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

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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Molecular Characterization of Multidrug Resistant Uropathogenic E. Coli Isolates from Jordanian Patients

The Open Microbiology Journal ◽

10.2174/1874285801812010001 ◽

2018 ◽

Vol 12 (1) ◽

pp. 1-7 ◽

Cited By ~ 7

Author(s):

Yacoub R. Nairoukh ◽

Azmi M. Mahafzah ◽

Amal Irshaid ◽

Asem A. Shehabi

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Multidrug Resistant ◽

Urine Samples ◽

Diffusion Method ◽

Molecular Characteristics ◽

Biochemical Tests ◽

E Coli ◽

Tract Infections ◽

St131 Clone

Background: Emergence of multi-drug resistant uropathogenic E. coli strains is an increasing problem to empirical treatment of urinary tract infections in many countries. This study investigated the magnitude of this problem in Jordan. Methods: A total of 262 E. coli isolates were recovered from urine samples of Jordanian patients which were suspected to have urinary tract infections (UTIs). All isolates were primarily identified by routine biochemical tests and tested for antimicrobial susceptibility by disc diffusion method. Fifty representative Multidrug Resistance (MDR) E. coli isolates to 3 or more antibiotic classes were tested for the presence of resistance genes of blaCTX-M- 1, 9 and 15, carbapenemase (blaIMP, blaVIM, blaNDM-1, blaOXA-48), fluoroquinolones mutated genes (parC and gyrA) and clone of ST131 type using PCR methods. Results: A total of 150/262 (57.3%) of E. coli isolates were MDR. Urine samples of hospitalized patients showed significantly more MDR isolates than outpatients. Fifty representative MDR E. coli isolates indicated the following molecular characteristics: All were positive for mutated parC gene and gyrA and for ST131 clone, and 78% were positive for genes of CTX-M-15, 76% for CTX-M-I and for 8% CTX-M-9, respectively. Additionally, all 50 MDR E. coli isolates were negative for carbapenemase genes (blaIMP, blaVIM, blaNDM-1, blaOXA-48), except of one isolate was positive for blaKPC-2 . Conclusion: This study indicates alarming high rates recovery of MDR uropathogenic E. coli from Jordanian patients associated with high rates of positive ST131 clone, fluoroquinolone resistant and important types of blaCTX-M.

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Prevalence and antibiotic susceptibility pattern of pathogens from urinary tract infections (UTI) in a private diagnostic laboratory in Bangladesh

Asian Journal of Medical and Biological Research ◽

10.3329/ajmbr.v6i3.49809 ◽

2020 ◽

Vol 6 (3) ◽

pp. 564-569

Author(s):

Md Habibur Rahman ◽

Mushtaque Ahmed ◽

Dayanidhi Sarkar ◽

Md Asadur Rahman

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Antibiotic Susceptibility ◽

Antimicrobial Agents ◽

Urine Samples ◽

Gram Positive ◽

Diagnostic Laboratory ◽

Gram Negative ◽

Antibiotic Susceptibility Test ◽

Tract Infections

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

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Occurrence of urinary tract infection among children attending Gandaki Medical College Teaching Hospital and Research Center, Pokhara, Nepal

International Journal of Infection and Microbiology ◽

10.3126/ijim.v2i3.8665 ◽

2013 ◽

Vol 2 (3) ◽

pp. 82-86 ◽

Cited By ~ 1

Author(s):

G Gautam ◽

S Regmi ◽

NT Magar ◽

B Subedi ◽

T Sharma ◽

...

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Teaching Hospital ◽

College Teaching ◽

Diffusion Method ◽

Disk Diffusion Method ◽

E Coli ◽

Medical College ◽

Tract Infections

INTRODUCTION: Urinary tract infection (UTI) is considered as the most common bacterial infectious disease seen among the pediatric patients. Most commonly, members of Enterobacteriaceae, particularly uropathogenic strains of E. coli and Enterobacter spp. are the primary causative pathogens of UTI in the different part of the world. Emergence of antimicrobial resistance rates among pathogens recovered from urinary tract infections is an increasing problem in the specific region. MATERIALS AND METHODS: Prevalence and anti microbial susceptibility pattern of the bacterial uropathogens isolated from the children attending Gandaki Medical College Teaching Hospital and Reserch Center (GMC) Nepal. A total of 155 children aged upto 15 years were included in this study. Urine cultures were carried out and the isolates were identified by Gram staining and conventional biochemical methods. Antimicrobial susceptibility testing was performed by disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI). RESULTS: In the present study 21.3 % of the sample size, showed significant bacterial growth. E. coli was the most frequently occurring pathogen (39.40%), followed by Proteus spp. 21.2%, Citrobacter spp. and Streptococcus faecalis (12.1%) Klebsiella spp. (9.1%), and Staphylococcus aureus and Enterobacter (3.0%). Susceptibility rate of E. coli were 69.2% to Gentamycin and Amikacin, 53.8% to Norfloxacin, 38.4% to Nalidixic acid and Norfloxacin. CONCLUSIONS: Pediatric urine culture isolates were becoming increasingly resistant to commonly used antibiotics. Finally, we suggest that empirical antibiotic selection should be based on knowledge of the local prevalence of bacterial organisms and antibiotic sensitivities rather than on universal guidelines. DOI: http://dx.doi.org/10.3126/ijim.v2i3.8665 Int J Infect Microbiol 2013;2(3):82-86

