scholarly journals Characterization of Klebsiella pneumoniae Strains Isolated from Urinary Tract Infection: Detection of ESBL Characteristics, Antibiotic Susceptibility and RAPD Genotyping

2013 ◽  
Vol 62 (4) ◽  
pp. 401-409 ◽  
Author(s):  
MUSTAFA ONUR ALADAG ◽  
AHMET UYSAL ◽  
NIYAZI DUNDAR ◽  
YUSUF DURAK ◽  
ERDOGAN GUNES
Keyword(s):  
Urinary Tract ◽  
Klebsiella Pneumoniae ◽  
Antibiotic Susceptibility ◽  
Test Method ◽  
Penicillin G ◽  
Diffusion Method ◽  
Esbl Production ◽  
Rapd Pcr ◽  
Pcr Method ◽  
Tract Infections

In this study, a hundred Klebsiella pneumoniae strains isolated from urinary tract infections were evaluated in terms of genotyping, susceptibility to certain antibiotics and detection of extended spectrum of beta lactamase (ESBL) production. The random amplified polymorphic DNA (RAPD-PCR) method was used to identify the genetic differentiation of K. pneumoniae isolates. A total of 26 different DNA bands ranging between 334 bp and 28033 bp were detected among the strains. It was found that 100 K. pneumoniae strains revealed 11 different RAPD profiles. Antibiotic susceptibility tests were conducted using a disc diffusion method against 16 antibiotics. Fifty-five different resistance profiles were determined among the strains. ESBL-productions of the strains were determined by the double disc synergy test (DDST) and ESBL E-test methods. ESBL production rates among the strains were found to be 55% by E-test method and 45% by DDST method. While ESBL-producing K. pneumoniae strains showed the greatest resistance to penicillin G (100%), followed by piperacillin (92.7%) and erythromycin (85.4%),the resistance rates of non ESBLproducing strains to those antibiotics were determined as 97.8%, 88.8% and 88.8%, respectively. Both groups of strains showed the highest sensitivity to meropenem. Based on the results obtained from the study, it was concluded that the detection of ESBL-producing strains by the E-test method was more sensitive than by the DDST method. Phenotypic and genotypic identification methods should be used together to detect ESBL presence. The RAPD-PCR method alone will not be adequate in the genotyping of the strains and alternative DNA-based methods should be used.

scholarly journals Antibiotic sensitivity pattern of urinary tract infection at a tertiary care hospital

2014 ◽  
Vol 2 (1) ◽  
pp. 21-24
Author(s):  
Rama Biswas ◽  
Raihan Rabbani ◽  
Hasan Shahrear Ahmed ◽  
Mohammed Abdus Satter Sarker ◽  
Nahida Zafrin ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Test Method ◽  
High Rate ◽  
Diffusion Method ◽  
Care Hospital ◽  
Esbl Production ◽  
Sensitivity Pattern ◽  
Tract Infections

Background: Urinary tract infections (UTIs) remain the common infections in outpatients as well as hospitalized patients. Current knowledge on antimicrobial sensitivity pattern is essential for appropriate therapy. The aim of the study is to determine the changing pattern of antibiotic sensitivity among uropathogens causing UTI. Methods: Urinary isolates from symptomatic UTI cases attending in Square hospital were processed in the Microbiology lab. Antimicrobial susceptibility testing was performed by Kirby Bauer’s disc diffusion method. Extended spectrum beta lactamase (ESBL) production was determined by double disk synergy test method. Results: Of the 200 tested sample 110 samples showed growth of pathogens among which the most prevalent were E.coli (58.18%) followed by Enterococci (13.6%). The majority (68.18%) of the isolates were from female. ESBL production was observed in 46.87% o E.coli strains and 25% of Klebsiella strains. More than 98% of the isolates are sensitive to Imipenem, Meropenem , while 86.36% are sensitive to Amikacin, 73.63% to Nitrofurantoin and 74.54% to Gentamicin. Very high rate of resistance is seen against amoxicillin (88.19%), cefixime (65.46%), cotrimoxazole (68.19%) and ceftriaxone (63.63%). E. coli showed high sensitivity to meropenem, imipenem and amikacin (100%) followed by Gentamicin (94.1%). Conclusion: The study revealed that E.coli was the predominant bacterial pathogens of UTIs. An increasing trend in the production ESBLs among UTI pathogens in the community was noted. Nitrofurantoin should be used as empirical therapy for primary, uncomplicated UTIs. DOI: http://dx.doi.org/10.3329/bccj.v2i1.19952 Bangladesh Crit Care J March 2014; 2 (1): 21-24

