Ampicillin for the treatment of complicated urinary tract infections caused by vancomycin–resistant Enterococcus spp (VRE): a single-center university hospital experience

2018 ◽  
Vol 51 (1) ◽  
pp. 57-61 ◽  
Author(s):  
Kairav J. Shah ◽  
Kartikeya Cherabuddi ◽  
Joseph Shultz ◽  
Samuel Borgert ◽  
Reuben Ramphal ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
University Hospital ◽  
Vancomycin Resistant Enterococcus ◽  
Single Center ◽  
Hospital Experience ◽  
Enterococcus Spp ◽  
Vancomycin Resistant ◽  
Tract Infections

scholarly journals Prevalence of vancomycin resistance phenotypes among Enterococcus species isolated from clinical samples in a Romanian hospital

2019 ◽  
Vol 9 (6) ◽  
pp. 4699-4704 ◽  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Vancomycin Resistance ◽  
Clinical Samples ◽  
Vancomycin Resistant Enterococcus ◽  
Hospital Unit ◽  
Vancomycin Resistant ◽  
Etiological Agents ◽  
High Level ◽  
Tract Infections

Vancomycin resistant Enterococcus (VRE) has been increasingly reported since the 1980s. Although normally regarded as harmless commensals, enterococci can become the etiological agents of nosocomial infections causing urinary tract infections, peritonitis, bacteriemia, wound infections and endocarditis. The acquisition of vancomycin resistance has seriously affected the treatment and infection control of these bacteria. VRE are frequently resistant to most antibiotics that are effective against vancomycin susceptible enterococci, the therapeutic options of VRE infections being thus very limited. The aim of this study was to assess the genetic support of vancomycin resistance among VRE strains isolated from patients admitted to intensive care units in one hospital unit from Bucharest, Romania Out of 84 enterococcal strains isolated from urine prelevated from catheterized and non-catheterized patients with urinary tract infections, wound secretions, pus, blood, ascite liquid and stool, 28 strains had glycopeptide resistance. Out of these, in the 12 vancomycin-resistant Enterococcus faecalis strains, the VanA phenotype was detected in 9 strains and VanB in 3 strains. From the 16 E. faecium strains resistant to vancomycin, 10 strains showed the VanA phenotype and 6 strains had the VanB phenotype. According to the results of this study, the VanA phenotype, conferring high-level resistance to vancomycin and teicoplanin, was more prevalent than VanB in the Enterococcus sp. strains isolated from hospitalized patients.

scholarly journals Linezolid to treat urinary tract infections caused by vancomycin-resistant Enterococcus

2020 ◽  
Vol 8 ◽  
pp. 205031212097074
Author(s):  
Benjamin Alan Pontefract ◽  
Suzette Amy Rovelsky ◽  
Karl Joseph Madaras-Kelly
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Treatment Outcomes ◽  
Urinary Tract Infections ◽  
Post Treatment ◽  
Vancomycin Resistant Enterococcus ◽  
Health Administration ◽  
Vancomycin Resistant ◽  
Tract Infections

Background: Vancomycin-resistant Enterococcus can cause urinary tract infection. Linezolid possesses antimicrobial activity against vancomycin-resistant Enterococcus but has limited urinary excretion. Minimal data demonstrate efficacy of linezolid for treatment of urinary tract infections. Objective: The main aim of this study is to compare post-treatment outcomes of linezolid to other antibiotics with vancomycin-resistant Enterococcus activity in the treatment of urinary tract infection caused by vancomycin-resistant Enterococcus. Methods: A retrospective cohort of inpatients within Veterans Health Administration facilities with urinary tract infection caused by vancomycin-resistant Enterococcus was created. Patients with vancomycin-resistant Enterococcus isolated from urine cultures and chart documentation meeting criteria for urinary tract infection were identified. Demographics, comorbidity, treatments, and post-treatment outcomes were extracted from the electronic health record. Outcomes were compared between patients treated with linezolid and alternative antibiotics possessing vancomycin-resistant Enterococcus activity 14 days after treatment completion. Logistic regression adjusted for covariates associated with each outcome. Results: Of 4,683 patients with a positive vancomycin-resistant Enterococcus culture, 624 (13%) met criteria for chart review, and 92 (15%) had documentation of urinary tract infection symptoms and treatment. The primary reason for exclusion was asymptomatic bacteriuria (64%). Patients had high Charlson Comorbidity Scores (mean = 8.7; standard deviation (SD) = 3.3), and 70% were located on general medical/surgical wards on the day of culture collection. Linezolid was prescribed in 54 (59%) cases. No difference between linezolid and comparator antibiotics were observed in re-initiation of antibiotics for vancomycin-resistant Enterococcus urinary tract infection (9% and 5% respectively (p = 0.56), (adjusted odds ratio (OR) = 1.90; 95% confidence interval (CI) = 0.34–10.63)), recurrent positive vancomycin-resistant Enterococcus culture (4% and 11%, respectively (p = 0.23), (adjusted OR = 0.36; 95% CI = 0.05–2.31)), or mortality (7% and 3%, respectively (p = 0.39) (adjusted OR = 2.96; 95% CI = 0.37–41.39)). Conclusion: Most patients with vancomycin-resistant Enterococcus identified on urine culture were asymptomatic. Linezolid appears effective as comparator antibiotics for the treatment of mild vancomycin-resistant Enterococcus urinary tract infection.

