scholarly journals Carbapenem-Resistant but Cephalosporin-Susceptible Pseudomonas aeruginosa in Urinary Tract Infections: Opportunity for Colistin Sparing

Antibiotics ◽  
2020 ◽  
Vol 9 (4) ◽  
pp. 153 ◽  
Author(s):  
Márió Gajdács
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Disk Diffusion ◽  
Diffusion Method ◽  
Phenotypic Characterization ◽  
Care Hospital ◽  
Disk Diffusion Test ◽  
Carbapenem Resistant ◽  
Tract Infections

This paper briefly reports the occurrence and epidemiology of carbapenem-resistant but cephalosporin-susceptible (Car-R/Ceph-S) Pseudomonas aeruginosa isolates from urinary tract infections (UTIs) in a tertiary-care hospital in the Southern Region of Hungary, and the phenotypic characterization of the possible resistance mechanisms in these isolates. Isolates and data were collected regarding P. aeruginosa UTIs corresponding to the period between 2008 and 2017. Susceptibility testing was performed using the Kirby–Bauer disk diffusion method; minimum inhibitory concentrations (MICs) of the isolates were determined using E-tests. The phenotypic detection of ampicillin C-type (AmpC) β-lactamases, efflux pump overexpression and carbapenemase production was also performed. P. aeruginosa represented n = 575 (2.72% ± 0.64%) from outpatient, and n = 1045 (5.43% ± 0.81%) from inpatient urinary samples, respectively. Based on the disk diffusion test, n = 359 (22.16%) were carbapenem-resistant; in addition to carbapenems, n = (64.34%) were also resistant to ciprofloxacin; n = (60.17%) to gentamicin/tobramycin; n = (58.51%) to levofloxacin; and n = (27.57%) to amikacin. From among the carbapenem-resistant isolates, n = 56 (15.59%) isolates were multidrug-resistant, while n = 16 (4.46%) were extensively drug-resistant. From among the Car-R/Ceph-S isolates (n = 57), overexpression of AmpC was observed in n = 7 cases (12.28%); carbapenemase production in n = 4 (7.02%); while overexpression of efflux pumps was present in n = 31 (54.39%) isolates. To spare last-resort agents, e.g., colistin, the use of broad-spectrum cephalosporins or safe, alternative agents should be considered in these infections.

Urinary Tract Infections in Patients with Type 1 and Type 2 Diabetes: Etiology, Resistance to Antibacterial Chemicals and Virulence Features

2017 ◽  
Vol 68 (3) ◽  
pp. 566-569 ◽  
Author(s):  
Mihaela Magdalena Mitache ◽  
Carmen Curutiu ◽  
Elena Rusu ◽  
Ramona Bahna ◽  
Mara Ditu ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Virulence Factors ◽  
Urinary Tract Infections ◽  
Disk Diffusion ◽  
Diffusion Method ◽  
Diabetic Patients ◽  
Disk Diffusion Test ◽  
Tract Infections ◽  
Susceptibility Profiles ◽  
Diabetes Patients

One of the most frequent chronic complications occurred in diabetes patients are the urinary tract infections (UTIs). This study aimed to investigate the incidence of UTIs in a cohort of 93 (47 males: 46 females) diabetic patients, the prevalence of different microbial species involved and their virulence and antibiotic resistance profiles. The identification of the uropathogenic strains in the positive urine samples was performed using conventional methods and API tests. After identification, the antibiotic susceptibility profiles were established by the standardized disk diffusion method and double disk diffusion test was performed for the confirmation of ESBL and inducible AmpC b �lactamase phenotypes. The isolated strains were tested for the production of different cell associated and soluble virulence factors, i.e.: bacterial adherence to cellular substrata (HeLa cells), hemolysins (hemolysis spot, CAMP-like), amylase, caseinase, aesculin hydrolysis, DNA-ase, lipase and lecithinase. In the analyzed group, the total prevalence of UTIs was of 46%, a higher incidence being observed in the female patients (64%). Similar to other studies, the etiology of UTI in the investigated diabetes patients was dominated by E. coli, followed by Klebsiella sp. strains. The isolated strains preserved good susceptibility rates to quinolones and aminoglycosides and revealed important virulence features, related to their capacity to colonize the cellular substratum and to produce soluble virulence factors involved in persistence, colonization and progression of the infectious process. The high percentage of beta-lactam resistant strains (including carbapenem-resistant ones) requires careful surveillance of the dynamics of susceptibility profiles for limiting the emergence of these strains in community.

