scholarly journals Association of overexpression of efflux pump genes with antibiotic resistance in Pseudomonas aeruginosa strains clinically isolated from urinary tract infection patients

2015 ◽  
Vol 68 (9) ◽  
pp. 568-572 ◽  
Author(s):  
Katsumi Shigemura ◽  
Kayo Osawa ◽  
Ayaka Kato ◽  
Issei Tokimatsu ◽  
Soichi Arakawa ◽  
...  

Objective: To determine the spectrum and antibiotic resistance pattern of uropathogens causing urinary tract infection among inpatients and outpatients in a tertiary care hospital in Karachi Methods: This descriptive cross-sectional study was conducted in the Department of Microbiology, Sindh Institute of Urology and Transplant, Karachi, The study was conducted from March 2016 to March 2017 after taking approval from the Hospital Ethics Committee. Urine specimens were analyzed to establish a diagnosis of UTI and identify uropahtogens. The antibiotic susceptibility pattern of uropathogens was studied using disc diffusion method against the following antibiotics; fosfomycin, ampicillin, amoxicillin-clavulanate, nitrofurantoin, cefotaxime, ceftazidime, amikacin, cefoxitin, imipenem and vancomycin. Results: A total of 480 samples of UTI were received during the study period. The average age of patients was 54.79±12.09 years. The majority of samples came out positive from the male gender (65%) and in-patient department (n=400, 83.3%). The highest prevalent microorganism was E.coli (82.1%) followed by Klebsiella spp (14%), Pseudomonas aeruginosa (1%), Proteus mirabilis (1%), Morganella morgannii (1%) and Staphylococcus aureus (0.8%). All microorganisms were highly resistant to augmentin, cefoxitin, cefotaxime, ceftazidime. Only pseudomonas aeruginosa was highly resistant to imipenem (60%). Pseudomonas aeruginosa (100%), E.coli (86.8%) and Klebsiella spp (71.6%) were highly sensitive for Amikacin (100%). Morganella morgannii (80%) and Proteus Mirabilis (40%) were mainly resistant to Fosfomycin. Only E.coli was sensitive to nitrofurantoin (74.1%). Conclusion: The presented study demonstrated that gram-negative bacteria was the most frequent cause of urinary tract infection. Microorganisms showed variable resistance to different antibiotics. The first line of antibiotics should be rationally selected by physicians to treat urinary tract infections.


2020 ◽  
Vol 7 (4) ◽  
Author(s):  
Manijeh Dehnamaki ◽  
Maryam Ghane ◽  
Laleh Babaeekhou

Background: The emergence and spread of drug resistance among Klebsiella pneumoniae clinical isolates have limited the treatment options for these bacteria. Efflux pumps are considered as one of the key mechanisms of antibiotic resistance in K. pneumoniae isolates. Objectives: The present study aimed to detect oqxA, oqxB, and qepA efflux genes in K. pneumoniae isolated from urinary tract infection (UTI) and survey their association with antibiotic resistance. Methods: In total, 100 K. pneumoniae isolates were obtained from urine samples, and an antimicrobial susceptibility test was conducted using the disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) instructions. Polymerase chain reaction (PCR) was done for the detection of efflux pump genes including, oqxA, oqxB, and qepA, and their association was statistically analyzed with resistance to antibiotics. Results: The highest rate of resistance was obtained against trimethoprim-sulfamethoxazole (72%), amikacin (70%), levofloxacin (68%), gentamicin (56%), ceftazidime (56%), and ceftriaxone (51%), and the lowest resistance was against imipenem (10%). Thirty one percent of isolates were multidrug resistant (MDR). Molecular distribution test showed that 57% and 56% of isolates carried the oqxA and oqxB genes, respectively. Also, the frequency of qepA genes was 21%. The presence of oqxA/oqxB and qepA efflux genes were significantly associated with fluoroquinolone and beta-lactam resistance phenotypes (P < 0.05). Conclusions: The high frequency of efflux genes showed that this resistance mechanism is the main way, along with other resistance mechanisms in K. pneumoniae isolates. It is necessary to adopt appropriate treatment to reduce the incidence of resistance.


