scholarly journals PSI-25 development of local Kansas E. coli UTI antibiograms to improve antimicrobial stewardship in companion animal medicine

2019 ◽  
Vol 97 (Supplement_2) ◽  
pp. 241-241
Author(s):  
Brianna Salgado ◽  
Katherine KuKanich ◽  
Brian Lubbers
Keyword(s):  
Antimicrobial Therapy ◽  
Antimicrobial Agents ◽  
Susceptibility Testing ◽  
Fluoroquinolone Resistance ◽  
Beta Lactam ◽  
E Coli ◽  
Animal Medicine ◽  
Amoxicillin Clavulanate ◽  
The One ◽  
Tract Infections

Abstract Urinary tract infections are common in dogs, but rare in cats. Antimicrobial susceptibility testing of urine isolates is required to determine optimal antimicrobial therapy, but empirical antimicrobial guidelines are needed while culture is pending or if testing is declined. Antibiograms are summaries of local susceptibility trends that assist clinicians in selecting empirical antimicrobial therapy. Antibiograms were developed from E. coli feline (N = 138) and canine (N = 640) urinary isolates submitted by the KSU Veterinary Health Center and private veterinary practices from 2013–2017. Results showed a high prevalence of resistance among feline isolates to amoxicillin-clavulanate (99.3%, S ≤ 0.25) and ampicillin (99.3%, S ≤ 0.25), but lower prevalence among canine isolates (amoxicillin/clavulanate 7.7% S ≤ 8), ampicillin 46.7%, S ≤ 8). Resistance to other antimicrobials was uncommon, with no antimicrobial agents demonstrating resistance above 6% in feline isolates, or above 14% in canine isolates. Canine isolates from private veterinary practices had increased resistance as compared with KSU isolates to orbifloxacin (9.5% vs 0.1%) and pradofloxaxin (9.4% vs 0.1%). Application of different breakpoints and differences in antibiotic exposures may explain the disparity of Beta-Lactam resistance between cats and dogs. Different use patterns between hospitals may explain the disparity between fluoroquinolone resistance. These findings emphasize the need for definitive urine culture and susceptibility testing in pets with UTIs, so that appropriate and effective antimicrobial therapy can be prescribed. Veterinary clinicians in Kansas can use these antibiogram results in addition to following stewardship guidelines to maximize successful UTI therapy for veterinary patients and minimize development of antimicrobial resistance for the One Health community.

scholarly journals SENSITIVITY AND RESISTANCE TO ANTIMICROBIAL AGENTS ESBL-PRODUCING AND NOT PRODUCING ESBL STRAINS OF E. COLI IN PATIENTS WITH URINARY TRACT INFECTION

2019 ◽  
Vol 64 (2) ◽  
pp. 104-110
Author(s):  
N. I. Dimitrova ◽  
T. D. Gasretova ◽  
E. L. Alutina ◽  
G. G. Kharseeva
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Agents ◽  
Beta Lactamase ◽  
Test Results ◽  
Beta Lactams ◽  
Esbl Production ◽  
E Coli ◽  
Amoxicillin Clavulanate ◽  
Resistant Strains ◽  
Tract Infections

As a result of the conducted researches it is shown that 44.1% of urinary tract infections (UTIS) caused by E. coli are accounted for by producers of beta-lactamase of the extended spectrum of action (ESBL). Associated resistance to fluoroquinolones and co-trimoxazole was found in 93.3% of BLRS-producing E. coli strains. All studied strains regardless of ESBL production were sensitive to imipenem, the majority showed sensitivity to ertapenem, gentamicin and resistance to doxycycline. Not producing ESBL strains of E. coli were sensitive to fosfomycin. Comparison of data obtained during testing of isolated cultures on ESBL, study of their sensitivity and resistance to beta-lactams (amoxicillin/clavulanate, ceftazidime, ceftriaxone, cefotaxime, imipenem) indicates the need to test isolates for AmpC products. To this end, during the screening test for ESBL and the method of «double disks», along with cephalosporins of III generation, it is necessary to use a phenotypic test for sensitivity to cefepime. The use of test results of E. coli isolates isolated from patients with UTIS for the production of ESBL, ampC enzymes, carbapenemase and sensitivity to AMP will improve the effectiveness of antimicrobial therapy and will help to curb the formation and spread of antimicrobial-resistant strains.