Prevalence, Antibiogram, and cdt Genes of Toxigenic Campylobacter jejuni in Salad Style Vegetables (Ulam) at Farms and Retail Outlets in Terengganu

2015 ◽  
Vol 78 (1) ◽  
pp. 65-71 ◽  
Author(s):  
MOHD IKHSAN KHALID ◽  
JOHN YEW HUAT TANG ◽  
NABILA HUDA BAHARUDDIN ◽  
NASIHA SHAKINA RAHMAN ◽  
NURUL FAIZZAH RAHIMI ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Multiplex Pcr ◽  
Campylobacter Jejuni ◽  
Antibiotic Susceptibility ◽  
Penicillin G ◽  
Diffusion Method ◽  
Cytolethal Distending Toxin ◽  
Disk Diffusion Method ◽  
Retail Outlets ◽  
Pcr Method

The present study was conducted to investigate the prevalence and antibiotic resistance among Campylobacter jejuni in ulam at farms and retail outlets located in Kuala Terengganu, Malaysia. A total of 526 samples (ulam, soil, and fertilizer) were investigated for the presence of C. jejuni and the gene for cytolethal distending toxin (cdt) by using a multiplex PCR method. Antibiotic susceptibility to 10 types of antibiotics was determined using the disk diffusion method for 33 C. jejuni isolates. The average prevalence of contaminated samples from farms, wet markets, and supermarkets was 35.29, 52.66, and 69.88%, respectively. The cdt gene was not detected in 24 of the 33 C. jejuni isolates, but 9 isolates harbored cdtC. Antibiotic resistance in C. jejuni isolates was highest to penicillin G (96.97% of isolates) followed by vancomycin (87.88%), ampicillin (75.76%), erythromycin (60.61%), tetracycline (9.09%), amikacin (6.06%), and norfloxacin (3.03%); none of the isolates were resistant to ciprofloxacin, enrofloxacin, and gentamicin. In this study, C. jejuni was present in ulam, and some isolates were highly resistant to some antibiotics but not to quinolones. Thus, appropriate attention and measures are required to prevent C. jejuni contamination on farms and at retail outlets.

scholarly journals Urinary tract infections and antibiotic susceptibility among the patients attending B & D hospital of Lalitpur, Nepal

2016 ◽  
Vol 7 (5) ◽  
pp. 47-51 ◽  
Author(s):  
Yadav Prasad Joshi ◽  
Shreejeet Shrestha ◽  
Russell Kabir ◽  
Anita Thapa ◽  
Parbati Upreti ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Tract Infection ◽  
Antibiotic Susceptibility ◽  
Bacterial Infections ◽  
Antimicrobial Agents ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Cross Sectional ◽  
Tract Infections

Background:Urinary tract infection is the most common bacterial infections in humans and serious health problem in many parts of the world. It has become more complicated in treatment due to different pathogens and increasing resistant to antimicrobial agents. This study aims to investigate the prevalence of urinary tract infection and antibiotic susceptibility patterns of pathogens among the patients attending in B & B hospital Nepal.Materials and Methods:A hospital based cross sectional study was conducted in between April 2010 to March 2011. Urine samples were collected from clinically suspected patients and tested bacteriologically using standard procedures. Antimicrobial susceptibility test was performed for isolated pathogen using the Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute guidelines.Results:Out of 1260 examined specimens 25.24 % were positive and majority 61.64% were females.  The most common pathogens isolated were Escherichia coli (66.67%), Enterococcus (7.55%) and Staphylococcus (6.60 %). The drug resistant among the positive cases were reported. The highest resistant of positive cases was found with Cefexime (87.88%) and Enterococcus with Ampicillin (66.67%) and Staphyllococcus with Cloxacillin (66.67%). The highest susceptibility was for Vancomycin and Ampicillin i.e. 33.33% in each.Conclusion:The findings showed that E. coli isolates were the predominant pathogen and the presence of bacterial isolates with very high resistance to the commonly prescribed drugs. As drug resistance among bacterial pathogens is an evolving process and serious issue. Therefore, routine surveillance and monitoring studies should be conducted to provide physicians knowledge on the updated and most effective empirical treatment of UTIs. Asian Journal of Medical Sciences Vol.7(5) 2016 47-51

