scholarly journals New and emerging technologies for the diagnosis of urinary tract infections

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Mohammed Harris ◽  
Tracy Fasolino

Abstract Urinary tract infections affect 150 million people worldwide, yet the diagnosis of this common infection is not straightforward. Misdiagnoses and incorrect prescriptions are frequent in the treatment of urinary tract infections; this also contributes to the increase in antibiotic resistance among pathogens. Present diagnostic practices take 2–3 days for pathogen identification and antibiotic susceptibility testing. New technologies are urgently needed for improved patient care as well as to promote antibiotic stewardship. An ideal new diagnostic technology will test clinical urine samples directly and identify the pathogen and determine its antibiotic susceptibilities within a few hours such that the patient can be prescribed the appropriate antibiotic treatment the same day. Screening tools, such as flow cytometers and new dipstick assays, can help with rapidly identifying negative samples and improving workflow and reducing costs. Several groups have made progress in optimizing mass spectrometry methods for direct urine processing, and there are also new multiplex PCR panels that are specific for UTI pathogens and antibiotic resistance. We also discuss several emerging technologies – microfluidics, biosensors, real-time microscopy systems, and sequence-based diagnostics – that show huge potential in delivering rapid results.

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S826-S827
Author(s):  
Leigh Ellyn Preston ◽  
Clifford McDonald ◽  
Babatunde Olubajo ◽  
Natalie McCarthy ◽  
Sujan Reddy ◽  
...  

Abstract Background Community-onset urinary tract infections (coUTIs) are one of the most common indications for antibiotic prescribing. It is important to understand patient demographic factors associated with microorganisms causing coUTI and their antibiotic resistance profiles, to tailor antibiotic prescribing practices. We analyzed microbiology data to understand factors associated with coUTI in the United States (US). Methods CoUTIs were identified in the Premier Healthcare Database and Cerner Health Facts among patients treated at participating healthcare facilities in the US between 2012-2017. Cases were defined by urine cultures yielding a bacterial organism and were collected in outpatient settings or within three days of hospitalization. Only the first specimen for each encounter was included in the analysis. Data on the organisms isolated, patient’s age, sex, and US census regions of the submitting facilities were described and compared using chi-square tests for associations. Encounters were classified as inpatient (INPT), observation (OBS), emergency department (ED), and outpatient (OTPT) based on the setting in which the culture was submitted. Results Using data from 637 acute care hospitals, urine samples from 3,291,561 encounters were included, with 776,653 (25.7%) INPT, 1,063,219 (34.8%) ED, 107,760 (3.5%) OBS, and 1,092,658 (35.8%) OTPT. The pathogens most frequently associated with coUTIs were Escherichia coli (57.3%), Klebsiella pneumoniae (9.7%), Enterococcus faecalis (5.1%), Proteus mirabilis (4.9%), and Pseudomonas aeruginosa (2.9%). Female sex, age < 65y and OTPT and ED settings were associated with higher relative frequency of E. coli (all p < 0.0001). Male sex, INPT setting and age >65 y were associated with higher relative frequency of P. aeruginosa, P. mirabilis and E. faecalis (all p < 0.0001, Figure). K. pneumoniae was found at higher relative frequency in those >45y, and in INPT and OBS settings (all p < 0.0001). Figure. Distribution of pathogens most frequently associated with community onset urinary tract infections Conclusion Understanding patient factors associated with the microbiology of coUTIs is an important step in developing treatment recommendations and antibiotic stewardship efforts. Further analyses will include assessing the impact of major antibiotic resistance phenotypes, geographic and healthcare settings. Disclosures All Authors: No reported disclosures


2017 ◽  
Vol 8 (2) ◽  
Author(s):  
Naeimeh Sadat Hashemi ◽  
Meysam Mojiri ◽  
Parivash Yazdani Kachouyi ◽  
Shiva Eskandari ◽  
Mehrsa Mohammadian ◽  
...  

Pseudomonas aeruginosa is one of the most important opportunistic pathogens responsible for various types of hospital infections. High prevalence of antibiotic resistance in P. aeruginosa strains of human clinical samples cause more severe diseases for a longer period of time. The current research was done in order to study the distribution of blaIMP-1 gene among the imipenem-resistant P. aeruginosa strains isolated from burn and urinary tract infections of hospitalized patients. Two-hundred and forty-three P. aeruginosa isolates recovered from the cases of burn and urinary tract infections of inpatients and outpatients were analysis for antibiotic resistance pattern using the disk diffusion method. Then, imipenem-resistant isolates were further analyzed for distribution of blaIMP-1 gene using the PCR. Of 243 P. aeruginosa isolates, 146 strains (60.08%) were taken from outpatients and 97 strains (39.91%) were taken from inpatients. P. aeruginosa isolates harbored the highest levels of resistance against streptomycin (100%), nalidixic acid (100%), aztreonam (100%), cotrimoxazole (95.47%), ciprofloxacin (88.47%), cefotaxime (84.36%) and gentamycin (83.95%). Inpatients had a relatively higher levels of antibiotic resistance. One-hundred and twenty-one out of 126 (96.03%) imipenem-resistant P. aeruginosa isolates harbored the blaIMP-1 gene. Inpatients also had a relatively higher prevalence of blaIMP-1 gene. High prevalence of blaIMP-1 gene and also imipenemresistant P. aeruginosa are important public health issue. Clinical laboratories should consider the detection of the blaIMP-1 gene among the P. aeruginosa isolates of clinical samples.


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