Most research on American cranberry in the prevention of urinary tract infection (UTI) has used juices. The spectrum of components in juice is limited. This study tested whether whole cranberry fruit powder (proanthocyanidin content 0.56%) could prevent recurrent UTI in 182 women with two or more UTI episodes in the last year. Participants were randomized to a cranberry (n = 89) or a placebo group (n = 93) and received daily 500 mg of cranberry for 6 months. The number of UTI diagnoses was counted. The intent-to-treat analyses showed that in the cranberry group, the UTIs were significantly fewer [10.8% vs. 25.8%, p = 0.04, with an age-standardized 12-month UTI history (p = 0.01)]. The Kaplan-Meier survival curves showed that the cranberry group experienced a longer time to first UTI than the placebo group (p = 0.04). Biochemical parameters were normal, and there was no significant difference in urinary phenolics between the groups at baseline or on day180. The results show that cranberry fruit powder (peel, seeds, pulp) may reduce the risk of symptomatic UTI in women with a history of recurrent UTIs.

• Klíčová slova
• Vaccinium macrocarpon, clinical chemistry markers, haematology, recurrent, urinary metabolites, urinary tract infection,
• MeSH
• dospělí MeSH
• infekce močového ústrojí * farmakoterapie   prevence a kontrola   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• ovoce MeSH
• proantokyanidiny MeSH
• rostlinné extrakty terapeutické užití   MeSH
• semena rostlinná MeSH
• Vaccinium macrocarpon * chemie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• proanthocyanidin MeSH Prohlížeč
• proantokyanidiny MeSH
• rostlinné extrakty MeSH

The objective is to review the literature related to lower urinary tract (LUT) conditions in children to conceptualize general practice guidelines for the general practitioner, pediatrician, pediatric urologist, and urologist. PubMed was searched for the last 15-year literature by the committee. All articles in peer-review journal-related LUT conditions (343) have been retrieved and 76 have been reviewed extensively. Prospective trials were few and the level of evidence was low. Most of the recommendations have been done by committee consensus after extensive discussion of literature reports. History taking is an integral part of evaluation assessing day- and nighttime urine and bowel control, urgency, and frequency symptoms. Exclusion of any neurogenic and organic cause is essential. Uroflowmetry and residual urine determination are recommended in all patients to evaluate bladder emptying. Urodynamic studies are reserved for refractory or complicated cases. Urotherapy that aims to educate the child and family about bladder and bowel function and guides them to achieve normal voiding and bowel habits should initially be employed in all cases except those who have urinary tract infections (UTI) and constipation. Specific medical treatment is added in the case of refractory overactive bladder symptoms and recurrent UTIs.Conclusion: Producing recommendations for managing LUTS in children based on high-quality studies is not possible. LUTS in children should be evaluated in a multimodal way by minimal invasive diagnostic procedures. Urotherapy is the mainstay of treatment and specific medical treatment is added in refractory cases.What is Known:• Symptoms of the lower urinary tract may have significant social consequences and sometimes clinical morbidities like urinary tract infections and vesicoureteral reflux. In many children, however, there is no such obvious cause for the incontinence, and they are referred to as having functional bladder problems.What is New:• This review aims to construct a practical recommendation strategy for the general practitioner, pediatrician, pediatric urologist, and urologist for LUTS in children. Producing recommendations for managing LUTS in children based on high-quality studies is not possible. LUTS in children should be evaluated in a multimodal way by minimal invasive diagnostic procedures. Urotherapy is the mainstay of treatment and specific medical treatment is added in refractory cases.

• Klíčová slova
• Dysfunction, Incontinence, Lower urinary tract, Management, Pediatric, Treatment,
• MeSH
• dítě MeSH
• infekce močového ústrojí diagnóza   etiologie   terapie   MeSH
• inkontinence moči diagnóza   etiologie   terapie   MeSH
• kombinovaná terapie MeSH
• lidé MeSH
• symptomy dolních močových cest diagnóza   etiologie   terapie   MeSH
• vezikoureterální reflux diagnóza   terapie   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• směrnice pro lékařskou praxi MeSH

Urinary tract infections affect mostly females. The infection and possible consequent ascent of bacteria is enhanced by various risk factors. Sex hormones regulate gene transcription implicated in immune cell development and maturation, in regulation of immune responses and immune signalling pathways. Limited knowledge is available; however, recent findings underline the importance of understanding the interactions between sex hormones and urinary tract infection to diminish the occurrence of complications related to this infection. This review summarizes and discusses the current knowledge on the correlation and impact of sex hormones on urinary tract infections.

