Aetiology and antibiotic resistance patterns of urinary tract infections in the elderly: a 6-month study

2013 ◽  
Vol 62 (6) ◽  
pp. 859-863 ◽  
Author(s):  
Elena De Vecchi ◽  
Simona Sitia ◽  
Carlo Luca Romanò ◽  
Cristian Ricci ◽  
Roberto Mattina ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
The Elderly ◽  
Gram Positive ◽  
Development Of Resistance ◽  
Tract Infections ◽  
Almost All ◽  
Micro Organisms ◽  
The Impact

Urinary tract infections (UTIs) are a common cause of bacteraemia in the elderly and are associated with a high probability of hospitalization. Despite the impact of UTIs on health status and quality of life, a limited number of studies have evaluated their aetiology in this population. This study aimed to evaluate the microbial aetiology and pattern of susceptibility of bacteria causing UTIs in the elderly. For this purpose, a retrospective cohort study of elderly residents (n = 472, aged >65 years) in 14 nursing homes in Milan (Italy) and its province was performed. Globally, 393 micro-organisms from 328 samples were isolated: Escherichia coli was the most prevalent (44.8 %), followed by Proteus mirabilis (20.4 %), Providencia spp. (8.9 %), Klebsiella spp. (6.4 %) and Pseudomonas aeruginosa (4.6 %). Enterococci were the most frequently isolated Gram-positive organisms (7.4 %). Almost all Enterobacteriaceae were susceptible to nitrofurantoin, carbapenems and amikacin. Extended-spectrum β-lactamases were detected in 42.1 % of isolates. The most active antibiotics against P. aeruginosa were colistin, amikacin and piperacillin/tazobactam. All Gram-positive organisms were susceptible to glycopeptides and linezolid, and 90 % were susceptible to nitrofurantoin. Fluoroquinolones showed a limited activity against all the tested micro-organisms. Escherichia coli remains the major micro-organism responsible for UTIs in older people, although to a lesser extent than in a younger population. The high rates of resistance observed in this study make careful use of antibiotics advisable to limit further development of resistance.

scholarly journals Determination of nitrofurantoin and fosfomycin susceptibility among urinary Escherichia coli isolates

2020 ◽  
Vol 8 (9) ◽  
pp. 3274
Author(s):  
Rachana Kanaujia ◽  
Amit Kumar ◽  
Malay Bajpai
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urine Samples ◽  
E Coli ◽  
Tract Infections ◽  
Therapeutic Alternatives ◽  
Micro Organisms ◽  
Staphylococcus Spp

Background: Urinary tract infections (UTIs) are one of the most common infections. For treatment of UTIs, there are limited antibiotics due to increased resistance among uropathogens. Two older antibiotics; Nitrofurantoin and Fosfomycin have become novel oral therapeutic options against uropathogens. Aim of the study was to identify UTI causing micro-organisms and evaluate in-vitro activity of nitrofurantoin and fosfomycin against most common isolated organism (E. coli).Methods: Results of urine samples culture and susceptibility testing over a period of 1 year were analysed and included in this study.Results: Micro-organisms were isolated from 568 urine samples. Most commonly isolated organism was Escherichia coli (40.50%), followed by Klebsiella spp. (20.07%) and Staphylococcus spp. (17.07%). Susceptibility of E. coli to nitrofurantoin and fosfomycin was 91.74% and 65.65% respectively. Conclusion: Good activity of nitrofurantoin and fosfomycin against E. coli indicates that these two drugs are potential therapeutic alternatives for urinary tract infections.

scholarly journals Bacterial Resistance to Leucyl-tRNA Synthetase Inhibitor GSK2251052 Develops during Treatment of Complicated Urinary Tract Infections

2014 ◽  
Vol 59 (1) ◽  
pp. 289-298 ◽  
Author(s):  
Karen O'Dwyer ◽  
Aaron T. Spivak ◽  
Karen Ingraham ◽  
Sharon Min ◽  
David J. Holmes ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Bacterial Resistance ◽  
Multidrug Resistant ◽  
Trna Synthetase ◽  
Content Type ◽  
Development Of Resistance ◽  
Tract Infections ◽  
Abdominal Infections

