Different strategies have been approved for controlling extended-spectrum βeta lactamase (ESBL) producing uropathogenic bacteria. The antibacterial activity of Lactic acid bacteria (LAB) is an effective strategy due to its probiotic characteristics and beneficial effects on human health. The antibiotic susceptibility test, disk diffusion method, and double disc synergy test indicated that five enteric uropathogenic isolates were ESBL producers during the present study. They recorded diameters of inhibition zones as ≤ 18, ≤ 8, ≤ 19, and ≤ 8 mm against cefotaxime (CTX), ceftazidime (CAZ), aztreonam (ATM), and ceftriaxone (CRO). Genotypically, blaTEM genes are the most common, with (100 %) occurrence in all the five enteric tested uropathogens, followed by blaSHV and blaCTX genes (60 %). In addition, out of 10 LAB isolates from dairy products, the CFS of isolate no. K3 had high antibacterial activity against the tested ESBLs, especially no. U60, with a MIC of 600 µl. Additionally, the MIC and sub-MIC of K3 CFS inhibited the production of antibiotic-resistant bla TEM genes of U60. Analyzing the 16S rRNA sequence confirmed that the most potent ESBL-producing bacteria (U60) and LAB (K3) isolates were identified as Escherichia coli U60.1 and Weissella confuse K3 with accession numbers MW173246 and MW173299.1, respectively, in GenBank.

UNASSIGNED: Bacterial infections affect survival of patients with cirrhosis. Hospital-acquired bacterial infections present a growing healthcare problem because of the increasing prevalence of multidrug-resistant organisms. This study aimed to investigate the impact of an infection prevention and control programme and coronavirus disease 2019 (COVID-19) measures on the incidence of hospital-acquired infections and a set of secondary outcomes, including the prevalence of multidrug-resistant organisms, empiric antibiotic treatment failure, and development of septic states in patients with cirrhosis.
UNASSIGNED: The infection prevention and control programme was a complex strategy based on antimicrobial stewardship and the reduction of patient\'s exposure to risk factors. The COVID-19 measures presented further behavioural and hygiene restrictions imposed by the Hospital and Health Italian Sanitary System recommendations. We performed a combined retrospective and prospective study in which we compared the impact of extra measures against the hospital standard.
UNASSIGNED: We analysed data from 941 patients. The infection prevention and control programme was associated with a reduction in the incidence of hospital-acquired infections (17 vs. 8.9%, p <0.01). No further reduction was present after the COVID-19 measures had been imposed. The impact of the infection prevention and control programme remained significant even after controlling for the effects of confounding variables (odds ratio 0.44, 95% CI 0.26-0.73, p = 0.002). Furthermore, the adoption of the programme reduced the prevalence of multidrug-resistant organisms and decreased rates of empiric antibiotic treatment failure and the development of septic states.
UNASSIGNED: The infection prevention and control programme decreased the incidence of hospital-acquired infections by nearly 50%. Furthermore, the programme also reduced the prevalence of most of the secondary outcomes. Based on the results of this study, we encourage other liver centres to adopt infection prevention and control programmes.
UNASSIGNED: Infections are a life-threatening problem for patients with liver cirrhosis. Moreover, hospital-acquired infections are even more alarming owing to the high prevalence of multidrug-resistant bacteria. This study analysed a large cohort of hospitalised patients with cirrhosis from three different periods. Unlike in the first period, an infection prevention programme was applied in the second period, reducing the number of hospital-acquired infections and containing multidrug-resistant bacteria. In the third period, we imposed even more stringent measures to minimise the impact of the COVID-19 outbreak. However, these measures did not result in a further reduction in hospital-acquired infections.

This is a report of a women who failed 2 surgical repairs of vesicovaginal fistula secondary to refractory bladder spasms. After each surgical procedure - the hysterectomy and subsequent fistula repairs - the patient reported severe bladder spasms refractory to medical management. Our treatment was intradetrusor onabotuliniumtoxinA injections 4 weeks prior to a planned surgical fistula repair. The patient had successful vaginal approach fistula repair and has not required any subsequent overactive bladder (OAB) treatment.

Prostatic utricle cysts result from incomplete regression of the Müllerian duct remnant or decreased androgenic stimulation of the urogenital sinus. Children usually present with urinary tract infections (UTIs), irritative symptoms and urine retention, although some cases are asymptomatic. These cysts sometimes can cause a palpable abdominal mass, urethral discharge, terminal hematuria and recurrent epididymitis. A high incidence of such cysts is seen in boys with hypospadias, especially the more proximal types.

Duplex collecting systems are common congenital abnormalities of the urinary tract but are infrequently reported in adult populations. This abnormality can present with hydroureteronephrosis secondary to urinary tract obstruction or concomitant vesicoureteral reflux (VUR), recurrent urinary tract infections (UTIs), and urinary incontinence. Options for surgical management include common-sheath ureteral reimplantation, uretero-ureterostomy, pyelostomy, and heminephroureterectomy. We report the case of a 39-year-old female with a duplex kidney who presented with severe hydroureteronephrosis following a sacrocolpopexy.

