Antimicrobial resistance patterns of urine culture specimens from 27 nursing homes: Impact of a two-year antimicrobial stewardship intervention

2019 ◽  
Vol 40 (7) ◽  
pp. 780-786 ◽  
Author(s):  
Meera Tandan ◽  
Philip D. Sloane ◽  
Kimberly Ward ◽  
David J. Weber ◽  
Akke Vellinga ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Nursing Homes ◽  
Antimicrobial Stewardship ◽  
Pathogenic Bacteria ◽  
Intervention Program ◽  
Urine Culture ◽  
Effect Change ◽  
E Coli ◽  
Resistance Patterns ◽  
Culture Positive

AbstractObjective:Identify changes in the prevalence and antimicrobial resistance patterns of potentially pathogenic bacteria in urine cultures during a 2-year antimicrobial stewardship intervention program in nursing homes (NHs).Design:Before-and-after intervention study.Setting:The study included 27 NHs in North Carolina.Methods:We audited all urine cultures ordered before and during an antimicrobial stewardship intervention. Analyses compared culture rates, culture positive rates, and pathogen antimicrobial resistance patterns.Results:Of 6,718 total urine cultures collected, 68% were positive for potentially pathogenic bacteria. During the intervention, significant reductions in the urine culture and positive culture rates were observed (P= .014). Most of the identified potentially uropathogenic isolates wereEscherichia coli(38%),Proteusspp (13%), andKlebsiella pneumoniae(12%). A significant decrease was observed during the intervention period in nitrofurantoin resistance amongE. coli(P≤ .001) and ciprofloxacin resistance amongProteusspp (P≤ .001); however carbapenem resistance increased forProteusspp (P≤ .001). Multidrug resistance also increased forProteusspp compared to the baseline. The high baseline resistance ofE. colito the commonly prescribed antimicrobials ciprofloxacin and trimethoprim-sulfamethoxazole (TMP/SMX) did not change during the intervention.Conclusions:The antimicrobial stewardship intervention program significantly reduced urine culture and culture-positive rates. Overall, very high proportions of antimicrobial resistance were observed among common pathogens; however, antimicrobial resistance trended downward but reductions were too small and scattered to conclude that the intervention significantly changed antimicrobial resistance. Longer intervention periods may be needed to effect change in resistance patterns.

Antimicrobial Resistance Patterns of E. coli Detected from Hospitalized Urine Culture Samples

2010 ◽  
Vol 3 (4) ◽  
pp. 195-201 ◽  
Author(s):  
Mohsen Mohammadi ◽  
Ehsan Ghasemi ◽  
Hamid Mokhayeri ◽  
Yadollah Pournia ◽  
Hadis Boroun
Keyword(s):  
Antimicrobial Resistance ◽  
Urine Culture ◽  
E Coli ◽  
Resistance Patterns

scholarly journals Antibiotic Susceptibility of Common Organisms Isolated from Urine Cultures of Nursing Home Residents

2020 ◽  
Vol 41 (S1) ◽  
pp. s118-s120
Author(s):  
Austin R. Penna ◽  
Taniece R. Eure Eure ◽  
Nimalie D. Stone ◽  
Grant Barney ◽  
Devra Barter ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Antibiotic Susceptibility ◽  
Clinical Decision Making ◽  
Service Providers ◽  
Urine Culture ◽  
Nursing Home Residents ◽  
Antibiotic Prescribing ◽  
E Coli ◽  
Susceptibility Data

