scholarly journals Resistance profile for pathogens causing urinary tract infection in a pediatric population, and antibiotic treatment response, at a university hospital 2010-2011

2014 ◽  
pp. 39-44 ◽  
Author(s):  
Catalina María Vélez Echeverri ◽  
Lina María Serna-Higuita ◽  
Ana Katherina Serrano Gayubo ◽  
Carolina Ochoa-García ◽  
Luisa Rojas Rosas ◽  
...  

Introduction: Urinary tract infection (UTI) is one of the most common bacterial infections in childhood and causes acute and chronic morbidity and long-term hypertension and chronic kidney disease. Objectives To describe the demographic characteristics, infectious agents, patterns of antibiotic resistance, etiologic agent and profile of susceptibility and response to empirical treatment of UTI in a pediatric population. Methods: This is a descriptive, retrospective study. Results: Included in the study were 144 patients, 1:2.06 male to female ratio. The most common symptom was fever (79.9%) and 31.3% had a history of previous UTI. 72.0% of the patients had positive urine leukocyte count (>5 per field), urine gram was positive in 85.0% of samples and gram negative bacilli accounted for 77.8% for the total pathogens isolated. The most frequent uropathogens isolated were Escherichia coli and Klebsiella pneumoniae. Our E.coli isolates had a susceptibility rate higher than 90% to most of the antibiotics used, but a resistance rate of 42.6% to TMP SMX and 45.5% to ampicillin sulbactam. 6.3% of E. coliwas extended-spectrum beta-lactamases producer strains. The most frequent empirical antibiotic used was amikacin, which was used in 66.0% of the patients. 17 of 90 patients who underwent voiding cistouretrography (VCUG) had vesicoureteral reflux. Conclusion: This study revealed that E. coli was the most frequent pathogen of community acquired UTI. We found that E. coli and other uropathogens had a high resistance rate against TMP SMX and ampicillin sulbactam. In order to ensure a successful empirical treatment, protocols should be based on local epidemiology and susceptibility rates.

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S532-S533
Author(s):  
Changseung Liu ◽  
Eun-Jeong Yoon ◽  
Dokyun Kim ◽  
Jong Hee Shin ◽  
Jeong Hwan Shin ◽  
...  

Abstract Background Korean Antimicrobial Surveillance System (Kor-GLASS) was established in 2016, which is compatible with the Global Antimicrobial Resistance Surveillance System launched by WHO. Here, we report a one-year assessment of Kor-GLASS in 2017, focusing on the antimicrobial resistance of urine isolates. Methods Non-duplicated clinical isolates of E. coli and K. pneumoniae recovered from urine cultures were collected from 8 sentinel hospitals. Demographic information, infection origin (hospital origin or community origin), and admission type were investigated. Bacterial species were confirmed using a matrix-assisted laser desorption/ionization time-of-flight mass spectrometer. Antimicrobial susceptibility was tested by disk diffusion and broth microdilution methods. Results During the one-year period of surveillance from January 2017 to December 2017, a total of 9,130 (11.9%) isolates of target pathogens were recovered from urine specimens of 76,625 patients with suspected urinary tract infection (UTI). The rate of culture-positive was the highest in the < 1 age group (AG) (22.5%), stiffly decreased in the 5–<15 AG to 3.4%, and gradually increased with age up to 19.6% in the ≥ 85 AG. The mean occurrence of UTI per 10,000 patient-days for inpatients was 19.3 (range, 3.4–46.1) for E. coli and 4.0 (range, 1.5–7.3) for K. pneumoniae. Resistance rate for cefotaxime was higher than those for ceftazidime both in E. coli (31.3% vs. 10.3%) and K. pneumoniae isolates (39.0% vs. 29.8%). Resistance rate for ciprofloxacin in E. coli isolates was 40.9%, and that in K. pneumoniae isolates was 31.9%. Only 4.9% and 10.9% of E. coli and K. pneumoniae isolates exhibited resistance phenotype to cefoxitin, respectively. Ertapenem-resistance was more frequently identified in K. pneumoniae isolates (1.6%) than in E. coli isolates (0.1%). Multidrug-resistance (MDR) phenotype was identified in 61.4% of the E. coli and 44.8% of K. pneumoniae urine isolates. Conclusion Kor-GLASS generated well-curated surveillance data devoid of collection bias or isolate duplication. Cefoxitin was an alternative treatment to ciprofloxacin for urinary tract infections caused by Enterobacteriaceae. About one-half of urine isolates belonged to either MDR or XDR. Disclosures All authors: No reported disclosures.


