scholarly journals Clinical Features And Risk Factors For Infection In Patients With Rheumatoid Arthritis

Author(s):  
Yan Xie ◽  
Yiping Lin

Abstract Background: To explore the infection characteristics of patients with rheumatoid arthritis(RA) and related risk factors for infection. Methods: A retrospective analysis of the clinical data of 648 hospitalized patients with RA, including related risk factors that may cause infection and infection sites, pathogens, and drug resistance. Chi-square test 、Mann-Whitney U test and binary Logistic-regression analysis were used to identify risk factors.Results: 648 patients with RA were 182 cases of infection, the infection rate 28.09%. Common infection were pneumonia(19.60%), urinary tract infection(5.25%), upper respiratory tract infection(5.09%). Gram-negative bacteria ranked first in the pathogen composition (67.57%), the main pathogenic bacteria were Pseudomonas aeruginosa and Escherichia coli; Staphylococcus aureus was the main pathogenic bacteria among the Gram-positive bacteria . In addition, there were 7 strains of fungi, 3 strains each of Mycobacterium tuberculosis and herpes virus. The proportion of resistant strains was relatively high, and the gram-negative bacteria had a relatively high sensitivity to penicillins/cephalosporins+β-lactamase inhibitors, aminoglycosides, and carbopenems. The risk scores included higher age (P=0.020), long disesses duration (P=0.004), smoking (P=0.016), hypoproteinemia (P=0.010), use of corticosteroids (P<0.01).Use of nonbiologic DMARDs was negatively with infection(P= 0.006).Conclusions: Our results indicate that the common infection sites in patients with RA are the respiratory and urinary tract. Gram-negative bacteria are common pathogens. RA patients with higher age, long diseases duration, smoking, hypoproteinemia, and long-term use of corticosteroids are prone to infection. Nonbiologic DMARDs is significantly associated with a decreased risk for infection. The proportion of drug-resistant patients with RA co-infection is relatively high.

Bionatura ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 1346-1351
Author(s):  
Risala H Allami ◽  
Raghad S. Mouhamad ◽  
Sura A. Abdulateef ◽  
Khlood abedalelah al-Khafaji

Urinary tract infection (UTI) is the second most common infection after respiratory tract infection. Its prevalence is more in women as compared to men. Approximately 50% of women have an infection of the Urinary tract in their life-time. The bacterial infection is one of the most important bioactivity; using their ability to imitate evanish then distributes international fitness problems into the 21st centenary. Thus a recent study was undertaken to investigate the antibacterial activity of a mixture of three medicinal plants against UTI infectious isolates. The three considered plants were (Aloe vera, Artemisia herba alba and Teucrium polium), which were used in Iraqi medicine for many centuries. The effectiveness of this combination was investigated using in vitro well diffusion method. The extract was tested against four isolated pathogenic bacteria (Staphylococcus aureus, Klebsiella spp, and Proteus spp). The aqueous extract exhibited antibacterial activity against gram-positive and gram-negative bacteria. The mixture extract had the highest effect against S. aureus and Proteus spp, followed by a lower effect on Klebsiella spp. In conclusion, the antibacterial effect of the tested plant extracts confirmed a higher impact on Gram-positive bacteria as compared to Gram-negative bacteria. Therefore, it can be concluded that the usage of these plants as a traditional medicine form can be considered as a strong assistant to regular medicine drugs and treatments.


2019 ◽  
Vol 5 (2) ◽  
pp. 61-64
Author(s):  
Md Badrul Islam ◽  
Md Abdullah Yusuf ◽  
Samia Afrin ◽  
Md Abul Bashar

Objectives: This study was carried out to detect extended spectrum B-lactamases (ESBLs) among Gram negative bacteria isolated from hospitalized patients and community patients (OPD) by double disc synergy test and phenotypic confirmatory test. Methodology: This cross-sectional, prospective study was carried out in the Department of Microbiology. Dhaka National Medical College, over a period of 1 (one) year 2016. Urine samples were collected from patients. Urine samples were from hospitalized patients and community patients. Samples were collected from in-patient and outpatient department of Dhaka National Medical College Hospital having clinical symptoms of microbial infection. Samples were collected from both sexes and different age groups. Result: Total 220 urine samples were collected from suspected cases of urinary tract infection. Total 132 (60%) Gram negative bacteria were isolated from these patients as causative agents. Among the isolates, 88 (75.86%) in hospitalized patients and 44 (42.31%) in community patients were isolated. Out of 132 Gram negative bacteria, 31 (23.48%) were ESBL producers. The percentage of ESBL producing bacteria was (31.81%) in hospitalized patients and (6.82%) in community patients. Conclusion: In the present study, it was observed that considerable numbers of ESBL producing bacteria were detected from urinary tract infection cases. These cases indicate ESBLs will be major threat for antibiotic therapy. Bangladesh Journal of Infectious Diseases, December 2018;5(2):61-64


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S243-S243
Author(s):  
Sukhjit Takhar ◽  
Anusha Krishnadasan ◽  
Gregory J Moran ◽  
William Mower ◽  
Kavitha Pathmarajah ◽  
...  

