Distribution and antibiotic resistance profile of key Gram-negative bacteria that cause community-onset urinary tract infections in the Russian Federation: RESOURCE multicentre surveillance 2017 study

Urinary tract infection is one of the most common bacterial infections in children, which in 30% of cases may be the first manifestation of the presence of congenital malformations of the urinary tract and urodynamic disorders in a child. Late diagnosis, initiation of therapy, and the choice of an inadequate antimicrobial drug increase the risks of disease progression, development of nephrosclerosis and patient disability. Purpose – to study the microbial landscape in urinary tract infections, its antibiotic resistance in newborns with anomalies in the development of the urinary system. Materials and methods. The results of microbiological examination of urine in newborns with urinary tract infections against the background of anomalies in the development of the urinary tract, which are being treated in intensive care units and neonatal pathology in the period 2016–2020, have been analyzed. Results. The main causative agents of urinary tract infections in newborns with anomalies of the urinary system are Enterobacterales (63.4%), 13.8% are producers of extended spectrum beta-lactamases. Cefoperazone/sulbactam, amikacin, meropenem and nitrofurantoin were most active against Escherichia coli. In relation to other representatives of the order Enterobacterales, only amikacin was highly active. The strains of Enterococcus spp., Detected in 20%, were resistant to reserve vancomycin in every fourth case. Representatives of non-fermenting gram-negative bacteria were found in 6.4% of cases, resistance to the main titrated antibiotics ranged from 44.4% to 100%. Conclusions. The main causative agents of urinary tract infections in newborns with anomalies of the urinary system are representatives of the order Enterobacterales, Enterococcus spp. and non-fermenting gram-negative bacteria, which were characterized by high resistance, including to reserve antibiotics. The high indices of resistance of the isolated microflora make it difficult to choose an effective antibacterial therapy in this category of patients and in most cases requires combined antibiotic therapy. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: Urinary tract infection, newborn babies, urinary tract abnormalities, antibiotic resistance.

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Antibiotic Resistance of Isolated Gram Negative Bacteria From Urinary Tract Infections (UTIs) in Isfahan

Jundishapur Journal of Microbiology ◽

10.5812/jjm.6883 ◽

2013 ◽

Vol 6 (8) ◽

Cited By ~ 6

Author(s):

Mahsa Mirzarazi ◽

Seyedeh Elham Rezatofighi ◽

Mahdi Pourmahdi ◽

Mohamad Reza Mohajeri

Keyword(s):

Antibiotic Resistance ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Gram Negative Bacteria ◽

Gram Negative ◽

Tract Infections

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Διερεύνηση νέων β-λακταμασών σε στελέχη gram-αρνητικών βακτηρίων στην κοινότητα

10.12681/eadd/31678 ◽

2011 ◽

Author(s):

