Applied Risk Scoring in Acute Pyelonephritis: Evidence, Implementation, and Future Directions | Chapter 5 | Newer Frontiers in Urology, Volume III

 

Acute pyelonephritis (APN) spans a broad severity spectrum from uncomplicated febrile illness to emphysematous pyelonephritis with shock, creating a persistent need for reliable, bedside risk stratification. This chapter synthesises evidence on physiologic, disease-specific, and imaging-based scoring tools. It shows how to assemble them into a practical, layered pathway that improves triage, timing of imaging, and source control decisions. We review general sepsis scores (SIRS, SOFA, qSOFA, NEWS2) for early physiological surveillance; APN-specific clinical models for bacteremia prediction at first contact; global severity tools (Pitt Bacteremia Score, Charlson Comorbidity Index) for comorbidity and mortality profiling; and radiologic frameworks led by the Huang–Tseng CT classification for emphysematous pyelonephritis. Particular attention is given to a modified NEWS2 (mNEWS2) tailored for EPN, which retains original variables but re-bands risk and identifies scores ≥15 as a decisive high-risk delimiter linked to ICU need, nephrectomy, and mortality. We appraise biomarkers that add dynamic signal pro-calcitonin for bacteremia likelihood, lactate for occult hypoperfusion, and presepsin as an emerging adjunct and show how trends over 24–72 hours refine escalation or de-escalation. The chapter translates these elements into an implementation pathway: screen with NEWS2 or qSOFA; obtain early pro-calcitonin and lactate; expedite ultrasound or CT when red flags exist (diabetes, obstruction, acute kidney injury); apply APN specific bacteremia models to support admission and empiric coverage; and, in confirmed EPN, pair CT class with mNEWS2 bands to set thresholds for ICU, drainage, and early nephrectomy if non-responding. Special populations, such as those with diabetes, elderly or frail patients, transplant recipients, and those with obstruction, are addressed with lower action thresholds. Finally, we outline emerging opportunities for precision risk prediction, including machine learning classifiers to refine early bacteremia detection, radiomics-enhanced CT to integrate imaging features with clinical data, and transparent validation standards, moving APN care from static scores to adaptive, multimodal, precision risk prediction. The result is a clinician-facing roadmap that accelerates antibiotics, imaging, and decompression, reducing preventable harm across care systems.

 

 

Author(s) Details

Punith Jain R
Department of Urology and Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research Chennai, India.

 

Suryaram Aravind
Department of Urology and Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research Chennai, India.

 

Vivek Meyyappan
Department of Urology and Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research Chennai, India.

 

Velmurugan Palaniyandi
Department of Urology and Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research Chennai, India.

 

Hariharasudhan Sekar
Department of Urology and Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research Chennai, India.

 

Sriram Krishnamoorthy
Department of Urology and Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research Chennai, India.

 

Please see the book here :- https://doi.org/10.9734/bpi/mono/978-93-47485-93-0/CH5

Prevalence and Antimicrobial Susceptibility of Emerging Nosocomial Achromobacter xylosoxidans in a North Indian Tertiary Care Hospital | Chapter 4 | Research Perspectives of Microbiology and Biotechnology Vol. 4

 

The present study evaluates the prevalence and trends of Achromobacter xylosoxidans in clinical specimens and the trend in its sensitivity pattern. Achromobacter xylosoxidans is an emerging nosocomial pathogen that is commonly found in the environment. It may lead to nosocomial infections in hospital settings, particularly in the intensive care unit. It is frequently identified in humidifiers in intensive care units and is also frequently linked to patients who have several comorbidities and are immunocompromised. The Retrospective analysis was done of the culture reports positive for Achromobacter xylosoxidans by VITEK 2 method and its Antimicrobial sensitivity pattern was analysed from period of September 2021 to February 2023. The maximum (54.54%) infection was seen in the age group >50 years. The maximum number (66.2%) of Achromobacter xylosoxidans were isolated from the Suction tip, followed by blood (8%) and the Tracheal Tip (5%). Surgical ICU contributed to the maximum number of infections i.e. 40.2%, followed by Respiratory ICU (22.1%). Maximum sensitivity was seen for Cotrimoxazole and Meropenem (around 80%), followed by Cefoperazone-Sulbactam (74%), Imipenem, Levofloxacin, Ceftazidime (around 65%). The sensitivity was minimal for Ceftriaxone (0%), Aztreonam (1.3%), and Gentamicin (5.2%). The most common risk factors/comorbidities associated with Achromobacter infections was recent ICU admission (87.01%). The variation in antibiotic sensitivity or resistance can be due to the various factors like antibiotics used in patients in primary treatment, the immune status of the patients from which the sample was collected, overuse or misuse of antibiotics, availability of antibiotics, etc. The antibiotic of choice in our conclusion is Cotrimoxazole, followed by Piperacillin-Tazobactam. Colistin should be kept as a reserve drug for the last resort treatment.

