Antibiotic Resistance in Urinary Tract Infections in College Students

Abstract

Objective: To determine resistance to antibiotics of Escherichia coli in uncomplicated urinary tract infections (uUTIs) in female college students. Participants: Symptomatic patients presenting to a student health service from September 2008 to December 2009. Methods: Clean catch midstream urine samples were tested for urinalysis (UA) and culture and sensitivity. Results: Of 168 students enrolled in the study, 138 had positive UA, and 94 of these grew >100,000 colonies/mL of E. coli. Ampicillin resistance was 31.9%, trimethoprim-sulfamethoxazole (TMP-SMX) resistance 16.0%, ciprofloxacin resistance 4.3%, amoxicillin/clavulanate resistance 3.2%, and nitrofurantoin resistance 1.1%. The sensitivity of UA was 95.4% and the positive predictive value was 87.0% (p ≤ .001). Specificity was 77.5% and negative predictive value 92.9%. Conclusions: In healthy college women with uUTI symptoms, TMP-SMX should not be universally used for empirical therapy, whereas use of ciprofloxacin, amoxicillin/clavulanate, and nitrofurantoin are appropriate.     

Uncomplicated E. coli urinary tract infection in college women: a follow-up study of E. coli sensitivities to commonly prescribed antibiotics

Treatment of uncomplicated urinary tract infections (UTIs) has changed in the past few years with researchers advocating empiric treatment for shorter periods of time without the use of cultures. Researchers report that antibiotic resistance of Escherichia coli (E. coli) to commonly prescribed antibiotics in uncomplicated UTIs has been increasing. Trimethoprim/sulfamethoxazole (TMP/SMX) is 1 of these antibiotics. Researchers also report that resistance patterns may differ depending on the geographic area of the United States. In this study, the authors present the results of a 7-month retrospective chart analysis of 98 E. coli sensitivities to commonly prescribed antibiotics in the treatment of uncomplicated UTIs at a college health service. They examined the more common antibiotic choices and analyzed their in vitro responses. Of these antibiotics, ciprofloxacin, nitrofurantoin, amoxicillin/clavulanate, and TMP/SMX had the highest sensitivity rates. The authors compared the results with a previous study that they performed at the same institution in 1993. The results of this study show a sensitivity rate of 86% for TMP/SMX. When compared with the previous result of 87%, this represented a 1% change. Because of this slight decrease in sensitivity and the increasing concern over resistance, the authors suggest that they will continue to reevaluate the resistance pattern in their population on a regular basis. This will help determine if there is a need for modifying choices of empiric therapy for UTIs.     

Developing a screening questionnaire for problem drinking in college students.

The CAGE questionnaire is one of several brief screening instruments that has been successful in detecting alcoholism in a general population. There is evidence, however, indicating that none of these instruments has sufficient validity for detecting the less severe pattern of problem drinking that is more typical of college students. This study analyzed survey data, including CAGE questions, to identify items that would have sufficient test operating characteristics more valid for screening problem drinkers. Problem and normal drinking patterns were defined by combining certain categories of quantity-frequency data with categories of alcohol-related problems. Problem and normal drinkers were identified as those students at the ends of the quantity-frequency/alcohol-problems continuum. Differences between the two groups in response frequencies to a 17-item alcohol-use survey were examined using chi-square analyses. Five items showing highly significant differences were identified, and sensitivity, specificity, and positive predictive values were calculated at possible cutoff points. These items were (1) a positive response to any 2 of the 4 CAGE items, (2) reporting rarely or never choosing nonalcoholic beverages at social events, (3) driving under the influence at least 6 to 10 times or more in the last year, and (4) having started regular use of alcohol before the college years. At the recommended cutoff score for a positive test, the items have a sensitivity of 88%, specificity of 87%, and positive predictive value of 52%. When used for screening in a population similar to this, it will fail to identify 12% of the problem drinkers and will falsely classify 13% of all normal drinkers as problem drinkers.(ABSTRACT TRUNCATED AT 250 WORDS)     

American College Health Association Annual Pap Test and Sexually Transmitted Infection Survey: 2006

