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

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.

Author(s):  
Rana M. Abdullah Al-Shwaikh ◽  
Abbas Falih Alornaaouti

       Current study obtained (75) isolate of Pseudomonas aeruginosa collected from different cases included : 28 isolates from otitis media, 23 isolates from burn infections, 10 isolates from wound infections, 8 isolates from urinary tract infections and 6 isolates from blood, during the period between 1/9/2014 to 1/11/2014        The result revealed that the tox A gene was present in 54 isolates (72%) of Pseudomonas aeruginosa. The gel electrophoresis showed that the molecular weight of tox A gene was 352 bp. The result shows 17 isolates (60.71%) from otitis media has tox A gene, 18 isolates (78.26%) from burn followed by 8 isolate (80%) from wound infection and 5 isolates (62.5%) from urinary tract infection , finally 6 isolates (100%) from blood have this gene.


2020 ◽  
Vol 7 (2) ◽  
Author(s):  
Shima Sadat Lesani ◽  
Mohammad Soleimani ◽  
Pegah Shakib ◽  
Mohammad Reza Zolfaghari

Background: Escherichia coli is considered as one of the causes of opportunistic infections. Nowadays, due to the increase in drug resistance, the treatment of these infections has become very difficult and they are recognized as the main causes of death in hospitalized patients. Objectives: The aim of this study was to determine the prevalence of blaTEM, blaSHV, and blaCTX-M genes in E. coli strains isolated from the urinary tract infection in patients in Intensive Care Units of three different hospitals in Qom, Iran. Methods: This study was conducted in three months from October to December 2014. A total of 200 E. coli samples were taken from the patients with urinary tract infections in Intensive Care units of Qom hospital. The disc diffusion method was used to determine the susceptibility pattern of antibiotic and phenotypic confirmatory tests for screening of the expanded spectrum beta-lactamase (ESBL) isolates. The presence of blaTEM, blaSHV, and blaCTX-M genes was evaluated by the polymerase chain reaction (PCR) assay. Results: Of 200 samples, ampicillin (96%) and nitrofurantoin (19.5%) showed the highest and lowest drug resistance, respectively. A total of 156 isolates (78%) were identified as ESBLs using the phenotypic method. Moreover, 76 (38%), 90 (45%), and 123 (61.5%) isolates consisted of blaCTX-M, blaSHV, and blaTEM, respectively. Conclusions: Overall, the findings of this study showed that blaTEM was the most common gene with a frequency of 61.5% in ESBL E. coli.


2013 ◽  
Vol 38 (3) ◽  
pp. 79-83 ◽  
Author(s):  
S Ahmad

Antibiotic resistance of urinary tract pathogens has increased worldwide. The purpose of this study is to provide information regarding the causative agents of urinary tract infection in Kashmiri patients, identify the uropathogens responsible for the infection and study the antibiotic susceptibility patterns of the uropathogens. Clean voided mid-stream urine samples were collected from 2190 patients. The specimens were cultured and the isolates were identified using standard microbiological techniques. The antibiotic susceptibilities of the isolates were also determined. Of 2190 specimens, 591 (27%) showed significant growth upon culture. Approximately 84.1 % (497/591) of the 591 patients with UTI were females, most of which belonged to the 21-30 age group (206). The males accounted for 15.9% (94/591) UTI cases. Most of the male patients belonged to the 21-30 age group (34). The lowest incidence of urinary tract infections was seen among the 13-20 years age group. Throughout this study males accounted for only 16% of all UTI cases. Esherichia coli was the most predominant isolate, 53.8% followed by Klebsiella pneumoniae 22.4% and Pseudomonas aeruginosa 7.6%. All isolates were fully sensitive to ofloxacin, and more than 94% were sensitive to cefuroxime. Apart from group D Streptococcus , the overall response to ampicillin by all isolates was less than 15%. The prevalence of multi-resistant Pseudomonas aeruginosa in community-acquired urinary tract infections is increasing. All Pseudomonas aeruginosa isolates were fully susceptible to cefuroxime and ofloxacin. It is recommended that cefuroxime and ofloxacin or both are used in the blind treatment of urinary tract infection while awaiting the culture and sensitivity results. Concurrent with the necessary shift in the prescription pattern, attention should be paid to restriction of antibiotic abuse in the community to retard development of further drug resistance. DOI: http://dx.doi.org/10.3329/bmrcb.v38i3.14330 Bangladesh Med Res Counc Bull 2012; 38(3): 79-83 (December)


2017 ◽  
Vol 11 (1) ◽  
pp. 292-300 ◽  
Author(s):  
Angus N. Oli ◽  
Vivian B. Akabueze ◽  
Chijioke E. Ezeudu ◽  
George U. Eleje ◽  
Obiora S. Ejiofor ◽  
...  

