Profiles and genetic determinants of antimicrobial resistance in pathogens causing community-acquired urinary tract infections in reproductive-age women

2021 ◽  
pp. 12-15
Author(s):  
T. A. Khusnutdinova ◽  
E. V. Shipitsyna ◽  
A. A. Krysanova ◽  
A. M. Savicheva
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Urinary Tract Infections ◽  
Reproductive Age ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Genetic Determinants ◽  
Women Of Reproductive Age ◽  
Beta Lactamases ◽  
Tract Infections

Objective. To characterize the profiles and genetic determinants of antibiotic resistance in pathogens of community-acquired urinary tract infections (UTI) in women of reproductive age in St. Petersburg (Russia).Materials and methods. The study included strains of microorganisms obtained from 145 women of reproductive age with diagnosed with a UTI. Antibiotic susceptibility was evaluated by disk diffusion method; the interpretation of the results was carried out in accordance with the EUCAST criteria. Strains of uropathogenic enterobacteria were tested by PCR for the presence of beta-lactamase genes: beta-lactamase genes encoding enzymes of the AmpC group (MOX, CMY, LAT, BIL, DHA, ACC, MIR, ACT, FOX), TEM, SHV, OXA‑1, ESBL genes of the CTX–M group, genes of carbapenemases (KPC, OXA‑48) and metal-beta-lactamases (VIM, IMP, NDM).Results. Most cases (81 %) of UTIs in women in St. Petersburg were due to enterobacteria, with Escherichia coli highly prevailing (66 %). Fosfomycin, meropenem and nitrofurantoin had the highest in vitro activity against uropathogenic Enterobacteriaceae. High rates of resistance to betalactam antibiotics were found (from 16 % to cefotaxime to 28 % to amoxicillin/clavulanic acid). The genes of TEM-beta-lactamases were found in 31 isolates (26.7 %), SHV – in 17 (14.6 %), CTX–M type – in 15 (12.9 %), DHA – in 2 (1.7 %). The other beta-lactam resistance genes (MOX, CMY, LAT, BIL, ACC, MIR, ACT, FOX, KPC group, OXA-like group, VIM, IMP, NDM) were not detected.Conclusion. Microbiological and molecular analysis of the structure of beta-lactam resistance is important for the effective of epidemiological control of antimicrobial resistance in pathogens causing urinary tract infections.

scholarly journals Prevention of post coital cystitis: the role of D-mannose. Case report

2021 ◽  
pp. 590-593
Author(s):  
Anton Iu. Tsukanov ◽  
Keyword(s):  
Case Report ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Lower Urinary Tract ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Tract Infections ◽  
Recurrent Cystitis ◽  
Lower Urinary

Recurrent lower urinary tract infections are common among women. One of the important factors of their genesis is sexual activity: there is a positive correlation between sexual intercourse frequency and recurrences of lower urinary tract infections. Post coital cystitis accounts for 30–40% of all chronic recurrent cystitis and occurs in about 25–30% of women of reproductive age. One of the methods for the prevention of post coital cystitis is the use of D-mannose, the effectiveness of which was demonstrated with a clinical example.

scholarly journals Cedecea lapagei An Extremely Rare Uropathogen: A Case Report and Review of the Literature

2021 ◽  
Author(s):  
Abdikarim Hussein Mohamed ◽  
Hussein Ali Mohamud
Keyword(s):  
Renal Failure ◽  
Case Report ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Beta Lactam ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases ◽  
Tract Infections

Abstract Background: Gram-negative enterobacteria are the most common cause of urinary tract infections. Cedecea is a new separate genus in the family enterobacteriaceae, and it is a very rare pathogen that was primarily found in the respiratory tract. Cedecea lapagei is a very rare pathogen of urinary tract infections. To the best of our knowledge, this is the first case report in the world reported in English literature. Case presentation: A 55 years old man with chronic renal failure, poorly controlled diabetes mellitus, and hypertension presented with acute exacerbations of renal failure and irritative voiding symptoms. After stabilization and empirical antibiotic therapy with Ceftriaxone, the patient’s condition was not improved and deteriorated progressively. After the request of urine culture, the culture was isolated, an extremely rare uropathogen recently recognized by the Centers for Disease Control and Prevention (CDC); the Cedecea lapagei. Cedecea lapagei identification had been done using Eosin methylene blue agar (EMB). Gram-negative lipase positive bacteria with bacillus in shape, motile in nature that is non-spore-forming, and non-encapsulated enterobacteria with the final result of >100,000 colony-forming units per ml of Cedecea lapagei were isolated. Mueller-Hinton agar had been used to perform antimicrobial sensitivity and resistance. The pathogen was extensively resistant to the extended-spectrum beta-lactamases antibiotics and extended-spectrum beta-lactam inhibitors while carbapenems, fluoroquinolones, aminoglycosides, and Trimethoprim-sulfamethoxazole showed a higher sensitivity rate. Conclusion: The treatment of Cedecea lapagei infections represents a challenging issue due to its multi-drug resistant and extensive drug resistance patterns to a variety of antimicrobial classes, such as extended-spectrum beta-lactamases, cephalosporins, and beta-lactam inhibitors. Antimicrobial treatment should be aligned with the culture findings once available.

