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UNASSIGNED: This study aims to investigate the impacts of phimosis on the health of the genitourinary system through Mendelian random analysis.
UNASSIGNED: A dual-sample Mendelian randomization (MR) analysis was conducted using the publicly available genome-wide association study (GWAS) data. The inverse variance weighted based on the random effects model (Re-IVW) method was used as the main statistical analysis. Complementary methods, including weighted median, MR-Egger regression, and MR pleiotropy residual sum and outlier (MR-PRESSO), were applied to detect or correct the impact of horizontal pleiotropy.
UNASSIGNED: Re-IVW showed a genetic predictive causal relationship of phimosis on glomerulonephritis (odds ratio [OR]: 1.37 [1.13-1.65], p = 0.00149) and IgA glomerulonephritis (OR: 1.57 [1.18-2.09), p = 0.00187). Suggestive evidence indicated that phimosis was associated with chronic nephritis syndrome (OR: 1.23 (1.00-1.51), p = 0.0481], acute nephritis syndrome (OR: 1.50 [1.13-2.01], p = 0.0058), and impotence (OR: 1.39 [1.11-1.73], p = 0.0035). Kidney and ureteral stone (OR: 1.14 [1.04-1.26], p = 0.0069), urethral strictures (OR: 1.26 [1.07-1.48], p = 0.0050), benign prostatic hyperplasia (OR: 1.07 [1.01-1.13], p = 0.0242), and decreased testicular function (OR: 0.72 [0.56-0.94], p = 0.0141) have genetically predictive causal relationships.
UNASSIGNED: In summary, we employed a series of reliable analytical methods to investigate the association between phimosis and 26 urogenital diseases. We have reported several strong associations, but more research is needed to evaluate whether this discovery is replicated in other environments and to gain a better understanding of potential mechanisms.

UNASSIGNED: This study aims to discern the significance of common hematological and biochemical parameters for predicting urinary tract infections in geriatric patients with hip fractures.
UNASSIGNED: Multivariable logistic regression and propensity score-matched analyses were conducted to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for UTIs. The abilities of these parameters to predict UTIs were evaluated by receiver operating characteristic (ROC) curves. Dose-response relationships were assessed by categorizing hematological and biochemical parameters into quartiles. Subgroup analyses were further explored to investigate the relationship between these parameters and urinary tract infections.
UNASSIGNED: Out of the 1,231 participants, 23.2% were diagnosed with UTIs. Hyperglycemia, hypoproteinemia and hyperglobulinemia were risk factors for UTIs in multivariate analysis. After propensity score matching, hyperglycemia (OR 2.14, 95% CI 1.50-3.05, p < 0.001), hypoproteinemia (OR 1.75, 95% CI 1.18-2.63, p = 0.006), and hyperglobulinemia (OR 1.38, 95% CI 0.97-1.97, p = 0.074) remained significantly associated with increased odds of urinary tract infections. ROC curve analyses showed moderate predictive accuracy of blood glucose, albumin and globulin for UTIs, with areas under the curves of 0.714, 0.633, and 0.596, respectively. Significant dose-response relationships were observed between these parameters and UTIs. The associations were consistent in subgroup analyses.
UNASSIGNED: Blood glucose, albumin and globulin levels can facilitate early identification of geriatric hip fracture patients at high risk of UTIs. These easily obtainable hematological and biochemical parameters provide a practical clinical prediction tool for individualized UTI prevention in this population.

Urinary tract infection (UTI) is a well-known bacterial infection posing serious health problem in children. A retrospective study was conducted to explore the uropathogen and its antibiotic resistance in children with UTI. Data of urine culture and antimicrobial susceptibility test was collected. Consequently, 840 children were included. The overall culture-positive UTI was 458 (54.52 %) with Escherichia coli 166 (36.24 %), followed by Enterococcus faecalis 59 (12.88 %), Enterococcus faecium 70 (15.28 %) and others. They were highly resistant to the most commonly used antibiotics. In 694 children with complicated UTI, there were 8 children with fungal infection. Multiple drug resistance (MDR) was recorded in 315 (80.98 %). The overall proportion of Extended Spectrum β-Lactamase (ESβL) production was 25 (6.43 %). In 146 children with simple UTI, MDR were also detected in 47 (77.05 %). There were 6 (9.84 %) positive for ESβL production. Our study found that complicated UTI was relatively common. Escherichia coli was the most prevalent isolate, followed by Enterococcus faecium and Enterococcus faecalis. These organisms were highly resistant to the most commonly used antibiotics. Relatively high prevalence of MDR and low ESβL-producing organisms were observed.