Abstract Background Gram-negative infections due to extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae, and carbapenem-resistant Enterobacteriaceae (CRE) and non-fermenting (CR-NF) strains, are increasingly encountered. Study objectives were to determine prevalence and associated risk factors and outcomes for these strains among emergency department patients hospitalized for urinary tract infection (UTI) at 11 US hospitals. Methods This was a prospective observational study of patients ≥18 years hospitalized for UTI. Clinical data were collected at the index visit. Urine was obtained for culture and susceptibility testing. Electronic medical record and telephone follow-up were conducted after 30 days for site laboratory results, treatment, and clinical outcomes. Positive culture was defined as 1 uropathogen with growth at ≥104 cfu/mL, or 2 with 1 or both at ≥105 cfu/mL, or ≥3 with 1 or 2 at ≥105 cfu/mL. Isolates with ceftriaxone (CRO) or meropenem MIC >1 μg/mL will undergo reference laboratory (IHMA, Inc., Schaumburg, IL) susceptibility testing, including against newer antibiotics and cefiderocol. Results We enrolled 774 participants between 2018 and 2019; 289 (37.3%) excluded due to urine culture not done, no growth, or contamination. Of 485 culture-positive participants (median age 56 years, 62.0% female), 432 (89.1%) grew 1 uropathogen, 48 (9.9%) 2, and 5 (1.0%) ≥3. Prevalences of CRO-resistant Enterobacteriaceae, CRE, and CR-NF were 19.9%, 2.1%, and 10.7%, respectively. At sites, 95.7% of CRO-resistant Enterobacteriaceae isolates were ESBL. Among participants with any or no antibiotic resistance risk factors, i.e., antibiotics, hospitalization, long-term care, or travel within 90 days, prevalence of CRO-resistant Enterobacteriaceae was 68/228 (29.8%) and 10/155 (6.5%), respectively. Among those with CRO-resistant vs. susceptible Enterobacteriaceae infections, ICU admission and death occurred in 9.9% vs. 6.6% and 3.7% vs. 1.0%, with median time home over 30 days, 24 vs. 27 days, respectively. Conclusion Among US hospitalized patients with UTI, infections due to CRE remain uncommon; however, ESBL and CR-NF now account for a substantial proportion of cases and are associated with resistance risk factors and worse outcomes. Disclosures All authors: No reported disclosures.


1970 ◽  
Vol 19 (4) ◽  
pp. 3217-3224
Author(s):  
Martha F Mushi ◽  
Vaileth G Alex ◽  
Mwanaisha Seugendo ◽  
Vitus Silago ◽  
Stephen E Mshana

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.


2021 ◽  
Vol 10 (4) ◽  
pp. 2820-2830

Recently, the world's problem has become in the spread of microbes and the extent of their impact on public health, especially the problem of urinary tract infections (UTIs). Therefore, the purpose of the study was to clarify the extent of infection of the urinary tract and the extent of development of these microbes in resistance to antibiotics (antibiotic susceptibility pattern). The pathogens are isolated from hospitals and private medical centers. In this study, two hundred twenty-five urine samples were collected from various sources, where 126 patients were infected with bacteria while 99 patients had no infection. In Gram-negative bacteria, the most common bacteria were E. coli (55.5%) followed by Klebsiella spp (23.0%), Proteus spp (7.14%), Pseudomonas spp (6.34%), and Acinetobacter spp (3.96%). In the Gram-positive bacteria Staphylococcus spp (2.38%) and Enterococcus spp (1.58%) were found. Antibiotic susceptibilities for Gram-negative and positive bacteria were investigated according to clinical laboratory standard institute(CLSI 2019). In Gram-negative bacteria, Amikcin, Impinem, and levofloxacin were sensitive. However, in Gram-positive bacteria, levofloxacin, ofloxacin, and linezolid were sensitive. At the same time, most of the remaining antibiotics are 100% resistant to pathogenic-bacterial isolates. This study showed bacteria that are isolated from urine which causing urinary tract infection and showed resistance to almost all antibiotics, so UTI is difficult to treat by common antibiotics.


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