scholarly journals Analysis of Geriatric Infections and a Guide to Empirical Antibiotic Therapy

2021 ◽  
Vol 8 (12) ◽  
pp. 694-698
Author(s):  
Mayanka A ◽  
Vasanthan K ◽  
Vengadakrishnan K ◽  
Sudagar Singh R.B ◽  
Senthil N
Keyword(s):  
Staphylococcus Aureus ◽  
Urinary Tract ◽  
Elderly People ◽  
Respiratory Infections ◽  
Common Source ◽  
Multiorgan Dysfunction ◽  
E Coli ◽  
Common Organism ◽  
Increased Risk ◽  
Tract Infections

BACKGROUND Elderly people have increased susceptibility to infection and are at significantly increased risk of morbidity and mortality due to various common infections. Urinary tract and respiratory tract infections predominate in elderly people. Gram negative pathogens especially E. coli are commonly observed pathogens. In gram positive infections, staphylococcus is usually isolated from skin and soft tissue infections. METHODS Data was collected prospectively between the months of March 2015 and August 2016. Patient demographics and clinical data were recorded from oral questionnaires and hospital records. 219 patients satisfied the inclusion criteria. All patients were subjected to basic investigations with blood and urine cultures at the time of admission. Other cultures like respiratory or pus cultures were collected as and when needed. Specific investigations such as ultrasound abdomen, computed tomography kidneys, ureters and bladder (CT KUB), CT thorax, echocardiography, neuroimaging and procalcitonin were done in certain patients when required. RESULTS Of the 219 patients included in this study, 127 (58 %) were males and 92 (42 %) were females. Mean age of the study population was 72.40. The most common source of bacteraemia was urinary in 33 % and was unknown in 25 %. The most common organism isolated in blood culture was Staphylococcus aureus followed by E. coli. Respiratory infections had unidentified pathogens in 81 % of patients. The most common organism isolated from respiratory secretions was klebsiella followed by acinetobacter and pseudomonas. 11 % of patients developed multi organ dysfunction syndrome of which urinary and respiratory systems were the most common primary sources of infection. CONCLUSIONS A significant incidence of unidentified source of infection was observed. Staphylococcus bacteraemia was a significant observation as E. coli is reported to be common. Urinary tract and respiratory infections were seen to be associated with increased incidence of multiorgan dysfunction. KEYWORDS Elderly, Febrile Illness, Staphylococcus aureus, Escherichia coli, Multiorgan Dysfunction

scholarly journals Cephalosporin resistant bacterial strains isolated from respiratory infections

2015 ◽  
Vol 21 (1) ◽  
pp. 7-11
Author(s):  
Mihaela Botnarciuc ◽  
Irina Stan ◽  
Sorina Ispas
Keyword(s):  
Staphylococcus Aureus ◽  
Clavulanic Acid ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Fourth Generation ◽  
Third Generation ◽  
Bacterial Strains ◽  
Hemolytic Streptococcus ◽  
E Coli ◽  
Tract Infections

Abstract Objectives: The objective of the study is the evaluation of the actual resistance to second, third, and fourth generation cephalosporins over bacterial strains isolated from respiratory infections. The main causes for cephalosporin resistance of pathogenic and conditioned pathogen bacteria are: widespread usage, and impair immune response. Materials and methods: The analyzed specimens were throat swabs and sputum, from adult patients. The tests were performed using disk diffusion technique. We tested the following cephalosporin: From second generation: cefuroxime axetil; from third generation: cefotaxime, ceftazidime, cefpodoxime; Combinations of cephalosporins and beta-lactamase inhibitors: cefotaxime + clavulanic acid; ceftazidim + clavulanic acid; From fourth generation: cefepime; and association cefepime and clavulanic acid. Results: The following bacterial strains were isolated: Staphylococcus aureus, Streptococcus pneumoniae, Group C β-hemolytic Streptococcus, E. coli, Klebsiella pneumoniae and Proteus sp. The Group A. β-hemolytic Streptococcus isolated strains were not tested. For Staphylococcus aureus, E. coli, K. pneumoniae and Proteus, we found a high frequency resistance tocefuroxim, approximately 47%. Highest resistance to third generation cephalosporin was identified to E.coli and Klebsiella pneumoniae, especially resistant to cefotaxime, cefotaxime + clavulanic acid and ceftazidime. Conclusions: Cefpodoxime can be considered as a first election antibiotic in treating upper and lower respiratory tract infections, due to the lowest level of bacterial strain resistance, approximately 10% of the third generation cephalosporines tested. Also, cefepime may be proper in treating severe respiratory tract infections, with resistant broad-spectrum antibiotics bacterial strains. In our trial, resistance to cefepime was to a minimum low, approximately 4%, represented by the E.coli strains.

