Atypical pathogens in urinary tract infections: a systematic review
Abstract
Urinary tract infection [UTI] accounts for a significant portion of the worldwide infections, whose cause occurs predominantly through Gram-negative bacilli, followed by Gram-positive bacteria and fungi. However, a number of cases by atypical pathogens are increasing. Thus, a systematic review was carried out on UTIs caused by atypical/emerging agents, covering etiological, epidemiological, clinical and therapeutic aspects. The search conducted via PubMed database and 59 articles composed the final sample. The laboratory approaches reported have included uroculture with special media; molecular methods such as PCR, real-time PCR, and nucleic acid sequencing; and MALDI-TOF mass spectrometry. Pathogens found among bacteria, including Gram-negative bacilli, Gram-positive cocci, diphtheroids, Mycoplasmataceae members, actinomycetes, and Gram-variable coccobacilli; yeasts, molds and microsporidia; virus, including BK polyomavirus, HPV, CMV and HSV-2; and a protozoan, Trichomonas vaginalis. The risk factors appear to be associated with patients' intrinsic features, such as advanced age, female gender, chronic diseases, prostatic hyperplasia, immunocompromised, genitourinary tract alteration; or risky situations as long-term urinary catheter usage, urinary tract manipulation, cancer chemotherapy, alcoholism, prolonged use of antibiotics and risky sexual behavior. The difficulty in identifying these agents was also evident, due to their peculiar characteristics or the unavailability…
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Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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