2018 ◽  
Vol 41 (2) ◽  
pp. 77-83 ◽  
Author(s):  
Nure Ishrat Nazme ◽  
Abdullah Al Amin ◽  
Farhana Jalil ◽  
Jesmin Sultana ◽  
Nurun Nahar Fatema

Background: Urinary tract infection (UTI) is an important cause of morbidity and mortality in the paediatric age group. The spectrum of etiologic agents causing UTI and their antimicrobial resistance pattern has been continuously changing over the years. It varies among geographical locations, hospitals and also in different age groups.Objective: The aim of this study was to find out the causative agents of UTI and their antibiotic sensitivity pattern in paediatric patients in CMH, Dhaka.Methodology: This is an observational cross sectional study. A total of 180 children aged 0 months to 15 years attending pediatric outpatient department or admitted in Department of Paediatrics CMH, Dhaka with suspected UTI were subjected for urine routine and microscopic examination between June 2015 to May 2016. Those having pyuria (n=120) were then sent for urine culture and sensitivity to the laboratory of Armed Forces Institute of Pathology (AFIP). Patients having significant growth of organism were enrolled as cases of confirmed UTI. After enrollment, relevant information such as age, sex, sociodemographic profile was obtained and recorded in case record form.Result: In the present study, urine routine microscopy was done in all 180 cases of suspected UTI. Among all urine analysis 67% had significant pyuria (n=120). Of the 120 cases with pyuria, 58 cases were having culture positive accounting 48.3% of the total sample studied. Occurrence of urinary tract infections was highest in the age group below 5 year (62.5%). UTI was more prevalent in girls (63.3%) with male to female ratio 1:1.7. E. coli was the commonest isolate (62.1%) followed by Enterococcus (19.2%) and Klebsiella (10.2%). E. coli was found to be most sensitive to Ciprofloxacin, Nitrofurantoin, Amikacin, and Levofloxacin in descending order. There was a generally high level of resistance of isolates to Cotrimoxazole, Amoxycillin, Aminoglycosides, Azythromycin and the Cephalosporins like Cefuroxime, Ceftazidime, Cefixime and Ceftriaxone compared to Ciprofloxacin, Nitrofurantoin and Levofloxacin.Conclusion: Based on our findings, Ciprofloxacin, Levofloxacin and Nitrofurantoin are appropriate for initial empirical therapy for UTI among Bangladeshi children.Bangladesh J Child Health 2017; VOL 41 (2) :77-83


2013 ◽  
Vol 3 (3) ◽  
pp. 22-25
Author(s):  
SP Shrestha ◽  
AK Shrestha ◽  
L Lamsal ◽  
M Joshi

This study aimed to find bacterial profile of urinary tract infection (UTI) in children between 2 months to 15 years of age. This is a hospital based retrospective study conducted at Gandaki medical college and teaching hospital, Pokhara over a period of 18 months. Among the total 575 children enrolled for the study, 110 children (19.1%) were found to be culture positive. Most common age group having culture positivity is 1-5 years (40%). Present study showed that UTI is more common in girls (69.1%) than in boys (30.9%). E. coli was still the most commonly isolated bacteria (70.9%) followed by Proteus (20%), Klebsiella (5.4%) and Pseudomonas sp. in (1.8%). E. coli was sensitive to Nitrofurantoin (84.6 %), Amikacin (80.7%), Gentamicin (73%) and Ofloxacin in (53.8%). Most commonly used drugs for the treatment of UTI like Cefixime and Ceftriaxone was sensitive only in 15% and 10% respectively. Similarly, Klebsiella was sensitive to Amikacin and Gentamicin (100%) but sensitive to Nitrofurantoin in only 66% of cases. Proteus was sensitive to Nitrofurantoin (95.4%), Amikacin (86%) and to Gentamicin (59%). High resistance rate was observed to Cefixime and Ceftriaxone, the commonly used drugs for its treatment in OPD basis. DOI: http://dx.doi.org/10.3126/jcmc.v3i3.8633 Journal of Chitwan Medical College 2013; 3(3): 22-25