scholarly journals Bacteriology and Antibiogram of Urinary Tract Infection Among Female Patients in a Tertiary Health Facility in South Eastern Nigeria

2017 ◽  
Vol 11 (1) ◽  
pp. 292-300 ◽  
Author(s):  
Angus N. Oli ◽  
Vivian B. Akabueze ◽  
Chijioke E. Ezeudu ◽  
George U. Eleje ◽  
Obiora S. Ejiofor ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antibiotic Susceptibility ◽  
Empirical Treatment ◽  
Urine Samples ◽  
Diffusion Method ◽  
P Value ◽  
Female Patients ◽  
Tract Infections

Background: Urinary Tract Infection (UTI) is a common contagion among men and women with the incidence relatively higher among women due to their differing anatomy. An understanding of the kind of pathogens implicated in urinary tract infections as well as antibiotic susceptibility profiling may help the clinician make rationally correct empirical choice in their treatment. Objective: This study is aimed at determining the type and antibiotic susceptibility pattern of bacterial uropathogens isolated from female patients attending Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Awka, Nigeria. Method: Two hundred and forty patients with clinically diagnosed UTI and who were on at least 5 days’ antibiotic holiday were recruited into the study. Their demographic characteristics were captured using pre-tested questionnaire. Their clean catch mid-stream urine samples were collected using sterile universal container and sent to the Microbiology Department for processing. Within 30 minutes of samples collection, the specimens were cultured and the isolates were identified, after 24 h of incubation, using standard microbiological techniques. Antibiotic susceptibility tests were done with standard antibiotic discs using the Kirby–bauer disc diffusion method. Results: Out of the 240 urine samples, 89.17% yielded significant bacteriuria. The pathogens implicated were Escherichia coli (28.5%), Staphylococcus aureus (28.0%), Salmonella spp (22.8%) and Pseudomonas aeruginosa (20.5%). HIV status, patients age, pregnancy status and marital status all significantly affected bacteriuria rate (p value < 0.05), while patients’ location (sub-urban/rural dwelling), and level of education did not (p value > 0.05). The pattern of microbial resistance to antibiotics suggests that ceftazidime, fosfomycin and cefoxitin may not be used as first-line agents in the empirical treatment of UTIs rather; levofloxacin, meropenem or aztreonam should be considered. Levofloxacin was significantly effective against all the isolates and may be administered empirically while waiting for the culture result (Mean % susceptibility was 79.85). Conclusion: E. coli and S. aureus were the predominant pathogens in the study and many were resistant to the commonly prescribed antibiotics and so leave the clinicians with only few alternative drugs for UTIs treatment. Routine surveillance and monitoring studies need to be constantly conducted to update clinicians on the prevalent pathogens and the rational and empirical treatment of UTIs. Aggressive and consistent health education using every possible media is also recommended to combat the menace of drug resistance occasioned by inappropriate antibiotic use.

scholarly journals Predominance of an ST11 extended-spectrum β-lactamase-producing Klebsiella pneumoniae clone causing bacteraemia and urinary tract infections in Korea

2010 ◽  
Vol 59 (7) ◽  
pp. 822-828 ◽  
Author(s):  
Kwan Soo Ko ◽  
Ji-Young Lee ◽  
Jin Yang Baek ◽  
Ji-Yoeun Suh ◽  
Mi Young Lee ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Klebsiella Pneumoniae ◽  
Susceptibility Testing ◽  
Tertiary Care ◽  
Sequence Type ◽  
Esbl Production ◽  
Extended Spectrum ◽  
Tract Infections ◽  
M 14

