A study on urinary tract infection in a tertiary care hospital

Background: Urinary tract infection is defined as bacteriuria along with urinary symptoms. It is one of the most common bacterial infections in humans and a major cause of morbidity. UTI has become difficult to treat because of appearance of pathogens with increasing resistance to antimicrobial agents. The objective of this study was to determine the bacteriological profile of pathogens responsible for urinary tract infection and to assess the antibiotic sensitivity pattern of the causative uropathogens.Methods: This cross-sectional study was performed at the hospital of Sree Mookambika Institute of Medical Sciences, Kulasekharam during January 1, 2016 to December 12, 2016. Institutional ethical committee clearance was obtained. We surveyed 628 patients, who had clinical manifestations of UTI. Urine specimens were cultured for isolation of the microbial agents of UTI. The isolated bacteria were identified using biochemical tests. Data was entered in Microsoft Excel Version 2016.Statistical analysis was done using SPSS TRIAL VERSION 21C.Results: The commonest organism isolated overall was extended spectrum beta lactamase positive E. coli (35.5%) followed by extended spectrum beta lactamase negative E. coli and Enterococcus. Females (68.63%) were mostly affected than males in our study. The people in the age group of 41-60 years are found to be more (48.46%) affected than the people of other age groups. The most sensitive oral antibiotic to almost all organisms in our study is Nitrofurantoin followed by Cotrimoxazole and Norfloxacin and among parenteral antibiotics, Amikacin stands first followed by Piperacillin-Tazobactam and Gentamicin. Apart from the above antibiotics, Klebsiellapnemoniae also shows good response to Cefotaxime (96.15%) and Cefipime (96.15%) and Aztreonam (92.3%).Conclusions: From our study, it is observed that the most common causative organism for Urinary tract infection is found to be extended spectrum beta lactamase positive E. coli followed by Extended Spectrum Beta Lactamase negative E. coli and Enterococcus. The current status of sensitivity of common organism rests mainly on Nitrofurantoin (oral) and Amikacin, Piperacillin-Tazobactam (parenteral).

Download Full-text

Efficacy of cefoxitin for the treatment of urinary tract infection due to extended-spectrum-beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates

Therapeutic Advances in Infectious Disease ◽

10.1177/2049936118811053 ◽

2018 ◽

Vol 6 ◽

pp. 204993611881105

Author(s):

Olivia Senard ◽

Frédérique Bouchand ◽

Laurene Deconinck ◽

Morgan Matt ◽

Lesly Fellous ◽

...

Keyword(s):

Escherichia Coli ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Klebsiella Pneumoniae ◽

Care Hospital ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

Extended Spectrum

Introduction: Cefoxitin has a good in vitro activity and stability in resistance to hydrolysis by extended-spectrum beta-lactamases and is a good candidate for the treatment of urinary tract infection. However, data are scarce regarding its use in clinical practice. Methods: We conducted a retrospective study from September 2014 to November 2017, in a tertiary care hospital in Garches (France). We gathered all prescriptions of cefoxitin for urinary tract infection due to extended-spectrum beta-lactamase isolates. We compared the clinical outcomes between Escherichia coli and Klebsiella pneumoniae extended-spectrum-beta-lactamase-producing isolates after a 90-day follow-up. When available, we assessed whether cefoxitin-based regimen was associated with an emergence of resistance. Results: The treatment of 31 patients with a mean age of 60 ± 18 years was analyzed. We observed a clinical cure of 96.7% ( n = 30/31) at day 30 and of 81.2% ( n = 13/16) and 85.7% (12/14) at day 90 for extended-spectrum beta-lactamase Escherichia coli and Klebsiella pneumoniae isolates, respectively ( p = 0.72). No adverse events were reported. One patient who relapsed carried a Klebsiella pneumoniae isolate that became intermediate to cefoxitin in the follow-up. Conclusion: In a period of major threat with a continuous increase of extended-spectrum beta-lactamase obliging to a policy of carbapenem-sparing regimens, it seems detrimental to deprive physicians of using cefoxitin for extended-spectrum beta-lactamase Enterobacteriaceae for the treatment of urinary tract infection while our data show its efficacy.

Download Full-text

Frequency of Extended-Spectrum Beta-Lactamase Producing Organisms Causing Urinary Tract Infection and Their Antibiotic Sensitivity Pattern

Journal of Medicine ◽

10.3329/jom.v18i1.31162 ◽

2017 ◽

Vol 18 (1) ◽

pp. 3-5

Author(s):

Md Raziur Rahman ◽

Muhammad Abdur Rahim ◽

Samira Rahat Afroze ◽

Chinmay Shaha Poddar ◽

Khwaja Nazim Uddin

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Antibiotic Sensitivity ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

E Coli ◽

Extended Spectrum ◽

Number Of Patients ◽

Sensitivity Pattern

Background: The spectrum of bacteria causing urinary tract infection (UTI) and their antibiotic sensitivity pattern is not uniform. Escherichia coli and Klebsiella sp. are two common organisms responsible for UTI through-out the world. The incidence of UTI due to infection with extended-spectrum beta-lactamase (ESBL) producing organisms are increasing. This study was aimed to describe the frequency of ESBL positive organisms causing UTI and their antibiotic sensitivity pattern.Methods: This cross-sectional study was done in the Department of Internal Medicine, BIRDEM General Hospital from January to April, 2016.Results: Total number of patients was 137 with females predominance (M:F ratio 1 : 3.7). Mean age was 60.3 ±11.7 years. Most patients (131, 95.6%) of the study population were diabetic and glycaemic control was poor (mean HbA1c 9.3 ±2.3) in these subjects. Common symptoms were fever, vomiting, increased urinary frequency, dysuria, suprapubic pain, and loin pain. Neutrophilic leukocytosis was common (94.9%). E. coli (73.7%) was the commonest aetiological agent followed by Klebsiella (8.8%), Enterococcus (4.4%), Citrobacter (3.6%), Staphylococcus aureus (3.6%), Acinetobacter (2.9%), Enterobacter (1.5%), and Pseudomonas (1.5%). Over half of E. coli and of Klebsiella sp. and 100% of Enterobacter organisms were ESBL positive. Imipenem (100%), amikacin, netilmycin,and nitrofurantoin were among the most sensitive antibiotics.Conclusion: More than half (71, 51.82%) of UTI cases were due to ESBL positive organisms. Imipenem, amikacin, netilmycin, and nitrofurantoin remain the drug of choice.J MEDICINE January 2017; 18 (1) : 3-5

Download Full-text