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Chapter 8 : Urosepsis: Overview of the Diagnostic and Treatment Challenges

Authors: Florian M. E. Wagenlehner1, Adrian Pilatz2, Wolfgang Weidner3, Kurt G. Naber4
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Affiliations: 1: Clinic for Urology, Pediatric Urology and Andrology, Justus-Liebig-University Gießen, D-35390 Gießen, Germany; 2: Clinic for Urology, Pediatric Urology and Andrology, Justus-Liebig-University Gießen, D-35390 Gießen, Germany; 3: Clinic for Urology, Pediatric Urology and Andrology, Justus-Liebig-University Gießen, D-35390 Gießen, Germany; 4: Technical University, 80333 Munich, Germany
Content Type: Monograph
Publication Year: 2017

Category: Microbial Genetics and Molecular Biology; Clinical Microbiology

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Abstract:

Urosepsis is defined as sepsis caused by an infection in the urogenital tract ( Table 1 ). In urosepsis, as in other types of sepsis, the severity of sepsis depends mostly upon the host response. Patients who are more likely to develop urosepsis include elderly patients; diabetics; immunosuppressed patients, such as transplant recipients; cancer patients receiving chemotherapy or corticosteroids; and patients with acquired immunodeficiency syndromes. However, all patients can be affected by bacterial species capable of inducing inflammation within the urinary tract.

Citation: Wagenlehner F, Pilatz A, Weidner W, Naber K. 2017. Urosepsis: Overview of the Diagnostic and Treatment Challenges, p 135-157. In Mulvey M, Klumpp D, Stapleton A (ed), Urinary Tract Infections: Molecular Pathogenesis and Clinical Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.UTI-0003-2012
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Urosepsis: Overview of the Diagnostic and Treatment Challenges
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Citation: Wagenlehner F, Pilatz A, Weidner W, Naber K. 2017. Urosepsis: Overview of the Diagnostic and Treatment Challenges, p 135-157. In Mulvey M, Klumpp D, Stapleton A (ed), Urinary Tract Infections: Molecular Pathogenesis and Clinical Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.UTI-0003-2012
/content/10.1128/9781555817404.chap8.fig8-1
Figure 1

Bacterial spectrum of pathogens detected in patients with septicaemia (n = 6,128).

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10.1128/9781555817404/fig8-1.gif
Image of Figure 1
Figure 1

Bacterial spectrum of pathogens detected in patients with septicaemia (n = 6,128).

Citation: Wagenlehner F, Pilatz A, Weidner W, Naber K. 2017. Urosepsis: Overview of the Diagnostic and Treatment Challenges, p 135-157. In Mulvey M, Klumpp D, Stapleton A (ed), Urinary Tract Infections: Molecular Pathogenesis and Clinical Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.UTI-0003-2012
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Figure 2

Ciprofloxacin resistance from the German blood culture studies 1983–1985, 1991–1992, 2000–2001, 2006–2007, and the Paul-Ehrlich resistance surveillance study 2007.

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10.1128/9781555817404/fig8-2.gif
Image of Figure 2
Figure 2

Ciprofloxacin resistance from the German blood culture studies 1983–1985, 1991–1992, 2000–2001, 2006–2007, and the Paul-Ehrlich resistance surveillance study 2007.

Citation: Wagenlehner F, Pilatz A, Weidner W, Naber K. 2017. Urosepsis: Overview of the Diagnostic and Treatment Challenges, p 135-157. In Mulvey M, Klumpp D, Stapleton A (ed), Urinary Tract Infections: Molecular Pathogenesis and Clinical Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.UTI-0003-2012
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Figure 3

Cefotaxime resistance from the German blood culture studies 1983–1985, 1991–1992, 2000–2001, 2006–2007, and the Paul-Ehrlich resistance surveillance study 2007.

10.1128/9781555817404/fig8-3_thmb.gif
10.1128/9781555817404/fig8-3.gif
Image of Figure 3
Figure 3

Cefotaxime resistance from the German blood culture studies 1983–1985, 1991–1992, 2000–2001, 2006–2007, and the Paul-Ehrlich resistance surveillance study 2007.