Αγγελική Πούλου

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Health Care Facilities ◽

Gram Negative Bacteria ◽

Gram Negative ◽

Carbapenem Resistant ◽

Plasmid Analysis ◽

Previous Hospitalization ◽

Tract Infections ◽

Community Onset

The aim of the study was to investigate the dissemination in the community of carbapenem-resistant gram-negative bacteria and the mechanisms of acquired resistance.Patients who were referred to the outpatient department of Serres General Hospital with community-onset infections due to carbapenem-resistant gram-negative bacteria during a 3 year period (2005-2008) were included in this study. The selected isolates were tested by determination of agar dilution MICs, phenotypic carbapenemase testing and molecular typing methods. PCR and sequencing analyses were employed for identification of bla genes and mapping of the integron carrying the metallo-β-lactamase (MBL) gene. The location of the MBL allele was investigated by mating experiments, plasmid analysis, and hybridization of the Southern-blotted plasmid extract with a blaVIM probe. The demographic and clinical characteristics of the outpatients were prospectively collected.During the study period 12 Proteus mirabilis, 97 Pseudomonas aeruginosa and 24 Klebsiella pneumoniae isolates with reduced susceptibility to imipenem and/or meropenem were recovered from urinary tract infections of 12, 45 and 12 outpatients, respectively. As many as 64 of the outpatients had a history of previous hospitalization or visit to the healthcare facilities in the preceding year while the remaining 5 outpatients with urinary tract infections due to P. aeruginosa carbapenem-resistant isolates had not been hospital admission in the preceding year.In 18 outpatients infected with P. aeruginosa and 6 outpatients infected with K. pneumoniae the carbapenem-resistant organisms caused recurrent community-onset infections, while in three outpatients P. aeruginosa isolates were also implicated in community-onset bacteremic episodes. Diabetes mellitus, prostatic hyperplasia and infection with an MBL-producing strain during a previous hospitalization were significantly associated with recurrent infections in the community setting.Recurrent infections were not detected among patients infected with MBL-producing P. mirabilis isolates. Among P. mirabilis isolates imipenem, meropenem and ertapenem MICs ranged from 32 to >128 mg/L, 1 to 8 mg/L and 0.5 to 4 mg/L, respectively. The isolates originated from the same clonal strain and harbored a blaVIM-1 gene in a common integron structure. Conjugation experiments, plasmid analysis and hybridization assays indicated the chromosomal location of blaVIM-1 gene. All 45 single-patient P. aeruginosa isolates harbored the blaVIM-2 MBL gene in a common class 1 integron structure. They belonged to one predominant pulsed-field gel electrophoresis type and three sporadically detected types; two of the sporadic clonal types were identified among outpatients without previous exposure to health care facilities, while the predominant clonal type was also identified to cause infections in hospitalized patient. The integron carrying the MBL gene was located on the bacterial chromosome.For the K. pneumoniae isolates imipenem, meropenem and ertapenem MICs ranged from 8 to 64mg/L, 4 to 32mg/L and 8 to 128mg/L, respectively. All studied isolates as well as those two recovered during previous hospitalization belonged to a single PFGE clone. They harbored a plasmid-mediated blaVIM-1 gene in an integron structure that has been previously described among clinical isolates from Greek hospitals.This is the first study to document the dissemination of MBL-producing P. mirabilis, P. aeruginosa and K. pneumoniae isolates in the community. Present clinical and molecular data provided evidence that MBL-producing strains could easily disseminated in the community from patients colonized during a previous hospitalization. Increased awareness and intensified infection control practices in the hospital as well as the community setting are the keys to curtailing the spread of these alarming carbapenem resistant pathogens.

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1686. Microbiology of Community-Onset Urinary Tract Infections in the United States, 2012-2017

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1864 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S826-S827

Author(s):

Leigh Ellyn Preston ◽

Clifford McDonald ◽

Babatunde Olubajo ◽

Natalie McCarthy ◽

Sujan Reddy ◽

...

Keyword(s):

United States ◽

Antibiotic Resistance ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Relative Frequency ◽

The United States ◽

Antibiotic Prescribing ◽

Factors Associated ◽

Tract Infections ◽

Community Onset

Abstract Background Community-onset urinary tract infections (coUTIs) are one of the most common indications for antibiotic prescribing. It is important to understand patient demographic factors associated with microorganisms causing coUTI and their antibiotic resistance profiles, to tailor antibiotic prescribing practices. We analyzed microbiology data to understand factors associated with coUTI in the United States (US). Methods CoUTIs were identified in the Premier Healthcare Database and Cerner Health Facts among patients treated at participating healthcare facilities in the US between 2012-2017. Cases were defined by urine cultures yielding a bacterial organism and were collected in outpatient settings or within three days of hospitalization. Only the first specimen for each encounter was included in the analysis. Data on the organisms isolated, patient’s age, sex, and US census regions of the submitting facilities were described and compared using chi-square tests for associations. Encounters were classified as inpatient (INPT), observation (OBS), emergency department (ED), and outpatient (OTPT) based on the setting in which the culture was submitted. Results Using data from 637 acute care hospitals, urine samples from 3,291,561 encounters were included, with 776,653 (25.7%) INPT, 1,063,219 (34.8%) ED, 107,760 (3.5%) OBS, and 1,092,658 (35.8%) OTPT. The pathogens most frequently associated with coUTIs were Escherichia coli (57.3%), Klebsiella pneumoniae (9.7%), Enterococcus faecalis (5.1%), Proteus mirabilis (4.9%), and Pseudomonas aeruginosa (2.9%). Female sex, age < 65y and OTPT and ED settings were associated with higher relative frequency of E. coli (all p < 0.0001). Male sex, INPT setting and age >65 y were associated with higher relative frequency of P. aeruginosa, P. mirabilis and E. faecalis (all p < 0.0001, Figure). K. pneumoniae was found at higher relative frequency in those >45y, and in INPT and OBS settings (all p < 0.0001). Figure. Distribution of pathogens most frequently associated with community onset urinary tract infections Conclusion Understanding patient factors associated with the microbiology of coUTIs is an important step in developing treatment recommendations and antibiotic stewardship efforts. Further analyses will include assessing the impact of major antibiotic resistance phenotypes, geographic and healthcare settings. Disclosures All Authors: No reported disclosures

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