Bacterial Pattern of Community acquired Urinary Tract Infections: A Challenge for Antimicrobial Resistance

2021 ◽  
Vol 30 (3) ◽  
pp. 153-162
Author(s):  
Nader A. Nemr ◽  
Rania M. Kishk ◽  
Mohammed Abdou ◽  
Hassnaa Nassar ◽  
Noha M Abu bakr Elsaid ◽  
...  

Background: Urinary tract infection (UTI) is considered one of the most common bacterial infections seen in health care. To our knowledge, there is no available antimicrobial resistance surveillance system for monitoring of community-acquired UTIs (CA- UTIs) in our country. Objectives: we aimed to discuss the bacterial pattern and resistance profile of CA-UTIs in Ismailia, Egypt. Methods: This cross-sectional study included 400 patients suffering from symptoms of acute UTIs. Urine specimens were collected by clean-catch mid-stream method, examined microscopically and inoculated immediately on blood agar and MacConkey's agar plates. Colony counting, isolation and identification of the urinary pathogens were performed by the conventional biochemical tests according to the isolated organism. Antibiotic susceptibility testing was performed by Kirby Bauer disk diffusion method. Interpretation was performed according to Clinical Laboratory Standard Institute (CLSI) guidelines. Results: out of 400 specimens, 136 of them revealed no bacterial growth or insignificant bacteriuria. Most of participants with UTI were females (81.8%) (p=0.008) and 54.5% of them were married (P=0.1). Gram negative bacteria were more common than Gram positive representing 66 % and 34% respectively. E. coli was the most common isolated organism (39%) followed by S. aureus (32%), K. Pneumoniae and Pseudomonas (10.5% for each), Proteus (6%) and Enterococci (2%). E. coli isolates showed the highest susceptibility to imipenem, meropenem, amikacin, nitrofurantoin, levofloxacin and ciprofloxacin. Most of our patients were diabetics (64.8%) (p=0.004). The mean ± SD of HbA1c was 6.4±2.0 with 4 to 12.6 range, S.E was 0.1 and 95% C.I was 6.2- 6.7. The highest mean ± SD of HbA1c was in S. aureus infections. Conclusion: Gram negative bacteria were most common than Gram positive with predominance of E. coli with significant relation to the presence of diabetes.

Author(s):  
V. Naveen Kumar ◽  
Chitralekha Saikumar

Urinary tract infections (UTI) are the most common bacterial infection among the humans. One of the most important factors impacting the management of UTI over the past decade is emergence of anti-microbial resistance among uropathogens. ESBL production is one of the most common mechanisms of anti-microbial resistance, the other being Amp C β-lactamases in gram negative bacteria. This study was undertaken to establish the prevalence of ESBL producing strains and their anti-microbial susceptibility pattern to newer agents to guide therapy for urinary tract infection. The present studies isolates and identify Uropathogenic Escherichia coli and its antibiotic susceptibility pattern with special reference to ESBL. The emergence of β-lactamase is a Metter of serious concern .The drug resistance in gram negative bacilli is due to production of β-lactamases, AmpC lactamases, Efflux mechanisms and Porin deficiency. Out of the total 3580 urine samples, 987 samples (27.56%) showed No growth, 1786 (49.88%) showed the presence of Gram negative bacteria. Totally, 1081 E. coli species were isolated and < 30% of them were found to be ESBL positive. Uropathogenic E. coli   isolates are highly susceptible towards Meropenem and Imipenem antibiotics and highly resistant towards β-lactam and Cephalosporins antibiotics. Hence, the present study urged to implement the management plan for using those antibiotics in patients for preventing the antibiotic resistance.


KYAMC Journal ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 3-7
Author(s):  
Tania Rahman ◽  
Sharmeen Sultana ◽  
Taslima Akber Happy ◽  
Kamrunnahar Alo ◽  
Momtaz Begum

Background: Resistance of micro-organisms to multiple broad-spectrum antimicrobial agents is a major problem in treating neonatal sepsis. It is a matter of utmost importance to have knowledge of trends in changing pattern of antimicrobial resistance. Objective: This study was done to observe antimicrobial resistance of gram-positive and gram-negative bacteria isolated from cases of neonatal sepsis Material and Methods: This cross sectional descriptive study was conducted in Department of Microbiology in collaboration with Department of Neonatology, Dhaka Medical College Hospital, Dhaka. Antimicrobial resistance of all the isolated bacteria was performed by Modified Kirby-bauer disk diffusion method following standard guideline after isolation and identification of bacteria from blood samples of suspected septicemic neonates by automated blood culture and standard microbiological protocol. Results: All of the isolated Staphylococcus aureus, Coagulase negative Staphylococcus, Group-B Streptococcus and Micrococcus showed 100% resistance to ceftriaxone, cefotaxime and ceftazidime. Among the isolated gram-negative bacteria, all of Enterobacter spp., Pseudomonas aeruginosa and Citrobacter spp. showed 100% resistance to amoxiclav, amikacin, ceftriaxone, cefixime, ceftazidime. Conclusion: Majority of the gram-positive and gram-negative bacteria are developing resistance to multiple antimicrobial agents and surveillance is necessary to tackle this alarming situation. KYAMC Journal.2021;12(01): 03-07


2019 ◽  
Vol 15 (4) ◽  
pp. 260-266
Author(s):  
Sanjib Adhikari ◽  
Sujan Khadka ◽  
Sanjeep Sapkota ◽  
Jid Chani Rana ◽  
Santosh Khanal ◽  
...  