scholarly journals Gender and Age-Dependent Etiology of Community-Acquired Urinary Tract Infections

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Enrico Magliano ◽  
Vittorio Grazioli ◽  
Loredana Deflorio ◽  
Antonia Isabella Leuci ◽  
Roberto Mattina ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antimicrobial Agents ◽  
Age And Gender ◽  
E Coli ◽  
Gender And Age ◽  
Amoxicillin Clavulanate ◽  
And Gender ◽  
Tract Infections

Urinary tract infections (UTIs) are among the most frequent community-acquired infections worldwide.Escherichia coliis the most common UTI pathogen although underlying host factors such as patients’ age and gender may influence prevalence of causative agents. In this study, 61 273 consecutive urine samples received over a 22-month period from outpatients clinics of an urban area of north Italy underwent microbiological culture with subsequent bacterial identification and antimicrobial susceptibility testing of positive samples. A total of 13 820 uropathogens were isolated and their prevalence analyzed according to patient’s gender and age group. OverallEscherichia coliaccounted for 67.6% of all isolates, followed byKlebsiella pneumoniae(8.8%),Enterococcus faecalis(6.3%),Proteus mirabilis(5.2%), andPseudomonas aeruginosa(2.5%). Data stratification according to both age and gender showedE. coliisolation rates to be lower in both males aged ≥60 years (52.2%),E. faecalisandP. aeruginosabeing more prevalent in this group (11.6% and 7.8%, resp.), as well as in those aged ≤14 years (51.3%) in whomP. mirabilisprevalence was found to be as high as 21.2%.Streptococcus agalactiaeoverall prevalence was found to be 2.3% although it was shown to occur most frequently in women aged between 15 and 59 years (4.1%). Susceptibility ofE. colito oral antimicrobial agents was demonstrated to be as follows: fosfomycin (72.9%), trimethoprim/sulfamethoxazole (72.9%), ciprofloxacin (76.8%), ampicillin (48.0%), and amoxicillin/clavulanate (77.5%). In conclusion, both patients’ age and gender are significant factors in determining UTIs etiology; they can increase accuracy in defining the causative uropathogen as well as providing useful guidance to empiric treatment.

scholarly journals High prevalence of qnrA and qnrB genes among fluoroquinolone-resistant Escherichia coli isolates from a tertiary hospital in Southern Nigeria

2021 ◽  
Vol 45 (1) ◽  
Author(s):  
Chibuzor M. Nsofor ◽  
Mirabeau Y. Tattfeng ◽  
Chijioke A. Nsofor
Keyword(s):  
Escherichia Coli ◽  
Susceptibility Testing ◽  
Tertiary Hospital ◽  
Vaginal Swab ◽  
Fluoroquinolone Resistance ◽  
E Coli ◽  
Diffusion Technique ◽  
High Prevalence ◽  
Polymerase Chain ◽  
And Control

Abstract Background This study was aimed to determine the prevalence of qnr genes among fluoroquinolone-resistant Escherichia coli (FREC) isolates from Nigeria. Antimicrobial susceptibility testing was performed by disc diffusion technique. Polymerase chain reaction was used to identify Escherichia coli (E. coli) and for the detection of qnr genes. Results A total of 206 non-duplicate E. coli were isolated from 300 clinical specimens analyzed. In all, 30 (14.6%) of these isolates were FREC; the resistance to fluoroquinolones among these 30 FREC showed 80% (24), 86.7% (26), 86.7% (26), 100% (30), 86.7% (26), 93.3% (28) and 86.7% (26) were resistant to pefloxacin, ciprofloxacin, sparfloxacin, levofloxacin, nalidixic acid, ofloxacin and moxifloxacin, respectively. The distribution of FREC among the various sample sources analyzed showed that 14%, 10%, 13.3%, 16.7% and 20% of the isolates came from urine, stool, high vaginal swab, endo cervical swab and wound swab specimens, respectively. More FREC were isolated from female samples 73.3% (22) compared to male samples 26.7% (8) and were more prevalent among the age group 26–35 years (40%). Twenty eight out of the 30 (93.3%) FREC isolates possessed at least one fluoroquinolone resistance gene in the form of qnrA 10 (33.3%) and qnrB 18 (60%), respectively; qnrS was not detected among the FREC isolates analyzed and 13.5% of the isolates possessed both the qnrA and qnrB genes. Phylogenetic analysis showed that these isolates were genetically diverse. Conclusions These findings suggest a possible resistance to fluoroquinolone is of high interest for better management of patients and control of antimicrobial resistance in Nigeria.