Escherichia colishedding patterns in humans and dogs: insights into within-household transmission of phylotypes associated with urinary tract infections

2009 ◽  
Vol 137 (10) ◽  
pp. 1457-1464 ◽  
Author(s):  
P. DAMBORG ◽  
S. S. NIELSEN ◽  
L. GUARDABASSI
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Fragment Length Polymorphism ◽  
Diversity Index ◽  
Sampling Time ◽  
Common Source ◽  
E Coli ◽  
Household Transmission ◽  
Household Members ◽  
Tract Infections

SUMMARYWithin-household transmission ofEscherichia colimay contribute to the pathogenesis of urinary tract infection but understanding of transmission is limited by the lack of longitudinal data on individual shedding patterns. In this study, faecalE. coliwas isolated over 6 months from 18 humans and 13 dogs in eight households. Typing 322E. coliisolates by amplified fragment length polymorphism showed high overall diversity as indicated by the average diversity index (0·66). However, individual shedding patterns varied considerably: two persons carried a single residentE. coliclone throughout the study whereas distinct clones were isolated from other individuals on each sampling time. Nineteen clones were shared within six of the eight households and seven of these clones were shared between humans and dogs. The frequent sharing of clones belonging to phylotypes B2 (n=7) or D (n=4) supports the hypothesis that urovirulentE. coliare transmitted between household members, including dogs, or may be acquired by a common source such as food.

scholarly journals Trends in Antimicrobial Susceptibility of Escherichia coli Isolates in a Taiwanese Child Cohort with Urinary Tract Infections between 2004 and 2018

Antibiotics ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 501
Author(s):  
Hung-En Chen ◽  
You-Lin Tain ◽  
Hsiao-Ching Kuo ◽  
Chien-Ning Hsu
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Annual Incidence ◽  
Hospitalized Children ◽  
E Coli ◽  
Factors Associated ◽  
Increased Risk ◽  
Study Results ◽  
Tract Infections

The aim of this study was to investigate the annual incidence of Escherichia coli isolates in urinary tract infections (UTIs) and the antimicrobial resistance of the third-generation cephalosporin (3GCs) to E. coli, including the factors associated with the resistance in hospitalized children in Taiwan. A large electronic database of medical records combining hospital admission and microbiological data during 2004–2018 was used to study childhood UTIs in Taiwan. Annual incidence rate ratios (IRR) of E. coli in children with UTIs and its resistant rate to the 3GCs and other antibiotics were estimated by linear Poisson regression. Factors associated with E. coli resistance to 3GCs were assessed through multivariable logistic regression analysis. E. coli UTIs occurred in 10,756 unique individuals among 41,879 hospitalized children, with 92.58% being community associated based on urine culture results reported within four days after the hospitalization. The overall IRR E. coli UTI was 1.01 (95% confidence interval (CI) 0.99–1.02) in community-associated (CA) and 0.96 (0.90–1.02) in healthcare-associated infections. The trend in 3GCs against E. coli increased (IRR 1.18, 95% CI 1.13–1.24) over time in CA-UTIs. Complex chronic disease (adjusted odds ratio (aOR), 2.04; 95% CI, 1.47–2.83) and antibiotics therapy ≤ 3 months prior (aOR, 1.49; 95% CI, 1.15–1.94) were associated with increased risk of 3GCs resistance to E. coli. The study results suggested little or no change in the trend of E. coli UTIs in Taiwanese youths over the past 15 years. Nevertheless, the increase in 3GCs-resistant E. coli was substantial. Interventions for children with complex chronic comorbidities and prior antibiotic treatment could be effective in reducing the incidence of 3GCs-resistant E. coli in CA-UTIs in this region and more generally.

scholarly journals Microbial spectrum of urinary tract infections and its antibiogram in a tertiary care hospital

2017 ◽  
Vol 5 (6) ◽  
pp. 2718
Author(s):  
Monika Yadav ◽  
Rohan Pal ◽  
Shan Damrolien ◽  
Sulochana D. Khumanthem
Keyword(s):  
Staphylococcus Aureus ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Tertiary Care ◽  
Care Hospital ◽  
Major Health Problem ◽  
E Coli ◽  
Antibiotic Susceptibility Test ◽  
Tract Infections ◽  
Klebsiella Spp

