scholarly journals The Causative Organism of Urinary Tract Infections UTI: a Cross-sectional Study from a Tertiary Hospital In Saudi Arabia

2022 ◽  
Vol 2 (1) ◽  
pp. 70-75
Author(s):  
Mohammed Alwaladali ◽  
Maya Talal Soufan ◽  
Bandar Almutairi

BACKGROUND: Urinary tract infections (UTIs) are a common disease with a high burden on the healthcare industry. A systematic exploration is necessary of the organisms that cause UTIs, to improve empirical management of patients with acute illness before culture results are obtained. The prevalence of these organisms, both in immunocompetent and immunocompromised patients in Saudi Arabia, needs further clarification. METHODS: This is a cross-sectional analysis reviewing the charts of patients visiting the emergency department of, and those admitted to, a tertiary hospital in Saudi Arabia during the month of July-August 2021. RESULT: The total number of participants was 199, with a mean age of 55.8 years (SD=20.02), ranging from 14 to 97 years. 61.8% of patients were immunocompromised, and one-third were from the oncology wards. 40.7% (n=81) were diabetics and 8.54% (n=17) had CKD/ESRD. Females were 25% more likely than males to acquire Candida infections, while Pseudomonas aeruginosa was 26.7% more prevalent in males. Nevertheless, mixed gram-negative bacteria caused the most UTIs, in 40.20% (n=80) of cases, followed by Candida, 16.1% (n=32), and then mixed gram-positive bacteria, in 14.57% (n=29). This was also observed among immunocompromised patients and the subsegment of oncology patients on active chemotherapy, although with variable percentages. CONCLUSION: This study demonstrates that patients’ immune status is the main determinant of the causative organism of UTIs. The treatment threshold for Candida in diabetic patients and those with CKD/ESRD should be lower, especially when they require admission.

2018 ◽  
Vol 12 (04) ◽  
pp. 220-227 ◽  
Author(s):  
Bander Balkhi ◽  
Wael Mansy ◽  
Sultan AlGhadeer ◽  
Abdulrahman Alnuaim ◽  
Abdullah Alshehri ◽  
...  

Introduction: Urinary Tract Infections (UTIs) is one of the most common infections worldwide. UTIs remain a challenge to the healthcare system because of the emergence of antimicrobial resistance. The aim of this study is to report the most common UTI-causative organisms associated with the emergence of antimicrobial resistance in Saudi Arabia. Methodology: a retrospective cross sectional study of 1918 positive urine culture samples of both gender collected over 9 months (May 2015 to February 2016) from a major tertiary hospital in Riyadh, Saudi Arabia. Results: the median age of individuals involved in the study was 43 years, with males constituting 27.7% only of the population. Among cases deemed complicated (81.1%), common causes were diabetes, pregnancy, and immunocompromization, comprising 24.7%, 11.9%, and 10.8%, respectively.  Escherichia coli (52%) was the most common uropathogen, followed by Klebsiella pneumoniae (15%), Pseudomonas aeruginosa (8%) Streptococcus agalactiae (Group B streptococcus) (7%), and Enterococcus faecalis (5%). Overall sensitivity studies showed the most highly resistant uropathogen was Escherichia coli (60%) followed by Klebsiella pneumoniae (16%), Pseudomonas aeruginosa (4%) Enterococcus faecalis (3%), and Enterobacter cloacae (2%). Concerning the first defense antibiotics prescribed for UTI, E. coli was most frequently resistant to Sulfamethoxazole/Trimethoprim (47%) followed by ciprofloxacin (34%). K. pneumoniae was most frequently resistant to Sulfamethoxazole/trimethoprim (35%) followed by cefuroxime (30%), while P. aeruginosa to ciprofloxacin (13%). Conclusion: Because of a high level of antimicrobial resistance amongst uropathogens in Saudi Arabia, the development of regional and national UTI guidelines is recommended.


2021 ◽  
Vol 15 (1) ◽  
pp. 139-144
Author(s):  
Maysaa El Sayed Zaki ◽  
Abd ElRahman Eid ◽  
Samah Sabry El-Kazzaz ◽  
Amr Mohamed El-Sabbagh

Background: There are insufficient data about the presence of E. albertii as a causative organism in urinary tract infection in pediatric patients. Objective: The present study aimed to detect E. albertii by polymerase chain reaction (PCR) for detection of uidA, mdh, and lysP genes among isolated E.coli from children with urinary tract infection. Methods: The present study was a cross-sectional retrograde study which was carried out on 100 isolates of phenotypically confirmed E.coli detected in urine samples of children suffering from urinary tract infection. The isolates were subjected to molecular identification by PCR for uidA, mdh, and lysP genes. Results: E. albertii was identified by PCR in 7% of the isolates and E.coli was identified in 93% of the isolates. Two mdh and lysP genes were detected for E. albertii and the uidA gene for E. coli. E. albertii isolates had marked resistance to gentamicin (71.4%), followed by resistance to ciprofloxacin (57.1%), meropenem and imipenem (42.9% each) and ESBL activity by double discs method was reported in 57.1% of the isolates. However, none of the isolates had shown resistance to nalidixic acid and only one isolate had resistance to norfloxacin. There was a statistically insignificant difference between resistance to the used antibiotics such as aztreonam (P=0.083), ampicillin/clavulanate (P=0.5), ciprofloxacin (P=0.69), gentamicin (P=0.3) and ceftazidime (P=1.00). Conclusion: The present study highlights the emergence of E. albertii as a pathogen associated with urinary tract infections in children. There is marked antibiotic resistance of this pathogen, especially toward extended spectrum beta-lactams antibiotics. The identification method depends mainly on genetic studies. Further longitudinal studies with large number of patients are required to verify the accurate prevalence of this bacterium.


