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Khan M, Hussain F, Naseem M, Clementina R, Gul N, Habib A, Khan LA, Ali A, Rahim W, Khan I. Investigating Urinary Pathogens and Their Antibiotic Resistance: A Cross-Sectional Urine Culture Study. Cureus 2024; 16:e63663. [PMID: 39092326 PMCID: PMC11293364 DOI: 10.7759/cureus.63663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2024] [Indexed: 08/04/2024] Open
Abstract
INTRODUCTION Urinary tract infections (UTIs) are among the most prevalent infectious diseases. Females are more affected than males. The primary culprit is Escherichia coli. Multiple research investigations have documented widespread antimicrobial resistance in uropathogens, sparking global concerns, especially regarding the rise of multidrug resistance (MDR). METHODOLOGY This cross-sectional study was conducted from December 2023 to March 2024. A non-probability purposive sampling technique was employed to select participants, and informed consent was obtained from them. Data were extracted from the culture and sensitivity reports of these patients. The collected data were meticulously entered into IBM SPSS Statistics for Windows, Version 21 (IBM Corp., Armonk, NY). The findings were then presented using a blend of percentages and numerical figures, offering a clear and concise representation of the data. RESULTS Our study of 313 participants showed a higher prevalence of UTIs in females (219, 70%) compared to males (94, 30%). E. coli and Citrobacter were the predominant pathogens, with E. coli and Citrobacter more common in females, while Enterobacter and Staphylococcus were more prevalent in males. Antibiogram analysis revealed sensitivities to specific drugs like nitrofurantoin and meropenem, while resistance was observed against others, including polymyxin B and ampicillin. These findings stress the need for tailored UTI treatment approaches. CONCLUSIONS In conclusion, our research highlights a concerning trend of escalating antibiotic resistance among Pakistani patients with UTIs. Tobramycin B, ticarcillin-clavulanic acid, ampicillin, and clotrimazole exhibited the highest resistance rates, while imipenem, meropenem, nitrofurantoin, sulfonamides, and tigecycline demonstrated notable sensitivity. These findings emphasize the urgent need for the exploration of alternative treatment options to combat rising resistance levels effectively.
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Affiliation(s)
- Muzamil Khan
- Internal Medicine, The George Washington University School of Medicine and Health Sciences, Washington, D.C., USA
| | - Fazeel Hussain
- Internal Medicine, Bangladesh Medical College, Dhaka, BGD
| | | | | | - Nida Gul
- Internal Medicine, MTI Khyber Teaching Hospital, Peshawar, PAK
| | - Aysha Habib
- Internal Medicine, Saidu Medical College, Swat, PAK
| | - Laiba Ali Khan
- Internal Medicine, MTI Khyber Teaching Hospital, Peshawar, PAK
| | - Ayaz Ali
- Internal Medicine, MTI Khyber Teaching Hospital, Peshawar, PAK
| | - Waqas Rahim
- General Surgery, MTI Khyber Teaching Hospital, Peshawar, PAK
| | - Izhar Khan
- Internal Medicine, MTI Khyber Teaching Hospital, Peshawar, PAK
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Getie M, Gebre-Selassie S, Getu Y, Birara S, Tiruneh C, Abebaw A, Akelew Y, Abeje G, Enkobahry A. Bacterial profile and extended spectrum beta lactamase screening of urinary tract infection among asymptomatic and symptomatic pregnant women attending antenatal care in ALERT Hospital, Addis Ababa, Ethiopia. SAGE Open Med 2023; 11:20503121231197587. [PMID: 37933290 PMCID: PMC10625732 DOI: 10.1177/20503121231197587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/10/2023] [Indexed: 11/08/2023] Open
Abstract
Introduction The occurrence of extended spectrum beta lactamase-producing uropathogens, especially in pregnant women can result in life-threatening condition and morbidity for both the mother and the newborn due to very limited drug options for treatment of these pathogens. The aim of this study was to determine the bacterial profile, associated factors, and their antimicrobial susceptibility patterns and to identify extended spectrum beta lactamase-producing bacterial uropathogens. Methods A hospital-based cross-sectional study was conducted from July to September 2018 on a total of 177 pregnant women with and without symptoms of urinary tract infection at ALERT Hospital, Addis Ababa, Ethiopia. From these study participants, 72 have symptoms, whereas 105 have no symptoms. All urine samples were inoculated onto cysteine lactose electrolyte deficient medium and MacConkey agar. Colonies were counted to check the presence of significant bacteriuria. Pure isolates of bacterial pathogen were characterized and identified at species level by colony morphology, gram stain, and standard biochemical procedures. All Gram-negative isolates were put into Muller-Hinton agar plates for antibiotic susceptibility test by Kirby-Bauer disc diffusion technique. Extended spectrum beta lactamase was detected using double-disk synergy methods on Muller-Hinton agar. The data were double entered into epidemiological Information system and analyzed using Statistical Package for Social Science version 26. Results The overall proportion of urinary tract infection among pregnant women was 14.7% (n = 26/177). Klebsiella pneumoniae was the predominant bacterial etiologic agent of urinary tract infection 26.9% (n = 7/26). The proportion of extended spectrum beta lactamase among Gram-negative isolates was 50% (n = 6/12). Among extended spectrum beta lactamase-producing isolates (100%), all are resistance to amikacin and gentamicin while intermediate level resistance rate of 66.7% was observed among trimethoprim-sulphamethoxazole. They were susceptible for some limited drugs, and these were Nitrofurantoin (83.3%) and Chloramphenicol (83.3%). Conclusions Majority of extended spectrum beta lactamase-producing isolates exhibited co-resistance to other commonly prescribed antibiotics. This indicates that the option of treatment for these pathogens rapidly decreased from time to time which results serious life-threatening conditions, especially in mother and newborn unless the appropriate measure is taken.
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Affiliation(s)
- Molla Getie
- Departments of Medical Laboratory Science, Injibara University, Injibara, Ethiopia
| | - Solomon Gebre-Selassie
- Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yemeserach Getu
- Department of Medical Laboratory/Microbiology Unit, ALERT Hospital, Addis Ababa, Ethiopia
| | - Setognal Birara
- Department of Epidemiology and Biostatics’, University of Gonder, Gonder, Ethiopia
| | - Chalachew Tiruneh
- Departments of Biomedical Science, Injibara University, Injibara, Ethiopia
| | - Abtie Abebaw
- Department of Medical Laboratory Science, Debere Markose University, Debere Markose, Ethiopia
| | - Yibeltal Akelew
- Department of Medical Laboratory Science, Debere Markose University, Debere Markose, Ethiopia
| | - Getu Abeje
- Departments of Biomedical Science, Samara University, Samara, Ethiopia
| | - Aklesya Enkobahry
- Departments of Biomedical Science, Injibara University, Injibara, Ethiopia
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Rezaei M, Habibi M, Ehsani P, Asadi Karam MR, Bouzari S. Design and computational analysis of an effective multi-epitope vaccine candidate using subunit B of cholera toxin as a build-in adjuvant against urinary tract infections. BIOIMPACTS : BI 2023; 14:27513. [PMID: 38327629 PMCID: PMC10844585 DOI: 10.34172/bi.2023.27513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 12/26/2022] [Accepted: 01/06/2023] [Indexed: 02/09/2024]
Abstract
Introduction Urinary tract infection (UTI) is one of the most common infections, usually caused by uropathogenic Escherichia coli (UPEC). However, antibiotics are a usual treatment for UTIs; because of increasing antibiotic-resistant strains, vaccination can be beneficial in controlling UTIs. Using immunoinformatics techniques is an effective and rapid way for vaccine development. Methods Three conserved protective antigens (FdeC, Hma, and UpaB) were selected to develop a novel multi-epitope vaccine consisting of subunit B of cholera toxin (CTB) as a mucosal build-in adjuvant to enhance the immune responses. Epitopes-predicted B and T cells and suitable linkers were used to separate them and effectively increase the vaccine's immunogenicity. The vaccine protein's primary, secondary, and tertiary structures were evaluated, and the best 3D model was selected. Since CTB is the TLR2 ligand, molecular docking was made between the vaccine protein and TLR2. Molecular dynamic (MD) simulation was employed to evaluate the stability of the vaccine protein-TLR2 complex. The vaccine construct was subjected to in silico cloning. Results The designed vaccine protein has multiple properties in the analysis. The HADDOCK outcomes show an excellent interaction between vaccine protein and TLR2. The MD results confirm the stability of the vaccine protein- TLR2 complex during the simulation. In silico cloning verified the expression efficiency of our vaccine protein. Conclusion The results of this study suggest that our designed vaccine protein could be a promising vaccine candidate against UTI, but further in vitro and in vivo studies are needed.
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Affiliation(s)
- Maryam Rezaei
- Molecular Biology Department, Pasteur institute of Iran, Tehran, Iran
| | - Mehri Habibi
- Molecular Biology Department, Pasteur institute of Iran, Tehran, Iran
| | - Parasoo Ehsani
- Molecular Biology Department, Pasteur institute of Iran, Tehran, Iran
| | | | - Saeid Bouzari
- Molecular Biology Department, Pasteur institute of Iran, Tehran, Iran
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Khatoon I, Khanam S, Azam A, Qadeer S, Naz S, Hassan NU. Incidence Pattern, Antibiotic Susceptibility Pattern and Associated Risk Factors of Bacterial Uropathogens Among General Population of Pakistan. Infect Drug Resist 2023; 16:4995-5005. [PMID: 37551281 PMCID: PMC10404436 DOI: 10.2147/idr.s418045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/21/2023] [Indexed: 08/09/2023] Open
Abstract
Purpose Urinary tract infections (UTIs) are of the most common bacterial infections in Pakistan. Rapid increase in antibiotic resistance has resulted in a limited number of treatment options available. This study aimed to determine the incidence patterns of uropathogens, their antimicrobial susceptibility pattern and risk factors for UTI among the general population. Methods This laboratory-based cross-sectional study was conducted between November 2020 and March 2021. Urine samples were collected, cultured and bacterial isolates were identified. Bacterial isolates were tested for antimicrobial susceptibility. Data regarding socio-demographic characteristics, clinical features and risk factors were collected using structured questionnaire. Results Of 459 urine samples, 299 (65.1%) showed positive urine cultures (105 CFU/mL). Both gram-negative and gram-positive isolates were obtained, with a prevalence of 230 (76.9%) and 69 (23%), respectively. Escherichia coli was the predominant bacteria isolated 146 (48.8%), and it showed most susceptibility to cefoperazone and imipenem. Most of the gram-negative isolates were resistant towards ampicillin. Most risk factors were not significantly associated with UTI, except for age, income, and previous history of hospitalization. Conclusion UTI is an important problem in the study area, with a prevalence rate of 65%. All bacterial isolates developed resistance towards most antibiotics available on the market. Therefore, there is a need to develop management strategies based on susceptibility pattern of uropathogens. Additionally, proper public education regarding causes of disease transmission and control strategies is required.
