scholarly journals Multidrug-Resistant Microorganisms Associated with Urinary Tract Infections Following Orthopaedic Patients: A Laboratory-Based Analysis of 5239 Patients

2020 ◽  
Author(s):  
Grzegorz Ziółkowski ◽  
Iwona Pawłowska ◽  
Michał Stasiowski ◽  
Estera Jachowicz ◽  
Tomasz Bielecki
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Surgical Site Infections ◽  
Incidence Density ◽  
Utilization Rate ◽  
Microbiological Analysis ◽  
Gram Negative ◽  
Orthopaedic Patients ◽  
Tract Infections ◽  
Orthopedic Patients

Abstract Background: The risk of healthcare associated infections (HAI) in surgical wards remains closely related to the type of surgery and procedures performed on patients. They also condition the risk of various, apart from the most common, surgical site infections, forms of clinical infections, especially urinary tract infections (UTIs). Their occurrence in orthopedic patients is most often – in about 70%-80%, associated with the use of the bladder catheter in the perioperative period. The aim of this study was the epidemiological and microbiological analysis of UTIs following orthopedic patients, especially MDR in 2013-2015.Methods: The study was conducted in 38-bed Department of Orthopedic-Traumatic Surgery in Sosnowiec, Poland. 5 239 patients surgery included in the study, the urinary catheter utilization rate was 30.7 %. Laboratory based study using the UTI definition of the HAI-Net program, MDR was defined as resistant to at least one antibiotic from 2< antibiotics groups. The results were analyzed using the statistical package PQStat ver. 1.6.0.428 using the chi-square test (chi ^ 2) or Fisher's exact test.Results The UTI incidence was 3.2% (168 cases), CA-UTI incidence density was 9.6/1 000 catheter-days. The highest risk of UTI was found in patients aged 75 years and older. Gram-negative flora prevailed among microorganisms: 76.1%. Predominantly isolated Enterobacterales were: Escherichia coli, Klebsiella pneumoniae. Isolated microorganisms were fully sensitive to carbapenems. Gram-negative bacilli showed the lowest sensitivity to extended substrate spectrum penicillins and fluoroquinolones: 37-64%, trimethoprim-sulfamethoxazole: 50%; MDR prevalence: 24.4%.Conclusions The presented data indicate that UTI incidence is a significant problem in studied population, as well as antimicrobialresistance, especially to quinolones and extended spectrum cephalosporins, as first-line therapy remains a major challenge. To reduce the problem of high UTI incidence and MDR prevalence, the priority should be the reduction of UTI risk – which exceeded the expected values.

scholarly journals Multidrug-Resistant Micro-Organisms Associated with Urinary Tract Infections in Orthopedic Patients: A Retrospective Laboratory-Based Study

Antibiotics ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 7
Author(s):  
Grzegorz Ziółkowski ◽  
Iwona Pawłowska ◽  
Michał Stasiowski ◽  
Estera Jachowicz ◽  
Jadwiga Wójkowska-Mach ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Perioperative Period ◽  
Multidrug Resistant ◽  
Incidence Density ◽  
Microbiological Analysis ◽  
Gram Negative ◽  
Tract Infections ◽  
Micro Organisms ◽  
Orthopedic Patients

Background: The risk of healthcare-associated infections (HAIs) in surgical wards remains closely related to the type of surgery and procedures performed on patients. Those factors also condition the risk of various forms of clinical infections, especially urinary tract infections (UTIs). UTIs are most frequently (70–80% of cases) caused by the use of bladder catheter in the perioperative period. The aim of this study was to perform an epidemiological and microbiological analysis of UTIs in orthopedic patients, with an emphasis on multidrug-resistant (MDR) micro-organisms. Methods: The study was conducted in a 38-bed Department of Orthopedic-Traumatic Surgery in Sosnowiec, Poland. 5239 patients, operated on in 2013–2015, were included in the study. The urinary catheter use rate was 30.7%. Laboratory-based study used the UTI definition of the HAI-Net program. A micro-organism was declared MDR if it was resistant to at least one antibiotic from three or more groups of antibacterial drugs, and extensively drug-resistant (XDR) if it was sensitive to antibiotics from no more than two groups of drugs. Results: The UTI incidence was 3.2% (168 cases), the CA-UTI incidence density was 9.6/1000 catheter days. The highest risk of UTI was found in patients aged 75 or older. Monomicrobial cultures were detected in 163 specimens (78% of all microbiologically confirmed UTIs). Gram-negative flora prevailed among the micro-organisms, the predominantly isolated Enterobacteriaceae being Escherichiacoli and Klebsiellapneumoniae. In 16 patients (7.7% of microbiologically confirmed UTIs), yeast infection was confirmed. Isolated micro-organisms were fully sensitive to carbapenems. Gram-negative bacilli showed the lowest sensitivity to extended substrate spectrum penicillins and fluoroquinolones (37–64%), as well as to trimethoprim-sulfamethoxazole (50%). The MDR prevalence was 24.4%. Conclusions: The presented data indicates that UTIs are a significant problem in the studied population, so is antimicrobial resistance, especially to quinolones, and extended-spectrum cephalosporins, which are often used as first-line therapy. To tackle the problem of high UTI incidence and MDR prevalence, reducing the UTI risk factors should be prioritized.

scholarly journals Morganella morganii, subspecies morganii, biogroup A: An unusual causative pathogen of brain abscess

2012 ◽  
Vol 03 (03) ◽  
pp. 370-372 ◽  
Author(s):  
Asha B. Patil ◽  
Shobha D. Nadagir ◽  
S. A. Lakshminarayana
Keyword(s):  
Urinary Tract ◽  
Brain Abscess ◽  
Urinary Tract Infections ◽  
Unusual Case ◽  
Causative Pathogen ◽  
Morganella Morganii ◽  
Gram Negative ◽  
Cns Infections ◽  
Tract Infections ◽  
High Index Of Suspicion

ABSTRACT Morganella morganii is a gram negative aerobe , found often as intestinal commensal. It is commonly implicated in Urinary tract infections and pyogenic infections, but rarely causes CNS infections especially brain abscess. There are very few published reports of Morganella morganii as a causative pathogen in brain abscess. High index of suspicion of this pathogen is important in cases of brain abscess secondary to otogenic infections. This paper reports an unusual case of Morganella morganii, subspecies morganii, biogroup A Brain abscess .The paper also reviews other infections caused by Morganell morganii.