• MeSH
• infekce močového ústrojí etiologie   metabolismus   MeSH
• lidé MeSH
• pohlavní steroidní hormony metabolismus   MeSH
• rizikové faktory MeSH
• signální transdukce genetika   fyziologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• pohlavní steroidní hormony MeSH

Microsporidia are emerging pathogens which cause an opportunistic infections in immunocompromised patients, especially those with AIDS. Intestinal microsporidiosis is the most recognized infection, whereas urinary tract infections caused by microsporidia are rarely paid attention to either due to their subclinical course or diagnostic difficulties. In this report dual microsporidial infection of urinary tract, caused by Enterocytozoon bieneusi and Encephalitozoon cuniculi was described in HIV/AIDS patients under cART therapy. Since microsporidiosis can cause severe complications or even death in immunosuppressed patients, our results suggest that microsporidial infection should be included in routine investigation of HIV-positive patients, even asymptomatic.

• MeSH
• Encephalitozoon cuniculi * fyziologie   MeSH
• encephalitozoonóza * komplikace   MeSH
• Enterocytozoon * fyziologie   MeSH
• HIV infekce komplikace   mikrobiologie   MeSH
• koinfekce MeSH
• lidé MeSH
• mikrosporidióza * komplikace   MeSH
• močové ústrojí * mikrobiologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Febrile urinary tract infections (fUTIs) are common after kidney transplantation (KTx); however, prospective data in a multicenter pediatric cohort are lacking. We designed a prospective registry to record data on fUTI before and after pediatric KTx. METHODS: Ninety-eight children (58 boys and 40 girls) ≤ 18 years from 14 mid-European centers received a kidney transplant and completed a 2-year follow-up. RESULTS: Posttransplant, 38.7% of patients had at least one fUTI compared with 21.4% before KTx (p = 0.002). Before KTx, fUTI was more frequent in patients with congenital anomalies of kidneys and urinary tract (CAKUT) vs. patients without (38% vs. 12%; p = 0.005). After KTx, fUTI were equally frequent in both groups (48.7% vs. 32.2%; p = 0.14). First fUTI posttransplant occurred earlier in boys compared with girls: median range 4 vs. 13.5 years (p = 0.002). Graft function worsened (p < 0.001) during fUTI, but no difference was recorded after 2 years. At least one recurrence of fUTI was encountered in 58%. CONCLUSION: This prospective study confirms a high incidence of fUTI after pediatric KTx, which is not restricted to patients with CAKUT; fUTIs have a negative impact on graft function during the infectious episode but not on 2-year graft outcome.

• Klíčová slova
• CAKUT, Children, Kidney transplantation, Outcome, Urinary tract infection,
• MeSH
• dítě MeSH
• horečka epidemiologie   etiologie   MeSH
• incidence MeSH
• infekce močového ústrojí komplikace   epidemiologie   etiologie   MeSH
• lidé MeSH
• mladiství MeSH
• nemoci ledvin chirurgie   MeSH
• opožděný nástup funkce štěpu epidemiologie   etiologie   MeSH
• předškolní dítě MeSH
• prospektivní studie MeSH
• rejekce štěpu epidemiologie   etiologie   MeSH
• rizikové faktory MeSH
• sexuální faktory MeSH
• transplantace ledvin škodlivé účinky   MeSH
• výsledek terapie MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH

INTRODUCTION: Kidney transplantation is now a routine method used to treat end-stage renal disease. About 10 % of kidney transplant patients are patients with autosomal dominant polycystic kidney disease (ADPKD). After successful kidney transplantation, recurrent urinary tract infections also occur in initially asymptomatic patients. MATERIAL AND METHODS: The group included 320 patients after kidney transplantation. We compared patients with ADPKD versus patients without ADPKD in terms of the presence of recurrent urinary tract infections. THE RESULTS: The incidence of recurrent urinary tract infections (rIMCs) was 18% in patients without ADPKD and 48% in patients without ADPKD. Nephrectomy after kidney transplantation due to recurrent urinary tract infections eliminated this infectious complication (in 86% of patients). CONCLUSION: Kidney transplant patients with ADPKD have a significantly higher incidence of recurrent urinary tract infections. Removal of polycystic kidneys is a suitable solution if the infection persists.

