scholarly journals Multidrug-Resistant Micro-Organisms Associated with Urinary Tract Infections in Orthopedic Patients: A Retrospective Laboratory-Based Study

Antibiotics ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 7
Author(s):  
Grzegorz Ziółkowski ◽  
Iwona Pawłowska ◽  
Michał Stasiowski ◽  
Estera Jachowicz ◽  
Jadwiga Wójkowska-Mach ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Perioperative Period ◽  
Multidrug Resistant ◽  
Incidence Density ◽  
Microbiological Analysis ◽  
Gram Negative ◽  
Tract Infections ◽  
Micro Organisms ◽  
Orthopedic Patients

Background: The risk of healthcare-associated infections (HAIs) in surgical wards remains closely related to the type of surgery and procedures performed on patients. Those factors also condition the risk of various forms of clinical infections, especially urinary tract infections (UTIs). UTIs are most frequently (70–80% of cases) caused by the use of bladder catheter in the perioperative period. The aim of this study was to perform an epidemiological and microbiological analysis of UTIs in orthopedic patients, with an emphasis on multidrug-resistant (MDR) micro-organisms. Methods: The study was conducted in a 38-bed Department of Orthopedic-Traumatic Surgery in Sosnowiec, Poland. 5239 patients, operated on in 2013–2015, were included in the study. The urinary catheter use rate was 30.7%. Laboratory-based study used the UTI definition of the HAI-Net program. A micro-organism was declared MDR if it was resistant to at least one antibiotic from three or more groups of antibacterial drugs, and extensively drug-resistant (XDR) if it was sensitive to antibiotics from no more than two groups of drugs. Results: The UTI incidence was 3.2% (168 cases), the CA-UTI incidence density was 9.6/1000 catheter days. The highest risk of UTI was found in patients aged 75 or older. Monomicrobial cultures were detected in 163 specimens (78% of all microbiologically confirmed UTIs). Gram-negative flora prevailed among the micro-organisms, the predominantly isolated Enterobacteriaceae being Escherichiacoli and Klebsiellapneumoniae. In 16 patients (7.7% of microbiologically confirmed UTIs), yeast infection was confirmed. Isolated micro-organisms were fully sensitive to carbapenems. Gram-negative bacilli showed the lowest sensitivity to extended substrate spectrum penicillins and fluoroquinolones (37–64%), as well as to trimethoprim-sulfamethoxazole (50%). The MDR prevalence was 24.4%. Conclusions: The presented data indicates that UTIs are a significant problem in the studied population, so is antimicrobial resistance, especially to quinolones, and extended-spectrum cephalosporins, which are often used as first-line therapy. To tackle the problem of high UTI incidence and MDR prevalence, reducing the UTI risk factors should be prioritized.

scholarly journals Multidrug-Resistant Microorganisms Associated with Urinary Tract Infections Following Orthopaedic Patients: A Laboratory-Based Analysis of 5239 Patients

2020 ◽  
Author(s):  
Grzegorz Ziółkowski ◽  
Iwona Pawłowska ◽  
Michał Stasiowski ◽  
Estera Jachowicz ◽  
Tomasz Bielecki
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Surgical Site Infections ◽  
Incidence Density ◽  
Utilization Rate ◽  
Microbiological Analysis ◽  
Gram Negative ◽  
Orthopaedic Patients ◽  
Tract Infections ◽  
Orthopedic Patients

Abstract Background: The risk of healthcare associated infections (HAI) in surgical wards remains closely related to the type of surgery and procedures performed on patients. They also condition the risk of various, apart from the most common, surgical site infections, forms of clinical infections, especially urinary tract infections (UTIs). Their occurrence in orthopedic patients is most often – in about 70%-80%, associated with the use of the bladder catheter in the perioperative period. The aim of this study was the epidemiological and microbiological analysis of UTIs following orthopedic patients, especially MDR in 2013-2015.Methods: The study was conducted in 38-bed Department of Orthopedic-Traumatic Surgery in Sosnowiec, Poland. 5 239 patients surgery included in the study, the urinary catheter utilization rate was 30.7 %. Laboratory based study using the UTI definition of the HAI-Net program, MDR was defined as resistant to at least one antibiotic from 2< antibiotics groups. The results were analyzed using the statistical package PQStat ver. 1.6.0.428 using the chi-square test (chi ^ 2) or Fisher's exact test.Results The UTI incidence was 3.2% (168 cases), CA-UTI incidence density was 9.6/1 000 catheter-days. The highest risk of UTI was found in patients aged 75 years and older. Gram-negative flora prevailed among microorganisms: 76.1%. Predominantly isolated Enterobacterales were: Escherichia coli, Klebsiella pneumoniae. Isolated microorganisms were fully sensitive to carbapenems. Gram-negative bacilli showed the lowest sensitivity to extended substrate spectrum penicillins and fluoroquinolones: 37-64%, trimethoprim-sulfamethoxazole: 50%; MDR prevalence: 24.4%.Conclusions The presented data indicate that UTI incidence is a significant problem in studied population, as well as antimicrobialresistance, especially to quinolones and extended spectrum cephalosporins, as first-line therapy remains a major challenge. To reduce the problem of high UTI incidence and MDR prevalence, the priority should be the reduction of UTI risk – which exceeded the expected values.