Background: With the emergence of antibiotic resistant threats and the need for appropriate antibiotic use, laboratory microbiology information is important to guide clinical decision making in nursing homes, where access to such data can be limited. Susceptibility data are necessary to inform antibiotic selection and to monitor changes in resistance patterns over time. To contribute to existing data that describe antibiotic resistance among nursing home residents, we summarized antibiotic susceptibility data from organisms commonly isolated from urine cultures collected as part of the CDC multistate, Emerging Infections Program (EIP) nursing home prevalence survey. Methods: In 2017, urine culture and antibiotic susceptibility data for selected organisms were retrospectively collected from nursing home residents’ medical records by trained EIP staff. Urine culture results reported as negative (no growth) or contaminated were excluded. Susceptibility results were recorded as susceptible, non-susceptible (resistant or intermediate), or not tested. The pooled mean percentage tested and percentage non-susceptible were calculated for selected antibiotic agents and classes using available data. Susceptibility data were analyzed for organisms with ≥20 isolates. The definition for multidrug-resistance (MDR) was based on the CDC and European Centre for Disease Prevention and Control’s interim standard definitions. Data were analyzed using SAS v 9.4 software. Results: Among 161 participating nursing homes and 15,276 residents, 300 residents (2.0%) had documentation of a urine culture at the time of the survey, and 229 (76.3%) were positive. Escherichia coli, Proteus mirabilis, Klebsiella spp, and Enterococcus spp represented 73.0% of all urine isolates (N = 278). There were 215 (77.3%) isolates with reported susceptibility data (Fig. 1). Of these, data were analyzed for 187 (87.0%) (Fig. 2). All isolates tested for carbapenems were susceptible. Fluoroquinolone non-susceptibility was most prevalent among E. coli (42.9%) and P. mirabilis (55.9%). Among Klebsiella spp, the highest percentages of non-susceptibility were observed for extended-spectrum cephalosporins and folate pathway inhibitors (25.0% each). Glycopeptide non-susceptibility was 10.0% for Enterococcus spp. The percentage of isolates classified as MDR ranged from 10.1% for E. coli to 14.7% for P. mirabilis. Conclusions: Substantial levels of non-susceptibility were observed for nursing home residents’ urine isolates, with 10% to 56% reported as non-susceptible to the antibiotics assessed. Non-susceptibility was highest for fluoroquinolones, an antibiotic class commonly used in nursing homes, and ≥ 10% of selected isolates were MDR. Our findings reinforce the importance of nursing homes using susceptibility data from laboratory service providers to guide antibiotic prescribing and to monitor levels of resistance.Disclosures: NoneFunding: None

scholarly journals Bacteriological profile and antibiotic sensitivity pattern in patients with Urinary tract infection

2017 ◽  
Vol 7 (1) ◽  
pp. 1066-1069 ◽  
Author(s):  
N Subedi ◽  
S Pudasaini
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Urine Culture ◽  
Antibiotic Sensitivity ◽  
Sensitivity Test ◽  
Age Group ◽  
E Coli ◽  
Bacteriological Profile ◽  
Culture And Sensitivity ◽  
Culture Positive

Background: Urinary tract infection is one of the common bacterial infections seeking treatment in clinical practice. A variety of organisms are associated with UTI and the most common organisms are Escherichia coli and other coliforms. Bacteriological investigations of UTI are not complete without antibiotic sensitivity test of the isolate. The aim of this study is to determine the bacteriological profile and antibiotic sensitivity patterns and their disease association.Materials and methods: This study was conducted in Shankarapur Hospital over a period of one year. All cases of suspected UTI sent for urine culture and sensitivity test were evaluated in this study. Disease associated with UTI, bacteriological profile and antibiotic sensitivity patterns were evaluated.Results: A total of 974 cases were sent for urine culture and sensitivity test. The total culture positive cases were 165 (17.4%).  The most common age group for culture positive test was 21- 30 years (33.3%) followed by 31- 40 years (25.5%). Female patients formed the majority of culture positive cases (84.8%) and E Coli (86.1%) was the most common organism isolated. Piperacillin- tazobactum and ceftriaxone were the most common antibiotic sensitive to the organisms. Simple uncomplicated UTI and PID were the most common indication for subjecting the patients to urine culture.Conclusion: UTI is most commonly seen in female of reproductive age group and the most common causative organism is E coli. Culture result and antibiogram helps the clinician for specific treatment of UTI.

scholarly journals Antimicrobial Resistance Patterns and ESBL of Uropathogens Isolated from Adult Females in Najran Region of Saudi Arabia

2021 ◽  
Vol 11 (3) ◽  
pp. 650-658
Author(s):  
Mohammed Yahia Alasmary
Keyword(s):  
Escherichia Coli ◽  
Saudi Arabia ◽  
Antimicrobial Resistance ◽  
Klebsiella Pneumoniae ◽  
Urine Samples ◽  
Klebsiella Species ◽  
E Coli ◽  
Government Hospitals ◽  
Resistance Patterns ◽  
Tract Infections

