PDF(Pubmed)
Abstract：
UNASSIGNED: Urinary tract infection (UTI) stands out as the third-most common infection following gastrointestinal and respiratory tract infections. Over the past decade, the biomarker procalcitonin (PCT) has gained prominence to facilitate the detection of bacterial infections and reduce excessive antibiotic exposure.
UNASSIGNED: The objective of this study was to mitigate the overuse of antibiotics, by promoting the noninitiation or early discontinuation of empirical antibiotics, which would significantly help minimize the proliferation of multidrug-resistant bacteria.
UNASSIGNED: A prospective observational study was carried out at the tertiary care center in the Department of General Medicine of Kalinga Institute of Medical Sciences, Bhubaneswar, involving 200 patients with symptoms of lower UTI such as increased frequency, urgency, burning micturition, retention, and suprapubic tenderness with or without positive urinalysis. Detailed demographic profiles along with symptoms at the time of admission were recorded in a pretested structured format. To determine a positive diagnosis of UTI, signs and symptoms of UTI with or without urinary cultures were tested. The PCT level was estimated using enhanced chemiluminescence technique. Other routine tests such as complete blood count, renal function test, liver function test, urine routine microscopy, culture, chest X-ray, and ultrasonography abdomen pelvis were done and recorded. All patients, who had an initial serum PCT level of < 0.5 ng/mL, were kept under observation with only conservative and symptomatic treatments. Patients were further reviewed for improvement in symptoms and repeat urine microscopy. All patients, who had an initial serum PCT level of > 0.5 ng/mL, were initiated with antibiotics as per the culture and sensitivity reports. Patients were followed up for improvement in symptoms with reports of repeated urinalysis.
UNASSIGNED: Our study reported the fact that 9.5% of the patients with initial serum PCT ≥ 0.5 ng/mL showed no improvement in symptoms despite starting antibiotics while significantly higher number of symptomatic patients (60%) with initial serum PCT < 0.5 ng/ml showed improvement in symptoms with conservative treatment without antibiotics.
UNASSIGNED: A lower PCT level rules out bacterial invasion and thus can be used as a novel marker in antibiotic stewardship.
UNASSIGNED: The objective of this study was to mitigate the overuse of antibiotics, by promoting the noninitiation or early discontinuation of empirical antibiotics, which would significantly help minimize the proliferation of multidrug-resistant bacteria.
UNASSIGNED: A prospective observational study was carried out at the tertiary care center in the Department of General Medicine of Kalinga Institute of Medical Sciences, Bhubaneswar, involving 200 patients with symptoms of lower UTI such as increased frequency, urgency, burning micturition, retention, and suprapubic tenderness with or without positive urinalysis. Detailed demographic profiles along with symptoms at the time of admission were recorded in a pretested structured format. To determine a positive diagnosis of UTI, signs and symptoms of UTI with or without urinary cultures were tested. The PCT level was estimated using enhanced chemiluminescence technique. Other routine tests such as complete blood count, renal function test, liver function test, urine routine microscopy, culture, chest X-ray, and ultrasonography abdomen pelvis were done and recorded. All patients, who had an initial serum PCT level of < 0.5 ng/mL, were kept under observation with only conservative and symptomatic treatments. Patients were further reviewed for improvement in symptoms and repeat urine microscopy. All patients, who had an initial serum PCT level of > 0.5 ng/mL, were initiated with antibiotics as per the culture and sensitivity reports. Patients were followed up for improvement in symptoms with reports of repeated urinalysis.
UNASSIGNED: Our study reported the fact that 9.5% of the patients with initial serum PCT ≥ 0.5 ng/mL showed no improvement in symptoms despite starting antibiotics while significantly higher number of symptomatic patients (60%) with initial serum PCT < 0.5 ng/ml showed improvement in symptoms with conservative treatment without antibiotics.
UNASSIGNED: A lower PCT level rules out bacterial invasion and thus can be used as a novel marker in antibiotic stewardship.
摘要：
■尿路感染（UTI）是继胃肠道和呼吸道感染之后的第三大常见感染。在过去的十年里，生物标志物降钙素原(PCT)在促进细菌感染检测和减少抗生素过度暴露方面得到了重视.
■这项研究的目的是减轻抗生素的过度使用，通过促进经验性抗生素的不开始或早期停药，这将大大有助于减少多药耐药细菌的增殖。
■在卡林加医学科学研究所普通医学系的三级护理中心进行了一项前瞻性观察性研究，布巴内斯瓦尔,涉及200名具有较低UTI症状的患者，例如频率增加，紧迫性,燃烧的排尿，保留,和耻骨上压痛伴或不伴阳性尿液分析。详细的人口统计学特征以及入院时的症状以预先测试的结构化格式记录。为了确定UTI的阳性诊断，对有或没有尿培养的UTI的体征和症状进行了测试。使用增强化学发光技术估计PCT水平。其他常规检查，如全血细胞计数，肾功能试验,肝功能检查,尿常规显微镜检查,文化,胸部X光,进行腹部骨盆超声检查并记录。所有患者,初始血清PCT水平<0.5ng/mL，只接受保守和对症治疗。进一步检查患者的症状改善和重复尿液显微镜检查。所有患者,初始血清PCT水平>0.5ng/mL，根据培养和敏感性报告，用抗生素开始。随访患者症状改善，并报告重复尿液分析。
■我们的研究报告了以下事实：尽管开始使用抗生素，但初始血清PCT≥0.5ng/mL的患者中有9.5％的患者症状没有改善，而有症状的患者数量显着增加（60％）初始血清PCT<0.5ng/mL的患者在不使用抗生素的保守治疗下症状有所改善。
■较低的PCT水平可以排除细菌入侵，因此可以用作抗生素管理中的新型标记。
■这项研究的目的是减轻抗生素的过度使用，通过促进经验性抗生素的不开始或早期停药，这将大大有助于减少多药耐药细菌的增殖。
■在卡林加医学科学研究所普通医学系的三级护理中心进行了一项前瞻性观察性研究，布巴内斯瓦尔,涉及200名具有较低UTI症状的患者，例如频率增加，紧迫性,燃烧的排尿，保留,和耻骨上压痛伴或不伴阳性尿液分析。详细的人口统计学特征以及入院时的症状以预先测试的结构化格式记录。为了确定UTI的阳性诊断，对有或没有尿培养的UTI的体征和症状进行了测试。使用增强化学发光技术估计PCT水平。其他常规检查，如全血细胞计数，肾功能试验,肝功能检查,尿常规显微镜检查,文化,胸部X光,进行腹部骨盆超声检查并记录。所有患者,初始血清PCT水平<0.5ng/mL，只接受保守和对症治疗。进一步检查患者的症状改善和重复尿液显微镜检查。所有患者,初始血清PCT水平>0.5ng/mL，根据培养和敏感性报告，用抗生素开始。随访患者症状改善，并报告重复尿液分析。
■我们的研究报告了以下事实：尽管开始使用抗生素，但初始血清PCT≥0.5ng/mL的患者中有9.5％的患者症状没有改善，而有症状的患者数量显着增加（60％）初始血清PCT<0.5ng/mL的患者在不使用抗生素的保守治疗下症状有所改善。
■较低的PCT水平可以排除细菌入侵，因此可以用作抗生素管理中的新型标记。
