scholarly journals SENSITIVITY AND RESISTANCE TO ANTIMICROBIAL AGENTS ESBL-PRODUCING AND NOT PRODUCING ESBL STRAINS OF E. COLI IN PATIENTS WITH URINARY TRACT INFECTION

2019 ◽  
Vol 64 (2) ◽  
pp. 104-110
Author(s):  
N. I. Dimitrova ◽  
T. D. Gasretova ◽  
E. L. Alutina ◽  
G. G. Kharseeva
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Agents ◽  
Beta Lactamase ◽  
Test Results ◽  
Beta Lactams ◽  
Esbl Production ◽  
E Coli ◽  
Amoxicillin Clavulanate ◽  
Resistant Strains ◽  
Tract Infections

As a result of the conducted researches it is shown that 44.1% of urinary tract infections (UTIS) caused by E. coli are accounted for by producers of beta-lactamase of the extended spectrum of action (ESBL). Associated resistance to fluoroquinolones and co-trimoxazole was found in 93.3% of BLRS-producing E. coli strains. All studied strains regardless of ESBL production were sensitive to imipenem, the majority showed sensitivity to ertapenem, gentamicin and resistance to doxycycline. Not producing ESBL strains of E. coli were sensitive to fosfomycin. Comparison of data obtained during testing of isolated cultures on ESBL, study of their sensitivity and resistance to beta-lactams (amoxicillin/clavulanate, ceftazidime, ceftriaxone, cefotaxime, imipenem) indicates the need to test isolates for AmpC products. To this end, during the screening test for ESBL and the method of «double disks», along with cephalosporins of III generation, it is necessary to use a phenotypic test for sensitivity to cefepime. The use of test results of E. coli isolates isolated from patients with UTIS for the production of ESBL, ampC enzymes, carbapenemase and sensitivity to AMP will improve the effectiveness of antimicrobial therapy and will help to curb the formation and spread of antimicrobial-resistant strains.

scholarly journals Gender and Age-Dependent Etiology of Community-Acquired Urinary Tract Infections

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Enrico Magliano ◽  
Vittorio Grazioli ◽  
Loredana Deflorio ◽  
Antonia Isabella Leuci ◽  
Roberto Mattina ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antimicrobial Agents ◽  
Age And Gender ◽  
E Coli ◽  
Gender And Age ◽  
Amoxicillin Clavulanate ◽  
And Gender ◽  
Tract Infections

Urinary tract infections (UTIs) are among the most frequent community-acquired infections worldwide.Escherichia coliis the most common UTI pathogen although underlying host factors such as patients’ age and gender may influence prevalence of causative agents. In this study, 61 273 consecutive urine samples received over a 22-month period from outpatients clinics of an urban area of north Italy underwent microbiological culture with subsequent bacterial identification and antimicrobial susceptibility testing of positive samples. A total of 13 820 uropathogens were isolated and their prevalence analyzed according to patient’s gender and age group. OverallEscherichia coliaccounted for 67.6% of all isolates, followed byKlebsiella pneumoniae(8.8%),Enterococcus faecalis(6.3%),Proteus mirabilis(5.2%), andPseudomonas aeruginosa(2.5%). Data stratification according to both age and gender showedE. coliisolation rates to be lower in both males aged ≥60 years (52.2%),E. faecalisandP. aeruginosabeing more prevalent in this group (11.6% and 7.8%, resp.), as well as in those aged ≤14 years (51.3%) in whomP. mirabilisprevalence was found to be as high as 21.2%.Streptococcus agalactiaeoverall prevalence was found to be 2.3% although it was shown to occur most frequently in women aged between 15 and 59 years (4.1%). Susceptibility ofE. colito oral antimicrobial agents was demonstrated to be as follows: fosfomycin (72.9%), trimethoprim/sulfamethoxazole (72.9%), ciprofloxacin (76.8%), ampicillin (48.0%), and amoxicillin/clavulanate (77.5%). In conclusion, both patients’ age and gender are significant factors in determining UTIs etiology; they can increase accuracy in defining the causative uropathogen as well as providing useful guidance to empiric treatment.