Background: This study was conducted to determine the prevalence and antibiotic susceptibility pattern of the uropathogens among the patients attending Bharatpur Hospital. Methods: A laboratory-based cross-sectional study was carried out among the patients attending Bharatpur Hospital from December 2017 to February 2018. Aseptically collected clean catch mid-stream urine samples from 200 clinically suspected patients were cultured and processed for the identification of the uropathogens in the laboratory using standard microbiological procedures. Antibiotic susceptibility test was performed for all the isolates against commonly used antibiotics using the Kirby-Bauer disc diffusion method according to Clinical and Laboratory Standards Institute guidelines 2017. Results: Out of 200 samples collected, 59(29.5%) of the samples showed the presence of pathogens causing urinary tract infection (UTI). Among them, 43(72.9%) were Gram-negative and 16(27.1%) were Gram-positive bacteria. UTI was found to be the most prevalent in females compared to the males and in the age group of 21-30 years. E. coli (72.0%) and Staphylococcus epidermidis (50.0%) were the most predominant Gram-negative and Gram-positive isolates respectively. The isolates were resistant to cefpodoxime (54.2%) and least resistant to gentamicin (10.2%). Twenty (33.9%) isolates were found to be multi-drug resistant (MDR). Conclusions: Higher frequency of antibiotic resistance among UTI patients alerts for continuous surveillance to assure effective control of this infection. Awareness of good hygienic practice especially in females and prudent use of antibiotics in case of infection can be sug-gested. Keywords: antibiotic susceptibility test; E. coli; MDR; urine.


2020 ◽  
Vol 7 (4) ◽  
pp. 109-113
Author(s):  
Sahar Baie ◽  
Ania Ahani Azari ◽  
Teena Dadgar

Background: This descriptive cross-sectional study was conducted to determine the antibacterial activity of Lactobacillus strains isolated from buffalo milk and yogurt in Aliabad-e Katul city, Golestan province, north-east of Iran. Methods: Raw milk and yogurt samples were collected and cultured on MRS medium by incubating anaerobically at 37°C for 48 hours. The suspected colonies were identified on the basis of Gram staining, biochemical tests, and carbohydrates fermentation. The antibacterial activity of the cell-free supernatant (CFS) extracted from Lactobacillus strains was determined using the agar well diffusion method against standard strains of Escherichia coli ATCC 11303, Klebsiella pneumoniae ATCC 13883, and Pseudomonas aeruginosa ATCC 15442 as well as gram-negative uropathogens previously isolated from patients with urinary tract infections (UTIs). Three isolates of E. coli (E1, E2, and E3), two isolates of P. aeruginosa (P1 and P2), and two isolates of K. pneumoniae (K1 and K2) were used in this study. Results: A total of 19 Lactobacillus strains were identified as L. plantarum, L. casei, L. acidophilus, and L. helveticus. Based on the results of antibacterial activity test, the isolates had the highest and lowest inhibitory effects on the E. coli and K. pneumoniae isolates, respectively. Among the isolates, only L. casei isolates showed inhibitory activity against K. pneumoniae isolates. Conclusions: In this study, Lactobacilli from buffalo milk and yogurt demonstrated a good inhibitory activity against E. coli as a common cause of urinary tract infection. Therefore, further studies are recommended to elucidate their potential for being used as an alternative to antibiotic therapy.


2021 ◽  
Vol 5 (S1) ◽  
pp. 34-38
Author(s):  
Nor Aleesa Ali ◽  
Wan Amalina Wan Mamat ◽  
Syed Ahmad Tajudin Tuan Johari ◽  
Muhammad Yusran Abdul Aziz ◽  
Ahmad Syibli Othman

