scholarly journals MICROBIOLOGICAL ANALYSIS OF URINARY TRACT INFECTIONS IN NORTH WEST ENGLAND AND THE IMPACT OF FLUID INTAKE ON THE INCIDENCE OF URINARY TRACT INFECTION

2018 ◽  
Author(s):  
Morkos Iskander
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Confidence Interval ◽  
Urinary Tract Infections ◽  
Fluid Intake ◽  
Microbiological Analysis ◽  
North West ◽  
Tract Infections ◽  
Resistance Rates ◽  
The Impact

BACKGROUNDManagement of urinary tract infections (UTIs) is compounded by the rising rates of resistance to antimicrobials. Public Health England highlighted areas of the North West of England as having suboptimal practices in the treatment of UTIs. This project aims to evaluate the resistance in Merseyside compared to the national rates, examine resistance in urological patients, review the rates of extended spectrum β-lactamase producing (ESBL) Escherichia coli over time, as well as consider increased fluid intake in the management of UTIs.METHODSUropathogen resistance rates in Merseyside from December 2012 to February 2013 were compared to those nationally reported, with sub analysis of resistance rates in urological patients. The rate of ESBL Escherichia coli in Cheshire was reviewed.MEDLINE, EMBASE, and unpublished literature using OpenGrey and OpenDOAR, were searched since inception to February 2015. Five studies recruiting 2182 patients were included in the analyses. Statistical analysis was performed using SPSS 22 and MedCalc 15.4.RESULTSResistance rates in Merseyside were not found to be higher than the national rates. Urological patients exhibited a statistically significant higher resistance (p<0.0001). The relative risk of ESBL UTI in 2013 compared to 2005 was 8.18, 95% confidence interval (4.86 - 13.74). A preventative effect of increased fluid intake on the incidence of UTIs was found, odds ratio of UTI with increased fluid 0.27, 95% confidence interval (0.21 - 0.33).DISCUSSIONThe equivocal resistance rates in Merseyside and nationally suggests that modification of local practice is indicated. The higher resistance rate in urological patients highlights the need for separate empirical treatment.Increased fluid intake is appealing, due to the low cost and morbidity. Increase fluid intake has been demonstrated to be an effective method of reducing the rate of UTIs.

Molecular characterization of Escherichia coli isolates from patients with urinary tract infections in Palestine

2014 ◽  
Vol 63 (2) ◽  
pp. 229-234 ◽  
Author(s):  
Kamel Adwan ◽  
Naser Jarrar ◽  
Awni Abu-Hijleh ◽  
Ghaleb Adwan ◽  
Elena Awwad
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Enterobacterial Repetitive Intergenic Consensus ◽  
The West ◽  
E Coli ◽  
Amoxicillin Clavulanic Acid ◽  
Tract Infections ◽  
Resistance Rates

Antibiotic resistance of Escherichia coli isolated from urinary tract infections (UTIs) is increasing worldwide. A total of 41 E. coli isolates were obtained from urine samples from hospitalized patients with a UTI in three hospitals in the northern districts of the West Bank, Palestine during March and June 2011. Resistance rates were: erythromycin (95 %), trimethoprim–sulfamethoxazole (59 %), ciprofloxacin (56 %), gentamicin (27 %), imipenem (22 %), amoxicillin (93 %), amoxicillin–clavulanic acid (32 %), ceftazidime (66 %) and cefotaxime (71 %). No meropenem-resistant isolates were identified in this study. Among the isolates, phylogenetic group B2 was observed in 13 isolates, D in 12 isolates, A in 11 isolates and B1 in five isolates. Thirty-five of the isolates were positive for an extended-spectrum β-lactamase phenotype. Among these isolates, the bla CTX-M gene was detected in 25, and eight harboured the bla TEM gene. None of the isolates contained the bla SHV gene. Transformation experiments indicated that some of the β-lactamase genes (i.e. bla CTX-M and bla TEM) with co-resistance to erythromycin and gentamicin were plasmid encoded and transmissible. Apart from this, enterobacterial repetitive intergenic consensus-PCR (ERIC-PCR) revealed that the 41 isolates were genetically diverse and comprised a heterogeneous population with 11 ERIC-PCR profiles at a 60 % similarity level.