Background: To explore the prevalence of urinary tract infections (UTIs) among female patients in the Najran region of Saudi Arabia and determine their antimicrobial resistance pattern. Methods: This study was conducted on 136 urine samples collected from outpatient departments (OPDs) of the different government hospitals in the Najran region of Saudi Arabia. Over one year, the results of susceptibility testing reports of outpatient midstream urine samples from three government hospitals were prospectively evaluated. Results: Of 136 urine samples, only 123 (90.45%) were found to show significant growth for UTIs, from which 23 different uropathogens were identified. Escherichia coli (58.5%) was the most commonly isolated organism, followed by Klebsiella pneumoniae (8.1%). The isolated microorganism showed increased resistance patterns from 3.3% to 62.6%, with an overall resistance of 27.19%. Meropenem was the most effective antimicrobial, followed by amikacin and ertapenem (0.47%, 0.91%, and 1.5% resistance, respectively). At the same time, ampicillin and cephazolin were the least (62.6% and 59.5% resistance, respectively) effective. Overall, eleven (8.94%) uropathogens isolates were ESBLs, among which there were eight (6.5%) Escherichia coli, one (0.81%) Klebsiella pneumoniae, one (0.81%) Klebsiella oxytoca, and one (0.81%) Citrobacter amalonaticus. Conclusions: E. coli remains the most commonly isolated causative uropathogens, followed by Klebsiella species. The prevalence of pathogenic E. coli and Klebsiella species underscores the importance of developing cost-effective, precise, and rapid identification systems to minimize public exposure to uropathogens. Antibiotic susceptibility data revealed that most of the isolates were resistant to the majority of the antibiotics. The patients with UTIs in the Najran region of Saudi Arabia are at a high risk of antibiotic resistance, leading to significant problems in outpatient department (OPD) treatment outcomes and raising the alarm for the physician to change their empiric treatment.

scholarly journals Characterization of cefotaxime resistant Escherichia coli isolated from broiler farms in Ecuador

2018 ◽  
Author(s):  
Christian Vinueza-Burgos ◽  
David Ortega-Paredes ◽  
Cristian Narváez ◽  
Lieven De Zutter ◽  
Jeannete Zurita
Keyword(s):  
Antimicrobial Resistance ◽  
Latin American ◽  
Production Systems ◽  
Diffusion Method ◽  
Poultry Production ◽  
Disk Diffusion Method ◽  
E Coli ◽  
Resistance Patterns ◽  
Latin American Countries

AbstractAntimicrobial resistance (AR) is a worldwide concern. Up to a 160% increase in antibiotic usage in food animals is expected in Latin American countries. The poultry industry is an increasingly important segment of food production and contributor to AR. The objective of this study was to evaluate the prevalence, AR patterns and the characterization of relevant resistance genes in Extended Spectrum β-lactamases (ESBL) and AmpC E. coli from large poultry farms in Ecuador. Sampling was performed from June 2013 to July 2014 in 6 slaughterhouses that slaughter broilers from 115 farms totaling 384 flocks. Each sample of collected caeca was streaked onto TBX agar supplemented with cefotaxime (3 mg/l). In total, 176 isolates were analyzed for antimicrobial resistance patterns by the disk diffusion method and for blaCTX-M, blaTEM, blaCMY, blaSHV, blaKPC, and mcr-1 by PCR and sequencing. ESBL and AmpC E. coli were found in 362 flocks (94.3%) from 112 farms (97.4%). We found that 98.3% of the isolates were multi-resistant to antibiotics. Low resistance was observed for ertapenem and nitrofurantoin. The most prevalent ESBL genes were the blaCTX-M (90.9%) blaCTX-M-65, blaCTX-M-55 and blaCTX-M-3 alleles. Most of the AmpC strains presented the blaCMY-2 gene. Three isolates showed the mcr-1 gene. Poultry production systems represent a hotspot for antimicrobial resistance in Ecuador, possibly mediated by the extensive use of antibiotics. Monitoring this sector in national and regional plans of antimicrobial resistance surveillance should therefore be considered.