Objective: The authors describe the cervical cytology and sexually transmitted infection (STI) testing patterns of US college health centers. Participants and Methods: A total of 128 self-selected US college health centers—representing more than 2 million college students—completed an online survey during February and March 2007. Results: Almost 13% of cervical cytology results were abnormal; most of these were atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesions. In women, 2.9% of chlamydia tests and 0.4% of gonorrhea tests were positive. Human immunodeficiency virus (HIV) and syphilis tests were positive in 0.1% and 0.3% of students tested, respectively. Herpes simplex virus type 1 (HSV-1) accounted for 59.9% of genital herpes infections. Conclusions: College health centers are important sources for Pap and STI test data. Pap tests frequently yield low-grade abnormalities, and screening tests for chlamydia and especially gonorrhea are infrequently positive. Rates of HIV and syphilis in this population are low, raising concerns about positive predictive value when screening low-risk students. A majority of genital herpes infections are caused by HSV-1.     

Antimicrobial resistance of urinary tract isolates in acute uncomplicated cystitis among college-aged women: choosing a first-line therapy

OBJECTIVE AND PARTICIPANTS: The authors of this retrospective case study focused on antimicrobial susceptibility of urinary tract isolates in cases of acute uncomplicated cystitis in college-aged women, aged 18 to 24 years, diagnosed at a major south-central university student health center. METHODS: The authors obtained pertinent data from patient medical and laboratory records, including, diagnoses, urine culture, and susceptibility results. RESULTS: Of 179 isolates, 161 (90%) were Escherichia coli (E. Coli) isolates, of which 23% were resistant to trimethoprimsulfamethoxazole, <1% were resistant to Ciprofloxacin, and <1% were resistant to nitrofurantoin. Sixty-eight (42%) E. Coli isolates were multidrug resistant. There were 18 isolates cultured in the study group that were significant organisms other than E. coli. For all organisms in the study group, there was a combined resistance rate of 22% to trimethoprim-sulfamethoxazole, <1.0% for Ciprofloxacin, and 7% for nitrofurantoin. CONCLUSIONS: The findings suggest that both Ciprofloxacin and Nitrofurantoin are acceptable choices for empiric therapy of acute uncomplicated urinary tract infection in this study population, keeping in mind the potential for rising resistance rates to Ciprofloxacin in the community setting.     

Positive Social Support,Negative Social Exchanges,and Suicidal Behavior in College Students

Abstract

Objective: Risk for suicide is often higher among college students, compared to same-age noncollegiate peers, and may be exacerbated by quality of social support and interactions. The authors examined the independent contributions of positive social support and negative social exchanges to suicide ideation and attempts in college students. Participants: Participants were 439 volunteer undergraduate students, who were primarily female (71%). Methods: Cross-sectional, survey design. Participants completed measures assessing positive social support, including emotional, informational, and tangible support; negative social exchanges; and suicidal behavior, including ideation and attempts. Results: Positive social support, particularly tangible support, and negative social exchanges were significantly predictive of greater suicidal behavior. Conclusions: Practical manifestations of support may buffer against suicide risk for college students, whereas conflict-based interactions may contribute to increased risk. At the institutional, parental, and peer levels, promotion of supportive relationships may be an important suicide prevention strategy.     

Partying before the party: examining prepartying behavior among college students

OBJECTIVE: The authors examined the phenomenon known to college students as prepartying, which is the consumption of alcohol prior to attending an event or activity (eg, party, bar, concert) at which more alcohol may be consumed. PARTICIPANTS: To explore the extent of this behavior, the authors surveyed 227 college students about each drinking event over a 1-month period. RESULTS: Principal results revealed that 64% of participants engaged in prepartying (75% of drinkers) and that prepartying is involved in approximately 45% of all drinking events. Prepartying was predictive of more drinking throughout the day of the drinking event and alcohol-related negative consequences. Men and women engaged in this behavior at similar rates, and prepartying was most related to social reasons for drinking. CONCLUSION: Because prepartying is well-known among students, the authors suggest that clinicians and researchers target it to better understand college drinking and to help students understand the associated dangers.     