scholarly journals 1621. Novel Beta-lactam Beta-lactamase Inhibitors Against Alternative Antibiotics for the Treatment of Complicated Urinary Tract Infections and Pyelonephritis Caused by Carbapenem-resistant Enterobacterales

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S803-S803
Author(s):  
Bliss Green ◽  
Jacqueline Meredith ◽  
Renee Ackley ◽  
Maggie S McCarter ◽  
Christopher Polk
Keyword(s):  
Urinary Tract ◽  
Adverse Effects ◽  
Combination Therapy ◽  
Urinary Tract Infections ◽  
Beta Lactamase ◽  
Clinical Failure ◽  
Beta Lactam ◽  
Carbapenem Resistant ◽  
Safety Outcomes ◽  
Tract Infections

Abstract Background There is little data on the comparative efficacy or safety of carbapenem-resistant Enterobacterales (CRE)-targeted beta-lactam beta-lactamase inhibitors (BL-BLI), including ceftazidime/avibactam (CZA) and meropenem/vaborbactam (MVB), versus alternative antibiotics for the treatment of CRE complicated urinary tract infections/acute pyelonephritis (cUTI/AP). The objective of this study was to evaluate rates of clinical failure in patients with CRE cUTI/AP treated with CRE-targeted BL-BLI vs. alternative regimens. Methods This was a multicenter, retrospective cohort study of adults admitted with a CRE cUTI/AP treated with CRE-active antibiotic(s), including combination therapy, for at least 48 hours between January 2012 and June 2019. Exclusion criteria included CRE colonization, non-urinary source co-infection, non-Enterobacterales cUTI/AP, or mortality within 48 hours of index culture. The primary outcome was clinical failure, defined as continued symptoms or recurrence at 30 days from index culture. Secondary outcomes included 90-day recurrence and 30-day readmission. Safety outcomes included treatment-limiting adverse effects, non-treatment limiting nephrotoxicity, and C. difficile infection. Results A total of 47 patients were included (BL-BLI, n=16; alternative, n=31). Alternative regimens contained aminoglycosides, carbapenems, polymyxins, and tigecycline and utilized combination therapy more often (32.3% vs. 6.3%, p=0.046). Clinical failure occurred in 12.5% of patients in the BL-BLI group vs. 38.7% in the alternative group (p=0.063). Higher rates of 90-day recurrence (25.8% vs. 18.8%) and 30-day readmissions (51.6% vs. 31.3%) occurred in the alternative group vs. the BL-BLI group but were not statistically significant (Table 2). There were clinically significant rates of nephrotoxicity in the alternative group (45.2%) compared to the BL-BLI group (18.8%), contributing largely to the difference in treatment-limiting adverse effects (29% vs. 0%, p=0.017). Table 1: Antibiotic Data Table 2: Efficacy Outcomes Table 3: Safety Outcomes Conclusion In this retrospective study, no difference in clinical failure resulted among groups; however, there was significantly more treatment-limiting adverse effects in the alternative group compared to the BL-BLI-based regimens, driven by nephrotoxicity. Disclosures All Authors: No reported disclosures

Modeling the antimicrobial resistance of enterobacteria responsible for Urinary Tract Infections in Benin: Another way to control Antimicrobial Resistance

2020 ◽  
Author(s):  
DOUGNON Victorien ◽  
ASSOGBA Phenix ◽  
JIBRIL Mohammed ◽  
GNIMATIN Jean-Pierre ◽  
AGBANKPE Jerrold ◽  
...  
Keyword(s):  
Mathematical Modeling ◽  
Developing Countries ◽  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Urinary Tract Infections ◽  
Urine Samples ◽  
Public Health Issue ◽  
Beta Lactamase ◽  
Deterministic Models ◽  
Tract Infections

