scholarly journals Significant bacteriuria among requested repeat urine samples and its clinical correlation

Author(s):  
Arjun Bhugra ◽  
Supriya Gachinmath

Background and Objectives: Urinary tract infections (UTI) are the most common bacterial infections in both outpatient and inpatient department received for routine bacterial culture and sensitivity. We looked for significant bacteriuria in re- quested repeat urine sample after primary urine culture yielded significant growth (>105  CFU/ml) of ≥3 types of colonies. Also studied, different isolates grown with their sensitivity pattern and contamination rates of urine samples from different departments. Materials and Methods: In routine, primary urine cultures yielding ≥3 types of colonies on Cystine Lactose Electrolyte Deficient (C.L.E.D) were requested for repeat samples, collected with aseptic precautions after proper instructions. Data was analyzed for the Microbiological profile and its clinical correlation. Results: Among 617 received requested urine samples, 292 (47.3%) yielded significant bacteriuria. Clinical details were available for 252 cases out of which 100 (39.7%) showed asymptomatic bacteriuria, 87 (34.5%) complicated UTI and 65 (25.7%) uncomplicated UTI. Null hypothesis was rejected as 292 (47.3%) of the received repeat samples showed significant bacteriuria and 325 (53%) showed normal flora/no growth i.e. there is a 50% chance of getting either a positive culture or normal flora/no growth in repeat urine samples after the primary urine culture showed ≥3 types of colonies. It indicates the importance of requesting repeat urine samples for an accurate urine culture report. Male patients were significantly associ- ated with significant bacteriuria and complicated UTI (p= 0.001). Escherichia coli (n=112, 28%) was the most common fol- lowed by Klebsiella species (n=66, 16.4%) and Enterococcus species (n=69, 17.2%). 183 (45.6%) isolates were Multi-Drug Resistant (MDR) Gram Negative Bacilli (GNBs), Escherichia coli (50.3%) being most common. Vancomycin Resistant Enterococcus (VRE) (n=8, 2.0%) was also isolated. Conclusion: Our study justifies the rationale for asking a repeat urine samples which helps in providing an appropriate mi- crobiological report with antibiotic sensitivity pattern, hence preventing unwanted reporting of commensals/contaminants facilitating evidence based therapy.

Children ◽  
2021 ◽  
Vol 8 (7) ◽  
pp. 597
Author(s):  
Luca Pierantoni ◽  
Laura Andreozzi ◽  
Simone Ambretti ◽  
Arianna Dondi ◽  
Carlotta Biagi ◽  
...  

Urinary tract infections (UTIs) are among the most common bacterial infections in children, and Escherichia coli is the main pathogen responsible. Several guidelines, including the recently updated Italian guidelines, recommend amoxicillin-clavulanic acid (AMC) as a first-line antibiotic therapy in children with febrile UTIs. Given the current increasing rates of antibiotic resistance worldwide, this study aimed to investigate the three-year trend in the resistance rate of E. coli isolated from pediatric urine cultures (UCs) in a metropolitan area of northern Italy. We conducted a retrospective review of E. coli-positive, non-repetitive UCs collected in children aged from 1 month to 14 years, regardless of a diagnosis of UTI, catheter colonization, urine contamination, or asymptomatic bacteriuria. During the study period, the rate of resistance to AMC significantly increased from 17.6% to 40.2% (p < 0.001). Ciprofloxacin doubled its resistance rate from 9.1% to 16.3% (p = 0.007). The prevalence of multidrug-resistant E. coli rose from 3.9% to 9.2% (p = 0.015). The rate of resistance to other considered antibiotics remained stable, as did the prevalence of extended spectrum beta-lactamases and extensively resistant E. coli among isolates. These findings call into question the use of AMC as a first-line therapy for pediatric UTIs in our population, despite the indications of recent Italian guidelines.


2021 ◽  
Vol 1 (1) ◽  
pp. 46-55
Author(s):  
Massimo Pieri ◽  
Flaminia Tomassetti ◽  
Paola Cerini ◽  
Roberta Felicetti ◽  
Lucia Ceccaroni ◽  
...  

Urinary tract infections (UTI) are the most frequent bacterial infections, and the detection of infection in urine samples is expensive and time-consuming. Also, in laboratories a significant proportion of samples processed yield negative results. For this, screening methods represent an important improvement towards the final UTI diagnosis. SediMAX is an automated microscopy, easier to use in laboratories due to its basic procedure and it is widely used for urine sediment analysis. In our study, we evaluated the performance of SediMAX, applying some screening parameters, compared with the gold standard methods, urine culture, to identify all the positive cases for UTI. We analysed 1185 urine samples from our daily laboratory routine. The basis of our screening model was to establish a cut-off for bacterial count (BACT), as 300 bacteria/µL in order to avoid missing positive cases. However, the sensitivity and the specificity achieved were not enough to identify all UTI infection in urine samples. So, in addition to BACT we have considered other parameters, such as White Blood Cell (WBC), Red Blood Cell (RBC), Yeasts (YEST), Age and Nitrates (NIT). The second screening method reached a sensitivity of 100%, that could be reliably employed in detect of UTIs.