Antimicrobial Resistance of Urinary Tract Isolates in Acute Uncomplicated Cystitis Among College-Aged Women: Choosing a First-Line Therapy

Objective and Participants The authors of this retrospective case study focused on antimicrobial susceptibility of urinary tract isolates in cases of acute uncomplicated cystitis in college-aged women, aged 18 to 24 years, diagnosed at a major south-central university student health center. Methods The authors obtained pertinent data from patient medical and laboratory records, including, diagnoses, urine culture, and susceptibility results. Results Of 179 isolates, 161 (90%) were Escherichia coli (E. Coli) isolates, of which 23% were resistant to trimethoprimsulfamethoxazole, < 1% were resistant to Ciprofloxacin, and < 1% were resistant to nitrofurantoin. Sixty-eight (42%) E. Coli isolates were multidrug resistant. There were 18 isolates cultured in the study group that were significant organisms other than E. coli. For all organisms in the study group, there was a combined resistance rate of 22% to trimethoprim-sulfamethoxazole, < 1.0% for Ciprofloxacin, and 7% for nitrofurantoin. Conclusions The findings suggest that both Ciprofloxacin and Nitrofurantoin are acceptable choices for empiric therapy of acute uncomplicated urinary tract infection in this study population, keeping in mind the potential for rising resistance rates to Ciprofloxacin in the community setting.     

家庭环境对大学生社会主义核心价值体系认同的影响

家庭教育环境与大学生对社会主义核心价值体系的社会认同之间存在一定的内在逻辑。调查表明,大学生对社会主义核心价值体系的认知度、认同度和践行度均呈现出“中度偏高”的特征,且相互之间呈正相关。在影响大学生对社会主义核心价值体系的社会认同的一系列家庭教育环境因素中,家庭指导性因子与社会主义核心价值体系的认知度和践行度呈显著的正相关,家庭利他性因子与社会主义核心价值体系的认同度和践行度呈显著的正相关,家庭道德性因子对社会主义价值体系的认同度施加着显著的正向影响．家庭自由性因子则与对社会主义价值体系的践行度呈显著的负相关。     

Partying Before the Party: Examining Prepartying Behavior Among College Students

Objective: The authors examined the phenomenon known to college students as prepartying, which is the consumption of alcohol prior to attending an event or activity (eg, party, bar, concert) at which more alcohol may be consumed. Participants: To explore the extent of this behavior, the authors surveyed 227 college students about each drinking event over a 1-month period. Results: Principal results revealed that 64% of participants engaged in prepartying (75% of drinkers) and that prepartying is involved in approximately 45% of all drinking events. Prepartying was predictive of more drinking throughout the day of the drinking event and alcohol-related negative consequences. Men and women engaged in this behavior at similar rates, and prepartying was most related to social reasons for drinking. Conclusion: Because prepartying is well-known among students, the authors suggest that clinicians and researchers target it to better understand college drinking and to help students understand the associated dangers.     

Effects of Aerobic Training on Primary Dysmenorrhea Symptomatology in College Females

Abstract

“Single-Dose Therapy for Cystitis in Women: A Comparison of Trimethoprim-Sulfamethoxazole, Amoxicillin, and Cyclacillin,” Thomas M. Hooton et al. We evaluated single-dose regimens of trimethoprim-sulfamethoxazole, amoxicillin, and cyclacillin as treatment for acute cystitis in 38 women. The trial was prematurely stopped because of frequent treatment failures. At two days after treatment, all 13 patients given trimethoprim-sulfamethoxazole were cured, while four (31%) of the 13 given amoxicillin and four (33%) of 12 given cyclacillin had persistent bacteriuria. At two weeks, 11 (85%) of 13 patients given trimethoprim-sulfamethoxazole, six (50%) of 12 given amoxicillin, and three (30%) of ten given cyclacillin were cured. One patient with positive results of antibody-coated bacteria testing who was treated with cyclacillin had signs and symptoms of acute pyelonephritis three days after treatment, and two patients treated with amoxicillin and one treated with trimethoprim-sulfamethoxazole converted antibody-coated bacteria test results from negative to positive after therapy. We conclude that single-dose treatment of cystitis in unselected women with cyclacillin and amoxicillin may result in low cure rates and that progression to acute pyelonephritis may occur following ineffective single-dose therapy. (Journal of the American Medical Association 1985;253:387-390.)     