scholarly journals Phenotypic detection of Carbapenamase among Klebsiella pneumoniae isolated from clinical samples using modified Hodged test

2020 ◽  
Vol 13 (3) ◽  
pp. 135-140
Author(s):  
HauwaYakubu ◽  
Mahmud Yerima Iliyasu ◽  
Asma’u Salisu ◽  
Abdulmumin Ibrahim Sulaiman ◽  
Fatima Tahir ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Susceptibility Testing ◽  
University Teaching ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Beta Lactam ◽  
Beta Lactamases ◽  
Beta Lactam Antibiotics ◽  
Microbiological Techniques ◽  
Tract Infections

Carbapenemases are microbial enzymes that confer resistance to virtually all available beta-lactam antibiotics and the most frequent carbapenemases are the Klebsiella pneumoniae Carbapenamase (KPC). Detection of carbapenemases is a significant infection control strategy as the enzymes are often associated with extensive antimicrobial resistance, therapeutic failures and mortality associated with infectious diseases. A total of 400 clinical samples were collected from different groups of patients in Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria and 118 K. pneumoniae were isolated using standard microbiological techniques. The isolates were subjected to antibiotic susceptibility testing by Kirby-Bauer disc diffusion method, then screened for Carbapenamase production using modified Hodge test. The results indicated that the isolates were resistant to Ampicillin (61.9%), Ceftriaxone (50.8%) and Ceftazidime (50.8%), then Ciprofloxacin (54.2%), but predominantly sensitive to Imipenem (66.9%), Eterpenem (60.2%) and Meropenem (65.3%). It was found that 38 (32.2%) of the isolates phenotypically shows the presence of Carbapenamase, with highest frequency of (40.7%) among patients, mainly adult females with cases of Urinary Tract Infections (UTIs) and the least from wound (11.8%).This study revealed that the isolates produced other beta-lactamases than KPC or variants of Carbapenamase that cannot be detected by modified Hodge test, thus shows low resistance to carbapenems. Therefore further studies is needed to genotypically confirm the presence of KPC in these isolates.

scholarly journals Oral beta-lactam step down in bacteremic E. coli urinary tract infections

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Stephan Saad ◽  
Neil Mina ◽  
Colin Lee ◽  
Kevin Afra
Keyword(s):  
Urinary Tract ◽  
Propensity Score ◽  
Urinary Tract Infections ◽  
Clinical Cure ◽  
Beta Lactam ◽  
Beta Lactams ◽  
E Coli ◽  
Secondary Outcomes ◽  
Step Down ◽  
Tract Infections

Abstract Background Literature is scarce regarding oral step down to beta-lactams in bacteremic urinary tract infections. Oral fluoroquinolones are an accepted and common step down for bacteremic urinary tract infections; however, their use is associated with mounting safety concerns. We compared clinical cure in patients with E. coli bacteremic urinary tract infections who were stepped down to oral beta-lactams compared to oral fluoroquinolones. Methods This multicentre retrospective cohort study included patients with first positive concurrent urine and blood cultures from January 2016 to December 2016. Patients were included if they received empiric intravenous beta-lactam therapy with step down to either oral beta-lactam or fluoroquinolone for treatment completion. The primary outcome was clinical cure. Secondary outcomes were length of hospitalization, all-cause mortality and C. difficile infection. Multivariate analysis and propensity score were used to control for confounding. Results A total of 207 patients were identified with bacteremic E.coli urinary tract infections. Clinical cure was achieved in 72/77 (94%) in the oral beta-lactam group versus 127/130 (98%) in the oral fluoroquinolone group (absolute difference − 4.2, 95% confidence interval [CI] -10.3 to 1.9%, p = 0.13). The adjusted odds ratio (OR) for clinical cure with oral beta-lactams was 0.31 (95% CI 0.05–1.90, p = 0.21); propensity score adjusted analysis showed a similar result. There was no statistically significant difference in secondary outcomes. Conclusions Oral beta-lactams appear to be a safe and effective step down option in bacteremic E. coli urinary tract infections compared to oral fluoroquinolones.