Antimicrobial Resistance in Campylobacter, Salmonella, and Escherichia coli Isolated from Retail Grain-Fed Veal Meat from Southern Ontario, Canada

2011 ◽  
Vol 74 (8) ◽  
pp. 1245-1251 ◽  
Author(s):  
ANGELA COOK ◽  
RICHARD J. REID-SMITH ◽  
REBECCA J. IRWIN ◽  
SCOTT A. McEWEN ◽  
VIRGINIA YOUNG ◽  
...  
Keyword(s):  
Public Health ◽  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Tetracycline Resistance ◽  
Antimicrobial Susceptibility Testing ◽  
E Coli ◽  
Testing Resistance ◽  
Resistance Patterns

This study estimated the prevalence of Salmonella, Campylobacter, and Escherichia coli isolates in fresh retail grain-fed veal obtained in Ontario, Canada. The prevalence and antimicrobial resistance patterns were examined for points of public health significance. Veal samples (n = 528) were collected from February 2003 through May 2004. Twenty-one Salmonella isolates were recovered from 18 (4%) of 438 samples and underwent antimicrobial susceptibility testing. Resistance to one or more antimicrobials was found in 6 (29%) of 21 Salmonella isolates; 5 (24%) of 21 isolates were resistant to five or more antimicrobials. No resistance to antimicrobials of very high human health importance was observed. Ampicillin-chloramphenicol-streptomycin-sulfamethoxazole-tetracycline resistance was found in 5 (3%) of 21 Salmonella isolates. Campylobacter isolates were recovered from 5 (1%) of 438 samples; 6 isolates underwent antimicrobial susceptibility testing. Resistance to one or more antimicrobials was documented in 3 (50%) of 6 Campylobacter isolates. No Campylobacter isolates were resistant to five or more antimicrobials or category I antimicrobials. E. coli isolates were recovered from 387 (88%) of 438 samples; 1,258 isolates underwent antimicrobial susceptibility testing. Resistance to one or more antimicrobials was found in 678 (54%) of 1,258 E. coli isolates; 128 (10%) of 1,258 were resistant to five or more antimicrobials. Five (0.4%) and 7 (0.6%) of 1,258 E. coli isolates were resistant to ceftiofur and ceftriaxone, respectively, while 34 (3%) of 1,258 were resistant to nalidixic acid. Ciprofloxacin resistance was not detected. There were 101 different resistance patterns observed among E. coli isolates; resistance to tetracycline alone (12.7%, 161 of 1,258) was most frequently observed. This study provides baseline prevalence and antimicrobial resistance data and highlights potential public health concerns.

Antimicrobial stewardship in rural nursing homes: Impact of interprofessional education and clinical decision tool implementation on urinary tract infection treatment in a cluster randomized trial

2019 ◽  
Vol 40 (4) ◽  
pp. 432-437 ◽  
Author(s):  
Darren K. Pasay ◽  
Micheal S. Guirguis ◽  
Rhonda C. Shkrobot ◽  
Jeremy P. Slobodan ◽  
Adrian S. Wagg ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Nursing Homes ◽  
Antimicrobial Stewardship ◽  
Hospital Admissions ◽  
Urine Culture ◽  
Intervention Group ◽  
Clinical Decision ◽  
Rural Nursing ◽  
Antimicrobial Prescribing ◽  
Cluster Randomized

AbstractObjectives:To measure the impact of an antimicrobial stewardship initiative on the rate of urine culture testing and antimicrobial prescribing for urinary tract infections (UTIs) between control and intervention sites. Secondary objectives included evaluation of potential harms of the intervention and identifying characteristics of the population prescribed antimicrobials for UTI.Design:Cluster randomized controlled trial.Setting:Nursing homes in rural Alberta, Canada.Participants:The study included 42 nursing homes ranging from 8 to 112 beds.Methods/interventions:Intervention sites received on-site staff education, physician academic detailing, and integrated clinical decision-making tools. Control sites provided standard care. Data were collected for 6 months prior to and 12 months after the intervention.Results:Resident age (83.0 vs 83.8 years) and sex distribution (female, 62.5% vs 64.5%) were similar between the groups. Statistically significant decreases in the rate of urine culture testing (−2.1 tests per 1,000 resident days [RD]; 95% confidence interval [CI], −2.5 to −1.7;P< .001) and antimicrobial prescribing for UTIs (−0.7 prescriptions per 1,000 RD; 95% CI, −1.0 to −0.4;P< .001) were observed in the intervention group. There was no difference in hospital admissions (0.00 admissions per 1,000 RD; 95% CI, −0.4 to 0.3;P= .76), and the mortality rate decreased by 0.2 per 1,000 RD in the intervention group (95% CI, −0.5 to −0.1;P= .002). Chart reviews indicated that UTI symptoms were charted in 16% of cases and that urine culture testing occurred in 64.5% of cases.Conclusion:A multimodal antimicrobial stewardship intervention in rural nursing homes significantly decreased the rate of urine culture testing and antimicrobial prescriptions for UTI, with no increase in hospital admissions or mortality.