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Affiliation(s)
- Iram Khatoon
- Department of Zoology, Women University Swabi, Swabi, Khyber Pakhtunkhwa, Pakistan
| | - Surrya Khanam
- Department of Zoology, Women University Swabi, Swabi, Khyber Pakhtunkhwa, Pakistan
| | - Asima Azam
- Department of Zoology, Shaheed Benazir Bhutto Women University, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Saima Qadeer
- Department of Zoology, Division of Science & Technology, University of Education Lahore, Lahore, Punjab, 54000, Pakistan
| | - Shumaila Naz
- Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Punjab, Pakistan
| | - Najm Ul Hassan
- Department of Microbiology, Abdul Wali Khan University, Mardan, Khyber Pakhtunkhwa, Pakistan
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Lalezadeh A, Ghotaslou P, Ghotaslou R. The Detection of Fosfomycin-Modifying Enzymes (fos) in Uropathogenic Enterobacterale, Azerbaijan, Iran. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2023; 2023:3766269. [PMID: 37250435 PMCID: PMC10219773 DOI: 10.1155/2023/3766269] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 04/04/2023] [Accepted: 05/11/2023] [Indexed: 05/31/2023]
Abstract
Enterobacteriaceae is the most common agent of urinary tract infections (UTIs). Multidrug resistant (MDR) and XDR (extensively drug-resistant) Enterobacteriaceae in UTIs have increased in the world. The present study aimed to study the fosfomycin resistance frequency and the fosfomycin resistance genes among Enterobacteriaceae isolated from UTIs. The urine was collected and cultured in the standard protocol. To determine the susceptibility testing to fosfomycin in 211 isolates, agar dilution and disk agar diffusion methods were used. MDR was nonsusceptibility to at least one agent in three or more antimicrobial categories. The fosfomycin resistance genes were also evaluated by PCR. The frequency of resistance to fosfomycin was in 14 (6.6%) and 15 (7.1%) isolates by the disk agar diffusion and MIC assays, respectively. However, the MIC50 and MIC90 existed at 8 μg/mL and 16 μg/mL, respectively. The MDR was found in 80%. The frequencies of fosfomycin resistance genes were 5 (33.3%), 3 (20%), 2 (13.3%), 1 (6.6%), and 1 (6.6%) for fosC, fosX, fosA3, fosA, and fosB2, respectively. The fosB and fosC2 were not found. A low resistance rate to fosfomycin is observed. Fosfomycin is still one of the most effective and valuable alternative antibiotics against MDR Enterobacteriaceae isolated from UTIs in our region.
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Affiliation(s)
- Aidin Lalezadeh
- Department of Microbiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Pardis Ghotaslou
- Students' Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Ghotaslou
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Bhusal B, Yadav B, Dawadi P, Rijal KR, Ghimire P, Banjara MR. Multi-drug Resistance, β-Lactamases Production, and Coexistence of bla NDM-1 and mcr-1 in Escherichia coli Clinical Isolates From a Referral Hospital in Kathmandu, Nepal. Microbiol Insights 2023; 16:11786361231152220. [PMID: 36741474 PMCID: PMC9893399 DOI: 10.1177/11786361231152220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/04/2023] [Indexed: 02/04/2023] Open
Abstract
The ability of pathogenic Escherichia coli to produce carbapenemase enzymes is a characteristic that allows them to resist various antibiotics, including last-resort antibiotics like colistin and carbapenem. Our objectives were to identify rapidly developing antibiotic resistance (AR), assess β-lactamases production, and detect mcr-1 and bla NDM-1 genes in the isolates. A prospective cross-sectional study was carried out in a referral hospital located in Kathmandu from November 2019 to December 2020 using standard laboratory and molecular protocols. Among 77 total E. coli isolates, 64 (83.1%) of them were categorized as MDR. Phenotypically 13 (20.3%) colistin-resistant, 30 (46.9%) ESBL and 8 (12.5%) AmpC producers, and 5 (7.8%) ESBL/AmpC co-producers were distributed among MDR-E. coli. Minimum inhibitory concentrations (MIC) against the majority of MDR isolates were exhibited at 1 g/L. Of these 77 E. coli isolates, 24 (31.2%) were carbapenem-resistant. Among these carbapenem-resistant bacteria, 11 (45.9%) isolates were reported to be colistin-resistant, while 15 (62.5%) and 2 (8.3%) were MBL and KPC producers, respectively. Out of 15 MBL producers, 6 (40%) harbored bla NDM-1, and 8 (61.5%) out of 13 colistin-resistant pathogens possessed mcr-1. The resistance by colistin- and carbapenem were statistically associated (P < .001). However, only 2 (18.2%) of the co-resistant bacteria were found to have both genes. Our study revealed the highly prevalent MDR and the carbapenem-resistant E. coli and emphasized that the pathogens possess a wide range of capabilities to synthesize β-lactamases. These findings could assist to expand the understanding of AR in terms of enzyme production.
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Affiliation(s)
- Bhimarjun Bhusal
- Central Department of Microbiology,
Tribhuvan University, Kathmandu, Bagmati, Nepal
| | - Bindeshwar Yadav
- Shahid Gangalal National Heart Center,
Kathmandu, Bagmati, Nepal
| | - Prabin Dawadi
- Central Department of Microbiology,
Tribhuvan University, Kathmandu, Bagmati, Nepal
| | - Komal Raj Rijal
- Central Department of Microbiology,
Tribhuvan University, Kathmandu, Bagmati, Nepal
| | - Prakash Ghimire
- Central Department of Microbiology,
Tribhuvan University, Kathmandu, Bagmati, Nepal
| | - Megha Raj Banjara
- Central Department of Microbiology,
Tribhuvan University, Kathmandu, Bagmati, Nepal,Megha Raj Banjara, Central Department of
Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Bagmati 44618, Nepal.
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Isolation, Identification, Characterization, and Plasmid Profile of Urinary Tract Infectious Escherichia coli from Clinical Samples. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:7234586. [PMID: 35356239 PMCID: PMC8958076 DOI: 10.1155/2022/7234586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 03/04/2022] [Indexed: 12/04/2022]
Abstract
Objective In recent times, urinary tract infection (UTI) is one of the most widely recognized bacterial diseases all over the planet. UTI influences individuals of any age and gender. The target of this study is to concentrate on the recurrence of uropathogens, the antimicrobial susceptibility pattern of the isolates, and the plasmid profile of people from the government clinics of Karaikudi. Methods From July 2017 to December 2017, 100 urine tests were gathered and handled for the isolation of pathogenic microbes. In total, 89 isolates were found from the samples collected. Results Escherichia coli was discovered as the most common bacterial isolate screened from the UTI-infected people, accounting for 28.09 percent of all isolates. E. coli was seen to be the highest prevalent bacterium for UTI in all age groups and demonstrated resistance to routinely used medications, especially cefpodoxime and novobiocin, which have been 100 percent resistant. The E. coli isolates screened were positive for beta-lactamase and film generation, and they have strong antimicrobial resistance. As a result, the E. coli strains with the highest prevalence of virulence determinants have become more resistant to many medications because they support the microorganism in overcoming the host's defense and colonizing or entering the urinary system. The amplified 16S rRNA product was analyzed, and phylogenetic relationships were determined. The presence of TEM (56 percent), CTX-M (64 percent), SHV (40 percent), and OXA (60 percent) was discovered. Among E. coli isolates, CTX-M was the most common extended spectrum-beta lactamase (ESBL). Multiplex PCR was also used to identify the existence of CTX-M subgroups in E. coli isolates. Conclusion Finally, we urge that antibiotic selection should be predicated on the awareness of the specific prevalence and that novel antimicrobial medicines for urinary infections be developed to combat the overuse of antibiotics.
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Mahmoudi A, Moghadami M, Shirazi B, Tabari P, Moosavi M. What Left for Us for Urinary Tract Infection Treatment? An Experience from the South of Iran. Adv Biomed Res 2022; 10:52. [PMID: 35127579 PMCID: PMC8781903 DOI: 10.4103/abr.abr_255_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 09/21/2020] [Accepted: 03/06/2021] [Indexed: 11/25/2022] Open
Abstract
Background: The aim of the study is to define the prevalence and antimicrobial susceptibility pattern of bacteria from cases of urinary tract infections (UTIs). Materials and Methods: A retrospective analysis of urinary pathogens and their antimicrobial susceptibility was done on urine cultures at Shiraz University Laboratory from 2015 to 2017. Antimicrobial susceptibility tests have done using the disk-diffusion technique as per the standard of CSLI. Results: During 2 years of study, 3489 samples were culture positive. Escherichia coli was the dominant isolate (84%), followed by Klebsiella spp. (10.7%) and Enterococci spp. (2,2%). The overall resistance rates to trimethoprim-sulfamethoxazole, ceftriaxone, and ciprofloxacin were 56.1%, 47.2%, and 37%, respectively. The most frequently isolated bacteria were E. coli, which had resistance rates of 58.6%, 49.1% to TMP-STX, and cefixime, also sensitivity rates of 95.1% to nitrofurantoin (FM). Conclusions: In the study area, resistance rates to fluoroquinolones and cephalosporins were high. Because most isolates were sensitive to FM and aminoglycoside, they are suggested as appropriate antimicrobials for empirical treatment of UTIs before available urine culture results.
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Affiliation(s)
- Ali Mahmoudi
- Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Moghadami
- The Department of Internal Medicine, Shiraz University of Medical Sciences, Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Babak Shirazi
- Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parinaz Tabari
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahsa Moosavi
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Shaaban OA, Mahmoud NA, Zeidan AA, Kumar N, Finan AC. Prevalence and Resistance Patterns of Pediatric Urinary Tract Infections in Bahrain. Cureus 2021; 13:e20859. [PMID: 35141098 PMCID: PMC8802020 DOI: 10.7759/cureus.20859] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2021] [Indexed: 12/04/2022] Open
Abstract
Background Urinary tract infections (UTI) are a commonly encountered infection in the pediatric age group. Knowledge of the causative pathogens and their antimicrobial resistance patterns in specific geographical locations is important to provide optimum care. The aim of this study is to describe the prevalence and the antimicrobial resistance patterns of the pathogens causing UTI in the pediatric age group in one tertiary inpatient Pediatric unit in Bahrain. Methods This is a retrospective cross-sectional study, conducted at King Hamad University Hospital (KHUH), Bahrain. The inclusion criteria consisted of patients ≤ 14 years of age admitted to the Pediatrics department at KHUH with bacteriologically proven UTI between the months of January 2018 and May 2021. Patients who were identified to have chronic urinary tract conditions or neurodevelopmental problems involving the urinary tract were excluded from the study. Electronic medical records were used to collect data regarding the isolated pathogens and sensitivity testing results. Results A total of 242 cases with positive culture were included. The most common bacteria causing UTI in this sample were successively Escherichia coli (68.60%), Klebsiella pneumoniae (10.30%), Proteus mirabilis (4.69%) and Pseudomonas aeruginosa (3.31%) (p<0.01). E. coli was most resistant to cefazolin (94%), followed by ampicillin (62.68%), whilst it was most sensitive to nitrofurantoin (98.96%) followed by amikacin (98.43%) (p<0.01). K. pneumoniae showed the highest rate of resistance to ampicillin (95.24%) followed by cefazolin (83.33%), meanwhile having the highest sensitivity rate to amikacin (95.24%), followed by ciprofloxacin (90.48%). P. mirabilis had the highest resistance to cefazolin (100%) followed by nitrofurantoin (87.50%), while having the highest sensitivity to piperacillin/tazobactam (100%). Conclusion E. coli is the most common cause of UTI in the pediatric population and it was found to be most sensitive to nitrofurantoin and amikacin whilst being relatively resistant to cefazolin and ampicillin. Similarities between our study and previous studies around the world were found when comparing the antibiotics resistance patterns. Nevertheless, it is our recommendation that empirical antibiotic selection should be tailored to the local data collected from the region.
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Affiliation(s)
- Omaima A Shaaban
- Pediatrics, Royal College of Surgeons in Ireland - Bahrain, Busaiteen, BHR
| | - Nermin A Mahmoud
- Pediatrics, Royal College of Surgeons in Ireland - Bahrain, Busaiteen, BHR
| | - Anas A Zeidan
- Pediatrics, Royal College of Surgeons in Ireland - Bahrain, Busaiteen, BHR
| | - Nitya Kumar
- Epidemiology and Public Health, Royal College of Surgeons in Ireland - Bahrain, Busaiteen, BHR
| | - Alan C Finan
- Pediatrics, King Hamad University Hospital, Busaiteen, BHR
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Ball HS, Girma MB, Zainab M, Soojhawon I, Couch RD, Noble SM. Characterization and Inhibition of 1-Deoxy-d-Xylulose 5-Phosphate Reductoisomerase: A Promising Drug Target in Acinetobacter baumannii and Klebsiella pneumoniae. ACS Infect Dis 2021; 7:2987-2998. [PMID: 34672535 PMCID: PMC8594541 DOI: 10.1021/acsinfecdis.1c00132] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
![]()
The ESKAPE pathogens
comprise a group of multidrug-resistant bacteria
that are the leading cause of nosocomial infections worldwide. The
prevalence of antibiotic resistant strains and the relative ease by
which bacteria acquire resistance genes highlight the continual need
for the development of novel antibiotics against new drug targets.