Catunaregam tomentosa is a plant from Rubiaceae family that is used in traditional medicine for the treatment of stomatitis and ulcers due to bacterial infections. Besides, it also helps in the treatment of oliguria and dysuria. Indiscriminate use of commercial antibacterial medicines had led to the search for novel antibacterial drugs. Since for ages medicinal plants have been used to treat bacterial infection, so they can be excellent sources of the novel antibacterial drug. To evaluate the scientific basis of the use of plant, antibacterial activity leaves extract of C.tomentosa was investigated against selected Gram-positive and Gram-negative bacteria. The study also investigated the effect of pH on its antibacterial activity. Antibacterial activity of the plant extracts was evaluated against Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa by using the disc diffusion method at 100mg/mL concentration. Extracts of C. tomentosa inhibit the activity of S. aureus but do not inhibit the activity of Gram-negative bacteria. Minimum inhibitory concentration (MIC) was also determined against S. aureus at concentration 100, 50, 25, 12.5, 6, 3, 1.5, 0.75 and 0.395mg/mL and 3mg/mL were the MIC value. Evaluation on the effect of different pH on antibacterial activity of plant extracts shows that the activity of the plant extracts does not affect when treated with acidic pH but increased at alkaline pH. Based on the present finding, C. tomentosa leaves extract have the potential to be a viable candidate in the discovery of a natural antibacterial agent against S. aureus infections. This study provides scientific knowledge to further determine the antibacterial values of C. tomentosa extracts.


2023 ◽  
Vol 83 ◽  
Author(s):  
S. Mumtaz ◽  
S. Mumtaz ◽  
S. Ali ◽  
H. M. Tahir ◽  
S. A. R. Kazmi ◽  
...  

Abstract Now a day’s multidrug resistance phenomenon has become the main cause for concern and there has been an inadequate achievement in the development of novel antibiotics to treat the bacterial infections. Therefore, there is an unmet need to search for novel adjuvant. Vitamin C is one such promising adjuvant. The present study was aimed to elucidate the antibacterial effect of vitamin C at various temperatures (4°C, 37°C and 50°C) and pH (3, 8, and 11), against Gram-positive and Gram-negative bacteria at various concentrations (5-20 mg/ml) through agar well diffusion method. Growth inhibition of all bacterial strains by vitamin C was concentration-dependent. Vitamin C significantly inhibited the growth of Gram-positive bacteria: Bacillus licheniformis (25.3 ± 0.9 mm), Staphylococcus aureus (22.0 ± 0.6 mm), Bacillus subtilis (19.3 ± 0.3 mm) and Gram-negative bacteria: Proteus mirabilis (27.67 ± 0.882 mm), Klebsiella pneumoniae (21.33±0.9 mm), Pseudomonas aeruginosa (18.0 ± 1.5 mm) and Escherichia coli (18.3 ± 0.3 mm). The stability of vitamin C was observed at various pH values and various temperatures. Vitamin C showed significant antibacterial activity at acidic pH against all bacterial strains. Vitamin C remained the stable at different temperatures. It was concluded that vitamin C is an effective and safe antibacterial agent that can be used in the future as an adjunct treatment option to combat infections in humans.


2021 ◽  
Vol 21 (2) ◽  
pp. 497-504
Author(s):  
Souad Youssouf Kani Elmi ◽  
Medhat Saber Ashour ◽  
Fathy Zakaria Alsewy ◽  
Nashwa Fawzy Abd El Moez Azzam

Background: T2DM patients are more likely to have UTIs caused by resistant organisms such as ESBLs producing bacteria. Challenging reliable identification and prompt characterization of in-vitro susceptibilities of these bacteria are the first steps of deciding the appropriate antimicrobial therapy for UTIs caused by them. Objectives: To isolate and identify E. coli and K. pneumoniae from urine of T2DM patients with UTIs, to determine antibiotic resistance pattern among isolates, and to identify ESBLs production phenotypically and genotypically. Material and method: All samples were cultured on Cystine-Lactose-Electrolyte-Deficient Agar medium (CLED) by using calibrated loop. Growth of 100 colonies or more, i.e. 105 colony forming units (CFU)/mL urine was considered as signifi- cant bacteriuria. Isolation and identification were done according to standard method. All isolates were tested for antibiotic susceptibility testing by the disc diffusion method according to CLSI guidelines. Phenotypic detection of ESBLs was done by double-disk synergy test. Genotypic detection of blaTEM, blaSHV and blaCTX-M genes by using PCR. Results: Results of this study showed that E. coli and K. pneumoniae were the dominant bacterial isolates, they constituted 103 (91.2%) out of 113 urine isolates. E. coli (58. 4%) K. pneumoniae (32.7%), Enterococcus spp. (4.4%), Proteus spp. (2.7%) and Pseu- domonas spp. (1.8%). About 25 (24.3%) out of 103 E. coli and K. pneumoniae isolates were ESBLs positive by DDST, and 22 (88.0%) out of them had ESBLs encoding genes by conventional PCR. The most common gene detected was blaTEM (59.1%), followed by blaSHV (27.3%). CTX-M had not been detected in any of testes isolates. Conclusion: blaTEM and blaSHV genes were detected in 22 out of 25 ESBLs producing E. coli and K. pneumoniae isolates phenotypically detected by DDST. blaTEM was found to be the predominant gene (59.1%), while blaCTX-Mene was not detected in any of tested isolates. Keywords: Extended Spectrum β-Lactamases; Type 2 diabetes mellitus; Urinary tract infections; Phenotypic; genotypic methods.


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