Genotypic and phenotypic characterization of Pseudomonas aeruginosa isolates from urinary tract infections

2011 ◽  
Vol 301 (4) ◽  
pp. 282-292 ◽  
Author(s):  
Petra Tielen ◽  
Maike Narten ◽  
Nathalie Rosin ◽  
Ilona Biegler ◽  
Isam Haddad ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Phenotypic Characterization ◽  
Tract Infections

scholarly journals Prevalence of antibiotic resistance and blaIMP-1 gene among Pseudomonas aeruginosa strains isolated from burn and urinary tract infections in Isfahan, central Iran

2017 ◽  
Vol 8 (2) ◽  
Author(s):  
Naeimeh Sadat Hashemi ◽  
Meysam Mojiri ◽  
Parivash Yazdani Kachouyi ◽  
Shiva Eskandari ◽  
Mehrsa Mohammadian ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Public Health Issue ◽  
High Prevalence ◽  
Tract Infections

Pseudomonas aeruginosa is one of the most important opportunistic pathogens responsible for various types of hospital infections. High prevalence of antibiotic resistance in P. aeruginosa strains of human clinical samples cause more severe diseases for a longer period of time. The current research was done in order to study the distribution of blaIMP-1 gene among the imipenem-resistant P. aeruginosa strains isolated from burn and urinary tract infections of hospitalized patients. Two-hundred and forty-three P. aeruginosa isolates recovered from the cases of burn and urinary tract infections of inpatients and outpatients were analysis for antibiotic resistance pattern using the disk diffusion method. Then, imipenem-resistant isolates were further analyzed for distribution of blaIMP-1 gene using the PCR. Of 243 P. aeruginosa isolates, 146 strains (60.08%) were taken from outpatients and 97 strains (39.91%) were taken from inpatients. P. aeruginosa isolates harbored the highest levels of resistance against streptomycin (100%), nalidixic acid (100%), aztreonam (100%), cotrimoxazole (95.47%), ciprofloxacin (88.47%), cefotaxime (84.36%) and gentamycin (83.95%). Inpatients had a relatively higher levels of antibiotic resistance. One-hundred and twenty-one out of 126 (96.03%) imipenem-resistant P. aeruginosa isolates harbored the blaIMP-1 gene. Inpatients also had a relatively higher prevalence of blaIMP-1 gene. High prevalence of blaIMP-1 gene and also imipenemresistant P. aeruginosa are important public health issue. Clinical laboratories should consider the detection of the blaIMP-1 gene among the P. aeruginosa isolates of clinical samples.

scholarly journals Phenotypic and genotypic characterization of multidrug-resistant isolates from patients with catheter-associated urinary tract infection in a tertiary care hospital

2019 ◽  
Vol 11 (03) ◽  
pp. 206-211
Author(s):  
Jaison Jayakaran ◽  
Nirupa Soundararajan ◽  
Priyadarshini Shanmugam
Keyword(s):  
Urinary Tract ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Carbapenem Resistance ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Care Hospital ◽  
Disk Diffusion Method ◽  
Carbapenem Resistant ◽  
Tract Infections