The methylerythritol phosphate (MEP) pathway is an attractive target
for the development of new antibiotics. The MEP pathway governs the
synthesis of isoprenoids, which are key lipid precursors for vital
cell components such as ubiquinone and bacterial hopanoids. Additionally,
the MEP pathway is entirely distinct from the corresponding mammalian
pathway, the mevalonic acid (MVA) pathway, making the first committed
enzyme of the MEP pathway, 1-deoxy-d-xylulose 5-phosphate
reductoisomerase (IspC), an attractive target for antibiotic development.
To facilitate drug development against two of the ESKAPE pathogens, Acinetobacter baumannii and Klebsiella
pneumoniae, we cloned, expressed, purified, and characterized
IspC from these two Gram-negative bacteria. Enzyme inhibition assays
using IspC from these two pathogens, and compounds fosmidomycin and
FR900098, indicate IC50 values ranging from 19.5–45.5
nM. Antimicrobial susceptibility tests with these inhibitors reveal
that A. baumannii is susceptible to
FR900098, whereas K. pneumoniae is
susceptible to both compounds. Finally, to facilitate structure-based
drug design of inhibitors targeting A. baumannii IspC, we determined the 2.5 Å crystal structure of IspC from A. baumannii in complex with inhibitor FR900098,
and cofactors NADPH and magnesium.
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Affiliation(s)
- Haley S. Ball
- Department of Chemistry and Biochemistry, George Mason University, Manassas, Virginia 20109, United States of America
- Wound Infections Department, Bacterial Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Springs, Maryland 20910, United States of America
| | - Misgina B. Girma
- Department of Chemistry and Biochemistry, George Mason University, Manassas, Virginia 20109, United States of America
| | - Mosufa Zainab
- Department of Chemistry and Biochemistry, George Mason University, Manassas, Virginia 20109, United States of America
| | - Iswarduth Soojhawon
- Wound Infections Department, Bacterial Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Springs, Maryland 20910, United States of America
| | - Robin D. Couch
- Department of Chemistry and Biochemistry, George Mason University, Manassas, Virginia 20109, United States of America
| | - Schroeder M. Noble
- Wound Infections Department, Bacterial Diseases Branch, Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Springs, Maryland 20910, United States of America
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Gautam G, Gogoi S, Saxena S, Kaur R, Dhakad MS. Nitrofurantoin Susceptibility Pattern in Gram-Negative Urinary Isolates: In Need of Increased Vigilance. J Lab Physicians 2021; 13:252-256. [PMID: 34602790 PMCID: PMC8478500 DOI: 10.1055/s-0041-1731106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Nitrofurantoin is the first-line drug in the treatment of uncomplicated urinary tract infections (UTIs) and its use has increased exponentially in recent years. Objectives
This study aims to determine the susceptibility pattern of nitrofurantoin in gram-negative urinary isolates and to evaluate their bacteriological and epidemiological profile along with co-existing resistance to other important urinary antimicrobials.
Material and Methods
This was a retrospective study conducted in a tertiary care hospital in New Delhi in which 500 gram-negative bacterial urinary isolates were evaluated. Records of antimicrobial susceptibility were reviewed from July to September 2019. Antimicrobial susceptibility was performed using the Kirby–Bauer disk diffusion method on Mueller Hinton agar and interpreted using CLSI 2019. Test for extended spectrum β-lactamase (ESBL) producers was done using double disk approximation test.
Statistical Analysis
Data analysis was performed using the SPSS windows version 25.0 software.
Results
Out of total 500 isolates, 20.17% (94) isolates were resistant (R) to nitrofurantoin and 9.01% (42) were found to be intermediate (I). Highest resistance was seen in
Klebsiella
sp. (44.61%) and
Escherichia coli
(8.12%). About 28.82% of the I/R isolates were of the pediatrics age group and most of the isolates belonged to females (64.69%). High resistance was also seen against ampicillin (92.30%), cefazolin (88.46%), ceftazidime (73.0%), and fluoroquinolones (65.38%). Carbapenemase co-resistance was seen in 57.15% isolates whereas ESBL production was seen in 30.76% of
E. coli
and 12.06% of
Klebsiella
sp.
Conclusion
Increase in multidrug resistance uropathogens along with a near absence of novel oral antibiotics has led to increased consumption of nitrofurantoin since its resistance has increased.
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Affiliation(s)
- Garima Gautam
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Sanjib Gogoi
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Sonal Saxena
- Department of Microbiology, Maulana Azad Medical College and Associated Hospitals, New Delhi, India
| | - Ravinder Kaur
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Megh Singh Dhakad
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
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12
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Ejerssa AW, Gadisa DA, Orjino TA. Prevalence of bacterial uropathogens and their antimicrobial susceptibility patterns among pregnant women in Eastern Ethiopia: hospital-based cross-sectional study. BMC Womens Health 2021; 21:291. [PMID: 34364376 PMCID: PMC8348837 DOI: 10.1186/s12905-021-01439-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 07/28/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Urinary tract infection (UTI) is the commonest bacterial infections during pregnancy, leading to significant maternal and prenatal morbidity and mortality. METHOD This hospital-based cross-sectional study during November 2017 to January 2018 was aimed to determine hospital-based antibacterial susceptibility patterns of bacterial uropathogens among 200 pregnant women in Eastern Ethiopia. ~ 10-20 ml clean-catch midstream urine samples were collected by the study participants. The well-mixed urine samples standardized to 1 µl have inoculated onto Cystine Lactose Electrolyte-Deficient and MacConkey agar. The inoculum was cultured at 37 °C under aerobic conditions for 18-48 h and examined macroscopically to evaluate the colony appearance and size of colonies. The isolate on the plates with pure growth and colonies ≥ 105 CFU/ml were further subjected to biochemical identification and susceptibility testing according to the standard procedures explained in the Clinical and Laboratory Standards Institute guideline. SPSS version 25 was used for data analysis. Descriptive statistics such as frequency, percentage, and cross-tabulation were used to present the findings in the form of graphs and tables. RESULTS The response rate for this study was 98.04%. Thirty-one bacteria were isolated among the 200 urine samples processed, which gave the overall UTI prevalence of 15.5%. The majority (90.3%) of the isolates were Gram-negative. Escherichia coli (45.2%) was the most frequent isolated uropathogen which followed by Proteus spp. (22.6%), Klebsiella pneumoniae (16.1%), Staphylococcus aureus (9.7%), and Pseudomonas aeruginosa (6.5%). Among the isolates, 96.4% of them were susceptible to amikacin and followed by nitrofurantoin (90.3%), and gentamicin (83.9%). However, high rates of resistance to ampicillin (58.1%), amoxicillin-clavulanate (51.6%), and cotrimoxazole (51.6%) were observed. Overall, 16(51.6%) of the bacterial isolates had developed multiple drug resistance to the selected antimicrobials. CONCLUSION In general, the overall prevalence of UTI was high, 15.5%. Most of isolated bacterial uropathogens were Gram-negative bacteria, and Escherichia coli was the most frequent isolate. The majority of the isolates were susceptible to amikacin, nitrofurantoin, and gentamicin. However, a high rate of resistance was observed to ampicillin, amoxicillin-clavulanate, and cotrimoxazole. More than half of the isolated bacteria had multiple drug-resistant features. Therefore, periodic and continuous urine culture for screening and diagnosis is mandatory to reduce the consequence of UTI and multidrug resistance bacteria in pregnancy.
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Affiliation(s)
- Alemseged Workneh Ejerssa
- Department of Pharmacy, Harar Health Sciences College, P.O.Box 228, Harar, Harari Regional State Ethiopia
| | - Diriba Alemayehu Gadisa
- Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, P.O. Box 19, Ambo, Oromia Regional State Ethiopia
| | - Teferra Abula Orjino
- Department of Pharmacology, College of Health Sciences, School of Pharmacy, Addis Ababa University, P.O.Box 1176, Addis Ababa, Oromia Regional State Ethiopia
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13
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Salh KK. Evolution of the Antimicrobial resistance of Bacteria causing Urinary Tract Infections. Comb Chem High Throughput Screen 2021; 25:1219-1229. [PMID: 34161207 DOI: 10.2174/1386207324666210622161325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 05/17/2021] [Accepted: 05/28/2021] [Indexed: 11/22/2022]
Abstract
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).
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Affiliation(s)
- Khonaw Kader Salh
- Basic Science Department, College of Medicine, Hawler Medical University, Erbil, Kurdistan Region. Iraq
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14
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Mofolorunsho KC, Ocheni HO, Aminu RF, Omatola CA, Olowonibi OO. Prevalence and antimicrobial susceptibility of extended-spectrum beta lactamases-producing Escherichia coli and Klebsiella pneumoniae isolated in selected hospitals of Anyigba, Nigeria. Afr Health Sci 2021; 21:505-512. [PMID: 34795702 PMCID: PMC8568240 DOI: 10.4314/ahs.v21i2.4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Escherichia coli and Klebsiella pneumoniae are commonly implicated in urinary tract infections accounting for majority of the antimicrobial resistance encountered in hospitals. OBJECTIVES To determine the prevalence and antimicrobial susceptibility of extended-spectrum beta-lactamases (ESBLs) producing E. coli and K. pneumoniae among patients in Anyigba, Nigeria. METHODS This hospital-based cross-sectional study was conducted using urine samples from 200 patients of Grimmard Catholic hospital and Maria Goretti hospital. Urine samples were processed to identify ESBL-producing E. coli and K. pneumoniae using standard microbiological techniques. Isolates were then tested against antimicrobial agents. RESULTS A total of 156 bacterial isolates were recovered consisting 128 of E. coli and 28 of K. pneumoniae. Extended spectrum beta-lactamases production was observed in 69% of E. coli and 31% of K. pneumoniae. These pathogens were resistant to 3 or more antibiotics. Of the antimicrobials tested, cefotaxime demonstrated the highest rates of resistance (100%) for both ESBL-producing E. coli and K. pneumoniae. Fifty-four isolates of ESBL-producing E. coli showed a high level of resistance to amoxicillin clavulanic acid (83.3%), ciprofloxacin (83.3%), and ceftazidime (79.6%). ESBL-positive K. pneumoniae isolates were highly resistant to ciprofloxacin (75%), and amoxicillin clavulanic acid (83.3%). Cefoxitin (62.5%) and gentamicin (66.7%) showed substantially higher rates of resistance against these isolates while all 24 strains were resistant to imipenem. CONCLUSION This study indicated the prevalence of ESBL-positive Gram-negative pathogens in these study sites and also demonstrated their resistance to a few antibiotics. This highlights the need for new antimicrobials that are potent and improved policy on use of antibiotics.
