Risk factors for aquiring multidrug-resistant organisms in urinary tract infections: A systematic literature review

Background: Urinary tract infections (UTIs) are one of the most seen infection among community. Objectives: In this cross-sectional study we aimed to investigate the risk factors of multidrug-resistant (MDR) bacteria that caused community-acquired UTI (CA-UTI). Methods: Consecutive patients admitted to the Urology and Infectious Diseases policlinics with the diagnosis of CA-UTI were included in the study. A standard form including possible predisposing factors for MDR bacteria was applied. Results: In total, 240 patients (51.3% females) were enrolled in the study. The mean age of participants were 59.8 ± 18.3 years old. Escherichia coli (n =166; 69.2%)was the most frequently isolated bacteria and its incidence was higher in females than in males (p=0.01). In total, 129 (53.8%) of the identified pathogens were MDR bacteria. According to multivariate analysis, the use of antibiotics three or more times increased the risk of infection with MDR bacteria by 4.6 times, the history of urinary tract infection in the last 6 months by 2 times, being male and over 65 years old by 3 times. Conclusion: Doctors should consider prescribing broad-spectrum antibiotics in patients with severe UTIs with a history of UTI, advanced age, male gender, and multiple antibiotic usage, even if they have a CA-UTI. Keywords: Urinary tract infection; community acquired; multidrug-resistant; male; multiple antibiotic usage; advanced age.

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Multidrug-resistant organisms in urinary tract infections in children

Pediatric Nephrology ◽

10.1007/s00467-019-04316-5 ◽

2019 ◽

Vol 35 (9) ◽

pp. 1563-1573 ◽

Cited By ~ 3

Author(s):

Michelle Mahony ◽

Brendan McMullan ◽

Jeremy Brown ◽

Sean E Kennedy

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Multidrug Resistant ◽

Multidrug Resistant Organisms ◽

Tract Infections

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Management of Urinary Tract Infections From Multidrug-Resistant Organisms

Infectious Disease Clinics of North America ◽

10.1016/j.idc.2013.10.002 ◽

2014 ◽

Vol 28 (1) ◽

pp. 49-59 ◽

Cited By ~ 36

Author(s):

Kalpana Gupta ◽

Nahid Bhadelia

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Multidrug Resistant ◽

Multidrug Resistant Organisms ◽

Tract Infections

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Resistance and Virulence Properties of Extraintestinal Pathogenic E. Coli Causing Nosocomial-and Community-Acquired Urinary Tract Infections in Hospitalized Patients in Rio de Janeiro, Brazil

10.20944/preprints202009.0655.v1 ◽

2020 ◽

Author(s):

Ana Carolina da C. Campos ◽

Nathália Andrade ◽

Julio C. D. Correal ◽

Carla C. Santos ◽

Marines du Teil Espina ◽

...

Keyword(s):

Risk Factors ◽

Urinary Tract ◽

High Risk ◽

Urinary Tract Infections ◽

Asymptomatic Bacteriuria ◽

Multidrug Resistant ◽

Hospitalized Patients ◽

E Coli ◽

Tract Infections ◽

Resistance Rates

Background: Extraintestinal pathogenic Escherichia coli (ExPEC) is the most common cause of urinary tract infections (UTIs). They are often multidrug-resistant (MDR), making them challenging to treat. Additionally, virulence mechanisms as biofilm formation are associated with persistent UTIs. Aims: To reveal a possible association between patients’ risk factors and UTIs caused by MDR or biofilm-forming ExPECs and characterize ExPECs causing asymptomatic bacteriuria, community- (CA), or hospital-acquired (HA) UTIs in hospitalized patients in Brazil. Methods: Bacterial DNA was extracted from the urine of 63 hospitalized patients and sequenced using short-read sequencing. Antibiotic susceptibility was evaluated using VITEK-2, and the biofilm-forming, adhesion, and invasion abilities were quantitatively assessed. Results: Antibiotic resistance rates were high, and the majority of UTIs were complicated CA-UTIs. Most MDR- and ESBL-producing E. coli isolates belonged to high-risk lineages and were associated with UTIs in patients with comorbidities and over 60 years of age. The mortality rate of patients infected with MDR-isolates was higher than of those infected with non-MDR isolates. Most isolates were biofilm-forming, but no association with patients’ risk factors was found. Conclusions: Complicated UTIs caused by MDR- and biofilm-forming bacteria are frequently found in hospitalized patients in Brazil suffering from a UTI and are associated with high-risk lineages.

