scholarly journals Antibiotic resistance pattern of Escherichia coli isolates from outpatients with urinary tract infections in Somalia

2020 ◽  
Vol 14 (03) ◽  
pp. 284-289 ◽  
Author(s):  
Malyun Adam Mohamed ◽  
Omar Abdifetah ◽  
Fatima Abdullahi Hussein ◽  
Sa’adia Abdullahi Karie

Introduction: Several studies suggest increasing rates of antibiotic resistance among adult populations with Urinary tract infections (UTI). Escherichia coli (E. coli), is the predominant bacterium both in the community and in hospital environments causing uropathogenic infections. This study aimed to estimate the common uropathogen bacteria that cause UTI among outpatients as well as to determine the antibiotic resistance pattern of E. coli isolates among outpatients with UTI infections at Shaafi hospital, Mogadishu, Somalia. Methodology: A cross-sectional study was conducted at Shaafi Hospital, Mogadishu, Somalia. A total of 128 samples were collected from outpatients suspected of UTI and tested through bacteriological investigations and antimicrobial susceptibility tests following the Kirby-Bauer agar disc diffusion method. Results: E. coli was isolated in 34 (41%) out of the total 83 samples that showed growth followed by Staphylococcus aureus 22 (26.5%), Pseudomonas aeruginosa, 13 (15.7%), Klebsiella pneumoniae 8 (9.6 %) and Proteus spp. 6 (7.2%). E. coli was highly sensitive to nitrofurantoin, 29 (85.3%), and ciprofloxacin (n = 23, 67.6%), and had the highest resistance rate of ceftriaxone, 33 (97.1%). The odds of having UTI were higher in patients with a history of UTI (Odds ratio OR = 0.211, 95% confidence interval CI: 0.080, 0.553) and history of antibiotic use (OR = 0.322, 95% CI: 0.113, 0.917). Increased resistance rate of E. coli against cephalosporins could be due to its excessive use as empirical therapy. Conclusion: The study indicates that outpatients with UTI could be at high risk of antibiotic resistance, suggesting regular surveillance and monitoring of antibiotics.

Author(s):  
Mohamed Kettani Halabi ◽  
Fatima Azzahra Lahlou ◽  
Idrissa Diawara ◽  
Younes El Adouzi ◽  
Rabiaa Marnaoui ◽  
...  

Extended-spectrum β-lactamases producing Escherichia coli (ESBL-EC) lend resistance to most β-lactam antibiotics. Because of limited treatment options, ESBL-EC infections are generally more difficult to treat, leading to higher hospital costs, reduced rates of microbiological and clinical responses, and a threat to the patient’s life. This study aimed to determine the antibiotic resistance pattern of ESBL-EC isolated from patients with urinary tract infection in Morocco. This retrospective laboratory-based study was conducted at Cheikh Khalifa International University Hospital, Casablanca, from January 2016 to June 2019. A total of 670 urine samples were collected from urinary tract infection patients and processed by standard microbiological methods. In vitro susceptibility testing to different antibiotics of all identified isolates of Escherichia coli (E. coli) was performed following Kirby–Bauer’s disc diffusion method on Mueller–Hinton Agar according to the EUCAST standards. The reviewing of ESBL-EC was confirmed by the appearance of a characteristically shaped zone referred to as a “champagne cork” using the Combined Disk Test. Among a total of 438 E. coli isolated from nonrepetitive urine samples, two hundred fifty-nine (59%) were ESBL-EC, of which 200 (77%) were isolated from adult patients (over the age of 50) and the majority were female. All ESBL-EC isolates were resistant to third-generation cephalosporin and quinolones and sensitive to carbapenem and fosfomycin. Knowledge of antimicrobial resistance patterns in ESBL-EC, the major pathogen associated with urinary tract infection, is indispensable as a guide in choosing empirical antimicrobial treatment.