Author(s):  
Samirah . ◽  
Darwati . ◽  
Windarwati . ◽  
Hardjoeno .

The bacterial and sensitivity pattern towards antimicrobials on urinary tract infections (UTI) patients are very important to beknown by clinicians to get a successful treatment. The bacterial and sensitivity pattern towards antimicrobials will be changed in differentplace and time, so that those should be analyzed routinely. To evaluate the bacterial and antimicrobials resistance pattern on urinarytract infections patients. A retrospective study on 220 urinary samples in January until December 2004 at Clinical Microbiology subunit of Dr.Wahidin Sudirohusodo hospital . Of 99 samples of UTI, Prevalence of UTI in woman (54.5%) were higher than man (45.5%).Most of sample (28 samples) were found in 0 to 15 years group. The most bacteries in urine were Escherichia coli (39.4%) and Klebsiella(26.3%). Amikacin was sensitive to all bacteries, while amoxicilin and ampicilin were resistance. Prevalence of UTI in women werehigher than in men. Incidens of UTI was highest in children group. The most bacteries in urine samples were Escherichia coli. Amikacinwas sensitive to all bacteries, while Amoxicilin and Ampicilin were resistance.


2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i1-i8
Author(s):  
H G T Brice ◽  
N Doherty ◽  
C Biss ◽  
T Quigley

Abstract Introduction The diagnosis of urinary tract infections (UTI) becomes increasingly difficult with age. Dipsticks are unreliable and with the prevalence of asymptomatic bacteriuria increasing to 17% in females over 75 even urine culture results can be unreliable. Public Health England (PHE) released new guidelines in November 2018 with criteria for diagnosing UTIs in the over 65s. Methods Identify patients over 65 who are diagnosed with a UTI in Solihull acute medical unit. Collect data on presenting symptoms, dipstick and culture results and antibiotic use. Aim to improve guideline adherence and decrease dipstick use through education of medical and nursing staff via presentations and posters. Results Prior to the educational intervention guideline adherence when diagnosing UTIs in over 65s was 55%. This rose to 82% following the educational intervention. Dipstick usage decreased from 49% to 28% following the intervention. Dipsticks were shown to be unreliable as 21.6% of dipstick positive urine samples sent for culture had a normal (0-80) white cell count in the laboratory, whilst 43.8% of dipstick negative urine samples sent for culture had a raised white cell count in the laboratory. On retrospective analysis 16.1% of patients treated for a UTI appeared to have had an asymptomatic bacteriuria. Co-amoxiclav was initially used for 51% of patients however there was resistance to Co-amoxiclav in 31% of samples where an organism was cultured. Conclusions The educational intervention was able to increase PHE guideline adherence for diagnosing UTIs in the over 65s. There was also a decrease in the use of dipsticks which were shown to be unreliable in this age group. Prescribers remained reliant on broad-spectrum antibiotics with Co-Amoxiclav being most commonly used. This is likely to be ineffective in a significant number of patients given the common resistance seen in urine culture sensitivities.


2021 ◽  
Vol 9 (01) ◽  
pp. 38-42
Author(s):  
Shristi Raut ◽  
Sulochana Khatiwada ◽  
Narayan GC

INTRODUCTION Urinary tract of female undergoes tremendous changes during pregnancy which increases their risk of acquiring infection. Asymptomatic bacteriuria is a common entity among pregnant women which refers to significant bacteriuria (>105 bacteria per ml of urine) without any typical symptoms of urinary tract infection. Asymptomatic bacteriuria can lead to various maternal and fetal complications if not detected and treated on time. MATERIAL AND METHODS Total 280 urine samples were collected in sterile universal containers from pregnant women not showing typical symptoms of urinary tract infection at the time of sample collection. Urine samples were inoculated in both MacConkey agar and Blood agar by semi quantitative culture method. Culture plates were reported after 24 hours of incubation at 370C. Bacteria isolated were subjected to antibacterial susceptibility testing by modified Kirby-Bauer disc diffusion method. RESULTS Out of 280 urine cultures, 213 samples were sterile. Significant bacteriuria was seen in 25 cases (8.9%) followed by insignificant bacteriuria (20, 7.14%) and contamination (17, 6.10%). Highest number of cultures positive were in age group 21-30 years (19, 9.1%,). Out of 25 cases of significant bacteriuria, 60% were primigravida and 40% were multigravida. The most common organism isolated was Escherichia coli (10, 60%) followed by Klebsiella pneumoniae (5, 40%). CONCLUSION Screening of all pregnant women for asymptomatic bacteriuria is essential during their antenatal checkup. Escherichia coli is the commonest organism that cause asymptomatic bacteriuria. Appropriate antibiotic therapy is absolutely necessary for positive cases on the basis of antimicrobial susceptibility result to prevent unwanted obstetric complications.