ABSTRACTGSK2251052, a novel leucyl-tRNA synthetase (LeuRS) inhibitor, was in development for the treatment of infections caused by multidrug-resistant Gram-negative pathogens. In a phase II study (study LRS114688) evaluating the efficacy of GSK2251052 in complicated urinary tract infections, resistance developed very rapidly in 3 of 14 subjects enrolled, with ≥32-fold increases in the GSK2251052 MIC of the infecting pathogen being detected. A fourth subject did not exhibit the development of resistance in the baseline pathogen but posttherapy did present with a different pathogen resistant to GSK2251052. Whole-genome DNA sequencing ofEscherichia coliisolates collected longitudinally from two study LRS114688 subjects confirmed that GSK2251052 resistance was due to specific mutations, selected on the first day of therapy, in the LeuRS editing domain. Phylogenetic analysis strongly suggested that resistantEscherichia coliisolates resulted from clonal expansion of baseline susceptible strains. This resistance development likely resulted from the confluence of multiple factors, of which only some can be assessed preclinically. Our study shows the challenges of developing antibiotics and the importance of clinical studies to evaluate their effect on disease pathogenesis. (These studies have been registered at ClinicalTrials.gov under registration no. NCT01381549 for the study of complicated urinary tract infections and registration no. NCT01381562 for the study of complicated intra-abdominal infections.)

scholarly journals MICROBIOLOGICAL ANALYSIS OF URINARY TRACT INFECTIONS IN NORTH WEST ENGLAND AND THE IMPACT OF FLUID INTAKE ON THE INCIDENCE OF URINARY TRACT INFECTION

2018 ◽  
Author(s):  
Morkos Iskander
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Confidence Interval ◽  
Urinary Tract Infections ◽  
Fluid Intake ◽  
Microbiological Analysis ◽  
North West ◽  
Tract Infections ◽  
Resistance Rates ◽  
The Impact

BACKGROUNDManagement of urinary tract infections (UTIs) is compounded by the rising rates of resistance to antimicrobials. Public Health England highlighted areas of the North West of England as having suboptimal practices in the treatment of UTIs. This project aims to evaluate the resistance in Merseyside compared to the national rates, examine resistance in urological patients, review the rates of extended spectrum β-lactamase producing (ESBL) Escherichia coli over time, as well as consider increased fluid intake in the management of UTIs.METHODSUropathogen resistance rates in Merseyside from December 2012 to February 2013 were compared to those nationally reported, with sub analysis of resistance rates in urological patients. The rate of ESBL Escherichia coli in Cheshire was reviewed.MEDLINE, EMBASE, and unpublished literature using OpenGrey and OpenDOAR, were searched since inception to February 2015. Five studies recruiting 2182 patients were included in the analyses. Statistical analysis was performed using SPSS 22 and MedCalc 15.4.RESULTSResistance rates in Merseyside were not found to be higher than the national rates. Urological patients exhibited a statistically significant higher resistance (p<0.0001). The relative risk of ESBL UTI in 2013 compared to 2005 was 8.18, 95% confidence interval (4.86 - 13.74). A preventative effect of increased fluid intake on the incidence of UTIs was found, odds ratio of UTI with increased fluid 0.27, 95% confidence interval (0.21 - 0.33).DISCUSSIONThe equivocal resistance rates in Merseyside and nationally suggests that modification of local practice is indicated. The higher resistance rate in urological patients highlights the need for separate empirical treatment.Increased fluid intake is appealing, due to the low cost and morbidity. Increase fluid intake has been demonstrated to be an effective method of reducing the rate of UTIs.

scholarly journals Prevalence and Antimicrobial Susceptibility Patterns of Bacterial Pathogens in Urinary Tract Infections in University Hospital of Campania “Luigi Vanvitelli” between 2017 and 2018

Antibiotics ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. 215 ◽  
Author(s):  
Veronica Folliero ◽  
Pina Caputo ◽  
Maria Teresa Della Rocca ◽  
Annalisa Chianese ◽  
Marilena Galdiero ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
The Elderly ◽  
University Hospital ◽  
Bacterial Strains ◽  
Gram Positive ◽  
Antibiotic Resistant ◽  
Gram Negative ◽  
Flight Mass Spectrometry ◽  
Tract Infections