2018 ◽  
Vol 5 (1) ◽  
pp. 13-18
Author(s):  
Selma Kirac ◽  
Dilek Keskin ◽  
F. Banu Karahasanoğlu

Objective: The research was carried out with isolate and determines the antimicrobial sensitivity in E. coli from urinary tract infections in special hospital in Denizli and recorded at specimens. Methods: Urine samples (n=21) were collected from patients with signs and symptoms of Urinary tract infections. Bacteria were isolated and identified by conventional biochemical profile. Antibiotic resistance pattern of E. coli against different antibiotic was determined by Kirby-Baur method. Results: The results revealed that sensitivity rate of antimicrobial agents were in the range of meropenem (100%), norfloxacin and ciprofloxacin (86%), cefotaxime (80%), aztreonam (76%). None of the samples showed no resistance to amikacin, ceftazidime, aztreonam, amoxicillin/clavulanic acid, and meropenem. Out of 21 isolates, 3(14%) isolates showed Multiple Antibiotic Resistance ten to thirteen antibiotics. Conclusion: It is concluded that most of the urinary tract infections in human are caused by E.coli exhibited highest resistance to meropenem (100%), followed by norfloxacin and ciprofloxacin  (86%).


Doctor Ru ◽  
2021 ◽  
Vol 20 (10) ◽  
pp. 48-53
Author(s):  
N.A. Belykh ◽  
◽  
S.V. Tereschenko ◽  
N.A. Anikeeva ◽  
S.S. Kantutis ◽  
...  

Study Objective: To study a spectrum of uropathogens and their sensitivity to antimicrobials in urinary tract infections (UTIs) in children in Ryazan and Ryazan Region. Study Design: retrospective study. Materials and Methods. We conducted a retrospective local laboratory monitoring of urinary microflora and analysed its sensitivity to antimicrobials in 111 patients aged 2 months to 17 years old who were undergoing traditional UI therapy in 2020. The study group comprised 75 (67.6%) girls and 36 (32.4%) boys. Pathogen isolation and type identification were performed using urine specimens collected in sterile disposable plastic containers prior to antimicrobial therapy. Material was delivered for analysis within 2 hours from collection. For testing of pathogen sensitivity to antimicrobials, we used the phenotyping diffusion test and an analytical test for carbapenems inactivation. Study Results. Prevailing causative agents of UIs were Escherichia coli (50.4%) and Klebsiella pneumoniae (14.4%). Resistance determinants were found in 9.0% and 2.7% of Е. соli and K. pneumoniae urological strains, respectively. The main mechanism of resistivity was production of wide spectrum plasmid β-lactamases. The highest activity in E. coli was demonstrated by generation III–IV cephalosporins, aminoglycosides, fosfomicin (100%), nitrofurantoin (91.3%), and aminopenicillins (76.1–86.9%). For K. pneumoniae, generation III–IV cephalosporins and aminoglycosides were most potent (100%). All resistant pathogens were sensitive to cefoperazone sulbactam, meropenem, imipenem, aminoglycosides (100%); tigecycline, nitrofurantoin, and fosfomicin were most potent against E. coli. Conclusion. Children with UIs in Ryazan Region had mostly gram-negative bacteria in their urine (85.6%), Enterobacteralеs (81.1%) being a prevailing type. Antimicrobials resistance determinants were quite rare (17.8%) in these urine isolates; all of them were class A ЕSBL producers. These characteristic features of antibiotic resistance of uropathogenic enterobacteria strains allow using β-lactam antibiotics in empiric initial treatment and emphasising the need in patient-specific selection of antimicrobials. Keywords: antibacterial therapy, antibiotic resistance, children, urinary tract infections, Escherichia coli, Klebsiella pneumoniae.


2019 ◽  
Author(s):  
Koen B Pouwels ◽  
Berit Muller-Pebody ◽  
Timo Smieszek ◽  
Susan Hopkins ◽  
Julie V Robotham

