic virulence factors have been identified by comparing the prevalence of these among urinary tract isolates and environmental strains. The uropathogenic-specific protein (USP) gene is present on the pathogenicity island (PAI) of uropathogenic Escherichia coli (UPEC) and, depending on its two diverse gene types and the sequential patterns of three open reading frame units (orfUs) following it, there is a method to characterize UPEC epidemiologically called PAIusp subtyping.. A total of 162 UPEC isolates from Sabah, Malaysia, were tested for the presence of the usp gene and the sequential patterns of three orfUs following it using polymerase chain reaction (PCR). In addition, by means of triplex PCR, the prevalence of the usp gene was compared with other two VFs of UPEC, namely alpha hemolysin (α-hly) and cytotoxic necrotizing factor (cnf-1) genes encoding two toxins.. The results showed that the usp gene was found in 78.40% of UPEC isolates, indicating that its prevalence was comparable to that found in a previous study in Japan. The two or three orfUs were also associated with the usp gene in this study. All the PAIusp subtypes observed in Japan were present in this study, while subtype IIa was the most common in both studies. The usp gene was observed in a higher percentage of isolates when compared with α-hly and cnf-1 genes.. The findings in Japan and Sabah, East Malaysia, were similar, indicating that PAIusp subtyping is applicable to the characterization of UPEC strains epidemiologically elsewhere in the world.

Topics: Bacterial Toxins; Escherichia coli Infections; Escherichia coli Proteins; Gene Order; Genomic Islands; Genotype; Genotyping Techniques; Hemolysin Proteins; Humans; Japan; Malaysia; Molecular Epidemiology; Molecular Typing; Open Reading Frames; Polymerase Chain Reaction; Urinary Tract Infections; Uropathogenic Escherichia coli; Virulence Factors

To determine the proportion of albicans and non-albicans candiduria in a hospital setting and to ascertain if fluconazole is still suitable as empirical antifungal therapy based on antifungal susceptibility patterns of Candida species.. The cross-sectional study was conducted between December 2010 and December 2011 at UKM Medical Centre, Kuala Lumpur, Malaysia and comprised 64 urine samples from patients who were either suspected or confirmed to have urinary tract infections. Yeasts were speciated using ID 32 C and subjected to antifungal susceptibility testing using Sensititre® YeastOne YO8.. Candida albicans accounted for 38(59.4%) of the isolates, Candida tropicalis 18(28.1%), Candida glabrata 6(9.4%) and Candida parapsilosis 2(3.1%). Overall, the isolates were susceptible to both amphotericin B (MIC90 1 μg/ml) and to 5-flucytosine (MIC90 0.25 μg/ml), but susceptible-dose dependent towards fluconazole (MIC90 16 μg/ml). Individually, Candida albicans was susceptible to fluconazole (MIC90 2 μg/ml), amphotericin B (MIC90 0.5 μg/ml) and 5-flucytosine (MIC90 0.25 μg/ml). Candida tropicalis was also susceptible to fluconazole (MIC90 4 μg/ml), amphotericin B (MIC90 1 μg/ml) and 5-flucytosine (MIC90 0.125 μg/ml). Candida glabrata was resistant to fluconazole (MIC90 64 μg/ml), but susceptible to amphotericin B (MIC90 1 μg/ml) and 5-flucytosine (MIC90 0.125 μg/ml). Lastly, Candida parapsilosis was resistant to fluconazole (MIC90 256 μg/ml), but susceptible to amphotericin B (MIC90 0.5 μg/ml) and 5-flucytosine (MIC90 0.5 μg/ml).. The commonest yeast associated with candiduria at the study site was Candida albicans, and fluconazole can still be used for empirical therapy of candiduria.

