scholarly journals Multi Drug Resistant Pathogens Causing Urinary Tract Infections in Children at Kathmandu Model Hospital

2013 ◽  
Vol 32 (3) ◽  
pp. 233-238 ◽  
Author(s):  
Basudha Shrestha ◽  
Rajesh Lal Gurubacharya ◽  
Basanta Maharjan ◽  
Sanjit Shrestha

Introduction: Antibiotic resistance of urinary tract pathogens has increased globally. Updated knowledge of the antibiotic resistance patterns of uropathogens in the health institutes is important for the selection of an appropriate empirical antimicrobial therapy. The aim of this study was to evaluate the multi drug resistant urinary isolates in the children from 1 to15 years and evaluate the options for empiric antibiotic therapy. Materials and Methods: The study was conducted from December 2011 to May 2012 in the Bacteriology laboratory, Kathmandu Model Hospital. Urine samples received in the laboratory were processed for routine, culture and its sensitivity. The antimicrobial susceptibility of bacterial isolates was determined following Clinical and Laboratory Standard Institute (CLSI) recommended Kirby-Bauer Disc Diffusion method. Results: Of the total 372 urine samples received in the laboratory, 60 (16.13%) showed significant growth; of which 55.0 % (33/60) were MDR isolates. Escherichia coli were the predominant isolate from urine sample. Out of 49 Escherichia coli isolates, 27 (45.0%) were Multi drug resistant. Enterococcus faecalis (N=3) was the most predominant Gram positive isolate and 66.67 % (2/3) of this organism were multi drug resistant. Among the first line drugs used against gram negative isolates, nitrofurantoin was the most effective drug followed by quinolones, while among the second line drugs; meropenem was the most effective drug followed by chloramphenicol and amikacin, whereas; nitrofurantoin (100%) was the most effective drug for Gram positive isolates followed by norfloxacin and cefotaxime. Conclusion: High percentages of multi drug resistant uropathogens were revealed in children. Nitrofurantoin was found to be the most effective drug for gram positive, gram negative and multi drug resistant isolates. DOI: http://dx.doi.org/10.3126/jnps.v32i3.6771 J. Nepal Paediatr. SocVol.32(3) 2012 233-238

2020 ◽  
Vol 6 (3) ◽  
pp. 564-569
Author(s):  
Md Habibur Rahman ◽  
Mushtaque Ahmed ◽  
Dayanidhi Sarkar ◽  
Md Asadur Rahman

Urinary tract infection (UTI) is one of the commonest infections encountered by clinicians and despite the widespread availability of antimicrobial agents UTI has become difficult to treat because of appearance pathogens with increasing resistance to antimicrobial agents. The aim and objectives of this study were to determine the pathogens causing UTI and to determine the antibiotic sensitivity status among these isolates in a diagnostic laboratory in Dhaka city. A laboratory based cross sectional survey was conducted in Popular Diagnostic Centre Ltd. Dhanmondi, Dhaka-1205, Bangladesh from July 2016 to December 2016. A total of 553 freshly voided midstream urine samples (10-20 ml) were collected in a wide mouth sterile container from patients and processed in microbiology laboratory to isolate pathogens and antibiotic susceptibility test using standard procedure. Among 553 urine sample, the culture positivity in urine samples was found to be 158 (28.57%) of which 39 (24.70%) were isolated from male patients and 119 (75.30%) from female patients. Escherichia coli (43.67%) were found to be the predominant pathogen followed by Staphylococcus spp. (16.45%), Enterococcus spp. (13.39%), Klebsiella spp. (13.29%), Candida spp. (5.70%), Acinetobacter spp. (4.43%), Psudomonas spp. (3.80%) and Proteus spp. (1.27%). Carbapenem group (Imipenem, Meropenem) were the most effective antibiotic with resistance between 0 and 5.1% of the gram negative isolates and Linezolid and Vancomycin was most effective in gram positive isolates. Nitrofurantoin was most effective both gram negative and gram positive isolates. This study finding showed That Escherichia. coli isolates were the predominant pathogens and showed increasing pattern to the commonly prescribed drugs in private practice that in turn leaves the clinicians with very few alternative options in drug for the treatment of UTIs. Asian J. Med. Biol. Res. September 2020, 6(3): 564-569


2018 ◽  
Vol 2 ◽  
pp. 34-40
Author(s):  
Surendra Prasad Yadav ◽  
Puspa Raj Dahal ◽  
Shiv Nandan Sah ◽  
Vijay Kumar Sharma

