URINARY TRACT INFECTIONS IN CHILDREN

The review addresses the main issues related to the rational pharmacotherapy of urinary tract infection (UTI). UTIs are a common and important clinical problem in children. Among UTI causative agents in children are dominated by gram-negative bacteria, E. coli. According to modern clinical guidelines, the leading direction in the treatment of UTI in children is antibiotic therapy, which should be prescribed taking into account the sensitivity of microorganisms. Drugs of choice for UTI in children: cephalosporins or protected aminopenicillins

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Urinary tract infections in newborn children: microbial landscape and antibiotic resistance problems

Paediatric Surgery Ukraine ◽

10.15574/ps.2021.72.56 ◽

2021 ◽

pp. 56-62

Author(s):

I.M. Veshkurtseva ◽

◽

M.A. Akselrov ◽

V.A. Emelyanova ◽

S.N. Suprunets ◽

...

Keyword(s):

Urinary Tract Infection ◽

Antibiotic Resistance ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Gram Negative Bacteria ◽

Urinary System ◽

Gram Negative ◽

Enterococcus Spp ◽

Causative Agents ◽

Tract Infections

Urinary tract infection is one of the most common bacterial infections in children, which in 30% of cases may be the first manifestation of the presence of congenital malformations of the urinary tract and urodynamic disorders in a child. Late diagnosis, initiation of therapy, and the choice of an inadequate antimicrobial drug increase the risks of disease progression, development of nephrosclerosis and patient disability. Purpose – to study the microbial landscape in urinary tract infections, its antibiotic resistance in newborns with anomalies in the development of the urinary system. Materials and methods. The results of microbiological examination of urine in newborns with urinary tract infections against the background of anomalies in the development of the urinary tract, which are being treated in intensive care units and neonatal pathology in the period 2016–2020, have been analyzed. Results. The main causative agents of urinary tract infections in newborns with anomalies of the urinary system are Enterobacterales (63.4%), 13.8% are producers of extended spectrum beta-lactamases. Cefoperazone/sulbactam, amikacin, meropenem and nitrofurantoin were most active against Escherichia coli. In relation to other representatives of the order Enterobacterales, only amikacin was highly active. The strains of Enterococcus spp., Detected in 20%, were resistant to reserve vancomycin in every fourth case. Representatives of non-fermenting gram-negative bacteria were found in 6.4% of cases, resistance to the main titrated antibiotics ranged from 44.4% to 100%. Conclusions. The main causative agents of urinary tract infections in newborns with anomalies of the urinary system are representatives of the order Enterobacterales, Enterococcus spp. and non-fermenting gram-negative bacteria, which were characterized by high resistance, including to reserve antibiotics. The high indices of resistance of the isolated microflora make it difficult to choose an effective antibacterial therapy in this category of patients and in most cases requires combined antibiotic therapy. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: Urinary tract infection, newborn babies, urinary tract abnormalities, antibiotic resistance.

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Isolation and Identification of Uropathogenic E. coli and its Antimicrobial Susceptibility Pattern with Special Reference to Extended Spectrum Beta-Lactamases (Esbl)

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i24a31431 ◽

2021 ◽

pp. 56-67

Author(s):

V. Naveen Kumar ◽

Chitralekha Saikumar

Keyword(s):