 

 

Author(s) Details

Malvika Singh

Department of Microbiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.

Dimple Raina

Department of Microbiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.

Ranjana Rohilla

Department of Microbiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.

Himanshu Narula

Department of Microbiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.

Ajay Pandita

Department of Community Medicine, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.

 

Please see the link:- https://doi.org/10.9734/bpi/rpmab/v4/274

Prevalence and Antimicrobial Susceptibility of Emerging Nosocomial Achromobacter xylosoxidans in a North Indian Tertiary Care Hospital | Chapter 4 | Research Perspectives of Microbiology and Biotechnology Vol. 4

 

The present study evaluates the prevalence and trends of Achromobacter xylosoxidans in clinical specimens and the trend in its sensitivity pattern. Achromobacter xylosoxidans is an emerging nosocomial pathogen that is commonly found in the environment. It may lead to nosocomial infections in hospital settings, particularly in the intensive care unit. It is frequently identified in humidifiers in intensive care units and is also frequently linked to patients who have several comorbidities and are immunocompromised. The Retrospective analysis was done of the culture reports positive for Achromobacter xylosoxidans by VITEK 2 method and its Antimicrobial sensitivity pattern was analysed from period of September 2021 to February 2023. The maximum (54.54%) infection was seen in the age group >50 years. The maximum number (66.2%) of Achromobacter xylosoxidans were isolated from the Suction tip, followed by blood (8%) and the Tracheal Tip (5%). Surgical ICU contributed to the maximum number of infections i.e. 40.2%, followed by Respiratory ICU (22.1%). Maximum sensitivity was seen for Cotrimoxazole and Meropenem (around 80%), followed by Cefoperazone-Sulbactam (74%), Imipenem, Levofloxacin, Ceftazidime (around 65%). The sensitivity was minimal for Ceftriaxone (0%), Aztreonam (1.3%), and Gentamicin (5.2%). The most common risk factors/comorbidities associated with Achromobacter infections was recent ICU admission (87.01%). The variation in antibiotic sensitivity or resistance can be due to the various factors like antibiotics used in patients in primary treatment, the immune status of the patients from which the sample was collected, overuse or misuse of antibiotics, availability of antibiotics, etc. The antibiotic of choice in our conclusion is Cotrimoxazole, followed by Piperacillin-Tazobactam. Colistin should be kept as a reserve drug for the last resort treatment.

 

 

Author(s) Details

Malvika Singh

Department of Microbiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.

Dimple Raina

Department of Microbiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.

Ranjana Rohilla

Department of Microbiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.

Himanshu Narula

Department of Microbiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India.

Ajay Pandita

Department of Community Medicine, Shri Guru Ram Rai Institute of Medical and Health Sciences,

Dehradun, Uttarakhand, India.

 

Please see the link:- https://doi.org/10.9734/bpi/rpmab/v4/274

Newer Frontiers in Urology | Book Publisher International

The field of urology is undergoing a rapid evolution, shaped by groundbreaking research, innovative technologies, and a deeper understanding of patient-centred care. Newer Frontiers in Urology presents a comprehensive exploration of these transformative developments, offering readers an invaluable resource that bridges current practices with future possibilities. This book delves into cutting-edge topics such as minimally invasive surgical techniques, advancements in imaging modalities, and the growing role of artificial intelligence in diagnostics and treatment planning.

 

Key chapters address emerging therapies for challenging urological conditions, including genitourinary cancers, urinary tract infections, and stone disease. Contributions from leading experts highlight the integration of precision medicine, biomarkers, and genetic insights into personalized patient care. The text also considers the global impact of urological diseases, emphasizing equity in access to innovations and the need for collaborative international efforts.

 

By combining rigorous scientific analysis with practical applications, Newer Frontiers in Urology serves as an essential guide for clinicians, researchers, and healthcare professionals eager to stay at the forefront of their field. With its focus on innovation and patient outcomes, this volume inspires a forward-thinking approach to urology, underscoring the discipline's potential to improve lives worldwide.