scholarly journals Multicenter Evaluation of the Etest Gradient Diffusion Method for Ceftolozane-Tazobactam Susceptibility Testing of Enterobacteriaceae and Pseudomonas aeruginosa

2018 ◽  
Vol 56 (9) ◽  
Author(s):  
Adam L. Bailey ◽  
Tom Armstrong ◽  
Hari-Prakash Dwivedi ◽  
Gerald A. Denys ◽  
Janet Hindler ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Susceptibility Testing ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Beta Lactam ◽  
Content Type ◽  
Gradient Diffusion ◽  
Tract Infections ◽  
Abdominal Infections ◽  
Inhibitor Combination

ABSTRACT Ceftolozane-tazobactam (C/T) is a novel beta-lactam–beta-lactamase inhibitor combination antibiotic approved by the U.S. Food and Drug Administration in 2014 for the treatment of complicated intra-abdominal infections (in combination with metronidazole) and complicated urinary tract infections. In this study, we evaluated the performance of the C/T Etest, a gradient diffusion method. C/T Etest was compared to broth microdilution (BMD) for 51 Enterobacteriaceae challenge isolates and 39 Pseudomonas aeruginosa challenge isolates at three clinical sites. Essential agreement (EA) between the methods ranged from 47 to 49/51 (92.2 to 96.1%) for the Enterobacteriaceae, and categorical agreement (CA) ranged from 49 to 51/51 (96.1 to 100.0%). EA and CA for P. aeruginosa were 100% at all sites. The C/T Etest was also compared to BMD for susceptibility testing on 966 clinical isolates (793 Enterobacteriaceae, including 167 Klebsiella pneumoniae and 159 Escherichia coli isolates, in addition to 173 P. aeruginosa isolates) collected at four clinical sites. EA between Etest and BMD was 96.9% for Enterobacteriaceae isolates and 98.8% for P. aeruginosa isolates. Within the Enterobacteriaceae, isolates from each species examined had >96% CA. For the clinical isolates, no very major errors were identified but two major errors were found (one for K. pneumoniae and one for Providencia rettgeri). By BMD, 47.0% of Enterobacteriaceae and 46.2% of P. aeruginosa challenge strains were nonsusceptible to C/T by CLSI breakpoint criteria; 8.2% of clinical Enterobacteriaceae isolates and 12.1% of clinical P. aeruginosa isolates were nonsusceptible to C/T by CLSI breakpoint criteria. In conclusion, Etest is accurate and reproducible for C/T susceptibility testing of Enterobacteriaceae and P. aeruginosa.

scholarly journals Oral and Parenteral Therapeutic Options for Outpatient Urinary Infections Caused by Enterobacteriaceae Producing CTX-M Extended-Spectrum β-Lactamases

2009 ◽  
Vol 53 (3) ◽  
pp. 1278-1280 ◽  
Author(s):  
Vidhya Prakash ◽  
James S. Lewis ◽  
Monica L. Herrera ◽  
Brian L. Wickes ◽  
James H. Jorgensen
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Agents ◽  
Therapeutic Options ◽  
Extended Spectrum ◽  
Urinary Infections ◽  
Amoxicillin Clavulanate ◽  
Long Acting ◽  
Tract Infections ◽  
Community Onset ◽  
Urinary Isolates

ABSTRACT Effective therapeutic options are needed for community-onset urinary tract infections due to Escherichia coli strains that produce CTX-M extended-spectrum β-lactamases. We examined 46 urinary isolates producing CTX-M against several oral or long-acting parenteral antimicrobial agents. Approximately 90% were susceptible to fosfomycin and to a combination of cefdinir plus amoxicillin-clavulanate. All were susceptible to ertapenem.

scholarly journals Susceptibility Testing of Extensively Drug-Resistant and Pre-Extensively Drug-Resistant Mycobacterium tuberculosis against Levofloxacin, Linezolid, and Amoxicillin-Clavulanate