scholarly journals Trends in antibiotic resistance patterns of methicillin resistant and methicillin sensitive Staphylococcus aureus in Khwaja Yunus Ali Medical College Hospital

KYAMC Journal ◽  
2018 ◽  
Vol 9 (1) ◽  
pp. 6-10 ◽  
Author(s):  
Abdullah Akhtar Ahmed ◽  
Md Abdus Salam ◽  
Md Shakhaowat Hossain ◽  
Md Babul Aktar ◽  
Nusrat Akhtar Juyee ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Pathogenic Bacteria ◽  
Current Status ◽  
Clinical Samples ◽  
Sensitivity Testing ◽  
Methicillin Resistant ◽  
Resistance Patterns ◽  
Antibiotic Resistance Patterns

Background: Antimicrobial resistance in pathogens is a growing concern for health. It is a great concern around the globe about the threat of increasing antimicrobial resistance. In response to this concerns, medical experts have proposed initiatives to curtail the spread of antimicrobial resistance in pathogenic bacteria. We have taken this surveillance study in KYAMCH to contain the spread of antimicrobial resistance.Objectives: To determine the prevalence of MRSA from different clinical samples and to record its current status to commonly used anti Staphylococcus antibiotics.Methods: The clinical samples were taken to the laboratory and within four hours cultured for isolates and identification pathogens. Finally, antibiotic sensitivity testing of the isolated Staphylococcus aureus was performed. Results: More than 80% of MRSA isolates were resistant to ampicillin (98%) followed by amoxicillin, cefixime and azithromycin with 94%, 93.5% and 85% respectively and maximum sensitivity toward tobramycin with 86% followed by 85% gentamicin and 79% meropenem.Conclusion: The detected trend in antibiotic resistance patterns of methicillin-resistant and methicillin-sensitive Staphylococcus aureus in this study is alarming. This has created a huge clinical burden in the hospital settings as well as in the community.KYAMC Journal Vol. 9, No.-1, April 2018, Page 6-10

scholarly journals Biofilm Production and Antimicrobial Resistance among Uropathogens in Pediatric Cases: a Hospital Based Study

2018 ◽  
Vol 16 (2) ◽  
pp. 178-183
Author(s):  
Dhiraj Shrestha ◽  
Pratigya Thapa ◽  
Dinesh Bhandari ◽  
Hiramani Parajuli ◽  
Prakash Chaudhary ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Tract Infection ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Resistance Pattern ◽  
E Coli ◽  
Biofilm Production ◽  
Resistance Patterns

Background: The study was designed to provide account of etiological agents of urinary tract infection in pediatric patients and the antimicrobial resistance pattern plus biofilm producing profile of the isolates.Methods: The prospective study was conducted in Alka Hospital, Nepal with 353 clean catch urine samples from children. It was obtained during July 2014 to January 2015 which were first cultured by semi-quantitative method, followed by antimicrobial susceptibility testing and biofilm production assay on Congo red agar. Multidrug- resistance, extensively drug- resistance and pandrug- resistance among isolates were considered as per international consensus.Results: Out of 353 samples, 64 (18.13%) showed positive growth in culture, confirming urinary tract infection. E. coli, 44 (68.8%) was the predominant organism followed by Klebsiella spp. 6 (14.1%). Most E. coli were sensitive to amikacin (93.2%) followed by nitrofurantoin (86.4%), and highly resistant to ampicillin (95.5%). Of 64 isolates, 23 (35.93%) were found to be multidrug- resistant strains. Biofilm was produced by 36 (56.25%) isolates.Conclusions: This study showed higher biofilm production and resistance to in-use antibiotics rendering ineffective for empirical use. Regular surveillance of resistance patterns should be done to regulate multidrug- resistant bugs and to ensure effective management of urinary tract infection in children in a tertiary care setups.Keywords: AMR; antimicrobial resistance; biofilm; urinary tract infection; UTI.

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