Citation: Wagenlehner F, Pilatz A, Weidner W, Naber K. 2017. Urosepsis: Overview of the Diagnostic and Treatment Challenges, p 135-157. In Mulvey M, Klumpp D, Stapleton A (ed), Urinary Tract Infections: Molecular Pathogenesis and Clinical Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.UTI-0003-2012
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Figure 4

Algorithm for management of urosepsis.

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10.1128/9781555817404/fig8-4.gif
Image of Figure 4
Figure 4

Algorithm for management of urosepsis.

Citation: Wagenlehner F, Pilatz A, Weidner W, Naber K. 2017. Urosepsis: Overview of the Diagnostic and Treatment Challenges, p 135-157. In Mulvey M, Klumpp D, Stapleton A (ed), Urinary Tract Infections: Molecular Pathogenesis and Clinical Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.UTI-0003-2012
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Tables

Urosepsis: Overview of the Diagnostic and Treatment Challenges
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Citation: Wagenlehner F, Pilatz A, Weidner W, Naber K. 2017. Urosepsis: Overview of the Diagnostic and Treatment Challenges, p 135-157. In Mulvey M, Klumpp D, Stapleton A (ed), Urinary Tract Infections: Molecular Pathogenesis and Clinical Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.UTI-0003-2012
/content/10.1128/9781555817404.chap8.tab8-1
TABLE 1

Definitions

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TABLE 1

Definitions

Citation: Wagenlehner F, Pilatz A, Weidner W, Naber K. 2017. Urosepsis: Overview of the Diagnostic and Treatment Challenges, p 135-157. In Mulvey M, Klumpp D, Stapleton A (ed), Urinary Tract Infections: Molecular Pathogenesis and Clinical Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.UTI-0003-2012
/content/10.1128/9781555817404.chap8.tab8-2
TABLE 2

Clinical diagnostic criteria of sepsis and septic shock

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TABLE 2

Clinical diagnostic criteria of sepsis and septic shock

Citation: Wagenlehner F, Pilatz A, Weidner W, Naber K. 2017. Urosepsis: Overview of the Diagnostic and Treatment Challenges, p 135-157. In Mulvey M, Klumpp D, Stapleton A (ed), Urinary Tract Infections: Molecular Pathogenesis and Clinical Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.UTI-0003-2012
/content/10.1128/9781555817404.chap8.tab8-3
TABLE 3

Antibiotics recommended for the treatment of urinary tract infections

Generic image for table
TABLE 3

Antibiotics recommended for the treatment of urinary tract infections

Citation: Wagenlehner F, Pilatz A, Weidner W, Naber K. 2017. Urosepsis: Overview of the Diagnostic and Treatment Challenges, p 135-157. In Mulvey M, Klumpp D, Stapleton A (ed), Urinary Tract Infections: Molecular Pathogenesis and Clinical Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.UTI-0003-2012
/content/10.1128/9781555817404.chap8.tab8-4
TABLE 4

Antibiotics recommended for the treatment of urosepsis

Generic image for table
TABLE 4

Antibiotics recommended for the treatment of urosepsis

Citation: Wagenlehner F, Pilatz A, Weidner W, Naber K. 2017. Urosepsis: Overview of the Diagnostic and Treatment Challenges, p 135-157. In Mulvey M, Klumpp D, Stapleton A (ed), Urinary Tract Infections: Molecular Pathogenesis and Clinical Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.UTI-0003-2012
/content/10.1128/9781555817404.chap8.tab8-5
TABLE 5

Target parameters of early goal-directed therapy ( )

Generic image for table
TABLE 5

Target parameters of early goal-directed therapy ( )

Citation: Wagenlehner F, Pilatz A, Weidner W, Naber K. 2017. Urosepsis: Overview of the Diagnostic and Treatment Challenges, p 135-157. In Mulvey M, Klumpp D, Stapleton A (ed), Urinary Tract Infections: Molecular Pathogenesis and Clinical Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.UTI-0003-2012

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