Aetiology and antibiotic resistance patterns of urinary tract infections in the elderly: a 6-month study

2013 ◽  
Vol 62 (6) ◽  
pp. 859-863 ◽  
Author(s):  
Elena De Vecchi ◽  
Simona Sitia ◽  
Carlo Luca Romanò ◽  
Cristian Ricci ◽  
Roberto Mattina ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
The Elderly ◽  
Gram Positive ◽  
Development Of Resistance ◽  
Tract Infections ◽  
Almost All ◽  
Micro Organisms ◽  
The Impact

Urinary tract infections (UTIs) are a common cause of bacteraemia in the elderly and are associated with a high probability of hospitalization. Despite the impact of UTIs on health status and quality of life, a limited number of studies have evaluated their aetiology in this population. This study aimed to evaluate the microbial aetiology and pattern of susceptibility of bacteria causing UTIs in the elderly. For this purpose, a retrospective cohort study of elderly residents (n = 472, aged >65 years) in 14 nursing homes in Milan (Italy) and its province was performed. Globally, 393 micro-organisms from 328 samples were isolated: Escherichia coli was the most prevalent (44.8 %), followed by Proteus mirabilis (20.4 %), Providencia spp. (8.9 %), Klebsiella spp. (6.4 %) and Pseudomonas aeruginosa (4.6 %). Enterococci were the most frequently isolated Gram-positive organisms (7.4 %). Almost all Enterobacteriaceae were susceptible to nitrofurantoin, carbapenems and amikacin. Extended-spectrum β-lactamases were detected in 42.1 % of isolates. The most active antibiotics against P. aeruginosa were colistin, amikacin and piperacillin/tazobactam. All Gram-positive organisms were susceptible to glycopeptides and linezolid, and 90 % were susceptible to nitrofurantoin. Fluoroquinolones showed a limited activity against all the tested micro-organisms. Escherichia coli remains the major micro-organism responsible for UTIs in older people, although to a lesser extent than in a younger population. The high rates of resistance observed in this study make careful use of antibiotics advisable to limit further development of resistance.

scholarly journals Is there a rise in resistance rates to fosfomycin and other commonly used antibiotics in Escherichia coli-mediated urinary tract infections? A perspective for 2004 – 2011

2013 ◽  
Vol 43 ◽  
pp. 537-541 ◽  
Author(s):  
Hüsnü PULLUKÇU ◽  
Şöhret AYDEMİR ◽  
Meltem IŞIKGÖZ TAŞBAKAN ◽  
Oğuz Reşat SİPAHİ ◽  
Feriha ÇİLLİ HALL JR ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Tract Infections ◽  
Resistance Rates

scholarly journals Antimicrobial resistance in patients with urinary tract infections and the impact on empiric therapy in Serbia

2016 ◽  
Vol 10 (10) ◽  
pp. 1065-1072
Author(s):  
Simon Zec ◽  
Aleksa Despotovic ◽  
Aleksandra Spurnic-Radovanovic ◽  
Ivana Milosevic ◽  
Milica Jovanovic ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Urinary Tract Infections ◽  
Large Scale ◽  
Empiric Therapy ◽  
Age And Gender ◽  
And Gender ◽  
Tract Infections ◽  
Resistance Rates ◽  
The Impact

Introduction: Surveillance of antimicrobial resistance is essential in establishing treatment guidelines for urinary tract infections. The aim of this pilot study was to analyse resistance rates of pathogens, across different demographics and determine whether adjustments in empiric therapy should be considered for different age and gender groups. Methodology: A 5-year retrospective study included 256 patients hospitalised, under the initial diagnosis of Fever of Unknown Origin who were then subsequently diagnosed with a urinary tract infection at the Clinic for Infectious and Tropical Diseases, Clinical Centre of Serbia. Patients were evaluated using demographic, clinical, and antimicrobial resistance data with appropriate statistical analysis including ANOVA significance testing, univariate, and multivariate analysis. Results: Resistance rates were above the threshold of 20% for the majority of the antimicrobials tested, the only exception being carbapenems. Amikacin, cefepime, and norfloxacin were agents that could be effectively used as empiric therapy in younger adults with resistance rates of 4.2, 8.0, and 10.0%, respectively. Moderate resistance rates of 17.4% for amikacin and 19.1% for cefepime were observed in the age group 35-64 years. High resistance rates were observed for all antimicrobials among patients 65 years and over. Among male patients, resistance rates to most antimicrobials were high. In female patients, amikacin and cefepime had resistance rates less than 20%. Younger age presented as a negative risk factor for infection by a multi-drug resistant pathogen. Conclusion: Age and gender demonstrated to be significant factors for determining proper empiric therapy; large-scale studies from Serbia are needed to solidify these findings.