Abstract INTRODUCTION: Urinary tract infections (UTIs) remain as the most common infection. Catheter-associated (CA) UTI can lead to bacteremia and thereby is the leading cause of morbidity and mortality in hospitalized patients in our country. AIMS AND OBJECTIVES: This study aims to check the prevalence of CAUTI and study the phenotypic and genotypic characters of the multidrug-resistant organisms in a tertiary care hospital, with special reference to NDM-1 and OXA-23. MATERIALS AND METHODS: A total of 231 urine samples from patients with CA-UTI in different wards in a tertiary care hospital over a period of 3 months between June and August 2018 were collected and processed following the standard protocol. Antibiotic susceptibility tests were performed by disk-diffusion method. Modified Hodge test (MHT) was done to isolate carbapenem-resistant isolates, and polymerase chain reaction was done to detect NDM-1 and OXA-23. RESULTS: Out of 231 samples, 101 samples yielded significant growth. These 38 samples were Gram-negative bacilli which were resistant to carbapenems. Out of the 38 which showed carbapenem resistance, 23 were MHT positive. Out of the 23 MHT-positive isolates, 8 (21.05%) were positive for NDM-1 gene and only 1 (2.6%) was positive for the OXA-23 gene. CONCLUSION: This study has shown that carbapenem-resistant isolates from all the CA urinary tract-infected patients were 52.77% and most of them were Klebsiella. About 21% of them harbored the NDM-1 gene whereas only 2% had the OXA-23 gene. There has been an alarming increase in the spread of carbapenem resistance.

scholarly journals Prevalence and Antibiogram of Bacterial Uropathogens of Urinary Tract Infections from a Tertiary Care Hospital of Bangladesh

2017 ◽  
Vol 9 (3) ◽  
pp. 317-328 ◽  
Author(s):  
S. A. Sanjee ◽  
M. E. Karim ◽  
T. Akter ◽  
M. A. K. Parvez ◽  
M. Hossain ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Tertiary Care ◽  
Age Groups ◽  
Diffusion Method ◽  
Multi Drug Resistance ◽  
Care Hospital ◽  
Resistance Patterns ◽  
Tract Infections ◽  
Antibiotic Resistance Patterns

Urinary tract infections (UTIs) are one of the most frequently occurring infections majority of which are caused by multi-drug resistant (MDR) uropathogens. Hence, the present study was designed to find out the prevalence of bacterial pathogens causing UTIs and to determine their antibiotic resistance patterns against different classes of antibiotics. Clean-catch midstream urine samples were collected from 200 UTI patients of different sex and age groups. The uropathogens were isolated using Hi-Chrome UTI agar, Blood agar, MacConkey agar and then subjected to antibiotic susceptibility analysis against nine antibiotics of different classes using Kirby-Bauer’s disc diffusion method. From 55.08% positive samples, it was found that females were more prone to UTIs than males and in both cases; the prevalence rate was higher in the age group 21-40 years (33%). Among the uropathogens, E.coli was the predominant etiological agent (57.38%) followed by Enterococcus sp. (36.06%), Pseudomonas aeruginosa (3.28%) and Staphylococcus aureus (3.28%). The pathogens showed remarkable amount of sensitivity against Gentamicin and Ciprofloxacin. The present experiment can be helpful for the clinicians in finding proper drugs in the developing countries like Bangladesh where multi-drug resistance problem has just complicated the treatment of UTIs.

scholarly journals Prevalence of Urinary Tract Infections in Children and Changes in Sensitivity to Antibiotics of E. coli Strains

2019 ◽  
Vol 70 (11) ◽  
pp. 3788-3792
Author(s):  
Adrian Hasegan ◽  
Maria Totan ◽  
Elisabeta Antonescu ◽  
Adrian Gheorghe Bumbu ◽  
Carmen Pantis ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Disk Diffusion ◽  
Diffusion Method ◽  
Sensitivity Testing ◽  
Disk Diffusion Method ◽  
E Coli ◽  
Positive Urine ◽  
Tract Infections

