Incidence, Causative Organisms and Pattern of Drug Resistance of Nosocomial Urinary Tract Infection in Patients with Liver Cirrhosis

2021 ◽  
Vol 30 (1) ◽  
pp. 125-132
Author(s):  
Mohamed A.A. Ghaliony ◽  
Ehab F. Mostafa ◽  
Omnia El-Badawy ◽  
Hebatallah M. Hassan ◽  
Sahar M Hassany
Keyword(s):  
Drug Resistance ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Significant Risk ◽  
Urinary Catheterization ◽  
Gram Negative ◽  
Nosocomial Urinary Tract Infection ◽  
Cirrhotic Patients ◽  
Time Of Admission

Background: The nosocomial urinary tract infections (UTIs) creates a major health problem in hospitals all over the world. Objectives: We aimed in this study to determine the incidence of nosocomial UTIs in our cirrhotic patients, identification of the most common pathogens responsible for nosocomial UTIs and identification of the pattern of drug resistance. Methodology: 366 cirrhotic patients were studied within one year. Patients with apparent clinical manifestations of any UTI at time of admission were excluded. All patients were subjected to clinical evaluation, abdominal ultrasound examination, and laboratory investigations including complete blood picture, renal function tests, liver function tests and urine analysis at time of admission. Urine samples were collected from the infected patients for both bacterial and fungal cultures and drug sensitivity testing. Results: The frequency of nosocomial UTIs in cirrhotic patients was 7.1%. The most significant risk factor was urinary catheterization (OR=189.0). Gram negative bacilli were the first cause (46%) of nosocomial urinary tract infection followed by fungi (36%). The sensitivity revealed that the most sensitive antibiotic for both Gram positive and Gram negative cocci was Gatifloxacin. The most sensitive antifungal for candida albicans was Nystatin. Conclusion: The frequency of nosocomial UTIs in cirrhotic patients was not low. Malnutrition and urinary catheterization were the most significant risk factors. Urinary fungal infection was not rare and must be in mind. Both bacterial and fungal cultures and their sensitivity to antibacterial and antifungal drugs were very important to improve the survival rate of patients.

scholarly journals Etiology of urinary tract infection and drug resistance cases of uropathogenes

2013 ◽  
Vol 1 (2) ◽  
pp. 114-120 ◽  
Author(s):  
CP Bhatt ◽  
B Shrestha ◽  
S Khadka ◽  
S Swar ◽  
B Shah ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Drug Resistance ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Enterococcus Faecalis ◽  
Gram Positive ◽  
Gram Negative ◽  
Effective Drugs ◽  
Culture Positive

Background: Multidrug resistant bacterial isolates have been frequently reported from different parts of the world as emerging treatment problem. Objectives: The study was conducted to find out etiology of urinary tract infection and drug resistance trend among clinical pathogens in urinary tract. Methods: Mid-stream urine samples from patients suspected of urinary tract infection were collected for routine culture and antibiotic susceptibility testing and were processed according to the standard laboratory methods. Results: In this study 41.7% urine samples showed significant bacterial growth. Gram negative bacteria were the predominant organisms. Among them Escherichia coli was the predominant isolate (85.1%) whereas Enterococcus faecalis (40.6%), was the major Gram positive isolate. Among culture positive cases organisms were isolated in highest frequency (29.5%) in the age group 21 to 30 years. Urinary tract infections were found more common in females (61.1%) than in males (38.9%). Nitrofurantoin (82.2%) and Ofloxacin (57.8%) were found to be the most effective drugs against Gram negative organisms, whereas for Gram positive organisms, Nitrofurantoin (87.5%) and Gentamycin (78.1%) were found to be the most effective drugs. Escherichia coli was found sensitive to Nitrofurantoin (89.3%) followed by Ofl oxacin (63.3%). Enterococcus faecalis was most susceptible to Nitrofurantion (92.3%) followed by Cotrimoxazole (76.9%). Conclusion: In this study, among the participants 41.7% had culture positive urinary tract infection. Drug resistance was found to be high in both Gram negative and Gram positive organisms. The high prevalence of drug resistance among urinary tract infection patients calls for the need of judicious measures for control of this infection and knowledge of patterns of resistance helps in deciding empirical therapy for urinary tract infection. DOI: http://dx.doi.org/10.3126/jkmc.v1i2.8150 Journal of Kathmandu Medical College, Vol. 1, No. 2, Oct.-Dec., 2012: 114-120

scholarly journals Risk factors for hospital readmission following complicated urinary tract infection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tanya Babich ◽  
Noa Eliakim-Raz ◽  
Adi Turjeman ◽  
Miquel Pujol ◽  
Jordi Carratalà ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Medical Condition ◽  
Hospital Readmissions ◽  
Multivariable Analysis ◽  
Significant Risk ◽  
Complicated Urinary Tract Infection ◽  
Negative Influence