scholarly journals Antibiotic resistance of pathogens causing uncomplicated urinary tract infections in Russian Federation

2018 ◽  
Vol 6 (3) ◽  
pp. 50-56 ◽  
Author(s):  
V. V. Rafalsky
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Empirical Therapy ◽  
Test Results ◽  
Local Data ◽  
Antibacterial Drugs ◽  
E Coli ◽  
Resistant Strains ◽  
Tract Infections ◽  
Summary Data

Introduction.The choice of antibiotic for the treatment of uncomplicated urinary tract infections (UTI) is mainly carried out empirically. At the same time, it should correspond to local data on the sensitivity of uropathogens to antibacterial drugs. If the level of uropathogen resistance in the region is more than 10-20% to any antibiotic, its use should be limited to empirical therapy.Purpose of research.Identify the structure of pathogens of uncomplicated UTIs and determine the dynamics of their sensitivity to the most commonly used antibacterial drugs.Materials and methods.This article presents a summary data of Russian multicenter epidemiological on the etiology of uncomplicated UTIs and the resistance of pathogens to antibiotics. The study are included female outpatients meeting the following criteria: 1) non-pregnant women over 18; 2) the presence of lower UTIs (acute or exacerbation of chronic cystitis); 3) uropathogen isolation > 103 CFU/ml with a positive test results for the presence of leukocytes in the urine and >105 CFU/ml for any test results for the presence of leukocytes in the urine.Results.The most frequent uropathogen causing uncomplicated UTI is E. coli, which is excreted in 72.4% - 90.6% of patients. Cephalosporins of the third generation (cefixime), Nitrofurantoin, Fosfomycin have a high microbiological activity against E. coli, the frequency of resistant strains to them is 0%, 0-1.9% and 0%, respectively. The persistently high resistance of E. coli strains is determined to Ampicillin (33.1% - 41.5%) and Co-trimoxazole (19.3% - 26.2%). For non-fluorinated and fluorinated quinolones, there is a tendency to increase the proportion of resistant strains during the study period.Conclusions.High generation Cephalosporins (cefixime), Nitrofurantoin, Fosfomycin have high activity against uropathogens сausing uncomplicated UTI. Ampicillin and Co-trimoxazole cannot be considered the drugs of choice for the treatment of uncomplicated UTI according to currently established criteria.

scholarly journals Oral beta-lactam step down in bacteremic E. coli urinary tract infections

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Stephan Saad ◽  
Neil Mina ◽  
Colin Lee ◽  
Kevin Afra
Keyword(s):  
Urinary Tract ◽  
Propensity Score ◽  
Urinary Tract Infections ◽  
Clinical Cure ◽  
Beta Lactam ◽  
Beta Lactams ◽  
E Coli ◽  
Secondary Outcomes ◽  
Step Down ◽  
Tract Infections

Abstract Background Literature is scarce regarding oral step down to beta-lactams in bacteremic urinary tract infections. Oral fluoroquinolones are an accepted and common step down for bacteremic urinary tract infections; however, their use is associated with mounting safety concerns. We compared clinical cure in patients with E. coli bacteremic urinary tract infections who were stepped down to oral beta-lactams compared to oral fluoroquinolones. Methods This multicentre retrospective cohort study included patients with first positive concurrent urine and blood cultures from January 2016 to December 2016. Patients were included if they received empiric intravenous beta-lactam therapy with step down to either oral beta-lactam or fluoroquinolone for treatment completion. The primary outcome was clinical cure. Secondary outcomes were length of hospitalization, all-cause mortality and C. difficile infection. Multivariate analysis and propensity score were used to control for confounding. Results A total of 207 patients were identified with bacteremic E.coli urinary tract infections. Clinical cure was achieved in 72/77 (94%) in the oral beta-lactam group versus 127/130 (98%) in the oral fluoroquinolone group (absolute difference − 4.2, 95% confidence interval [CI] -10.3 to 1.9%, p = 0.13). The adjusted odds ratio (OR) for clinical cure with oral beta-lactams was 0.31 (95% CI 0.05–1.90, p = 0.21); propensity score adjusted analysis showed a similar result. There was no statistically significant difference in secondary outcomes. Conclusions Oral beta-lactams appear to be a safe and effective step down option in bacteremic E. coli urinary tract infections compared to oral fluoroquinolones.