Guidance of antibiotic treatment for urinary tract infections in the early postoperative phase after Kidney Transplantation

2020 ◽  
Author(s):  
Jens Karl Hugo Strohäker ◽  
Silvio Nadalin ◽  
Alfred Königsrainer ◽  
Robert Bachmann
Keyword(s):  
Kidney Transplantation ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Asymptomatic Bacteriuria ◽  
Graft Function ◽  
Postoperative Phase ◽  
Kidney Transplant Recipients ◽  
Laboratory Findings ◽  
Gram Negative ◽  
Tract Infections

Abstract Purpose: Urinary tract infections are the most common infections early after kidney transplantation. The goals of this study were to evaluate our perioperative antibiotic protocol and risk factors for the occurrence of urinary tract and its effect on the early graft function. We evaluated laboratory alterations during episodes of UTI regarding their potential to guide treatment.Methods: Retrospective single-center analysis of all kidney transplant recipients of an academic transplant center between 2015 and 2017.Results: 96 patients were included in the study. Overall, in 22 patients a asymptomatic bacteriuria (ASB) was detected and 33 patients developed a urinary tract infection (UTI). Gram-negative UTIs appeared earlier than gram-positive UTIs. The most common lab findings during UTI were leukocytosis and CRP increase, both more common in gram-negative UTI (p .00 & .03). All complicated UTIs were caused by gram-negative bacteria (p .00). No difference in UTIs was seen between perioperative antibiotic regimens. Patients that suffered from UTIs showed less favorable graft function at discharge (GFR 43 vs 52 ml / min, p .03).Conclusion: UTIs are associated with worse graft functions while ASBs are not. Whether UTIs are caused by or lead to decreased graft function is still unclear. Proper gram-negative coverage is needed in cases of complicated UTIs or severe laboratory findings. Perioperative antibiotic regimens appear to have no beneficial influence on the incidence of UTIs.

scholarly journals Multiple myeloma complicated with pseudomonas endocartiditis

2012 ◽  
Vol 10 (4) ◽  
pp. 498-501 ◽  
Author(s):  
Juliana Todaro ◽  
Patrícia Weinschenker Bollmann ◽  
Amit Nussbacher ◽  
Luis Fernando Aranha Camargo ◽  
Bento Fortunato Cardoso dos Santos ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Rare Case ◽  
Morbidity And Mortality ◽  
Infectious Agents ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Tract Infections

Patients diagnosed with multiple myeloma are more susceptible to infections which are the major causes of morbidity and mortality associated to this disease. The main infectious agents involved are Gram-positive bacteria. However, after chemotherapy an increase in the incidence of Gram-negative strains is observed. These bacteria are also responsible for most cases of urinary tract infections. Here is reported a rare case in a 73-year-old man with multiple myeloma who developed endocarditis due to pseudomonas.

Microbiological Analysis of the Urine Isolates in Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal

2012 ◽  
Vol 9 (4) ◽  
pp. 295-297 ◽  
Author(s):  
S Raza ◽  
S Pandey ◽  
C P Bhatt
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antimicrobial Agents ◽  
College Teaching ◽  
Urine Samples ◽  
Diffusion Method ◽  
Microbiological Analysis ◽  
Medical College ◽  
Antibiotic Susceptibility Test ◽  
Tract Infections

Background Urinary tract infections (UTIs) are the common cause of bacterial infection. Recently UTI become more complicated and difficult to treat because of appearance of pathogen with increasing resistance to antimicrobial agents. Objective To determine the etiology of the urinary tract infections and their susceptibility to antimicrobial agents. Methods This study was carried out in Kathmandu Medical College, at department of microbiology. Total 3,460 urine samples were tested microbiologically by standard procedure. Antibiotic susceptibility test was performed for all the isolates by Kirby Bauer disc diffusion method and result was interpreted according to National Committee for Clinical Laboratory Standards (NCCLS) guide line. Results Out of 3,460 urine samples 680 (19.7%) showed the significant bacteriuria. The most common pathogens isolated were Escherichia coli 75.7% followed by Klebsiella pneumoniae 10.7%, Acinetobacter spp 5.5%, Proteus spp 3.5% and Pseudomonas aeruginosa 1.2%. Most susceptible antibiotic was Amikacin, Ceftriaxone and Ciprofloxacin for most of the isolates. E. coli which was the main isolate was found to be most susceptible to Amikacin 96.1%, Nitrofurantoin 91.3% and Gentamicin 77.7% followed by Ceftriaxone 65.8% and Ciprofloxacin 64.1%. ConclusionRegular surveillance of the resistance rate among uro-pathogens is needed to ensure the appropriate therapy of UTI.DOI: http://dx.doi.org/10.3126/kumj.v9i4.6348 Kathmandu Univ Med J 2011;9(4):295-7 

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