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Affiliation(s)
| | - Hannah O Ocheni
- Kogi State University, Faculty of Natural Sciences, Department of Microbiology
| | - Ruth F Aminu
- Kogi State University, Faculty of Natural Sciences, Department of Microbiology
| | - Cornelius A Omatola
- Kogi State University, Faculty of Natural Sciences, Department of Microbiology
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15
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Vakilzadeh MM, Heidari A, Mehri A, Shirazinia M, Sheybani F, Aryan E, Naderi H, Najaf Najafi M, Varzandeh M. Antimicrobial Resistance among Community-Acquired Uropathogens in Mashhad, Iran. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2020; 2020:3439497. [PMID: 33082791 PMCID: PMC7556082 DOI: 10.1155/2020/3439497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 09/10/2020] [Accepted: 09/21/2020] [Indexed: 11/18/2022]
Abstract
Background Antimicrobial resistance among community-acquired uropathogens is an emerging concern over the past decades that warrants a continuing reevaluation of the appropriateness of recommended empiric antimicrobial regimens for treatment of urinary tract infections (UTIs). Aims To describe the microbial spectrum and resistance profile of community-acquired uropathogens and predictors of isolation of resistant strains. Methods Between October 2017 and June 2019, individuals who visited the outpatient clinics for diagnosis of UTIs or screening of asymptomatic bacteriuria were included in the study if they were tested for urine culture in one of the three main medical diagnostic laboratories of Mashhad, Iran. The standard disk diffusion antimicrobial susceptibility testing was used, with the Clinical and Laboratory Standards Institute (CLSI) threshold cutoffs for susceptibility of isolated uropathogens. Results Three hundred thirty cases were included with a median age of 47 years. Two hundred seventy-six (83.6%) were female. The most common isolated uropathogens were Escherichia coli in 201 (60.9%) cases and Klebsiella species in 46 (13.9%) cases. E. coli isolates showed the highest rates of susceptibility to nitrofurantoin (89.3%), cefixime (75%), and gentamicin (72.4%). Exposure to antibiotics in the past 3 months was a predictor of resistance to ciprofloxacin (OR: 2.8, 95% CI: 1.33-6.28), and older age was a predictor of resistance to TMP-SMX (OR: 2.1, 95% CI: 1.07-3.97) among E. coli isolates. Conclusion. E. coli and Klebsiella species accounted for about two-thirds of community-acquired uropathogens. In regard to the high susceptibility rates, nitrofurantoin was identified as the first-choice agent for empiric treatment of community-acquired cystitis, while cefixime and gentamicin might be the second-choice alternatives. Ciprofloxacin and TMP-SMX, on the other hand, cannot be considered appropriate agents for empiric therapy of community-acquired UTIs, particularly in those who had exposure to antibiotics in the past 3 months and the elderly.
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Affiliation(s)
| | | | - Ali Mehri
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Matin Shirazinia
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fereshte Sheybani
- Department of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Aryan
- Antimicrobial Resistance Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - HamidReza Naderi
- Department of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mona Najaf Najafi
- Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Marjan Varzandeh
- Department of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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16
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Omidifar N, Taghi E, Mohebi S, Motamedifar M. Distribution and antimicrobial susceptibility pattern of bacterial pathogens causing urinary tract infection in pregnant women in Shiraz, Southwest Iran. GENE REPORTS 2020. [DOI: 10.1016/j.genrep.2020.100731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Raya GB, Dhoubhadel BG, Shrestha D, Raya S, Laghu U, Shah A, Raya BB, Kafle R, Parry CM, Ariyoshi K. Multidrug-resistant and extended-spectrum beta-lactamase-producing uropathogens in children in Bhaktapur, Nepal. Trop Med Health 2020; 48:65. [PMID: 32774128 PMCID: PMC7397599 DOI: 10.1186/s41182-020-00251-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 07/22/2020] [Indexed: 11/10/2022] Open
Abstract
Background The emergence of multidrug-resistant (MDR) and extended-spectrum beta-lactamase (ESBL)-producing uropathogens has complicated the treatment of urinary tract infections (UTI). Paediatric UTI is a common illness, which if not treated properly, may lead to acute and long-term complications, such as renal abscess, septicaemia, and renal scarring. This study aimed to determine the prevalence of MDR and ESBL-producing uropathogens among children. Methods During the study period (April 2017–April 2018), midstream urine samples were collected following aseptic procedures from children < 16 years in Siddhi Memorial Hospital. Standard culture and biochemical tests were performed to identify uropathogens and antimicrobial susceptibility test was done by modified Kirby-Bauer disc diffusion method following Clinical and Laboratory Standard Institute (CLSI) guidelines. ESBL-producing uropathogens were screened by ceftazidime (30 μg) and cefotaxime (30 μg) discs, and confirmed by the combination disc tests: ceftazidime + clavulanic acid (30/10 μg) or cefotaxime + clavulanic acid (30/10 μg) as recommended by CLSI. Results We processed 5545 non-repeated urine samples from the children with symptoms of UTI. A significant growth of uropathogens was observed in 203 samples (3.7%). The median age of the children was 24 months (interquartile range (IQR), 12–53 months). Escherichia coli (n = 158, 77.8%) and Klebsiella pneumoniae (n = 30, 14.8%) were common among the uropathogens. Among them, 80.3% were resistant to amoxycillin and 51.2% were resistant to cotrimoxazole. Most of them were susceptible to amikacin, nitrofurantoin, and ofloxacin. MDR was detected in 34.5% (n = 70/203) and ESBL producers in 24.6% (n = 50/203) of them. The proportion of MDR isolates was higher in children < 5 years (n = 59/153, 38.6%) than children ≥ 5 years (n = 11/50, 22%) (P = 0.03). Conclusions Nitrofurantoin, ofloxacin, and amikacin can be used for the empirical treatment for UTI in children in Bhaktapur, Nepal. MDR and ESBL-producing uropathogens are prevalent; this warrants a continuous surveillance of antimicrobial resistance.
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Affiliation(s)
| | - Bhim Gopal Dhoubhadel
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan.,School of Tropical Medicine and Global Health (TMGH), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan
| | | | | | | | - Ashok Shah
- Siddhi Memorial Hospital, Bhaktapur, Nepal
| | | | - Rita Kafle
- Kathmandu Medical College, Kathmandu, Nepal
| | - Christopher M Parry
- School of Tropical Medicine and Global Health (TMGH), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan.,Liverpool School of Tropical Medicine, Liverpool, UK
| | - Koya Ariyoshi
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan.,School of Tropical Medicine and Global Health (TMGH), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan
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18
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Omokhua-Uyi AG, Abdalla MA, Leonard CM, Aro A, Uyi OO, Van Staden J, McGaw LJ. Flavonoids isolated from the South African weed Chromolaena odorata (Asteraceae) have pharmacological activity against uropathogens. BMC Complement Med Ther 2020; 20:233. [PMID: 32703212 PMCID: PMC7376718 DOI: 10.1186/s12906-020-03024-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 07/10/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Urinary tract infections (UTIs) caused by opportunistic pathogens are among the leading health challenges globally. Most available treatment options are failing as a result of antibiotic resistance and adverse effects. Natural sources such as plants may serve as promising alternatives. METHODS Compounds were isolated from the South African weed Chromolaena odorata through column chromatography. Purified compounds were tested for antimicrobial activity using the p-iodonitrotetrazolium chloride (INT) colorimetric method, against uropathogenic Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Aspergillus fumigatus and Cryptococcus neoformans. Anti-biofilm, anti-adhesion and metabolic inhibition activities were investigated against selected strains. Safety of the compounds was determined against Vero monkey kidney, C3A human liver and colon (Caco2) cells. RESULTS Four compounds identified as pectolinaringenin (1), (±)-4',5,7-trimethoxy flavanone (2), 5-hydroxy-3,7,4'-trimethoxyflavone (3) and 3,5,7-trihydroxy-4'-methoxyflavone) (4) were isolated. Minimum inhibitory concentration (MIC) varied between 0.016 and 0.25 mg/mL. Compounds 2 and 3 showed promising antimicrobial activity against E. coli, S. aureus, K. pneumoniae, A. fumigatus and C. neoformans with MIC between 0.016 and 0.125 mg/mL, comparable to gentamicin, ciprofloxacin and amphotericin B used as positive controls. Compounds 2 and 3 showed good anti-biofilm and metabolic inhibition activities against E. coli and S. aureus but weak anti-adhesion activity against the organisms. Low toxicity with selectivity indexes between 1 and 12.625 were recorded with the compounds, indicating that the compounds were rather toxic to the microbial strains and not to the human and animal cells. CONCLUSION Pharmacological activities displayed by compounds 2 and 3 isolated from C. odorata and low toxicity recorded credits it as a potential lead for the development of useful prophylactic treatments and anti-infective drugs against UTIs. Although known compounds, this is the first time these compounds have been isolated from the South African weed C. odorata and tested for antimicrobial, anti-biofilm, metabolic inhibition and anti-adhesion activities.
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Affiliation(s)
- Aitebiremen G. Omokhua-Uyi
- Phytomedicine Programme, Department of Paraclinical Sciences, University of Pretoria, Private Bag X04, Onderstepoort, 0110 South Africa
- Research Centre for Plant Growth and Development, School of Life Sciences, University of KwaZulu-Natal, Private Bag X01, Scottsville, 3201 South Africa
| | - Muna A. Abdalla
- Phytomedicine Programme, Department of Paraclinical Sciences, University of Pretoria, Private Bag X04, Onderstepoort, 0110 South Africa
- Deparment of Food Science and Technology, Faculty of Agriculture, University of Khartoum, 13314 Khartoum North, Sudan
| | - Carmen M. Leonard
- Department of Pharmaceutical Sciences, Tshwane University of Technology, Private Bag X680, Pretoria, 0001 South Africa
| | - Abimbola Aro
- Phytomedicine Programme, Department of Paraclinical Sciences, University of Pretoria, Private Bag X04, Onderstepoort, 0110 South Africa
| | - Osariyekemwen O. Uyi
- Department of Animal and Environmental Biology, University of Benin, P.M.B, Benin City, 1154 Nigeria
| | - Johannes Van Staden
- Research Centre for Plant Growth and Development, School of Life Sciences, University of KwaZulu-Natal, Private Bag X01, Scottsville, 3201 South Africa
| | - Lyndy J. McGaw
- Phytomedicine Programme, Department of Paraclinical Sciences, University of Pretoria, Private Bag X04, Onderstepoort, 0110 South Africa
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19
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Faujdar SS, Bisht D, Sharma A. Antibacterial activity of Syzygium aromaticum (clove) against uropathogens producing ESBL, MBL, and AmpC beta-lactamase: Are we close to getting a new antibacterial agent? J Family Med Prim Care 2020; 9:180-186. [PMID: 32110587 PMCID: PMC7014883 DOI: 10.4103/jfmpc.jfmpc_908_19] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 12/06/2019] [Accepted: 12/16/2019] [Indexed: 11/04/2022] Open
Abstract
Introduction The present study was done to access the antibacterial activity of clove (Syzygium aromaticum) against extended-spectrum beta-lactamase (ESBL), metallo-beta-lactamase (MBL), and AmpC beta-lactamase-producing gram-negative bacteria causing urinary tract infection. Methods A total of 221 gram-negative uropathogens were isolated and screened for beta-lactamase (ESBL, MBL, and AmpC) production and further tested against ethanolic extract of clove (S. aromaticum) for its antibacterial activity. Results Clove was effective against all gram-negative isolates but the best antibacterial activity was shown against Proteus species with 19 mm zone of inhibition, 0.39 mg/ml minimum inhibitory concentration (MIC) and 0.19 mg/ml minimum bactericidal concentration (MBC). Conclusions Clove extract showed different antibacterial potential against all gram-negative uropathogens. Clove activity for particular strain was found to be similar between isolates producing beta-lactamase and non beta-lactamase.