 

Author (s) Details

Sriram Krishnamoorthy
Professor & Head, Department of Urology, Sri Ramachandra Institute of Higher Education & Research, Chennai, Tamil Nadu, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/mono/978-93-49238-86-2/CH0

Study and Prevalence of Orodental and Tongue Infections and Lesions Including Various Underlying Interconnected Conditions in Patients | Chapter 7 | Recent Updates in Disease and Health Research Vol. 6

 In the dental branch, the tongue and surrounding areas, are important for several functions. Likewise any deviation in oral mucosa and tongue, its size, shape, surface, or any disease, affects dental diagnosis, treatment plan and prognosis. It's therefore imperative to give importance to the tongue, oral mucosa and some medical dental conditions of the patient's mouth. Here, tongue and oral mucosa with their defects and conditions are studied. They impact patients' quality of life and dental health. The aim of this study is to assess the prevalence of tongue and oral mucosa lesions, and infections in patients with medical dental conditions. A cross-sectional study was conducted at a dental hospital in Lucknow, involving 100 patients aged between 18-75 years. Routine dental patients were screened for oral mucosa and tongue changes. The patient's medical history and tongue plus oral mucosa changes if any, were recorded. The results showed that some tongue and oral mucosa lesions including medical conditions were very much prevalent in high numbers of patients. Few patients had no complaints. Major patients were males and over 45 years of age. These findings highlight the importance of examining the tongue and oral mucosa thoroughly especially in medical conditions. These become vital for providing appropriate treatment and care. Also, the tongue and oral mucosa changes in medical history patients have to be given significance for improving patients' quality of life and dental oral health.

 

Author(s) Details:-

 

Isha Rastogi
Department of Dental, Mayo Institute of Medical Sciences, Barabanki, Uttar Pradesh, India.

 

Please see the link here:  https://doi.org/10.9734/bpi/rudhr/v6/8286E

The Effect of Aqueous Extract of Sutherlandia frutescens (Unwele) and Benzathine Penicillin on Enterococcus faecalis| Chapter 6 | Challenges and Advances in Pharmaceutical Research Vol. 10

 Therapeutic plants have existed used, for many age, traditionally for situation of infections. The mounting tumor of antimicrobial resistance, now, has led to chemists exploring their decontaminating activity to form an essential part of alternative situations.Aim: To assess the operation of the combination of the liquid extracts of Sutherlandia frutescens (S. frutescens) and benzathine penicillin on Enterococcus faecalis (E faecalis) utilizing disc spread and microdilution methods.Method: Leaf extract, of S. frutescens, were prepared in accordance with modified form of the German Homeopathic Pharmacopoea. The antibacterial endeavor of the combination, of the plant extract and benzathine medicine, was evaluated utilizing the disk diffusion test. The consolidation, of plant extract and penicillin, was in the percentage of 1:1. Results showing some form of inhibition were rooted, by the minimum inhibitory concentration assays, utilizing the agar dilution form. Bacterial sensitivity experiment was performed similarly modified Kirby-Bauer antimicrobial sympathy test. The combination and penicillin were all proven against E faecalis and, the results were compared to decide the synergistic or opposing activity.Results: Benzathine medicine inhibited the microorganisms producing a zone of hindrance which was effective 27 mm. The zones of inhibition for the alliance of extract and benzathine penicillin, against E faecalis, was 21 mm. The minimum inhibitory aggregation, of the combination, was 0% growth for 1 in 2 to 1 in 16 dilutions. This plainly indicates an opposing activity.Conclusion: The potential for evolving antimicrobials from plants, in vitro, supports a platform for phytomedicine and pharmacological studies.

Author(s) Details:

N. W. Nsele,
Department of Biomedical Sciences, Mangosuthu University of Technology, Umlazi, South Africa.

S. Moodley,
Department of Biomedical Sciences, Mangosuthu University of Technology, Umlazi, South Africa.

Please see the link here: https://stm.bookpi.org/CAPR-V10/article/view/8800

Indicators of Hookworm and Opisthorchis viverrini Infection: A Study among Adolescents in Urban Laos| Chapter 10 | Current Innovations in Medicine and Medical Science Vol. 7

 Present study proposed to recognize the determinants, containing elementary school fitness programs, had connection with infec- tion accompanying hookworm and O. viverrini between high school pupils in a big city of Laos. Children and youths in Laos are at extreme risk for hookworm and Opisthorchis viverrini contaminations. The study transported a cross-divided survey in September 2013. First, schoolteachers and graduates were cognizant about the study goals and processes. A total of 197 graduates consented to freely engage and marked consent forms. Students in first grade were not contained cause they were when confirmation all along the study ending.The contamination rates of O. viverrini and hookworm were 39.0% and 36.0%, respec- tively. Older pupils (OR=1.55, 95% CI: 1.01–2.37, p=0.046) and those whose father had uneven revenue (OR=0.47, 95% CI: 0.13–0.93, p=0.036) had a taller risk for hookworm contamination. Students whose mom had uneven pay (OR=0.30, 95% CI: 0.13–0.69, p=0.005) had a taller risk for O. viverrini contamination. Higher elementary school fitness program scores were guide a lower risk for hookworm contamination in the univariate model but not in the multivariate model.Hookworm contamination is connected to age and whole of the father. Older scholars are at a greater risk of contamination, while graduates whose father everything and earns a consistent gains are at a lower risk. Current elementary school well-being programs concede possibility need to underrate O. viverrini contaminations, and added measures, to a degree bright daughters to inquire takeovers that offer a compatible occupation for their offspring, grant permission should.