scholarly journals Characterization and Comparison of Enterococcus spp. Isolates from Feces of Healthy Dogs and Urine of Dogs with UTIs

Animals ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 2845
Author(s):  
Dagmara Stępień-Pyśniak ◽  
Fabrizio Bertelloni ◽  
Marta Dec ◽  
Giulia Cagnoli ◽  
Dorota Pietras-Ożga ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Virulence Genes ◽  
Multidrug Resistant ◽  
Opportunistic Pathogens ◽  
Enterococcus Spp ◽  
Resistant Strains ◽  
Healthy Dogs ◽  
Vancomycin Resistant ◽  
Tract Infections

Enterococcus spp. are opportunistic pathogens of both humans and animals characterized by high resistance to antimicrobials. Dogs could be intestinal carriers or suffer from Enterococcus infections, mainly urinary tract infections (UTIs). This study aimed to analyze and compare Enterococcus spp. isolated from healthy dog stools and sick dog urine. Overall, 51 isolates (29 from stools and 22 from UTI) were characterized at species level and tested for antimicrobial resistance, biofilm production and presence of resistance and virulence genes. E. faecium and E. faecalis resulted as equally distributed in stools samples, while E. faecalis predominated among UTI isolates. HLAR phenotype was detected in 47.1% isolates; 64.7% isolates were resistant to ampicillin (47.1% with a MIC ≥ 64 µg/mL). High levels of resistance were recorded for fluoroquinolones (enrofloxacin 74.5%, ciprofloxacin 66.7%), clindamycin (84.3%), tetracycline (78.4%) and quinupristin–dalfopristin (78.4%). No vancomycin resistant strains were detected. All but one isolate were multidrug-resistant. Most detected resistance genes were tetM (70.5%), pbp4 (52.9%) and aph(3′)-IIIa (39.2%). All isolates were able to produce biofilm, but isolates from UTIs and belonging to E. faecalis more frequently resulted in strong biofilm producers. Most detected virulence genes were asa1 (52.9%), gelE (41.2%), cylA (37.3%) and esp (35.3%); all of them resulted as more frequently associated to E. faecalis. No particular differences emerged between isolates from feces and UTI, considering all evaluated aspects. Our results confirm pet dogs as carriers of multidrug-resistant enterococci; stool microflora could be considered as the most probable source of enterococcal UTI and E. faecalis carried by dogs seems to be more virulent than E. faecium, justifying its more frequent involvement in urinary tract infections.

URINARY INFECTION AT DEPARTMENT OF UROLOGY OF HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2018 ◽  
pp. 100-108
Author(s):  
Dinh Khanh Le ◽  
Dinh Dam Le ◽  
Khoa Hung Nguyen ◽  
Xuan My Nguyen ◽  
Minh Nhat Vo ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
University Hospital ◽  
E Coli ◽  
Positive Urine ◽  
Tract Infections

Objectives: To investigate clinical characteristics, bacterial characteristics, drug resistance status in patients with urinary tract infections treated at Department of Urology, Hue University Hospital. Materials and Method: The study was conducted in 474 patients with urological disease treated at Department of Urology, Hue Universiry Hospital from July 2017 to April 2018. Urine culture was done in the patients with urine > 25 Leu/ul who have symptoms of urinary tract disease or infection symptoms. Patients with positive urine cultures were analyzed for clinical and bacterial characteristics. Results: 187/474 (39.5%) patients had symptoms associated with urinary tract infections. 85/474 (17.9%) patients were diagnosed with urinary tract infection. The positive urine culture rate was 45.5%. Symptoms of UTI were varied, and no prominent symptoms. E. coli accounts for the highest proportion (46.67%), followed by, Staphycoccus aureus (10.67%), Pseudomonas aeruginsa (8,0%), Streptococcus faecali and Proteus (2.67%). ESBL - producing E. coli was 69.23%, ESBL producing Enterobacter spp was 33.33%. Gram-negative bacteria are susceptible to meropenem, imipenem, amikacin while gram positive are vancomycin-sensitive. Conclusions: Clinical manifestations of urinary tract infections varied and its typical symptoms are unclear. E.coli is a common bacterium (46.67%). Isolated bacteria have a high rate of resistance to some common antibiotics especially the third generation cephalosporins and quinolones. Most bacteria are resistant to multiple antibiotics at the same time. Gram (+) bacteria are susceptible to vancomycin, and gram (-) bacteria are susceptible to cefoxitin, amikacin, and carbapenem. Key words: urinary tract infection

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

Chemotherapy ◽  
2016 ◽  
Vol 62 (2) ◽  
pp. 100-104 ◽  
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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