Background: Urinary Tract Infection (UTI) is a common contagion among men and women with the incidence relatively higher among women due to their differing anatomy. An understanding of the kind of pathogens implicated in urinary tract infections as well as antibiotic susceptibility profiling may help the clinician make rationally correct empirical choice in their treatment. Objective: This study is aimed at determining the type and antibiotic susceptibility pattern of bacterial uropathogens isolated from female patients attending Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Awka, Nigeria. Method: Two hundred and forty patients with clinically diagnosed UTI and who were on at least 5 days’ antibiotic holiday were recruited into the study. Their demographic characteristics were captured using pre-tested questionnaire. Their clean catch mid-stream urine samples were collected using sterile universal container and sent to the Microbiology Department for processing. Within 30 minutes of samples collection, the specimens were cultured and the isolates were identified, after 24 h of incubation, using standard microbiological techniques. Antibiotic susceptibility tests were done with standard antibiotic discs using the Kirby–bauer disc diffusion method. Results: Out of the 240 urine samples, 89.17% yielded significant bacteriuria. The pathogens implicated were Escherichia coli (28.5%), Staphylococcus aureus (28.0%), Salmonella spp (22.8%) and Pseudomonas aeruginosa (20.5%). HIV status, patients age, pregnancy status and marital status all significantly affected bacteriuria rate (p value < 0.05), while patients’ location (sub-urban/rural dwelling), and level of education did not (p value > 0.05). The pattern of microbial resistance to antibiotics suggests that ceftazidime, fosfomycin and cefoxitin may not be used as first-line agents in the empirical treatment of UTIs rather; levofloxacin, meropenem or aztreonam should be considered. Levofloxacin was significantly effective against all the isolates and may be administered empirically while waiting for the culture result (Mean % susceptibility was 79.85). Conclusion: E. coli and S. aureus were the predominant pathogens in the study and many were resistant to the commonly prescribed antibiotics and so leave the clinicians with only few alternative drugs for UTIs treatment. Routine surveillance and monitoring studies need to be constantly conducted to update clinicians on the prevalent pathogens and the rational and empirical treatment of UTIs. Aggressive and consistent health education using every possible media is also recommended to combat the menace of drug resistance occasioned by inappropriate antibiotic use.


2009 ◽  
Vol 9 (1) ◽  
pp. 2-9 ◽  
Author(s):  
Amela Dedeić-Ljubović ◽  
Mirsada Hukić

Urinary tract infection is commoner in patients with spinal cord injuries because of incomplete bladder emptying and the use of catheters that can result in the introduction of bacteria into the bladder. 145 patients suffering from spinal cord injuries, admitted to the Institute for physical medicine and rehabilitation, Centre for paraplegia of the Clinical Centre of the University of Sarajevo, were included. The patients were divided in three groups according to the method of bladder drainage: Group A (n=61) consisted of patients on clean intermittent catheterization; Group B (n=54) consisted of patients with indwelling catheters; Group C (n=30) consisted of patients who had performed self-catheterization. From a total of 4539 urine samples, 3963 (87,3%) were positive and 576 (12,7%) were sterile. More than 90% of the infected patients were asymptomatic.The overall rate of urinary infection amounted to about 2,1 episodes, and bacteriuria to 8,1 episodes per patient. 77% of infections (113/145) were acquired within seven days from catheterization.Infection was usually polymicrobial; the greatest number of urine samples 1770/3943 (44,9%) included more than one bacterium.The vast majority of cases of urinary tract infection and bacteriuria are caused by Gram-negative bacilli and enterococci, commensal organisms of the bowel and perineum, representative of those from the hospital environment. Providencia stuarti (18,9%) being the most common, followed by Proteus mirabilis (16,3%), Escherichia coli (11,8%), Pseudomonas aeruginosa (10,2%), Klebsiella pneumoniae (8,1%), Morganella morgani (5,4%), Acinetobacter baumannii (4,6%), Providencia rettgeri (3,5%). 15,7% of isolates were Gram-positive with Enterococcus faecalis (8,6%) as the most common. 55,3% of isolates were multidrug-resistant, and the highest rates of resistance were found among Acinetobacter baumannii (87,8%), Providencia rettgeri (86,7%), Pseudomonas aeruginosa (85,4%), Providencia stuarti (84,3%) and Morganella morgani (81,0%). Lower rates of resistance were found in Group C, i.e. patients on intermittent self- catheterisation. Eradication of organisms was achieved in only 53 (10,05%) of patients; hence, antibiotic therapy had no or very low effect.Significant correlations were found between the method of catheterization and the frequency of bacteriuria and urinary tract infections. The analysis of Group C showed a rate of lower urinary tract infection and bacteriuria than the other two Groups of patients. The objective of this study is the update of etiology and antimicrobial susceptibility in urinary tract infections in this group of patients. In addition, possible correlations between UTI and the type of bladder management were examined.


