scholarly journals Oral Amoxicillin-Clavulanic Acid Treatment in Urinary Tract Infections Caused by Extended-Spectrum Beta-Lactamase–Producing Organisms

2014 ◽  
Vol 8 (1) ◽  
Author(s):  
Ali Beytur ◽  
Yusuf Yakupogullari ◽  
Fatih Oguz ◽  
Baris Otlu ◽  
Halim Kaysadu
Keyword(s):  
Urinary Tract ◽  
Clavulanic Acid ◽  
Urinary Tract Infections ◽  
Acid Treatment ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Oral Amoxicillin ◽  
Extended Spectrum ◽  
Amoxicillin Clavulanic Acid ◽  
Tract Infections

scholarly journals Isolation of Extended-Spectrum β-lactamase- (ESBL-) Producing Escherichia coli and Klebsiella pneumoniae from Patients with Community-Onset Urinary Tract Infections in Jimma University Specialized Hospital, Southwest Ethiopia

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Mengistu Abayneh ◽  
Getnet Tesfaw ◽  
Alemseged Abdissa
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Klebsiella Pneumoniae ◽  
Clavulanic Acid ◽  
Urinary Tract Infections ◽  
Southwest Ethiopia ◽  
Extended Spectrum ◽  
Specialized Hospital ◽  
Amoxicillin Clavulanic Acid ◽  
Tract Infections

Background. Klebsiella pneumoniae and Escherichia coli are the major extended-spectrum β-lactamase- (ESBL-) producing organisms increasingly isolated as causes of complicated urinary tract infections and remain an important cause of failure of therapy with cephalosporins and have serious infection control consequence. Objective. To assess the prevalence and antibiotics resistance patterns of ESBL-producing Escherichia coli and Klebsiella pneumoniae from community-onset urinary tract infections in Jimma University Specialized hospital, Southwest Ethiopia, 2016. Methodology. A hospital-based cross-sectional study was conducted, and a total of 342 urine samples were cultured on MacConkey agar for the detection of etiologic agents. Double-disk synergy (DDS) methods were used for detection of ESBL-producing strains. A disc of amoxicillin + clavulanic acid (20/10 µg) was placed in the center of the Mueller–Hinton agar plate, and cefotaxime (30 µg) and ceftazidime (30 µg) were placed at a distance of 20 mm (center to center) from the amoxicillin + clavulanic acid disc. Enhanced inhibition zone of any of the cephalosporin discs on the side facing amoxicillin + clavulanic acid was considered as ESBL producer. Results. In the current study, ESBL-producing phenotypes were detected in 23% (n = 17) of urinary isolates, of which Escherichia coli accounts for 76.5% (n = 13) and K. pneumoniae for 23.5% (n = 4). ESBL-producing phenotypes showed high resistance to cefotaxime (100%), ceftriaxone (100%), and ceftazidime (70.6%), while both ESBL-producing and non-ESBL-producing isolates showed low resistance to amikacin (9.5%), and no resistance was seen with imipenem. In the risk factors analysis, previous antibiotic use more than two cycles in the previous year (odds ratio (OR), 6.238; 95% confidence interval (CI), 1.257–30.957; p = 0.025) and recurrent UTI more than two cycles in the last 6 months or more than three cycles in the last year (OR, 7.356; 95% CI, 1.429–37.867; p = 0.017) were found to be significantly associated with the ESBL-producing groups. Conclusion. Extended-spectrum β-lactamases- (ESBL-)producing strain was detected in urinary tract isolates. The occurrence of multidrug resistance to the third-generation cephalosporins, aminoglycosides, fluoroquinolones, trimethoprim-sulfamethoxazole, and tetracyclines is more common among ESBL producers. Thus, detecting and reporting of ESBL-producing organisms have paramount importance in the clinical decision-making.

scholarly journals Faecal Microbiota Transplantation Eradicated Extended-Spectrum Beta-Lactamase-Producing Klebsiella pneumoniae from a Renal Transplant Recipient with Recurrent Urinary Tract Infections

2019 ◽  
Vol 9 (2) ◽  
pp. 102-107 ◽  
Author(s):  
Anne Karmisholt Grosen ◽  
Johan Vestergaard Povlsen ◽  
Lars Erik Lemming ◽  
Simon Mark Dahl Jørgensen ◽  
Jens Frederik Dahlerup ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Renal Transplant ◽  
Klebsiella Pneumoniae ◽  
Urinary Tract Infections ◽  
Beta Lactamase ◽  
Faecal Microbiota ◽  
Extended Spectrum Beta Lactamase ◽  
Faecal Microbiota Transplantation ◽  
Extended Spectrum ◽  
Tract Infections

Renal transplant recipients (RTRs) are highly susceptible to infections, and antimicrobial resistance is an increasing problem with limited treatment options. Faecal microbiota transplantation (FMT) is effective for recurrent Clostridium difficile infection and may be used for patients with intestinal carriage of multidrug-resistant (MDR) microorganisms. We present a RTR who suffered from recurrent urinary tract infections (UTIs) caused by extended-spectrum beta-lactamase-producing (ESBL+) Klebsiella pneumoniae. Blood and urinary isolates revealed the same antibiotic susceptibility pattern, and whole-genome sequencing confirmed identical isolates in blood and urine. Despite several treatments with meropenem, the patient experienced recurrent infections that caused hospitalisation. ESBL+ K. pneumoniae was isolated in faeces. In an attempt to decolonise the gut, FMT was performed. A few days after nasojejunal infusion of donor faeces, the patient experienced a single relapse of UTI. During the subsequent 12 months, no further episodes of UTI occurred. Absence of ESBL+ K. pneumoniae in urine and faeces was demonstrated during follow-up. We conclude that FMT may be an effective treatment in RTRs with recurrent UTIs caused by intestinal colonisation with MDR organisms.

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