Urinary tract infection (UTI) is one of the most common diseases encountered worldwide and is a major public health problem in terms of morbidity and financial costs. A cross-sectional study was conducted in Alka Hospital, Lalitpur, Nepal from February to July, 2014. A total of 353 midstream urine samples were collected from postmenopausal women visiting Alka Hospital, Lalitpur, Nepal. The samples were examined by microscopically and culture methods. The isolated organisms were identified by conventional microbiological methods. Antibiotic susceptibility test was performed by modified Kirby-Bauer disc diffusion method according to CLSI (2011) guidelines. Among 353 urine samples processed, 32 % (113) showed significant bacteriuria. Out of 113 bacterial isolates, the prevalence of gram negative bacteria was 97.3% (110) while that of gram positive was 2.7% (3). The most predominating organisms causing UTI were Escherichia coli (84.9%) followed by Klebsiella pneumoniae (5.3%), Enterococcus faecalis (1.7%), Providencia spp. (1.7%), Klebsiella oxytoca (1.7%), Proteus mirabilis (1.7%), Proteus vulgaris (0.9%), Citrobacter freundii (0.9%) and Staphylococcus aureus (0.9%). Antibiotic susceptibility tests of the isolates showed that, most of the gram negative bacterial isolates were sensitive to Piperacillin+Tazobactam followed by Amikacin, Imipenem and Nitrofurantoin, while they were resistant to Amoxicillin. All gram positive isolates were sensitive to Amoxicillin and resistant to Gentamycin. This study showed that higher aged postmenopausal women (>80 years) were at higher risk for UTI than those of lower aged ones (<80 years).


2020 ◽  
Vol 14 (4) ◽  
pp. 2577-2584
Author(s):  
Tariq Ahmad Shah ◽  
P. Preethishree ◽  
Ashwini ◽  
Vidya Pai

Urinary tract infection (UTI) is one of the most common complaints in the outpatient clinic and a major health problem owing to the emergence of antibiotic resistance and biofilm formation. The objective of this study was to isolate and identify the causative bacterial agent of UTI and detect in vitro biofilm formation by Escherichia coli and investigate its correlation with antibiotic resistance. Urine samples from 519 patients with suspected UTIs were collected and processed by conventional microbiological procedures. Antimicrobial susceptibility testing for E. coli isolates was performed on Mueller Hinton agar (MHA) plates using the Kirby-Bauer disk diffusion method. Biofilm production was evaluated using the tissue culture plate method. Of 519 urine samples, 115 (22.1%) showed significant bacteriuria. The most common isolate was E. coli (n=57, 49.6%), followed by Klebsiella spp. (n=23, 20%). All E. coli isolates were evaluated for their ability to form biofilms in vitro. Of 57 isolates, 50 (87.7%) were biofilm producers and 7 (12.3%) were non-biofilm producers. Antibiogram of E. coli isolates revealed the highest resistance to ampicillin (96.5%) and nitrofurantoin (91.2%), followed by amoxyclav (82.5%), ceftazidime (73.7%), cefepime (71.9%), and tetracycline (71.9%). A significant association (p<0.05) was observed between biofilm formation and resistance to amoxyclav, ceftazidime, cefepime, imipenem, and nitrofurantoin. A significant correlation was noted between biofilm production and antibiotic resistance. Hence, screening of all isolates of uropathogenic E. coli for biofilm production and studying their antibiogram would allow appropriate choice of antibiotic therapy.


2020 ◽  
Vol 12 (3) ◽  
Author(s):  
Ibrahim A Naqid ◽  
Nawfal R Hussein ◽  
Amer Balatay ◽  
Kurdistan A Saeed ◽  
Hiba A Ahmed

