scholarly journals THE ETIOLOGICAL SPECTRUM AND ANTIBIOTIC RESISTANCE PATTERN OF BACTERIA CAUSING UNCOMPLICATED URINARY TRACT INFECTIONS: A TEN-YEAR SURVEILLANCE STUDY (2005-2015)

Author(s):  
M. Kolesnyk ◽  
N. Stepanova ◽  
V. Kruglikov ◽  
A. Rudenko

Background and objective. Knowledge of local antimicrobial resistance pattern is very important for evidence-based empirical antibiotic prescribing. The main objective of the present study was to evaluate the prevalence and the antimicrobial resistance pattern of the main bacteria responsible for uncomplicated urinary tract infection (UTI) in Kyiv region (Ukraine), throughout a ten year period, in order to establish an appropriate empirical therapy. Materials and methods. A retrospective analysis of the etiological spectrum and antimicrobial resistance of uropathogens in urine samples isolated over the 10-year period, 2005 to 2015, in a single center was performed. Results. In total 380positive urine samples processed at our laboratory of which 193/380 (51 %) had E. coli as the infecting organism. Although E. coli was, as usual, the most common pathogen implicated in UTI, it were observed increasing the share of Enterococcus spp. - 82/380 (21.6%). Ampicillin and trimethoprim were the least-active agents against E. coli with resistance rates of 75% and 70%, respectively. Significant trends of increasing resistance over the 10-year period were identified for trimethoprim, fluoroquinolones ІІ and III generations, penicillins, and carbapenems. Nitrofuran derivative remains a reasonable empirical antibiotic choice in this community with a 10-year resistance rate of 8.3 %. Was determined that recurrent UTI is an independent risk factor for bacterial multidrug-resistance. Conclusions. Over the last 10 years, the proportions of fluoroquinolones resistant E. coli and multidrug-resistant bacteria have significantly increased. The fluoroquinolones shall not be used in the empirical treatment of uncomplicated UTI in Kyiv region patients. For the empirical treatment of uncomplicated UTI in women should be used nitrofuran derivative (furazydyn K). If required of parenteral administration of antibiotics should be used cephalosporins IVgeneration. This data will enable evidence-based empirical prescribing which will ensure more effective treatment and lessen the emergence of resistant uropathogens in the community.

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Amirhossein Yousefi ◽  
Saam Torkan

Resistant uropathogenic Escherichia coli is the most common cause of urinary tract infections in dogs. The present research was done to study the prevalence rate and antimicrobial resistance properties of UPEC strains isolated from healthy dogs and those which suffered from UTIs. Four-hundred and fifty urine samples were collected and cultured. E. coli-positive strains were subjected to disk diffusion and PCR methods. Two-hundred out of 450 urine samples (44.4%) were positive for E. coli. Prevalence of E. coli in healthy and infected dogs was 28% and 65%, respectively. Female had the higher prevalence of E. coli (P=0.039). Marked seasonality was also observed (P=0.024). UPEC strains had the highest levels of resistance against gentamicin (95%), ampicillin (85%), amikacin (70%), amoxicillin (65%), and sulfamethoxazole-trimethoprim (65%). We found that 21.50% of UPEC strains had simultaneously resistance against more than 10 antibiotics. Aac(3)-IV (77%), CITM (52.5%), tetA (46.5%), and sul1 (40%) were the most commonly detected antibiotic resistance genes. Findings showed considerable levels of antimicrobial resistance among UPEC strains of Iranian dogs. Rapid identification of infected dogs and their treatment based on the results of disk diffusion can control the risk of UPEC strains.


2019 ◽  
Vol 6 (5) ◽  
pp. 1421
Author(s):  
C. Sayee Sankar Vinod ◽  
Vishnu Anjan Nareddy ◽  
M. V. Nagabhushana

Background: The main aim of the present study is to investigate the differences in clinical, microbiological, characteristics of Urinary tract infection between diabetic and non-diabetic patients and influence of diabetes on the spectrum of URO pathogens and the antimicrobial resistance in patients with urinary tract infections.Methods: The present study is conducted from February 2018-April 2019 in Narayana general hospital. A total of 181 diabetics and 124 non-diabetics are included. A thorough history examination investigations done. The final data was analysed using statistical package SPSS. The percentages in different categories were compared using chi square test and means were compared using student ‘t’ test.Results: The mean age among diabetic and non-diabetic patients was 60.2+/-13.79 years and 53.47+/-18.56 years. Fever is the most common presenting symptom. BPH was the most common predisposing factor in both diabetes and non-diabetes followed by indwelling catherization but there was no statistically significant difference. Diabetics with UTI majority (87.14%) had glyco HBA1C >6.5% with p<0.001. The prevalence of recurrent UTI is higher in diabetics compared to non-diabetics however difference was not statistically significant. Recurrent UTI is higher in females in both diabetics and non-diabetics. The presence of E coli is significantly higher in diabetics compared to non- diabetics. The antimicrobial resistance pattern was similar in both diabetic and no-diabetic subjects in E coli with maximum sensitivity to meropenem and least to ampicillin and there is no statistically significant difference.Conclusion: The host factors found to be associated with UTI are female sex, presence of diabetes, poor glycemic control, presence of fever. No correlation was noted with age, duration of diabetes and type of treatment for diabetes. An elevated HBA1C correlates with occurrence of UTI. Escherichia coli (E. coli) was the most frequent uropathogen. The resistance of uropathogens to antibiotics are similar in patients with and without diabetes and non-diabetes.


