scholarly journals Gut microbiota and urinary tract infections in children

2021 ◽  
Vol 6 (2) ◽  
pp. 24-30
Author(s):  
L. A. Levanova ◽  
A. A. Markovskaya ◽  
L. Yu. Otdushkina ◽  
Yu. V. Zakharova
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Urinary Tract Infections ◽  
Intestinal Microbiota ◽  
Neonatal Intensive Care ◽  
Intestinal Microbiome ◽  
Intestinal Dysbiosis ◽  
Tract Infections ◽  
Klebsiella Spp

Aim. To evaluate the role of intestinal dysbiosis in the development of urinary tract infections in children admitted to a multidisciplinary hospital.Materials and Methods. We performed a bacteriological analysis of 2,694 urine samples collected from ≤ 3-years-old children who have been admitted to a multidisciplinary hospital (Kemerovo, Russian Federation). Urine specimens were inoculated by the 4-sector technique. Concurrently, we quantified the intestinal microbiota and its antimicrobial resistance in 100 children with urinary tract infections.Results. Titers of pathogenic microbes significantly differed in patients from distinct units (p = 0.02). The highest number of positive samples was detected in the neonatal pathology and neonatal intensive care units (43.8% each) as well as urology unit (37.9%). The most frequent pathogens belonged to Enterobacteriaceae family, in particular Escherichia coli, Klebsiella spp., Enterobacter spp., and Proteus spp. All studied children (100/100) suffered from intestinal dysbiosis. Titers of Bifidobacterium spp. and Lactobacillus spp. were reduced to 6 (5.0; 8.0) and 5 (4.0; 6.0) lg CFU/g, respectively. In 89.2% children, Escherichia coli lac+ levels were elevated to 9-10 lg CFU/g. Of note, 18.9% children had high Escherichia coli lac- titers [8 (6.0; 9.0) lg] and 24.3% had high Escherichia coli hly+ titers [5 (4.5; 6.0) lg] in the intestine. We have also found a high frequency (44.6%) and density [8.1 (7.0; 8.5) lg] of Klebsiella spp., in the intestinal mucosa of such patients. Notably, Enterobacter spp. and Proteus spp. were abundant [7 (5.0; 8.0) CFU/g] in the intestinal microbiota of 10.8% children. The prevalence of resistance strains in the studied setting reached 63%.Conclusions. More than 75% children with urinary tract infections suffer from intestinal dysbiosis. The microbiome of these patients was predominantly composed of Enterobacteriaceae and was characterized by high titers of Escherichia coli lac+, Klebsiella spp., Enterobacte spp., and Proteus spp. Similar profile of antimicrobial resistance in urinary and intestinal isolates of enterobacteria suggests intestinal microbiome as the main source of pathogens causing urinary tract infections in children. 

Recurrence of Urinary Tract Infections due to Escherichia coli and Its Association with Antimicrobial Resistance

2021 ◽  
Author(s):  
Maria Angeles Ormeño ◽  
Maria José Ormeño ◽  
Antonio M. Quispe ◽  
Miguel Angel Arias-Linares ◽  
Elba Linares ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Urinary Tract Infections ◽  
Tract Infections

scholarly journals Comparative Genomics of Antibiotic-Resistant Uropathogens Implicates Three Routes for Recurrence of Urinary Tract Infections

mBio ◽  
2019 ◽  
Vol 10 (4) ◽  
Author(s):  
Robert Thänert ◽  
Kimberly A. Reske ◽  
Tiffany Hink ◽  
Meghan A. Wallace ◽  
Bin Wang ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Urinary Tract Infections ◽  
Intestinal Microbiome ◽  
Empiric Antibiotic Therapy ◽  
Phenotypic Characterization ◽  
Drug Resistant ◽  
Content Type ◽  
Symptomatic Disease ◽  
Tract Infections

