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 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.

URINARY INFECTION AT DEPARTMENT OF UROLOGY OF HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2018 ◽  
pp. 100-108
Author(s):  
Dinh Khanh Le ◽  
Dinh Dam Le ◽  
Khoa Hung Nguyen ◽  
Xuan My Nguyen ◽  
Minh Nhat Vo ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
University Hospital ◽  
E Coli ◽  
Positive Urine ◽  
Tract Infections

Objectives: To investigate clinical characteristics, bacterial characteristics, drug resistance status in patients with urinary tract infections treated at Department of Urology, Hue University Hospital. Materials and Method: The study was conducted in 474 patients with urological disease treated at Department of Urology, Hue Universiry Hospital from July 2017 to April 2018. Urine culture was done in the patients with urine > 25 Leu/ul who have symptoms of urinary tract disease or infection symptoms. Patients with positive urine cultures were analyzed for clinical and bacterial characteristics. Results: 187/474 (39.5%) patients had symptoms associated with urinary tract infections. 85/474 (17.9%) patients were diagnosed with urinary tract infection. The positive urine culture rate was 45.5%. Symptoms of UTI were varied, and no prominent symptoms. E. coli accounts for the highest proportion (46.67%), followed by, Staphycoccus aureus (10.67%), Pseudomonas aeruginsa (8,0%), Streptococcus faecali and Proteus (2.67%). ESBL - producing E. coli was 69.23%, ESBL producing Enterobacter spp was 33.33%. Gram-negative bacteria are susceptible to meropenem, imipenem, amikacin while gram positive are vancomycin-sensitive. Conclusions: Clinical manifestations of urinary tract infections varied and its typical symptoms are unclear. E.coli is a common bacterium (46.67%). Isolated bacteria have a high rate of resistance to some common antibiotics especially the third generation cephalosporins and quinolones. Most bacteria are resistant to multiple antibiotics at the same time. Gram (+) bacteria are susceptible to vancomycin, and gram (-) bacteria are susceptible to cefoxitin, amikacin, and carbapenem. Key words: urinary tract infection

scholarly journals Detection of plasmid-mediated qnr genes among the quinolone-resistant Escherichia coli isolates in Iran

2014 ◽  
Vol 8 (07) ◽  
pp. 818-822 ◽  
Author(s):  
Farzaneh Firoozeh ◽  
Mohammad Zibaei ◽  
Younes Soleimani-Asl
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Quinolone Resistance ◽  
Diffusion Method ◽  
Chain Reaction ◽  
Disk Diffusion Method ◽  
E Coli ◽  
Polymerase Chain ◽  
Tract Infections

Introduction: Plasmid-mediated quinolone resistance, which complicates treatment, has been increasingly identified in Escherichia coli isolates worldwide. The purpose of this study was to identify the plasmid-mediated qnrA and qnrB genes among the quinolone-resistant Escherichia coli isolated from urinary tract infections in Iran. Methodology: A total of 140 Escherichia coli isolates were collected between March and October 2012 from urinary tract infections in Khorram Abad, Iran. All isolates were tested for quinoloe resistance using the disk diffusion method. Also, all quinolone-resistant isolates were screened for the presence of the qnrA and qnrB genes by polymerase chain reaction. Minimum inhibitory concentrations (MICs) of ciprofloxacin for the qnr-positive isolates were determined. Results: One hundred sixteen (82.8%) of 140 Escherichia coli isolates were nalidixic acid-resistant; among them, 14 (12.1%) and 9 (7.8%) were qnrA and qnrB-positive, respectively. Two quinolone-resistant isolates harbored both qnrA and qnrB. Among 63 ciprofloxacin-resistant isolates, 14 (22.2%) and 9 (14.3%) were found to carry qnrA and qnrB genes, respectively. The ciprofloxacin MIC range was 0.25–512 μg/mL for 23 qnr-positive Escherichia coli isolates, 18 of which had MICs values of 4–512 μg/mL. Conclusion: Our study shows that the frequency of plasmid-mediated quinolone resistance genes among E. coli isolates in Iran is high.

Mecillinam: Old Molecule, New Option

2018 ◽  
Vol 13 (03) ◽  
pp. 229-233
Author(s):  
Mevliye Yetik ◽  
Fulya Bayındır Bilman
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Susceptibility Testing ◽  
Diffusion Method ◽  
First Line ◽  
Disk Diffusion Method ◽  
In Vitro Susceptibility ◽  
E Coli ◽  
Tract Infections