Background: Urinary Tract Infections (UTIs) are one of the most common bacterial infections worldwide. The study of bacterial uropathogens in a local area and their susceptibility to antimicrobial agents is required to determine empirical therapy. Objectives: This study aimed to assess the profile and antibiotic resistance patterns of bacteria, causing urinary infections isolated from female patients in Duhok province, Iraq. Methods: A total of 530 urine samples were collected from females clinically suspected of UTIs over three years between January 2017 and February 2020. The samples were inoculated directly on MacConkey and Blood agar media and then incubated aerobically for 24 h at 37°C. Samples that gave up colony counts of ≥ 105 CFU/mL were considered as positive growth. Purified colonies were identified through standard bacteriological tests, and their susceptibility to different antibiotics was determined using the Vitek-2 system. Results: Out of 530 urine samples, 450 (84.9%) contained Gram-negative bacteria, while the other 80 (15.1%) harbored Gram-positive bacteria. Escherichia coli was the most common uropathogenic isolate (58.5%), followed by K. pneumoniae (14.3%), Staphylococcus spp. (8.9%), P. mirabilis (6.6%), E. faecalis (3.2%), and S. agalactiae (3.02%). The majority of Gram-negative uropathogens were resistant to ampicillin, aztreonam, ceftriaxone, and cefepime and around 95% were sensitive to ertapenem and imipenem. Most Gram-positive isolates showed high resistance to benzylpenicillin, oxacillin, gentamicin, and erythromycin, and high susceptibility to linezolid, tigecycline, and nitrofurantoin. Conclusions: It was concluded from this study that E. coli is the predominant pathogen causing UTIs in female patients in Duhok province, Iraq. There were increasing antibiotic resistance rates, particularly to ampicillin, aztreonam, ceftriaxone, benzylpenicillin, and erythromycin. Therefore, empirical antibiotic therapy should be based on local sensitivity patterns rather than international guidelines.


2017 ◽  
Vol 10 (1) ◽  
pp. 98
Author(s):  
Mansoor Khalid ◽  
Maryam Khalifa Al Naimi ◽  
Hafiz Ghulam Murtaza Saleem ◽  
Muhammad Muqeet Ullah ◽  
Ahmed Yar Mohammed Dawood Al Baloshi

BACKGROUND: Urinary tract infections (UTIs) is a worldwide problem of all age groups and gender. Emerging resistance to antibiotics making difficult in the choice of treatment and management of UTI cases. This study sought to determine the gender wise prevalence of common uropathogens from UTI patients and the resistance profile of uropathogens against commonly used antibiotics.METHOD: This cross sectional study was conducted in Al Buraimi Hospital, Sultanate of Oman. The data of UTI patients visited hospital was analyzed for the isolation of uropathogens from positive urine culture and antimicrobial sensitivity test was performed by disc diffusion method. Descriptive statistics was used to analyze the data using SPSS 21.0 and Microsoft Excel.RESULT: Total 4,480 urine samples were analyzed for isolation of uropathogens and significant bacteriuria were found in total 846 (19%) samples. Overall 728 (86%) Gram-negative and 118 (14%) Gram positive uropathogens were isolated from total (846) positive urine samples and the highest prevalence of isolates was observed in females 542(74%) than males 186(26%). E.coli was found the highest prevalent (50.3%) uropathogens followed by Klebsiella species (13.9%), Pseudomonas (6.3%), A.baumannii (4%), E.Cloacae (2.2%), Proteus species (1.4%), Citrobacter species (1.2%), M. morgani (0.3%) and Serratia species (0.1%). The highest (34.3%) antibiotic resistance was noticed in E.coli against Nalidixic Acid, however, susceptiblity was found against Ceftriaxone, Ceftazidime, Ciprofloxacin and Nitrofurantoin among female and males.CONCLUSION: Overall, β- lactam antibiotics, Cephalosporins, Fluroquiolones, Macrobids would be the first line of drugs and the most effective for the empirical treatment of Gram-negative and Gram-positive uropathogens; however Aminoglycosides, Carbapenems and Polymyxin could be used for the treatment of UTI infections as the second choice.


2018 ◽  
Vol 12 (04) ◽  
pp. 244-249
Author(s):  
Abdelhakim Aouf ◽  
Taha Gueddi ◽  
Bilal Djeghout ◽  
Houria Ammari

Introduction: The frequency of Enterobacteriaceae involved in urinary tract infections (UTI) has increased significantly since the early 1990s, particularly in at-risk facilities such as resuscitation, surgery, urology and nephrology. The objective of this study was to evaluate the antimicrobial susceptibility of Enterobacteriaceae causing urinary tract infections (UTIs)at the University Hospital Centre of Benimessous in Algiers. Methodology: The study was designed as a retrospective study (between January 1st 2010 and December 31st 2012) and a prospective study (between January 1standApril 30th 2013) on 13,611 urine samples. Antimicrobial resistance phenotyping was conducted on the bacterial isolates using disk-diffusion method. Results: On 13,611 urine samples analysed, 1,790 (13.15%) fulfilled the criteria for urinary tract infection. Enterobacteriaceae were identified in 1,561 analysed samples (87%). Escherichia coli was the dominant uropathogen (66,15%) in both hospitalized and non-hospitalized patients. The other main detected Enterobacteriaceae members were Klebsiella pneumoniae (11,96%) and Proteus mirabilis (5,42%). Analysis of results showed also that women were more prone to UTI than men with sex ratio of 3.76(W/M). The susceptibilities of isolated Enterobacteriaceae to antibiotics revealed that they had acquired resistance to several classes, particularly toward β-lactams. Resistance frequencies were relatively high to ampicillin and sulfomethoxasole, while being very low to aminoglycosides and furans. Results obtained revealed also that 7% of isolates where resistant to third generation cephalosporins by production of extended spectrum β-lactamases (ESBL). Conclusions: The continuous monitoring of antibiotic resistance of uropathogenic Escherichia coli is crucial to guide the clinician to choose the best empiric treatment.