Urinary tract infections (UTIs) are the most common bacterial pathologies in children, but they are difficult to spot. The diagnosis relies on urine culture in order to measure the prevalence of the infection, to identify the etiology and the sensitivity of the germs to different antibiotics. Escherichia coli (E. coli) strains are the most common uro-pathogen germs. The change in sensitivity to antibiotic of these uro-pathogen bacteria should be closely monitored because the physicians should be informed about the evolution of the antibiotic resistance of E coli, for a more effective treatment in their fight against diseases. The study aimed to determine the prevalence of UTIs and the evolution of antimicrobial sensitivity for E. coli. This retrospective study was performed over a period of 4 years, 2013-2016, and included all the patients admitted in the Children�s Hospital, aged 0-18 years, with the suspicion of UTIs; also, the standard culture techniques for urine samples, the modified Kirby-Bauer disk diffusion method for the antibiotic sensitivity testing, and the disk diffusion method to confirm the ESBL production by the clinical isolates of E. coli in urine were used. The statistical analysis was performed using the proportions of sensitive, resistant and intermediates. Descriptive statistics like the total, mean and percentage were performed using the Statistical Package for the Social Sciences (SPSS), version 15.0 and Microsoft Excel. From 15389 urine cultures processed in 4 years, 1530 were positive (9.9 %). Among these positive urine cultures, 1056 (69 %) were positive for E. coli. Testing the E. coli to a range of antibiotics, according to CLSI standard, a high resistance to Ampicillin (69-96%), Amoxicillin/Clavulanic acid (32-70%), Trimethoprim/Sulfamethoxazole (36-42%) was observed and low levels of resistance to Ceftazidime, Cefuroxime, Cefpodoxime, Gentamycin, Nalidixic acid. Among E. Coli strains, 9-9.6 % were ESBL positive. Despite the low number of positive urine cultures in a paediatric population, it is very important to perform the urine culture in order to correctly identify the etiology of UTIs, recommend the right antibiotic, and avoid the wrong use of the antibiotics in children.

scholarly journals A HOSPITAL BASED SURVEILLANCE STUDY OF URINARY TRACT INFECTIONS CAUSED BY PSEUDOMONAS AERUGINOSA AND ACINETOBACTER SPECIES WITH SPECIAL EMPHASIS ON DRUG RESISTANCE

2019 ◽  
pp. 1-2
Author(s):  
Anju K K ◽  
Deepthy B J ◽  
Gogi Suresh ◽  
Harish P V
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Drug Resistance ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Urine Samples ◽  
Diffusion Method ◽  
Acinetobacter Species ◽  
Tract Infections

BACKGROUND: Urinary tract infection (UTI) is the commonest bacterial infection in community practice. The most common microorganisms causing UTI include E.coli, Klebsiella, Staphylococcus aureus, Coagulase negative staphylococci, Pseudomonas, Proteus and Acinetobacter. The increase in multidrug resistance in bacterial uropathogens is an important and emerging public health problem in non-fermenting isolates.So this study focuses the surveillance of Pseudomonas aeruginosa, and Acinetobacter species in UTI and also focuses the drug resistance of the isolates. METHOD: The study was conducted at the Department of Microbiology, DM WIMS,Meppadi,Wayanad, starting from May 2019 to July 2019. A total of 200 urine samples were taken for identifying the significant urinary tract infections. Organisms were isolated and identified using standard microbial techniques. Antibiotic sensitivity was studied using Kirby Bauer disc diffusion method and EDTA double disc synergy test. RESULT: Out of the 200 urine samples studied, 87 showed significant bacteriuria, with 26 (29.9%) Pseudomonas aeruginosa and 6(6.9%) Acinetobacter species. Other isolates were E.coli (24), klebsiella (22), enterobacter (4), Citrobacter (3) and one each were Serratia and Morganella. Among these isolates 15 Pseudomonas aeruginosa and 2 Acinetobacter species were MBL producers. CONCLUSION: The study reports that other than E.coli, Pseudomonas aeruginosa has a higher prevalence in urinary tract infection and more than half of the isolates are showing drug resistance to the commonly used drugs. Most of the infection with such strains were treated successfully with combination of drugs such as Tigecycline with colistin,colistin with a carbapenem, fosfomycin with a carbapenem, fosfomycin with aminoglycoside, and a carbapenem with an aminoglycoside have been reported as antibiotic combinations effectively administered to series of patients infected with carbapenemase producing organisms.

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.

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