scholarly journals Outbreak of extended spectrum beta-lactamase producing E. coli in a nursing home in Ireland, May 2006

2006 ◽  
Vol 11 (35) ◽  
Author(s):  
H Pelly ◽  
D Morris ◽  
E O’Connell ◽  
B Hanahoe ◽  
C Chambers ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Nursing Home ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Tract Infections

In May 2006, a consultant microbiologist noted two isolates of extended spectrum beta-lactamase (ESBL)-producing Escherichia coli associated with urinary tract infections in a single week in two residents in a nursing home in Ireland

scholarly journals OXA-48 Carbapenemase-Encoding Transferable Plasmids of Klebsiella pneumoniae Recovered from Egyptian Patients Suffering from Complicated Urinary Tract Infections

Biology ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 889
Author(s):  
Ann A. Elshamy ◽  
Sarra E. Saleh ◽  
Mohammad Y. Alshahrani ◽  
Khaled M. Aboshanab ◽  
Mohammad M. Aboulwafa ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antimicrobial Agents ◽  
Bacterial Species ◽  
Tertiary Care ◽  
Carbapenem Resistance ◽  
Clinical Isolates ◽  
Gram Negative ◽  
E Coli ◽  
Tract Infections

Gram-negative bacteria are common causes of urinary tract infections (UTIs). Such pathogens can acquire genes encoding multiple mechanisms of antimicrobial resistance, including carbapenem resistance. The aim of this study was to detect the carbapenemase-producing ability of some Gram-negative bacterial isolates from urine specimens of patients suffering from complicated UTIs at two vital tertiary care hospitals in Cairo, Egypt; to determine the prevalence of carbapenemase genes among plasmid-bearing isolates; and explore the possibility of horizontal gene transfer to other bacterial species. The collected isolates were subjected to antimicrobial susceptibility testing, phenotypic analysis of carbapenemase production, and molecular detection of plasmid-borne carbapenemase genes, then the extracted plasmids were transformed into competent E. coli DH5α. A total of 256 Gram-negative bacterial clinical isolates were collected, 65 (25.4%) isolates showed carbapenem resistance of which 36 (55.4%) were carbapenemase-producers, and of these 31 (47.7%) harbored plasmids. The extracted plasmids were used as templates for PCR amplification of blaKPC, blaNDM, blaVIM, blaOXA-48, and blaIMP carbapenemase genes. The blaOXA-48 gene was detected in 24 (77.4%) of the tested isolates while blaVIM gene was detected in 8 (25.8%), both blaKPC and blaNDM genes were co-present in 1 (3.2%) isolate. Plasmids carrying the blaOXA-48 gene from 4 K. pneumoniae clinical isolates were successfully transformed into competent E. coli DH5α. The transformants were carbapenemase-producers and acquired resistance to some of the tested antimicrobial agents as compared to untransformed E. coli DH5α. The study concluded that the rate of carbapenem resistance among Gram-negative bacterial uropathogens in Cairo, Egypt is relatively high and can be transferred horizontally to other bacterial host(s).

scholarly journals Characterization of auto-agglutinating and non-typeable uropathogenic Escherichia coli strains

2019 ◽  
Vol 13 (06) ◽  
pp. 465-472
Author(s):  
Ulises Hernández-Chiñas ◽  
Alejandro Pérez-Ramos ◽  
Laura Belmont-Monroy ◽  
María E Chávez-Berrocal ◽  
Edgar González-Villalobos ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Virulence Genes ◽  
Antimicrobial Agents ◽  
Multidrug Resistant ◽  
Uropathogenic Escherichia Coli ◽  
E Coli ◽  
Resistant Strains ◽  
Tract Infections ◽  
Disk Method

