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Redwood R, Claeys KC. The Diagnosis and Treatment of Adult Urinary Tract Infections in the Emergency Department. Emerg Med Clin North Am 2024; 42:209-230. [PMID: 38641388 DOI: 10.1016/j.emc.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
Emergency medicine has been called the art of "making complicated clinical decisions with limited information." This description is particularly relevant in the case of diagnosis and treatment of urinary tract infections (UTIs). Although common, UTIs are often challenging to diagnose given the presence of non-specific signs and symptoms and over-reliance on laboratory findings. This review provides an interdisciplinary interpretation of the primary literature and practice guidelines, with a focus on diagnostic and antimicrobial stewardship in the emergency department.
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Affiliation(s)
- Robert Redwood
- Bozeman Health Emergency Department, 915 Highland Avenue, Bozeman, MT 59715, USA
| | - Kimberly C Claeys
- Department of Pharmacy Science and Health Outcomes Research, University of Maryland School of Pharmacy, 20 N Pine Street, Baltimore, MD 21201, USA.
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Ahmed AE, Abdelkarim S, Zenida M, Baiti MAH, Alhazmi AAY, Alfaifi BAH, Majrabi RQM, Khormi NQM, Hakami AAA, Alqaari RAM, Alhasani RA, Alajam RA, Alshehri MM, Alenazi AM, Alqahtani B, Alshamrani M, Alhowimel A, Abdelwahab SI. Prevalence and Associated Risk Factors of Urinary Tract Infection among Diabetic Patients: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:healthcare11060861. [PMID: 36981518 PMCID: PMC10048613 DOI: 10.3390/healthcare11060861] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/26/2023] [Accepted: 02/28/2023] [Indexed: 03/17/2023] Open
Abstract
Urinary tract infections (UTIs) are one of the most common long-term complications of diabetes mellitus (DM). Additionally, various factors, such as socio-demographics, type of DM, fasting blood glucose, regular diabetes monitoring, comorbid chronic diseases, HbA1c, body mass index (BMI), and duration of DM, are also thought to predispose individuals to developing UTIs more frequently when they have DM. This research aims to evaluate the risk factors for UTIs and their prevalence among people with DM in Saudi Arabia (KSA). This cross-sectional study was conducted among 440 adults with type 1, type 2, and gestational DM. The participants had to be at least 18 years old, of both genders, and had been suffering from DM for any period of time. A self-administered questionnaire was utilized to collect data on demographic characteristics, such as sex, age, height, weight, material state, education level, income, and clinical profiles of DM and UTI. The crude (COR) and adjusted odds ratios (AOR) were calculated using logistic regression in the IBM SPSS software. The incidence of types 1 and 2 DM and gestational diabetes reached 34.1, 60.9, and 5%, respectively. Most of the participants had first-degree relatives with DM (65.9%). UTI was common in 39.3% of participants. A chi-squared statistical analysis revealed that the frequency of UTI varied depending (χ2 = 5.176, P = 0.023) on the type of DM. Burning urination and abdominal pain were the most common symptoms. The CORs for sex, marital status, hypertension, and BMI were significant (P < 0.05) and had values of 2.68 (95% CI = 1.78–4.02), 0.57 (95% CI = 0.36–0.92), 1.97 (95% CI = 1.14–3.43), and 2.83 (95% CI = 1.19–2.99), respectively. According to the adjusted model, only sex influenced the occurrence of UTIs. The AOR for sex was 3.45 (95% CI = 2.08–5.69). Based on this study, the authorities related to the health of DM patients can use its findings to guide awareness programs and clinical preparedness.
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Affiliation(s)
- Anas Elyas Ahmed
- Faculty of Medicine, Jazan University, Jazan GGGD6622, Saudi Arabia
| | | | - Maria Zenida
- Faculty of Medicine, Jazan University, Jazan GGGD6622, Saudi Arabia
| | | | | | | | | | | | | | | | | | - Ramzi Abdu Alajam
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan GGGD6622, Saudi Arabia
| | - Mohammed M. Alshehri
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan GGGD6622, Saudi Arabia
- Medical Research Centre, Jazan University, Jazan GGGD6622, Saudi Arabia
| | - Aqeel M. Alenazi
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan GGGD6622, Saudi Arabia
| | - Bader Alqahtani
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan GGGD6622, Saudi Arabia
| | - Meshal Alshamrani
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan GGGD6622, Saudi Arabia
| | - Ahmed Alhowimel
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan GGGD6622, Saudi Arabia
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