Background Mecillinam is a β-lactam antibiotic that is increasingly being used for the treatment of uncomplicated urinary tract infections. Nevertheless, the international guidelines still recommend nitrofurantoin, fosfomycin trometamol, and pivmecillinam as first-line agents in the treatment of such infections. Aim The objective of this study was to determine the in vitro efficacy of mecillinam against Escherichia coli and Klebsiella pneumoniae strains isolated from children with urinary tract infections. Materials Methods We investigated E. coli and K. pneumoniae isolates, obtained within the period from January 2016 to October 2017, from urine samples of patients aged 0 to 16 years. Antibiotics susceptibility testing was conducted through the disk diffusion method based on the guidelines provided by EUCAST (European Committee on Antimicrobial Susceptibility Testing). Extended-spectrum β-lactamase (ESBL)-positivity was detected by the double-disk synergy test. Isolates with mecillinam inhibition-zone diameter breakpoints lower than < 15 mm were considered to be resistant according to EUCAST criteria. Results A total of 450 isolates were assessed in the study, 135 of which were ESBL-producing E.coli, 230 were non-ESBL-producing E. coli, 35 were ESBL-producing K. pneumoniae, and 50 were non-ESBL-producing K. pneumoniae isolates. Mecillinam susceptibility was observed in most of the non-ESBL-producing and ESBL-producing E. coli isolates (230/230, 100% and 115/135, 85.1%, respectively). The rates of susceptibility of the non-ESBL-producing and ESBL-producing K. pneumoniae isolates were 37/50 (74%) and 24/35 (68.6%), respectively. Conclusion The in vitro susceptibility results obtained support the usage of mecillinam as a first-line agent. The high susceptibility of non-ESBL-producing E. coli and K. pneumoniae isolates established in vitro brings the hope that this antibiotic could soon be used in clinical practice in Turkey.

scholarly journals Distinct Characteristics of Escherichia coli Isolated from Patients with Urinary Tract Infections in a Medical Center at a Ten-Year Interval

Pathogens ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1156
Author(s):  
Wei-Hung Lin ◽  
Yen-Zhen Zhang ◽  
Po-Yao Liu ◽  
Po-Shun Chen ◽  
Shining Wang ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Bacterial Infections ◽  
Medical Center ◽  
Phylogenetic Group ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
E Coli ◽  
Tract Infections

Escherichia coli causing urinary tract infections (UTIs) are one of the most common outpatient bacterial infections. This study aimed to compare the characteristics of E. coli isolated from UTI patients in a single medical center in 2009–2010 (n = 504) and 2020 (n = 340). The antimicrobial susceptibility of E. coli was determined by the disk diffusion method. PCRs were conducted to detect phylogenetic groups, ST131, K1 capsule antigen, and 15 virulence factors. Phylogenetic group B2 dominated in our 2009–2010 and 2020 isolates. Moreover, no phylogenetic group E strains were isolated in 2020. E. coli isolates in 2020 were more susceptible to amoxicillin, ampicillin/sulbactam, cefuroxime, cefmetazole, ceftazidime, cefoxitin, tetracycline, and sulfamethoxazole/trimethoprim, compared to the isolates in 2009–2010. Extensively drug-resistant (XDR)-E. coli in 2009–2010 were detected in groups B1 (5 isolates), B2 (12 isolates), F (8 isolates), and unknown (1 isolate). In 2020, XDR-E. coli were only detected in groups A (2 isolates), B2 (5 isolates), D (1 isolate), and F (4 isolates). The prevalence of virulence factor genes aer and fimH were higher in E. coli in 2009–2010 compared to those in 2020. In contrast, afa and sat showed higher frequencies in E. coli isolates in 2020 compared to E. coli in 2009–2010.

scholarly journals Escherichia coli Isolated from Urinary Tract Infections of Lebanese Patients between 2000 and 2009: Epidemiology and Profiles of Resistance

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Ziad Daoud ◽  
Claude Afif
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
E Coli ◽  
Standard Culture ◽  
Tract Infections ◽  
Susceptibility Profiles ◽  
Third Generation Cephalosporins

The purpose of this study was to investigate the bacterial etiology of urinary tract infections in one of the busiest hospitals of Lebanon and to examine the epidemiologic and microbiologic properties of Escherichia coli isolated from urinary tract infections of Lebanese patients over a 10-year period. Methods. This retrospective study analyzed the data generated between 2000 and 2009 (10,013 Gram-positive and Gram-negative bacteria). Bacterial identification was based on standard culture and biochemical characteristics of isolates. Antimicrobial susceptibility was tested by the disk diffusion method, and ESBL production was detected by synergy with third-generation cephalosporins and amoxiclav. Results. E. coli was the most frequent isolate throughout the ten years (60.64% of the total isolates). It was followed by Klebsiella pneumoniae and Proteus sp., Pseudomonas aeruginosa, Enterococcus sp., and Streptococcus agalactiae. E. coli occurred more frequently in women (69.8%) than in men (61.4%). The lowest percentage of susceptibility of E. coli was manifested against piperacillin and ampicillin. An increase in the production of ESBL was observed (2.3% in 2000 to 16.8% in 2009). Conclusions. The etiology of urinary tract infections and their susceptibility profiles are important to be evaluated in countries like Lebanon where a severe misuse of antibiotics at all levels is observed.

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.

