2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T6d2,Urinary tract infections (UTIs) occur commonly following kidney transplant and are associated with significant morbidity. Some providers perform intra-operative antibiotic bladder irrigation at the time of ureteroneocystostomy, although practice varies widely among surgeons. As a result, this study was performed to assess outcomes following a single intravesical gentamicin injection for the prevention of UTIs. This was a retrospective cohort study of adult patients who underwent a first isolated kidney transplant between January 2018 and January 2023. Outcomes were compared between patients who received bladder irrigation with a single dose of gentamicin and controls who did not receive antibiotic irrigation. The primary end point was the incidence of culture-confirmed UTI within 3-months of transplant. Key secondary endpoints included delayed allograft function and serum creatinine at 3-months. A total of 764 patients were included in the study analysis (gentamicin = 406 vs. control = 358). At 3 months, the incidence of UTIs was 18.2% in the gentamicin group compared to 13.1% in the control group (p = 0.05). A higher incidence of BK viremia >10,000 copies/mL was also observed in the gentamicin group compared with control patients (5.9% vs. 2.5%; p = 0.02). After multivariable regression analysis older age, female sex, early rejection, longer dialysis vintage, and urinary catheter duration were all found to be positively correlated with the incidence of UTIs. Among kidney transplant recipients, bladder irrigation with gentamicin was not found to reduce the incidence of UTIs at 3 months. Additional studies should explore a possible association between antibiotic bladder irrigation and subsequent BK viremia.31:Ta18,ABSTRACT Introduction Urinary tract infections (UTIs) occur commonly following kidney transplant and are associated with significant morbidity. Some providers perform intra‐operative antibiotic bladder irrigation at the time of ureteroneocystostomy, although practice varies widely among surgeons. As a result, this study was performed to assess outcomes following a single intravesical gentamicin injection for the prevention of UTIs. Methods This was a retrospective cohort study of adult patients who underwent a first isolated kidney transplant between January 2018 and January 2023. Outcomes were compared between patients who received bladder irrigation with a single dose of gentamicin and controls who did not receive antibiotic irrigation. The primary end point was the incidence of culture‐confirmed UTI within 3‐months of transplant. Key secondary endpoints included delayed allograft function and serum creatinine at 3‐months. Results A total of 764 patients were included in the study analysis (gentamicin = 406 vs. control = 358). At 3 months, the incidence of UTIs was 18.2% in the gentamicin group compared to 13.1% in the control group ( p = 0.05). A higher incidence of BK viremia >10,000 copies/mL was also observed in the gentamicin group compared with control patients (5.9% vs. 2.5%; p = 0.02). After multivariable regression analysis older age, female sex, early rejection, longer dialysis vintage, and urinary catheter duration were all found to be positively correlated with the incidence of UTIs. Conclusion Among kidney transplant recipients, bladder irrigation with gentamicin was not found to reduce the incidence of UTIs at 3 months. Additional studies should explore a possible association between antibiotic bladder irrigation and subsequent BK viremia. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Urinary Tract Infection: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Urinary Tract Infection (condition). Clinician-written summaries and actionable practice insights. 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Reserve qPCR testing for patients with high clinical suspicion for UTI, and continue to integrate symptom assessment and culture data in diagnosis."}},{"doi":"10.1016/j.jtcvs.2026.07.017","pmid":"42546916","title":"Interhospital Variation in 180-Day Infections and Associated Medicare Spending after Cardiac Surgery","journal_title":"The Journal of Thoracic and Cardiovascular Surgery","journal_issn":"0022-5223","published_at":"2026-08-04T00:00:00.000Z","url":"https://doi.org/10.1016/j.jtcvs.2026.07.017","source_score":2,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-11T13:26:14.383Z","updated_at":"2026-08-11T13:26:14.383Z","tags":[{"paper_doi":"10.1016/j.jtcvs.2026.07.017","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1016/j.jtcvs.2026.07.017","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1016/j.jtcvs.2026.07.017","tag_type":"condition","value":"Pneumonia","value_numeric":null},{"paper_doi":"10.1016/j.jtcvs.2026.07.017","tag_type":"condition","value":"Postoperative Infection","value_numeric":null},{"paper_doi":"10.1016/j.jtcvs.2026.07.017","tag_type":"condition","value":"Sepsis","value_numeric":null},{"paper_doi":"10.1016/j.jtcvs.2026.07.017","tag_type":"condition","value":"Surgical Site Infection","value_numeric":null},{"paper_doi":"10.1016/j.jtcvs.2026.07.017","tag_type":"condition","value":"Urinary Tract Infection","value_numeric":null},{"paper_doi":"10.1016/j.jtcvs.2026.07.017","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.jtcvs.2026.07.017","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.jtcvs.2026.07.017","tag_type":"modality","value":"Cardiac Surgery","value_numeric":null},{"paper_doi":"10.1016/j.jtcvs.2026.07.017","tag_type":"sample_size","value":"n=239039","value_numeric":239039},{"paper_doi":"10.1016/j.jtcvs.2026.07.017","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jtcvs.2026.07.017","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.jtcvs.2026.07.017","tag_type":"warning","value":"The cohort is 87.1% White Medicare beneficiaries aged 74+ — findings may not generalize to younger, non-White, or non-Medicare cardiac surgery populations.","value_numeric":null},{"paper_doi":"10.1016/j.jtcvs.2026.07.017","tag_type":"warning","value":"The impact_flag 'practice_changing' is applied because the $441M avoidable spending projection and 23.6% spending variation attributable to infections represent a strong policy and quality-improvement signal, though causal inference is limited by study design.","value_numeric":null},{"paper_doi":"10.1016/j.jtcvs.2026.07.017","tag_type":"warning","value":"The study is observational using administrative claims; infection rate differences across hospitals may partly reflect coding practice variation rather than true clinical differences.","value_numeric":null}],"summaries":{"what_studied":"This study examined interhospital variation in 180-day postoperative infection rates (including UTI, pneumonia, sepsis, sternal wound infection, and others) among 239,039 Medicare beneficiaries undergoing cardiac surgery at 1,007 hospitals between January 2018 and June 2023, and linked those rates to Medicare spending and clinical outcomes.","key_result":"Infections occurred in 20.8% of procedures. High- vs. low-tercile infection-rate hospitals were associated with +$15,757 in mean 180-day Medicare spending per procedure (95% CI: $15,169–$16,345); infection rates explained 23.6% of spending variation. Benchmarking to the lowest tercile could prevent ~2,603 infections and ~$441M in annual Medicare payments.","limitations":"Observational Medicare claims data cannot establish causation; coding accuracy for infection diagnoses may vary by hospital. The cohort is limited to Medicare beneficiaries (mean age 74.2 years, predominantly White), limiting generalizability to younger or commercially insured populations.","practice_takeaway":"Hospitals in the highest infection-rate tercile carry a substantial cost and outcomes burden after cardiac surgery — reducing postoperative infections toward best-practice benchmarks could meaningfully cut both patient harm and healthcare spending. Cardiac surgery programs should benchmark their 180-day infection rates against low-tercile peers as a quality and cost-reduction target."}},{"doi":"10.1080/01443615.2026.2708142","pmid":"42516041","title":"Health Belief Model-based education on preventive behaviors of gestational urinary tract infections: a Quasi-experimental study","journal_title":"Journal of Obstetrics and Gynaecology","journal_issn":"0144-3615","published_at":"2026-07-28T00:00:00.000Z","url":"https://doi.org/10.1080/01443615.2026.2708142","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-06T13:22:08.378Z","updated_at":"2026-08-06T13:22:08.378Z","tags":[{"paper_doi":"10.1080/01443615.2026.2708142","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1080/01443615.2026.2708142","tag_type":"category","value":"Obstetrics & Gynecology","value_numeric":null},{"paper_doi":"10.1080/01443615.2026.2708142","tag_type":"condition","value":"Gestational Urinary Tract Infection","value_numeric":null},{"paper_doi":"10.1080/01443615.2026.2708142","tag_type":"condition","value":"Urinary Tract Infection","value_numeric":null},{"paper_doi":"10.1080/01443615.2026.2708142","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1080/01443615.2026.2708142","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1080/01443615.2026.2708142","tag_type":"modality","value":"Health Education Intervention","value_numeric":null},{"paper_doi":"10.1080/01443615.2026.2708142","tag_type":"sample_size","value":"n=93","value_numeric":93},{"paper_doi":"10.1080/01443615.2026.2708142","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1080/01443615.2026.2708142","tag_type":"study_design","value":"Quasi-Experimental Study","value_numeric":null},{"paper_doi":"10.1080/01443615.2026.2708142","tag_type":"warning","value":"Absolute score changes and effect sizes for HBM constructs and behavior scales are not reported in the abstract; numbers beyond p-values are unavailable.","value_numeric":null},{"paper_doi":"10.1080/01443615.2026.2708142","tag_type":"warning","value":"No randomization was performed — cluster assignment to intervention vs. control may introduce selection bias.","value_numeric":null},{"paper_doi":"10.1080/01443615.2026.2708142","tag_type":"warning","value":"Published date (2026-07-28) is in the future relative to today's date context; this appears consistent with the stated study period of 2024–2025.","value_numeric":null},{"paper_doi":"10.1080/01443615.2026.2708142","tag_type":"warning","value":"The study population was restricted to women with confirmed UTI, so findings may not apply to UTI-prevention in the general pregnant population.","value_numeric":null}],"summaries":{"what_studied":"A quasi-experimental study evaluated the effect of a 5-session, Health Belief Model (HBM)-based educational intervention vs. standard prenatal care on UTI preventive behaviors among 93 pregnant women with confirmed UTI in Khormoj, Iran (2024–2025), with outcomes assessed at baseline and 3 months post-intervention.","key_result":"All HBM constructs (perceived susceptibility, severity, benefits, barriers, cues to action, self-efficacy) improved significantly in the intervention group vs. control (p < 0.05), and UTI preventive behaviors increased significantly in the intervention group (p = 0.001).","limitations":"- Small, single-site sample (n=93) limits generalizability.\n- Non-randomized cluster allocation increases risk of selection bias.\n- Outcomes rely on self-reported questionnaires, which may overestimate behavior change.","practice_takeaway":"Adding brief, structured HBM-based education (five 30-minute sessions) to routine prenatal visits may meaningfully improve UTI preventive behaviors in pregnant women. Clinicians in antenatal care settings could consider integrating such targeted health education, particularly in under-resourced communities."}},{"doi":"10.1016/j.eururo.2026.04.011","pmid":"42457453","title":"European Association of Urology Guidelines on Urological Infections: Summary of the 2026 Guidelines","journal_title":"European Urology","journal_issn":"0302-2838","published_at":"2026-07-15T00:00:00.000Z","url":"https://doi.org/10.1016/j.eururo.2026.04.011","source_score":7,"is_retracted":false,"is_open_access":null,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":false},"created_at":"2026-07-21T13:34:33.271Z","updated_at":"2026-07-21T13:34:33.271Z","tags":[{"paper_doi":"10.1016/j.eururo.2026.04.011","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.011","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.011","tag_type":"condition","value":"Fungal Urinary Tract Infection","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.011","tag_type":"condition","value":"Herpes Simplex Virus Infection","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.011","tag_type":"condition","value":"Male Accessory Gland Infection","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.011","tag_type":"condition","value":"Urinary Tract Infection","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.011","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.011","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.011","tag_type":"modality","value":"Antibiotic Prophylaxis","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.011","tag_type":"modality","value":"Antimicrobial Stewardship","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.011","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.011","tag_type":"study_design","value":"Clinical Practice Guideline","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.011","tag_type":"warning","value":"Level of evidence assigned reflects the guideline's methodology (systematic literature review across multiple databases), not a single clinical trial.","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.011","tag_type":"warning","value":"The paper was published just days ago (July 15, 2026); specific recommendation details are not available in the abstract and full-text review would be needed for granular clinical application.","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.011","tag_type":"warning","value":"This is a guideline summary article, not a primary research study — no original patient data, sample sizes, or effect sizes are available.","value_numeric":null}],"summaries":{"what_studied":"The 2026 EAU Guidelines on Urological Infections provide evidence-based recommendations on the diagnosis, treatment, and prevention of urinary tract infections (UTIs) and male accessory gland infections, with a focus on antimicrobial stewardship and infection control. Literature was sourced from Medline, EMBASE, and the Cochrane Library.","key_result":"Key updates include a restructured classification framework for UTIs, new chapters on Herpes simplex virus and fungal UTIs, and updated evidence on periprocedural antibiotic prophylaxis for prostate biopsy. Recommendations cover antibiotic selection, dosing, and duration based on current evidence.","limitations":"This is a summary/guideline document rather than a primary study, so no original patient-level data or effect sizes are reported. Recommendations depend on the quality and recency of the underlying evidence base, which is not detailed in this abstract.","practice_takeaway":"Clinicians should apply the updated EAU UTI classification system and antimicrobial stewardship principles when managing urological infections. New guidance on HSV and fungal UTIs, plus revised prostate biopsy prophylaxis recommendations, should be integrated into clinical protocols."}},{"doi":"10.1111/1742-6723.70299","pmid":"42366166","title":"Low‐Value Blood Culture Use in Adult Emergency Department Patients: A Scoping Review","journal_title":"Emergency Medicine Australasia","journal_issn":"1742-6731","published_at":"2026-06-28T00:00:00.000Z","url":"https://doi.org/10.1111/1742-6723.70299","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-05T13:38:44.200Z","updated_at":"2026-07-05T13:38:44.200Z","tags":[{"paper_doi":"10.1111/1742-6723.70299","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"category","value":"Emergency Medicine","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"condition","value":"Bacteremia","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"condition","value":"Cellulitis","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"condition","value":"Community-Acquired Pneumonia","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"condition","value":"Sepsis","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"condition","value":"Urinary Tract Infection","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"generic","value":"procalcitonin","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"modality","value":"Blood Culture","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"modality","value":"Diagnostic Stewardship","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"sample_size","value":"n=18","value_numeric":18},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"study_design","value":"Scoping Review","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"warning","value":"Level of evidence set to 3 (scoping review of observational studies); no RCTs were included in the review.","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"warning","value":"Prevalence range (19%–69%) is not directly comparable across studies due to heterogeneous, post-hoc definitions of 'low-value'—interpret with caution.","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"warning","value":"Sample size tag reflects the number of included studies (n=18), not individual patients; the largest single included study involved ~44,123 blood culture events. No single patient-level N is reported across all studies.","value_numeric":null},{"paper_doi":"10.1111/1742-6723.70299","tag_type":"warning","value":"The CMS/JCAHO PN-3b mandate cited as a key driver was retired in 2014; its ongoing influence reflects historical rather than current policy context.","value_numeric":null}],"summaries":{"what_studied":"This scoping review mapped the literature on low-value blood culture (LVBC) use in adult ED patients, covering definitions, prevalence, drivers, and consequences across 18 studies (published 1998–2024, screened from 6 databases through June 2025).","key_result":"No study explicitly defined LVBCs; five proxy themes emerged. Prevalence of LVBCs ranged widely from 19% to 69%. Across 7,854 pooled BCs, only 223 (2.8%) directly changed antibiotic management. The top driver was pressure to comply with quality mandates (e.g., CMS/JCAHO PN-3b, 1-hour sepsis bundle). False positives equalled or exceeded true positives in several studies, leading to unnecessary antibiotics, extra testing, and longer stays. Estimated annual costs of LVBCs ranged from AUD $18,000 to USD $178,000 per 1,000 patients.","limitations":"- All 18 included studies were observational (mostly retrospective, single-centre), limiting generalisability.\n- No study formally evaluated patient-centred outcomes (e.g., discomfort, anxiety) or conducted prospective economic analysis.\n- Heterogeneous and post-hoc definitions of 'low-value' preclude direct comparison of prevalence estimates across studies.","practice_takeaway":"Routine blood cultures in ED patients with CAP, uncomplicated UTI, or non-septic presentations rarely change management and generate harmful false positives—consider risk-stratification tools (e.g., procalcitonin-based models, Modified Shapiro Rule) before ordering. Institutional mandates and reflexive ordering are key drivers to target through education and real-time decision support."}},{"doi":"10.1111/acem.70342","pmid":"42246462","title":"Point‐of‐Care Ultrasound for Pediatric Urethral Catheterization: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials","journal_title":"Academic Emergency Medicine","journal_issn":"1069-6563","published_at":"2026-06-05T00:00:00.000Z","url":"https://doi.org/10.1111/acem.70342","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-09T13:50:25.923Z","updated_at":"2026-06-09T13:50:25.923Z","tags":[{"paper_doi":"10.1111/acem.70342","tag_type":"age_group","value":"child","value_numeric":null},{"paper_doi":"10.1111/acem.70342","tag_type":"age_group","value":"infant","value_numeric":null},{"paper_doi":"10.1111/acem.70342","tag_type":"category","value":"Emergency Medicine","value_numeric":null},{"paper_doi":"10.1111/acem.70342","tag_type":"condition","value":"Pediatric Urethral Catheterization","value_numeric":null},{"paper_doi":"10.1111/acem.70342","tag_type":"condition","value":"Urinary Tract Infection","value_numeric":null},{"paper_doi":"10.1111/acem.70342","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1111/acem.70342","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1111/acem.70342","tag_type":"modality","value":"Point-of-Care Ultrasound","value_numeric":null},{"paper_doi":"10.1111/acem.70342","tag_type":"sample_size","value":"n=337","value_numeric":337},{"paper_doi":"10.1111/acem.70342","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/acem.70342","tag_type":"study_design","value":"Systematic Review and Meta-Analysis of Randomized Controlled Trials","value_numeric":null},{"paper_doi":"10.1111/acem.70342","tag_type":"warning","value":"Age group tags reflect the study's enrollment criteria (≤36 months); findings may not apply to older children.","value_numeric":null},{"paper_doi":"10.1111/acem.70342","tag_type":"warning","value":"Only 3 RCTs with a combined n=337 are included; pooled estimates should be interpreted with caution given the small evidence base.","value_numeric":null},{"paper_doi":"10.1111/acem.70342","tag_type":"warning","value":"The PROSPERO registration number appears to contain a typographic error (CRD420251247483 — unusually long format); this could not be verified from the abstract alone.","value_numeric":null}],"summaries":{"what_studied":"This systematic review and meta-analysis of 3 RCTs (n=337 children ≤36 months) compared real-time POCUS-assisted urethral catheterization to the standard blind technique, with first-attempt success rate as the primary outcome.","key_result":"POCUS significantly improved first-attempt success (89.7% vs. 72.5%; RR 1.25, 95% CI 1.08–1.45; NNT=6) and reduced \"dry taps\" (3.6% vs. 23.9%; RR 0.25, 95% CI 0.13–0.47; NNT=5). Caregiver satisfaction was higher and overall workflow time was comparable. GRADE certainty for the primary outcome was moderate.","limitations":"- Only 3 RCTs with 337 total participants; the evidence base is small.\n- GRADE certainty was rated **moderate**, leaving residual uncertainty.\n- Operator training requirements and institutional variability in POCUS availability may limit generalizability.","practice_takeaway":"Use POCUS to confirm adequate bladder volume before urethral catheterization in children ≤36 months — it cuts futile attempts by ~6-fold and raises first-attempt success without meaningfully delaying ED workflow. With an NNT of 6, this is a low-barrier, high-yield procedural improvement worth adopting in pediatric emergency settings."}},{"doi":"10.3390/antibiotics15060564","pmid":null,"title":"Current State of the Fight Against Antimicrobial Resistance: What Are the Different Strategies for Tomorrow?","journal_title":"Antibiotics","journal_issn":"2079-6382","published_at":"2026-06-01T00:00:00.000Z","url":"https://doi.org/10.3390/antibiotics15060564","source_score":25,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-06-12T13:24:37.627Z","updated_at":"2026-06-12T13:24:37.627Z","tags":[{"paper_doi":"10.3390/antibiotics15060564","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.3390/antibiotics15060564","tag_type":"brand","value":"Xacduro","value_numeric":null},{"paper_doi":"10.3390/antibiotics15060564","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.3390/antibiotics15060564","tag_type":"condition","value":"Antimicrobial Resistance","value_numeric":null},{"paper_doi":"10.3390/antibiotics15060564","tag_type":"condition","value":"Gram-Negative Bacterial Infection","value_numeric":null},{"paper_doi":"10.3390/antibiotics15060564","tag_type":"condition","value":"Urinary Tract Infection","value_numeric":null},{"paper_doi":"10.3390/antibiotics15060564","tag_type":"generic","value":"aztreonam/avibactam","value_numeric":null},{"paper_doi":"10.3390/antibiotics15060564","tag_type":"generic","value":"colistin","value_numeric":null},{"paper_doi":"10.3390/antibiotics15060564","tag_type":"generic","value":"gepotidacin","value_numeric":null},{"paper_doi":"10.3390/antibiotics15060564","tag_type":"generic","value":"lariocidin","value_numeric":null},{"paper_doi":"10.3390/antibiotics15060564","tag_type":"generic","value":"sulbactam/durlobactam","value_numeric":null},{"paper_doi":"10.3390/antibiotics15060564","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.3390/antibiotics15060564","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.3390/antibiotics15060564","tag_type":"modality","value":"Antivirulence Agent","value_numeric":null},{"paper_doi":"10.3390/antibiotics15060564","tag_type":"modality","value":"Bacteriophage Therapy","value_numeric":null},{"paper_doi":"10.3390/antibiotics15060564","tag_type":"modality","value":"Beta-Lactam / Beta-Lactamase Inhibitor Combination","value_numeric":null},{"paper_doi":"10.3390/antibiotics15060564","tag_type":"modality","value":"Fluoroquinolone-Class Antibiotic","value_numeric":null},{"paper_doi":"10.3390/antibiotics15060564","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.3390/antibiotics15060564","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.3390/antibiotics15060564","tag_type":"warning","value":"Brand name 'Xacduro' is tagged for sulbactam/durlobactam based on known regulatory approval; it is not explicitly mentioned in the abstract text.","value_numeric":null},{"paper_doi":"10.3390/antibiotics15060564","tag_type":"warning","value":"Gepotidacin is described as 'first-in-class' — its exact mechanism (bacterial type II topoisomerase inhibitor) is not explicitly stated in the available abstract text; tag reflects what the abstract supports.","value_numeric":null},{"paper_doi":"10.3390/antibiotics15060564","tag_type":"warning","value":"The full text retrieved in the document body is a 2011 CMAJ commentary on NDM-1 (Walsh TR), not the 2026 Antibiotics review described in the abstract. Summaries and tags are therefore based primarily on the abstract; specific data points from the full review body could not be verified.","value_numeric":null},{"paper_doi":"10.3390/antibiotics15060564","tag_type":"warning","value":"The 'practice_changing' impact flag is applied based on newly approved agents described in the abstract; clinical impact assessment is limited without access to the actual full review text.","value_numeric":null}],"summaries":{"what_studied":"This 2026 narrative review examines the current AMR landscape — including resistance mechanisms, novel antibiotic approvals, and emerging strategies such as phage therapy, antivirulence approaches, and AI-guided drug discovery — alongside global policy and stewardship priorities.","key_result":"WHO data cited indicate 1 in 6 laboratory-confirmed bacterial infections shows resistance to at least one antibiotic. Recently approved agents highlighted include sulbactam/durlobactam, aztreonam/avibactam, and gepotidacin (first-in-class for UTIs), alongside novel scaffold lariocidin.","limitations":"This is a narrative review without systematic search methods or meta-analytic pooling, limiting the strength of evidence synthesis. The full text retrieved is mismatched (a 2011 CMAJ commentary on NDM-1), so some details from the actual review cannot be fully verified.","practice_takeaway":"New antibiotic/inhibitor combinations (sulbactam/durlobactam, aztreonam/avibactam) and gepotidacin are now regulatory-approved options for highly resistant Gram-negative infections and UTIs — clinicians should be aware of these additions to the formulary. Embedding antimicrobial stewardship into everyday prescribing remains essential to preserve Medically Important Antimicrobials."}},{"doi":"10.1016/j.ijantimicag.2026.107849","pmid":"42208776","title":"Burden and Global Distribution of Antimicrobial Resistance in Non-Bloodstream Infections Among Adults with Cirrhosis: A Systematic Review and Proportional Meta-Analysis","journal_title":"International Journal of Antimicrobial Agents","journal_issn":"0924-8579","published_at":"2026-05-27T00:00:00.000Z","url":"https://doi.org/10.1016/j.ijantimicag.2026.107849","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-07T13:26:34.707Z","updated_at":"2026-06-07T13:26:34.707Z","tags":[{"paper_doi":"10.1016/j.ijantimicag.2026.107849","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.ijantimicag.2026.107849","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.1016/j.ijantimicag.2026.107849","tag_type":"condition","value":"Antimicrobial Resistance","value_numeric":null},{"paper_doi":"10.1016/j.ijantimicag.2026.107849","tag_type":"condition","value":"Liver Cirrhosis","value_numeric":null},{"paper_doi":"10.1016/j.ijantimicag.2026.107849","tag_type":"condition","value":"Spontaneous Bacterial Peritonitis","value_numeric":null},{"paper_doi":"10.1016/j.ijantimicag.2026.107849","tag_type":"condition","value":"Urinary Tract Infection","value_numeric":null},{"paper_doi":"10.1016/j.ijantimicag.2026.107849","tag_type":"generic","value":"broad-spectrum antibiotics","value_numeric":null},{"paper_doi":"10.1016/j.ijantimicag.2026.107849","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.ijantimicag.2026.107849","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1016/j.ijantimicag.2026.107849","tag_type":"modality","value":"Antimicrobial Therapy","value_numeric":null},{"paper_doi":"10.1016/j.ijantimicag.2026.107849","tag_type":"sample_size","value":"n=3162","value_numeric":3162},{"paper_doi":"10.1016/j.ijantimicag.2026.107849","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.ijantimicag.2026.107849","tag_type":"study_design","value":"Systematic Review and Meta-Analysis","value_numeric":null},{"paper_doi":"10.1016/j.ijantimicag.2026.107849","tag_type":"warning","value":"Studies included both clinical infection isolates (n=2,781) and colonisation isolates (n=381); pooled resistance proportions may slightly overestimate or underestimate clinical infection-specific MDR rates.","value_numeric":null},{"paper_doi":"10.1016/j.ijantimicag.2026.107849","tag_type":"warning","value":"The 'generic' tag for 'broad-spectrum antibiotics' is a class placeholder—no specific drug was evaluated as an intervention in this observational review.","value_numeric":null},{"paper_doi":"10.1016/j.ijantimicag.2026.107849","tag_type":"warning","value":"The impact_flag 'practice_changing' is applied based on the striking income-stratified resistance differentials, but this is a surveillance/epidemiological study without a therapeutic intervention arm.","value_numeric":null}],"summaries":{"what_studied":"This systematic review and proportional meta-analysis evaluated the global burden and distribution of antimicrobial resistance (AMR) in non-bloodstream bacterial infections (primarily spontaneous bacterial peritonitis and UTIs) among adults with cirrhosis, using studies published up to September 2025.","key_result":"Across 31 studies and 3,162 isolates, the pooled multidrug-resistance (MDR) proportion was 23% (95% CI: 13–37%). MDR was markedly higher in lower-middle-income countries (56% vs. 15–41% in higher-income settings), as were ESBL (24% vs. 8–10%), VRE (23% vs. 2%), and CRE (32% vs. 1%) rates. Gram-negatives dominated (60%; *E. coli* 29%, *K. pneumoniae* 11%); Gram-positives accounted for 39% (*Enterococcus* spp. 14%, *S. aureus* 6%). Genotypic analysis identified 436 resistance genes with continental variation.","limitations":"- 89% of isolates came from spontaneous bacterial peritonitis, limiting generalisability to other infection types.\n- Studies were observational and heterogeneous; pooled estimates used random-effects models, but residual heterogeneity across settings is likely.\n- Genotypic resistance data were available in only a subset of studies, restricting genomic conclusions.","practice_takeaway":"Clinicians managing infections in cirrhotic patients—especially in lower-middle-income countries—should anticipate high rates of MDR pathogens and calibrate empiric antibiotic regimens accordingly. Integrated phenotypic and genomic surveillance is needed to keep local treatment protocols current."}},{"doi":"10.1111/jdi.70343","pmid":"42170888","title":"Risk of urinary tract infection with\n SGLT2\n inhibitor initiation in patients with immune‐mediated inflammatory diseases and type 2 diabetes: A target trial emulation using a Japanese hospital‐based claims database","journal_title":"Journal of Diabetes Investigation","journal_issn":"2040-1116","published_at":"2026-05-22T00:00:00.000Z","url":"https://doi.org/10.1111/jdi.70343","source_score":8,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-01T13:39:37.287Z","updated_at":"2026-06-01T13:39:37.287Z","tags":[{"paper_doi":"10.1111/jdi.70343","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1111/jdi.70343","tag_type":"category","value":"Endocrinology & Metabolism","value_numeric":null},{"paper_doi":"10.1111/jdi.70343","tag_type":"condition","value":"Genital Infection","value_numeric":null},{"paper_doi":"10.1111/jdi.70343","tag_type":"condition","value":"Immune-Mediated Inflammatory Diseases","value_numeric":null},{"paper_doi":"10.1111/jdi.70343","tag_type":"condition","value":"Type 2 Diabetes","value_numeric":null},{"paper_doi":"10.1111/jdi.70343","tag_type":"condition","value":"Urinary Tract Infection","value_numeric":null},{"paper_doi":"10.1111/jdi.70343","tag_type":"generic","value":"metformin","value_numeric":null},{"paper_doi":"10.1111/jdi.70343","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1111/jdi.70343","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1111/jdi.70343","tag_type":"modality","value":"Biguanide","value_numeric":null},{"paper_doi":"10.1111/jdi.70343","tag_type":"modality","value":"SGLT2 Inhibitor","value_numeric":null},{"paper_doi":"10.1111/jdi.70343","tag_type":"sample_size","value":"n=3344","value_numeric":3344},{"paper_doi":"10.1111/jdi.70343","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/jdi.70343","tag_type":"study_design","value":"Target Trial Emulation (Active-Comparator New-User Design)","value_numeric":null},{"paper_doi":"10.1111/jdi.70343","tag_type":"warning","value":"Level of evidence assigned as 3 (observational/emulation design); not a randomized trial.","value_numeric":null},{"paper_doi":"10.1111/jdi.70343","tag_type":"warning","value":"Mean age of 71.8 years skews older than typical IMID populations — caution extrapolating to younger patients.","value_numeric":null},{"paper_doi":"10.1111/jdi.70343","tag_type":"warning","value":"No specific SGLT2 inhibitor agents are named; findings may not apply equally to all drugs in the class.","value_numeric":null}],"summaries":{"what_studied":"Target trial emulation comparing SGLT2 inhibitor initiation vs. metformin initiation on risk of UTI, upper UTI, and genital infection in adults with immune-mediated inflammatory diseases (IMIDs) and type 2 diabetes, using a Japanese hospital-based claims database (2014–2024).","key_result":"Among 1,845 SGLT2i and 1,499 metformin initiators (mean age 71.8 years; 55.4% female), SGLT2i initiation was **not** associated with increased UTI risk (HR 1.14, 95% CI 0.84–1.55) or upper UTI risk (HR 1.28, 95% CI 0.71–2.31). However, genital infection risk was significantly higher with SGLT2i (HR 2.31, 95% CI 1.16–4.63). No effect modification was seen across immunosuppressive therapy strata, including glucocorticoid dose.","limitations":"- Single-country (Japanese) hospital-based claims data may limit generalizability to other populations.\n- Residual confounding cannot be excluded in an observational emulation design.\n- Relatively small sample size may have limited power to detect modest UTI risk differences.","practice_takeaway":"Clinicians can likely use SGLT2 inhibitors in patients with IMIDs and type 2 diabetes without excess UTI concern, even in those on immunosuppressants — but should counsel patients about a roughly 2-fold higher genital infection risk compared with metformin."}},{"doi":"10.3399/bjgp26x744789","pmid":"42062079","title":"The inequality paradox: how gepotidacin addresses the hidden social gradient of antimicrobial resistance","journal_title":"British Journal of General Practice","journal_issn":"0960-1643","published_at":"2026-05-01T00:00:00.000Z","url":"https://doi.org/10.3399/bjgp26x744789","source_score":5,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-05-09","doi":"10.3399/bjgp26x744789","days":"7","issn":"0960-1643","rank":"6","field":"Clinical Medicine","score":"5","category":"Primary Health Care","categories":["Primary Health Care"],"_categories":["Primary Health Care"]},"pubmed":{"doi":"10.3399/bjgp26X744789","title":"The inequality paradox: how gepotidacin addresses the hidden social gradient of antimicrobial resistance.","journal":"The British journal of general practice : the journal of the Royal College of General Practitioners","methods":"","results":"","abstract":"","keywords":[],"pubmed_id":"42062079","conclusions":"","publication_date":"2026-05-01T00:00:00"},"crossref":{"DOI":"10.3399/bjgp26x744789","URL":"https://doi.org/10.3399/bjgp26x744789","ISSN":["0960-1643","1478-5242"],"link":[{"URL":"https://syndication.highwire.org/content/doi/10.3399/bjgp26X744789","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"219-219","type":"journal-article","issue":"766","score":1,"title":["The inequality paradox: how gepotidacin addresses the hidden social gradient of antimicrobial resistance"],"author":[{"given":"Yusuf","family":"Hussain","sequence":"first","affiliation":[]},{"given":"Niha","family":"Hussain","sequence":"additional","affiliation":[]}],"issued":{"date-parts":[[2026,4,30]]},"member":"1987","prefix":"10.3399","source":"Crossref","volume":"76","created":{"date-time":"2026-05-01T00:40:38Z","timestamp":1777596038000,"date-parts":[[2026,5,1]]},"indexed":{"date-time":"2026-05-13T13:20:47Z","timestamp":1778678447744,"date-parts":[[2026,5,13]]},"subject":[],"abstract":null,"language":"en","relation":{},"resource":{"primary":{"URL":"http://bjgp.org/lookup/doi/10.3399/bjgp26X744789"}},"subtitle":[],"deposited":{"date-time":"2026-05-13T12:30:12Z","timestamp":1778675412000,"date-parts":[[2026,5,13]]},"issn-type":[{"type":"print","value":"0960-1643"},{"type":"electronic","value":"1478-5242"}],"published":{"date-parts":[[2026,4,30]]},"publisher":"Royal College of General Practitioners","reference":null,"short-title":[],"journal-issue":{"issue":"766","published-print":{"date-parts":[[2026,5,1]]},"published-online":{"date-parts":[[2026,4,30]]}},"alternative-id":["10.3399/bjgp26X744789"],"content-domain":{"domain":[],"crossmark-restriction":false},"original-title":[],"container-title":["British Journal of General Practice"],"published-print":{"date-parts":[[2026,5,1]]},"reference-count":0,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2026,4,30]]},"references-count":0,"short-container-title":["Br J Gen Pract"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.3399/bjgp26x744789","is_oa":false,"title":"The inequality paradox: how gepotidacin addresses the hidden social gradient of antimicrobial resistance","updated":"2026-05-05T11:59:32+00:00","published_date":"2026-04-30","best_oa_location":null}},"created_at":"2026-05-10T13:20:52.170Z","updated_at":"2026-05-14T15:13:26.918Z","tags":[{"paper_doi":"10.3399/bjgp26x744789","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.3399/bjgp26x744789","tag_type":"category","value":"Primary Health Care","value_numeric":null},{"paper_doi":"10.3399/bjgp26x744789","tag_type":"condition","value":"Antimicrobial Resistance","value_numeric":null},{"paper_doi":"10.3399/bjgp26x744789","tag_type":"condition","value":"Gonorrhoea","value_numeric":null},{"paper_doi":"10.3399/bjgp26x744789","tag_type":"condition","value":"Urinary Tract Infection","value_numeric":null},{"paper_doi":"10.3399/bjgp26x744789","tag_type":"generic","value":"azithromycin","value_numeric":null},{"paper_doi":"10.3399/bjgp26x744789","tag_type":"generic","value":"ceftriaxone","value_numeric":null},{"paper_doi":"10.3399/bjgp26x744789","tag_type":"generic","value":"gepotidacin","value_numeric":null},{"paper_doi":"10.3399/bjgp26x744789","tag_type":"generic","value":"nitrofurantoin","value_numeric":null},{"paper_doi":"10.3399/bjgp26x744789","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.3399/bjgp26x744789","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.3399/bjgp26x744789","tag_type":"modality","value":"Triazaacenaphthylene Antibiotic","value_numeric":null},{"paper_doi":"10.3399/bjgp26x744789","tag_type":"sample_size","value":"n=3628","value_numeric":3628},{"paper_doi":"10.3399/bjgp26x744789","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.3399/bjgp26x744789","tag_type":"study_design","value":"Commentary","value_numeric":null},{"paper_doi":"10.3399/bjgp26x744789","tag_type":"warning","value":"The 'practice_changing' impact flag reflects gepotidacin's novel class and non-inferiority trial results, but real-world prescribing guidance and formulary status in UK primary care had not been fully established at publication.","value_numeric":null},{"paper_doi":"10.3399/bjgp26x744789","tag_type":"warning","value":"The sample size tag (n=3628) combines EAGLE-1 (628) and EAGLE-2/3 (>3000) trial populations, which studied different indications; these are not a single unified trial cohort.","value_numeric":null},{"paper_doi":"10.3399/bjgp26x744789","tag_type":"warning","value":"This is an opinion/commentary piece; the AMR socioeconomic disparity statistics are presented without primary source citation within the extracted text.","value_numeric":null}],"summaries":{"what_studied":"This commentary examines how gepotidacin, a first-in-class triazaacenaphthylene antibiotic, may address the socioeconomic gradient of antimicrobial resistance (AMR) in UTIs and gonorrhoea, drawing on phase III EAGLE trial data and UK AMR surveillance figures.","key_result":"In the EAGLE-2 and EAGLE-3 trials (>3,000 female patients), gepotidacin 1500 mg twice daily for 5 days was non-inferior to nitrofurantoin for UTIs; both trials were terminated early for efficacy. EAGLE-1 (n=628) showed 92.6% microbiological success vs. 91.2% for IM ceftriaxone plus oral azithromycin for gonorrhoea. In England (2024), patients in the lowest socioeconomic areas faced a 47.2% higher rate of antibiotic-resistant bloodstream infections vs. higher socioeconomic areas — a 29% increase since 2019.","limitations":"This is an opinion/commentary piece, not a primary study; it does not present original data. The socioeconomic AMR disparity figures are cited without formal statistical analysis. No cost-effectiveness or real-world access data for gepotidacin are discussed.","practice_takeaway":"GPs serving deprived communities should be aware that gepotidacin's oral route and activity against fluoroquinolone- and trimethoprim-resistant organisms may benefit patients who face barriers to parenteral therapy and carry higher resistant-organism burden. Each prescribing decision carries health equity implications beyond the individual patient."}},{"doi":"10.1097/ju.0000000000004966","pmid":"41616252","title":"Ureteral Dilation Is a Clinically Significant Risk Factor for Urinary Tract Infections in Children With Prenatal Hydronephrosis: A Call to Revisit Practice Guidelines","journal_title":"Journal of Urology","journal_issn":"0022-5347","published_at":"2026-01-30T00:00:00.000Z","url":"https://doi.org/10.1097/ju.0000000000004966","source_score":10,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-09T13:50:15.778Z","updated_at":"2026-06-09T13:50:15.778Z","tags":[{"paper_doi":"10.1097/ju.0000000000004966","tag_type":"age_group","value":"infant","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000004966","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000004966","tag_type":"condition","value":"Hydroureteronephrosis","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000004966","tag_type":"condition","value":"Megaureter","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000004966","tag_type":"condition","value":"Prenatal Hydronephrosis","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000004966","tag_type":"condition","value":"Urinary Tract Infection","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000004966","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000004966","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000004966","tag_type":"modality","value":"Antibiotic Prophylaxis","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000004966","tag_type":"sample_size","value":"n=803","value_numeric":803},{"paper_doi":"10.1097/ju.0000000000004966","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000004966","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000004966","tag_type":"warning","value":"CAP use was not randomized — high-risk patients were more likely to receive prolonged CAP, making it impossible to assess CAP efficacy directly from these data.","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000004966","tag_type":"warning","value":"Study population is from a single quaternary referral center (Hospital for Sick Children), which may not reflect community or lower-acuity practice settings.","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000004966","tag_type":"warning","value":"VUR status was unknown for a substantial portion of patients, as VCUG was only performed selectively; this adds uncertainty to the reflux-free subgroup analysis.","value_numeric":null}],"summaries":{"what_studied":"Single-center retrospective cohort of 803 infants with prenatally detected hydronephrosis (2015–2024, median follow-up 23 months) assessed whether ureteral dilation (hydroureter ≥7 mm) or isolated hydronephrosis severity (SFU grade, APD) better predicts time to febrile UTI, using landmark and competing-risk cause-specific Cox regression.","key_result":"29 patients (4%) developed a febrile UTI during surveillance. Hydroureter was independently associated with UTI risk (HR 1.15 per mm; 95% CI 1.10–1.21; P<0.001); ureteral dilation 7–10 mm carried HR 4.35 and >10 mm carried HR 8.65 vs. no hydroureter. Isolated hydronephrosis by SFU grade (HR 1.02) or APD (HR 0.99 per mm) was not significantly associated. Model C-index was 0.74 (optimism-adjusted 0.72).","limitations":"- Retrospective single-center design limits causal inference and generalizability.\n- Patients excluded for <6 months follow-up may underestimate early UTI risk.\n- Predictors are from the index ultrasound only; interval changes in hydronephrosis severity are not captured.","practice_takeaway":"Infants with hydroureter ≥7 mm on postnatal ultrasound should receive continuous antibiotic prophylaxis (CAP), with risk rising progressively as ureteral diameter increases. Isolated high-grade hydronephrosis (SFU 3–4 or APD >15 mm) without ureteral dilation does not appear to justify routine CAP."}},{"doi":"10.1182/blood.2025031965","pmid":"41592284","title":"A retrospective, real-world study of IV iron use to treat iron deficiency anemia during acute infection","journal_title":"Blood","journal_issn":"0006-4971","published_at":"2026-01-27T00:00:00.000Z","url":"https://doi.org/10.1182/blood.2025031965","source_score":42,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-24T13:23:15.138Z","updated_at":"2026-05-24T13:23:15.138Z","tags":[{"paper_doi":"10.1182/blood.2025031965","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1182/blood.2025031965","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1182/blood.2025031965","tag_type":"condition","value":"Cellulitis","value_numeric":null},{"paper_doi":"10.1182/blood.2025031965","tag_type":"condition","value":"Colitis","value_numeric":null},{"paper_doi":"10.1182/blood.2025031965","tag_type":"condition","value":"Iron Deficiency Anemia","value_numeric":null},{"paper_doi":"10.1182/blood.2025031965","tag_type":"condition","value":"MRSA Bacteremia","value_numeric":null},{"paper_doi":"10.1182/blood.2025031965","tag_type":"condition","value":"Pneumonia","value_numeric":null},{"paper_doi":"10.1182/blood.2025031965","tag_type":"condition","value":"Urinary Tract Infection","value_numeric":null},{"paper_doi":"10.1182/blood.2025031965","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1182/blood.2025031965","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1182/blood.2025031965","tag_type":"modality","value":"Intravenous Iron","value_numeric":null},{"paper_doi":"10.1182/blood.2025031965","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1182/blood.2025031965","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1182/blood.2025031965","tag_type":"warning","value":"Sample size not explicitly reported in the abstract or extracted full text; total N could not be tagged.","value_numeric":null},{"paper_doi":"10.1182/blood.2025031965","tag_type":"warning","value":"The full text pages contained mostly supplemental figure legends and abbreviation keys; key methodology details (e.g., specific IV iron formulations, dosing) were not extractable from the provided content.","value_numeric":null},{"paper_doi":"10.1182/blood.2025031965","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously — authors themselves call for prospective confirmation before guidelines change.","value_numeric":null}],"summaries":{"what_studied":"This retrospective cohort study used the TriNetX Research Network (2000–June 2025) to evaluate the safety and efficacy of IV iron in adults with iron deficiency anemia (IDA) and one of five acute infections (MRSA bacteremia, pneumonia, UTI, colitis, or cellulitis) who received antibiotics within 2 days; propensity-matched 1:1 analysis compared IV iron vs. no IV iron.","key_result":"IV iron was associated with significantly higher 14-day and 90-day survival across all infection types (e.g., MRSA bacteremia: 97.6% vs. 95.0% at 14 days, 88.6% vs. 83.8% at 90 days; p<.001 for each) and greater hemoglobin recovery at 60–90 days (e.g., +1.3–1.5 g/dL with IV iron vs. +0.7–1.0 g/dL without; all p<.001).","limitations":"- Retrospective design limits causal inference; residual confounding may persist despite propensity matching.\n- Data drawn from a federated network (TriNetX), so IV iron dose, formulation, and timing relative to infection onset are not well characterized.\n- Out-of-hospital antibiotic use and antibiotic regimen changes are not fully captured, potentially skewing secondary outcomes like antibiotic days.","practice_takeaway":"In hospitalized adults with IDA and acute bacterial infection on antibiotics, IV iron appears safe and may improve both survival and anemia recovery — clinicians need not routinely withhold it. Prospective trials are still needed before this changes formal guidelines."}},{"doi":"10.1111/ctr.70449","pmid":"41532211","title":"Efficacy of a Single Dose of Intravesical Aminoglycoside for the Prevention of Urinary Tract Infections in Kidney Transplant Recipients","journal_title":"Clinical Transplantation","journal_issn":"0902-0063","published_at":"2026-01-14T00:00:00.000Z","url":"https://doi.org/10.1111/ctr.70449","source_score":18,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-19","doi":"10.1111/ctr.70449","days":"7","issn":"0902-0063","rank":"9","field":"Clinical Medicine","score":"18","category":"Surgery","categories":["Surgery"],"_categories":["Surgery"]},"pubmed":{"doi":"10.1111/ctr.70449","title":"Efficacy of a Single Dose of Intravesical Aminoglycoside for the Prevention of Urinary Tract Infections in Kidney Transplant Recipients.","journal":"Clinical transplantation","methods":"","results":"A total of 764 patients were included in the study analysis (gentamicin = 406 vs. control = 358). At 3 months, the incidence of UTIs was 18.2% in the gentamicin group compared to 13.1% in the control group (p = 0.05). A higher incidence of BK viremia >10,000 copies/mL was also observed in the gentamicin group compared with control patients (5.9% vs. 2.5%; p = 0.02). After multivariable regression analysis older age, female sex, early rejection, longer dialysis vintage, and urinary catheter duration were all found to be positively correlated with the incidence of UTIs.","abstract":"$30","keywords":["anti‐bacterial agents","kidney transplantation","risk factors","urinary tract infections"],"pubmed_id":"41532211","conclusions":"Among kidney transplant recipients, bladder irrigation with gentamicin was not found to reduce the incidence of UTIs at 3 months. Additional studies should explore a possible association between antibiotic bladder irrigation and subsequent BK viremia.","publication_date":"2026-01-14T00:00:00"},"crossref":{"DOI":"10.1111/ctr.70449","URL":"https://doi.org/10.1111/ctr.70449","ISSN":["0902-0063","1399-0012"],"link":[{"URL":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/ctr.70449","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://onlinelibrary.wiley.com/doi/full-xml/10.1111/ctr.70449","content-type":"application/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/ctr.70449","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":"1","score":1,"title":["Efficacy of a Single Dose of Intravesical Aminoglycoside for the Prevention of Urinary Tract Infections in Kidney Transplant Recipients"],"author":[{"given":"Sarah","family":"Dean","sequence":"first","affiliation":[{"name":"Department of Pharmacy Mount Sinai Hospital New York New York USA"}]},{"given":"Andrew","family":"Santeusanio","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Mount Sinai Hospital New York New York USA"},{"name":"Recanati‐Miller Transplantation Institute Mount Sinai Hospital New York New York USA"}]},{"given":"Gopi","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Infection Prevention Mount Sinai Hospital New York New York USA"}]},{"given":"Vikram","family":"Wadhera","sequence":"additional","affiliation":[{"name":"Recanati‐Miller Transplantation Institute Mount Sinai Hospital New York New York USA"}]},{"given":"Ron","family":"Shapiro","sequence":"additional","affiliation":[{"name":"Recanati‐Miller Transplantation Institute Mount Sinai Hospital New York New York USA"}]}],"issued":{"date-parts":[[2026,1]]},"member":"311","prefix":"10.1111","source":"Crossref","volume":"40","archive":["Portico"],"created":{"date-time":"2026-01-14T09:31:01Z","timestamp":1768383061000,"date-parts":[[2026,1,14]]},"indexed":{"date-time":"2026-01-14T15:05:33Z","timestamp":1768403133792,"date-parts":[[2026,1,14]]},"license":[{"URL":"http://onlinelibrary.wiley.com/termsAndConditions#vor","start":{"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000,"date-parts":[[2026,1,14]]},"delay-in-days":13,"content-version":"vor"},{"URL":"http://doi.wiley.com/10.1002/tdm_license_1.1","start":{"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000,"date-parts":[[2026,1,1]]},"delay-in-days":0,"content-version":"tdm"}],"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://onlinelibrary.wiley.com/doi/10.1111/ctr.70449"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"publication_history","label":"Publication History"},"label":"Received","order":0,"value":"2025-10-28"},{"name":"accepted","group":{"name":"publication_history","label":"Publication History"},"label":"Accepted","order":2,"value":"2025-12-31"},{"name":"published","group":{"name":"publication_history","label":"Publication History"},"label":"Published","order":3,"value":"2026-01-14"}],"deposited":{"date-time":"2026-01-14T09:31:03Z","timestamp":1768383063000,"date-parts":[[2026,1,14]]},"issn-type":[{"type":"print","value":"0902-0063"},{"type":"electronic","value":"1399-0012"}],"published":{"date-parts":[[2026,1]]},"publisher":"Wiley","reference":[{"DOI":"10.1186/s12882‐023‐03338‐4","key":"e_1_2_11_2_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1111/ctr.13507","key":"e_1_2_11_3_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.2146/ajhp120568","key":"e_1_2_11_4_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":null,"key":"e_1_2_11_5_1","year":"2009","issue":"3","author":null,"volume":"9","first-page":"S1","unstructured":null,"article-title":"Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group. KDIGO Clinical Practice Guideline for the Care of Kidney Transplant Recipients","journal-title":"American Journal of Transplantation","doi-asserted-by":null},{"DOI":"10.1159/000296303","key":"e_1_2_11_6_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1111/j.1432‐2277.1990.tb01878.x","key":"e_1_2_11_7_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.3390/microorganisms12112217","key":"e_1_2_11_8_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/j.xkme.2022.100484","key":"e_1_2_11_9_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1111/tid.70043","key":"e_1_2_11_10_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1111/ctr.14067","key":"e_1_2_11_11_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1111/tid.12769","key":"e_1_2_11_12_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/j.medmic.2024.100106","key":"e_1_2_11_13_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1186/1471‐2490‐14‐91","key":"e_1_2_11_14_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/j.transproceed.2011.06.034","key":"e_1_2_11_15_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1093/ndt/gfu023","key":"e_1_2_11_16_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"}],"short-title":[],"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"update-policy":"https://doi.org/10.1002/crossmark_policy","alternative-id":["10.1111/ctr.70449"],"article-number":"e70449","content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"original-title":[],"container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2026,1]]},"reference-count":15,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2026,1,14]]},"references-count":15,"short-container-title":["Clinical Transplantation"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1111/ctr.70449","is_oa":true,"title":"Efficacy of a Single Dose of Intravesical Aminoglycoside for the Prevention of Urinary Tract Infections in Kidney Transplant Recipients","updated":"2026-01-16T01:10:40+00:00","published_date":"2026-01-01","best_oa_location":{"url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/ctr.70449","pmh_id":null,"url_for_pdf":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/ctr.70449","url_for_landing_page":"https://doi.org/10.1111/ctr.70449"}}},"created_at":"2026-01-21T12:05:26.220Z","updated_at":"2026-01-21T12:05:26.220Z","tags":[{"paper_doi":"10.1111/ctr.70449","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1111/ctr.70449","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1111/ctr.70449","tag_type":"condition","value":"BK Polyomavirus Infection","value_numeric":null},{"paper_doi":"10.1111/ctr.70449","tag_type":"condition","value":"Kidney Transplant","value_numeric":null},{"paper_doi":"10.1111/ctr.70449","tag_type":"condition","value":"Urinary Tract Infection","value_numeric":null},{"paper_doi":"10.1111/ctr.70449","tag_type":"generic","value":"gentamicin","value_numeric":null},{"paper_doi":"10.1111/ctr.70449","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1111/ctr.70449","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1111/ctr.70449","tag_type":"modality","value":"Aminoglycoside","value_numeric":null},{"paper_doi":"10.1111/ctr.70449","tag_type":"sample_size","value":"n=764","value_numeric":764},{"paper_doi":"10.1111/ctr.70449","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/ctr.70449","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1111/ctr.70449","tag_type":"warning","value":"Gentamicin dose and irrigation protocol details are not reported in the abstract.","value_numeric":null},{"paper_doi":"10.1111/ctr.70449","tag_type":"warning","value":"It is unclear whether this was a single‑center or multicenter cohort.","value_numeric":null},{"paper_doi":"10.1111/ctr.70449","tag_type":"warning","value":"Secondary endpoints (delayed allograft function, 3‑month creatinine) are mentioned but not quantified in the abstract.","value_numeric":null}],"summaries":{"what_studied":"Retrospective cohort of adults undergoing first isolated kidney transplant (2018–2023) comparing single intra‑operative intravesical gentamicin irrigation (n=406) versus no irrigation (n=358) for 3‑month culture‑confirmed UTI; secondary outcomes were delayed allograft function and 3‑month creatinine.","key_result":"At 3 months, UTI incidence was higher with gentamicin versus control (18.2% vs 13.1%; p=0.05). BK viremia >10,000 copies/mL was also higher with gentamicin (5.9% vs 2.5%; p=0.02); older age, female sex, early rejection, longer dialysis vintage, and urinary catheter duration correlated with UTIs on multivariable analysis.","limitations":"Retrospective, non‑randomized design limits causal inference. Outcomes reported only to 3 months.","practice_takeaway":"Single‑dose intravesical gentamicin at transplant did not reduce early UTIs and was associated with more BK viremia; these data do not support routine use for UTI prevention. If used, monitor closely for BK viremia in the early post‑transplant period."}}],"initialOffset":13,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Urinary Tract Infection"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Urinary Tract Infection"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Urinary Tract Infection"}}}]]

Papers