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Affiliation(s)
- Sameer S Faujdar
- Department of Microbiology, Santosh Medical College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Dakshina Bisht
- Department of Microbiology, Santosh Medical College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Amisha Sharma
- Department of Microbiology, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India
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20
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Mortazavi-Tabatabaei SAR, Ghaderkhani J, Nazari A, Sayehmiri K, Sayehmiri F, Pakzad I. Pattern of Antibacterial Resistance in Urinary Tract Infections: A Systematic Review and Meta-analysis. Int J Prev Med 2019; 10:169. [PMID: 32133087 PMCID: PMC6826787 DOI: 10.4103/ijpvm.ijpvm_419_17] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 01/09/2018] [Indexed: 11/04/2022] Open
Abstract
Background Urinary tract infection (UTI) is one of the most common infectious diseases ranking next to upper respiratory tract infections. UTIs are often significantly associated with morbidity and mortality. The inappropriate administration of antibiotics to treat these infections increased infection resistance to antibiotics. The aim of this study is to determine the frequency of antibiotic resistance pattern in UTIs. Methods We searched several databases including PubMed, Web of Science, Scopus, Google Scholar, Iran Medex, Magiran, IranDoc, MedLib, and Scientific Information Database to identify the studies addressing antibacterial resistance patterns of the most common uropathogenic bacteria in UTIs in Iran. A total of 90 reports published from different regions of Iran from 1992 to May 2015 were involved in this study. Results It is shown that the most common pathogen causing UTIs is Escherichia coli with 62%. The resistance among the isolates of E. coli was as follows: ampicillin (86%), amoxicillin (76%), tetracycline (71%), trimethoprim-sulfamethoxazole (64%), cephalexin (61%), and cefalothin (60%). The highest sensitivity among isolates of E. coli was as follows: imipenem (86%), nitrofurantoin (82%), amikacin (79%), chloramphenicol (72%), and ciprofloxacin (72%). Conclusions The results of this study showed that the most common resistance are antibiotics that are commonly used. The most effective antibiotics for E. coli were imipenem, nitrofurantoin, amikacin, chloramphenicol, and ciprofloxacin. Considering this study, it had better, use less gentamicin, second-generation cephalosporins, and nalidixic acid in the initial treatment of infections caused by E. coli, and no use penicillins, tetracyclines, cotrimoxazole, and first-generation cephalosporins.
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Affiliation(s)
| | - Jalal Ghaderkhani
- Department of Microbiology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Nazari
- Department of Infectious Diseases, Ilam University of Medical Sciences, Ilam, Iran
| | - Kourosh Sayehmiri
- Department Social Medicine, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Fatemeh Sayehmiri
- Student Research Committee, Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Iraj Pakzad
- Department of Microbiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
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21
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Alqasim A, Abu Jaffal A, Alyousef AA. Prevalence and molecular characteristics of sequence type 131 clone among clinical uropathogenic Escherichia coli isolates in Riyadh, Saudi Arabia. Saudi J Biol Sci 2019; 27:296-302. [PMID: 31889850 PMCID: PMC6933283 DOI: 10.1016/j.sjbs.2019.09.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 09/09/2019] [Accepted: 09/18/2019] [Indexed: 12/21/2022] Open
Abstract
Background The antimicrobial resistance of extraintestinal pathogenic Escherichia coli (ExPEC) has progressively been reported worldwide. This resistance has been ascribed to global dissemination of a single E. coli clone, namely E. coli sequence type 131 (E. coli ST131). The main goal of this study is to determine the prevalence and molecular traits of ST131 and its subclones among E. coli clinical urine isolates in Riyadh, Saudi Arabia. Methods Sixty E. coli urine isolates, of different extended spectrum β-lactamase (ESBL) carriage, were involved in this study. Molecular characterization was carried out to determine the ST131 status, phylogenetic groups and virulence carriage of these isolates. ST131 isolates were further tested to evaluate the prevalence of different phylogenetic groups, subclones and virulence carriage. Results Group B2 was the most common phylogroup from which E. coli isolates derived. Overall, 37 of 60 (61.7%) isolates belonged to ST131 clones. Of these, 19 (31.7%) isolates were from the H30 subclone, including 10 (16.7%) H30 non-Rx and 9 (15%) H30Rx. The remaining 18 (30%) ST131 isolates belonged to other non H30 subclones. H30 subclone was significantly higher in the virulence carriage in comparison to non H30 ST131 subclones. Conclusion This study reported the prevalence and traits of clinical E. coli ST131 main subclones in Saudi Arabia. It also demonstrated the high prevalence of E. coli ST131 locally, and found different virulence genotypes and antimicrobial resistance phenotypes among ST131 subclones. In the future, preforming whole genome sequence-based studies on ST131 and its subclones is crucial to elucidate factors that drive the success of these organisms.
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Affiliation(s)
- Abdulaziz Alqasim
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
| | - Ahmad Abu Jaffal
- Department of Clinical Laboratory Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdullah A Alyousef
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
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22
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Michno M, Sydor A, Wałaszek M, Sułowicz W. Microbiology and Drug Resistance of Pathogens in Patients Hospitalized at the Nephrology Department in the South of Poland. Pol J Microbiol 2019; 67:517-524. [PMID: 30550238 PMCID: PMC7256703 DOI: 10.21307/pjm-2018-061] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2018] [Indexed: 11/30/2022] Open
Abstract
A retrospective study was conducted among 498 patients with urinary tract infections (UTI) referred to our department from January 2013 to December 2015. This study was performed to evaluate the etiology of UTI and the antibiotic susceptibility profile of Escherichia coli (E. coli) as the main etiological factor in different age groups. Urine samples were examined using standard microbiological methods. Three hundred sixty-three samples (72.9%) were identified as E. coli, of which 29 (8.0%) can produce extended-spectrum β-lactamases (ESBL). E. coli was highly sensitive to imipenem (100.0%), gentamicin (91.0%), nitrofurantoin (89.4%), amikacin (88.2%), piperacillin/tazobactam (87.0%) and cephalosporins (79.7–89.5%). Low sensitivity was found in relation to fluoroquinolones (60.3–70.4%). E. coli was least sensitive to ampicillin (30.2%) and amoxicillin/clavulanic acid (49.9%). We observed a significant fall in susceptibility level to piperacillin/tazobactam (68.4% vs. 88.8%; p = 0.017), amikacin (61.1% vs. 90.7%; p = 0.001), gentamicin (70.0% vs. 93.2%; p = 0.002), cefalexin (41.2% vs. 83.3%; p < 0.001), cefotaxime (63.6% vs. 89.4%; p = 0.002), ceftazidime (61.9% vs. 85.6%; p = 0.008), cefepime (73.7% vs. 91.1%; p = 0.025), ciprofloxacin (54.1% vs. 72.2%; p = 0.024) and norfloxacin (40.5% vs. 62.5%; p = 0.011) among patients with catheter-associated UTI (CAUTI) compared to those with non-CAUTI. A similar susceptibility profile was observed between different age groups. In the longevity, E. coli showed a higher sensitivity to cephalosporins than in the young-old group. E. coli susceptibility to fluoroquinolones was low, which excludes them as a first-line drug in our department. Nitrofurantoin may be used as an alternative drug to carbapenems. Monitoring of susceptibility pattern is of great importance.
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Affiliation(s)
- Mikołaj Michno
- Department of Internal Medicine, Nephrology and Dialysis Centre, Regional St Lukas Hospital , Tarnów , Poland
| | - Antoni Sydor
- Department of Internal Medicine, Nephrology and Dialysis Centre, Regional St Lukas Hospital , Tarnów , Poland
| | | | - Władysław Sułowicz
- Chair and Department of Nephrology, Jagiellonian University , Cracow , Poland
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DEHBANIPOUR R, KHANAHMAD H, SEDIGHI M, BIALVAEI AZAHEDI, FAGHRI J. High prevalence of fluoroquinolone-resistant Escherichia coli strains isolated from urine clinical samples. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E25-E30. [PMID: 31041407 PMCID: PMC6477561 DOI: 10.15167/2421-4248/jpmh2019.60.1.884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 12/12/2018] [Indexed: 11/16/2022]
Abstract
Background Fluoroquinolone resistant Escherichia coli isolates have become an important challenge in healthcare settings in Iran. In this study, we have determined Fluoroquinolone resistant E. coli isolates (from both outpatients and inpatients) and evaluated mutations of gyrA and parC within the quinolone resistance-determining regions (QRDR) of these clinical isolates. Materials and methods Clinical isolates were recovered from the urine sample of patients with urinary tract infections admitted at Alzahra hospital, Iran, between September and February 2013. We assessed antimicrobial susceptibility of all isolates and determined mutations in QRDR of gyrA and parC genes from 13 fluoroquinolone-resistant isolates by DNA sequencing. Results A total of 135 E. coli strains were obtained from 135 patients (91 outpatients and 44 inpatients). The resistance rate of fluoroquinolones (Ciprofloxacin, Norfloxacin and Ofloxacin) among our strains was 45.2%. Two E. coli isolates were shown just a single mutation, but other isolates possessed 2-5 mutations in gyrA and parC genes. Mutations in the QRDR regions of gyrA were at positions Ser83 and Asp87 and parC at positions Ser80, Glu84, Gly78. Conclusions Ciprofloxacin is the most common antimicrobial agent used for treating urinary tract infections (UTIs) in healthcare settings in Iran. Accumulation of different substitutions in the QRDR regions of gyrA and parC confers high-level resistance of fluoroquinolones in clinical isolates.
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Affiliation(s)
- R. DEHBANIPOUR
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - H. KHANAHMAD
- Department of Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - M. SEDIGHI
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - A. ZAHEDI BIALVAEI
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - J. FAGHRI
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Jamshid Faghri, Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran - Tel/Fax +983137922421 - E-mail:
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Estaji M, Tabasi M, Sadeghpour Heravi F, Kheirvari Khezerloo J, Radmanesh A, Raheb J, Ghadirzadeh MR, Tabatabaei A. Genotypic identification of Pseudomonas aeruginosa strains isolated from patients with urinary tract infection. Comp Immunol Microbiol Infect Dis 2019; 65:23-28. [PMID: 31300119 DOI: 10.1016/j.cimid.2019.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 03/22/2019] [Accepted: 03/26/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Numerous nosocomial infections including urinary tract infection (UTI) have been reported to be linked to Pseudomonas aeruginosa (P. aeruginosa). This bacterium is one of the most common pathogen colonized in the urinary tract. The main purpose of this study was to evaluated the presence of antibiotic resistance genes and also the most frequent genotype patterns of P. aeruginosa in the patients with UTI hospitalized in different wards of hospitals. MATERIALS AND METHODS In this study, 70 strains of P. aeruginosa isolated of urine samples from the patients with UTI were assessed. The isolated strains were genotyped using Multiple-Locus Variable Number Tandem Repeat Analysis (MLVA) method. We have also analyzed the presence of TEM and SHV resistant genes in the isolates. RESULTS A total of 70 P. aeruginosa strains was isolated from the UTI patients. Based on MLVA method, 61 various genotypes of P. aeruginosa were identified which grouped into two main clusters and 4 sub-clusters. Moreover, approximately 80% and 70% of isolated strains carried the TEM and SHV resistance genes, respectively. CONCLUSION Our findings showed that the majority of patients hospitalized in different wards of hospitals have experienced the urinary tract infection caused by P. aeruginosa. According to the genotyping results, a high diversity of the P. aeruginosa population was observed in the patients with UTI. Our results can provide a better understanding of the P. aeruginosa genotype distribution and epidemiology of infection, which can be applied as basic data for future antibiotic therapies.
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Affiliation(s)
- Mohammad Estaji
- Molecular Medicine Department, Medical Institute, National Institute of Genetics and Biotechnology, Tehran, Iran
| | - Mohsen Tabasi
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | | | - Jamil Kheirvari Khezerloo
- Young Researchers and Elite Club, Islamic Azad University, Tehran Medical Sciences Branch, Tehran, Iran
| | - Amin Radmanesh
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Jamshid Raheb
- Molecular Medicine Department, Medical Institute, National Institute of Genetics and Biotechnology, Tehran, Iran
| | | | - Azardokht Tabatabaei
- Research Center of Pediatrics Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran.