Introduction: Uropathogenic Escherichia coli (UPEC) are the main etiological agent of urinary tract infections (UTIs). Association between different serotypes and UTIs is known, however, some strains are incapable to be serotyped. The aim of this work was to study bthe phenotypical and genotypical characteristics of 113 non-typeable (NT) and auto-agglutinating (AA) E. coli strains, isolated from UTIs in children and adults. Methodology: The 113 UPEC strains were analyzed by PCR assays using specific primers to determine their serogroups, fimH, papC, iutA, sat, hlyCA and cnf1, virulence associated genes, and chuA, yjaA and TSPE4.C2 for phylogroup determination. Additionally, the diffusion disk method was performed to evaluate the antimicrobial resistance to 18 antimicrobial agents. Results: Using the PCR assay, 63% (71) of the strains were genotyped showing O25 and O75 as the most common serogroups. The virulence genes fimH (86%) and iutA (74%) were the most prevalent, in relation to the phylogroups the commensal (A and B1) and virulent (B2 and D) showed similar frequencies (P > 0.05). The antimicrobial susceptibility test showed a high percentage (73%) of multidrug-resistant strains. Conclusions: The genotyping allowed identifying the serogroup in many of the strains that could not be typed by traditional serology. The strains carried virulence genes and were multidrug-resistant in both, commensal and virulent phylogroups. Our findings revealed that, in addition to the classical UPEC serogroups, there are pathogenic serogroups not reported yet.

scholarly journals 477. Characterization of Extended-Spectrum Β-Lactamase (ESBL) Producing Gram-negative (GN) Urinary Tract Infections (UTI) in Pediatric Patients

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S233-S233
Author(s):  
Leslie Stach ◽  
Regina Orbach ◽  
Kanokporn Mongkolrattanothai
Keyword(s):  
Urinary Tract ◽  
Pediatric Patients ◽  
Selective Pressure ◽  
Once Daily ◽  
E Coli ◽  
Colony Forming Units ◽  
Amoxicillin Clavulanate ◽  
Tract Infections ◽  
Abnormal Urinary Tract

Abstract Background There has been an increase in antimicrobial resistance among GN pathogens, not only in adults, but also pediatrics. UTIs are common in pediatrics; however, reports of pediatric UTI with ESBL producing GN are limited. Methods All urine cultures positive for ESBL producing GN from 5/1/18 to December 31/18 were retrospectively reviewed. Proven infection (PI) defined as ≥50,000 colony-forming units (CFU)/mL of bacteria plus pyuria or positive leukocyte esterase for catheterized or clean catch specimens. Relapsed infection defined as same pathogen cultured within 30 days of infection. Abnormal urinary tract systems or functions (AUTS) include neurogenic bladder, structural anomalies, or intermittent catheterization. Results A total of 107 urine cultures for ESBL producing GN, from 85 patients, were included. Majority of specimens [78/107 (73%)] were obtained from the ED or outpatient clinics. 43% of specimens were from patients with AUTS. E. coli was the majority (95%) of ESBL isolates. 57% of ESBL producing GNs were susceptible to amoxicillin/clavulanate (AC) or trimethoprim/sulfamethoxazole (TMP/SMX). 88% were nitrofurantoin susceptible. Only 1 isolate was meropenem resistant. Antibiotics (ABX) were prescribed for UTI in 67/107 episodes. However, only 52 episodes were PI. Of these, 38 were empirically treated with oral ABX and 29 with intravenous ABX. The most commonly prescribed empiric ABX was oral cephalexin (25/67, 37%.) Ineffective empiric ABX for UTI was very common, 83% (43/52). Of these, 5/43 never received effective therapy and none had relapse. Most common duration of ABX was 10 days (range 5–17 days.) 43% (23/52) of PI were treated with oral AC or TMP/SMX. 15% (8/52) of PI were treated with nitrofurantoin. 12% of PI were treated with a once-daily aminoglycoside. Only 6% of PI were treated with a carbapenem. Conclusion Many ESBL UTI isolates remain susceptible to oral ABX. Although small numbers, patients treated with ineffective ABX did not return with relapsed infection. Non-carbapenem ABX are a reasonable option to minimize selective pressure or unnecessary use. Empiric narrow-spectrum antibiotic therapy may still be appropriate. Disclosures All authors: No reported disclosures.

scholarly journals Community Urinary Tract Infection due to ESBL producing E. coli: epidemiology and susceptibility to oral antimicrobials including Mecillinam