Urinary Tract ◽

Special Reference ◽

Management Plan ◽

Gram Negative Bacteria ◽

Susceptibility Pattern ◽

Isolation And Identification ◽

Gram Negative ◽

Microbial Resistance ◽

E Coli ◽

Tract Infections

Urinary tract infections (UTI) are the most common bacterial infection among the humans. One of the most important factors impacting the management of UTI over the past decade is emergence of anti-microbial resistance among uropathogens. ESBL production is one of the most common mechanisms of anti-microbial resistance, the other being Amp C β-lactamases in gram negative bacteria. This study was undertaken to establish the prevalence of ESBL producing strains and their anti-microbial susceptibility pattern to newer agents to guide therapy for urinary tract infection. The present studies isolates and identify Uropathogenic Escherichia coli and its antibiotic susceptibility pattern with special reference to ESBL. The emergence of β-lactamase is a Metter of serious concern .The drug resistance in gram negative bacilli is due to production of β-lactamases, AmpC lactamases, Efflux mechanisms and Porin deficiency. Out of the total 3580 urine samples, 987 samples (27.56%) showed No growth, 1786 (49.88%) showed the presence of Gram negative bacteria. Totally, 1081 E. coli species were isolated and < 30% of them were found to be ESBL positive. Uropathogenic E. coli isolates are highly susceptible towards Meropenem and Imipenem antibiotics and highly resistant towards β-lactam and Cephalosporins antibiotics. Hence, the present study urged to implement the management plan for using those antibiotics in patients for preventing the antibiotic resistance.

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C - reactive protein and urinary tract infection due to Gram-negative bacteria in a pediatric population at a tertiary hospital, Mwanza, Tanzania

African Health Sciences ◽

10.4314/ahs.v19i4.45 ◽

1970 ◽

Vol 19 (4) ◽

pp. 3217-3224

Author(s):

Martha F Mushi ◽

Vaileth G Alex ◽

Mwanaisha Seugendo ◽

Vitus Silago ◽

Stephen E Mshana

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Enteric Bacteria ◽

Gram Negative Bacteria ◽

C Reactive Protein ◽

Gram Negative ◽

Reactive Protein ◽

Significant Bacteriuria ◽

Tract Infections

Introduction: Gram-negative bacteria are the major cause of urinary tract infections (UTI) in children. There is limited data on UTI systemic response as measured using C-reactive protein (CRP). Here, we report the association of CRP and UTI among children attending the Bugando Medical Centre, Mwanza, Tanzania.Methods: A cross-sectional study was conducted between May and July 2017. Urine and blood were collected and processed within an hour of collection. Data were analyzed using STATA version 13.Results: Of 250 enrolled children, 76(30.4%) had significant bacteriuria with 56(22.4%, 95%CI; 11.5-33.3) having gram-negative bacteria infection. There was dual growth of gram-negative bacteria in 3 patients. Escherichia coli (32.2%, 19/59) was the most frequently pathogen detected. A total of 88/250(35.2%) children had positive CRP on qualitative assay. By multinomial logistic regression, positive CRP (RRR=4.02, 95%CI: 2.1-7.7, P<0.001) and age ≤ 2years (RRR=2.4, 95%CI: 1.23-4.73, P<0.01) significantly predicted the presence of significant bacteriuria due to gram-negative enteric bacteria. Conclusion: C-reactive protein was significantly positive among children with UTI due to gram-negative bacteria and those with fever. In children with age ≤ 2 years, positive CRP indicates UTI due to gram-negative enteric bacteria.Keywords: C - reactive protein, urinary tract infection, Gram-negative bacteria, Mwanza, Tanzania.

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ISOLATION AND MOLECULAR STUDY OF SOME BACTERIAL URINARY TRACT INFECTIONS OF SHEEP IN BASRAH PROVINCE

IRAQI JOURNAL OF AGRICULTURAL SCIENCES ◽

10.36103/ijas.v51i3.1043 ◽

2020 ◽

Vol 51 (3) ◽

pp. 885-893

Author(s):

Mohammed & et al.

Keyword(s):

Escherichia Coli ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Molecular Detection ◽

Molecular Study ◽

E Coli ◽

Causative Agents ◽

Vitek 2 ◽

Tract Infections

This study was aimed isolation and molecular detection of some causative agents of urinary tract infection (cystitis and pyelonephritis). Out of 108 tested urine samples (56 from females and 52 from males); 60 samples (55.55%) have infected with Escherichia coli and Klebsiella pneumoniae were 36 (64.2%) females and 24 (46.1%) males. The sixty infected samples contain from 56 E. coli and (4) K. pneumoniae, this samples identified by Vitek 2 (44 isolates E. coli and 2 isolates K. pneumoniae) were subjected to DNA extraction. A total of 44 E. coli isolates detected to FimH and pai genes. 44/44 (100%) were positive for presence of FimH gene, and 20/44 (45.45%) were positive for presence of pai gene. The two isolates of K. pneumoniae which detection of Ecpa gene and given positive result to this gene 100%.

