Epidemiology of urinary tract infection: II. Diet, clothing, and urination habits.

Although several health habits and behaviors are commonly cited in medical and nursing textbooks as potential causes of urinary tract infection (UTI) in women, few have been studied in a systematic fashion. In a case-control study, we evaluated the associations between UTI and the most commonly mentioned risk factors: urination habits, diet, clothing, and soaps. Because sexual intercourse and diaphragm use increase the risk of UTI, we assessed the effect of health habits and behaviors controlling for these two risk factors. Women with initial UTI were compared with controls with no UTI history; women with a second UTI were compared to those with initial UTI. For the 25 initial cases, 19 secondary cases, and 181 controls enrolled in the study from a university health service, we found using tampons and drinking soft drinks to be moderately associated (RR greater than or equal to 1.4) with both initial and recurrent UTI. Although several other individual habits had only small associations with UTI, several of these behaviors together might substantially increase risk of initial or recurring UTI.     

Recurring urinary tract infection: incidence and risk factors.

Urinary tract infection (UTI) is a common infection among young women, with a high recurrence rate. This study documents the six-month incidence of second UTI among a cohort of women with one initial UTI and the factors associated with recurrence. Among the cohort of 113 women, 30 (26.6 percent) experienced at least one culture-confirmed recurrence within the six months following initial infection. The presence of hematuria and urgency as symptoms of initial infection were the strongest predictors of second infection. Behavioral factors associated with initial infection (frequency of sexual intercourse, diaphragm use, and voiding after sexual intercourse) did not distinguish between women who would and would not experience a second UTI during the six-month follow-up period.     

Religiosity,sexual intercourse and condom use among university students

Abstract: There is strong evidence that religiosity among adolescents is associated with delayed onset of sexual activity. However, research on relationships between religiosity and contraceptive practices is limited and inconsistent. This paper provides data from a survey of 374 students aged between 16 and 21 at two Brisbane universities (72.4 per cent response rate). Those who perceived religion to be important in their lives were less likely to have had intercourse. Among the sexually active sample, religious youth did not differ from their peers in recent condom use, the age at which they first used condoms or the rate of partner change. Contrary to several recent assertions in review articles, this and other empirical studies do not show that religious youth are less likely than nonreligious youth to take precautions during sex.     

Acute nosocomial urinary tract infection in children.

The spectrum and antimicrobial susceptibilities of pathogens causing acute nosocomial urinary tract infection in hospitalized pediatric patients were revealed to be heterogeneous. Therefore, to avoid the failure of empirical antimicrobial therapy in these patients, underlying disease and previous antimicrobial treatment have to be considered.     

L型菌慢性泌尿系感染诊断及抗生素运用

目的 探讨L型细菌在泌尿系的感染情况及其抗生素的耐药性,为临床诊治提供科学依据.方法 用改良Kagan培养基(L型平板)对临床泌尿系感染者的尿液进行分离培养,并对所获得的L型细菌进行药物敏感试验.结果 从128例患者的尿液标本中,检出L型伴细菌型感染率为82.8％ (106/128),普通培养细菌检出率为66.4％ (85/128).其中,慢性泌尿系感染L型伴细菌型分离率93.8％ (90/96),L型细菌分离率19.8％ (19/96),共19株,细菌型分离率为74.0％ (71/96).结论 对抗生素而言,耐药性最高的是青霉素类(青霉素G),其次依次为头孢菌素类(头孢三嗪、头孢唑啉、头孢噻肟)、氨基糖苷类(庆大霉素、阿米卡星、妥布霉素)和红霉素；而万古霉素、氯霉素、新生霉素呈低耐.临床对慢性泌尿系感染者应同时检测细菌及其L型,并根据药敏试验结果联合用药,以杀菌并阻止其变为L型.     

Interferences of urinary tract infection in the measurement of urinary nitrous oxide.

OBJECTIVES: To investigate the effective role of micro-organisms in producing N2O. METHODS: The N2O in either urine samples inoculated with 24 microbial strains or urine samples from patients with urinary tract infections were measured. RESULTS: Gram negative bacilli generally produced high amounts of nitrous oxide (N2O), whereas Gram positive cocci and yeasts did not. The production of N2O depends on the incubation time and follows exponential kinetics, reaching a plateau at 48 hours. Furthermore, the results of urinocultures agreed well with N2O concentrations found in urine samples: samples negative for bacteria were found to contain very low concentrations of N2O whereas those positive--for example, for Enterobacteriaceae--gave highest N2O values. CONCLUSION: The urinary tract infections caused by Gram negative bacilli are important confounding factors in biological monitoring practices of exposure to inhalation anaesthetics. The current methods adopted to avoid these factors (urine acidification, storage of samples at 4 degrees C) are not good enough because of the relative acid tolerance of some strains and the production of N2O directly into the bladder.     