Culturing practices and the care of the urinary catheter in reducing NHSN-defined catheter-associated urinary tract infections: The tale of two teaching hospitals

2018 ◽  
Vol 39 (12) ◽  
pp. 1494-1496 ◽  
Author(s):  
Ana Cecilia Bardossy ◽  
Takiah Williams ◽  
Karen Jones ◽  
Susan Szpunar ◽  
Marcus Zervos ◽  
...  
Keyword(s):  
Intensive Care ◽  
Urinary Tract ◽  
Intensive Care Units ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Urinary Catheter ◽  
Teaching Hospitals ◽  
Positive Urine ◽  
Tract Infections ◽  
Catheter Care

AbstractWe compared interventions to improve urinary catheter care and urine culturing in adult intensive care units of 2 teaching hospitals. Compared to hospital A, hospital B had lower catheter utilization, more compliance with appropriate indications and maintenance, but higher urine culture use and more positive urine cultures per 1,000 patient days.

scholarly journals Molecular Characterization of Multidrug Resistant Uropathogenic E. Coli Isolates from Jordanian Patients

2018 ◽  
Vol 12 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Yacoub R. Nairoukh ◽  
Azmi M. Mahafzah ◽  
Amal Irshaid ◽  
Asem A. Shehabi
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Multidrug Resistant ◽  
Urine Samples ◽  
Diffusion Method ◽  
Molecular Characteristics ◽  
Biochemical Tests ◽  
E Coli ◽  
Tract Infections ◽  
St131 Clone

Background: Emergence of multi-drug resistant uropathogenic E. coli strains is an increasing problem to empirical treatment of urinary tract infections in many countries. This study investigated the magnitude of this problem in Jordan. Methods: A total of 262 E. coli isolates were recovered from urine samples of Jordanian patients which were suspected to have urinary tract infections (UTIs). All isolates were primarily identified by routine biochemical tests and tested for antimicrobial susceptibility by disc diffusion method. Fifty representative Multidrug Resistance (MDR) E. coli isolates to 3 or more antibiotic classes were tested for the presence of resistance genes of blaCTX-M- 1, 9 and 15, carbapenemase (blaIMP, blaVIM, blaNDM-1, blaOXA-48), fluoroquinolones mutated genes (parC and gyrA) and clone of ST131 type using PCR methods. Results: A total of 150/262 (57.3%) of E. coli isolates were MDR. Urine samples of hospitalized patients showed significantly more MDR isolates than outpatients. Fifty representative MDR E. coli isolates indicated the following molecular characteristics: All were positive for mutated parC gene and gyrA and for ST131 clone, and 78% were positive for genes of CTX-M-15, 76% for CTX-M-I and for 8% CTX-M-9, respectively. Additionally, all 50 MDR E. coli isolates were negative for carbapenemase genes (blaIMP, blaVIM, blaNDM-1, blaOXA-48), except of one isolate was positive for blaKPC-2 . Conclusion: This study indicates alarming high rates recovery of MDR uropathogenic E. coli from Jordanian patients associated with high rates of positive ST131 clone, fluoroquinolone resistant and important types of blaCTX-M.

scholarly journals Incidence of bacterial colonisation after indwelling of double-J ureteral stent

2016 ◽  
Vol 87 (4) ◽  
pp. 291 ◽  
Author(s):  
Hasan Riza Aydin ◽  
Lokman Irkilata ◽  
Mustafa Aydin ◽  
Selim Gorgun ◽  
Hüseyin Cihan Demirel ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Early Period ◽  
Stent Insertion ◽  
Bacterial Colonisation ◽  
E Coli ◽  
Double J Stent ◽  
Aseptic Conditions ◽  
Tract Infections

Objective: To determine the bacterial colonisation after double-J stent use and the risk factors for bacteriuria linked to the stent. Materials and Methods: A total of 102 patients (61 men and 41 women, mean age 47.5 ± 14.16) were examined. The stents were removed under aseptic conditions, and a urine culture was obtained before the removal of the stents. After the stents were removed, the upper, central and lower sections were separated, and washing water was sent through the stent. Results: Bacterial colonisation was found in 29.4% (30 of 102) of the stents. The most frequently observed microorganisms were determined as staphylococcus, coagulase negative (8 of 30) and E. coli (5 of 30). The washing fluid used to clean the interior of the catheter produced pathogens in 8 patients (7.8%), and these pathogens were observed to be the same microorganisms that colonised the outside of the stent. There was no statistical difference between the patients with colonisation and those without in terms of age, gender, duration of stenting and reason for stent insertion. Conclusions: Though stent colonisation does not always entail symptomatic urinary tract infections, as shown in our study, the pathogens in the urine culture are the same as those colonising the stent, confirming the reality that colonisation is the main factor in these events. Additionally, according to our study, significant colonisation may be found in the first 3 weeks, contrary to the literature, causing us to consider that urinary tract infections may develop even in the early period.

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