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25
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Patel HB, Soni ST, Bhagyalaxmi A, Patel NM. Causative agents of urinary tract infections and their antimicrobial susceptibility patterns at a referral center in Western India: An audit to help clinicians prevent antibiotic misuse. J Family Med Prim Care 2019; 8:154-159. [PMID: 30911498 PMCID: PMC6396617 DOI: 10.4103/jfmpc.jfmpc_203_18] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background Urinary tract infections (UTIs) remain one of the most common infections in community and susceptibility of uropathogens to commonly used antimicrobials has declined over years. It is important to periodically study susceptibility patterns of uropathogens, so that empiric treatment can be determined using recent data, helping improve patient outcomes. Methods Urine samples received by the laboratory for culture and susceptibility testing over a period of 3 months were analyzed and included in this study. Antimicrobial susceptibility testing was done on cultured isolates. Results Of total 3,151 urine samples received, 3,066 were processed, and organisms were isolated from 1,401 (45.69%) samples. Isolation rate from male and female urine samples was 45.29% and 46.32%, respectively. The most commonly isolated organism was Escherichia coli (36.11%), followed by Candida spp. (18.56%), and Klebsiella spp. (18.06%). E. coli was most susceptible to meropenem (91.89%) and imipenem (91.69%). Klebsiella spp. was most susceptible to imipenem(75.89%) and meropenem(75.49%). Susceptibility of E. coli and Klebsiella spp. to nitrofurantoin, cotrimoxazole, and ciprofloxacin was 72.33%, 32.02%, and 18.97%, and 51.77%, 27.27%, and 22.13%, respectively. Candida spp. was most susceptible to amphotericin B (97.30%). Conclusion Treatment for UTIs should be determined based on current local antimicrobial susceptibility patterns of uropathogens to minimise therapeutic failures and prevent antibiotic misuse.
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Affiliation(s)
| | - Sumeeta T Soni
- Department of Microbiology, B. J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Aroor Bhagyalaxmi
- Department of Community Medicine, B. J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Neev M Patel
- B. J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
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26
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Paralikar P, Ingle AP, Tiwari V, Golinska P, Dahm H, Rai M. Evaluation of antibacterial efficacy of sulfur nanoparticles alone and in combination with antibiotics against multidrug-resistant uropathogenic bacteria. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART A, TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING 2019; 54:381-390. [PMID: 30912480 DOI: 10.1080/10934529.2018.1558892] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 11/29/2018] [Accepted: 12/01/2018] [Indexed: 06/09/2023]
Abstract
Urinary tract infections (UTIs) have been frequently reported from different parts of the world. The current knowledge on distribution of causative agents of urinary infections and antibiotics susceptibility pattern is essentially required. In the present study, total 351 uropathogenic bacteria were isolated; among them most prevalent were Escherichia coli (75%), followed by Pseudomonas aeruginosa (8%), Proteus mirabilis (6%), Klebsiella pneumoniae (4%), Staphylococcus aureus (4%) and Enterococcus faecalis (3%). Most isolates of uropathogenic bacteria showed resistance to amoxicillin and trimethoprim, followed by chloramphenicol and kanamycin. Biosynthesis of sulfur nanoparticles (SNPs) was performed by co-precipitation method using sodium thiosulfate in presence of Catharanthus roseus leaf extract. The characterization data showed that SNPs were polydispersed, spherical in shape with size range of 20-86 nm and having negative zeta potential of -9.24 mV. The potential antibacterial activity was observed for SNPs alone and in combination with antibiotics particularly amoxicillin and trimethoprim against majority of the uropathogens. The synergistic effect yielded increase in fold area with high activity index against tested uropathogens. Based on overall results, it can be recommended to use SNPs for the management of UTI alone and also in combination with antibiotics.
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Affiliation(s)
- Priti Paralikar
- a Nanobiotechnology Lab., Department of Biotechnology , SGB Amravati University , Amravati , India
| | - Avinash P Ingle
- a Nanobiotechnology Lab., Department of Biotechnology , SGB Amravati University , Amravati , India
- b Department of Biotechnology, Lorena School of Engineering , University of Sao Paulo , Lorena , Brazil
| | - Vaibhav Tiwari
- a Nanobiotechnology Lab., Department of Biotechnology , SGB Amravati University , Amravati , India
| | - Patrycja Golinska
- c Department of Microbiology , Nicolaus Copernicus University , Torun , Poland
| | - Hanna Dahm
- c Department of Microbiology , Nicolaus Copernicus University , Torun , Poland
| | - Mahendra Rai
- a Nanobiotechnology Lab., Department of Biotechnology , SGB Amravati University , Amravati , India
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27
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Noie Oskouie A, Hasani A, Ahangarzadeh Rezaee M, Soroush Bar Haghi MH, Hasani A, Soltani E. A Relationship Between O-Serotype, Antibiotic Susceptibility and Biofilm Formation in Uropathogenic Escherichia coli. Microb Drug Resist 2019; 25:951-958. [PMID: 30817229 DOI: 10.1089/mdr.2018.0330] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Uropathogenic Escherichia coli (UPEC) is a well-known pathogen that has perturbed the medical scenario because of its resistance to diverse therapeutic drugs and its ability to form a biofilm. Different O-serogroups are the prevalent cause of urinary tract infections (UTIs) along with their ability to form a biofilm. The present research aimed to assess antibiotic susceptibility, biofilm formation, and serotyping of UPEC isolates in conjunction with the demographic data. Antibiotic susceptibility was determined using the Kirby-Bauer method and biofilm formation was assessed phenotypically and at the molecular level. Serotyping was performed by multiplex PCR. A significant proportion of the total of 120 UPECs was isolated from women (p < 0.05). Most isolates were resistant to cefotaxime, ceftazidime, and tetracycline, but maintained their sensitivity to imipenem. O25, O15, O8, and O75 were the most commonly detected serogroups. Moreover, O25, O15, and O8 were the highest biofilm-producing serogroups among the UPEC isolates. Serogroups O75 and O21 were significantly associated with diabetic patients and subjects with renal disease, respectively (p < 0.05). Overall, our results show that UTI incidence in women should be a subject of concern. The high prevalence of the O25 serogroup associated with a specific antibiotic profile and a high percentage of biofilm formation suggests a close relation between serogroups and characteristic features of UPEC isolates.
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Affiliation(s)
- Arezoo Noie Oskouie
- 1 Infectious and Tropical Diseases Research Center and Department of Medical Microbiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, The Islamic Republic of Iran
| | - Alka Hasani
- 1 Infectious and Tropical Diseases Research Center and Department of Medical Microbiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, The Islamic Republic of Iran
| | - Mohammad Ahangarzadeh Rezaee
- 1 Infectious and Tropical Diseases Research Center and Department of Medical Microbiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, The Islamic Republic of Iran
| | - Mohammad Hossein Soroush Bar Haghi
- 1 Infectious and Tropical Diseases Research Center and Department of Medical Microbiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, The Islamic Republic of Iran
| | - Akbar Hasani
- 2 Drug and Applied Research Center and Department of Clinical Biochemistry and Laboratory Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, The Islamic Republic of Iran
| | - Elghar Soltani
- 1 Infectious and Tropical Diseases Research Center and Department of Medical Microbiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, The Islamic Republic of Iran
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Mama M, Manilal A, Gezmu T, Kidanewold A, Gosa F, Gebresilasie A. Prevalence and associated factors of urinary tract infections among diabetic patients in Arba Minch Hospital, Arba Minch province, South Ethiopia. Turk J Urol 2018; 45:56-62. [PMID: 30468427 DOI: 10.5152/tud.2018.32855] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 06/12/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Urinary tract infection (UTI) is a common and grave health problem in the world. In fact, patients with diabetes mellitus have an immense risk for developing UTI. The development of resistance among uropathogens to antibiotics is a major crisis which limits the use of drug of choice for the treatment of UTI. On this view point, the aim of the present study is to elucidate the prevalence of UTI, associated factors, causative agents and their antimicrobial susceptibility amongst diabetic patients attending Arba Minch Hospital, Arba Minch, Ethiopia. MATERIAL AND METHODS A facility based cross-sectional study was carried out in diabetic patients visiting the Internal Medicine Unit of Arba Minch Hospital (AMH) during the study period (March to May 2016). Pre-tested structured questionnaire was used for collecting the data pertaining to socio-demographic characteristics and possible risk factors. In order to quantify the uropathogens, midstream urine samples were collected in sterile leak proof culture bottles and streaked onto diverse bacteriological media. All the positive urine cultures showing significant bacteriuria as per the Kass count (>105 organisms/mL) were further subjected to biochemical tests. The antimicrobial susceptibility test was performed to determine the resistance/susceptibility pattern of isolated uropathogens. Data entry and analysis were done using Statistical Package for Social Services, version 20. RESULTS In total, 239 diabetic patients were included in the study of which 60.2% (n=144) were females. A total of 81 (33.8%) diabetic patients had positive urine cultures. Sixty-eight (83.9%) female diabetic patients had significant bacteriuria (p=0.000). Fifty-two (64.1%) participants had drinking habit and 79 (97.5%) of respondents had higher glucose levels (≥126 mg/dL) (p=0.004 and p=0.003), respectively. According to the biochemical tests, in a total of 90 isolates from patients with significant bacteriuria, eight species of uropathogens such as Escherichia coli, Klebsiella sp., Proteus sp., Citrobacter spp., Staphylococcus aureus, Coagulase negative Staphylococcus (CNS), Enterococcus faecalis and yeast isolates were identified. The antibiogram evidenced that 79.6% (n=51) of Gram-negative bacteria were invariably resistant to amoxicillin and penicillin whereas 73.4% (n=47) and 65.6 % (n=42) of them were resistant to trimethoprim, erythromycin and chloramphenicol, respectively. Regarding the Gram-positive bacteria, high degree of resistance was exhibited towards penicillin and trimethoprim (100%, n=24) followed by amoxicillin (83.3%, n=20) and gentamicin (62.5%, n=15). Invariably, all the Gram-positive cocci and Gram-negative bacilli were susceptible (100%) to amikacin, doxycycline, ceftriaxone and nitrofurantoin. CONCLUSION The prevalence of UTI is higher in diabetic patients. Results revealed that the predominant pathogens of UTI were Gram-negative bacilli (Enterobacteriaceae), particularly E. coli. Significant bacteriuria had an association with the consumption of alcohol, gender and glucose level. Based on the results of antimicrobial susceptibility tests, it might be inferred that the antibiotics such as amikacin, doxycycline, ceftriaxone and nitrofurantoin are the drugs of choice for the management of both Gram-negative and Gram-positive uropathogenic bacteria in the study area.
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Affiliation(s)
- Mohammedaman Mama
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Aseer Manilal
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Tigist Gezmu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Aschalew Kidanewold
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Firew Gosa
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Atsede Gebresilasie
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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29
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Foroughi A, Ramezan-Ghanbari S. Prevalence and Pattern of Antibiotic Resistance of Escherichia Coli Causing Urinary Tract Infections in Patients Referring to a Laboratory in Kermanshah. JOURNAL OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASES 2018. [DOI: 10.29252/jommid.6.4.99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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30
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Prevalence of Multidrug Resistance and Extended-Spectrum β-Lactamase Carriage of Clinical Uropathogenic Escherichia coli Isolates in Riyadh, Saudi Arabia. Int J Microbiol 2018; 2018:3026851. [PMID: 30305814 PMCID: PMC6165594 DOI: 10.1155/2018/3026851] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 08/17/2018] [Indexed: 12/30/2022] Open
Abstract
The prevalence of extended-spectrum β-lactamase-producing Escherichia coli (ESBL-producing E. coli) has recently increased worldwide. This study aims at determining the antimicrobial susceptibility patterns of a collection of clinical E. coli urine isolates and evaluating the ESBL carriage of these isolates at phenotypic and genotypic levels. A total of 100 E. coli urine isolates were collected at a tertiary healthcare centre in Riyadh from January 2018 to March 2018. Antimicrobial susceptibility testing was carried out for all isolates. ESBL production was characterized at phenotypic and genotypic levels using double-disc synergy test and polymerase chain reaction, respectively. Detection of different ESBL variants was performed using DNA sequencing. Of 100 E. coli isolates, 67 were associated with multidrug resistance (MDR) phenotype. All isolates showed variable resistance levels to all antibiotics used here expect to imipenem, where they were all imipenem-sensitive. 33 out of 100 E. coli isolates were positive for ESBLs by phenotypic and genotypic methods. Among all ESBL-positive E. coli isolates, the CTX-M was the most prevalent ESBL type (31/33 isolates; 93.94%). CTX-M-15 variant was detected in all isolates associated with CTX-M carriage. Multiple ESBL gene carriage was detected in 15/33 isolates (45.45%), where 11 (33.33%) isolates produced two different ESBL types while 4 isolates (12.12%) associated with carrying three different ESBL types. Our study documented the high antimicrobial resistance of ESBL-producing E. coli to many front-line antibiotics currently used to treat UTI patients, and this implies the need to continuously revise the local guidelines used for optimal empirical therapy for UTI patients. It also showed the high prevalence of ESBL carriage in E. coli urine isolates, with CTX-M-15 being the most predominant CTX-M variant.
