scholarly journals Bacterial Infection Diagnosis and Antibiotic Prescription in 3 h as an Answer to Antibiotic Resistance: The Case of Urinary Tract Infections

Antibiotics ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. 1168
Author(s):  
Eleonora Nicolai ◽  
Massimo Pieri ◽  
Enrico Gratton ◽  
Guido Motolese ◽  
Sergio Bernardini
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antimicrobial Susceptibility ◽  
Antibiotic Susceptibility ◽  
Clinical Laboratory ◽  
Point Of Care ◽  
Urine Samples ◽  
Clinical Approach ◽  
Antibiotic Susceptibility Test ◽  
Tract Infections

Current methods for the diagnosis of urinary tract infections with antimicrobial susceptibility testing take 2–3 days and require a clinical laboratory. The lack of a rapid, point-of-care antibiotic susceptibility test (AST) has contributed to the misuse of antibiotics when treating urinary tract infections (UTIs) and consequently to the rise of multi-drug-resistant organisms. The current clinical approach has led to reduced treatment options and increased costs of diagnosis and therapy. To address this issue, novel diagnostics are needed for the timely determination of antimicrobial susceptibility. We present a rapid, point-of-care, phenotypic AST device that can report the antibiotic susceptibility/resistance of a uropathogen to a panel of antibiotics in as few as 3 h by utilizing fluorescent-labelling chemistry and a highly sensitive particle-counting instrument. We analysed 744 urine samples from the outpatients and inpatients of two Italian hospitals. The 130 UTI-positive patient urine samples we found were measured using a panel of six common UTI antibiotics plus a growth control. By comparing our results to hospital laboratory urine cultures, we obtained an overall sensitivity = 81%, a specificity = 83%, an SPV (sensitivity predicted value) = 95%, and an RPV (resistance predicted value) = 54%. According to our preliminary data, the sensitivity predicted value for a single antibiotic agent was 95%, thus allowing (in the vast majority of cases) an early (within 3 h) recognition of an effective agent for a single patient.

scholarly journals A Rapid, point-of-care antibiotic susceptibility test for urinary tract infections

2020 ◽  
Vol 20 ◽  
pp. S77-S78
Author(s):  
V.M.Ambrosi Grappelli ◽  
S. Pastore ◽  
I. Amato ◽  
C.Fede Spicchiale ◽  
M. Carilli ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antibiotic Susceptibility ◽  
Point Of Care ◽  
Susceptibility Test ◽  
Antibiotic Susceptibility Test ◽  
Tract Infections

scholarly journals A rapid, point-of-care antibiotic susceptibility test for urinary tract infections

2020 ◽  
Vol 19 ◽  
pp. e1290
Author(s):  
V.M. Ambrosi Grappelli ◽  
E. Finazzi Agrò ◽  
I. Amato ◽  
S. Pastore ◽  
M. Carilli ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antibiotic Susceptibility ◽  
Point Of Care ◽  
Susceptibility Test ◽  
Antibiotic Susceptibility Test ◽  
Tract Infections

Microbiological Analysis of the Urine Isolates in Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal

2012 ◽  
Vol 9 (4) ◽  
pp. 295-297 ◽  
Author(s):  
S Raza ◽  
S Pandey ◽  
C P Bhatt
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antimicrobial Agents ◽  
College Teaching ◽  
Urine Samples ◽  
Diffusion Method ◽  
Microbiological Analysis ◽  
Medical College ◽  
Antibiotic Susceptibility Test ◽  
Tract Infections

Background Urinary tract infections (UTIs) are the common cause of bacterial infection. Recently UTI become more complicated and difficult to treat because of appearance of pathogen with increasing resistance to antimicrobial agents. Objective To determine the etiology of the urinary tract infections and their susceptibility to antimicrobial agents. Methods This study was carried out in Kathmandu Medical College, at department of microbiology. Total 3,460 urine samples were tested microbiologically by standard procedure. Antibiotic susceptibility test was performed for all the isolates by Kirby Bauer disc diffusion method and result was interpreted according to National Committee for Clinical Laboratory Standards (NCCLS) guide line. Results Out of 3,460 urine samples 680 (19.7%) showed the significant bacteriuria. The most common pathogens isolated were Escherichia coli 75.7% followed by Klebsiella pneumoniae 10.7%, Acinetobacter spp 5.5%, Proteus spp 3.5% and Pseudomonas aeruginosa 1.2%. Most susceptible antibiotic was Amikacin, Ceftriaxone and Ciprofloxacin for most of the isolates. E. coli which was the main isolate was found to be most susceptible to Amikacin 96.1%, Nitrofurantoin 91.3% and Gentamicin 77.7% followed by Ceftriaxone 65.8% and Ciprofloxacin 64.1%. ConclusionRegular surveillance of the resistance rate among uro-pathogens is needed to ensure the appropriate therapy of UTI.DOI: http://dx.doi.org/10.3126/kumj.v9i4.6348 Kathmandu Univ Med J 2011;9(4):295-7 

scholarly journals Prevalence and antibiotic susceptibility pattern of pathogens from urinary tract infections (UTI) in a private diagnostic laboratory in Bangladesh

