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Definitions of Urinary Tract Infection in Current Research: A Systematic Review.

ABSTRACT: Defining urinary tract infection (UTI) is complex, as numerous clinical and diagnostic parameters are involved. In this systematic review, we aimed to gain insight into how UTI is defined across current studies. We included 47 studies, published between January 2019 and May 2022, investigating therapeutic or prophylactic interventions in adult patients with UTI. Signs and symptoms, pyuria, and a positive urine culture were required in 85%, 28%, and 55% of study definitions, respectively. Five studies (11%) required all 3 categories for the diagnosis of UTI. Thresholds for significant bacteriuria varied from 10³ to 10⁵ colony-forming units/mL. None of the 12 studies including acute cystitis and 2 of 12 (17%) defining acute pyelonephritis used identical definitions. Complicated UTI was defined by both host factors and systemic involvement in 9 of 14 (64%) studies. In conclusion, UTI definitions are heterogeneous across recent studies, highlighting the need for a consensus-based, research reference standard for UTI.

SUBMITTER: Bilsen MP

PROVIDER: S-EPMC10323732 | biostudies-literature | 2023 Jul

REPOSITORIES: biostudies-literature

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Definitions of Urinary Tract Infection in Current Research: A Systematic Review.

Bilsen Manu P MP Jongeneel Rosa M H RMH Schneeberger Caroline C Platteel Tamara N TN van Nieuwkoop Cees C Mody Lona L Caterino Jeffrey M JM Geerlings Suzanne E SE Köves Bela B Wagenlehner Florian F Conroy Simon P SP Visser Leo G LG Lambregts Merel M C MMC

Open forum infectious diseases 20230627 7

Defining urinary tract infection (UTI) is complex, as numerous clinical and diagnostic parameters are involved. In this systematic review, we aimed to gain insight into how UTI is defined across current studies. We included 47 studies, published between January 2019 and May 2022, investigating therapeutic or prophylactic interventions in adult patients with UTI. Signs and symptoms, pyuria, and a positive urine culture were required in 85%, 28%, and 55% of study definitions, respectively. Five st ...[more]

PMID: 37426954

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Project description:Effective alternatives to antibiotics for alleviating symptoms of acute infections may be appealing to patients and enhance antimicrobial stewardship. Cranberry-based products are already in wide use for symptoms of acute urinary tract infection (UTI). The aim of this review was to identify and critically appraise the supporting evidence. The protocol was registered on PROSPERO. Searches were conducted of Medline, Embase, Amed, Cinahl, The Cochrane library, Clinicaltrials.gov and WHO International Clinical Trials Registry Platform. We included randomised clinical trials (RCTs) and non-randomised studies evaluating the effect of cranberry extract in the management of acute, uncomplicated UTI on symptoms, antibiotic use, microbiological assessment, biochemical assessment and adverse events. Study risk of bias assessments were made using Cochrane criteria. We included three RCTs (n = 688) judged to be at moderate risk of bias. One RCT (n = 309) found that advice to consume cranberry juice had no statistically significant effect on UTI frequency symptoms (mean difference (MD) -0.01 (95% CI: -0.37 to 0.34), p = 0.94)), on UTI symptoms of feeling unwell (MD 0.02 (95% CI: -0.36 to 0.39), p = 0.93)) or on antibiotic use (odds ratio 1.27 (95% CI: 0.47 to 3.43), p = 0.64), when compared with promoting drinking water. One RCT (n = 319) found no symptomatic benefit from combining cranberry juice with immediate antibiotics for an acute UTI, compared with placebo juice combined with immediate antibiotics. In one RCT (n = 60), consumption of cranberry extract capsules was associated with a within-group improvement in urinary symptoms and Escherichia coli load at day 10 compared with baseline (p < 0.01), which was not found in untreated controls (p = 0.72). Two RCTs were under-powered to detect differences between groups for outcomes of interest. There were no serious adverse effects associated with cranberry consumption. The current evidence base for or against the use of cranberry extract in the management of acute, uncomplicated UTIs is inadequate; rigorous trials are needed.