Author(s):  
Bitopan Das ◽  
Mrinmoy Sarma ◽  
Rohit Kumar ◽  
Palashi Borah ◽  
Sushama Sinha ◽  
...  

Background: Escherichia coli is one of the most frequent causes of many bacterial infections, including Urinary Tract Infections (UTI), blood stream infections, otitis media, pneumonia, meningitis, traveler’s diarrhoea, enteric infections and systemic infections. This study was done with the aim to surveying antibiotic sensitivity pattern of isolated Escherichia coli in both sex attended in NIMS Hospital, Jaipur under the taken time period.Methods: In this cross-sectional study, 62 Escherichia coli were isolated from various clinical specimens of the patients attending both OPD and IPD. The strains were selected using the laboratory standard methods and culture-specific. The antibiotic susceptibility testing was performed using Kirby-Bauer disk diffusion method.Results: Out of total 62 isolates of Escherichia coli 26(41.93%) isolates were from male while 36(58.064%) from female patients. Maximum sensitivity were shown by Polymyxin B and Colistin i.c 100% followed by Nitrofuratonin 82.5% followed by Meropenem 79.03%, Aztreonam 72.58%, Piperacillin/ Tazobactam and Ciprofloxacin 61.30%, each Amikacin 56.45%, Imipenem 54.83%, Ofloxacin 45.16%, Cefepime 43.54%, Ceftazidime 38.71%, Gentamycin and Ceftriaxone 37.09% each, Cefotaxime 30.64%, Norfloxacin 27.5%. Maximum resistance shown against Norfloxacin 72.5%, followed by Gentamycin and Ceftriaxone 62.90%, Ceftazidime 61.30%.Conclusions: Escherichia coli infected more in urinary tract infection as compare to other sample in human, and it is common in female than male. Regular monitoring of antimicrobial susceptibility for E.coli is recommended to improve treatment. A changing trend in antibiotic sensitivity profile of the isolates need to be monitored as there is limited availability of newer drugs and the emergence of resistant bacteria far exceeds the rate of new drug development.


2013 ◽  
Vol 5 (2) ◽  
pp. 23-26
Author(s):  
Sanya Tahmina Jhora ◽  
Shikha Paul ◽  
Bilkis Ara Begum ◽  
Abul Quashem Chowdhury

Urinary tract infections (UTIs) are one of the most common infectious diseases & an important cause of morbidity in general population. More than 90% of all uncomplicated UTI s are caused by Esch. coli infection. The study was carried out in Department of Microbiology of Sir Salimullah Medical College & Mitford Hospital (SSMC& MH) Dhaka from October 2002 to September 2003. A total of 749 urine samples were studied of which 414 (55.27) showed significant growth. Among the 414 isolates, E sch. coli was the most predominant (82.61%) organism. Esch. coli was highly sensitive to Imipenem (95.02%) followed by Ceftriaxone (86.84%), Cefuroxime (67.54%), Gentamicin (66.08%), and Ceftazidime (55.84%) respectively. Low sensitivity patterns were shown against Nitrofurantoin (44.73%) & Ciprofloxacin (40.64%). The sensitivity to other antibiotics varied from 23.39% to as low as 2.63%. The aim of the present study was to observe the antibiotic sensitivity pattern of isolated Esch. coli from urine samples of patients admitted in inpatient department or visited the out patient department of Sir Salimullah Medical College & Mitford Hospital (SSMC& MH) Dhaka.DOI: http://dx.doi.org/10.3329/bjmm.v5i2.16934 Bangladesh J Med Microbiol 2011; 05 (02): 23-26


2013 ◽  
Vol 5 (2) ◽  
pp. 103-105
Author(s):  
Most. Fahmida Begum ◽  
Abu Syed Md. Mosaddek ◽  
Kawser Perveen ◽  
Rezina Karim ◽  
Nurun Nahar Begum

