scholarly journals Linezolid Resistance in Enterococcus faecalis Associated With Urinary Tract Infections of Patients in a Tertiary Hospitals in China: Resistance Mechanisms, Virulence, and Risk Factors

2021 ◽  
Vol 9 ◽  
Author(s):  
Xiaoyu Ma ◽  
Fan Zhang ◽  
Bing Bai ◽  
Zhiwei Lin ◽  
Guangjian Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Enterococcus Faecalis ◽  
Urinary Tract Infections ◽  
Hospital Setting ◽  
Clinical Isolates ◽  
Rrna Genes ◽  
Molecular Characteristics ◽  
Indwelling Catheter ◽  
Tract Infections

Background:Enterococcus faecalis has been commonly considered as one of the major pathogens of the urinary tract infection (UTI) in human host worldwide, whereas the molecular characteristics of E. faecalis clinical isolates from the patients with UTI in China remains seldomly reported. This study aimed to investigate the resistance mechanism, molecular characteristics and risk factors of E. faecalis clinical isolates from patients with UTI in China.Methods: A total of 115 non-duplicated E. faecalis clinical isolates from patients with UTI were retrospectively collected in a tertiary hospital in China and their clinical data was further analyzed. The linezolid and tedizolid susceptibility were determined by agar dilution. The resistance genes, including erm(A), erm(B), erm(C), tet(M), optrA, cfr, cfr(B), poxtA, and MLST-based housekeeping genes were investigated by PCR.Results: In 115 non-duplicated E. faecalis clinical isolates from the patients with UTI in this hospital setting, the frequency of linezolid or tedizolid-resistant/intermediate isolates were 22.61 and 13.04%, respectively, and the frequency of linezolid-resistant/intermediate E. faecalis clinical isolates carrying with erm(A) were 86%. Among the five linezolid-resistant E. faecalis strains found in this study, three optrA-positive isolates and the other two linezolid-resistant strains were G2576U genetic mutations in the V domain of the 23S rRNA genes. The ST clonality analysis indicated that 31.42% (11/35) of ST16 E. faecalis UTI isolates were not susceptible to linezolid. Moreover, the univariable analysis indicated that the high risk factors of linezolid-resistant/intermediate E. faecalis infections involved the indwelling catheter, trachea cannula catheter and the carriage of erm(A) or optrA. Furthermore, the indwelling catheter and trachea cannula catheter were demonstrated as the independent predictors of linezolid-resistant/intermediate E. faecalis strains in patients with UTI by multivariable analysis.Conclusion: Linezolid-resistant/intermediate E. faecalis associated with urinary tract infections of patients in this hospital setting from China might be explained by the high carriage frequency of optrA genes and moreover, indwelling catheter and trachea cannula should be considered as the independent predictors of linezolid-resistant/intermediate E. faecalis infections. The transmission mechanism of linezolid-resistant/intermediate E. faecalis in this hospital setting should be further studied.

scholarly journals (p)ppGpp and CodY promoteEnterococcus faecalisvirulence in a murine model of catheter-associated urinary tract infection

2019 ◽  
Author(s):  
C Colomer-Winter ◽  
AL Flores-Mireles ◽  
S Kundra ◽  
SJ Hultgren ◽  
JA Lemos
Keyword(s):  
Urinary Tract ◽  
Enterococcus Faecalis ◽  
Urinary Tract Infections ◽  
Hospital Setting ◽  
Stringent Response ◽  
Nutrient Sensing ◽  
Transcriptional Analysis ◽  
Tract Infections

AbstractIn Firmicutes, the nutrient-sensing regulators (p)ppGpp, the effector molecule of the stringent response, and CodY work in tandem to maintain bacterial fitness during infection. Here, we tested (p)ppGpp andcodYmutant strains ofEnterococcus faecalisin a catheter-associated urinary tract infections (CAUTI) mouse model and used global transcriptional analysis to investigate the (p)ppGpp and CodY relationship. Absence of (p)ppGpp or single inactivation ofcodYled to lower bacterial loads in catheterized bladders, and diminished biofilm formation on fibrinogen-coated surfaces underin vitroandin vivoconditions. Single inactivation of the bifunctional (p)ppGpp synthetase/hydrolasereldid not affect virulence supporting previous evidence that association of (p)ppGpp with enterococcal virulence is not dependent on activation of the stringent response. Inactivation ofcodYin the (p)ppGpp0strain restoredE. faecalisvirulence in the CAUTI model as well as the ability to form biofilmsin vitro. Transcriptome analysis revealed that inactivation ofcodYrestores, for the most part, the dysregulated metabolism of (p)ppGpp0cells. While a clear linkage between (p)ppGpp and CodY with expression of virulence factors could not be established, targeted transcriptional analysis indicate that a possible association between (p)ppGpp and c-di-AMP signaling pathways in response to the conditions found in the bladder may plays a role in enterococcal CAUTI. Collectively, this study identifies the (p)ppGpp-CodY network as an important contributor to enterococcal virulence in catheterized mouse bladder and supports that basal (p)ppGpp pools and CodY promote virulence through maintenance of a balanced metabolism during adverse conditions.ImportanceCatheter-associated urinary tract infections (CAUTI) are one of the most frequent types of infection found in the hospital setting that can develop into serious and potentially fatal bloodstream infections. One of the infectious agents that frequently cause complicated CAUTI is the bacteriumEnterococcus faecalis, a leading cause of hospital-acquired infections that are often difficult to treat due to the exceptional multidrug resistance of some isolates. Understanding the mechanisms by whichE. faecaliscauses CAUTI will aid in the discovery of new druggable targets to treat these infections. In this study, we report the importance of two nutrient-sensing bacterial regulators, named (p)ppGpp and CodY, for the ability ofE. faecalisto infect the catheterized bladder of mice.