Topics: Amphotericin B; Antifungal Agents; Candida albicans; Candidiasis; Cross-Sectional Studies; Dose-Response Relationship, Drug; Fluconazole; Humans; Malaysia; Microbial Sensitivity Tests; Urinary Tract Infections

Topics: Anti-Bacterial Agents; beta-Lactam Resistance; beta-Lactamases; Female; Gene Expression Regulation, Bacterial; Gene Expression Regulation, Enzymologic; Humans; Klebsiella Infections; Klebsiella pneumoniae; Leukemia, Myeloid; Malaysia; Urinary Tract Infections; Young Adult

To study the causes and significance of both microscopic and macroscopic haematuria in adult patients and assess possible relevance to early detection of urological cancers.. 417 patients presenting with haematuria were assessed in our Urology Unit. Following confirmation of haematuria, these patients were subjected to imaging techniques and flexible cystoscopy. Parameters analysed included clinical characteristics, imaging results, flexible cystoscopy findings, time delay to diagnoses and eventual treatment and final diagnoses of all cases.. 390 haematuria cases were analysed from 417 consecutive patients with haematuria. After 27 cases were excluded as they had previous history, 245 microscopic and 145 macroscopic. Age range was 17 to 95 years old with predominance of 152 females to 239 males. The racial distribution included 180 Chinese, 100 Indians,95 Malays and 15 other races. The final diagnoses were benign prostatic hyperplasia (22.6%), no cause found (22.3%), other causes (18.7%), urolithiasis (11.5%), urinary tract infection UTI (10.8%), non specific cystitis (10.3%), bladder tumours (2.8%) and other genitourinary tumours (1%). 11 new cases (2.8%) of bladder cancers were diagnosed, with a mean age of 59 years. Only 3 of 245 (1.2%) patients with microscopic haematuria had newly diagnosed bladder tumour compared with 8 of 145 (5.5%) patients with frank haematuria (p=0.016). Mean time taken from onset of symptoms to diagnosis of bladder cancer was 53.3 days with definitive treatment (TURBT) in 20.1 days from diagnosis.. - This study has highlighted the common causes of haematuria in our local setting. We recommend that full and appropriate investigations be carried out on patients with frank haematuria especially those above 50 years old in order to provide earlier detection and prompt management of bladder diseases especially tumours.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Early Detection of Cancer; Female; Hematuria; Humans; Malaysia; Male; Middle Aged; Prostatic Hyperplasia; Urinary Bladder Neoplasms; Urinary Tract Infections; Urolithiasis; Young Adult

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.. Antibiotic prescribing data for URTI and UTI was extracted from a morbidity survey of randomly selected primary care clinics in Malaysia.. Analysis was performed of 1,163 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.. Greater effort is needed to bring about evidence based antibiotic prescribing in Malaysian primary care, especially for URTIs in private clinics.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Child; Drug Prescriptions; Drug Utilization; Female; Humans; Malaysia; Male; Middle Aged; Practice Patterns, Physicians'; Primary Health Care; Respiratory Tract Infections; Urinary Tract Infections; Young Adult

Xanthogranulomatous pyelonephritis is a clinico-pathological entity that is gaining awareness amongst urologists worldwide. It is an unusual chronic inflammatory lesion involving the kidney that destroys renal parenchyma and may mimic renal carcinoma. It is usually seen in middle-aged women and is associated with urinary tract infections and urinary calculi. Most reports and reviews of this condition come from the West; this study reviews the incidence and presentation of the condition in a Malaysian population.

Topics: Adult; Female; Granuloma; Humans; Malaysia; Male; Middle Aged; Pyelonephritis; Retrospective Studies; Time Factors; Urinary Calculi; Urinary Tract Infections; Xanthomatosis

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.

Topics: Biliary Tract Diseases; Bone Diseases; Cardiovascular Diseases; Communicable Diseases; Community Health Services; Diagnostic Services; Gastrointestinal Diseases; Humans; Joint Diseases; Lung Diseases; Malaysia; Neoplasms; Radiography; Radiology; Urinary Tract Infections