Urinary tract infections (UTIs) are the most common and expensive health problem globally. The treatment of UTIs is difficult owing to the onset of antibiotic-resistant bacterial strains. The aim of this study was to define the incidence of infections, identify the bacteria responsible, and identify the antimicrobial resistance profile. Patients of all ages and both sexes were included in the study, all admitted to University Hospital of Campania “Luigi Vanvitelli”, between January 2017 and December 2018. Bacterial identification and antibiotic susceptibility testing were performed using matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and Phoenix BD. Among the 1745 studied patients, 541 (31%) and 1204 (69%) were positive and negative for bacterial growth, respectively. Of 541 positive patients, 325 (60%) were females, while 216 (39.9%) were males. The largest number of positive subjects was recorded in the elderly (>61 years). Among the pathogenic strains, 425 (78.5%) were Gram-negative, 107 (19.7%) were Gram-positive, and 9 (1.7%) were Candida species. The most isolated Gram-negative strain is Escherichia coli (E. coli) (53.5%). The most frequent Gram-positive strain was Enterococcus faecalis (E. faecalis) (12.9%). Gram-negative bacteria were highly resistant to ampicillin, whereas Gram-positive bacteria were highly resistant to erythromycin.

scholarly journals Antibiotic Resistance Patterns of Uropathogens Causing Urinary Tract Infections in Children with Congenital Anomalies of Kidney and Urinary Tract

Children ◽  
2021 ◽  
Vol 8 (7) ◽  
pp. 585
Author(s):  
Raluca Isac ◽  
Diana-Georgiana Basaca ◽  
Ioana-Cristina Olariu ◽  
Ramona F. Stroescu ◽  
Andrada-Mara Ardelean ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Congenital Anomalies ◽  
Public Health Issue ◽  
Gram Positive ◽  
Pseudomonas Spp ◽  
Resistance Patterns ◽  
Tract Infections

Background: Urinary tract infections (UTI) are common in children worldwide. Congenital anomalies of kidney and urinary tract (CAKUT) increase the risk of UTI and consequently antibiotic resistance. Antibiotic resistance represents an important public health issue worldwide. We aimed to evaluate the local trend in terms of bacterial uropathogen resistance in the western part of Romania in children with CAKUT and UTI. Methods: 252 children with CAKUT were admitted to our hospital over a five-year period. Of them, 91 developed at least one UTI episode, with a total number of 260 positive urine cultures. We collected data about age at diagnosis of CAKUT, sex, origin environment, type and side of CAKUT, number of UTIs, type of uropathogen, and uropathogens antibiotic resistance. Results: Distribution of uropathogens was Escherichia coli (38.84%), Klebsiella spp. (21.15%), Enterococcus spp. (15.76%), Proteus spp. (8.07%), Pseudomonas spp. (8.07%), Enterobacter spp. (2.3%), other Gram-negative bacteria (2.3%), and other Gram-positive bacteria (3.45%). High antibiotic resistance was detected for ampicillin, amoxicillin, and second-generation cephalosporins. Escherichia coli presented high resistance for cefepime and ceftriaxone. Pseudomonas spp. remained susceptible to amikacin, quinolones, and colistin. Vancomycin, teicoplanin, linezolid, and piperacillin/tazobactam remained effective in treating Gram-positive UTI. Conclusions: High antibiotic resistance was identified for frequently used antibiotics. Lower antibiotic resistance was observed for some broad-spectrum antibiotics. Understanding uropathogens’ antibiotic resistance is important in creating treatment recommendations, based on international guidelines, local resistance patterns, and patient particularities.

scholarly journals Impact of the MIC of Piperacillin-Tazobactam on the Outcome of Patients with Bacteremia Due to Extended-Spectrum-β-Lactamase-Producing Escherichia coli

2013 ◽  
Vol 57 (7) ◽  
pp. 3402-3404 ◽  
Author(s):  
Pilar Retamar ◽  
Lorena López-Cerero ◽  
Miguel Angel Muniain ◽  
Álvaro Pascual ◽  
Jesús Rodríguez-Baño ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Bloodstream Infections ◽  
Content Type ◽  
Extended Spectrum ◽  
Tract Infections ◽  
The Impact

ABSTRACTWe investigated the impact of the piperacillin-tazobactam MIC in the outcome of 39 bloodstream infections due to extended-spectrum-β-lactamase-producingEscherichia coli. All 11 patients with urinary tract infections survived, irrespective of the MIC. For other sources, 30-day mortality was lower for isolates with a MIC of ≤2 mg/liter than for isolates with a higher MIC (0% versus 41.1%;P= 0.02).

scholarly journals Impact of restriction of over-the-counter sales of antimicrobials on antimicrobial resistance in Escherichia coli from community-onset urinary tract infections in inner São Paulo State, Brazil

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259632
Author(s):  
Fernanda Saad Rodrigues ◽  
Helena Ribeiro Aiello Amat ◽  
Carlos Magno Castelo Branco Fortaleza
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Urinary Tract Infections ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Over The Counter ◽  
Tract Infections ◽  
The Impact ◽  
Community Onset