Background: Urinary tract infections are one of the major health problem effecting both sexes of all age group. UTIs are often treated with different broad-spectrum antibiotics. The aim of this study was to determine the prevalence of bacteria causing urinary tract infections and their susceptibility pattern from patients reporting in RIMS Hospital.Methods: Mid stream urine (MSU) specimens sent to the laboratory from October 2014 to September 2016 were collected and inoculated onto blood agar and MacConkey agar and incubated at 37ºC for 24 hours. Identification and antibiotic susceptibility test was done following standard operative procedures.Results: 25.66% (1142/4450) samples showed a significant growth out of which 42% (479/1142) were male and 58% (663/1142) were female. E. coli has been found to be the major pathogen causing UTI which account for 61% (696/1142) followed by Staphylococcus aureus 12% (137/1142), CONS 7% (79), Enterococcus spp. 6% (67), Klebsiella spp. 5% (57), Proteus spp. 2% (22), Pseudomonas spp. 2%, Acinetobacter spp. 2% and Candida spp. 3%. Imipenem was the most susceptible antibiotic for Enterobacteriaceae, E. coli (85.9%), Klebsiella spp. (89.4%) and Proteus spp. (95.4%). Vancomycin is 100% sensitive while Linezolid, Nitrofurantoin and Gentamicin are also highly sensitive for both Staphylococcus aureus and CONS.Conclusions: These data may be used to determine trends in antimicrobial susceptibilities, to formulate local antibiotic policies in order to assist clinicians in the rational choice of antibiotic therapy to prevent misuse, or overuse, of antibiotics.

Bariatric Surgery and Perioperative Infections

2018 ◽  
Author(s):  
Mohammad Alsulaimy ◽  
Seyed Mohammad Kalantar Motamedi
Keyword(s):  
Bariatric Surgery ◽  
Urinary Tract ◽  
Respiratory Infections ◽  
Operative Procedure ◽  
Surgical Site Infections ◽  
Infectious Complications ◽  
Obese Patients ◽  
Preventative Measures ◽  
Increased Risk ◽  
Tract Infections

Morbid obesity is associated with an increased risk of infectious complications including surgical site, urinary tract, and pulmonary infections. Surgical site infections (SSI) are the most common, followed by urinary and respiratory infections. Various risk factors in obese patients including impaired immunity, and altered pulmonary and circulatory systems contribute to the increased susceptibility of morbid obese patients to infectious complications. Perioperative infections are defined to occur within 30 days of the initial operative procedure. Surgical site and urinary tract infections usually occur within 7–10 days post-operatively. Therefore, it is recommended that patients should be followed up between 7 to 10 days post-op to examine surgical sites, and to screen for possible urinary tract symptoms. This chapter will discuss the diagnosis, treatment, and possible preventative measures of the aforementioned infectious complications in the bariatric surgery population.

scholarly journals Risk factors for acquisition of multidrug-resistant Escherichia coli and development of community-acquired urinary tract infections

2017 ◽  
Vol 146 (1) ◽  
pp. 46-57 ◽  
Author(s):  
U. V. UKAH ◽  
M. GLASS ◽  
B. AVERY ◽  
D. DAIGNAULT ◽  
M. R. MULVEY ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Urinary Tract ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Health Concern ◽  
Drug Resistant ◽  
E Coli ◽  
Increased Risk ◽  
Tract Infections

SUMMARYWe examined risk factors associated with the intestinal acquisition of antimicrobial-resistant extraintestinal pathogenic Escherichia coli (ExPEC) and development of community-acquired urinary tract infection (UTI) in a case-control study of young women across Canada. A total of 399 women were recruited; 164 women had a UTI caused by E. coli resistant to ⩾1 antimicrobial classes and 98 had a UTI caused by E. coli resistant to ⩾3 antimicrobial classes. After adjustment for age, student health service (region of Canada) and either prior antibiotic use or UTI history, consumption of processed or ground chicken, cooked or raw shellfish, street foods and any organic fruit; as well as, contact with chickens, dogs and pet treats; and travel to Asia, were associated with an increased risk of UTI caused by antimicrobial resistant E. coli. A decreased risk of antimicrobial resistant UTI was associated with consumption of apples, nectarines, peppers, fresh herbs, peanuts and cooked beef. Drug-resistant UTI linked to foodborne and environmental exposures may be a significant public health concern and understanding the risk factors for intestinal acquisition of existing or newly emerging lineages of drug-resistant ExPEC is important for epidemiology, antimicrobial stewardship and prevention efforts.