scholarly journals Mechanisms of and Risk Factors for Fluoroquinolone Resistance in Clinical Enterococcus faecalis Isolates from Patients with Urinary Tract Infections

2011 ◽  
Vol 49 (11) ◽  
pp. 3912-3916 ◽  
Author(s):  
Tomihiko Yasufuku ◽  
Katsumi Shigemura ◽  
Toshiro Shirakawa ◽  
Minori Matsumoto ◽  
Yuzo Nakano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Enterococcus Faecalis ◽  
Urinary Tract Infections ◽  
Fluoroquinolone Resistance ◽  
Tract Infections

scholarly journals Urinary Excretion and Bactericidal Activities of Gemifloxacin and Ofloxacin after a Single Oral Dose in Healthy Volunteers

2001 ◽  
Vol 45 (12) ◽  
pp. 3524-3530 ◽  
Author(s):  
Christoph K. Naber ◽  
Michaela Hammer ◽  
Martina Kinzig-Schippers ◽  
Christian Sauber ◽  
Fritz Sörgel ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Urinary Tract ◽  
Urinary Excretion ◽  
Enterococcus Faecalis ◽  
Urinary Tract Infections ◽  
Parent Drug ◽  
Oral Dosage ◽  
Tract Infections ◽  
Cumulative Excretion

ABSTRACT In a randomized crossover study, 16 volunteers (8 men, 8 women) received single oral doses of 320 mg of gemifloxacin and 400 mg of ofloxacin on two separate occasions in the fasting state to assess the urinary excretion and urinary bactericidal titers (UBTs) at intervals for up to 144 h. Ofloxacin showed higher concentrations in urine compared with those of gemifloxacin. The median (range) cumulative excretion of gemifloxacin was 29.7% (8.4 to 48.7%) of the parent drug administered, and median (range) cumulative excretion of ofloxacin was 84.3% (46.5 to 95.2%) of the parent drug administered. The UBTs, i.e., the highest twofold dilutions (with antibiotic-free urine as the diluent) of urine that were still bactericidal, were determined for a reference strain and nine uropathogens for which the MICs of gemifloxacin and ofloxacin were as follows:Escherichia coli ATCC 25922, 0.016 and 0.06 μg/ml, respectively; Klebsiella pneumoniae, 0.03 and 0.06 μg/ml, respectively; Proteus mirabilis, 0.125 and 0.125 μg/ml, respectively; Escherichia coli, 0.06 and 0.5 μg/ml, respectively; Pseudomonas aeruginosa, 1 and 4 μg/ml, respectively; Staphylococcus aureus, 0.008 and 0.25 μg/ml, respectively; Enterococcus faecalis, 0.06 and 2 μg/ml, respectively;Staphylococcus aureus, 0.25 and 4 μg/ml, respectively;Enterococcus faecalis, 0.5 and 32 μg/ml, respectively; and Staphylococcus aureus, 2 and 32 μg/ml, respectively. Generally, the UBTs for gram-positive uropathogens were higher for gemifloxacin than for ofloxacin and the UBTs for gram-negative uropathogens were higher for ofloxacin than for gemifloxacin. According to the UBTs, ofloxacin-resistant uropathogens (MICs, ≥4 mg/liter) should also be considered gemifloxacin resistant. Although clinical trials have shown that gemifloxacin is effective for the treatment of uncomplicated urinary tract infections, whether an oral dosage of 320 mg of gemifloxacin once daily is also adequate for the treatment of complicated urinary tract infections has yet to be confirmed.

Effect of an external urinary collection device for women on institutional catheter utilization and catheter-associated urinary tract infections

2020 ◽  
pp. 1-3
Author(s):  
Lindsey Rearigh ◽  
Gayle Gillett ◽  
Adrienne Sy ◽  
Terry Micheels ◽  
Luana Evans ◽  
...  
Keyword(s):  
Experimental Study ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Indwelling Catheter ◽  
Collection Device ◽  
Quasi Experimental ◽  
Tract Infections

Abstract External urinary collection devices (EUCDs) may reduce indwelling catheter usage and catheter-associated urinary tract infections (CAUTIs). In this retrospective quasi-experimental study, we demonstrated that EUCD implementation in women was associated with significantly decreased indwelling catheter usage and a trend (P = .10) toward decreased CAUTI per 1,000 patient days.