AbstractThe majority of studies that link antibiotic usage and resistance focus on simple associations between the resistance against a specific antibiotic and the use of that specific antibiotic. However, the relationship between antibiotic use and resistance is more complex. Here we evaluate which antibiotics, including those mainly prescribed for respiratory tract infections, are associated with increased resistance among Escherichia coli isolated from urinary samples.Monthly primary care prescribing data were obtained from National Health Service (NHS) Digital. Positive E. coli records from urine samples in English primary care (n=888,207) between April 2014 and January 2016 were obtained from the Second Generation Surveillance System. Elastic net regularization was used to evaluate associations between prescribing of different antibiotic groups and resistance against amoxicillin, cephalexin, ciprofloxacin, co-amoxiclav and nitrofurantoin at the clinical commissioning group (CCG) level. England is divided into 209 CCGs, with each NHS practice prolonging to one CCG.Amoxicillin prescribing (measured in DDD/ 1000 inhabitants / day) was positively associated with amoxicillin (RR 1.03, 95% CI 1.01 – 1.04) and ciprofloxacin (RR 1.09, 95% CI 1.04 – 1.17) resistance. In contrast, nitrofurantoin prescribing was associated with lower levels of resistance to amoxicillin (RR 0.92, 95% CI 0.84 – 0.97). CCGs with higher levels of trimethoprim prescribing also had higher levels of ciprofloxacin resistance (RR 1.34, 95% CI 1.10 – 1.59).Amoxicillin, which is mainly (and often unnecessarily) prescribed for respiratory tract infections is associated with increased resistance against various antibiotics among E. coli causing urinary tract infections. Our findings suggest that when predicting the potential impact of interventions on antibiotic resistances it is important to account for use of other antibiotics, including those typically used for other indications.Author summaryAntibiotic resistance is increasingly recognised as a threat to modern healthcare. Effective antibiotics are crucial for treatment of serious bacterial infections and are necessary to avoid that complicated surgical procedures and chemotherapy becoming life-threatening. Antibiotic use is one of the main drivers of antibiotic resistance. The majority of antibiotic prescriptions are prescribed in primary care, however, a large proportion of these antibiotic prescriptions are unnecessary. Understanding which antibiotics are causing antibiotic resistance to what extent is needed to prevent under- or over-investment in interventions lowering use of specific antibiotics, such as rapid diagnostic tests for respiratory tract infection.We have statistically evaluated which antibiotics are associated with higher and lower levels of antibiotic resistance against common antibiotics among Escherichia coli bacteria sampled from the urinary tract by comparing antibiotic prescribing and resistance in different geographical areas in England. Our model shows that amoxicillin, the most commonly used antibiotic in England and mainly used for respiratory tract infections, is associated with increased resistance against several other antibiotics among bacteria causing urinary tract infections. The methods used in this study, that overcome several of the limitations of previous studies, can be used to explore the complex relationships between antibiotic use and antibiotic resistance in other settings.


2018 ◽  
Vol 6 (2) ◽  
pp. 13-20 ◽  
Author(s):  
K. L. Lokshin ◽  
V. N. Shirshov ◽  
A. S. Popko ◽  
Yu. L. Demidko ◽  
N. D. Luchenkova

Introduction.The main treatment component of asymptomatic bacteriuria, acute cystitis and pyelonephritis in pregnant women is antibiotic therapy, which in many patients is prescribed empirically. For successful selection of the drug, it is necessary to know both the structure of pathogens and the current profile of their antibiotic resistance.Purpose of research.The study of species composition and resistance to antibiotics of bacteria that cause urinary tract infections (UTIs) in pregnant women in the Moscow RegionMaterials and methods.The study included 104 pregnant women with uncomplicated UTIs who were observed and treated at the Lapino Clinical Hospital between 2016 and 2017. The material for bacteriological studies was the midstream portion of urine or urine collected by a catheter.Results.90 patients had asymptomatic bacteriuria, 10 had acute cystitis, and 4 had acute gestational pyelonephritis. The structure of the pathogens of UTI is presented: E. coli, Enterococcus faecalis, Klebsiella pneumoniae, Proteus spp., Staphylococcus spp., Streptococcus spp., Enterobacter cloacae. The most frequently detected pathogens were E. coli (67.3%) and E. faecalis (50%). Resistance rate of E.coli strains more than 20% was detected to ampicillin (36.4%), amoxicillin / clavulanate (23.2%), trimethoprim / sulfamethoxazole (27.4%), nalidixic acid (20.7%), cephalosporins 2 and 3 generation (respectively, 25.7% and 24.3%). Resistance rate more than 20% in Enterobacteriaceae family strains was detected to trimethoprim/sulfamethoxazole (24.4%), nalidixic acid (20.7%), cephalosporins 2 generations (21.7%). Antibiotic resistance of E.coli and other Enterobacteriaceae family taxons less than 10% was noted only with respect to carbapenems (0%) and fosfomycin (1.5% and 3.5%, respectively).Conclusions.It is expedient to use the obtained data on the composition and sensitivity profile of uropathogens in UTIs in pregnant women when choosing starting empirical antibiotic therapy. Disclosure: The study did not have sponsorship. The authors have declared no conflicts of interest.