scholarly journals Identification phenotypic and genotypic characterization of biofilm formation in Escherichia coli isolated from urinary tract infections and their antibiotics resistance

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Elnaz Davari Abad ◽  
Amin Khameneh ◽  
Leila Vahedi
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Biofilm Formation ◽  
Microtiter Plate ◽  
Antibiotics Resistance ◽  
E Coli ◽  
Microbial Characteristics ◽  
Tract Infections ◽  
Resistance Rates

Abstract Objective Urinary tract infections (UTIs) are the most common infectious diseases, and Escherichia coli is the most common pathogen isolated from patients with UTIs. The products of sfa, afa and foc genes are important for binding of the bacterium to urinary tract epithelium. Our aim was to investigate these genes in E. colis isolated from patients with UTIS. The frequencies of the genes were determined using PCR. Biofilm formation and antibiotic resistance rates were determined using microtiter plate and disk diffusion methods, respectively. The P < 0.05 was considered statistically significant. Results The frequencies of sfa, afa and foc were 75.3%, 17.5% and 22.5%, respectively showing a significantly higher prevalence of the sfa gene. The most effective antibiotics against the E. colis were nitrofurantoin and amikacin. The highest microbial resistance rates were also observed against amoxicillin and ampicillin. Furthermore, 12.7%, 6.3%, 74.7% and 6.3% of the isolates showed strong, moderate, weak capacities and no connections to form biofilms, respectively. The expression of the sfa gene was significantly associated with forming strong biofilms. Regarding the variabilities in the characteristics of E. coli strains associated with UTIs, it seems reasonable to adjust diagnostic and therapeutic methods according to the regional microbial characteristics.

scholarly journals Antibiotic resistance and detection of the sul2 gene in urinary isolates of Escherichia coli in patients from Brazil

2014 ◽  
Vol 8 (01) ◽  
pp. 039-043 ◽  
Author(s):  
Aline Teichmann ◽  
Homero Neto de Cunha Agra ◽  
Luciana de Souza Nunes ◽  
Marion Pereira da Rocha ◽  
Jane Dagmar Pollo Renner ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
High Resistance ◽  
E Coli ◽  
Tract Infections ◽  
Resistance Rates ◽  
Urinary Isolates ◽  
Developing Strategies

Introduction: The present study aimed to assess the antibiotic resistance profiles and detect the presence of the sul2 gene in sulfamethoxazole-susceptible and resistant isolates of Escherichia coli obtained from outpatients and inpatients with urinary tract infections. Methodology: The resistance profiles of 739 strains were assessed and the presence of the sul2 gene in 100 isolates was tested. Results: The antibiotics with the highest resistance rates were ampicillin (57.4%) and trimethoprim-sulfamethoxazole (44.7%). The presence of the gene sul2 was detected in 66.7% of outpatient samples and 67.9% of inpatient samples. Conclusions: Our results demonstrate that E. coli isolates exhibit high resistance to various classes of antibiotics, highlighting the need for developing strategies to help in prescribing antibiotics.

scholarly journals Impact of the MIC of Piperacillin-Tazobactam on the Outcome of Patients with Bacteremia Due to Extended-Spectrum-β-Lactamase-Producing Escherichia coli

2013 ◽  
Vol 57 (7) ◽  
pp. 3402-3404 ◽  
Author(s):  
Pilar Retamar ◽  
Lorena López-Cerero ◽  
Miguel Angel Muniain ◽  
Álvaro Pascual ◽  
Jesús Rodríguez-Baño ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Bloodstream Infections ◽  
Content Type ◽  
Extended Spectrum ◽  
Tract Infections ◽  
The Impact

ABSTRACTWe investigated the impact of the piperacillin-tazobactam MIC in the outcome of 39 bloodstream infections due to extended-spectrum-β-lactamase-producingEscherichia coli. All 11 patients with urinary tract infections survived, irrespective of the MIC. For other sources, 30-day mortality was lower for isolates with a MIC of ≤2 mg/liter than for isolates with a higher MIC (0% versus 41.1%;P= 0.02).

scholarly journals Impact of restriction of over-the-counter sales of antimicrobials on antimicrobial resistance in Escherichia coli from community-onset urinary tract infections in inner São Paulo State, Brazil

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259632
Author(s):  
Fernanda Saad Rodrigues ◽  
Helena Ribeiro Aiello Amat ◽  
Carlos Magno Castelo Branco Fortaleza
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Urinary Tract Infections ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Over The Counter ◽  
Tract Infections ◽  
The Impact ◽  
Community Onset