ABSTRACT The rise of antimicrobial resistance in uropathogens has complicated the management of urinary tract infections (UTIs), particularly in patients who are afflicted by recurrent episodes of UTIs. Antimicrobial-resistant (AR) uropathogens persistently colonizing individuals at asymptomatic time points have been implicated in the pathophysiology of UTIs. The dynamics of uropathogen persistence following the resolution of symptomatic disease are, however, mostly unclear. To further our understanding, we determined longitudinal AR uropathogen carriage and clonal persistence of uropathogenic Escherichia coli, Proteus mirabilis, and Klebsiella pneumoniae isolates in the intestinal and urinary tracts of patients affected by recurrent and nonrecurrent UTIs. Clonal tracking of isolates in consecutively collected urine and fecal specimens indicated repeated transmission of uropathogens between the urinary tract and their intestinal reservoir. Our results further implicate three independent routes of recurrence of UTIs: (i) following an intestinal bloom of uropathogenic bacteria and subsequent bladder colonization, (ii) reinfection of the urinary tract from an external source, and (iii) bacterial persistence within the urinary tract. Taken together, our observation of clonal persistence following UTIs and uropathogen transmission between the intestinal and urinary tracts warrants further investigations into the connection between the intestinal microbiome and recurrent UTIs. IMPORTANCE The increasing antimicrobial resistance of uropathogens is challenging the continued efficacy of empiric antibiotic therapy for UTIs, which are among the most frequent bacterial infections worldwide. It has been suggested that drug-resistant uropathogens could persist in the intestine after the resolution of UTI and cause recurrences following periurethral contamination. A better understanding of the transmission dynamics between the intestinal and urinary tracts, combined with phenotypic characterization of the uropathogen populations in both habitats, could inform prudent therapies designed to overcome the rising resistance of uropathogens. Here, we integrate genomic surveillance with clinical microbiology to show that drug-resistant clones persist within and are readily transmitted between the intestinal and urinary tracts of patients affected by recurrent and nonrecurrent UTIs. Thus, our results advocate for understanding persistent intestinal uropathogen colonization as part of the pathophysiology of UTIs, particularly in patients affected by recurrent episodes of symptomatic disease.

scholarly journals Changing pattern of resistant pathogens causing urinary tract infections in Karachi

2013 ◽  
Vol 2 (3) ◽  
pp. 105-110
Author(s):  
H Najmul ◽  
A Tanveer
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antimicrobial Drugs ◽  
Klebsiella Species ◽  
Amoxicillin Clavulanic Acid ◽  
Tract Infections ◽  
Staphylococcus Spp ◽  
Klebsiella Spp

INTRODUCTION: The study under view is based under the aim to investigate the prevalence and susceptibility pattern of pathogens, causing urinary tract infections (UTIs), to antibiotics commonly used in routine medication. MATERIALS AND METHODS: Over a period of 10 months 100 isolates were collected for the determination of their susceptibility to chosen antibiotics, from a laboratory (MedPath Laboratories) in urban area of Karachi. All Gramnegative and Gram-positive urinary tract pathogens were re-identified by their morphological and biochemical characteristics and the susceptibility to seven antibiotics was determined. RESULTS: Pathogens were found as, Escherichia coli, Pseudomona spp, Klebsiella species, Enterobacter spp., and Staphylococci spp. In recent study, more than half of the Escherichia coli isolates were resistant to one or more of the all antimicrobial drugs tested. Resistance was most common to amoxicillin/clavulanic acid and ofloxacin, cefixime, followed by gentamicin. Our results indicate that Escherichia coli and Pseudomonas spp. were the most common organisms causing UTI. Other organisms involved were Enterobacter spp., Staphylococcus spp., and Klebsiella spp. Increasing patterns of resistant to gentamicin, and ofloxacin were also observed. CONCLUSIONS: In conclusion, pattern of antibiotic susceptibility to first line antibiotics is changing hence antimicrobial susceptibility testing of all isolates is crucial for the treatment of UTI. DOI: http://dx.doi.org/10.3126/ijim.v2i3.8069 Int J Infect Microbiol 2013;2(3):99-104  

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