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31
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Asadollahi P, Razavi S, Asadollahi K, Pourshafie MR, Talebi M. Rise of antibiotic resistance in clinical enterococcal isolates during 2001-2016 in Iran: a review. New Microbes New Infect 2018; 26:92-99. [PMID: 30319780 PMCID: PMC6180340 DOI: 10.1016/j.nmni.2018.08.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/06/2018] [Accepted: 08/25/2018] [Indexed: 12/14/2022] Open
Abstract
Introduction The clinical significance of enterococci is mostly related to its antibiotic resistance which contributes to colonization and infection, in particular amongst the hospitalized patients. The present review has examined the literature to provide a comprehensive data on enterococci antibiotic resistance during the last 20 years in Iran. Methods Search engines such as Google Scholar and PubMed were used to identify all Persian and English-language articles investigating enterococci in Iran from 1996 to 2017. The search terms were “enterococci”, “enterococcal”, “enterococcus”, “Iran”, “bacterial resistance”, “antibiotic resistance” and “resistance”. Results Decrease in the resistance trend against ampicillin, gentamycin and ciprofloxacin was observed over a period of 15 years (2001 to 2016) in Iran. During a 10 years period from 2001 to 2015, the rate of resistance among Enterococcus faecalis species was less than Enterococcus faecium. The resistancerate, however, was considerably increased for both species during this period. The mean resistance rates for vancomycin, gentamicin, ciprofloxacin, erythromycin, nitrofurantoin, chloramphenicol, trimethoprim-sulfametoxazol, imipenem and teicoplanin were higher among complicated cases (patients with underlying debilitating disorders) compared to general cases (hospitalized or outpatients with no specific underlying disorder). Conclusions E. faecalis and E. faecium showed a rise in the mean resistance against all the antibiotics during a 10-year period from 2010 to 2015. With the exception of penicillin and ampicillin, resistance to all antibiotics was higher amongst complicated cases compared to general patients.
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Affiliation(s)
- P Asadollahi
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Sh Razavi
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Microbial Biotechnology Research Centre, Iran University of Medical Sciences, Tehran, Iran
| | - Kh Asadollahi
- Department of Social Medicine, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran.,Biotechnology and Medicinal Plants Researches Center, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - M R Pourshafie
- Department of Microbiology, Pasteur Institute of Iran, Tehran, Iran
| | - M Talebi
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Yekani M, Baghi HB, Sefidan FY, Azargun R, Memar MY, Ghotaslou R. The rates of quinolone, trimethoprim/sulfamethoxazole and aminoglycoside resistance among Enterobacteriaceae isolated from urinary tract infections in Azerbaijan, Iran. GMS HYGIENE AND INFECTION CONTROL 2018; 13:Doc07. [PMID: 30202721 PMCID: PMC6124734 DOI: 10.3205/dgkh000313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Aim: Antibiotic susceptibility patterns help to select appropriate empirical treatments of urinary tract infections (UTIs). This study aimed to investigate antibiotic resistance among Enterobacteriaceae isolated from UTIs in Azerbaijan, Iran. Methods: This study was carried out during 2016 in hospitals located in Tabriz, Urmia, and Khoy. Midstream urine specimens were cultured and identified by the standard methods. Susceptibility testing was carried out using the disk diffusion agar method for cefotaxime, ceftazidime, ceftriaxone, cefoxitin, imipenem, meropenem, ertapenem, cefepime, ampicillin, cefazolin, cefuroxime, aztreonam, nitrofurantoin, and fosfomycin and the agar dilution method for MIC determination of aminoglycosides, quinolones, sulfamethoxazole, and trimethoprim. Results: A total of 219 non-duplicated Enterobacteriaceae were isolated from UTIs. According to the agar dilution assay, the following resistance rates were determined: trimethoprim/sulfamethoxazole (co-trimoxazole) 69.8%, nalidixic acid 68.9%, ciprofloxacin 66.2%, levofloxacin 58.5%, tobramycin 47.9%, kanamycin 39.3%, gentamicin 27.8%, and amikacin 5.5%. High levels of resistance were observed to trimethoprim (78.5%), sulfamethoxazole (88.1%), ampicillin (86.3%), and cephazoline (79.4%). Conclusion: The most effective agents against Enterobacteriaceae were fosfomycin, carbapenems, and amikacin. Quinolones, trimethoprim and sulfamethoxazole are not appropriate for empirical therapy due to high levels of resistance. Amikacin is more effective among aminoglycosides and may be more effective, in complicated cases, when used in combination with fosfomycin and carbapenems.
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Affiliation(s)
- Mina Yekani
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Microbiology Department, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Bannazadeh Baghi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Microbiology Department, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Infectious and Tropical Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Yeganeh Sefidan
- Microbiology Department, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Infectious and Tropical Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Robab Azargun
- Microbiology Department, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Infectious and Tropical Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Yousef Memar
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Microbiology Department, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Ghotaslou
- Infectious and Tropical Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Antimicrobial Susceptibility Pattern of Six Threatening Pathogens at Mofid Children’s Hospital, Tehran, Iran. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2018. [DOI: 10.5812/archcid.15576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Chu CM, Lowder JL. Diagnosis and treatment of urinary tract infections across age groups. Am J Obstet Gynecol 2018; 219:40-51. [PMID: 29305250 DOI: 10.1016/j.ajog.2017.12.231] [Citation(s) in RCA: 139] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 12/18/2017] [Accepted: 12/27/2017] [Indexed: 01/20/2023]
Abstract
Urinary tract infections are the most common outpatient infections, but predicting the probability of urinary tract infections through symptoms and test results can be complex. The most diagnostic symptoms of urinary tract infections include change in frequency, dysuria, urgency, and presence or absence of vaginal discharge, but urinary tract infections may present differently in older women. Dipstick urinalysis is popular for its availability and usefulness, but results must be interpreted in context of the patient's pretest probability based on symptoms and characteristics. In patients with a high probability of urinary tract infection based on symptoms, negative dipstick urinalysis does not rule out urinary tract infection. Nitrites are likely more sensitive and specific than other dipstick components for urinary tract infection, particularly in the elderly. Positive dipstick testing is likely specific for asymptomatic bacteriuria in pregnancy, but urine culture is still the test of choice. Microscopic urinalysis is likely comparable to dipstick urinalysis as a screening test. Bacteriuria is more specific and sensitive than pyuria for detecting urinary tract infection, even in older women and during pregnancy. Pyuria is commonly found in the absence of infection, particularly in older adults with lower urinary tract symptoms such as incontinence. Positive testing may increase the probability of urinary tract infection, but initiation of treatment should take into account risk of urinary tract infection based on symptoms as well. In cases in which the probability of urinary tract infection is moderate or unclear, urine culture should be performed. Urine culture is the gold standard for detection of urinary tract infection. However, asymptomatic bacteriuria is common, particularly in older women, and should not be treated with antibiotics. Conversely, in symptomatic women, even growth as low as 102 colony-forming unit/mL could reflect infection. Resistance is increasing to fluoroquinolones, beta-lactams, and trimethoprim-sulfamethoxazole. Most uropathogens still display good sensitivity to nitrofurantoin. First-line treatments for urinary tract infection include nitrofurantoin, fosfomycin, and trimethoprim-sulfamethoxazole (when resistance levels are <20%). These antibiotics have minimal collateral damage and resistance. In pregnancy, beta-lactams, nitrofurantoin, fosfomycin, and trimethoprim-sulfamethoxazole can be appropriate treatments. Interpreting the probability of urinary tract infection based on symptoms and testing allows for greater accuracy in diagnosis of urinary tract infection, decreasing overtreatment and encouraging antimicrobial stewardship.
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Antimicrobial Resistance Pattern of Uropathogens Isolated from Rafha Central Hospital, Rafha, Kingdom of Saudi Arabia. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2018. [DOI: 10.22207/jpam.12.2.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Mahmudunnabi G, Majlish ANK, Momtaz F, Foysal MJ, Rahman MM, Islam K. Molecular detection and PCR-RFLP analysis using Pst1 and Alu1 of multidrug resistant Klebsiella pneumoniae causing urinary tract infection in women in the eastern part of Bangladesh. J Genet Eng Biotechnol 2018; 16:77-82. [PMID: 30647708 PMCID: PMC6296566 DOI: 10.1016/j.jgeb.2017.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 12/22/2017] [Accepted: 12/29/2017] [Indexed: 11/18/2022]
Abstract
Klebsiella pneumoniae is the second leading causative agent of UTI. In this study, a rapid combined polymerase chain reaction and restriction fragment length polymorphism analysis was developed to identify K. pneumoniae in women, infected with urinary tract infection in the Sylhet city of Bangladesh. Analysis of 11 isolates from women at the age range of 20-55 from three different hospitals were done firstly by amplification with K. pneumoniae specific ITS primers. All of the 11 collected isolates were amplified in PCR and showed the expected 136 bp products. Then, restriction fragment length polymorphism analysis of 11 isolates were conducted after PCR amplification by 16s rRNA universal primers, followed by subsequent digestion and incubation with two restriction enzymes, Pst1 and Alu1. Seven out of 11 isolates were digested by Pst1 restriction enzymes, six isolates digested by Alu1, and while others were negative for both enzymes. Data results reveal that, women at age between 25 and 50 were digested by both enzymes. A woman aged over than 50 was negative while bellow 20 was digested by only Pst1. The results could pave the tactic for further research in the detection of K. pneumoniae from UTI infected women.