2014 ◽  
Vol 3 (1) ◽  
pp. 5-7 ◽  
Author(s):  
P Datta ◽  
V Gupta ◽  
S Sidhu ◽  
J Chander
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Agents ◽  
Clinical Laboratory ◽  
Renal Calculi ◽  
Diffusion Method ◽  
E Coli ◽  
Factors Associated ◽  
Epidemiological Factors ◽  
Recurrent Uti ◽  
Tract Infections

Background: There is increasing incidence of (Extended spectrumbeta lactamases) ESBL producing E. coli causing community urinary tract infections (UTI). The primary objective of this study was to study the epidemiological factors associated with ESBL positive community acquired uropathogenic E. coli isolates and to determine their susceptibility to newer oral drugs including mecillinam. Methods: In this prospective study, from total of 140 community isolates of E. coli causing UTI, ESBL was detected by Clinical Laboratory Standards Institute criteria. Drug susceptibility was done by Kirby-Bauer method disc diffusion method for various oral antimicrobial agents. Various epidemiological factors associated with ESBL for each patient were recorded on individual forms. This included age, presence of diabetes mellitus, renal calculi, pregnancy, history of urinary instrumentation, recurrent UTI and antibiotics intake. Results: Out of total of 140 strains of E. coli, which were screened for ESBL production, 30 (21.4%) isolates were positive. High-level resistance 94 (70%) was seen for many antimicrobial agents. Only4.5% of uropathogenic E. coli were resistant to Mecillinam. Various epidemiological factors associated with ESBL causing infections were female patients, H/o antimicrobial intake, elderly age > 60 years, renal calculi and H/o recurrent UTI. Conclusions: The epidemiology of ESBL positive uropathogenic E. coli is becoming more multifaceted. Nepal Journal of Medical Sciences | Volume 03 | Number 01 | January-June 2014 | Page 5-7 DOI: http://dx.doi.org/10.3126/njms.v3i1.10341

Determination of ESBL Production & Antibiotic Resistance Profile of Escherichia Coli Isolated from Patients with Urinary Tract Infections: A Study from Tertiary Care Hospital

2020 ◽  
Vol 7 (1) ◽  
pp. 23-29
Author(s):  
Gunjal P. N. ◽  
Gunjal S. P.
Keyword(s):  
Urinary Tract ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Multidrug Resistant ◽  
Care Hospital ◽  
Esbl Production ◽  
Sensitivity Testing ◽  
E Coli ◽  
Tract Infections

Urinary tract infection (UTI), is defined as a disease caused by invasion of urinary tract by microorganisms. Majority of UTI cases are due to bacterial infection constitute about 95% of total UTI cases. About 80% of UTI cases are caused by E.coli producing extended spectrum ?-lactamase (ESBL) producing isolates. In recent years limitations in treating infections caused by multidrug resistant organisms has increased. This study aims to determine ESBL production of E. coli cases from a tertiary care hospital. Methodology: A total 358 midstream urine samples were collected by random sampling method during March 2015 to June 2018. Identification, antibiotic sensitivity testing, performed according to standard protocol following Clinical and Laboratory Standard Institute (CLSI) guidelines, 2013. Screening for ESBL producing E.coli isolates performed using ceftazidime further confirmation done by phenotypic disc diffusion test using combined disc method using ceftazidime (30µg) & ceftazidime/ clavulanic acid (30/10 µg) as per CLSI guidelines. Results: Total 358 specimens processed for urine culture. Gram negative bacilli isolated from 123(34.35 %), out of which 68 (55.28%) were E.coli, 19 (15.44%) K. pneumoniae, 15 (12.19%), Pseudomonas spp. 08 (6.50%), Citrobacter spp and Acinetobacter spp, 03 (2.43%), Proteus mirabilis, 01 (0.81%) Proteus vulgaris and Enterobacter respectively. Out of 68 isolates of E.coli, 65 (95.58%) were MDR, ESBL was detected in 31 (47.69%) out of these 65 isolates. Out of these 31 cases 19 (61.29%) were female and 12 (38.70%) were male cases. Conclusion: This study concludes 47.69% ESBL producing MDR E. coli were isolated from UTI cases with female predominance.

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