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Urinary Tract Infections due to Multidrug-Resistant Enterobacteriaceae: Prevalence and Risk Factors in a Chicago Emergency Department

Emergency Medicine International ◽

10.1155/2013/258517 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 39

Author(s):

Thana Khawcharoenporn ◽

Shawn Vasoo ◽

Kamaljit Singh

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Multidrug Resistant ◽

Tract Infections

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The Clinical Significance of High Antimicrobial Resistance in Community-Acquired Urinary Tract Infections

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2020/2967260 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Maria G. Zavala-Cerna ◽

Midrori Segura-Cobos ◽

Ricardo Gonzalez ◽

Isidro G. Zavala-Trujillo ◽

Silvia F. Navarro-Perez ◽

...

Keyword(s):

Risk Factors ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Multidrug Resistant ◽

Clinical Variable ◽

Microbiological Analysis ◽

Cross Sectional ◽

E Coli ◽

Tract Infections ◽

Esbl Producers

Background. Urinary tract infections (UTIs) affect up to 150 million individuals annually worldwide, mainly due to Escherichia coli (E. coli) and Klebsiella. The emergence and spread of multidrug-resistant (MDR) bacteria are increasing, representing one of the biggest threats for human health. The objective of our study was to describe antimicrobial patterns of resistance and identify risk factors associated with MDR uropathogens. Methods. We conducted a cross-sectional study in 296 patients with community-acquired UTI who underwent clinical and microbiologic analysis, and clinical associations to MDR uropathogens were investigated. Findings. Microbiological analysis included E. coli (55%), ESBL-E. coli (26%), Enterococcus (6%), Klebsiella (5%), and others (8%). Higher frequencies of MDR bacteria were found among ESBL-E. coli, with resistance to ampicillin (100%), ceftriaxone (96%), gentamicin (57%), ciprofloxacin (89%), and TMP/SMX (53%). However, they were sensitive to fosfomycin (6.6%), nitrofurantoin (1.3%), and carbapenems (0%). Fosfomycin MIC90 for ESBL-E. coli was 5.78 μg/mL. The only clinical variable with significant association to ESBL producers was the presence of comorbidities: hypertension and type 2 diabetes mellitus with an OR (95%CI) of 2.51.3−4.9p<0.01 and 2.81.2−6.7p<0.05, respectively. Conclusions. In the majority of cases, resistance rates to commonly prescribed antimicrobials in UTIs were high, except for fosfomycin, nitrofurantoin, and carbapenems. To provide appropriate treatment, both the identification of risk factors and the uropathogen would be important. An active surveillance in UTIs in the community is required since the proportion of ESBL producers is increasing.

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Multidrug resistance and risk factors associated with community-acquired urinary tract infections caused by Escherichia coli in Venezuela

Biomédica ◽

10.7705/biomedica.v39i2.4030 ◽

2019 ◽

Vol 39 ◽

pp. 96-107 ◽

Cited By ~ 1

Author(s):

Militza Guzmán ◽

Elsa Salazar ◽

Vicmaris Cordero ◽

Ana Castro ◽

Andreína Villanueva ◽

...