2004 ◽  
Vol 171 (4S) ◽  
pp. 22-23
Author(s):  
Shingo Minagawa ◽  
Chikara Ohyama ◽  
Shingo Hatakeyama ◽  
Kazunari Sato ◽  
Shigeru Sato ◽  
...  

2018 ◽  
Vol 1 (2) ◽  
pp. 40-57
Author(s):  
Abdulghani Alsamarai ◽  
Shler Khorshed ◽  
Imad Weli

Background: Antibiotic resistance emerged as clinical problem challenge the effective treatment of infections. Virulence factor may play an important role in the influence of antimicrobial resistance. Objective: To determine the frequency of resistance gene in E. coli clinical isolates from women with urinary tract infection. Materials and Methods: Fifteen E.coli clinical isolates were tested by PCR to determine their molecular characterization. Results: The bla CTX –M gene was not detected in 6.7% out of the tested 15 E. coli clinical isolates from women with urinary tract infection. However, bla OXA gene was detected in all E. coli tested clinical isolates from pregnant women, female student and diabetic women with urinary tract infection. While bla TEM gene and bla SHV gene were not detected in 33.3% and 40% out of the tested E. coli clinical isolates respectively. Conclusions: Four types of ESBL genes were detected, and shows new trend of distribution, which indicated the predominance of OXA and CTX-M genes.


2018 ◽  
pp. 100-108
Author(s):  
Dinh Khanh Le ◽  
Dinh Dam Le ◽  
Khoa Hung Nguyen ◽  
Xuan My Nguyen ◽  
Minh Nhat Vo ◽  
...  

Objectives: To investigate clinical characteristics, bacterial characteristics, drug resistance status in patients with urinary tract infections treated at Department of Urology, Hue University Hospital. Materials and Method: The study was conducted in 474 patients with urological disease treated at Department of Urology, Hue Universiry Hospital from July 2017 to April 2018. Urine culture was done in the patients with urine > 25 Leu/ul who have symptoms of urinary tract disease or infection symptoms. Patients with positive urine cultures were analyzed for clinical and bacterial characteristics. Results: 187/474 (39.5%) patients had symptoms associated with urinary tract infections. 85/474 (17.9%) patients were diagnosed with urinary tract infection. The positive urine culture rate was 45.5%. Symptoms of UTI were varied, and no prominent symptoms. E. coli accounts for the highest proportion (46.67%), followed by, Staphycoccus aureus (10.67%), Pseudomonas aeruginsa (8,0%), Streptococcus faecali and Proteus (2.67%). ESBL - producing E. coli was 69.23%, ESBL producing Enterobacter spp was 33.33%. Gram-negative bacteria are susceptible to meropenem, imipenem, amikacin while gram positive are vancomycin-sensitive. Conclusions: Clinical manifestations of urinary tract infections varied and its typical symptoms are unclear. E.coli is a common bacterium (46.67%). Isolated bacteria have a high rate of resistance to some common antibiotics especially the third generation cephalosporins and quinolones. Most bacteria are resistant to multiple antibiotics at the same time. Gram (+) bacteria are susceptible to vancomycin, and gram (-) bacteria are susceptible to cefoxitin, amikacin, and carbapenem. Key words: urinary tract infection


Gene Reports ◽  
2021 ◽  
Vol 23 ◽  
pp. 101035
Author(s):  
Ali Akbar Shabani ◽  
Sima Ravaei ◽  
Hussein Anani ◽  
Reza Nasr ◽  
Mohammad Hussein Maroufi ◽  
...  