Background Antimicrobial resistance in community-associated infections is an increasing worldwide concern. In low-to-middle income countries, over-the-counter (OTC) sales of antimicrobials without medical prescription have been blamed for increasing consumption and resistance. We studied the impact of restriction of OTC sales of antimicrobials in Brazil (instituted in October 2010) on resistance trends of Escherichia coli from community-onset urinary tract infections. Methods We analyzed monthly resistance trend of Escherichia coli from community-onset urinary tract infections from 2005 through 2018. The data were submitted to interrupted time series analysis in both linear and Poisson regression models. Results We found impact on cefazolin (p<0.001) and amikacin (p<0.001) resistance as immediate impact of the intervention, and no beneficial impact on resistance to ciprofloxacin, ceftriaxone or sulfamethoxazole-trimethoprim. Conclusion At the present study, we found that OTC sales restriction did not generally impact on antimicrobial resistance.

scholarly journals Snapshot of Phylogenetic Groups, Virulence, and Resistance Markers in Escherichia coli Uropathogenic Strains Isolated from Outpatients with Urinary Tract Infections in Bucharest, Romania

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Violeta Corina Cristea ◽  
Irina Gheorghe ◽  
Ilda Czobor Barbu ◽  
Laura Ioana Popa ◽  
Bogdan Ispas ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Virulence Gene ◽  
Epidemiological Surveillance ◽  
Phylogenetic Groups ◽  
Gene Encoding ◽  
Extended Spectrum Beta Lactamases ◽  
Tract Infections ◽  
Resistance Rates

Background. Urinary tract infections (UTIs) caused by Uropathogenic Escherichia coli (UPEC) are among the most common infections worldwide, including Romania. To the best of our knowledge, this is the first study performed on a significant number of community-acquired (CA) UPEC strains isolated from Romanian outpatients, aiming to evaluate and establish potential correlations among the phylogenetic groups (PG), resistance profiles, and the virulence factors (VF) genes of the CA-UPEC isolates. Materials/Methods. The present study was performed on a total of 787 UPEC nonrepetitive isolates consecutively isolated during one month from outpatients with CA-UTIs, visiting one of the biggest laboratories in Bucharest, Romania, receiving patients from all over the country. The strains identification was performed by MALDI TOF and the susceptibility patterns were tested using Microscan according to CLSI guidelines. PCR assays were performed to detect the presence of different VFs (fimH gene encoding for type 1 fimbriae, afaBC for A fimbriae, sfaDE for S fimbriae, KpsMTII for capsule, hlyA for haemolysin A, hlyD for haemolysin D, and cnf-1 for tumor necrosis factor), the phylogenetic groups (PG) A, B1, B2, and D, and the extended spectrum beta-lactamases (ESBLs) genes. Results. The 787 CA-UPEC strains were isolated predominantly from female patients (90.95%) of >30 years (~74%). The resistance rates were 47.52% for ampicillin, 41.16% for tetracycline, 24.39% for cotrimoxazole, 19.18% for amoxicillin-clavulanic acid, 15.50% for cefazolin, 14.99% for ciprofloxacin, and 14.86% for levofloxacin; 35.19% of the investigated strains were MDR and 9.03% ESBL producers (from which 42.25% were positive for blaCTX-M, 38.02% for blaTEM, and 19.71% for blaSHV). FimH was the most frequent virulence gene (93.90%) followed by hlyD (44.34%); afaBC (38.24%); KpsMTII (32.65%); sfaDE (23.88%); hlyA (12.45%); and cnf-1 (7.75%). The distribution of the analyzed UPEC strains in phylogenetic groups was different for non-MDR and MDR strains. Overall, 35% of the strains belonged to the phylogenetic group B2 (harboring the yjaA gene); 27% to group B1 (confirmed by the presence of the TspE4C2 fragment); 16% to group D; and 22% to group A. The CA-UPEC strains included in PG B1 and PG B2 proved to be the most virulent ones, the number of strains carrying multiple VFs (>3) being significantly larger as compared to strains belonging to PG A and PG D) (p<0,0001). The presence of one or two ESBL genes was significantly associated (p =0.0024) with PGs A and D. Conclusions. Our findings showed that the community UPEC strains circulating in Bucharest, Romania, belong predominantly to group B2 and >90% harbored the fimH gene. High MDR resistance rates were observed, as well as extended VF profiles, highlighting the importance of this type of studies for improving the epidemiological surveillance and the therapeutic or prophylactic management of the respective infections, in the context of antibiotic resistance emergence.

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