scholarly journals URINARY TRACT INFECTIONS

2016 ◽  
Vol 23 (01) ◽  
pp. 010-014
Author(s):  
Muhammad Usman Anjum ◽  
Muhammad Safdar Khan ◽  
Abdul Razzaq Shahid ◽  
Syed Humayun Shah
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antimicrobial Susceptibility ◽  
Geographical Area ◽  
Gram Negative ◽  
E Coli ◽  
Amoxicillin Clavulanic Acid ◽  
Gram Negative Organisms ◽  
Tract Infections ◽  
Micro Organisms

Background: Urinary tract infections (UTIs) constitute important bacterialdisease which contributes to significant morbidity world-wide. Empirical treatment in patientssuffering from UTI depends upon the local knowledge of common microorganisms responsiblefor UTI in that geographical area as well as their antimicrobial susceptibility patterns.Objectives: To determine the frequency and antimicrobial susceptibility of uropathogenswhich are responsible for urinary tract infections. Study Design: Experimental study. Setting:Department of Pathology, Frontier Medical & Dental College and Mohi Ud Din Islamic MedicalCollege. Period: January 2015 to June 2015. Material & methods: Total of 113 patients wereincluded in the study. Urine samples were cultured on MacConkey’s agar and Cysteine LactoseElectrolyte Deficient (CLED) agar. Micro-organisms were identified using standard tests andantimicrobial susceptibility was checked using modified Kirby Bauer method following Clinicaland Laboratory Standards Institute (CLSI) guidelines. Results: The average age of patientswas 32.19±16.47 years. Gram negative organisms accounted for majority of cases, about 89(78.76%) cases. Escherichia coli was the most common micro-organism which was found in50 (44.24%) cases followed by Staphylococcus aureus in 24 (21.24%), Enterobacter spp. in19 (16.81%), Klebsiella spp. in 11 (9.73%) and Proteus spp. in 9 (7.96%) cases. E. coli wassensitive to imipenem and ciprofloxacin and was resistant to amoxicillin/clavulanic acid andgentamicin. Conclusion: Gram negative organisms are largely responsible for UTIs and E. colibeing the most common etiological agent. E. coli is sensitive to commonly prescribed drugs forUTI like ciprofloxacin.

scholarly journals The Clinical Significance of High Antimicrobial Resistance in Community-Acquired Urinary Tract Infections

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Maria G. Zavala-Cerna ◽  
Midrori Segura-Cobos ◽  
Ricardo Gonzalez ◽  
Isidro G. Zavala-Trujillo ◽  
Silvia F. Navarro-Perez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Multidrug Resistant ◽  
Clinical Variable ◽  
Microbiological Analysis ◽  
Cross Sectional ◽  
E Coli ◽  
Tract Infections ◽  
Esbl Producers

Background. Urinary tract infections (UTIs) affect up to 150 million individuals annually worldwide, mainly due to Escherichia coli (E. coli) and Klebsiella. The emergence and spread of multidrug-resistant (MDR) bacteria are increasing, representing one of the biggest threats for human health. The objective of our study was to describe antimicrobial patterns of resistance and identify risk factors associated with MDR uropathogens. Methods. We conducted a cross-sectional study in 296 patients with community-acquired UTI who underwent clinical and microbiologic analysis, and clinical associations to MDR uropathogens were investigated. Findings. Microbiological analysis included E. coli (55%), ESBL-E. coli (26%), Enterococcus (6%), Klebsiella (5%), and others (8%). Higher frequencies of MDR bacteria were found among ESBL-E. coli, with resistance to ampicillin (100%), ceftriaxone (96%), gentamicin (57%), ciprofloxacin (89%), and TMP/SMX (53%). However, they were sensitive to fosfomycin (6.6%), nitrofurantoin (1.3%), and carbapenems (0%). Fosfomycin MIC90 for ESBL-E. coli was 5.78 μg/mL. The only clinical variable with significant association to ESBL producers was the presence of comorbidities: hypertension and type 2 diabetes mellitus with an OR (95%CI) of 2.51.3−4.9p<0.01 and 2.81.2−6.7p<0.05, respectively. Conclusions. In the majority of cases, resistance rates to commonly prescribed antimicrobials in UTIs were high, except for fosfomycin, nitrofurantoin, and carbapenems. To provide appropriate treatment, both the identification of risk factors and the uropathogen would be important. An active surveillance in UTIs in the community is required since the proportion of ESBL producers is increasing.

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