2021 ◽  
pp. 212-219
Author(s):  
Souadkia Sarra ◽  
Mbarga Manga Joseph Arsene ◽  
Volina Elena Grigorievna ◽  
Podoprigora Irina Victorovna ◽  
Yashina Natalia Vyacheslavovna ◽  
...  

Background and Aim: Uropathogenic Escherichia coli (UPEC) is commonly involved in urinary tract infections (UTIs), which are generally treated with antibiotics. However, the emergence of multidrug-resistant (MDR) strains of UPEC has made the treatment difficult. There is thus a need to continuously assess their sensitivity to antibiotics. This study aimed to determine the antibiotic resistance patterns and MDR phenotypes of UPEC strains isolated from children diagnosed with UTIs at the Russian Children's Clinical Hospital in Moscow, Russia. Materials and Methods: Kirby–Bauer's disc diffusion method was used to study the sensitivity to antibiotics of 106 UPEC isolates from urine specimens from children (aged from 9 months to 18 years old) diagnosed with UTIs. The results were interpreted in accordance with the Clinical and Laboratory Standards Institute guidelines and the correlations of variables with the degree to which each antibiotic inhibited the UPEC strains in terms of diameter on the disc were determined using Spearman's rank correlation test. A t-test and principal component analysis were performed to visualize the correlations of the susceptibility of UPEC to antibiotics with the age and sex of the patients. Statistical significance was set at p≤0.05. Results: Among the 106 UPEC strains tested, none (0%) showed resistance to fosfomycin (FO), while 84 (79.2%) were resistant (R) to at least one antibiotic. The highest rates of resistance were observed to amoxicillin (69.8%), ampicillin (62.3%), cefazolin (39.6%), trimethoprim (TR) (37.7%), ceftriaxone (34.9%), and tetracycline (33.0%). Interestingly, 22 (20.8%) strains were R to imipenem. UPEC isolates from males aged 1-6 years were more R to antibiotics than those from the other groups, with the exception of TR, to which UPEC isolates from females aged 13-18 years old were less sensitive (S). The multidrug-resistance (MDR) index ranged between 0.00 and 0.75 and we found that more than a quarter of UPEC (31/106) had an MDR index ≥0.5 and only 22 (20.7%) strains were S to all antibiotics tested (MDR index=0). Finally, Spearman's rank correlation test showed that, with the exception of FO, there were correlations between the inhibition diameters of all other antibiotics. Conclusion: FO is the only antibiotic to which all UPECs were S and may be suggested as the first line of treatment for UPEC. Further research is needed to continue monitoring antibiotic resistance and to investigate the genetic features associated with such resistance observed in this study.


2021 ◽  
Vol 30 (3) ◽  
pp. 153-162
Author(s):  
Nader A. Nemr ◽  
Rania M. Kishk ◽  
Mohammed Abdou ◽  
Hassnaa Nassar ◽  
Noha M Abu bakr Elsaid ◽  
...  