Author(s):  
Sunil Shivaputrayya Gidamudi ◽  
Gaurav V Salunke

ABSTRACTObjective: The objective of this study was to find out the etiology of urinary tract infections (UTIs) in patients attending B.K.L. Walawalkar Hospital,Dervan and to determine their antibiotic sensitivity pattern to currently used antimicrobial agents.Methods: A cross-sectional study was conducted in a rural hospital of Konkan Maharashtra, and urine samples were collected from368 clinically - suspected cases of UTIs using the mid-stream “clean catch” method and was tested and cultured using standard procedures. Antimicrobialsusceptibility test (AST) was performed for the isolated pathogens according to the Clinical and Laboratory Standards Institute guidelines.Results: Escherichia coli (54.84%) was the most prevalent uropathogen. 76.47% of the isolated E. coli were found to be extended spectrum betalactamase producers. A higher prevalence rate of resistance was seen among E. coli to the commonly prescribed antibiotic agents. 32 (94.11%) of34 E. coli isolates recovered had multiple antibiotic resistance (MAR), with 16 isolates (50%) possessing MAR indices of 0.6.Conclusion: The study indicates the isolated microorganisms in UTI showed very high resistance to the commonly prescribed antimicrobial drugs.This suggests the monitoring and rational use of the antimicrobial agents.Keywords: Mid-stream, Culture, Uropathogen, Resistance, Multiple antibiotic resistance.


Author(s):  
Somayeh Bakhtiari ◽  
Hassan Mahmoudi ◽  
Sara Khosravi Seftjani ◽  
Mohammad Ali Amirzargar ◽  
Sima Ghiasvand ◽  
...  

Background and Objectives: Escherichia coli is the most common causative agent of urinary tract infections (UTIs) in 90-80% of patients in all age groups. Phylogenetic groups of these bacteria are variable and the most known groups are A, B1, B2 and D. The present study aimed to evaluate the phylogenetic groups of E. coli samples obtained from UTIs and their relation with antibiotic resistance patterns of isolates. Materials and Methods: In this study 113 E. coli isolates were isolated from distinct patients with UTIs referred to Hamadan hospitals. After biochemical and molecular identification of the isolates, typing and phylogenetic grouping of E. coli strains were performed using multiplex PCR targeting chu, yjaA and TSPE4.C2 genes. The anti-microbial susceptibility of the isolates to amikacin, ampicillin, trimethoprim-sulfamethoxazole, amoxicillin/clavulanic acid, ciprofloxacin, cefotaxime, imipenem, aztreonam, gentamicin, meropenem, nitrofurantoin, nalidixic acid and cefazolin was determined using disk diffusion method. Results: Of 113 isolates, 50 (44.2%), 35 (31%), 23 (20.4%) and 5 (4.4%) of samples belonged to group B2, group D, group A and group B1 phylogenetic groups respectively. All isolates were susceptible to meropenem, imipenem (100%), followed by amikacin (99.1%). The highest resistance rates were observed against ampicillin (74.3%) and nalidixic acid (70.8%). Correlation between phylogenetic groups and antibiotic susceptibilities was significant only with co-amoxiclav (P = 0.006), which had the highest resistance in phylogenetic group A. Conclusion: Prevalence of different phylogroup and resistance associated with them in E. coli samples could be variable in each region. Therefore, investigating of these items in E. coli infections, could be more helpful in selecting the appropriate antibiotic treatment and epidemiological studies.


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