Project description:BackgroundEndometriosis is a common gynecological disorder, with rising incidence rates and a decreasing age of onset, significantly affecting patients' quality of life and overall health. Urinary tract endometriosis (UTE) is a rare and invasive form of endometriosis that often leads to urinary obstruction and can even result in renal failure. The clinical significance of diagnosing and treating UTE is increasingly recognized. However, there is currently a lack of systematic bibliometric analysis to provide an overview of this field. The purpose of this study is to comprehensively summarize the research status in this field over the past 30 years and predict future development trends to address diagnostic and therapeutic challenges.MethodsA comprehensive analysis was conducted on literature related to UTE published in the Web of Science Core Collection from 1995 to 2024. Research trends in this field were thoroughly analyzed and visualized using VOSviewer, CiteSpace, and the Bibliometrix R package.ResultsA total of 361 publications were analyzed, sourced from 122 journals, authored by 1,699 scholars affiliated with 610 institutions across 48 countries. Notably, Charles Chapron, Pietro Santulli, and Bruno Borghese from France led in publication volume. The University of Paris emerged as a prominent institution in this research area. Co-occurrence and co-citation analyses indicated that Charles Chapron holds the top position among global authors, demonstrating significant influence in the field. Future key research directions include studying the pathogenesis of the disease, conducting epidemiological studies, and developing comprehensive management strategies, with particular emphasis on renal and urethral endometriosis.ConclusionsThis study represents the first bibliometric analysis of UTE, summarizing its key values and emerging trends. The treatment approach for UTE has undergone significant changes due to ongoing research, shifting from surgical interventions to integrated management strategies. This evolution encompasses early diagnosis, treatment options, preoperative assessment and preparation, and long-term postoperative follow-up. The importance of enhanced collaboration among specialists in urology, gynecology, and other multidisciplinary areas is emphasized to promote effective diagnosis and treatment of UTE.

Project description:ObjectivesDespite the common use of contagion to analogize the spread of suicide, there is a lack of rigorous assessment of the underlying concept or theory supporting the use of this term. The present study aims to examine the varied definitions and potential utility of the term contagion in suicide-related research.Methods100 initial records and 240 reference records in English were identified as relevant with our research objectives, through systematic literature screening. We then conducted narrative syntheses of various definitions and assessed their potential value for generating new research.Results20.3% of the 340 records used contagion as equivalent to clustering (contagion-as-cluster); 68.5% used it to refer to various, often related mechanisms underlying the clustering phenomenon (contagion-as-mechanism); and 11.2% without clear definition. Under the category of contagion-as-mechanism, four mechanisms have been proposed to explain how suicide clusters occurred: transmission (contagion-as-transmission), imitation (contagion-as-imitation), contextual influence (contagion-as-context), and affiliation (contagion-as-affiliation). Contagion-as-cluster both confounds and constrains inquiry into suicide clustering by blending proposed mechanism with the phenomenon to be studied. Contagion-as-transmission is, in essence, a double or internally redundant metaphor. Contagion-as-affiliation and contagion-as-context involve mechanisms that are common mechanisms that often occur independently of apparent contagion, or may serve as a facilitating background. When used indiscriminately, these terms may create research blind spots. Contagion-as-imitation combines perspectives from psychology, sociology, and public health research and provides the greatest heuristic utility for examining whether and how suicide and suicidal behaviors may spread among persons at both individual and population levels.ConclusionClarifying the concept of "suicide contagion" is an essential step for more thoroughly investigating its mechanisms. Developing a clearer understanding of the apparent spread of suicide-promoting influences can, in turn, offer insights necessary to build the scientific foundation for prevention and intervention strategies that can be applied at both individual and community levels.

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Definitions of Urinary Tract Infection in Current Research: A Systematic Review.

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Definitions of Urinary Tract Infection in Current Research: A Systematic Review.

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