scholarly journals Outcomes of high-dose levofloxacin therapy remain bound to the levofloxacin minimum inhibitory concentration in complicated urinary tract infections

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Eliana S. Armstrong ◽  
Janelle A. Mikulca ◽  
Daniel J. Cloutier ◽  
Caleb A. Bliss ◽  
Judith N. Steenbergen
Keyword(s):  
Urinary Tract ◽  
Minimum Inhibitory Concentration ◽  
Urinary Tract Infections ◽  
Inhibitory Concentration ◽  
High Dose ◽  
Tract Infections

An automated and portable antimicrobial susceptibility testing system for urinary tract infections

Lab on a Chip ◽  
2021 ◽  
Vol 21 (4) ◽  
pp. 755-763
Author(s):  
Kuo-Wei Hsu ◽  
Wen-Bin Lee ◽  
Huey-Ling You ◽  
Mel S. Lee ◽  
Gwo-Bin Lee
Keyword(s):  
Urinary Tract ◽  
Minimum Inhibitory Concentration ◽  
Urinary Tract Infections ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Inhibitory Concentration ◽  
Microfluidic System ◽  
Antimicrobial Susceptibility Testing ◽  
Testing System ◽  
Tract Infections

A portable, integrated microfluidic system capable of automatically conducting antimicrobial susceptibility testing (AST) and minimum inhibitory concentration (MIC) measurements using urine samples were developed.

scholarly journals Clinical Impact of Revised Ciprofloxacin Breakpoint in Patients with Urinary Tract Infections by Enterobacteriaceae

Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 469
Author(s):  
Ga-Eun Park ◽  
Jae-Hoon Ko ◽  
Sun-Young Cho ◽  
Hee-Jae Huh ◽  
Jin-Yang Baek ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Clinical Outcomes ◽  
Urinary Tract Infections ◽  
Inhibitory Concentration ◽  
Clinical Impact ◽  
Definitive Treatment ◽  
Primary Endpoints ◽  
Tract Infections ◽  
Susceptible Group ◽  
Selection Of

In 2018, the Clinical and Laboratory Standards Institute (CLSI) revised ciprofloxacin (CIP)-susceptible breakpoint for Enterobacteriaceae from ≤1 μg/mL to ≤0.25 μg/mL, based on pharmacokinetic-pharmacodynamic (PK-PD) analysis. However, clinical data supporting the lowered CIP breakpoint are insufficient. This retrospective cohort study evaluated the clinical outcomes of patients with bacteremic urinary tract infections (UTIs) caused by Enterobacteriaceae, which were previously CIP-susceptible and changed to non-susceptible. Bacteremic UTIs caused by Enterobacteriaceae with CIP minimal inhibitory concentration (MIC) ≤ 1 μg/mL were screened, and then patients treated with CIP as a definitive treatment were finally included. Patients in CIP-non-susceptible group (MIC = 0.5 or 1 μg/mL) were compared with patients in CIP-susceptible group (MIC ≤ 0.25 μg/mL). Primary endpoints were recurrence of UTIs within 4 weeks and 90 days. A total of 334 patients were evaluated, including 282 of CIP-susceptible and 52 of CIP-non-susceptible. There were no significant differences in clinical outcomes between two groups. In multivariate analysis, CIP non-susceptibility was not associated with recurrence of UTIs. CIP non-susceptibility based on a revised CIP breakpoint, which was formerly susceptible, was not associated with poor clinical outcomes in bacteremic UTI patients were treated with CIP, similar to those of the susceptible group. Further evaluation is needed to guide the selection of definitive antibiotics for UTIs.

scholarly journals Determination of antibiotic resistance and minimum inhibitory concentration of meropenem and imipenem growth in Klebsiella strains isolated from urinary tract infection in Shahrekord educational hospitals

2019 ◽  
Vol 21 (2) ◽  
pp. 80-85
Author(s):  
Farshad Kakian ◽  
Behnam Zamzad ◽  
Abolfazl Gholipour ◽  
Kiarash Zamanzad
Keyword(s):  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Minimum Inhibitory Concentration ◽  
Bacterial Infections ◽  
Inhibitory Concentration ◽  
Diffusion Method ◽  
Disc Diffusion ◽  
Disc Diffusion Method ◽  
Accurate Identification ◽  
Tract Infections