AbstractHospital readmissions following severe infections are a major economic burden on the health care system and have a negative influence on patients' quality of life. Understanding the risk factors for readmission, particularly the extent to which they could be prevented, is of a great importance. In this study we evaluated potentially preventable risk factors for 60-day readmission in patients surviving hospitalization for complicated urinary tract infection (cUTI). This was a multinational, multicentre retrospective cohort study conducted in Europe and the Middle East. Our cohort included survivors of hospitalization due to cUTI during the years 2013–2014. The primary outcome was 60-day readmission following index hospitalization. Patient characteristics that could have influenced readmission: demographics, infection presentation and management, microbiological and clinical data; were collected via computerized medical records from infection onset up to 60 days after hospital discharge. Overall, 742 patients were included. The cohort median age was 68 years (interquartile range, (IQR) 55–80) and 43.3% (321/742) of patients were males. The all-cause 60-day readmission rate was 20.1% (149/742) and more than half were readmitted for infection [57.1%, (80/140)]. Recurrent cUTI was the most frequent cause for readmission [46.4% (65/140)]. Statistically significant risk factors associated with 60-day readmission in multivariable analysis were: older age (odds ratio (OR) 1.02 for an one-year increment, confidence interval (CI) 1.005–1.03), diabetes mellitus (OR 1.63, 95% CI 1.04–2.55), cancer (OR 1.7, 95% CI 1.05–2.77), previous urinary tract infection (UTI) in the last year (OR 1.8, 95% CI: 1.14–2.83), insertion of an indwelling bladder catheter (OR 1.62, 95% CI 1.07–2.45) and insertion of percutaneous nephrostomy (OR 3.68, 95% CI 1.67–8.13). In conclusion, patients surviving hospitalization for cUTI are frequently re-hospitalized, mostly for recurrent urinary infections associated with a medical condition that necessitated urinary interventions. Interventions to avoid re-admissions should target these patients.

Control of the duration of urinary catheterization: impact on catheter-associated urinary tract infection

2007 ◽  
Vol 67 (3) ◽  
pp. 253-257 ◽  
Author(s):  
J. Crouzet ◽  
X. Bertrand ◽  
A.G. Venier ◽  
M. Badoz ◽  
C. Husson ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Catheterization

Decreasing Nosocomial Urinary Tract Infection in a Large Academic Community Hospital

2001 ◽  
Vol 6 (3) ◽  
pp. 127-136 ◽  
Author(s):  
Barbara Doyle ◽  
Zubina Mawji ◽  
Margaret Horgan ◽  
Paula Stillman ◽  
Amy Rinehart ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Community Hospital ◽  
Academic Community ◽  
Nosocomial Urinary Tract Infection

TREATMENT OF CARBAPENEM RESISTANT ENTEROBACTERIACEAE URINARY TRACT INFECTION WITH COMBINATION OF AMIKACIN AND MEROPENEM

2021 ◽  
pp. 54-55
Author(s):  
Jayesh Kalbhande ◽  
Vicky Kuldeep
Keyword(s):  
Drug Resistance ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
New Drugs ◽  
Resistant Organism ◽  
Drug Resistant ◽  
Carbapenem Resistant ◽  
Multiple Drugs ◽  
Near Future

Drug resistance of bacteria is biggest challenge humanity is going to face in near future. Bacteria are rapidly developing resistant to multiple drugs and there are not many new drugs in pipeline. Infection because of drug resistant organism is a common cause of morbidity and mortality in intensive care unit. If acquisition of drug resistance by microorganism progresses at this rate, that time is not very far when we will be pushed in to preantibiotic era. We need to develop new strategies to combat drug resistant by microorganism. We report a case of highly drug resistant urinary tract infection caused by Klebsiella. This strain was resistant to both Inj. Meropenem and Inj. Amikacin. This case was successfully treated by combination of Inj. Meropenem and Inj. Amikacin and complete resolution of infection was observed.