URINARY INFECTION AT DEPARTMENT OF UROLOGY OF HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2018 ◽  
pp. 100-108
Author(s):  
Dinh Khanh Le ◽  
Dinh Dam Le ◽  
Khoa Hung Nguyen ◽  
Xuan My Nguyen ◽  
Minh Nhat Vo ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
University Hospital ◽  
E Coli ◽  
Positive Urine ◽  
Tract Infections

Objectives: To investigate clinical characteristics, bacterial characteristics, drug resistance status in patients with urinary tract infections treated at Department of Urology, Hue University Hospital. Materials and Method: The study was conducted in 474 patients with urological disease treated at Department of Urology, Hue Universiry Hospital from July 2017 to April 2018. Urine culture was done in the patients with urine > 25 Leu/ul who have symptoms of urinary tract disease or infection symptoms. Patients with positive urine cultures were analyzed for clinical and bacterial characteristics. Results: 187/474 (39.5%) patients had symptoms associated with urinary tract infections. 85/474 (17.9%) patients were diagnosed with urinary tract infection. The positive urine culture rate was 45.5%. Symptoms of UTI were varied, and no prominent symptoms. E. coli accounts for the highest proportion (46.67%), followed by, Staphycoccus aureus (10.67%), Pseudomonas aeruginsa (8,0%), Streptococcus faecali and Proteus (2.67%). ESBL - producing E. coli was 69.23%, ESBL producing Enterobacter spp was 33.33%. Gram-negative bacteria are susceptible to meropenem, imipenem, amikacin while gram positive are vancomycin-sensitive. Conclusions: Clinical manifestations of urinary tract infections varied and its typical symptoms are unclear. E.coli is a common bacterium (46.67%). Isolated bacteria have a high rate of resistance to some common antibiotics especially the third generation cephalosporins and quinolones. Most bacteria are resistant to multiple antibiotics at the same time. Gram (+) bacteria are susceptible to vancomycin, and gram (-) bacteria are susceptible to cefoxitin, amikacin, and carbapenem. Key words: urinary tract infection

scholarly journals Urinary Excretion and Bactericidal Activities of Gemifloxacin and Ofloxacin after a Single Oral Dose in Healthy Volunteers

2001 ◽  
Vol 45 (12) ◽  
pp. 3524-3530 ◽  
Author(s):  
Christoph K. Naber ◽  
Michaela Hammer ◽  
Martina Kinzig-Schippers ◽  
Christian Sauber ◽  
Fritz Sörgel ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Urinary Tract ◽  
Urinary Excretion ◽  
Enterococcus Faecalis ◽  
Urinary Tract Infections ◽  
Parent Drug ◽  
Oral Dosage ◽  
Tract Infections ◽  
Cumulative Excretion

ABSTRACT In a randomized crossover study, 16 volunteers (8 men, 8 women) received single oral doses of 320 mg of gemifloxacin and 400 mg of ofloxacin on two separate occasions in the fasting state to assess the urinary excretion and urinary bactericidal titers (UBTs) at intervals for up to 144 h. Ofloxacin showed higher concentrations in urine compared with those of gemifloxacin. The median (range) cumulative excretion of gemifloxacin was 29.7% (8.4 to 48.7%) of the parent drug administered, and median (range) cumulative excretion of ofloxacin was 84.3% (46.5 to 95.2%) of the parent drug administered. The UBTs, i.e., the highest twofold dilutions (with antibiotic-free urine as the diluent) of urine that were still bactericidal, were determined for a reference strain and nine uropathogens for which the MICs of gemifloxacin and ofloxacin were as follows:Escherichia coli ATCC 25922, 0.016 and 0.06 μg/ml, respectively; Klebsiella pneumoniae, 0.03 and 0.06 μg/ml, respectively; Proteus mirabilis, 0.125 and 0.125 μg/ml, respectively; Escherichia coli, 0.06 and 0.5 μg/ml, respectively; Pseudomonas aeruginosa, 1 and 4 μg/ml, respectively; Staphylococcus aureus, 0.008 and 0.25 μg/ml, respectively; Enterococcus faecalis, 0.06 and 2 μg/ml, respectively;Staphylococcus aureus, 0.25 and 4 μg/ml, respectively;Enterococcus faecalis, 0.5 and 32 μg/ml, respectively; and Staphylococcus aureus, 2 and 32 μg/ml, respectively. Generally, the UBTs for gram-positive uropathogens were higher for gemifloxacin than for ofloxacin and the UBTs for gram-negative uropathogens were higher for ofloxacin than for gemifloxacin. According to the UBTs, ofloxacin-resistant uropathogens (MICs, ≥4 mg/liter) should also be considered gemifloxacin resistant. Although clinical trials have shown that gemifloxacin is effective for the treatment of uncomplicated urinary tract infections, whether an oral dosage of 320 mg of gemifloxacin once daily is also adequate for the treatment of complicated urinary tract infections has yet to be confirmed.