To investigate the antimicrobial resistance, extended-spectrum β-lactamases (ESBLs) and clones of Klebsiella pneumoniae isolates causing bacteraemia or urinary tract infection (UTI) in Korea, a total of 406 K. pneumoniae isolates from patients with bacteraemia (221 isolates) and UTI (185 isolates) were collected from 10 tertiary-care Korean hospitals from July 2006 to October 2007. In vitro antimicrobial susceptibility testing was performed for all isolates and ESBL production was tested. Multilocus sequence typing (MLST) analyses were performed to characterize genotypes of ESBL-producing K. pneumoniae isolates. PFGE was performed for sequence type 11 (ST11) isolates. Forty-seven UTI isolates (25.4 %) produced ESBLs, while 30 bacteraemia isolates (13.6 %) produced ESBLs (P=0.002). Among 77 ESBL-producing isolates, thirty-two (41.6 %) produced SHV-type ESBLs. bla CTX-M genes such as bla CTX-M-14 and bla CTX-M-15 were detected in 36.4 %. MLST and PFGE analyses showed that ST11 was dominant in ESBL-producing K. pneumoniae isolates causing UTI (57.4 %) and in those causing bacteraemia (70.0 %) and has been prevalent in Korean hospitals. ST11 isolates harbour a combination of different ESBL genes. The ST11 clone of ESBL-producing K. pneumoniae isolates prevails in Korea, but most isolates might acquire ESBL genes independently or several different clones might be distributed in Korea.

scholarly journals Bacteriological Profile of Urinary Tract Infections among Postmenopausal Women Visiting Alka Hospital, Lalitpur, Nepal

2018 ◽  
Vol 2 ◽  
pp. 34-40
Author(s):  
Surendra Prasad Yadav ◽  
Puspa Raj Dahal ◽  
Shiv Nandan Sah ◽  
Vijay Kumar Sharma
Keyword(s):  
Urinary Tract ◽  
Postmenopausal Women ◽  
Antibiotic Susceptibility ◽  
Urine Samples ◽  
Diffusion Method ◽  
Bacterial Isolates ◽  
Gram Positive ◽  
Gram Negative ◽  
Microbiological Methods ◽  
Tract Infections

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).

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

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.

scholarly journals Uropathogens and their antibiotic susceptibility profile in a tertiary carehospital

2021 ◽  
Vol 8 (2) ◽  
pp. 112-118
Author(s):  
Anjali Agarwal ◽  
Jyoti Srivastava ◽  
Seema Bose ◽  
Ujjwal Maheshwari
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antibiotic Susceptibility ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Diffusion Method ◽  
Care Hospital ◽  
Recurrence Rates ◽  
Antibiotic Sensitivity Test ◽  
Tract Infections

Urinary tract infections (UTI) are one of the most common infections in the community and hospitals. Uropathogens colonize the urinary tract and may ascend to bladder causing cystitis, if left untreated reach kidneys through ureters can be responsible for acute pyelonephritis and cause renal damage. The aim of the present study is to determine the prevalence of urinary tract infections and antibiotic susceptibility pattern in a tertiary care hospital.This is an observational study conducted in Microbiology department, Hind Institute of Medical Sciences, Barabanki.A total of 623 urine(mid-stream) samples were collected from indoor and outdoor departments of hospital and culture was done on UTI chromogenic agar using semiquantitative method. Antibiotic sensitivity test was performed using Kirby Bauer disc diffusion method.Prevalence of urinary tract infections is 29% in the study. (43%) is the most common micro-organism isolated followed by (13%), (11%), (10.4%), (8.8%), (3.3%), (1.6%), CONS & (1.1%) and (6.6%). The females(56.6%) are more commonly affected than males.In the present study, beta-lactamase inhibitors and aminoglycosides were effective drugs against gram negative bacteria. Vancomycin and linezolid were sensitive in gram positive bacteria. Nitrofurantoin is the promising drug in cases of uncomplicated UTI, and safe to use in pregnancy. High recurrence rates and antimicrobial resistance are responsible for increasing the burden of disease. It is advised to use the antibiotics judiciously as per the hospital antibiotic policy which will help prevent multidrug resistance micro-organism further reducing morbidity and mortality.