2003 ◽  
Vol 71 (6) ◽  
pp. 3088-3096 ◽  
Author(s):  
Peter Redford ◽  
Paula L. Roesch ◽  
Rodney A. Welch

ABSTRACT Extraintestinal Escherichia coli strains cause meningitis, sepsis, urinary tract infection, and other infections outside the bowel. We examined here extraintestinal E. coli strain CFT073 by differential fluorescence induction. Pools of CFT073 clones carrying a CFT073 genomic fragment library in a promoterless gfp vector were inoculated intraperitoneally into mice; bacteria were recovered by lavage 6 h later and then subjected to fluorescence-activated cell sorting. Eleven promoters were found to be active in the mouse but not in Luria-Bertani (LB) broth culture. Three are linked to genes for enterobactin, aerobactin, and yersiniabactin. Three others are linked to the metabolic genes metA, gltB, and sucA, and another was linked to iha, a possible adhesin. Three lie before open reading frames of unknown function. One promoter is associated with degS, an inner membrane protease. Mutants of the in vivo-induced loci were tested in competition with the wild type in mouse peritonitis. Of the mutants tested, only CFT073 degS was found to be attenuated in peritoneal and in urinary tract infection, with virulence restored by complementation. CFT073 degS shows growth similar to that of the wild type at 37°C but is impaired at 43°C or in 3% ethanol LB broth at 37°C. Compared to the wild type, the mutant shows similar serum survival, motility, hemolysis, erythrocyte agglutination, and tolerance to oxidative stress. It also has the same lipopolysaccharide appearance on a silver-stained gel. The basis for the virulence attenuation is unclear, but because DegS is needed for σE activity, our findings implicate σE and its regulon in E. coli extraintestinal pathogenesis.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rafael Peñalver Penedo ◽  
Marta Rupérez Lucas ◽  
Luis Antonio Álvarez-Sala Walther ◽  
Alicia Torregrosa Benavent ◽  
María Luisa Casas Losada ◽  
...  

Abstract Background Midregional-proadrenomedullin (MR-proADM) is a useful prognostic peptide in severe infectious pathologies in the adult population. However, there are no studies that analyze its utility in febrile urinary tract infection (fUTI) in children. An accurate biomarker would provide an early detection of patients with kidney damage, avoiding other invasive tests like renal scintigraphy scans. Our objective is to study the usefulness of MR-proADM as a biomarker of acute and chronic renal parenchymal damage in fUTI within the pediatric population. Methods A prospective cohort study was conducted in pediatric patients with fUTI between January 2015 and December 2018. Plasma and urine MR-proADM levels were measured at admission in addition to other laboratory parameters. After confirmation of fUTI, renal scintigraphy scans were performed during the acute and follow-up stages. A descriptive study has been carried out and sensitivity, specificity and ROC curves for MR-proADM, C-reactive protein, and procalcitonin were calculated. Results 62 pediatric patients (34 female) were enrolled. Scintigraphy showed acute pyelonephritis in 35 patients (56.5%). Of those patients, the median of plasmatic MR-proADM (P-MR-proADM) showed no differences compared to patients without pyelonephritis. 7 patients (11.3%) developed renal scars (RS). Their median P-MR-proADM levels were 1.07 nmol/L (IQR 0.66–1.59), while in patients without RS were 0.48 nmol/L (0.43–0.63) (p < 0.01). The AUC in this case was 0.92 (95% CI 0.77–0.99). We established an optimal cut-off point at 0.66 nmol/L with sensitivity 83.3% and specificity 81.8%. Conclusion MR-ProADM has demonstrated a poor ability to diagnose pyelonephritis in pediatric patients with fUTI. However, P-MR-proADM proved to be a very reliable biomarker for RS prediction.


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