Special Issue "Urinary Tract Infection: Diagnosis, Treatment and Management"

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Diagnostic Microbiology and Infectious Disease".

Deadline for manuscript submissions: 31 July 2021.

Special Issue Editor

Dr. Tomislav Mestrovic
E-Mail
Guest Editor
University North, University Centre Varazdin, Varazdin, Croatia; Clinical Microbiology and Parasitology Unit, Dr. Zora Profozic Polyclinic, Zagreb, Croatia
Interests: community and hospital acquired urinary tract infections; surveillance of urinary tract infections; antimicrobial resistance of uropathogens; human microbiome; epidemiology; public health

Special Issue Information

Dear Colleagues,

Urinary tract infections (UTIs) represent one of the most common clinical entities in both community and health care settings; however, there is still a clear lack of practical clinical research to inform long-awaited clinical advances for improving UTI management strategies. Uncomplicated UTIs are usually self-limiting and generally considered benign, but untreated infections may progress to the upper urinary tract, resulting in pyelonephritis and kidney damage. The problem is additionally compounded by an increase of multiresistant uropathogens around the globe, which threatens our medical advances and has the potential to render our standard antibiotic treatment regimens ineffective.

As a result, swift and appropriate diagnosis is indispensable for timely treatment and UTI management. This Special Issue in the journal "Diagnostics" will focus on articles covering a range of topics including novel diagnostic approaches, the appropriateness of urine specimen collection, utilizing our available diagnostic armamentarium for surveillance, antimicrobial sensitivity/resistance patterns, as well as novel treatment and management approaches. Recently, there has also been a focus on the prevention of UTIs in hospitals and the community.

It is, therefore, my pleasure to invite submissions of high quality research-based or review papers related to the aforementioned topics to create a timely and highly relevant collection of articles tackling this pertinent medical problem.

Dr. Tomislav Mestrovic
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • diagnostics of UTI
  • surveillance of UTI
  • antibiotic resistance in uropathogens
  • antimicrobial treatment of UTI
  • antibiotic stewardship principles for UTI
  • non-antimicrobial management of UTI
  • prevention of UTI.

Published Papers (4 papers)

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Review

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Open AccessReview
Mechanisms of Resistance in Gram-Negative Urinary Pathogens: From Country-Specific Molecular Insights to Global Clinical Relevance
Diagnostics 2021, 11(5), 800; https://doi.org/10.3390/diagnostics11050800 - 28 Apr 2021
Viewed by 334
Abstract
Urinary tract infections (UTIs) are the most frequent hospital infections and among the most commonly observed community acquired infections. Alongside their clinical importance, they are notorious because the pathogens that cause them are prone to acquiring various resistance determinants, including extended-spectrum beta-lactamases (ESBL); [...] Read more.
Urinary tract infections (UTIs) are the most frequent hospital infections and among the most commonly observed community acquired infections. Alongside their clinical importance, they are notorious because the pathogens that cause them are prone to acquiring various resistance determinants, including extended-spectrum beta-lactamases (ESBL); plasmid-encoded AmpC β-lactamases (p-AmpC); carbapenemases belonging to class A, B, and D; qnr genes encoding reduced susceptibility to fluoroquinolones; as well as genes encoding enzymes that hydrolyse aminoglycosides. In Escherichia coli and Klebsiella pneumoniae, the dominant resistance mechanisms are ESBLs belonging to the CTX-M, TEM, and SHV families; p-AmpC; and (more recently) carbapenemases belonging to classes A, B, and D. Urinary Pseudomonas aeruginosa isolates harbour metallo-beta-lactamases (MBLs) and ESBLs belonging to PER and GES families, while carbapenemases of class D are found in urinary Acinetobacter baumannii isolates. The identification of resistance mechanisms in routine diagnostic practice is primarily based on phenotypic tests for the detection of beta-lactamases, such as the double-disk synergy test or Hodge test, while polymerase chain reaction (PCR) for the detection of resistance genes is mostly pursued in reference laboratories for research purposes. As the emergence of drug-resistant bacterial strains poses serious challenges in the management of UTIs, this review aimed to appraise mechanisms of resistance in relevant Gram-negative urinary pathogens, to provide a detailed map of resistance determinants in Croatia and the world, and to discuss the implications of these resistance traits on diagnostic approaches. We summarized a sundry of different resistance mechanisms among urinary isolates and showed how their prevalence highly depends on the local epidemiological context, highlighting the need for tailored interventions in the field of antimicrobial stewardship. Full article
(This article belongs to the Special Issue Urinary Tract Infection: Diagnosis, Treatment and Management)
Open AccessReview
A New Gold Rush: A Review of Current and Developing Diagnostic Tools for Urinary Tract Infections
Diagnostics 2021, 11(3), 479; https://doi.org/10.3390/diagnostics11030479 - 09 Mar 2021
Viewed by 388
Abstract
Urinary tract infections (UTIs) are one of the most common infections in the United States and consequently are responsible for significant healthcare expenditure. The standard urine culture is the current gold standard for diagnosing urinary tract infections, however there are limitations of the [...] Read more.
Urinary tract infections (UTIs) are one of the most common infections in the United States and consequently are responsible for significant healthcare expenditure. The standard urine culture is the current gold standard for diagnosing urinary tract infections, however there are limitations of the test that directly contribute to increased healthcare costs. As a result, new and innovative techniques have been developed to address the inefficiencies of the current standard—it remains to be seen whether these tests should be performed adjunctly to, or perhaps even replace the urine culture. This review aims to analyze the advantages and disadvantages of the newer and emerging diagnostic techniques such as PCR, expanded quantitative urine culture (EQUC), and next generation sequencing (NGS). Full article
(This article belongs to the Special Issue Urinary Tract Infection: Diagnosis, Treatment and Management)
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Open AccessReview
The Role of Gut, Vaginal, and Urinary Microbiome in Urinary Tract Infections: From Bench to Bedside
Diagnostics 2021, 11(1), 7; https://doi.org/10.3390/diagnostics11010007 - 22 Dec 2020
Cited by 2 | Viewed by 936
Abstract
The current paradigm of urinary tract infection (UTI) pathogenesis takes into account the contamination of the periurethral space by specific uropathogens residing in the gut, which is followed by urethral colonization and pathogen ascension to the urinary bladder. Consequently, studying the relationship between [...] Read more.
The current paradigm of urinary tract infection (UTI) pathogenesis takes into account the contamination of the periurethral space by specific uropathogens residing in the gut, which is followed by urethral colonization and pathogen ascension to the urinary bladder. Consequently, studying the relationship between gut microbiota and the subsequent development of bacteriuria and UTI represents an important field of research. However, the well-established diagnostic and therapeutic paradigm for urinary tract infections (UTIs) has come into question with the discovery of a multifaceted, symbiotic microbiome in the healthy urogenital tract. More specifically, emerging data suggest that vaginal dysbiosis may result in Escherichia coli colonization and prompt recurrent UTIs, while urinary microbiome perturbations may precede the development of UTIs and other pathologic conditions of the urinary system. The question is whether these findings can be exploited for risk reduction and treatment purposes. This review aimed to appraise the three aforementioned specific microbiomes regarding their potential influence on UTI development by focusing on the recent studies in the field and assessing the potential linkages between these different niches, as well as evaluating the state of translational research for novel therapeutic and preventative approaches. Full article
(This article belongs to the Special Issue Urinary Tract Infection: Diagnosis, Treatment and Management)
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Other