• Klíčová slova
• ADPKD, Transplantation, kidneys, polycystic kidneys, recurrent urinary tract infection,
• MeSH
• infekce močového ústrojí * komplikace   epidemiologie   MeSH
• lidé MeSH
• nefrektomie metody   MeSH
• polycystická choroba ledvin * komplikace   chirurgie   MeSH
• polycystické ledviny autozomálně dominantní * komplikace   chirurgie   MeSH
• retrospektivní studie MeSH
• transplantace ledvin * škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

CONTEXT: In 30% of children with urinary tract anomalies, urinary tract infection (UTI) can be the first sign. Failure to identify patients at risk can result in damage to the upper urinary tract. OBJECTIVE: To provide recommendations for the diagnosis, treatment, and imaging of children presenting with UTI. EVIDENCE ACQUISITION: The recommendations were developed after a review of the literature and a search of PubMed and Embase. A consensus decision was adopted when evidence was low. EVIDENCE SYNTHESIS: UTIs are classified according to site, episode, symptoms, and complicating factors. For acute treatment, site and severity are the most important. Urine sampling by suprapubic aspiration or catheterisation has a low contamination rate and confirms UTI. Using a plastic bag to collect urine, a UTI can only be excluded if the dipstick is negative for both leukocyte esterase and nitrite or microscopic analysis is negative for both pyuria and bacteriuria. A clean voided midstream urine sample after cleaning the external genitalia has good diagnostic accuracy in toilet-trained children. In children with febrile UTI, antibiotic treatment should be initiated as soon as possible to eradicate infection, prevent bacteraemia, improve outcome, and reduce the likelihood of renal involvement. Ultrasound of the urinary tract is advised to exclude obstructive uropathy. Depending on sex, age, and clinical presentation, vesicoureteral reflux should be excluded. Antibacterial prophylaxis is beneficial. In toilet-trained children, bladder and bowel dysfunction needs to be excluded. CONCLUSIONS: The level of evidence is high for the diagnosis of UTI and treatment in children but not for imaging to identify patients at risk for upper urinary tract damage. PATIENT SUMMARY: In these guidelines, we looked at the diagnosis, treatment, and imaging of children with urinary tract infection. There are strong recommendations on diagnosis and treatment; we also advise exclusion of obstructive uropathy within 24h and later vesicoureteral reflux, if indicated.

• Klíčová slova
• Antibacterial treatment, Children, Diagnosis, EAU, ESPU, Follow-up imaging, Renal scar, Treatment, Ultrasound, Urinary tract infection, Urine sampling, guidelines,
• MeSH
• antibakteriální látky terapeutické užití   MeSH
• diagnostické techniky urologické normy   MeSH
• dítě MeSH
• infekce močového ústrojí diagnóza   farmakoterapie   mikrobiologie   MeSH
• kojenec MeSH
• lidé MeSH
• novorozenec MeSH
• pediatrie normy   MeSH
• prediktivní hodnota testů MeSH
• rizikové faktory MeSH
• stupeň závažnosti nemoci MeSH
• urologie normy   MeSH
• výsledek terapie MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• směrnice pro lékařskou praxi MeSH
• Názvy látek
• antibakteriální látky MeSH

OBJECTIVES: The aim of this study was to evaluate the dependence of Escherichia coli resistance to fluoroquinolones on their use in the outpatients and inpatients in the Olomouc region of the Czech Republic. METHODS: Data on inpatient antibiotic use were obtained from the database of the Department of Pharmacology and expressed as defined daily dose per 100 bed-days (DBD). Data on outpatient prescriptions were obtained from the database of General Health Insurance Company and expressed in defined daily doses per 1000 clients per day (DID). Escherichia coli strains were isolated from samples of urine of both community and hospitalized patients suffering from acute bacterial urinary tract infection, examined using aerobic cultivation, and determined by standard biochemical procedures. RESULTS: The utilization of fluoroquinolones in inpatients has significantly (p < 0.01) increased from 2.52 DBD in 1997 to 4.29 DBD in 2002. In outpatients, fluoroquinolone utilization has also increased significantly from 0.14 to 0.95 DID (p < 0.01). In the same period, 9192 E. coli strains were isolated from inpatients and outpatients suffering by urinary tract infections and tested for the susceptibility to fluoroquinolones. Resistance increased significantly (p < 0.01) both in the hospital (from 2 to 9%) and in the community (from 1 to 10%). The development of E. coli resistance to fluoroquinolones correlates significantly with their utilization both in the hospital (r = 0.944, p = 0.005) and in the community (r = 0.859, p = 0.029). CONCLUSIONS: Results of this study shows the impact of fluoroquinolone utilization on E. coli resistance and support the need of controlled use of these effective antibiotics.

