366: Bacterial Resistance Patterns In Patients With Ureteral Calculi and Urinary Tract Infections

Urinary tract infections constitute an important public health issue due to recurrence and antibiotic resistance. Currently, antibiotics are the standard therapy but non-antibiotic approaches, such as food supplements, could be beneficial and reduce bacterial resistance. This work aimed at a better understanding of the perception of health professionals involved in dispensing and counselling, in the community pharmacy, regarding the utility of these products as preventive alternatives and therapeutic approaches.

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Assessment of Fosfomycin for Complicated or Multidrug-Resistant Urinary Tract Infections: Patient Characteristics and Outcomes

Chemotherapy ◽

10.1159/000449422 ◽

2016 ◽

Vol 62 (2) ◽

pp. 100-104 ◽

Cited By ~ 18

Author(s):

Stephanie E. Giancola ◽

Monica V. Mahoney ◽

Michael D. Hogan ◽

Brian R. Raux ◽

Christopher McCoy ◽

...

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Bacterial Resistance ◽

Clinical Success ◽

Patient Characteristics ◽

Multidrug Resistant ◽

Enterococcus Spp ◽

Tract Infections ◽

Microbiological Cure

Background: Bacterial resistance among uropathogens is on the rise and has led to a decreased effectiveness of oral therapies. Fosfomycin tromethamine (fosfomycin) is indicated for uncomplicated urinary tract infections (UTIs) and displays in vitro activity against multidrug-resistant (MDR) isolates; however, clinical data assessing fosfomycin for the treatment of complicated or MDR UTIs are limited. Methods: We conducted a retrospective evaluation of patients who received ≥1 dose of fosfomycin between January 2009 and September 2015 for treatment of a UTI. Patients were included if they had a positive urine culture and documented signs/symptoms of a UTI. Results: Fifty-seven patients were included; 44 (77.2%) had complicated UTIs, 36 (63.2%) had MDR UTIs, and a total of 23 (40.4%) patients had a UTI that was both complicated and MDR. The majority of patients were female (66.7%) and elderly (median age, 79 years). Overall, the most common pathogens isolated were Escherichia coli (n = 28), Enterococcus spp. (n = 22), and Pseudomonas aeruginosa (n = 8). Twenty-eight patients (49.1%) were clinically evaluable; the preponderance achieved clinical success (96.4%). Fifteen out of 20 (75%) patients with repeat urine cultures had a microbiological cure. Conclusions: This retrospective study adds to the limited literature exploring alternative therapies for complicated and MDR UTIs with results providing additional evidence that fosfomycin may be an effective oral option.

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Long-term surveillance of Escherichia coli antibiotic resistance patterns in urinary tract infections in a southern India hospital

Astrocyte ◽

10.4103/2349-0977.161609 ◽

2015 ◽

Vol 1 (4) ◽

pp. 264

Author(s):

DDevaprasath Jeyasekharan ◽

RNelson Manohar ◽

M Andreas ◽

B Bhatia ◽

R Devaprasath

Keyword(s):

Escherichia Coli ◽

Antibiotic Resistance ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Southern India ◽

Resistance Patterns ◽

Tract Infections ◽

Antibiotic Resistance Patterns

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Bacterial Resistance to Leucyl-tRNA Synthetase Inhibitor GSK2251052 Develops during Treatment of Complicated Urinary Tract Infections

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.03774-14 ◽

2014 ◽

Vol 59 (1) ◽

pp. 289-298 ◽

Cited By ~ 49

Author(s):

Karen O'Dwyer ◽

Aaron T. Spivak ◽

Karen Ingraham ◽

Sharon Min ◽

David J. Holmes ◽

...

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Bacterial Resistance ◽

Multidrug Resistant ◽

Trna Synthetase ◽

Content Type ◽

Development Of Resistance ◽

Tract Infections ◽

Abdominal Infections

ABSTRACTGSK2251052, a novel leucyl-tRNA synthetase (LeuRS) inhibitor, was in development for the treatment of infections caused by multidrug-resistant Gram-negative pathogens. In a phase II study (study LRS114688) evaluating the efficacy of GSK2251052 in complicated urinary tract infections, resistance developed very rapidly in 3 of 14 subjects enrolled, with ≥32-fold increases in the GSK2251052 MIC of the infecting pathogen being detected. A fourth subject did not exhibit the development of resistance in the baseline pathogen but posttherapy did present with a different pathogen resistant to GSK2251052. Whole-genome DNA sequencing ofEscherichia coliisolates collected longitudinally from two study LRS114688 subjects confirmed that GSK2251052 resistance was due to specific mutations, selected on the first day of therapy, in the LeuRS editing domain. Phylogenetic analysis strongly suggested that resistantEscherichia coliisolates resulted from clonal expansion of baseline susceptible strains. This resistance development likely resulted from the confluence of multiple factors, of which only some can be assessed preclinically. Our study shows the challenges of developing antibiotics and the importance of clinical studies to evaluate their effect on disease pathogenesis. (These studies have been registered at ClinicalTrials.gov under registration no. NCT01381549 for the study of complicated urinary tract infections and registration no. NCT01381562 for the study of complicated intra-abdominal infections.)

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