Background Antimicrobial resistance in community-associated infections is an increasing worldwide concern. In low-to-middle income countries, over-the-counter (OTC) sales of antimicrobials without medical prescription have been blamed for increasing consumption and resistance. We studied the impact of restriction of OTC sales of antimicrobials in Brazil (instituted in October 2010) on resistance trends of Escherichia coli from community-onset urinary tract infections. Methods We analyzed monthly resistance trend of Escherichia coli from community-onset urinary tract infections from 2005 through 2018. The data were submitted to interrupted time series analysis in both linear and Poisson regression models. Results We found impact on cefazolin (p<0.001) and amikacin (p<0.001) resistance as immediate impact of the intervention, and no beneficial impact on resistance to ciprofloxacin, ceftriaxone or sulfamethoxazole-trimethoprim. Conclusion At the present study, we found that OTC sales restriction did not generally impact on antimicrobial resistance.

scholarly journals Actinotignum schaalii Abscess in a Patient with Common Variable Immunodeficiency

Pathogens ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 494 ◽  
Author(s):  
Christine Marie Panganiban ◽  
Sudhir Gupta
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Common Variable Immunodeficiency ◽  
The Elderly ◽  
Urogenital Tract ◽  
Gram Positive ◽  
Incision And Drainage ◽  
First Case ◽  
Tract Infections ◽  
Common Variable

Actinotignum schaalii is an anaerobic, gram-positive commensal organism of the urogenital tract. A. schaalii typically causes urinary tract infections, predominantly in the elderly. Here, we describe the first case of A. schaalii infection presenting as cellulitis and abscess in a patient with common variable immunodeficiency. The patient was successfully treated with an incision and drainage and a prolonged antibiotic course. A. schaalii infection should be considered in sterile abscesses, and anaerobic cultures should be requested in the absence of positive routine cultures.

scholarly journals Rising Prevalence of Antimicrobial Resistance in Urinary Tract Infections During Pregnancy: Necessity for Exploring Newer Treatment Options

2011 ◽  
Vol 3 (02) ◽  
pp. 098-103 ◽  
Author(s):  
Meher Rizvi ◽  
Fatima Khan ◽  
Indu Shukla ◽  
Abida Malik ◽  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antimicrobial Susceptibility ◽  
Methicillin Resistance ◽  
Asymptomatic Bacteriuria ◽  
Gram Positive ◽  
Gram Negative ◽  
Tract Infections ◽  
Gram Positive Cocci

ABSTRACT Background: Urinary tract infections (UTI) are one of the most common medical complications of pregnancy. The emergence of drug resistance and particularly the Extended-spectrum beta-lactamase production by Escherichia coli and methicillin resistance in Staphylococci, limits the choice of antimicrobials. Materials and Methods: Patients in different stages of pregnancy with or without symptoms of urinary tract infection attending the antenatal clinic of obstetrics and gynaecology were screened for significant bacteriuria, by standard loop method on 5% sheep blood agar and teepol lactose agar. Isolates were identified by using standard biochemical tests and antimicrobial susceptibility testing was done using Kirby Bauer disc diffusion method. Results: A total of 4290 (51.2%) urine samples from pregnant females showed growth on culture. Prevalence of asymptomatic bacteriuria 3210 (74.8%) was higher than symptomatic UTI 1080 (25.2%). Escherichia coli was the most common pathogen accounting for 1800 (41.9%) of the urinary isolates. Among the gram-positive cocci, coagulase negative species of Staphylococci 270 (6.4%) were the most common pathogen. Significantly high resistance was shown by the gram negative bacilli as well as gram positive cocci to the β-lactam group of antimicrobials, flouroquinolones and aminoglycosides. Most alarming was the presence of ESBL in 846 (47%) isolates of Escherichia coli and 344 (36.9%) isolates of Klebsiella pneumoniae, along with the presence of methicillin resistance in 41% of Staphylococcus species and high-level aminoglycoside resistance in 45(30%) isolates of Enterococcus species. Glycopeptides and carbepenems were the only group of drugs to which all the strains of gram positive cocci and gram negative bacilli were uniformly sensitive, respectively. Conclusions: Regular screening should be done for the presence of symptomatic or asymptomatic bacteriuria in pregnancy and specific guidelines should be issued for testing antimicrobial susceptibility with safe drugs in pregnant women so that these can be used for the treatment. For empirical treatment cefoperazone-sulbactum can be recommended, which is a safe drug, covering both gram positive and gram negative organisms and with a good sensitivity.

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