Background and aims: Klebsiella is an opportunistic organism that is the cause of severe diseases such as pneumonia, septicemia, and urinary tract infections (UTIs). In addition, high antibiotic resistance has challenged the treatment of this bacterium. However, carbapenem antibiotics are considered as the therapeutic agents for selecting the treatment of penicillin- and cephalosporin-resistant gram-negative bacterial infections. The present study aimed to determine the resistance and minimum inhibitory concentration (MIC) of meropenem and imipenem. Methods: A total of 80 Klebsiella spp isolated from UTIs were collected in various educational wards (i.e., urology, obstetrics, and gynecology, as well as the units of infectious diseases, internal medicine, and intensive care) in different hospitals of Shahrekord. The isolates were then identified by using biochemical tests. Further, disc diffusion method was employed to determine the antibiotic resistance. Furthermore, MIC was estimated by the Epsilon-test strip. Moreover, P=Q=0.50, an error of 0.05, and an accuracy of 0.11 were considered for determining the sample size (n=80). Results: Based on the results of disc diffusion method, 24 strains were resistant to meropenem and imipenem. Additionally, the MIC was 24 (30%) by the E-test. In addition, 24 isolates had a MIC of ≥4 μg/mL for meropenem and imipenem and thus were resistant while 18 isolates were found to have a MIC of 1≤ MIC<4 μg/mL and therefore, were considered semi-sensitive (P<0.001). Conclusion: In general, Klebsiella strains were found to be resistant to meropenem and imipenem. Therefore, rapid and accurate identification of these strains and the selection of appropriate antibiotics can help quickly eradicate the infections caused by these bacteria. Accordingly, a waste of time, the consumption of medication, or even an increased resistance are prevented.

scholarly journals Emergence of and Risk Factors for Ciprofloxacin-Gentamicin-ResistantEscherichia coliUrinary Tract Infections in a Region of Quebec

2009 ◽  
Vol 20 (4) ◽  
pp. e163-e168 ◽  
Author(s):  
Jacques Pépin ◽  
Mireille Plamondon ◽  
Caroline Lacroix ◽  
Isabelle Alarie
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Minimum Inhibitory Concentration ◽  
Inhibitory Concentration ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Definitive Treatment ◽  
Tertiary Care Centre ◽  
E Coli ◽  
Tract Infections

BACKGROUND: An increased incidence of urinary tract infections (UTIs) caused by ciprofloxacin-gentamicin-resistantEscherichia coli(CiGREC) has been observed in a tertiary care centre in Sherbrooke, Quebec. The risk factors for such infections remained unclear.METHODS: To determine risk factors for, and outcomes of, CiGREC UTIs, a case control study was conducted. Between 2000 and 2007, 93 cases and 186 controls were identified using laboratory records of patients with greater than 107colony-forming units/L ofE coliin a urinary specimen. Cases hadE coliwith minimum inhibitory concentration to ciprofloxacin of 4 mg/L or greater and minimum inhibitory concentration to gentamicin of 8 mg/L or greater (CiGREC), and controls hadE coliwith any other susceptibility pattern to ciprofloxacin and gentamicin. Clinical and laboratory data were collected. Adjusted odds ratios (AOR) and their 95% CIs were calculated by logistic regression.RESULTS: The prevalence of CiGREC increased sixfold during the study period. Risk factors associated with CiGREC UTI were advanced age, male sex, urological abnormality, domicile outside Sherbrooke, living in a nursing home (AOR 11.73; 95% CI 3.70 to 37.15), use of fluoroquinolones (AOR 15.24; 95% CI 5.42 to 42.83) or aminoglycosides (AOR 6.59; 95% CI 1.22 to 35.61) within the previous month, and use of fluoroquinolones during the preceding one to 12 months (AOR 2.45; 95% CI 1.06 to 5.62). Compared with controls, cases were more likely not to receive an active antibiotic as empirical or definitive treatment, and were more likely to relapse.INTERPRETATION: In the future, it may become necessary to avoid selecting as empirical therapy of urinary tract infection an antibiotic to which the patient has been recently exposed.

scholarly journals 1445. Antimicrobial Activity of Novel β-Lactamase Inhibitor Combinations Tested against Organisms Causing Complicated Urinary Tract Infections in United States Medical Centers

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S527-S528
Author(s):  
Helio S Sader ◽  
Cecilia G Carvalhaes ◽  
Dee Shortridge ◽  
Michael D Huband
Keyword(s):  
United States ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Clinical Development ◽  
High Dose ◽  
E Coli ◽  
Highly Active ◽  
Medical Centers ◽  
Tract Infections ◽  
Extended Infusion