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A HOSPITAL BASED SURVEILLANCE STUDY OF URINARY TRACT INFECTIONS CAUSED BY PSEUDOMONAS AERUGINOSA AND ACINETOBACTER SPECIES WITH SPECIAL EMPHASIS ON DRUG RESISTANCE

10.36106/paripex/6200324 ◽

2019 ◽

pp. 1-2

Author(s):

Anju K K ◽

Deepthy B J ◽

Gogi Suresh ◽

Harish P V

Keyword(s):

Pseudomonas Aeruginosa ◽

Drug Resistance ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Urinary Tract Infections ◽

Urine Samples ◽

Diffusion Method ◽

Acinetobacter Species ◽

Tract Infections

BACKGROUND: Urinary tract infection (UTI) is the commonest bacterial infection in community practice. The most common microorganisms causing UTI include E.coli, Klebsiella, Staphylococcus aureus, Coagulase negative staphylococci, Pseudomonas, Proteus and Acinetobacter. The increase in multidrug resistance in bacterial uropathogens is an important and emerging public health problem in non-fermenting isolates.So this study focuses the surveillance of Pseudomonas aeruginosa, and Acinetobacter species in UTI and also focuses the drug resistance of the isolates. METHOD: The study was conducted at the Department of Microbiology, DM WIMS,Meppadi,Wayanad, starting from May 2019 to July 2019. A total of 200 urine samples were taken for identifying the significant urinary tract infections. Organisms were isolated and identified using standard microbial techniques. Antibiotic sensitivity was studied using Kirby Bauer disc diffusion method and EDTA double disc synergy test. RESULT: Out of the 200 urine samples studied, 87 showed significant bacteriuria, with 26 (29.9%) Pseudomonas aeruginosa and 6(6.9%) Acinetobacter species. Other isolates were E.coli (24), klebsiella (22), enterobacter (4), Citrobacter (3) and one each were Serratia and Morganella. Among these isolates 15 Pseudomonas aeruginosa and 2 Acinetobacter species were MBL producers. CONCLUSION: The study reports that other than E.coli, Pseudomonas aeruginosa has a higher prevalence in urinary tract infection and more than half of the isolates are showing drug resistance to the commonly used drugs. Most of the infection with such strains were treated successfully with combination of drugs such as Tigecycline with colistin,colistin with a carbapenem, fosfomycin with a carbapenem, fosfomycin with aminoglycoside, and a carbapenem with an aminoglycoside have been reported as antibiotic combinations effectively administered to series of patients infected with carbapenemase producing organisms.

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Frequency and susceptibility pattern of uropathogenic Enterobacteriaceae isolated from patients in Algiers, Algeria

The Journal of Infection in Developing Countries ◽

10.3855/jidc.10017 ◽

2018 ◽

Vol 12 (04) ◽

pp. 244-249

Author(s):

Abdelhakim Aouf ◽

Taha Gueddi ◽

Bilal Djeghout ◽

Houria Ammari

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Acquired Resistance ◽

Urine Samples ◽

University Hospital ◽

Diffusion Method ◽

Disk Diffusion Method ◽

Tract Infections ◽

A Prospective Study

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.

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Antibiotic susceptibility profile and extended spectrum β-lactamases production by uropathogenic Escherichia coli from tertiary care hospital of rural settings

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20184901 ◽

2018 ◽

Vol 6 (12) ◽

pp. 4022

Author(s):

Mustafa Sofiur Rahman ◽

Ritu Garg ◽

Varsha A. Singh ◽

Dipankar Biswas

Keyword(s):

Escherichia Coli ◽

Drug Resistance ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Antibiotic Susceptibility ◽

