Low occurrence of extended spectrum beta-lactamases in urinary tract infections is reassuring given limited treatment options

2016 ◽  
Vol 106 (1) ◽  
pp. 148-148
Author(s):  
Matti Uhari
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Treatment Options ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases ◽  
Tract Infections

scholarly journals Cedecea lapagei An Extremely Rare Uropathogen: A Case Report and Review of the Literature

2021 ◽  
Author(s):  
Abdikarim Hussein Mohamed ◽  
Hussein Ali Mohamud
Keyword(s):  
Renal Failure ◽  
Case Report ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Beta Lactam ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases ◽  
Tract Infections

Abstract Background: Gram-negative enterobacteria are the most common cause of urinary tract infections. Cedecea is a new separate genus in the family enterobacteriaceae, and it is a very rare pathogen that was primarily found in the respiratory tract. Cedecea lapagei is a very rare pathogen of urinary tract infections. To the best of our knowledge, this is the first case report in the world reported in English literature. Case presentation: A 55 years old man with chronic renal failure, poorly controlled diabetes mellitus, and hypertension presented with acute exacerbations of renal failure and irritative voiding symptoms. After stabilization and empirical antibiotic therapy with Ceftriaxone, the patient’s condition was not improved and deteriorated progressively. After the request of urine culture, the culture was isolated, an extremely rare uropathogen recently recognized by the Centers for Disease Control and Prevention (CDC); the Cedecea lapagei. Cedecea lapagei identification had been done using Eosin methylene blue agar (EMB). Gram-negative lipase positive bacteria with bacillus in shape, motile in nature that is non-spore-forming, and non-encapsulated enterobacteria with the final result of >100,000 colony-forming units per ml of Cedecea lapagei were isolated. Mueller-Hinton agar had been used to perform antimicrobial sensitivity and resistance. The pathogen was extensively resistant to the extended-spectrum beta-lactamases antibiotics and extended-spectrum beta-lactam inhibitors while carbapenems, fluoroquinolones, aminoglycosides, and Trimethoprim-sulfamethoxazole showed a higher sensitivity rate. Conclusion: The treatment of Cedecea lapagei infections represents a challenging issue due to its multi-drug resistant and extensive drug resistance patterns to a variety of antimicrobial classes, such as extended-spectrum beta-lactamases, cephalosporins, and beta-lactam inhibitors. Antimicrobial treatment should be aligned with the culture findings once available.

scholarly journals Quinolone resistance in different uropathogens isolated from urine cultures in patients with urinary tract infection

2020 ◽  
Author(s):  
Jorge Angel Almeida Villegas ◽  
Iris Mellolzy Estrada Carrillo ◽  
Rodolfo Garcia Contreras ◽  
Silvia Patricia Peña
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Gram Positive ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases ◽  
Tract Infections

AbstractObjectiveTo identify patterns of resistance against quinolones in various uropathogens in urinary tract infections in the population of the Toluca valley, MexicoIntroductionQuinolones are antibiotics with a spectrum of activity for both gram-positives and gram-negatives and are antibiotics used for the empirical treatment of urinary tract infections. Recently, a high index of resistance to quinolones has been reported due to different mechanisms on the part of bacteria, however the one that has taken the greatest importance is the presence of extended spectrum beta-lactamasesMethods155 samples were collected from patients with suspected urinary tract infection without exclusion criteria such as age or gender. Automated equipment was used for the identification of the etiological agent and sensitivity tests to quinolones.ResultsThe results positives were divided to evaluate which of the two antibiotics studied had greater resistance. For ciprofloxacin there are 27 resistant strains 37%, 1 strain with intermediate resistance 1% and 45 susceptible strains 62%. For levofloxacin 26 strains are resistant 36%, 41 strains are sensitive 56% and 6 strains show intermediate sensitivity 8%.ConclusionDifferent microorganisms, both gram-positive and gram-negative, were isolated and it can be observed that gram-negative strains are the ones with the greatest resistance against quinolones, mainly Escherichia coli, which produces extended-spectrum beta-lactamases, in the case of gram-positive resistance patterns are variable with a tendency towards sensitivity.

scholarly journals Treatment duration of complicated urinary tract infections by extended-spectrum beta-lactamases producing enterobacterales

PLoS ONE ◽  
2020 ◽  
Vol 15 (10) ◽  
pp. e0237365
Author(s):  
Judith Álvarez Otero ◽  
Jose Luis Lamas Ferreiro ◽  
Ana Sanjurjo Rivo ◽  
Fernando Maroto Piñeiro ◽  
Lucía González González ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Treatment Duration ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases ◽  
Tract Infections

scholarly journals Clinical and Molecular Characterization of Community-Onset Urinary Tract Infections Due to Extended-Spectrum Cephalosporin-Resistant Enterobacteriaceae