Abstract Background High-dose extended-infusion cefepime-tazobactam (FEP-TAZ) is in clinical development at 2g/2g q8 hours administered over 90 minutes. We evaluated the potency and spectrum of activity of FEP-TAZ, ceftolozane–tazobactam (C-T), ceftazidime–avibactam (CAZ-AVI), and comparators tested against gram-negative bacilli (GNB) causing complicated urinary tract infections (cUTIs) in United States (US) hospitals. Methods In 2018, 3,023 GNBisolates (1/patient) were consecutively collected and susceptibility tested against FEP-TAZ (TAZ at fixed 8 mg/L) and comparators by reference broth microdilution methods. Percentage of isolates inhibited at ≤8 mg/L (CLSI, cefepime high dose) and at ≤16 mg/L (pharmacokinetic/pharmacodynamic [PK/PD] susceptible [S] breakpoint based on extended infusion and high dosage) were evaluated. Results FEP-TAZ (99.9% inhibited at ≤16 mg/L; Table), CAZ-AVI (99.9%S), and meropenem (MEM; 99.5%S) were the most active agents against Enterobacterales (ENT). An ESBL phenotype (CLSI criteria) was observed in 12.5%, 12.9%, and 3.6% of E. coli (EC), K. pneumoniae (KPN), and P. mirabilis (PM), respectively. FEP-TAZ and CAZ-AVI exhibited complete activity against EC, whereas C-T and piperacillin–tazobactam (PIP-TAZ) were active against 91.5% and 88.1% of ESBL-phenotype EC isolates, respectively. The most active agents against KPN were FEP-TAZ (99.6% inhibited at ≤16 mg/L), CAZ-AVI (100.0%S), and amikacin (AMK; 99.4%S). All PM isolates were S to FEP-TAZ (highest MIC, 0.12 mg/L), C-T, CAZ-AVI, MEM, PIP-TAZ and AMK. FEP-TAZ was highly active against E. cloacae (n = 94; MIC90, 0.5 mg/L; 98.9% inhibited at ≤16 mg/L) and Citrobacter spp. (n = 91; MIC90, 0.12 mg/L; highest MIC, 0.5 mg/L). Against P. aeruginosa (PSA), FEP-TAZ inhibited 97.6% of isolates at ≤16 mg/L, with spectrum of activity similar to CAZ-AVI (96.4%S), C-T (99.4%S) and AMK (97.6%S), and greater than MEM (85.5%S) and PIP-TAZ (87.3%S). Conclusion FEP-TAZ showed potent activity against ENT and PSA isolated in US hospitals in 2018, with overall spectrum (ENT + PSA) similar to CAZ-AVI and greater than C-T, PIP-TAZ, and MEM when FEP-TAZ proposed PK/PD S breakpoint of ≤16 mg/L was applied. FEP-TAZ may represent a valuable option for treating cUTIs caused by resistant GNB. Disclosures All authors: No reported disclosures.

scholarly journals High dose versus low dose standardized cranberry proanthocyanidin extract for the prevention of recurrent urinary tract infection in healthy women: a double-blind randomized controlled trial

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Asma Babar ◽  
Lynne Moore ◽  
Vicky Leblanc ◽  
Stéphanie Dudonné ◽  
Yves Desjardins ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Low Dose ◽  
Recurrent Urinary Tract Infection ◽  
High Dose ◽  
Double Blind ◽  
Symptomatic Urinary Tract Infection ◽  
Tract Infections

Abstract Purpose Our objective was to assess the efficacy of a high dose cranberry proanthocyanidin extract for the prevention of recurrent urinary tract infection. Material and methods We recruited 145 healthy, adult women with a history of recurrent urinary tract infection, defined as ≥ 2 in the past 6 months or ≥ 3 in the past 12 months in this randomized, controlled, double-blind clinical trial. Participants were randomized to receive a high dose of standardized, commercially available cranberry proanthocyanidins (2 × 18.5 mg daily, n = 72) or a control low dose (2 × 1 mg daily, n = 73) for a 24-week period. During follow-up, symptomatic women provided urine samples for detection of pyuria and/or bacteriuria and received an appropriate antibiotic prescription. The primary outcome for the trial was the mean number of new symptomatic urinary tract infections during a 24-week intervention period. Secondary outcomes included symptomatic urinary tract infection with pyuria or bacteriuria. Results In response to the intervention, a non-significant 24% decrease in the number of symptomatic urinary tract infections was observed between groups (Incidence rate ratio 0.76, 95%CI 0.51–1.11). Post-hoc analyses indicated that among 97 women who experienced less than 5 infections in the year preceding enrolment, the high dose was associated with a significant decrease in the number of symptomatic urinary tract infections reported compared to the low dose (age-adjusted incidence rate ratio 0.57, 95%CI 0.33–0.99). No major side effects were reported. Conclusion High dose twice daily proanthocyanidin extract was not associated with a reduction in the number of symptomatic urinary tract infections when compared to a low dose proanthocyanidin extract. Our post-hoc results reveal that this high dose of proanthocyanidins may have a preventive impact on symptomatic urinary tract infection recurrence in women who experienced less than 5 infections per year. Trial registration: Clinicaltrials.gov, identifier NCT02572895

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