Author(s) Details:

Itsuko Yoshida,
Department of Nursing Science, Yasuda Women’s University, Hiroshima, Japan.

Osamu Horie,
Department of Clinical Laboratory Science, Tenri Health Care University, Tenri, Nara, Japan.

Kongsap Akkhavong,
Lao Tropical and Public Health Institute, Ministry of Health, Vientiane, Laos.

Please see the link here: https://stm.bookpi.org/CIMMS-V7/article/view/8649

Asymptomatic Human Immunodeficiency Virus Infections in Women Delegates at a Christian Conference in Niger State, North Central, Nigeria: A Prospective Study | Chapter 16 | Current Topics in Medicine and Medical Research Vol. 13

 Background: The global HIV/AIDS outbreak has claimed the lives of an estimated 21.8 million people, with another 36.1 million infected. The most popular mode of transmission worldwide is sexual transmission. At the start of an outbreak, when prevalence in the general population is extremely low, the HIV virus is mostly found primarily in these subpopulations.

The aim of this study is to determine the HIV prevalence rate among the female delegates at the meeting, as well as the incidence rate by age group and occupational category.

Materials and Methods: Each subject had 2 mL of venous blood drawn and inoculated in a micro-container evacuated blood collection system with additives (K2EK2EDTA- Greiner bio-one USA). The serum samples were tested using Determine kit HIV 1 & 2 according to the manufacturer's instructions, and the positive serum was confirmed with Uni-Gold. SPSS version 16.0 was used to code, calculate, and analyse the data, and p values less than 0.05 were considered statistically significant.

Results: Our study found that 2.8 percent of the 327 women delegates between the ages of 16 and 65 in this population had HIV infections, which was statistically insignificant (p=0.837, mean value=4.91, median=5.00, S.D=2.03).

In relation to age, the age groups 26 – 30 years and 36 – 40 years had a higher proportion of (8.7%) and (4.2%) of HIV positive people, respectively. Housewives had the highest percentage of HIV positive people (9.5 percent), followed by civil servants (3.7 percent ).

Conclusion: The overall prevalence rate of HIV infections in this conference population of 2.8 percent is a major health concern. As a result, we advocate for sex education at all levels of our religious traditions, for both youth and adults; however, sex education should not be overly spiritualized in order to minimise the threat in our culture. In order to reduce the government's financial burden, the private sector, such as non-governmental organisations, must also provide assistance.

Author (s) Details

Abayomi Rachel Olufunmilayo
Department of Medical Microbiology, Federal Medical Centre, Bida, Niger State, Nigeria

Akobi Oliver Adeyemi
Department of Medical Microbiology, Federal Medical Centre, Bida, Niger State, Nigeria

Olowosulu Ruth Omotayo
Department of Obstetrics and Gynecology, Federal Medical Centre, Bida, Niger State, Nigeria

Igunnu Shola Anna
Department of Histopathology, Federal Medical Centre, Bida, Niger State, Nigeria

Akanbiola Iyadunni Oluwabunmi
Department of Histopathology, Federal Medical Centre, Bida, Niger State, Nigeria

Ogedengbe Sunday Oladokun
Department of Medical Microbiology, Federal Medical Centre, Bida, Niger State, Nigeria

Akpata Amos Sunday Francis
Department of Chemical Pathology, Federal Medical Centre, Bida, Niger State, Nigeria

Imhanrobobhor Erdman Amos
Department of Chemical Pathology, Federal Medical Centre, Bida, Niger State, Nigeria

Akobi Evelyn Chimerenma
Department of Nursing, Federal Medical Centre, Bida, Niger State, Nigeria

Abayomi Malomo Abiobun
Department of Nutrition and Diabetic, Federal Polytechnic, Bida, Niger State, Nigeria

Uzoigwe Eunice Ogochukwu
Department of Medical Microbiology, Federal Medical Centre, Bida, Niger State, Nigeria

View Book :- https://stm.bookpi.org/CTMMR-V13/article/view/747