2018 ◽  
Vol 5 (1) ◽  
pp. 13-18
Author(s):  
Selma Kirac ◽  
Dilek Keskin ◽  
F. Banu Karahasanoğlu

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%).


2021 ◽  
Vol 15 (7) ◽  
pp. 2292-2295
Author(s):  
Nargis . ◽  
Tayyab ur Rehman ◽  
Liaqat Ali ◽  
Hanif Khan ◽  
Madina .

Background: Carbapenem resistance in Enterobacteriaceae is an uprising problem worldwide. KPC is one of the important mechanisms of resistance in Enterobacteriaceae such as K. pneumoniae. Aims and Objectives: The current research focuses on the frequency of the KPC -2 gene in Enterobacteriaceae isolated from urine samples, as well as antibiotic resistance patterns. Methodology: Antibiotic sensitivity patterns were examined on 53 carbapenem-resistant isolates from the Enterobacteriaceae family. These isolates were subjected to the Modified Hodge Test (MHT) and PCR for KPC 2 gene identification. Results: A total of 150 urine samples were processed for the isolation of the most prevalent Enterobacteriaceae. 125 Gram-negative bacterial isolates were obtained in which the consistency of K. pneumonia was 50(40%),E. colin was 55(44%), and P. mirabilis was 20(16%). The test for susceptibility of antibioticresulted that among50 Klebsiella pneumoniae 40% were resistant to Imipenem, while in E. coli 54.4% and P. mirabilis 30 % were resistant to Imipenem respectively. PCR results show the gene KPC-2 out of 15 (75%) 2 (13.2%) Modified Hodge Test Positive Klebsiella pneumoniae isolates. In total 83.3% (n=25) E. coli Modified Hodge Test positive and for the KPC-2 gene 4% were positive. Conclusion:This research demonstrates that in Enterobacteriaceae there isexistence of carbapenem resistance. Surveillance research and complete antibiotic prescription standards should be established at Pakistan's various hospitals to stop the growth of antibiotic-resistant bacteria. Key Words: Enterobacteriaceae, Urinary Tract Infections, Carbapenem, Modified Hodge test


BJGP Open ◽  
2017 ◽  
Vol 1 (4) ◽  
pp. bjgpopen17X101145 ◽  
Author(s):  
Marianne Bollestad ◽  
Ingvild Vik ◽  
Nils Grude ◽  
Hege Salvesen Blix ◽  
Hanne Brekke ◽  
...  

BackgroundUncomplicated urinary tract infections in women are common, and urine samples from these patients are not routinely cultured. Empirical treatment is based on knowledge of resistance patterns for common uropathogens.AimTo evaluate the bacteriological findings and resistance patterns in urine samples from women with uncomplicated urinary tract infections, and to assess the relationship between antimicrobial use and resistance patterns from 2000–2015 in Norway.MethodBacteriology and resistance patterns were compared in 184 urine cultures from 2001, 406 urine cultures from 2010–2011 and 259 urine cultures from 2013–2015. Antibiotic use data from 2000–2015 were obtained from national databases.ResultsEscherichia coli (E. coli) was the main bacterial agent in 80% of the cultures. Staphylococcus saprophyticus (Staph. saprophyticus) represented 6–17%. For E. coli, resistance to mecillinam showed some variation but remained below 9%. There was negligible resistance to nitrofurantoin. Resistance to trimethoprim seemed to stabilise over the last 5 years at around 20%. Amoxicillin resistance had some variations, but remained stable around 30%. There was a steady rise in total consumption of selected antibiotics commonly used to treat urinary tract infections for the period 2000–2015.ConclusionMecillinam and nitrofurantoin are both excellent first choices for empirical treatment of uncomplicated urinary tract infections. This study suggests that increasing resistance to trimethoprim challenges the rationale for its use as a first-line agent.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Sally Mohammed Saber ◽  
Marwa Abd el Rasoul El-Ashry ◽  
Christina Magdy Lotfy Mikhail Assad