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Urinary Tract ◽

Urinary Tract Infections ◽

High Frequency ◽

Multidrug Resistant ◽

E Coli ◽

Regional Health Authorities ◽

Tract Infections

Introduction: The treatment of urinary tract infections has become more challenging due to the increasing frequency of multidrug-resistant Escherichia coli in human populations.Objective: To characterize multidrug-resistant E. coli isolates causing community-acquired urinary tract infections in Cumaná, Venezuela, and associate possible risk factors for infection by extended-spectrum beta-lactamases (ESBL)-producing isolates.Materials and methods: We included all the patients with urinary tract infections attending the urology outpatient consultation and emergency unit in the Hospital de Cumaná, Estado Sucre, Venezuela, from January through June, 2014. blaTEM, blaSHV and blaCTX-M genes detection was carried out by PCR.Results: We found a high prevalence of multidrug-resistant E. coli (25.2%) with 20.4% of the isolates producing ESBL. The ESBL-producing isolates showed a high frequency (66.7%) of simultaneous resistance to trimethoprim-sulphamethoxazole, fluoroquinolones and aminoglycosides compared to non-producing isolates (2.4%). Of the resistant isolates, 65.4% carried the blaTEM gene, 34.6% the blaCTX-M and 23.1% the blaSHV. The blaCTX-M genes detected belonged to the CTX-M-1 and CTX-M-2 groups. Plasmid transfer was demonstrated by in vitro conjugation in 17 of the 26 ESBL-producing isolates. All three genes detected were transferred to the transconjugants. Age over 60 years, complicated urinary tract infections and previous use of a catheter predisposed patients to infection by ESBL-producing E. coli.Conclusions: The high frequency of multidrug-resistant ESBL-producing isolates should alert the regional health authorities to take measures to reduce the risk of outbreaks caused by these types of bacteria in the community.

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Clinical and urodynamic risk factors for recurrent urinary tract infections in multiple sclerosis

10.26226/morressier.5b7578605aff7400151f3140 ◽

2018 ◽

Author(s):

paloma Montero ◽

Vanesa Pytel

Keyword(s):

Risk Factors ◽

Multiple Sclerosis ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Recurrent Urinary Tract Infections ◽

Tract Infections

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The Antibacterial Activity of Human Amniotic Membrane against Multidrug-Resistant Bacteria Associated with Urinary Tract Infections: New Insights from Normal and Cancerous Urothelial Models

Biomedicines ◽

10.3390/biomedicines9020218 ◽

2021 ◽

Vol 9 (2) ◽

pp. 218

Author(s):

Taja Železnik Ramuta ◽

Larisa Tratnjek ◽

Aleksandar Janev ◽

Katja Seme ◽

Marjanca Starčič Erjavec ◽

...

Keyword(s):

Antibacterial Activity ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Amniotic Membrane ◽

Multidrug Resistant ◽

Basic Knowledge ◽

Resistant Bacteria ◽

Human Amniotic Membrane ◽

Multidrug Resistant Bacteria ◽

Tract Infections

Urinary tract infections (UTIs) represent a serious global health issue, especially due to emerging multidrug-resistant UTI-causing bacteria. Recently, we showed that the human amniotic membrane (hAM) could be a candidate for treatments and prevention of UPEC and Staphylococcus aureus infections. However, its role against multidrug-resistant bacteria, namely methicillin-resistant S. aureus (MRSA), extended-spectrum beta-lactamases (ESBL) producing Escherichia coli and Klebsiella pneumoniae, vancomycin-resistant Enterococci (VRE), carbapenem-resistant Acinetobacter baumannii, and Pseudomonas aeruginosa has not yet been thoroughly explored. Here, we demonstrate for the first time that the hAM homogenate had antibacterial activity against 7 out of 11 tested multidrug-resistant strains, the greatest effect was on MRSA. Using novel approaches, its activity against MRSA was further evaluated in a complex microenvironment of normal and cancerous urinary bladder urothelia. Even short-term incubation in hAM homogenate significantly decreased the number of bacteria in MRSA-infected urothelial models, while it did not affect the viability, number, and ultrastructure of urothelial cells. The hAM patches had no antibacterial activity against any of the tested strains, which further exposes the importance of the hAM preparation. Our study substantially contributes to basic knowledge on the antibacterial activity of hAM and reveals its potential to be used as an antibacterial agent against multidrug-resistant bacteria.

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