• MeSH
• antiinfekční látky močové terapeutické užití   MeSH
• bakteriální léková rezistence účinky léků   MeSH
• Escherichia coli účinky léků   izolace a purifikace   MeSH
• fluorochinolony terapeutické užití   MeSH
• infekce močového ústrojí farmakoterapie   mikrobiologie   MeSH
• infekce vyvolané Escherichia coli farmakoterapie   mikrobiologie   MeSH
• lidé MeSH
• nemocnice fakultní MeSH
• pacienti ambulantní MeSH
• pacienti hospitalizovaní MeSH
• retrospektivní studie MeSH
• spotřeba léčiv MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• antiinfekční látky močové MeSH
• fluorochinolony MeSH

Antibiotic resistance is increasing among Staphylococcus saprophyticus strains isolated from urinary tract infection. This necessitates alternative therapies. For this, a lytic phage (vB_SsapS-104) against S. saprophyticus, which formed round and clear plaques on bacterial culture plates, was isolated from hospital wastewater and characterized. Microscopy analysis showed that it had a small head (about 50 nm), tail (about 80 nm), and a collar (about 22 nm in length and 19 nm in width) indicating to be a phage within Siphoviridae family. Phage vB_SsapS-104 showed a large latency period of about 40 min, rapid adsorption rate that was significantly enhanced by MgCl2 and CaCl2, and high stability to a wide range of temperatures and pH values. Restriction analyses demonstrated that phage consists of a double-stranded DNA with an approximate genome size of 40 Kb. BLAST results did not show high similarity (megablast) with other previously identified phages. But, in Blastn, similarity with Staphylococcus phages was observed. Phage vB_SsapS-104 represented high anti-bacterial activity against S. saprophyticus isolates in vitro as it was able to lyse 8 of the 9 clinical isolates (%88.8) obtained from a hospital in Gorgan, Iran. It was a S. saprophyticus-specific phage because no lytic activity was observed on some other pathogenic bacteria tested. Therefore, phage vB_SsapS-104 can be considered as a specific virulent phage against of S. saprophyitcus isolated from urinary tract infection. This study provided the partial genomic characterization of S. saprophyticus phage and its application against urinary tract infection associated with S. saprophyticus. This phage also can be considered as a good candidate for a therapeutic alternative in the future.

• Klíčová slova
• Lytic bacteriophage, Siphoviridae, Staphylococcus saprophyticus, Urinary tract infection,
• MeSH
• antibakteriální látky farmakologie   MeSH
• DNA virů MeSH
• fágová terapie MeSH
• genom virový MeSH
• hostitelská specificita MeSH
• infekce močového ústrojí mikrobiologie   MeSH
• koncentrace vodíkových iontů MeSH
• latence viru MeSH
• lidé MeSH
• odpadní voda virologie   MeSH
• sekvenční analýza DNA MeSH
• Siphoviridae genetika   izolace a purifikace   ultrastruktura   MeSH
• stafylokokové bakteriofágy genetika   MeSH
• stafylokokové infekce mikrobiologie   MeSH
• Staphylococcus saprophyticus účinky léků   virologie   MeSH
• teplota MeSH
• transmisní elektronová mikroskopie MeSH
• virulence MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Írán MeSH
• Názvy látek
• antibakteriální látky MeSH
• DNA virů MeSH
• odpadní voda MeSH

Catheter-associated urinary tract infections (CAUTI) are among the most common healthcare-associated infections, which increase morbidity, mortality, prolong the length of hospitalization and have a significant impact on the cost of treatment. The most efficient preventive method is removing catheters as soon as possible and avoid unnecessary catheterizations. Treatment of asymptomatic bacteriuria is not recommended. In cases of serious CAUTI, vigorous antibiotic therapy covering multidrug-resistant uropathogens should be initiated. These recommendations are intended for all medical specialties to improve the care of patients with indwelling catheters in the prevention, diagnosis, and treatment of CAUTI in primary care and subsequent long-term care.

• Klíčová slova
• catheter-associated urinary tract infections, dysfunction of lower urinary tract, intermittent catheterization, permanent urethral catheter, urinary infection, urinary tract infection,
• MeSH
• hospitalizace MeSH
• infekce močového ústrojí * MeSH
• lidé MeSH
• močové katétry * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH