Engineered reporter phages for detection of Escherichia coli, Enterococcus, and Klebsiella in urine.

The rapid detection and species-level differentiation of bacterial pathogens facilitates antibiotic stewardship and improves disease management. Here, we develop a rapid bacteriophage-based diagnostic assay to detect the most prevalent pathogens causing urinary tract infections: Escherichia coli, Enterococcus spp., and Klebsiella spp. For each uropathogen, two virulent phages were genetically engineered to express a nanoluciferase reporter gene upon host infection. Using 206 patient urine samples, reporter phage-induced bioluminescence was quantified to identify bacteriuria and the assay was benchmarked against conventional urinalysis. Overall, E. coli, Enterococcus spp., and Klebsiella spp. were each detected with high sensitivity (68%, 78%, 87%), specificity (99%, 99%, 99%), and accuracy (90%, 94%, 98%) at a resolution of ≥103 CFU/ml within 5 h. We further demonstrate how bioluminescence in urine can be used to predict phage antibacterial activity, demonstrating the future potential of reporter phages as companion diagnostics that guide patient-phage matching prior to therapeutic phage application.

Combined intra- and extraperitoneal urinary bladder rupture - a rare seat-belt injury: A case report.

INTRODUCTION: While isolated traumatic urinary bladder injuries are rare, combined intra- and extraperitoneal traumatic urinary bladder ruptures without an underlying fracture are an absolute rarity. PRESENTATION OF CASE: We report a case of combined intra- and extraperitoneal urinary bladder rupture without an underlying fracture resulting from blunt abdominal trauma during a high velocity car accident. A midline laparotomy was performed, and the intra- and extraperitoneal bladder ruptures were surgically treated. DISCUSSION: Based on the presented case the anatomical peculiarities of the urinary bladder and the different trauma mechanisms as well as the resulting lesions, the diagnostic modalities and the treatment options are discussed. CONCLUSION: Despite the rarity of traumatic urinary bladder injuries, and especially in the absence of an underlying fracture, physicians should maintain a high level of suspicion for urologic injuries in the presence of nonspecific lower abdominal pain, gross haematuria and the inability to urinate.

[Male Urinary Incontinence--a Taboo Issue]. / Urininkontinenz beim Mann--ein Tabuthema.

Male urinary incontinence is an underestimated and frequently not broached issue. The urinary incontinence is divided into stress-, urge incontinence and hybrid forms as well as overflow incontinence. The fact that there are increasingly more men over 60 means that the prevalence of the urinary incontinence is up to 40%, and urinary incontinence will increasingly gain importance in daily routine practice. Many investigations and therapies can be realized by the general practitioner. Already simple therapy approaches can lead to a considerable clinical improvement of male urinary incontinence. If the initial therapy fails or pathological results (i. e. microhaematuria, recurrent urinary tract infections, raised residual urine and so on) are found, the patient should be referred to a urologist.