Determinants of consistent condom use by adolescents: the impact of experience of sexual intercourse

This paper reports data from a cross-sectional survey of thedeterminants of consistent condom use of a random sample of1018 pupils (12 –19 years old) of 18 Dutch secondary schools.The survey is based on the theory of reasoned action and self-efficacytheory. In particular, the paper focuses upon the impact ofexperience of sexual intercourse on attitudes, perceived socialinfluences and self-efficacy assessments regarding condom usebecause of AIDS. The results clearly indicate that, besidesattitudes towards condom use, subjective social norms and self-efficacyexpectations are important determinants of intended use. Futhermore,the results show that intercourse experience has a negativeimpact on attitudes and perceived social norms regarding condomuse. It is concluded that besides a transfer of knowledge andpromotion of favorable attitudes towards condom use, AIDS educationshould pay attention to (1) the development and practice ofskills in coping with social pressures to engage in unprotectedintercourse, (2) the enhancement of skills regarding adequateuse, purchase and possession of condoms, and (3) the improvementof pupils' assertiveness in communicating about AIDS prevention,such as initiating a discussion on condom use.     

The determinants of sexual intercourse before age 16.

PURPOSE: To identify risk and protective factors for initiation of sexual intercourse before age 16 years at the level of the individual, family, and school. METHODS: A longitudinal study based on a cohort of 1020 people born in Dunedin, New Zealand in 1972/73 and followed up to age 21 years. Demographic characteristics of the sample were similar to the New Zealand population of that age, except that a smaller proportion (3%) were Maori or Pacific Island Polynesian. Information on individual, family and school factors was collected by interview with parents at ages 3, 5, 7 and 9 years and then by postal questionnaire two-yearly up to 15 years. Subjects were assessed two-yearly from age 3 years and interviewed about their behaviours and ambitions at ages 11, 13, and 15 years. Questions about age at first intercourse were asked by computer at age 21 years. Multivariate logistic regression was used to model associations with age of first intercourse less than 16 years. RESULTS: Data on age at first intercourse were available for 926/1020 (91%) of surviving members of the cohort assembled at age 3 years. Overall 27.5% of males and 31.7% of females reported sexual intercourse before age 16 years. In multivariate analyses the independent predictors for early sexual initiation for males were: not having outside home interests at age 13 years, no religious activity at age 11 years, not being attached to school at age 15 years, a low reading score, and a diagnosis of conduct disorder in early adolescence. For females, independent predictors were: socioeconomic status in the middle range, mother having her first child before age 20 years, IQ in the middle range, not being attached to school, being in trouble at school, planning to leave school early, cigarette smoking and higher self-esteem score. CONCLUSIONS: Individual and school factors appear to be more important than family composition or socioeconomic status in the decision to have sexual intercourse before age 16 years. The lowering of age at first intercourse may be partly a cohort effect related to high rates of teenage childbearing in the mothers' generation, and to changes in social acceptability of early sexual behaviour.     

导尿管相关尿路感染的监测及分析

目的了解留置导尿管患者导尿管相关尿路感染（CAUTI）发生情况,为降低CAUTI发病率提供依据。方法根据中国医院协会医院感染管理专业委员会“医院感染预防与控制能力建设项目”CAUTI监测项目要求,采用前瞻性监测方法,对某院2014年1—12月住院并接受留置导尿管≥2 d患者进行CAUTI监测,并比较不同患者情况CAUTI发病率。结果共监测留置导尿管患者6 046例,发生CAUTI 166例,留置导尿管总日数31 833 d,CAUTI发病率为2.75%、5.21‰。不同性别患者CAUTI发病率比较差异无统计学意义（χ2=1.23,P=0.54）;＞60岁组（4.72%）CAUTI发病率高于≤60岁组（2.07%）,差异有统计学意义（χ2=30.38,P＜0.01）;不同留置导尿管时间患者CAUTI发病率比较差异有统计学意义（χ2= 251.14,P＜0.01）;随着导尿管留置时间的延长,CAUTI发病率也随之增高（趋势χ2=211.82,P＜0.001）。神经内科平均留置导尿管时间最长（14.84 d）,CAUTI发病率最高（15.00%、10.11‰）;其他外科留置时间最短（3.56 d）,CAUTI发病率最低（0.97%、2.74‰）;不同科室留置导尿管患者CAUTI发病率（%）比较差异有统计学意义（χ2= 302.24,P＜0.001）。166例CAUTI患者检出病原菌66株,以革兰阴性杆菌为主（占86.36%）,大肠埃希菌占33.33%。结论CAUTI与患者年龄、留置导尿管时间有关,每日评估导尿管留置的必要性并及时拔管有利于减少CAUTI的发生。     

An outbreak of nosocomial Proteus rettgeri urinary tract infection.

Between December 1, 1971, and November 30, 1972, 11 patients on a single physical rehabilitation ward in a large St. Louis, Missouri, community hospital developed Proteus rettgeri urinary tract infections; P. rettgeri isolates from each patient were indole-negative and resistant in vitro to all antibiotics tested. Infected patients were more likely to have indwelling urinary tract catheters than were matched control patients, and all had previously received systemic antibiotic therapy. Retrospective epidemiologic investigation and microbiologic samplig at the time of the investigation failed to detect a common source of infection. Infected patients appeared to be the major reservoir of the epidemic strain, and indirect-contact transmission of the organism via nursing personnel probably occurred. Data collected from a prospective study suggested that placing catheterized patients in rooms that did not contain other catheterized patients may be an effective control measure.     

Salmonella urinary tract infection in pregnancy

Two cases of urinary tract infection in pregnancy are presented in which non-typhoid salmonellas were isolated in significant numbers from the urine. The implications of urinary tract excretion of salmonellas on laboratory identification protocols and hospital control of infection in maternity units is discussed.