Moderators of the Relationship Between Physical Activity and Alcohol Consumption in College Students

Abstract

Objective: Among college students, several studies have found a positive relationship between physical activity and alcohol use. The current study tested gender, Greek status, and ethnicity as potential moderators of the physical activity-alcohol use relationship. Participants: Participants were college freshmen (n = 310) endorsing alcohol/drug use. Methods: Students completed questionnaires assessing a number of health behaviors. Results: Results indicated that gender and Greek status were significant moderators of the relationship between physical activity and alcohol consumption. There was a positive relationship between physical activity and alcohol use for men and Greeks, but not for females and non-Greeks. Conclusions: These findings suggest that exercise does not serve as a protective factor for any of the subgroups of college students studied and is positively associated with drinking among college students who are men and/or involved with the Greek system.     

Understanding physical activity behavior in African American and Caucasian college students: an application of the theory of planned behavior

Only 30% of college students meet the recommended amount of physical activity (PA) for health benefits, and this number is lower for African American students. Moreover, the correlates of PA may vary by ethnicity. OBJECTIVE: In the present study, the authors tested the utility of the theory of planned behavior for explaining PA intentions and behavior in Caucasian and African American students. PARTICIPANTS AND METHODS: Participants were 238 African American (M age = 20.05 years, SD = 2.28) and 197 Caucasian (M age = 19.50 years, SD = 2.28) students who completed a baseline theory of planned behavior questionnaire and a follow-up PA measure 1 week later. RESULTS: Hierarchical regression analyses showed that affective (beta = .23) and instrumental (beta = .28) attitudes and perceived behavioral control (beta = .59) were significantly predictive of intention for the Caucasian students, whereas affective attitude (beta = .18) and perceived behavioral control (beta = .56) were significant for African American students. Furthermore, intention (beta = .33) was the lone significant predictor of PA for Caucasian students, whereas perceived behavioral control (beta = .23) was the significant predictor of PA for African American students. CONCLUSIONS: These data suggest that practitioners may need to consider ethnicity when developing PA interventions for college students based on the theory of planned behavior.     

Health value, perceived social support, and health self-efficacy as factors in a health-promoting lifestyle

During their college years, students may adopt healthpromoting lifestyles that bring about long-term benefits. OBJECTIVE AND PARTICIPANTS: The purpose of this study was to explore the roles of health value, family/friend social support, and health self-efficacy in the health-promoting lifestyles of a diverse sample of 162 college students. METHODS: Participants completed an Assessment Battery consisting of the following instruments: (1) a demographic questionnaire, (2) the Multi-Dimensional Support, (3) the Value on Health Scale, (4) the Self-Rated Abilities for Health Practices, (5) the Health-Promoting Lifestyle Profile II, and (6) the Marlowe-Crowne Social Desirability Scale. RESULTS: Correlational analyses indicated that health value, perceived family/friend social support, and health self-efficacy were significantly associated with engagement in a health-promoting lifestyle. An analysis of covariance (ANCOVA) revealed that health value and health self-efficacy significantly predicted the level of engagement in a health-promoting lifestyle. Perceived family/friend social support was not significant in the model. As age increased, level of perceived family/friend social support decreased. CONCLUSION: Present findings suggest that health interventions programs focus on assessing and increasing health self-efficacy and health value of these youth. College health professionals can design and evaluate the effectiveness of such health-promoting interventions.     

Eating Disorder Symptoms Among College Students: Prevalence,Persistence, Correlates,and Treatment-Seeking

Abstract

Objective: To examine the prevalence, correlates, persistence, and treatment-seeking related to symptoms of eating disorders (EDs) in a random sample of college students. Participants: A random sample of students at a large university were recruited for an Internet survey in Fall 2005 and a follow-up survey in Fall 2007. Methods: ED symptoms were measured using the SCOFF screen and adjusted for nonresponse using administrative data and a nonresponse survey. Results: 2,822 (56%) students completed the baseline survey. Among undergraduates the prevalence of positive screens was 13.5% for women and 3.6% for men. Among students with positive screens, 20% had received past-year mental health treatment. In the follow-up sample (N = 753), ED symptoms at baseline significantly predicted symptoms 2 years later. Conclusions: Symptoms of EDs were prevalent and persistent among college students in this study. These findings suggest that brief screens can identify a large number of students with untreated EDs.     