Abstract Background: Infectious diseases are serious public health issue both in developing countries and industrialized nations. In developing countries, they are the main cause of high mortality rates. In the second group, existing resistance strains to antibiotics is developing and growing at an alarming rate. The purpose of this study was to produce data of national interest to implement sustainable control program against the spread of antimicrobial resistance strains in Benin. Methods: One hundred and ninety (190) urine samples were collected in selected hospitals in Benin from patients with urinary tract infection. After getting the informed consent from the patients, samples collections were performed under aseptic conditions and cultured for further analysis in the laboratory. The resistance profile of the bacterial strains was established. The search for beta-lactamase production by the isolates was performed using the synergy test for amoxicillin/clavulanic acid and cephalosporins. Mathematical modeling for predicting the development of resistance of the strains by the year 2024 was carried out employing the compartmental deterministic models. Results: Two hundred and thirty (230) strains were identified from the urine samples. Male individuals were the most affected by urinary tract infections. Individuals between the ages of 21-30 were predominantly infected. E. coli was the most isolated species (32.43%) in the urine samples, followed by K. pneumoniae (26.85%) and E. cloacae (25.92%). The susceptibility testing of isolates showed a high resistance to amoxicillin (91.82%). Whereas the lowest resistance was to imipenem (2%). The beta-lactamase was produced by 24.03% of the strains. Escherichia coli (32.43%) was the most productive of broad spectrum beta-lactamase, followed by K. pneumoniae (31.03%). The mathematical modeling revealed a rampant rise in resistance development of the strains to the tested antibiotics. Conclusions: These results provide important data for developing new preventive strategies against the evolution of bacterial resistance to antibiotics. It therefore, further deserves a constructive advocacy so that more actions are taken against the rampant spread of antimicrobial resistance strains in our health facilities as well as in the communities.

scholarly journals MP23-13 ANTIMICROBIAL RESISTANCE AND EXTENDED SPECTRUM BETA-LACTAMASE AGENTS IN URINARY TRACT INFECTIONS: A SERIOUS PROBLEM IN THE NORTH OF MEXICO

2018 ◽  
Vol 199 (4S) ◽  
Author(s):  
José Iván Robles-Torres ◽  
Lauro Gómez-Guerra ◽  
Elvira Garza-González ◽  
Soraya Mendoza-Olazarán ◽  
Samantha Flores-Treviño ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Urinary Tract Infections ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
The North ◽  
Extended Spectrum ◽  
Tract Infections

scholarly journals Modeling the Antimicrobial Resistance of Enterobacteria Responsible for Urinary Tract Infections in Benin: Another Way to Control Antimicrobial Resistance

2020 ◽  
pp. 48-61
Author(s):  
Victorien Dougnon ◽  
Phénix Assogba ◽  
Jean-Pierre Gnimatin ◽  
Jerrold Agbankpé ◽  
Hornel Koudokpon ◽  
...  
Keyword(s):  
Mathematical Modeling ◽  
Developing Countries ◽  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Urinary Tract Infections ◽  
Urine Samples ◽  
Public Health Issue ◽  
Beta Lactamase ◽  
Deterministic Models ◽  
Tract Infections

Background: Infectious diseases are serious public health issue both in developing countries and industrialized nations. In developing countries, they are the main cause of high mortality rates. In the second group, existing resistance strains to antibiotics is developing and growing at an alarming rate. The purpose of this study was to produce data of national interest to implement sustainable control program against the spread of antimicrobial resistance strains in Benin. Methods: One hundred and ninety (190) urine samples were collected in selected hospitals in Benin from patients with urinary tract infection. After getting the informed consent from the patients, samples collections were performed under aseptic conditions and cultured for further analysis in the laboratory. The resistance profile of the bacterial strains was established. The search for beta-lactamase production by the isolates was performed using the synergy test for amoxicillin/clavulanic acid and cephalosporins. Mathematical modeling for predicting the development of resistance of the strains by the year 2024 was carried out employing the compartmental deterministic models. Results: Two hundred and thirty (230) strains were identified from the urine samples. Male individuals were the most affected by urinary tract infections. Individuals between the ages of 21-30 were predominantly infected. E. coli was the most isolated species (32.43%) in the urine samples, followed by K. pneumoniae (26.85%) and E. cloacae (25.92%). The susceptibility testing of isolates showed a high resistance to amoxicillin (91.82%). Whereas the lowest resistance was to imipenem (2%). The beta-lactamase was produced by 24.03% of the strains. Escherichia coli (32.43%) was the most productive of broad spectrum beta-lactamase, followed by K. pneumoniae (31.03%). The mathematical modeling revealed a rampant rise in resistance development of the strains to the tested antibiotics. Conclusions: These results provide important data for developing new preventive strategies against the evolution of bacterial resistance to antibiotics. It therefore, further deserves a constructive advocacy so that more actions are taken against the rampant spread of antimicrobial resistance strains in our health facilities as well as in the communities.

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