Author(s):  
Khonaw Kader Salh

Background: The bacteria, Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae), are the main reasons for urinary tract infections (UTIs). This research aimed to investigate the isolation of etiologic agents from patients with UTI; it also investigates the antibiotic resistance activities and incidence of ESBL genes between different clinical separates of uropathogenic E. coli, determining their association with ESBL genes. Methods: The study enrolled 1000 positive growth isolates. The predominant pathogen associated with urinary tract infection, Gram-negative, were the main isolates from UTI patients, including E. coli, K. pneumoniae, Pseudomonas aeruginosa, Proteus mirabilis, Staphylococcus aureus and Enterococcus faecalis. Results: Among suspicious cases of urinary tract infection, we showed that 15.2% of the patients had UTI, and female patients in the childbearing age group were more affected. 644 E. coli (64.4%) and 322 (32.2%) K. pneumoniae were more isolated. Among 936 (93.6%) ESBL producing bacteria, 614 (61.4 %) E. coli showedhigh resistance to the antibiotics, Cefotaxime (85.7 %), Cefepime (85.7 %), Ciprofloxacin (83.1 %) and Kanamycin (77.9 %). Most ESBL-producing K. pneumoniae were multidrug-resistant (MDR). Nitrofurantoin, gentamycin, and imipenem were the most effective antibiotics for ESBL-producing E. coli isolates. Conclusion: This study shows that the high rates of MDR Escherichia coli infection in our hospital were frequentative reasons for UTI. Nitrofurantoin and aminoglycosides were the most beneficial first-line drugs to be applied in the cases of UTI. It is recommended to conduct regular investigations on the drug resistance of all isolates and formulate helpful antibiotic treatment policies in China. It is important to determine the prevalence of ESBL in urine E. coli and K. pneumoniae isolates because it has a great influence on the selection of suitable antibacterial agents. In short, more than half of ESBL producers have multiple drug resistance (MDR).


2020 ◽  
Vol 5 (1) ◽  
pp. 881-885
Author(s):  
Ruchee Manandhar ◽  
Bijendra Raj Raghubanshi ◽  
Moni Mahato ◽  
Sweekrity Neupane ◽  
Rajni Lama

Introduction: Urinary tract infection (UTI) is a microbial infection of the urinary system involving the urinary tract anywhere from kidney to urethra. It is one of the most common bacterial infections affecting men and women in developing countries with a high rate of morbidity and financial cost. Objectives: The objective of our study is to study the prevalence of UTI in patients attending KIST Medical College & Teaching Hospital (KISTMCTH), and determine the antimicrobial susceptibility pattern of bacteria thus isolated. Methodology: A total of 3742 urine samples from patients suspected of urinary tract infections presenting with the history and symptoms suggestive of urinary tract infection, attending various departments of KISTMCTH from April 2017 to April 2018 were studied. Isolates were identified by standard microbiological methods and tested for in vitro antibiotic susceptibility by modified Kirby-Bauer disc diffusion method. Results: Pathogenic bacteria were isolated from 646 out of 3742 urine samples (17.26%). Escherichia coli was the most common bacteria isolated (67.02%) followed by Klebsiella pneumoniae (14.5%). Other bacteria isolated were Enterococcus spp, Pseudomonas aeurigenosa, Klebsiella oxytoca, Proteus mirabilis, Satphylococcus aureus, Coagulase negative staphylococcus spp, Proteus vulgaris, Acinetobacter spp, Citrobacter freundii, Citrobacter diversus and Enterobacter spp. The isolated pathogenic bacterias were most resistant to Ampicillin (46.43%) and least resistant to Imipenem (6.03%). However, the first line antibiotic the bacterias were least resistant to was cefotaxime (7.12%). Conclusions: Marked resistance has been observed with commonly prescribed antibiotics like Ciprofloxacin and Norfloxacin. Therefore, studies should be conducted routinely to identify the common bacteria causing UTI and formulate appropriate antibiotic policy.


2018 ◽  
pp. 100-108
Author(s):  
Dinh Khanh Le ◽  
Dinh Dam Le ◽  
Khoa Hung Nguyen ◽  
Xuan My Nguyen ◽  
Minh Nhat Vo ◽  
...  

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


2017 ◽  
Vol 38 (8) ◽  
pp. 998-1001 ◽  
Author(s):  
Taniece Eure ◽  
Lisa L. LaPlace ◽  
Richard Melchreit ◽  
Meghan Maloney ◽  
Ruth Lynfield ◽  
...  

We assessed the appropriateness of initiating antibiotics in 49 nursing home (NH) residents receiving antibiotics for urinary tract infection (UTI) using 3 published algorithms. Overall, 16 residents (32%) received prophylaxis, and among the 33 receiving treatment, the percentage of appropriate use ranged from 15% to 45%. Opportunities exist for improving UTI antibiotic prescribing in NH.Infect Control Hosp Epidemiol 2017;38:998–1001


PEDIATRICS ◽  
1972 ◽  
Vol 50 (6) ◽  
pp. 975-975
Author(s):  
James Kennedy Todd

The recent paper by Cohen in the August issue of Pediatisics relies on the use of "one or more cultures of over 100,000 organisms per millimeter of urine" to make the diagnosis of urinary tract infections upon which the remainder of the study is dependent. Obviously, the colony count was intended to read "per milliliter," and yet the results of the study must be seriously questioned since the criterion for diagnosis of urinary tract infection was not rigid enough to exclude a large number of false-positives— patients who never really had urinary tract infections.


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