大学生亲社会倾向与志愿动机的关系研究

大学生是社会志愿服务群体的重要力量,探析大学生亲社会倾向与志愿动机的关系非常重要。对233名大学生的调查表明:当前大学生志愿动机水平较高,不同性别在志愿动机上有显著差异,政治面貌影响志愿动机。亲社会倾向与志愿动机高度正相关,情绪性、依从性、利他性是志愿动机的有效预测变量。组织类型在亲社会倾向与志愿动机之间起到调节作用。     

Prevalence of snoring in college students

Snoring in college students may be the earliest presentation of adult sleep-disordered breathing, yet the literature contains few studies that demonstrate its effects on learning or whether early diagnosis leads to interruption of disease progression or prevention of comorbidities. OBJECTIVE AND PARTICIPANTS: The authors conducted this study in January-April 2004 to assess the prevalence of snoring in college students (N = 2,200). METHODS: They developed a questionnaire on sleep behaviors and distributed it to 18- to 25-year-old undergraduates at a California university. RESULTS: Almost one-third (30%) of participants reported snoring. The prevalence of snoring was higher among men than women (42% and 25%, respectively). The prevalence of self-reported snoring was highest in Asian students (37%). CONCLUSIONS: Snoring is highly prevalent in college students; prevalence is higher in men than women, correlates with body mass index, and varies by ethnicity.     

Life change and spirituality among a college student cohort

OBJECTIVE: Because college marks a time when life-change is typically high, the authors designed this study to determine whether life-change was related to degree of spirituality, the "directing" component of health, among a college student cohort. PARTICIPANTS AND METHODS: The sample group, consisting of 180 northeastern US undergraduate college students, completed the 48-item Life Attitude Profile-Revised (LAP-R) and the Schedule of Recent Experience (SRE) in the fall semester of 2004. RESULTS: Findings indicate that college students who reported experiencing higher levels of life change, both positive and negative, also scored lower on spirituality. Nevertheless, these students had scores indicative of a higher desire to find spirituality, even though their motivation to do so was low. CONCLUSIONS: Although life changes among college students likely will remain high, lower spirituality can be enhanced; therefore, interested health educators are encouraged to help students increase their degree of spirituality.     

大学生流行语变迁的心理学分析

大学生流行语是在某一个特定时期内,流行于高校大学生中的一种具有代表性的话语,能够概括性地反映出当代社会的某种本质性特点及大学生的普遍心态。大学生流行语的价值取向表现出兼容性、多样性和时代性特点。负面词汇流行语是大学生释放心理压力的一种方式。同时,大学生并不会偏重某一方面的流行,而是兼容了正负面的影响。大学生流行语体现了当代大学生的心理状态,成为大学生社会文化心态的表征符号,为我们了解大学生的心理状态和人生价值取向等问题提供了一面镜子。     

Understanding Physical Activity Behavior in African American and Caucasian College Students: An Application of the Theory of Planned Behavior

Only 30% of college students meet the recommended amount of physical activity (PA) for health benefits, and this number is lower for African American students. Moreover, the correlates of PA may vary by ethnicity. Objective: In the present study, the authors tested the utility of the theory of planned behavior for explaining PA intentions and behavior in Caucasian and African American students. Participants and Methods: Participants were 238 African American (M age = 20.05 years, SD = 2.28) and 197 Caucasian (M age = 19.50 years, SD = 2.28) students who completed a baseline theory of planned behavior questionnaire and a follow-up PA measure 1 week later. Results: Hierarchical regression analyses showed that affective (β = .23) and instrumental (β = .28) attitudes and perceived behavioral control (β = .59) were significantly predictive of intention for the Caucasian students, whereas affective attitude (β = .18) and perceived behavioral control (β = .56) were significant for African American students. Furthermore, intention (β = .33) was the lone significant predictor of PA for Caucasian students, whereas perceived behavioral control (β = .23) was the significant predictor of PA for African American students. Conclusions: These data suggest that practitioners may need to consider ethnicity when developing PA interventions for college students based on the theory of planned behavior.