Background: Urinary tract infections are among the most common bacterial infections caused by pathogens with a decreasing susceptibility to several classes of antimicrobials.Objective: The purpose of the present study was to see the trend of sensitivity pattern of Escherichia coli (E. coli) isolated from the urinary tract patients.Methodology: This retrospective study was conducted at Uttara Adhunik Medical College Hospital, Dhaka from 2008 to 2012 for a period of 5(five) years. All patients were within ages 1 month to 80 years, comprising of both male and female, either out or in patients were included as study population. Urine sample was collected and Escherichia coli was isolated and identified as well as the antimicrobial susceptibility patterns was determined.Results: A total number of 16,666 urine samples were collected. No significant changes of susceptibility pattern of Escherichia coli was found to ciprofloxacin, cephradine, ceftriaxone, levofloxacin,  nalidixic  acid,  imipenem  and  meropenem;  however,  significant  change  was  detected  to amoxicillin, amoxiclav, cefixime, trimethoprim-sulfamethoxazole, amikacin, ceftazidime and mecillinam between 2008 and 2012.Conclusion: Trend of sensitivity pattern of Escherichia coli is changing to few important antibiotics.DOI: http://dx.doi.org/10.3329/jssmc.v5i2.20766J Shaheed Suhrawardy Med Coll, 2013;5(2):103-105


2016 ◽  
Vol 65 (4) ◽  
pp. 50-56
Author(s):  
Tatyana A. Khusnutdinova ◽  
Elena V Shipitsina ◽  
Yulia A. Savochkina ◽  
Olga Yu. Timoshina ◽  
Elena V. Rybina ◽  
...  

Introduction. Urinary tract infections are the most common infections in obstetrics and gynecology. Bacteriological method to investigate urine is laborious and time-consuming, therefore development of accurate and rapid methods for the detection of significant bacteriuria is important. Objective. Evaluation of quantitative real-time PCR based approach for the detection of significant bacteriuria in pregnant women. Material and methods. A retrospective investigation of mid-stream urine samples obtained from pregnant women was performed. Urine culture was performed using quantitative method, and a case was considered as significant bacteriuria if ≥ 105 CFU/ml were detected. Urine samples were analyzed for main uropathogens / groups of uropathogens using quantitative multiplex real-time PCR. Diagnostic characteristics of PCR were computed relative to the results of urine culture. Results. In total, 896 urine samples were tested. Of them, significant bacteriuria was found in 28 cases (3%). The frequency of detection of Escherichia coli was 50%, Enterococcus spp. — 25%, Klebsiella spp. — 7%, Proteus spp. and S. saprophyticus 4% each, Streptococcus spp. — 14%. Sensitivity and specificity of the detection of significant bacteriuria using quantitative real-time PCR for the majority of bacterial species / groups were 99% to 100%. Sensitivity and specificity of the quantitative real-time PCR based method were 96% and 98%, respectively. Conclusions. Prevalence of significant bacteriuria among pregnant women is 3%. Half of the uropathogens isolated from pregnant women with bacteriuria are E. coli. Sensitivity and specificity of quantitative PCR for the detection of significant bacteriuria are 96% and 98%, respectively.


2021 ◽  
Vol 25 (1) ◽  
pp. 43-46
Author(s):  
Taofeeq Garuba ◽  
Nency Katrodiya ◽  
Nikita Patel ◽  
Swetal Patel ◽  
Dhanji. P. Rajani ◽  
...  

Urinary tract infections (UTI) are one of the most common form of bacterial infections but the treatment becomes cumbersome as the etiological bacteria are developing resistance against antibiotics. This present study evaluated the efficacy of antimicrobial   activity of Urena lobata against uropathogens. Six urine samples from UTI patients were collected from Pathological Laboratory, G.B. Vaghani Multispecialty Hospital, Surat. Bacteria were isolated from these samples using Nutrient agar, Mac Conkey agar plate, Blood agar, Mannitol salt agar, Eosin Methylene Blue agar and King’s agar. The bacterial isolates were identified using cultural  characteristics, microscopic features and biochemical characteristics. Leaf extract of Urena lobata was prepared using Soxhlet Extraction Method whereby methanol and distilled water were the extractants used. Herbal extract disc was prepared at  concentrations of 50,75, and100 mg/ml and tested against all the isolates. DMSO and antibiotics (Nitrofurantion, Amikacin, Levofloxacin, Norofloxacin, Ofloxacin and Cephalosporins) were used as negative and positive controls respectively.Staphylococcus aureus, Escherichia coli, Bacillus cereus, Streptococcus pneumoniae, Klebsiella spp. and Brevibacillus panacihumi were isolated from the urine samples. All concentrations of aqueous and methanolic extracts of U. lobata leaf displayed highest zone of inhibition against B. cereus. No inhibitory effect was observed against the growth of Klebsiella except at the highest concentrations. Further study is encouraged on the in-vivo study of efficacy of U. lobata on etiological agent of UTI.


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