OBJECTIVE: Urinary tract infection (UTI) is a common postoperative complication, so exploring its risk factors is helpful to provide a basis for clinical prevention. This study aims to analyse the risk factors for UTI after lumbar interbody fusion (LIF).
METHODS: A single-centre retrospective study was conducted on the clinical data of 358 patients treated with LIF from April 2020 to April 2023. In accordance with the results of postoperative urine culture, the patients were divided into UTI group (n = 19, those with UTI after LIF) and control group (n = 332, those without UTI after LIF). Binary logistic regression analysis was carried out through collecting the medical records of the two groups to probe into the risk factors for UTI after LIF.
RESULTS: After seven patients were excluded, the remaining 351 patients were included in the analysis. In this study, 19 patients (5.41%) developed postoperative UTI, whereas 332 patients (94.59%) had no UTI. Regression analysis results showed drinking (odds ratio (OR) = 16.193, 95% confidence interval (CI): 1.017-257.860) and high preoperative C-reactive protein (CRP) level (OR = 3.237, 95% CI: 1.213-8.636) as risk factors for UTI after LIF. A high professional title of main surgeon (OR = 0.095, 95% CI: 0.010-0.932) and preoperative red blood cell (RBC) count (OR = 0.001, 95% CI: 0.000-0.198) were protective factors for UTI after LIF (p < 0.05).
CONCLUSIONS: This study advocated strengthening the prevention and treatment of UTI in patients who had drinking history, high preoperative CRP level and low preoperative RBC count, and received LIF based on the study results. Attention should be paid to the training of physicians with low professional title.

Urinary tract infection (UTI) is one of the most common infectious diseases among children, but there is controversy regarding the use of preventive antibiotics for children first diagnosed with febrile pyelonephritis. To the best of our knowledge, no studies have addressed this issue by the deep learning technology. Therefore, in the current study, we conducted a study using Tc99m-DMSA renal static imaging data to investigate the need for preventive antibiotics on children first diagnosed with febrile pyelonephritis under 2 years old. The self-collected dataset comprised 64 children who did not require preventive antibiotic treatments and 112 children who did. Using several classic deep learning models, we verified that it is feasible to screen whether the first diagnosed children with febrile pyelonephritis require preventive antibacterial therapy, achieving a graded diagnosis. With the AlexNet model, we obtained accuracy of 84.05%, sensitivity of 81.71% and specificity of 86.70%, respectively. The experimental results indicate that deep learning technology could provide a new avenue to implement computer-assisted decision support for the diagnosis of the febrile pyelonephritis.

BACKGROUND: Urinary tract infections (UTIs) are common bacterial infections, primarily caused by uropathogenic Escherichia coli (UPEC), leading to significant health issues and economic burden. Although antibiotics have been effective in treating UPEC infections, the rise of antibiotic-resistant strains hinders their efficacy. Hence, identifying novel bacterial targets for new antimicrobial approaches is crucial. Bacterial factors required for maintaining the full virulence of UPEC are the potential target. MepM, an endopeptidase in E. coli, is involved in the biogenesis of peptidoglycan, a major structure of bacterial envelope. Given that the bacterial envelope confronts the hostile host environment during infections, MepM\'s function could be crucial for UPEC\'s virulence. This study aims to explore the role of MepM in UPEC pathogenesis.
RESULTS: MepM deficiency significantly impacted UPEC\'s survival in urine and within macrophages. Moreover, the deficiency hindered the bacillary-to-filamentous shape switch which is known for aiding UPEC in evading phagocytosis during infections. Additionally, UPEC motility was downregulated due to MepM deficiency. As a result, the mepM mutant displayed notably reduced fitness in causing UTIs in the mouse model compared to wild-type UPEC.
CONCLUSIONS: This study provides the first evidence of the vital role of peptidoglycan endopeptidase MepM in UPEC\'s full virulence for causing UTIs. MepM\'s contribution to UPEC pathogenesis may stem from its critical role in maintaining the ability to resist urine- and immune cell-mediated killing, facilitating the morphological switch, and sustaining motility. Thus, MepM is a promising candidate target for novel antimicrobial strategies.

OBJECTIVE: To investigate the effect of low concentration of Wenyang Tonglin Decoction (WTD) on the binding conditions of R45 plasmid conjugative transfer under liquid phase conjugation and its mechanism.
METHODS: Escherichia coli CP9 (R45) and Staphylococcus aureus RN450RF were cultured in medium containing WTD, and their minimum inhibitory concentration (MIC) values were obtained. Using promoter fusion technology, E. coli CP9 (R45) containing a promoter fusion was obtained. β-Galactosidase activity of TrfAp and TrbBp was tested, and the mRNA expression of regulatory factors (TrbA, KorA, and KorB) was detected by real-time fluorescent quantitative polymerase chain reaction.
RESULTS: The MIC of E. coli CP9 (R45) was 400 g/L and that of S. aureus RN450RF was 200 g/L. When the drug concentration in the culture medium was 200 g/L, the highest number of conjugants was (3.47 ±0.20) × 107 CFU/mL At 90 h of conjugation, the maximum number of conjugants was (1.15 ±0.06) × 108 CFU/mL When the initial bacterial concentration was 108 CFU/mL, the maximum number of conjugants was (3.47 ± 0.20) × 107 CFU/mL. When the drug concentration was 200 g/L, the β-galactosidase activity of TrfAp and TrbBp significantly increased; the relative quantification of TrbA, KorA and KorB were significantly inhibited.
CONCLUSIONS: Low concentration of WTD promoted the development of bacterial resistance by affecting promoters and inhibiting the expression of regulatory factors.