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Ciprofloxacin Resistance in Hospital and Community-acquired Urinary Tract Infections by Escherichia coli: A Systematic Review and Meta-analysis

10.1101/2020.04.09.034041 ◽

2020 ◽

Author(s):

Guanyu Zhou ◽

Xiaoju Lv

Keyword(s):

Systematic Review ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Main Concern ◽

Gram Negative Bacteria ◽

Gram Negative ◽

E Coli ◽

Ciprofloxacin Resistance ◽

Tract Infections ◽

Hospital Acquired

AbstractIn recent years, antimicrobial resistance has been increasingly reported. One main concern is the resistance of gram-negative bacteria like E. coli to ciprofloxacin (fluoroquinolones). Gram-negative bacteria are the main cause of community and hospital-acquired urinary tract infections (UTI). We aimed to review and analyze the data on ciprofloxacin resistance in hospital and community-acquired UTI. A literature search of three electronic databases (PubMed, Medline, and Cochrane) was performed. We considered the papers that were published from January 2004 to May 2019. The search yielded a total of 16097 studies besides 31 studies from a manual search. Filtering yielded 1297 relevant full-text papers. Eighty-three papers, equivalent of 99 cohorts, were finally included in this systematic review and in the analysis. The analysis results suggest that pooled ciprofloxacin resistance for community and hospital-acquired E. coli UTI is 0.27 (95% CI 0.246–0.303) and 0.30 (95% CI 0.22–0.38), respectively. Pooled resistance rates according to regions are 0.43 (95% CI 0.31–0.54) for Asia ensued by Africa 0.31 (95% CI 0.22–0.35), the Middle East 0.21(95% CI 0.13-0.30), Europe 0.18 (95% CI 0.13-0.22), and Australia 0.06 (95% CI 0.04-0.08). The pooled estimates revealed that ciprofloxacin resistance was higher in developing countries compared to that in developed countries, 0.35 (95% CI 0.30-0.40) and 0.13 (95% CI 0.10-0.16), respectively. Finally, plotting resistance over time deemed statistically significant (n= 79, r= 0.29, p= 0.038). Our findings suggest that ciprofloxacin resistance among UTI patients is a highly prevalent and serious issue. The suggested risks are low-income, acquiring hospital infection, and falling in highly-vulnerable regions like Asia and Africa. We also shed light on some approaches to correct the perception of patients and general practitioners (GPs) for antibiotic usage. We also suggest ideas to impede the progress of the post-antibiotic era in countries known for high antibiotic resistance.

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Bacterial Pattern of Community acquired Urinary Tract Infections: A Challenge for Antimicrobial Resistance

10.51429/ejmm30320 ◽

2021 ◽

Vol 30 (3) ◽

pp. 153-162

Author(s):

Nader A. Nemr ◽

Rania M. Kishk ◽

Mohammed Abdou ◽

Hassnaa Nassar ◽

Noha M Abu bakr Elsaid ◽

...

Keyword(s):