scholarly journals Prevalence of urinary tract infection and associated risk factors among women in Sindhupalchowk district, Nepal

2018 ◽  
Vol 5 (7) ◽  
pp. 2714 ◽  
Author(s):  
Leela Paudel ◽  
Naresh Manandhar ◽  
Saroj Sah ◽  
Sudesha Khadka ◽  
Samikshya Neupane ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Abdominal Pain ◽  
Urinary Tract ◽  
Tract Infection ◽  
Significant Risk ◽  
Lower Abdominal Pain ◽  
Common Symptom ◽  
High Power Field ◽  
Toilet Facility

Background: Urinary tract infection (UTI) occurs in all age groups, more common in women due to short urethra and its close proximity to anus and vagina. UTI is defined as “microscopic finding of >10 pus cells/high power field (40x) in urine”. The purpose of the study is to find the prevalence of UTI and its association with various risk factors.Methods: An analytical cross-sectional study on prevalence of UTI was done among 260 women aged 15 years and above. Convenient sampling technique was used. Semi-structured questionnaire was designed to collect the data and urine sample was collected for routine and microscopic examination at the time of interview. Collected urine was sent, within 3 hours of collection.Results: The mean age of the respondents was 36.43±16.17 years. The prevalence of UTI among women aged 15 years and above was 36.9%.The most common symptom was frequency of micturition (35%) followed by lower abdominal pain (38.46%). There was significant association between frequency of micturition, burning micturition and lower abdominal pain with occurrence of urinary tract infection. On urinalysis, 96 samples were positive for pus cell; one sample showed blood, 16 samples showed ca-oxalate and 57 samples showed protein which determines the type of UTI. Smoking [COR-2.15, C.I-(1.12, 4.09)] and unavailability of toilet facility [COR-0.27, C.I-(0.08, 0.93)] were the significant risk factors for occurrence of UTI.Conclusions: There was high prevalence of UTI among women aged 15 years and above and association between smoking and unavailability of toilet facility and UTI was significant.

scholarly journals Heterogeneity of Recent Phase 3 Complicated Urinary Tract Infection Clinical Trials

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Simon Portsmouth ◽  
Almasa Bass ◽  
Roger Echols ◽  
Glenn Tillotson
Keyword(s):  
Clinical Trials ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Study Design ◽  
Patient Population ◽  
Complicated Urinary Tract Infection ◽  
Gram Negative ◽  
Regulatory Guidelines ◽  
New Antibiotics

Abstract Background For new antibiotics developed to treat antibiotic-resistant Gram-negative infections, the US Food and Drug Administration (FDA) regulatory pathway includes complicated urinary tract infection (cUTI) clinical trials in which the clinical isolates are susceptible to the active control. This allows for inferential testing in a noninferiority study design. Although complying with regulatory guidelines, individual clinical trials may differ substantially in design and patient population. To determine variables that impacted patient selection and outcome parameters, 6 recent cUTI trials that were pivotal to an new drug application (NDA) submission were reviewed. Methods This selective descriptive analysis utilized cUTI trial data, obtained from publicly disclosed information including FDA documents and peer-reviewed publications, from 6 new antibiotics developed to treat multidrug-resistant Gram-negative infections: ceftolozane-tazobactam, ceftazidime-avibactam, meropenem-vaborbactam, cefiderocol, plazomicin, and fosfomycin. Eravacycline was not approved for cUTI and is not included. Results Microbiologic modified intent-to-treat sample size, age, proportions of female patients, acute pyelonephritis (AP), Escherichia coli and other pathogens at baseline, protocol-specified switch to oral antibiotic, and the noninferiority margin were compared. Outcome data included clinical response, microbiologic eradication, and composite outcomes, including a subset of patients with AP. Conclusions A study design can follow regulatory guidelines but still have variable populations. The proportion of AP within a study varied greatly and influenced population demographics (age, gender) and baseline microbiology. A smaller proportion of AP resulted in an older patient population, fewer females, less E coli, and lower proportions of patients achieving success. Fluoroquinolones and piperacillin/tazobactam should be reconsidered as active comparators given the high rates of resistance to these antibiotics.

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