Urinary Tract Infections Caused by Multi-Drug Resistant Proteus mirabilis: Risk Factors and Clinical Outcomes

Infection ◽  
2009 ◽  
Vol 38 (1) ◽  
pp. 41-46 ◽  
Author(s):  
K. Cohen-Nahum ◽  
L. Saidel-Odes ◽  
K. Riesenberg ◽  
F. Schlaeffer ◽  
A. Borer
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Clinical Outcomes ◽  
Urinary Tract Infections ◽  
Proteus Mirabilis ◽  
Drug Resistant ◽  
Tract Infections

scholarly journals Single Clinical Isolates from Acute Uncomplicated Urinary Tract Infections Are Representative of Dominant In Situ Populations

mBio ◽  
2014 ◽  
Vol 5 (2) ◽  
Author(s):  
Dana Willner ◽  
Serene Low ◽  
Jason A. Steen ◽  
Narelle George ◽  
Graeme R. Nimmo ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Clinical Isolates ◽  
Content Type ◽  
E Coli ◽  
Strain Diversity ◽  
Amplicon Pyrosequencing ◽  
Culture Independent ◽  
Tract Infections

ABSTRACTUrinary tract infections (UTIs) are one of the most commonly acquired bacterial infections in humans, and uropathogenicEscherichia colistrains are responsible for over 80% of all cases. The standard method for identification of uropathogens in clinical laboratories is cultivation, primarily using solid growth media under aerobic conditions, coupled with morphological and biochemical tests of typically a single isolate colony. However, these methods detect only culturable microorganisms, and characterization is phenotypic in nature. Here, we explored the genotypic identity of communities in acute uncomplicated UTIs from 50 individuals by using culture-independent amplicon pyrosequencing and whole-genome and metagenomic shotgun sequencing. Genus-level characterization of the UTI communities was achieved using the 16S rRNA gene (V8 region). Overall UTI community richness was very low in comparison to other human microbiomes. We strain-typedEscherichia-dominated UTIs using amplicon pyrosequencing of the fimbrial adhesin gene,fimH. There were nine highly abundantfimHtypes, and each UTI sample was dominated by a single type. Molecular analysis of the corresponding clinical isolates revealed that in the majority of cases the isolate was representative of the dominant taxon in the community at both the genus and the strain level. Shotgun sequencing was performed on a subset of eightE. coliurine UTI and isolate pairs. The majority of UTI microbial metagenomic sequences mapped to isolate genomes, confirming the results obtained using phylogenetic markers. We conclude that for the majority of acute uncomplicatedE. coli-mediated UTIs, single cultured isolates are diagnostic of the infection.IMPORTANCEIn clinical practice, the diagnosis and treatment of acute uncomplicated urinary tract infection (UTI) are based on analysis of a single bacterial isolate cultured from urine, and it is assumed that this isolate represents the dominant UTI pathogen. However, these methods detect only culturable bacteria, and the existence of multiple pathogens as well as strain diversity within a single infection is not examined. Here, we explored bacteria present in acute uncomplicated UTIs using culture-independent sequence-based methods.Escherichia coliwas the most common organism identified, and analysis ofE. colidominant UTI samples and their paired clinical isolates revealed that in the majority of infections the cultured isolate was representative of the dominant taxon at both the genus and the strain level. Our data demonstrate that in most cases single cultured isolates are diagnostic of UTI and are consistent with the notion of bottlenecks that limit strain diversity during UTI pathogenesis.

Risk factors, demographic profiles, and management of uncomplicated recurrent urinary tract infections

Menopause ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Amanda Ingram ◽  
Tasha Posid ◽  
Aroh Pandit ◽  
Justin Rose ◽  
Sabrina Amin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Demographic Profiles ◽  
Recurrent Urinary Tract Infections ◽  
Tract Infections

scholarly journals RECOMMENDATIONS FOR THE THERAPEUTIC MANAGEMENT OF NON COMPLICATED URINARY TRACT INFECTIONS IN ADULTS

2010 ◽  
Vol 17 (3) ◽  
pp. 103
Author(s):  
L. CERSOSIMO ◽  
F. CATANZARO ◽  
E. IMPARATO ◽  
M. MESCHIA ◽  
T. MAZZEI ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Warning Signal ◽  
Therapeutic Management ◽  
Human Species ◽  
Bacterial Diseases ◽  
Frequent Relapses ◽  
Tract Infections ◽  
Male Subjects

Non complicated acute urinary tract infections (UTI) are among the most common bacterial diseases in the human species. More than 150 million UTIs (non complicated/complicated) are, in fact, annually diagnosed and treated worlwide (Sobel Kaye, 1990; Stamm and Hooton, 1993; Stamm, 1998; Stamm and Norrby, 2001; Foxman, 2002). UTI include cystitis and pyelonephritis (the latter is not discussed in this paper) that occur in individuals without morphological-functional alterations of the excretory tract. This disease is more common in female and/or in menopause patients. 25-50% of the individuals in this population, aged between 20 and 40 years, can be affected by UTI at least once in a lifetime and can be prone to more or less frequent relapses. (Johnson, 1998; Stamm, 2001). Male subjects are less frequently affected by UTI, but when affected, they experience more serious episodes often representing a warning signal of anatomical alterations of the urinary apparatus or the presence of risk factors.......

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