Uropathogenic Escherichia Coli ◽

Diffusion Method ◽

Care Hospital ◽

Antibiotic Susceptibility Test ◽

Tract Infections

Background: Escherichia coli are the most common cause of urinary tract infections in community as well as hospital settings. Emergence of drug resistance in Escherichia coli due to various mechanisms makes the treatment options very limited. This study was undertaken to detect ESBLs in uropathogenic Escherichia coli isolates and to determine their antimicrobial susceptibility pattern in rural setting.Methods: A prospective study was done on 502 E. coli isolates from clinically suspected cases of urinary tract infections (UTI) patients of all age groups. All samples were inoculated on Cysteine Lactose Electrolyte Deficient Agar (CLED). Organisms grown in pure culture were identified by standard biochemical tests. Antibiotic susceptibility test was done by the Kirby Bauer Disc diffusion method on Muller Hinton agar. ESBL detection was done as per CLSI guidelines.Results: Of the 502 isolates of Escherichia coli, nitrofurantoin (82%) was found be most sensitive antimicrobial followed by amikacin (73%), gentamycin (71%) and imipenem (64%). Common empirically used antibiotics like fluroquinolones and Cotrimoxazole drugs showed alarming rate of resistance. 60% isolates were found to be multidrug resistant. ESBL production was detected in 31% isolates. ESBL producing strains were found to be more drug resistant than non ESBL producing strains.Conclusions: So, drug resistance due to production of ESBLs in Escherichia coli is a serious threat for clinicians. Strict infection control measures and early detection of beta lactamase producing isolates are the need of the hour to contain the emergence of this type of resistance.

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Antimicrobial Resistance and Sensitivity among Isolates of Esherichia coli from Urine Samples in Denizli, Turkey

Malaysian Journal of Medical and Biological Research ◽

10.18034/mjmbr.v5i1.443 ◽

2018 ◽

Vol 5 (1) ◽

pp. 13-18

Author(s):

Selma Kirac ◽

Dilek Keskin ◽

F. Banu Karahasanoğlu

Keyword(s):

Antibiotic Resistance ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Antimicrobial Agents ◽

Signs And Symptoms ◽

Urine Samples ◽

Resistance Pattern ◽

E Coli ◽

Esherichia Coli ◽

Tract Infections

Objective: The research was carried out with isolate and determines the antimicrobial sensitivity in E. coli from urinary tract infections in special hospital in Denizli and recorded at specimens. Methods: Urine samples (n=21) were collected from patients with signs and symptoms of Urinary tract infections. Bacteria were isolated and identified by conventional biochemical profile. Antibiotic resistance pattern of E. coli against different antibiotic was determined by Kirby-Baur method. Results: The results revealed that sensitivity rate of antimicrobial agents were in the range of meropenem (100%), norfloxacin and ciprofloxacin (86%), cefotaxime (80%), aztreonam (76%). None of the samples showed no resistance to amikacin, ceftazidime, aztreonam, amoxicillin/clavulanic acid, and meropenem. Out of 21 isolates, 3(14%) isolates showed Multiple Antibiotic Resistance ten to thirteen antibiotics. Conclusion: It is concluded that most of the urinary tract infections in human are caused by E.coli exhibited highest resistance to meropenem (100%), followed by norfloxacin and ciprofloxacin (86%).

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Comparison Between Non-Catheterized And Catheter Associated Urinary Tract Infections Caused By Extended Spectrum Β-Lactamase Producing Escherichia Coli And Klebsiella Pneumoniae

10.1101/019026 ◽

2015 ◽

Cited By ~ 1

Author(s):

Fouzia Ashraf ◽

Shagufta Shagufta Iram ◽

Gul-e-zar Riaz ◽

Farhan Rasheed ◽

Mahmood Shaukat

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Klebsiella Pneumoniae ◽

Urinary Tract Infections ◽

Diffusion Method ◽

Medical College ◽

Extended Spectrum ◽

Screening And Surveillance ◽

Tract Infections ◽

Urinary Isolates

Abstract: Catheter associated urinary tract infection's (CAUTI) account for more than 80% of all healthcare associated infections (HAIs) as compared to non-catheterized urinary tract infections. Catheter associated urinary tract infections occur on the third day after insertion of catheter in patients having urinary tract infection (UTI). In long term catheter use, bio-film form along the catheter which increases the risk of antibiotic resistant pathogens. Most common pathogens involved were Escherichia coli and Klebsiella pneumoniae which produce the enzymes Extended Spectrum β-Lactamases (ESBLs). Objective: To compare the frequency of ESBLs in catheterized and non-catheterized UTI infections. Materials and Methods: This comparative study was conducted at the Microbiology Department, Allama Iqbal Medical College, Lahore, from June 2014 to January 2015. Urine samples were cultured according to WHO protocol and antimicrobial Susceptibility testing was performed by Modified Kirby-Bauer disc diffusion Method. Escherichia coli and Klebsiella pneumoniae were tested for ESBL production by phenotypic confirmatory method of disk diffusion synergy using a disc of amoxicillin-clavulonate (30μg) and ceftrixone (30μg), cefotaxime (30μg) and aztreonam (30μg) discs. Results: Out of 300 positive urinary isolates of Escherichia coli and Klebsiella pneumoniae from CAUTI, 65.33% were ESBL producing isolates whereas out of 300 positive urinary isolates of Escherichia coli and Klebsiella pneumoniae from non-catheterized UTI, 47.66% were ESBL producing isolates. The results were highly significant (p < 0.001). Conclusion: Results showed that frequency of ESBLs were higher in catheterized patients as compared to non-catheterized patients. This is suggestive of a need for regular screening and surveillance for ESBL producing organisms. Patients infected with these organisms should be nursed with contact precautions to avoid the spread of nosocomial infection.