2017 ◽  
Vol 68 (3) ◽  
pp. 566-569 ◽  
Author(s):  
Mihaela Magdalena Mitache ◽  
Carmen Curutiu ◽  
Elena Rusu ◽  
Ramona Bahna ◽  
Mara Ditu ◽  
...  

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.


2021 ◽  
Author(s):  
◽  
Gerald Turyatunga

Background: A urinary tract infection (UTIs) is a common type of infection caused by bacteria that travel up the urethra to the bladder. Globally, it is reported that 150 million people are diagnosed with a UTI annually, costing the world economy over 6 million US dollars in treatment and work loss. Studies conducted in the in-patients pediatric ward of Muhimbili Hospital in Tanzania and Mulago National Referral Hospital in Uganda between five to ten years reported the prevalence of UTI to be 16.8% and 14.6% respectively. On average at Kam Medical Consult Clinic, patients who turn up in the laboratory are about 20%, and 50% of patients present with recurring UTIs clinically. Therefore,  there is a need to establish and investigate the prevalence of bacterial pathogens associated with UTI and multiple pathogens that are not known. Methodology: The cross-sectional study was carried out at Kam medical consult clinic (KMCC) located in Kafeero zone Mulago II Kawempe division. The study population was adults and children presenting with symptoms of urinary tract infection. 120 Midstream urine Samples were collected from patients presenting clinical signs of UTI. The diagnosis was done through macroscopy dry chemistry, microscopy, and culture. Results Among the sampled population, 33% of males had urinary tract infections while 67% of females had urinary tract infections.  88.5% were outpatients while 11.5 % were in-patients The overall prevalence of UTI among patients was 63.3% with children aged (1-10) having a prevalence of 5.8 %. Conclusion and recommendation: E.coli is an etiological agent causing UTIs in male and female patients presenting UTI at Kam Medical Consult Clinic. Other etiological agents included Klebsiella, Coliform, Enterococcus species, staphylococcus aureus, pseudomonas species, and candida species. There is a need to monitor the profile of etiological bacteria of UTI through culture and sensitivity regularly. 


2021 ◽  
Vol 8 (10) ◽  
pp. 522-526
Author(s):  
Bhavani Shankar Rokkam ◽  
Chowdary Babu Menni ◽  
Ramu Pedada ◽  
Deepak Kumar Alikana

BACKGROUND Urinary tract infections (UTI) constitute a common cause of morbidity in infants and children. When associated with abnormalities of urinary tract, they may lead to long-term complications including renal scarring, loss of function and hypertension. Most urinary tract infections remain undiagnosed if investigations are not routinely performed to detect them. Prompt detection and treatment of urinary tract infections and any complicating factors are important. The objective of the study is to know the clinical, epidemiological and bacteriological profile (i.e. clinical signs and symptoms, age, sex, family history, associated urinary tract abnormalities, & causative organisms) of urinary tract infections in febrile children with culture positive urinary tract infection. METHODS This descriptive, cross sectional observational study was conducted at outpatient clinics of our “child health clinics” between May 2016 and April 2017 (one year). All children aged 0 to 12 years with culture positive urinary tract infections were included in this study to evaluate the clinical, epidemiological and bacteriological profile. RESULTS A total of 69 children with culture positive urinary tract infections were included in this study. Out of 69 children included in this study, 36 (52.2 %) were females and 33 (47.8 %) were males. Overall female preponderance was seen and the M: F ratio was 0.9:1. But during first year of life in our study group we had more boys (10, 14.49 %) affected with urinary tract infection than girls. 49.3 % of urinary tract infections in the present study belonged to lower socio-economic status. Most common organism causing urinary tract infection in our group was E. coli (56.5 %). Fever (100 %), anorexia or refusal of feeds (52.2 %), dysuria (46.4 %), vomiting (46.4 %) and abdominal pain (39.1 %) were the predominant clinical manifestations observed in our study. CONCLUSIONS Urinary tract infection is a common medical problem in children and it should be considered as a potential cause of fever in children. As febrile children with urinary tract infection usually present with non-specific signs and symptoms, urine culture should be considered as a part of diagnostic evaluation. KEYWORDS Urinary Tract Infections (UTI), Febrile Children, Bacteriological Profile, Urine Culture


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