2020 ◽  
Vol 6 (3) ◽  
pp. 564-569
Author(s):  
Md Habibur Rahman ◽  
Mushtaque Ahmed ◽  
Dayanidhi Sarkar ◽  
Md Asadur Rahman
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Antibiotic Susceptibility ◽  
Antimicrobial Agents ◽  
Urine Samples ◽  
Gram Positive ◽  
Diagnostic Laboratory ◽  
Gram Negative ◽  
Antibiotic Susceptibility Test ◽  
Tract Infections

Urinary tract infection (UTI) is one of the commonest infections encountered by clinicians and despite the widespread availability of antimicrobial agents UTI has become difficult to treat because of appearance pathogens with increasing resistance to antimicrobial agents. The aim and objectives of this study were to determine the pathogens causing UTI and to determine the antibiotic sensitivity status among these isolates in a diagnostic laboratory in Dhaka city. A laboratory based cross sectional survey was conducted in Popular Diagnostic Centre Ltd. Dhanmondi, Dhaka-1205, Bangladesh from July 2016 to December 2016. A total of 553 freshly voided midstream urine samples (10-20 ml) were collected in a wide mouth sterile container from patients and processed in microbiology laboratory to isolate pathogens and antibiotic susceptibility test using standard procedure. Among 553 urine sample, the culture positivity in urine samples was found to be 158 (28.57%) of which 39 (24.70%) were isolated from male patients and 119 (75.30%) from female patients. Escherichia coli (43.67%) were found to be the predominant pathogen followed by Staphylococcus spp. (16.45%), Enterococcus spp. (13.39%), Klebsiella spp. (13.29%), Candida spp. (5.70%), Acinetobacter spp. (4.43%), Psudomonas spp. (3.80%) and Proteus spp. (1.27%). Carbapenem group (Imipenem, Meropenem) were the most effective antibiotic with resistance between 0 and 5.1% of the gram negative isolates and Linezolid and Vancomycin was most effective in gram positive isolates. Nitrofurantoin was most effective both gram negative and gram positive isolates. This study finding showed That Escherichia. coli isolates were the predominant pathogens and showed increasing pattern to the commonly prescribed drugs in private practice that in turn leaves the clinicians with very few alternative options in drug for the treatment of UTIs. Asian J. Med. Biol. Res. September 2020, 6(3): 564-569

scholarly journals Impact of selective reporting of antibiotic susceptibility test results in urinary tract infections in the outpatient setting: a protocol for a pragmatic, prospective quasi-experimental trial

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e025810 ◽  
Author(s):  
Francesca Binda ◽  
Sébastien Fougnot ◽  
Patrice De Monchy ◽  
Anne Fagot-Campagna ◽  
Céline Pulcini ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Broad Spectrum ◽  
Antibiotic Susceptibility ◽  
Outpatient Setting ◽  
Susceptibility Test ◽  
Selective Reporting ◽  
Broad Spectrum Antibiotics ◽  
Antibiotic Susceptibility Test ◽  
Tract Infections

IntroductionAntibiotic resistance is a serious and increasing worldwide threat to global public health. One of antibiotic stewardship programmes’ objectives are to reduce inappropriate broad-spectrum antibiotics’ prescription. Selective reporting of antibiotic susceptibility test (AST) results, which consists of reporting to prescribers only few (n=5-6) antibiotics, preferring first-line and narrow-spectrum agents, is one possible strategy advised in recommendations. However, selective reporting of AST has never been evaluated using an experimental design.Methods and analysisThis study is a pragmatic, prospective, multicentre, controlled (selective reporting vs usual complete reporting of AST), before-after (year 2019 vs 2017) study. Selective reporting of AST is scheduled to be implemented from September 2018 in the ATOUTBIO group of 21 laboratories for all Escherichia coli identified in urine cultures in adult outpatients, and to be compared with the usual complete AST performed in the EVOLAB group of 20 laboratories. The main objective is to assess the impact of selective reporting of AST for E. coli-positive urine cultures in the outpatient setting on the prescription of broad-spectrum antibiotics frequently used for urinary tract infections (amoxicillin-clavulanate, third-generation cephalosporins and fluoroquinolones). The primary end point is the after (2019)–before (2017) difference in prescription rates for the previously mentioned antibiotics/classes that will be compared between the two laboratory groups, using linear regression models. Secondary objectives are to evaluate the feasibility of selective reporting of AST implementation by French laboratories and their acceptability by organising focus groups and individual semi-structured interviews with general practitioners and laboratory professionals.Ethics and disseminationThis protocol was approved by French national ethics committees (Comité d’expertise pour les recherches, les études et les évaluations dans le domaine de la santé (TPS 29064) and Commission Nationale de l’Informatique et des Libertés (Décision DR-2018–141)). Findings of this study will be widely disseminated through conference presentations, reports, factsheets and academic publications and generalisation will be further discussed.Trial registration numberNTC03612297.