Abstract Background Community acquired urinary tract infections (CAUTIs) are among the most common bacterial infections diagnosed in community health practice resulting in high rates of morbidity and high economic costs associated with its treatment. CAUTIs are usually treated empirically. Geographical variations in etiologic agents and their antibiotic sensitivity patterns are common. Knowledge of antibiotic resistance trends is important for improving evidence-based recommendations for empirical treatment of UTIs. Adequate empirical treatment can cause decrease in unnecessary hospital stays, treatment cost, antibiotic side effects as well as reducing antimicrobial resistance spread. Aim of the Work To determine the implicated uropathogens associated with community-acquired UTIs and their respective antimicrobial resistance pattern to improve the efficacy of empirical treatment of this infection. Patients and Methods This a cross-sectional descriptive study conducted from November 2018 to November 2019 at the main Microbiology Lab in Clinical Pathology Department, Ain Shams University Hospitals. Samples were received from patients attending different outpatient clinics in Ain Shams University Hospitals having UTI symptoms and whose urine samples showed significant bacterial growth (≥105 CFU/mL) associated with pyuria (more than 8–10 pus cells by microscopic urine analysis) and nitrite and leukocyte esterase positive by chemical analysis of urine strip. Results A total of 1600 patients who fulfilled our inclusion criteria were sampled. Of these, 1058 patients had urine samples that showed significant bacterial growth while about 34% of the samples were contaminated and excluded . Of the 1058 significant samples, 764 (72.21%) were from females and 294 (27.79%) from males with female to male ratio 2.6:1. Escherichia coli was found the dominant bacteria among a with the prevalence rate of 24.4% followed by Klebsiella pneumoniae (13.8%). Tetracycline was found the most resistant antibiotic 929 (95.4%) followed by Ampicillin, Tazobactam-piperacillin, and Ampicillin- sulbactam by 90.1%, 81.7% and 77.7% respectively; however, the most sensitive antibiotics against all uropathogens were Carbapenems (Ertapenem 72.9% fol Imipenem 66.5% and Meropenem 66.4%) followed by Nitrofurantoin and Amikacin showing 64.3% and 58.01% sensitivity respectively . However, For gram positive uropathogens, Linezolid showed the highest sensitivity in 84% of the isolates. Conclusion The present study reveals a familiar pattern with respect to the species of uropathogens involved in community acquired urinary tract infections, however with considerable bacterial resistance to common empirically prescribed antibiotics.


2010 ◽  
Vol 5 (6) ◽  
pp. 827-830
Author(s):  
Georgi Slavchev ◽  
Nadya Markova

AbstractUropathogenic strains of E. coli isolated from urine of patients with urinary tract infections were tested for antibiotic sensitivity using bio-Merieux kits and ATB-UR 5 expression system. The virulence of strains was evaluated by serum bactericidal assay, macrophage “killing” and bacterial adhesive tests. Survival capability of strains was assessed under starvation in saline. The results showed that quinolone-resistant uropathogenic strains of E. coli exhibit significantly reduced adhesive potential but relatively high resistance to serum and macrophage bactericidity. In contrast to laboratory strains, the quinolone-resistant uropathogenic clinical isolate demonstrated increased viability during starvation in saline. Our study suggests that quinolone-resistant uropathogenic strains are highly adaptable clones of E. coli, which can exhibit compensatory viability potential under unfavorable conditions. The clinical occurrence of such phenotypes is likely to contribute to the survival, persistence and spread strategy of resistant bacteria.