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Open AccessGuidelines
Guideline for Urine Culture and Biochemical Identification of Bacterial Urinary Pathogens in Low-Resource Settings
Diagnostics 2020, 10(10), 832; https://doi.org/10.3390/diagnostics10100832 - 16 Oct 2020
Viewed by 910
Abstract
Medical diagnosis in low-resource settings is confronted by the lack of suitable guidelines, protocols and checklists. Online-accessible procedural documents are difficult to find, might be mistranslated or interpreted and usually do not address the needs of developing countries. Urinalysis, one of the most [...] Read more.
Medical diagnosis in low-resource settings is confronted by the lack of suitable guidelines, protocols and checklists. Online-accessible procedural documents are difficult to find, might be mistranslated or interpreted and usually do not address the needs of developing countries. Urinalysis, one of the most frequently performed diagnostic examinations worldwide, involves a series of tests aiming to detect particular disorders, such as urinary tract infections, kidney disease and diabetes. In this guideline, we present an alternative approach for clinical laboratories with limited resources to identify common bacterial uropathogens. We propose dividing the identification plan into two levels. The implicated pathogen will first be assigned into a bacterial group, basic identification, against which a suitable panel of antimicrobial agents shall be selected for the antimicrobial susceptibility testing (AST). Characterization of the pathogen to the genus or species level, advanced identification, will then be performed to ensure correct reading of the AST results and determine the epidemiology of clinically significant pathogens. Most of the proposed steps in our guideline are tailored to meet the needs of clinical laboratories in low-resource settings. Such guidelines are needed to strengthen the capacity of regional pathology laboratories and to enhance international initiatives on antimicrobial resistance and health equity. Full article
(This article belongs to the Special Issue Urinary Tract Infection: Diagnosis, Treatment and Management)
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Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Title: The influence of natural phenolic componuds on FimH-mediated E. coli adhesion
Authors: Rosana Ribić (et al.)
Affiliation: University North, Croatia

Title: Mechanisms of resistance in Gram-negative urinary pathogens: from molecular insights to clinical relevance
Authors: Branka Bedenić (et al.)
Affiliation: University Hospital Centre Zagreb, Croatia

Title: The role of gut, vaginal and urinary microbiome in urinary tract infections: from bench to bedside
Authors: Mario Matijašić (et al.)
Affiliation: University of Zagreb Medical School, Croatia

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