2017 ◽  
Vol 5 (16) ◽  
Author(s):  
Mohamed Hussain ◽  
Malik Suliman ◽  
Abdalla Ahmed ◽  
Hisham Altayb ◽  
Elamin Elneima

ABSTRACT Pseudomonas aeruginosa infection is difficult to treat due to the presence of antibiotic resistance determinants. Here, we report the genome sequence of a multidrug-resistant P. aeruginosa strain isolated from a patient with a urinary tract infection in 2015.


Author(s):  
Rana M. Abdullah Al-Shwaikh ◽  
Abbas Falih Alornaaouti

       Current study obtained (75) isolate of Pseudomonas aeruginosa collected from different cases included : 28 isolates from otitis media, 23 isolates from burn infections, 10 isolates from wound infections, 8 isolates from urinary tract infections and 6 isolates from blood, during the period between 1/9/2014 to 1/11/2014        The result revealed that the tox A gene was present in 54 isolates (72%) of Pseudomonas aeruginosa. The gel electrophoresis showed that the molecular weight of tox A gene was 352 bp. The result shows 17 isolates (60.71%) from otitis media has tox A gene, 18 isolates (78.26%) from burn followed by 8 isolate (80%) from wound infection and 5 isolates (62.5%) from urinary tract infection , finally 6 isolates (100%) from blood have this gene.


Author(s):  
Bradley J Langford ◽  
Kevin A Brown ◽  
Christina Diong ◽  
Alex Marchand-Austin ◽  
Kwaku Adomako ◽  
...  

Abstract Background The role of antibiotics in preventing urinary tract infection (UTI) in older adults is unknown. We sought to quantify the benefits and risks of antibiotic prophylaxis among older adults. Methods We conducted a matched cohort study comparing older adults (≥66 years) receiving antibiotic prophylaxis, defined as antibiotic treatment for ≥30 days starting within 30 days of a positive culture, with patients with positive urine cultures who received antibiotic treatment but did not receive prophylaxis. We matched each prophylaxis recipient to 10 nonrecipients based on organism, number of positive cultures, and propensity score. Outcomes included (1) emergency department (ED) visit or hospitalization for UTI, sepsis, or bloodstream infection within 1 year; (2) acquisition of antibiotic resistance in urinary tract pathogens; and (3) antibiotic-related complications. Results Overall, 4.7% (151/3190) of UTI prophylaxis patients and 3.6% (n = 1092/30 542) of controls required an ED visit or hospitalization for UTI, sepsis, or bloodstream infection (hazard ratio [HR], 1.33; 95% confidence interval [CI], 1.12–1.57). Acquisition of antibiotic resistance to any urinary antibiotic (HR, 1.31; 95% CI, 1.18–1.44) and to the specific prophylaxis agent (HR, 2.01; 95% CI, 1.80–2.24) was higher in patients receiving prophylaxis. While the overall risk of antibiotic-related complications was similar between groups (HR, 1.08; 95% CI, .94–1.22), the risk of Clostridioides  difficile and general medication adverse events was higher in prophylaxis recipients (HR [95% CI], 1.56 [1.05–2.23] and 1.62 [1.11–2.29], respectively). Conclusions Among older adults with UTI, the harms of long-term antibiotic prophylaxis may outweigh their benefits.


2018 ◽  
Vol 12 (1) ◽  
pp. 243-247
Author(s):  
Marianne Stærk ◽  
Sara A. Tolouee ◽  
Jens J. Christensen

Introduction: Haemophilus influenzae commonly causes upper respiratory tract infections and has only rarely been reported etiology of urinary tract infections. Since the introduction of the Haemophilus influenzae b (Hib) vaccine, non-typable haemophilus species now cause the majority of invasive disease in Europe. Case Report: We report a case of an adult man with non-typable Haemophilus influenzae septicemia, urinary tract infection and bilateral renal stone disease. The patient presented with right sided flank pain and a CT scan showed bilateral renal stones and a right sided ureteral stone causing obstruction. Results and Discussion: Haemophilus influenzae was identified in blood and urine and despite a tendency of increasing antibiotic resistance among Haemophilus influenzae, our strain was susceptible to all antibiotics tested. Treatment consisted of 3 days of intravenous cefuroxime, insertion of a right sided JJ ureteric stent and 5 days of peroral ciprofloxacin after discharge. Physicians and microbiologists should be aware of Haemophilus influenzae as a possible urinary tract pathogen, especially when urinary tract abnormalities are present, and take the risk of antibiotic resistance into consideration at initial treatment.


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