scholarly journals Molecular Characterization of blaCTX-M, blaTEM and blaSHV Beta Lactamases Produced by Uropathogens

2020 ◽  
pp. 97-106
Author(s):  
Ashna Bhasin ◽  
Yogesh Chander ◽  
Harmesh Manocha
Keyword(s):  
Polymerase Chain Reaction ◽  
Test Method ◽  
Control Measures ◽  
Disk Diffusion ◽  
Diffusion Method ◽  
Esbl Production ◽  
Chain Reaction ◽  
Disk Diffusion Test ◽  
Polymerase Chain ◽  
Tract Infections

Background: This prospective study was carried out to look for the frequency of isolation of Extended spectrum b lactamase (ESBL) producing bacteria from urine samples and study their susceptibility pattern. The detection of ESBL genes responsible for their resistance was done by Polymerase chain reaction (PCR). Methods: The study was carried out over a period of one year from January 2016 to        December 2016. Urine specimens from patients were processed as per standard protocol. Antimicrobial susceptibility testing was performed by disk diffusion method as per CLSI guidelines 2016. Urine isolates obtained were screened for ESBL, by cefotaxime, ceftazidime disk and confirmation was made by Double disk diffusion test method. The detection of ESBL genes responsible for their resistance was done by Polymerase chain reaction (PCR) for blaCTX-M, blaTEM and blaSHV genes. Results: Prevalence of ESBL producing uropathogens were found to be 20.47% with most common organism to be isolated was Escherichia coli (E. coli) followed by Klebsiella pneumoniae. Nitrofurantoin and Imipenem were the most effective antibiotic agents against urinary isolates. Most common gene responsible for ESBL production was blaCTX-M (71.42%). Conclusion: A large number of ESBL producing strains are creating significant therapeutic problems. Therefore, monitoring of ESBL production, judicious use of antibiotics and infection control measures are necessary to avoid treatment failures in patients with Urinary Tract Infections (UTI).

scholarly journals Clinical and Economic Impact of Community-Onset Urinary Tract Infections Caused by ESBL-Producing Klebsiella pneumoniae Requiring Hospitalization: An Observational Cohort Study

2021 ◽  
Author(s):  
Dawid Rozenkiewicz ◽  
Erika Esteve-Palau ◽  
Mar Arenas-Miras ◽  
Santiago Grau ◽  
Xavier Duran ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Cohort Study ◽  
Urinary Tract ◽  
Klebsiella Pneumoniae ◽  
Economic Impact ◽  
Urinary Tract Infections ◽  
Esbl Production ◽  
Adequate Treatment ◽  
Tract Infections ◽  
Community Onset

Objective: To analyze the clinical and economic impact of community-onset urinary tract infections (UTI) caused by extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae requiring hospitalization. Methods: A retrospective cohort study included all adults with UTI caused by K. pneumoniae admitted to a tertiary care hospital in Barcelona, Spain, between 2011 and 2015. Demographic, clinical and economic data were analyzed. Results: One hundred and seventy-three episodes of UTI caused by K. pneumoniae were studied; 112 were non-ESBL-producing and 61 ESBL-producing. Multivariate analysis identified ESBL production, acute confusional state associated with UTI, shock, and time to adequate treatment as risk factors for clinical failure during the first 7 days. Economic analysis showed differences between ESBL-producing and non-ESBL-producing K. pneumoniae for the total cost of hospitalization per episode (mean 6,718 &euro; vs 3,688 &euro; respectively). Multivariate analysis of the higher costs of UTI episodes found statistically significant differences for ESBL production and time to adequate treatment. Conclusion: UTI caused by ESBL-producing K. pneumoniae requiring hospitalization, and time to adequate antimicrobial therapy are associated with worse clinical and economic outcomes.

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