2013 ◽  
Vol 57 (6) ◽  
pp. 2522-2525 ◽  
Author(s):  
Imran Ahmed ◽  
Kauser Jabeen ◽  
Raunaq Inayat ◽  
Rumina Hasan
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Susceptibility Testing ◽  
Critical Concentration ◽  
Drug Susceptibility ◽  
Drug Susceptibility Testing ◽  
Fluoroquinolone Resistance ◽  
Drug Resistant ◽  
Content Type ◽  
Extensively Drug Resistant ◽  
Amoxicillin Clavulanate

ABSTRACTPakistan is a high-burden country for tuberculosis (TB). The emergence and increasing incidence of extensively drug-resistant (XDR) TB has been reported in Pakistan. Similarly, the prevalence of multidrug-resistant TB infections with fluoroquinolone resistance (pre-XDR) is also increasing. To treat these infections, local drug susceptibility patterns of alternate antituberculosis agents, including levofloxacin (LVX), linezolid (LZD), and amoxicillin-clavulanate (AMC), is urgently needed. The aim of this study was to determine the susceptibility frequencies of drug-resistant (DR)Mycobacterium tuberculosisagainst LVX, LZD, and AMC. All susceptibilities were determined on Middlebrook 7H10 agar. A critical concentration was used for LVX (1 μg/ml), whereas MICs were determined for LZD and AMC.M. tuberculosisH37Rv was used as a control strain. A total of 102M. tuberculosisisolates (XDR,n= 59; pre-XDR,n= 43) were tested. Resistance to LVX was observed in 91.2% (93/102). Using an MIC value of 0.5 μg/ml as a cutoff, resistance to LZD (MIC ≥ 1 μg/ml) was noted in 5.9% (6/102). Although the sensitivity breakpoints are not established for AMC, the MIC values were high (>16 μg/ml) in 97.1% (99/102). Our results demonstrate that LZD may be effective for the treatment of XDR and pre-XDR cases from Pakistan. High resistance rates against LVX in our study suggest the use of this drug with caution for DR-TB cases from this area. Drug susceptibility testing against LVX and AMC may be helpful in complicated and difficult-to-manage cases.

scholarly journals Escherichia coli from community-acquired urinary tract infections resistant to fluoroquinolones and extended-spectrum beta-lactams

2007 ◽  
Vol 1 (03) ◽  
pp. 257-262 ◽  
Author(s):  
Samuel Kariuki ◽  
Gunturu Revathi ◽  
John Corkill ◽  
John Kiiru ◽  
Joyce Mwituria ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Nalidixic Acid ◽  
Urinary Tract Infections ◽  
Acid Resistance ◽  
Beta Lactam ◽  
E Coli ◽  
Extended Spectrum ◽  
Tract Infections ◽  
Multiple Drugs

Background: Uropathogenic Escherichia coli are increasingly becoming resistant to flouroquinolones and to other commonly available antimicrobials. We sought to investigate the genetic basis for fluoroquinolone and extended spectrum beta-lactam (ESBL) resistance in 17 fluoroquinolone-resistant (MIC of levofloxacin and ciprofloxacin >32 μg/ml) E. coli isolated from patients with urinary tract infections (UTIs). Methods: We applied PCR and Pulsed Field Gel Electrophoresis (PFGE) to characterize resistance genes and to determine clonal relatedness of strains, respectively. Results: Twelve of the 17 E. coli were resistant to multiple drugs, including ampicillin, co-amoxyclav, cefotaxime, ceftriaxone, ceftazidime and gentamicin and nalidixic acid and produced plasmid-mediated CTX-M-15 type ESBLs and CMY-2 AmpC type enzymes. The other 5 E. coli that were non-ESBL-producing were multiply resistant to ampicillin, nitrofurantoin, cefoxitin, nalidixic acid. Resistance to fluoroquinolones resulted from a combination of the presence of qnrA, qnrB, ciprofloxacin acetylating enzyme designated aac(6’)-1b-cr, and mutations in the two amino acid substitutions; 83 Serine (TCG) to Leucine (TTG) and 87 Aspartic acid (GAC) to Asparagine (AAC). Conclusion: Antibiogram patterns and PFGE of E. coli showed that these were community acquired UTI caused by pockets of clonally-related and some discreet strain types. Plasmid-mediated CTX-M-15 beta-lactamases and CMY-2 AmpC enzymes and fluoroquinolone resistant E. coli are becoming increasingly prevalent in hospitals in Kenya, posing a major challenge in the management of UTIs.

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