scholarly journals 1675. Epidemiology of Urinary Tract Infections in the United States, 2009 - 2018

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S823-S823
Author(s):  
Kendra Foster ◽  
Linnea A Polgreen ◽  
Brett Faine ◽  
Philip M Polgreen
Keyword(s):  
United States ◽  
Urinary Tract ◽  
Klebsiella Pneumoniae ◽  
Urinary Tract Infections ◽  
Proteus Mirabilis ◽  
Antibiotic Use ◽  
The United States ◽  
Drug Resistant ◽  
E Coli ◽  
Tract Infections

Abstract Background Urinary tract infections (UTIs) are one of the most common bacterial infections. There is a lack of large epidemiologic studies evaluating the etiologies of UTIs in the United States. This study aimed to determine the prevalence of different UTI-causing organisms and their antimicrobial susceptibility profiles among patients being treated in a hospital setting. Methods We used the Premier Healthcare Database. Patients with a primary diagnosis code of cystitis, pyelonephritis, or urinary tract infection and had a urine culture from 2009- 2018 were included in the study. Both inpatients and patients who were only treated in the emergency department (ED) were included. We calculated descriptive statistics for uropathogens and their susceptibilities. Multi-drug-resistant pathogens are defined as pathogens resistant to 3 or more antibiotics. Resistance patterns are also described for specific drug classes, like resistance to fluoroquinolones. We also evaluated antibiotic use in this patient population and how antibiotic use varied during the hospitalization. Results There were 640,285 individuals who met the inclusion criteria. Females make up 82% of the study population and 45% were age 65 or older. The most common uropathogen was Escherichia Coli (64.9%) followed by Klebsiella pneumoniae (8.3%), and Proteus mirabilis (5.7%). 22.2% of patients were infected with a multi-drug-resistant pathogen. We found that E. Coli was multi-drug resistant 23.8% of the time; Klebsiella pneumoniae was multi-drug resistant 7.4%; and Proteus mirabilis was multi-drug resistant 2.8%. The most common antibiotics prescribed were ceftriaxone, levofloxacin, and ciprofloxacin. Among patients that were prescribed ceftriaxone, 31.7% of them switched to a different antibiotic during their hospitalization. Patients that were prescribed levofloxacin and ciprofloxacin switched to a different antibiotic 42.8% and 41.5% of the time, respectively. Conclusion E. Coli showed significant multidrug resistance in this population of UTI patients that were hospitalized or treated within the ED, and antibiotic switching is common. Disclosures All Authors: No reported disclosures

scholarly journals Iron Acquisition of Urinary Tract Infection Escherichia coli Involves Pathogenicity in Caenorhabditis elegans

2021 ◽  
Vol 9 (2) ◽  
pp. 310
Author(s):  
Masayuki Hashimoto ◽  
Yi-Fen Ma ◽  
Sin-Tian Wang ◽  
Chang-Shi Chen ◽  
Ching-Hao Teng
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Caenorhabditis Elegans ◽  
Large Scale ◽  
Iron Acquisition ◽  
Infection Model ◽  
High Throughput Analysis ◽  
E Coli ◽  
C Elegans ◽  
Tract Infections

Uropathogenic Escherichia coli (UPEC) is a major bacterial pathogen that causes urinary tract infections (UTIs). The mouse is an available UTI model for studying the pathogenicity; however, Caenorhabditis elegans represents as an alternative surrogate host with the capacity for high-throughput analysis. Then, we established a simple assay for a UPEC infection model with C. elegans for large-scale screening. A total of 133 clinically isolated E. coli strains, which included UTI-associated and fecal isolates, were applied to demonstrate the simple pathogenicity assay. From the screening, several virulence factors (VFs) involved with iron acquisition (chuA, fyuA, and irp2) were significantly associated with high pathogenicity. We then evaluated whether the VFs in UPEC were involved in the pathogenicity. Mutants of E. coli UTI89 with defective iron acquisition systems were applied to a solid killing assay with C. elegans. As a result, the survival rate of C. elegans fed with the mutants significantly increased compared to when fed with the parent strain. The results demonstrated, the simple assay with C. elegans was useful as a UPEC infectious model. To our knowledge, this is the first report of the involvement of iron acquisition in the pathogenicity of UPEC in a C. elegans model.

Sign in / Sign up

Export Citation Format

Share Document