UNASSIGNED: Emphysematous cystitis (EC) is a rare urinary tract infection (UTI) typically associated with severe diabetes in older women. We present a unique case of this gas-forming infection in a man with type 2 diabetes mellitus (T2DM) treated with empagliflozin. To the best of our knowledge, this is the first case report of EC associated with the use of a sodium-glucose cotransporter 2 inhibitor (SGLT2i).
UNASSIGNED: A 62-year-old man with T2DM treated with an SGLT2i developed EC. His moderately controlled T2DM was treated for over 20 years with metformin, saxagliptin/metformin, and pioglitazone to which empagliflozin was added due to his consistently elevated hemoglobin A1c level, slightly reduced estimated glomerular filtration rate, and proteinuria. Four months after initiation of the SGLT2i, he reported lower urinary tract symptoms and was found to have EC radiographically. His urine cultures were positive for Klebsiella pneumonia and was found to have asymptomatic urinary retention. He was treated conservatively, and his outcome was favorable.
UNASSIGNED: EC is commonly seen in patients with diabetes mellitus, and symptoms range from asymptomatic to severe sepsis. Most urine cultures grow Escherichia coli and K. pneumonia. The association of increased UTIs in susceptible patients with T2DM with the use of SGLT2i is yet to be determined. Most cases of EC are diagnosed radiographically and treated conservatively, although some cases require surgical intervention.
UNASSIGNED: Initially, our patient was considered a good candidate for treatment with an SGLT2i. The subsequent development of EC precluded its further use. The role of SGLT2i in patients with T2DM susceptible to UTI is controversial.

The stone inside the Allium bulbar urethral stent for treatment of urethral stenosis is an exceedingly rare disease. Herein, we report a case of the stone inside the Allium bulbar urethral stent(BUS) for treating urethral stricture in a 48-year-old Chinese male patient. The patient underwent a cystoscopy and URS for the stone inside BUS. The patient had only a symptom of urodynia. Urination of the patient is unobstructed after removing BUS and the urethral stricture of the patient was cured.

UNASSIGNED: There is no \"gold standard\" tool for the assessment of frailty in cirrhosis. This study compares Liver Frailty Index (LFI), Short Physical Performance Battery (SPPB), Fried Frailty Criteria (FFC), and Clinical Frailty Scale (CFS) for frailty assessment and ascertains its impact on predicting mortality and hospitalizations in a cohort of outpatients with cirrhosis.
UNASSIGNED: 116 patients were enrolled in this prospective observational cohort study. Frailty assessment was done using LFI, SPPB, FFC, and CFS. All patients were followed up for 6 months. The primary outcome was the first of either all-cause unplanned hospitalization or all-cause mortality occurring within 6 months of the study period.
UNASSIGNED: 100 (86.2%) males and 16 (13.8%) females with a mean age of 50.2 (48.4-51.9, 95% CI) years were included. The most common cause of cirrhosis was alcoholic liver disease (47.4%) followed by hepatitis C (12.9%) and Nonalcoholic steatohepatitis (NASH) (10.3%). There was no significant difference in prevalence of frailty based on LFI (43.1%), FFC (36.2%), CFS (44%), and SPPB (47.4%) (P > 0.05). Frail patients had worse outcomes compared to the Not frail group. At 6 months, the mortality rate in Frail patients was 42% versus 1.5% for the Not frail; hospitalization in Frail patients occurred in 92% versus 6% in the Not frail. On multivariable analysis, independent predictors of mortality were Frailty [OR 14 (1.4-54.2)], alcohol-related cirrhosis [OR 4.2 (1.1-16.3)], Child-Turcotte-Pugh (CTP) [OR 2.1 (1.4-2.9)] and Chronic liver disease questionnaire (CLDQ) [OR 0.1 (0.1-0.4)] scores.
UNASSIGNED: LFI, SPPB, FFC, and CFS are comparable in frailty assessment in patients with cirrhosis. Importantly, comparability of the commonly used scores for frailty assessment and prediction of hospitalization and mortality allows flexibility for clinical application.

Ketamine induced uropathy (KIU) is a urological condition increasing in prevalence, with similar symptoms to UTI, OAB syndrome or interstitial cystitis/bladder pain syndrome. We present the case of an 18-year old male who established severe LUTS and acute kidney injury due to KIU, in a short time-span of 6 months. Since cessation of ketamine is the cornerstone of treating KIU, correct and early diagnosis is essential. Physicians should therefore consider KIU as a differential diagnosis in storage LUTS, especially in younger patients with therapy-resistant LUTS.

In medical centers and hospitals one of the most dangers that threaten health care worker and patient are Nosocomial infections (NIs) and Needle stick injuries (NSIs). The aim of this study was to determination the effects of nosocomial infection and needle sticks injuries on patents and health care worker. A review study of literature was conducted to One thousand and fifty manuscripts were retrieved based on various databases: Elsevier, PubMed, Web of Science, Springer, and Google Scholar. Reporting data were used on predetermined consequences nosocomial infection and needle sticks injuries and related to adverse health effects, routes of transmission, control and reduction. The literature signs a notable undesirable affect from potential NIS and NSIs attributed to risk investigated among patents and health care worker. Based on Result this study, the resistance of antibiotics, non-standard personal protective equipment, and Needle recapping can endanger health of human and increase transfer infectious disease risk among exposed patients and health care worker. Useful for health system decision makers and political officials in order to cope with the incidence of nosocomial infections and decrease number of needle stick injuries among patients and health care worker can be the main application the results of this study. Increasing the level of awareness, especially of sensitive groups (patients and HCW), about the ways to prevent nosocomial infections and reduce needle sticks and proper use of personal protective equipment are the main vital managers of the health department actions for decrease the prevalence of NIs. Further research using more sophisticated methodology is warranted. Holding regular and periodic training workshops in connection with standard precautions and prevention of occurrence nosocomial infection and needle sticks injuries can play an important role in increasing the health of patents and health care worker.