2016 ◽  
Vol 37 (12) ◽  
pp. 1433-1439 ◽  
Author(s):  
Judith A. Anesi ◽  
Ebbing Lautenbach ◽  
Irving Nachamkin ◽  
Charles Garrigan ◽  
Warren B. Bilker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Older Age ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases ◽  
Tract Infections ◽  
Community Onset

OBJECTIVETo evaluate risk factors for and molecular characteristics of community-onset extended-spectrum cephalosporin-resistant (ESC-R) Enterobacteriaceae (EB) urinary tract infections (UTIs) in a US health system.DESIGNCase-control study.PARTICIPANTSAll patients presenting to the emergency department or outpatient practices with EB UTIs from December 21, 2010, through April 22, 2013, were included. Case patients had ESC-R EB UTIs. Control patients had ESC-susceptible EB UTIs and were matched 1:1 on study year.METHODSRisk factors for ESC-R EB UTI were assessed using multivariable conditional logistic regression. A subset of case isolates was evaluated for extended-spectrum beta-lactamases.RESULTSA total of 302 patients with community-onset EB UTI were included, of which 151 were cases. On multivariable analysis, risk factors for ESC-R EB UTI included trimethoprim-sulfamethoxazole use in the prior 6 months (odds ratio, 2.40 [95% CI, 1.22–4.70];P=.01), older age (1.03 [1.01–1.04];P<.001), diabetes (2.91 [1.32–6.41];P=.008), and presentation to the emergency department ( 2.42 [1.31–4.46];P=.005). The prevalence of extended-spectrum beta-lactamases among 120 case isolates was 52% CTX-M, 29% TEM, 20% OXA, and 13% SHV. The prevalence of AmpC was 25%. Pulsed-field gel electrophoresis of the CTX-MEscherichia coliisolates showed no distinct clusters.CONCLUSIONSUse of trimethoprim-sulfamethoxazole, older age, diabetes, and presentation to the emergency department were associated with community-onset ESC-R EB UTI. There was a high prevalence of CTX-M among our community isolates. Further studies are needed to determine strategies to limit emergence of these organisms in the community.Infect Control Hosp Epidemiol2016;1433–1439

scholarly journals Urinary Tract Infections are becoming Multi-drug Resistant due to Extended Spectrum Beta-lactamases-producing Klebsiella pneumonia

2021 ◽  
Vol 6 (1) ◽  
pp. 35-44
Author(s):  
Henry Hackman ◽  
Lawrence Annison ◽  
Reuben Arhin ◽  
Bright Azumah ◽  
David Boateng ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Klebsiella Pneumoniae ◽  
Urinary Tract Infections ◽  
Klebsiella Pneumonia ◽  
Drug Resistant ◽  
Beta Lactams ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases ◽  
Tract Infections

Introduction: Klebsiella pneumoniae are among the most common cause of urinary tract infections such as cystitis and pyelonephritis. These multi-drug resistant K. pneumoniae are producers of extended spectrum beta-lactamases (ESBL) that are capable of hydrolyzing beta-lactams and non-beta-lactams. This laboratory-based study sought to establish the increase of ESBL-producing K. pneumoniae in multi-drug resistant urinary tract infections and determine the effective antibiotic treatment options. Methods: One hundred and seventy five K. pneumoniae isolates obtained from urine cultures were randomly collected and the combined disc synergy method was used to determine the ESBL-producing K. pneumoniae. The Vitek 2 system (bioMérieux, France) was used to perform antimicrobial susceptibility testing of 17 commonly used antibiotics.  The data from the work was collated and statistically analysed using the chi-square test and Mann-Whitney U test. P values < 0.05 were considered significant. Results: Of the 175 K. pneumoniae responsible for urinary tract infections, 73.7% were producing ESBL suggesting that most urinary tract infections caused by K. pneumoniae will be multi-drug resistant. The antimicrobial resistance differences between ESBL-producing and non-ESBL-producing Klebsiella pneumoniae indicated a significance difference with p < 0.05. This study indicated that imipenem and amikacin are the antibiotic of choice for the treatment of multi-drug resistant urinary tract infections caused by ESBL-producing K. pneumoniae. Cephalosporins and nitrofurantoin are suitable for the treatment of urinary tract infections due to non-ESBL-producing K. pneumoniae. Conclusion: This study indicated that imipenem (carbapenem) and amikacin are the antibiotic of choice for the treatment of multi-drug resistant urinary tract infections caused by ESBL-producing K. pneumoniae. The third and fourth generation cephalosporins and nitrofurantoin are suitable for the treatment of urinary tract infections due to non-ESBL-producing K. pneumoniae. Rational use of antibiotics and evidence based antibiotic prescription will help to control the spread of resistance by ESBL-producing K. pneumoniae. There is the need to intensify research in the use of natural products to treat multi-drug resistant urinary tract infections emanating from ESBL-producing K. pneumoniae

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