scholarly journals Evaluation of a phenotypic, point-of-care solution for the detection and quantitative antibiotic susceptibility testing for lower Urinary Tract Infection

2021 ◽  
Author(s):  
Ronal Turner ◽  
Rachel Kirkby ◽  
Emma Meader ◽  
John R Wain
Keyword(s):  
Urinary Tract ◽  
Predictive Value ◽  
Antibiotic Susceptibility ◽  
Point Of Care ◽  
Urine Samples ◽  
Reference Laboratory ◽  
Sensitivity Testing ◽  
Treatment Data ◽  
Culture And Sensitivity ◽  
Tract Infections

Background Urinary tract infections (UTIs) are one of the most common bacterial infections seen in primary care. The current standard for the definitive diagnosis of a UTI is culture and sensitivity testing of a mid-stream urine sample at a clinical laboratory; however, this technique is costly, labour intensive and is not directly relevant clinically - typically taking 2-3 days to yield a result. Study design and Objective This is a nonexperimental cross-sectional study. The aim of this study was to evaluate the efficacy of U-treat, a bioluminescent approach for rapid detection of bacteriuria and quantitative determination of the antimicrobial susceptibility profiles of uropathogens in clinical urine specimens - in under an hour. Method The evaluation was carried out in two UK-based Medical Centres using urine samples from patients presenting with symptoms of a UTI (n=249). The U-treat technology is a two test, two reagent process. Test 1 detects the presence of a bacterial UTI > 104 bacteria/mL (5-10 minutes). Test 2 produces quantitative antibiotic susceptibility (<50 minutes). Only urine samples testing positive for bacteria in Test 1 underwent Test 2 (n=82). U-treat results were compared retrospectively against reference laboratory culture and sensitivity findings. The influence of the technology on patient treatment outcomes was also analysed. Results Relative to reference laboratory analysis, Test 1 showed a sensitivity of 97.1% and specificity of 92.0%. (PPV: 89.3%; NPV: 97.8%). Test 2 produced an overall sensitivity (measurement of true susceptibility) of 94.1% (Predictive value: 96%) and an overall specificity (measurement of true resistance) of 90.5% (Predictive value 86.4%). Analysis of treatment data demonstrated that had the physicians had access to U-treat results at the point of care, the percentage of patients treated successfully would have risen from 68.3% to 92.7%. Conclusion U-treat represents the first technology, world-wide, capable of providing UTI treatment data to physicians at the point of care, in less than 60 minutes.

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 Prevalence and in vitro antibiotic susceptibility pattern of bacterial strains isolated from tribal women suffering from urinary tract infections in District Anuppur, Madhya Pradesh, India

2020 ◽  
Vol 7 (8) ◽  
pp. 3944-3953
Author(s):  
Poonam Sharma ◽  
Aashish Kumar Netam ◽  
Rambir Singh
Keyword(s):  
Public Health ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antibiotic Susceptibility ◽  
Madhya Pradesh ◽  
Urine Samples ◽  
Health Concern ◽  
E Coli ◽  
Tribal Women ◽  
Tract Infections

Introduction: Urinary tract infections (UTIs) are an increasing public health problem caused by a range of uropathogens. UTI is a major health concern among tribal women due to lack of adequate health facilities at regional public health centers and district hospitals. The objective of the study was to investigate the prevalence and antibiotic susceptibility of bacteria isolated from urine samples of tribal women suffering from UTI. Urine samples were collected from 550 tribal women who visited the Outpatient Department (OPD) of the District Hospital of Anuppur, Madhya Pradesh, India. Methods: The samples were cultured on different selective and differential media and identified by colony morphology, Gram staining and biochemical tests. Results: Out of 550 urine samples, 360 (65.45%) were culture-positive and 190 (34.55%) were culture-negative. Klebsiella pneumoniae, Proteus mirabilis, Escherichia coli & Pseudomonas aeruginosa have been identified as major uropathogens. K. pneumoniae is the most prevalent bacteria followed by P. mirabilis, E. coli and P. aeruginosa. The drug sensitivity analysis of bacterial uropathogens was performed against different antibiotics. The antibiotic susceptibility profiling showed that most of the isolates of K. pneumoniae, P. mirabilis and E. coli were resistant against penicillin (86.67-100%) and rifampicin (72.73-97.67%). Conclusions: Gentamycin, kanamycin and streptomycin were the most active antibiotics against the isolates of P. aeruginosa (76, 80 and 76%), P. mirabilis (76.62, 66.23 and 75.32%), K. pneumoniae (55.81, 20.93 and 44.19%) and E. coli (50.48, 37.14 and 62.86%), respectively, and may be the drug of choice for treatment of UTI in this region at present.

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