Urinary Tract ◽

Antimicrobial Resistance ◽

Bacterial Infections ◽

Diffusion Method ◽

Gram Negative Bacteria ◽

Isolation And Identification ◽

Gram Positive ◽

Gram Negative ◽

E Coli ◽

Tract Infections

Background: Urinary tract infection (UTI) is considered one of the most common bacterial infections seen in health care. To our knowledge, there is no available antimicrobial resistance surveillance system for monitoring of community-acquired UTIs (CA- UTIs) in our country. Objectives: we aimed to discuss the bacterial pattern and resistance profile of CA-UTIs in Ismailia, Egypt. Methods: This cross-sectional study included 400 patients suffering from symptoms of acute UTIs. Urine specimens were collected by clean-catch mid-stream method, examined microscopically and inoculated immediately on blood agar and MacConkey's agar plates. Colony counting, isolation and identification of the urinary pathogens were performed by the conventional biochemical tests according to the isolated organism. Antibiotic susceptibility testing was performed by Kirby Bauer disk diffusion method. Interpretation was performed according to Clinical Laboratory Standard Institute (CLSI) guidelines. Results: out of 400 specimens, 136 of them revealed no bacterial growth or insignificant bacteriuria. Most of participants with UTI were females (81.8%) (p=0.008) and 54.5% of them were married (P=0.1). Gram negative bacteria were more common than Gram positive representing 66 % and 34% respectively. E. coli was the most common isolated organism (39%) followed by S. aureus (32%), K. Pneumoniae and Pseudomonas (10.5% for each), Proteus (6%) and Enterococci (2%). E. coli isolates showed the highest susceptibility to imipenem, meropenem, amikacin, nitrofurantoin, levofloxacin and ciprofloxacin. Most of our patients were diabetics (64.8%) (p=0.004). The mean ± SD of HbA1c was 6.4±2.0 with 4 to 12.6 range, S.E was 0.1 and 95% C.I was 6.2- 6.7. The highest mean ± SD of HbA1c was in S. aureus infections. Conclusion: Gram negative bacteria were most common than Gram positive with predominance of E. coli with significant relation to the presence of diabetes.

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Prevalence of antimicrobial resistance genes and integrons in commensal Gram-negative bacteria in a college community

10.1101/683524 ◽

2019 ◽

Cited By ~ 1

Author(s):

Julia Rubin ◽

Kaitlyn Mussio ◽

Yuqi Xu ◽

Joy Suh ◽

Lee W. Riley

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Antimicrobial Resistance ◽

Tract Infection ◽

Resistance Genes ◽

Healthy Population ◽

Gram Negative Bacteria ◽

Gram Negative ◽

Fecal Samples ◽

E Coli

AbstractAlthough the human intestinal microbiome has been shown to harbor antimicrobial drug-resistance genes (ARG), the prevalence of such genes in a healthy population and their impact on extraintestinal infections that occur in that community are not well established. This study sought to identify ARG prevalence and their mobile elements in the intestines of a healthy community population at a California university, and compared these genes to those found in uropathogenic Escherichia coli isolated from patients with community-acquired urinary tract infection (CA-UTI). We isolated Gram-negative bacteria (GNB) from fecal samples of healthy volunteers and screened them by polymerase chain reaction (PCR) for ARG encoding resistance against ampicillin (AMP), trimethoprim-sulfamethoxazole (TMP-SMX), gentamicin (GENT), and colistin (COL). We found antimicrobial resistant GNB from 85 (83%) of 102 non-redundant rectal swab samples. Sixty-seven (66%) of these samples contained ß-lactamase genes (blaTEM, blaSHV, blaCTX-M, blaOXA,blaOXY), dihydrofolate reductase (DHFR) genes (dhfr-A17, dhfr-A7, dhfr-A5, dhfr-A21, dhfr-A1, dhfr-A15, and dhfr-B3), and aminoglycoside resistance genes (aadA5, aadA1, and aadB). Integron sequences were found in 37 fecal samples. These genes were found in 11 different GNB species isolated from the fecal samples. The same ARG were found in E. coli strains isolated from patients with CA-UTI examined at the college outpatient health clinic. The high prevalence of clinically-common ARG and integrons harbored by GNB in the intestine of a healthy population suggest that human intestines may serve as a major reservoir of these mobile ARG that appear in E. coli strains causing extraintestinal infections in the same community.ImportanceIncreasing frequency of antimicrobial resistance (AMR) in human pathogenic bacteria has compromised our ability to treat infections. Since mobile antibiotic resistance genes (ARG) are readily exchanged between different species of bacteria through horizontal gene transfer, there is interest in investigating sources of these genes. The normal intestinal flora has been shown to contain a wide variety of ARG, which may have been introduced via food-containing AMR bacteria. We sought to assess the prevalence of ARG carriage in the intestines of a healthy population and determine if these ARG are found in E. coli strains that cause community-acquired urinary tract infection (CA-UTI) in the same community. Our findings indicate that the human intestine may serve as an important reservoir as well as a site in which ARG are transferred into E. coli that cause UTI. Further research is needed to reduce ARG carriage and devise new strategies to prevent AMR infections.