Author(s):  
Trâm Quế Anh

TÓM TẮT Đặt vấn đề: Xác định đúng căn nguyên gây NKĐTN và mức độ kháng kháng sinh của các vi khuẩn sẽ giúp cho việc điều trị có hiệu quả, giảm được chi phí điều trị, hạn chế sự gia tăng vi khuẩn đề kháng kháng sinh. Đối tượng và phương pháp nghiên cứu: Các chủng VK gây nhiễm khuẩn đương tiết niệu phân lập được tại bệnh viện Hữu nghị Đa khoa Nghệ An từ 1/2020 đến 12/2020. Thiết kế nghiên cứu: Cắt ngang mô tả. Kết quả: Phân lập được 473 chủng vi khuẩn gây NKĐTN, trong đó, E. coli 38,48%; P. aeruginosa 14,15; Enterococcus sp 10,57; K. pneumoniae 13,32%. E. coli: kháng các kháng sinh Cephalosporine, Quinolones từ 56,7 - 63,8%, Carbapenem 4,5 - 6,2%, sinh ESBL 49,4%. P. aeruginosa: đã kháng các kháng sinh thử nghiệm từ 59,1 - 69,2%. Enterococcus sp: kháng với các kháng sinh nhóm Quinolone 73,5%, kháng Vancomycin 8,3%; Chưa ghi nhận đề kháng Linezolid. K. pneumoniae: kháng nhóm Cephalosporin, Quinolone từ 66,7 - 74,6%, đề kháng với Carbapenem từ 46,0 - 50,8%. Kết luận: Các vi khuẩn gây nhiễm khuẩn tiết niệu thường gặp là: E. coli, P. aeruginosa, Enterococcus sp. K. pneumoniae. Các vi khuẩn phân lập được đã đề kháng với nhiều kháng sinh thường dùng với các mức độ khác nhau. Xuất hiện các chủng vi khuẩn Gram âm kháng Carbapenem, Gram dương kháng Vancomycin. Từ khóa: Nhiễm khuẩn tiết niệu, E.coli, Klebsiella, P.aeruginosa, Enterococcus sp ABSTRACT RESEARCH OF ANTIBIOTICS RESISTANCE OF BACTERIA STRAINS CAUSING URINARY TRACT INFECTIONS ISOLATED AT NGHEAN FRIENDSHIP GENERAL HOSPITAL Background: The good identification of UTI microorganism and their antimicrobial susceptibility would promote the effective treatment, reduce the cost as well as the emergence of drug resistant bacteria. Methods: Bacterial strains causing urinary tract infections were isolated at Nghe An Friendship General Hospital from 1/2020 to 12/2020. Study design: Descriptive cross section. Results: 473 bacterial strains causing UTIs were isolated, in which, E. coli 38.48%; P. aeruginosa 14.15; Enterococcus sp 10.57; K. pneumoniae 13.32%. E. coli: resistant to Cephalosporin antibiotics, Quinolones from 56.7 - 63.8%, Carbapenem 4.5 - 6.2%, producing ESBL 49.4%. P. aeruginosa: was resistant to the tested antibiotics from 59.1 - 69.2%. Enterococcus sp: resistant to Quinolone antibiotics 73.5%, resistant to Vancomycin 8.3%; Linezolid resistance has not been recorded. K. pneumoniae: resistant to Cephalosporin, Quinolone from 66.7 - 74.6%, resistant to Carbapenem from 46.0 - 50.8%. Conclusion: Common bacteria causing urinary tract infections are: E. coli, P. aeruginosa, Enterococcus sp. K. pneumoniae. The isolates were resistant to many commonly used antibiotics to varying degrees. Occurrence of strains of Gram - negative bacteria resistant to Carbapenem, Gram - positive resistant to Vancomycin. Keywords: Urinary Tract infections, E. coli, Klebsiella, P. aeruginosa, Enterococcus sp.


2021 ◽  
Vol 11 (3) ◽  
pp. 650-658
Author(s):  
Mohammed Yahia Alasmary

Background: To explore the prevalence of urinary tract infections (UTIs) among female patients in the Najran region of Saudi Arabia and determine their antimicrobial resistance pattern. Methods: This study was conducted on 136 urine samples collected from outpatient departments (OPDs) of the different government hospitals in the Najran region of Saudi Arabia. Over one year, the results of susceptibility testing reports of outpatient midstream urine samples from three government hospitals were prospectively evaluated. Results: Of 136 urine samples, only 123 (90.45%) were found to show significant growth for UTIs, from which 23 different uropathogens were identified. Escherichia coli (58.5%) was the most commonly isolated organism, followed by Klebsiella pneumoniae (8.1%). The isolated microorganism showed increased resistance patterns from 3.3% to 62.6%, with an overall resistance of 27.19%. Meropenem was the most effective antimicrobial, followed by amikacin and ertapenem (0.47%, 0.91%, and 1.5% resistance, respectively). At the same time, ampicillin and cephazolin were the least (62.6% and 59.5% resistance, respectively) effective. Overall, eleven (8.94%) uropathogens isolates were ESBLs, among which there were eight (6.5%) Escherichia coli, one (0.81%) Klebsiella pneumoniae, one (0.81%) Klebsiella oxytoca, and one (0.81%) Citrobacter amalonaticus. Conclusions: E. coli remains the most commonly isolated causative uropathogens, followed by Klebsiella species. The prevalence of pathogenic E. coli and Klebsiella species underscores the importance of developing cost-effective, precise, and rapid identification systems to minimize public exposure to uropathogens. Antibiotic susceptibility data revealed that most of the isolates were resistant to the majority of the antibiotics. The patients with UTIs in the Najran region of Saudi Arabia are at a high risk of antibiotic resistance, leading to significant problems in outpatient department (OPD) treatment outcomes and raising the alarm for the physician to change their empiric treatment.


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