Background: Urinary tract infection (UTI) is considered one of the most common bacterial infections seen in health care. To our knowledge, there is no available antimicrobial resistance surveillance system for monitoring of community-acquired UTIs (CA- UTIs) in our country. Objectives: we aimed to discuss the bacterial pattern and resistance profile of CA-UTIs in Ismailia, Egypt. Methods: This cross-sectional study included 400 patients suffering from symptoms of acute UTIs. Urine specimens were collected by clean-catch mid-stream method, examined microscopically and inoculated immediately on blood agar and MacConkey's agar plates. Colony counting, isolation and identification of the urinary pathogens were performed by the conventional biochemical tests according to the isolated organism. Antibiotic susceptibility testing was performed by Kirby Bauer disk diffusion method. Interpretation was performed according to Clinical Laboratory Standard Institute (CLSI) guidelines. Results: out of 400 specimens, 136 of them revealed no bacterial growth or insignificant bacteriuria. Most of participants with UTI were females (81.8%) (p=0.008) and 54.5% of them were married (P=0.1). Gram negative bacteria were more common than Gram positive representing 66 % and 34% respectively. E. coli was the most common isolated organism (39%) followed by S. aureus (32%), K. Pneumoniae and Pseudomonas (10.5% for each), Proteus (6%) and Enterococci (2%). E. coli isolates showed the highest susceptibility to imipenem, meropenem, amikacin, nitrofurantoin, levofloxacin and ciprofloxacin. Most of our patients were diabetics (64.8%) (p=0.004). The mean ± SD of HbA1c was 6.4±2.0 with 4 to 12.6 range, S.E was 0.1 and 95% C.I was 6.2- 6.7. The highest mean ± SD of HbA1c was in S. aureus infections. Conclusion: Gram negative bacteria were most common than Gram positive with predominance of E. coli with significant relation to the presence of diabetes.


Author(s):  
Somayeh Bakhtiari ◽  
Hassan Mahmoudi ◽  
Sara Khosravi Seftjani ◽  
Mohammad Ali Amirzargar ◽  
Sima Ghiasvand ◽  
...  

Background and Objectives: Escherichia coli is the most common causative agent of urinary tract infections (UTIs) in 90-80% of patients in all age groups. Phylogenetic groups of these bacteria are variable and the most known groups are A, B1, B2 and D. The present study aimed to evaluate the phylogenetic groups of E. coli samples obtained from UTIs and their relation with antibiotic resistance patterns of isolates. Materials and Methods: In this study 113 E. coli isolates were isolated from distinct patients with UTIs referred to Hamadan hospitals. After biochemical and molecular identification of the isolates, typing and phylogenetic grouping of E. coli strains were performed using multiplex PCR targeting chu, yjaA and TSPE4.C2 genes. The anti-microbial susceptibility of the isolates to amikacin, ampicillin, trimethoprim-sulfamethoxazole, amoxicillin/clavulanic acid, ciprofloxacin, cefotaxime, imipenem, aztreonam, gentamicin, meropenem, nitrofurantoin, nalidixic acid and cefazolin was determined using disk diffusion method. Results: Of 113 isolates, 50 (44.2%), 35 (31%), 23 (20.4%) and 5 (4.4%) of samples belonged to group B2, group D, group A and group B1 phylogenetic groups respectively. All isolates were susceptible to meropenem, imipenem (100%), followed by amikacin (99.1%). The highest resistance rates were observed against ampicillin (74.3%) and nalidixic acid (70.8%). Correlation between phylogenetic groups and antibiotic susceptibilities was significant only with co-amoxiclav (P = 0.006), which had the highest resistance in phylogenetic group A. Conclusion: Prevalence of different phylogroup and resistance associated with them in E. coli samples could be variable in each region. Therefore, investigating of these items in E. coli infections, could be more helpful in selecting the appropriate antibiotic treatment and epidemiological studies.


BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stephen Shei-Dei Yang ◽  
Chun-Chun Yang ◽  
Yi-Sheng Chen ◽  
Shang-Jen Chang

Abstract Background The aim of this study was to compare the performance of the new flow cytometer UF-5000 with the UF-1000i and Gram staining for determining bacterial patterns in urine samples. Methods Women who attended our clinic with symptoms suggestive of urinary tract infection were enrolled in the study. Mid-stream urine samples were collected for gram staining, urine analysis and urine cultures. Bacterial patterns were classified using the UF-1000i (none, cocci bacteria or rods/mixed growth), the UF-5000 (none, cocci, rods or mixed growth) and Gram staining. Results Among the 102 included samples, there were 10 g-positive cocci, 2 g-positive bacilli, 66 g-negative rods, and 24 mixed growth. The sensitivity/specificity of the UF-1000i was 81.8/91.1% for gram-negative rods and 23.5/96.9% for cocci/mixed. The sensitivity/specificity of the UF-5000 was 80.0/88.2% for gram negative rods and 70.0/86.5% for gram-positive cocci. Conclusions The UF-5000 demonstrated good sensitivity and specificity for Gram-negative bacilli and demonstrated an improved sensitivity for detecting Gram-positive cocci compared with the UF-1000i.


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