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Urinary Tract Infection Bacterial at RSUP H. Adam Malik Medan in 2019: an Overview Study

Sumatera Medical Journal ◽

10.32734/sumej.v4i1.5849 ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Teguh Firdaus ◽

Rina Yunita

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Enterococcus Faecalis ◽

Secondary Data ◽

Sensitivity Study ◽

Gram Negative Bacteria ◽

Gram Negative ◽

E Coli ◽

Urinary Culture

Urinary Tract Infection (UTI) is the second-largest infection after respiratory tract infection (WHO, 2013). The prevalence of UTI in Indonesia is relatively high. UTI originated from the invasion and proliferation of microorganisms into the urinary tract in meaningful quantities. Gram-negative bacteria are mostly the cause of UTI including E. coli, Klebsiella sp, Enterobacter sp, and Proteus sp. Patients with UTI with inadequate treatment can experience complications e.g., acute renal failure and urosepsis. This study aims to find out the profile of bacteria that cause UTI at RSUP H. Adam Malik Medan in 2019. This descriptive study is using a non-analytical retrospective approach conducted to secondary data from urinary culture examination at RSUP H. Adam Malik Medan. Data were analyzed using the SPSS 24. Gram-negative bacteria results of 72.7% with E. coli postulated as the most common etiology (33,3%) and gram-positive bacteria results of 27.3%, dominated by Enterococcus faecalis (16.3%). The sensitivity study exhibited various results e.g., 100%, 98.2%, and 97.0% in E. coli for Tigecycline, Meropenem, and Amikacin respectively. Enterococcus faecalis also posed a similar results regarding its sensitivity result to different antibiotics. Gram-negative bacteria are the most common bacterial etiology of UTI, specifically E. coli with comparable sensitivity results

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The Clinical Efficacy and Safety of Ertapenem for the Treatment of Complicated Urinary Tract Infections Caused by ESBL-Producing Bacteria in Children

International Journal of Nephrology ◽

10.1155/2015/595840 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

Ayse Karaaslan ◽

Eda Kepenekli Kadayifci ◽

Serkan Atici ◽

Gulsen Akkoc ◽

Nurhayat Yakut ◽

...

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Clinical Efficacy ◽

Clinical Problem ◽

Efficacy And Safety ◽

Once Daily ◽

Extended Spectrum Beta Lactamase ◽

E Coli ◽

Important Clinical Problem ◽

Tract Infections

Background. Urinary tract infections (UTIs) are common and important clinical problem in childhood, and extended-spectrum-beta-lactamase- (ESBL-) producing organisms are the leading cause of healthcare-related UTIs. In this study, we aimed to evaluate the clinical efficacy and safety of ertapenem therapy in children with complicated UTIs caused by ESBL-producing organisms.Methods. Seventy-seven children with complicated UTIs caused by ESBL-producing organisms were included in this retrospective study, and all had been treated with ertapenem between January 2013 and June 2014.Results. Sixty-one (79%) females and sixteen (21%) males with a mean ± standard deviation (SD) age of76.6±52months (range 3–204, median 72 months) were enrolled in this study.Escherichia coli(E. coli) (n=67; 87%) was the most common bacterial cause of the UTIs followed byKlebsiella pneumoniae(K. pneumoniae) (n=9; 11.7%) andEnterobacter cloacae(E. cloacae) (n=1; 1.3%). The mean duration of the ertapenem therapy was8.9±1.6days (range 4–11). No serious drug-related clinical or laboratory adverse effects were observed, and the ertapenem therapy was found to be safe and well tolerated in the children in our study.Conclusion. Ertapenem is a newer carbapenem with the advantage of once-daily dosing and is highly effective for treating UTIs caused by ESBL-producing microorganisms.

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