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Bacterial Infection Diagnosis and Antibiotic Prescription in 3 h as an Answer to Antibiotic Resistance: The Case of Urinary Tract Infections

Antibiotics ◽

10.3390/antibiotics10101168 ◽

2021 ◽

Vol 10 (10) ◽

pp. 1168

Author(s):

Eleonora Nicolai ◽

Massimo Pieri ◽

Enrico Gratton ◽

Guido Motolese ◽

Sergio Bernardini

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Antimicrobial Susceptibility ◽

Antibiotic Susceptibility ◽

Clinical Laboratory ◽

Point Of Care ◽

Urine Samples ◽

Clinical Approach ◽

Antibiotic Susceptibility Test ◽

Tract Infections

Current methods for the diagnosis of urinary tract infections with antimicrobial susceptibility testing take 2–3 days and require a clinical laboratory. The lack of a rapid, point-of-care antibiotic susceptibility test (AST) has contributed to the misuse of antibiotics when treating urinary tract infections (UTIs) and consequently to the rise of multi-drug-resistant organisms. The current clinical approach has led to reduced treatment options and increased costs of diagnosis and therapy. To address this issue, novel diagnostics are needed for the timely determination of antimicrobial susceptibility. We present a rapid, point-of-care, phenotypic AST device that can report the antibiotic susceptibility/resistance of a uropathogen to a panel of antibiotics in as few as 3 h by utilizing fluorescent-labelling chemistry and a highly sensitive particle-counting instrument. We analysed 744 urine samples from the outpatients and inpatients of two Italian hospitals. The 130 UTI-positive patient urine samples we found were measured using a panel of six common UTI antibiotics plus a growth control. By comparing our results to hospital laboratory urine cultures, we obtained an overall sensitivity = 81%, a specificity = 83%, an SPV (sensitivity predicted value) = 95%, and an RPV (resistance predicted value) = 54%. According to our preliminary data, the sensitivity predicted value for a single antibiotic agent was 95%, thus allowing (in the vast majority of cases) an early (within 3 h) recognition of an effective agent for a single patient.

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Urinary Infections in Pregnancy Conditions

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i44b32671 ◽

2021 ◽

pp. 229-235

Author(s):

Vigila J, Kalpana Thalava

Keyword(s):

Urinary Tract ◽

Pregnant Women ◽

Urinary Tract Infections ◽

Culture Media ◽

First Trimester ◽

Diffusion Method ◽

Bacterial Isolates ◽

Cross Sectional ◽

Antibiotic Susceptibility Test ◽

Tract Infections

The urinary tract infections (UTI’s) are common infections that can affect kidneys, ureters, and urethra. About 40% of urinary tract infections are caused during hospitalization and globally an estimated 600,000 patients are affected per year. Urinary tract infections are more prevalent in women due to their short urethra and its anatomical proximity to the anal orifice. A bladder infection may cause pelvic pain, increased urge to urinate, pain with urination and blood in the urine. A kidney infection may cause back pain, nausea, vomiting and fever. Bacteriuria is a major risk factor for the development of urinary tract infections during pregnancy and with further risk of preterm birth & pyelonephritis if untreated. This study was carried out to isolate and identify bacteria involved in the first trimester of pregnancy. A cross sectional study was conducted from February, 2019 to June 2019. Structured questionnaires were used to collect data from pregnant women. UTI was diagnosed by urine culture on standard culture media. Out of 25 pregnant women included in this study, 15 (60.0%) were symptomatic and 10 (40.0%) asymptomatic. Escherichia coli(64%) was the most commonly found bacterial isolate followed by Psedomonas aeruginosa (20%), Klebsiella sp. (12%) and Proteus sp. (0.4%). Antibiotic susceptibility test by Kirby-Bayer Disc diffusion method revealed that all the bacterial isolates subjected to antibiogram test were sensitive or susceptible to Gentamycin, Nalidixic acid, Nitrofurantoin, Amikacin and Co-trimoxazole, and resistant to Amoxicillin, Norfloxacin and erythromycin were resistant to all bacterial isolates.

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