OBJECTIVE: To explore the influencing factors of urinary tract infection (UTI) in hospitalized patients with spinal cord injury and to construct and verify the nomogram prediction model.
METHODS: This study is a retrospective cohort study. From January 2017 to March 2022, 558 patients with spinal cord injury admitted to the Department of Rehabilitation Medicine of a tertiary hospital in Anhui Province, China, were selected as the research objects, and they were randomly divided into training group (n = 390) and verification group (n = 168) according to the ratio of 7:3, and clinical data including socio-demographic characteristics, disease-related data, and laboratory examination data were collected. Univariate analysis and multivariate logistic regression were used to analyze the influencing factors of UTI in hospitalized patients with spinal cord injuries. Based on this, a nomogram prediction model was constructed with the use of R software, and the risk prediction efficiency of the nomogram model was verified by the receiver operating characteristic curve and calibration curve.
RESULTS: Logistic regression analysis showed that the American Spinal Cord Injury Association (ASIA)-E grade (compared with ASIA-A grade) was an independent protective factor for UTI in hospitalized patients with spinal cord injury (odds ratio < 1, P < 0.05), while white blood cell count and indwelling catheter were independent risk factors for UTI in hospitalized patients with spinal cord injury (odds ratio > 1, P < 0.05). Based on this, a nomogram risk predictive model for predicting UTI in hospitalized rehabilitation patients with spinal cord injury was constructed, which proved to have good predictive efficiency. In the training group and the verification group, the area under the receiver operating characteristic curve of the nomogram model is 0.808 and 0.767, and the 95% confidence interval of the area under the receiver operating characteristic curve of the nomogram in the training group and the verification group is 0.760∼0.856 and 0.688∼0.845, respectively, indicating the nomogram model has good discrimination. According to the calibration curve, the prediction probability of the nomogram model and the actual frequency of UTI in the training group and the verification group are in good consistency, and the results of the Hosmer-Lemeshow bias test also suggest that the nomogram model has a good calibration degree in both the training group and the verification group (P = 0.329, 0.067).
CONCLUSIONS: ASIA classification level, white blood cell count, and indwelling catheter are independent influencing factors of UTI in hospitalized patients with spinal cord injury. The nomogram prediction model based on the above factors can simply and effectively predict the risk of UTI in hospitalized patients with spinal cord injury, which is helpful for clinical medical staff to identify high-risk groups early and implement prevention, treatment, and nursing strategies in time.

OBJECTIVE: Diabetes and Urinary Tract Infections (UTIs) are both common and serious health problems. Shuangdong capsule, a Chinese patent medicine, has been used to treat these conditions. This study assesses its efficacy and mechanism in treating diabetes combined with UTIs.
METHODS: We induced diabetes in rats using streptozotocin and UTIs with Escherichia coli, dividing the rats into five groups: control, model, levofloxacin, Shuangdong capsule, and levofloxacin + Shuangdong capsule. After two weeks, we measured blood glucose, insulin, infection indicators, and bladder histology. We also detected the expression of insulin receptor substrate 1 (IRS1)-phosphoinositide 3-kinase (PI3K)-protein kinase B (Akt)-C-X-C motif chemokine ligand 2 (CXCL2) signaling pathway by Western Blot and the myeloperoxidase (MPO) levels by Enzyme-Linked Immunosorbent Assay (ELISA). Additionally, we conducted a Mendelian randomization study using genetic variants of the insulin receptor to assess its causal effect on UTI risk.
RESULTS: Shuangdong capsule improved bladder pathology and infection indicators, similar to levofloxacin. It did not affect blood glucose or insulin levels. Moreover, it reversed the suppression of the IRS1-PI3K-Akt-CXCL2 pathway and MPO levels caused by UTI in diabetic rats. The Mendelian randomization study showed that increased insulin receptor expression reduced UTI risk, which was consistent with the results of the animal experiments.
CONCLUSIONS: The Shuangdong capsule was effective in treating diabetes with UTIs. It may function by activating the IRS1-PI3K-Akt signaling pathway, thereby increasing CXCL2 and MPO levels, enhancing innate immunity, and promoting bacterial clearance. The Mendelian randomization study provided further evidence supporting the causal role of the insulin receptor in UTI prevention.