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Affiliation(s)
- Golam Mahmudunnabi
- Department of Genetic Engineering and Biotechnology, Shahjalal University of Science and Technology, Sylhet 3114, Bangladesh
| | - Al Nahian Khan Majlish
- Department of Genetic Engineering and Biotechnology, Shahjalal University of Science and Technology, Sylhet 3114, Bangladesh
| | - Farhana Momtaz
- Department of Microbiology, University of Chittagong, Chittagong 4331, Bangladesh
| | - Md Javed Foysal
- Department of Genetic Engineering and Biotechnology, Shahjalal University of Science and Technology, Sylhet 3114, Bangladesh
- School of Molecular and Life Sciences, Curtin University, WA 6845, Australia
| | - Md Mahbubur Rahman
- Department of Biotechnology, Bangabandhu Sheikh Mujibur Rahman Agricultural University, Gazipur 1706, Bangladesh
| | - Kamrul Islam
- Department of Genetic Engineering and Biotechnology, Shahjalal University of Science and Technology, Sylhet 3114, Bangladesh
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Mirzaii M, Jamshidi S, Zamanzadeh M, Marashifard M, Malek Hosseini SAA, Haeili M, Jahanbin F, Mansouri F, Darban-Sarokhalil D, Khoramrooz SS. Determination of gyrA and parC mutations and prevalence of plasmid-mediated quinolone resistance genes in Escherichia coli and Klebsiella pneumoniae isolated from patients with urinary tract infection in Iran. J Glob Antimicrob Resist 2018; 13:197-200. [PMID: 29747008 DOI: 10.1016/j.jgar.2018.04.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 04/26/2018] [Accepted: 04/27/2018] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES Fluoroquinolones (FQs) are recommended as the drugs of choice for the empirical treatment of urinary tract infections (UTIs). This study investigated the molecular determinants of FQ resistance in Escherichia coli and Klebsiella pneumoniae isolates in Iran. METHODS A total of 364 clinical isolates of E. coli (n=144) and K. pneumoniae (n=220) were collected from patients with UTI. Susceptibility of the isolates to ciprofloxacin, levofloxacin, gatifloxacin and nalidixic acid was evaluated by disk diffusion. The presence of qnrA, qnrB and qnrS genes was assessed by PCR. Nucleotide sequences of the gyrA and parC genes were determined. RESULTS Eighty-seven (60.4%) and 15 (6.8%) E. coli and K. pneumoniae isolates, respectively, were resistant to at least one of the tested FQs. Plasmid-mediated quinolone resistance (PMQR) genes were detected in 12.6% and 60.0% of FQ-resistant E. coli and K. pneumoniae, respectively. Whilst qnrB predominated in K. pneumoniae, qnrS was the most prevalent PMQR gene in E. coli. S83L (98.9%) and D87N (59.8%) were the most frequent mutations identified in GyrA of E. coli, and 55.2% (n=48) of FQ-resistant E. coli isolates had mutation in ParC harbouring S80I and E84V substitutions. The GyrAS83L substitution was found in only one FQ-resistant K. pneumoniae isolate. CONCLUSIONS FQ resistance was much more common in E. coli isolates than in K. pneumoniae. Whilst mutations in the drug target-encoding genes gyrA and parC were the major mechanisms involved in FQ resistance in E. coli, PMQR determinants commonly mediated FQ resistance in K. pneumoniae.
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Affiliation(s)
- Mehdi Mirzaii
- Faculty of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Sanaz Jamshidi
- Department of Basic Sciences, Islamic Azad University, Yasooj Branch, Yasooj, Iran
| | - Maryam Zamanzadeh
- Department of Basic Sciences, Islamic Azad University, Yasooj Branch, Yasooj, Iran
| | - Masoud Marashifard
- Student Research Committee, Yasuj University of Medical Sciences, Yasuj, Iran
| | | | - Mehri Haeili
- Department of Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | - Fariba Jahanbin
- Department of Basic Sciences, Islamic Azad University, Yasooj Branch, Yasooj, Iran
| | - Fariba Mansouri
- Department of Basic Sciences, Islamic Azad University, Yasooj Branch, Yasooj, Iran
| | - Davood Darban-Sarokhalil
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Sajjad Khoramrooz
- Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran; Department of Microbiology, School of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran.
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Agyepong N, Govinden U, Owusu-Ofori A, Essack SY. Multidrug-resistant gram-negative bacterial infections in a teaching hospital in Ghana. Antimicrob Resist Infect Control 2018. [PMID: 29541448 PMCID: PMC5845144 DOI: 10.1186/s13756-018-0324-2] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Multidrug-resistant Gram-negative bacteria have emerged as major clinical and therapeutic dilemma in hospitals in Ghana. To describe the prevalence and profile of infections attributable to multidrug-resistant Gram-negative bacteria among patients at the Komfo Anokye Teaching Hospital in the Ashanti region of Ghana. Methods Bacterial cultures were randomly selected from the microbiology laboratory from February to August, 2015. Bacterial identification and minimum inhibitory concentrations were conducted using standard microbiological techniques and the Vitek-2 automated system. Patient information was retrieved from the hospital data. Results Of the 200 isolates, consisting of K. pneumoniae, A. baumannii, P. aeruginosa, Enterobacter spp., E. coli, Yersinia spp., Proteus mirabilis, Pasteurella spp., Chromobacterium violaceum, Salmomella enterica, Vibrio spp., Citrobacter koseri, Pantoea spp., Serratia spp., Providencia rettgeri Burkholderia cepacia, Aeromonas spp., Cadecea lapagei and Sphingomonas paucimobilis, 101 (50.5%) and 99 (49.5%) recovered from male and female patients respectively The largest proportion of patients were from age-group ≥60 years (24.5%) followed by < 10 years (24.0%) and least 10–19 years (9.5%) with a mean patient age of 35.95 ± 27.11 (0.2–91) years. The decreasing order of specimen source was urine 97 (48.5%), wound swabs 47 (23.5%), sputum 22 (11.0%) bronchial lavage, nasal and pleural swabs 1 (0.50%). Urinary tract infection was diagnosed in 34.5% of patients, sepsis in 14.5%, wound infections (surgical and chronic wounds) in 11.0%, pulmonary tuberculosis in 9.0% and appendicitis, bacteremia and cystitis in 0.50%. The isolates showed high resistance to ampicillin (94.4%), trimethoprim/sulfamethoxazole (84.5%), cefuroxime (79.0%) and cefotaxime (71.3%) but low resistance to ertapenem (1.5%), meropenem (3%) and amikacin (11%). The average multi-drug resistance was 89.5%, and ranged from 53.8% in Enterobacter spp. to 100.0% in Acinetobacter spp. and P. aeruginosa. Conclusion Bacterial infections caused by multi-drug resistant (isolates resistant to at least one agent in three or more antibiotic classes) Gram-negative pathogens among patients at Komfo Anokye Teaching Hospital in Kumasi, Ghana are rife and interventions are necessary for their containment.
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Affiliation(s)
- Nicholas Agyepong
- 1Antimicrobial Research Unit, Discipline of Pharmaceutical Sciences, University of Kwa-Zulu Natal, Durban, South Africa
| | - Usha Govinden
- 1Antimicrobial Research Unit, Discipline of Pharmaceutical Sciences, University of Kwa-Zulu Natal, Durban, South Africa
| | - Alex Owusu-Ofori
- 2School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Sabiha Yusuf Essack
- 1Antimicrobial Research Unit, Discipline of Pharmaceutical Sciences, University of Kwa-Zulu Natal, Durban, South Africa
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Kengne M, Dounia AT, Nwobegahay JM. Bacteriological profile and antimicrobial susceptibility patterns of urine culture isolates from patients in Ndjamena, Chad. Pan Afr Med J 2017; 28:258. [PMID: 29881501 PMCID: PMC5989234 DOI: 10.11604/pamj.2017.28.258.11197] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 11/10/2017] [Indexed: 11/25/2022] Open
Abstract
Introduction Bacteriological profile and antimicrobial susceptibility patterns of urine culture isolates were determined among patients in the Ndjamena General Hospital, a National Reference centre. Methods A cross-sectional study was carried out from July to November 2014. Six hundred and sixty patients were enrolled, to whom a cytobacteriological examination of urine was prescribed. Urine was collected and cultured. Bacterial identification and antimicrobial susceptibility patterns were performed using Vitek 2 compact automated system. Results 216 isolates were recovered from patients (age range: 10-90 years). E. coli was the pathogen frequently cultured 128 (59.3%) followed by K. pneumonia 28 (13.0%). Bacteriuria was more present in inpatients (70.4%) compared to outpatients (29.6%). High antibiotic-resistance rate (> 60%) of the total isolates was observed with ampicillin, ciprofloxacin and cephalosporins. Imipeneme (94.9%) displayed satisfactory activity against bacteria isolates. ESBLs phenotype was present in 68/105 (64.7%) of betalactamine resistant isolates. AAC(3)-I and AAC(6’)-I enzymes were found respectively in 16/36 (44.4%) and 20/36 (55.6%) of aminoglycosides resistant isolates. Resistance of isolates to quinolones was mainly due to an association of target modification (gyrA and parC), porin reduction and/or efflux mechanisms and was present in 107/213 (49%) of quinolones resistant isolates. Conclusion E. coli is the predominant uropathogen isolated in our setting and there are antibiotic-resistant uropathogens among the studied population. Therefore, routine surveillance of bacterial uropathogens to common used antibiotics must be a continuous process so as to provide physicians with up to date information about the local data of antimicrobial resistance.
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Affiliation(s)
- Michel Kengne
- Department of Medical Microbiology and Immunology, School of Health Sciences-Catholic University of Central Africa, Yaoundé, Cameroon
| | - Amon Todjimbaide Dounia
- Department of Medical Microbiology and Immunology, School of Health Sciences-Catholic University of Central Africa, Yaoundé, Cameroon.,Ndjamena General Hospital of National Reference, Chad
| | - Julius Mbekem Nwobegahay
- Department of Medical Microbiology and Immunology, School of Health Sciences-Catholic University of Central Africa, Yaoundé, Cameroon.,Yaoundé Military Hospital, Cameroon
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Badamchi A, Masoumi H, Javadinia S, Asgarian R, Tabatabaee A. Molecular detection of six virulence genes in Pseudomonas aeruginosa isolates detected in children with urinary tract infection. Microb Pathog 2017; 107:44-47. [PMID: 28315724 DOI: 10.1016/j.micpath.2017.03.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 03/01/2017] [Accepted: 03/06/2017] [Indexed: 11/19/2022]
Abstract
Although a vast majority of Urinary tract infections (UTIs) are caused by E. coli, epidemiological reports have indicated an increasing rate of such infections caused by some other opportunistic organisms including Pseudomonas aeruginosa. Antimicrobial susceptibility and pathogenesis mechanisms of P. aeruginosa are poorly understood. The aim of this study was to detect some virulence factor genes and antimicrobial susceptibility patterns of P. aeruginosa isolates detected in patients with UTI, in children hospital of Tehran, Tehran, Iran. Eighty-four Pseudomonas aeruginosa were isolated. Then, the presence of six virulence genes, in the genome of the isolates was evaluated using PCR amplifications techniques. Finally, antimicrobial susceptibility pattern of the isolates was determined by disk diffusion method. According to the results, lasB was the most prevalent virulence gene that could be detected in the P. aeruginosa isolates (92.9%) used in this study. This was followed by aprA (81.2%), toxA (69.4%), and algD (60%) genes. Two genes, plcH and plcN, were detected in about 38.8% of the isolates. Additionally, Imipenem was found as the most active agent against the P. aeruginosa isolates used in this research. However, Cefotaxime resistance was observed in most of the isolates. Our P. aeruginosa isolates exhibited a great degree of heterogeneity not only in their virulence genes but also in their antimicrobial susceptibility profiles. Imipenem therapies tend to be among the best choices in the management of UTI caused by P. aeruginosa. As a conclusion, assessment of antimicrobial susceptibility pattern and also analyzing the virulence factors can be highly helpful to develop effective treatment strategies against P. aeruginosa urinary infections.
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Affiliation(s)
- Ali Badamchi
- Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Masoumi
- Research Center of Pediatric Infectious Diseases, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Shima Javadinia
- Research Center of Pediatric Infectious Diseases, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ramin Asgarian
- Research Center of Pediatric Infectious Diseases, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Azardokht Tabatabaee
- Research Center of Pediatric Infectious Diseases, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
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Shafreen RB, Seema S, Ahamed AP, Thajuddin N, Ali Alharbi S. Inhibitory Effect of Biosynthesized Silver Nanoparticles from Extract of Nitzschia palea Against Curli-Mediated Biofilm of Escherichia coli. Appl Biochem Biotechnol 2017; 183:1351-1361. [DOI: 10.1007/s12010-017-2503-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 05/03/2017] [Indexed: 10/19/2022]
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An Epidemiological Study on the Prevalence and Antibiotic Resistance Patterns of Bacteria Isolated from Urinary Tract Infections in Central Iran. ACTA ACUST UNITED AC 2017. [DOI: 10.5812/ajcmi.42214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Clinical risk factors, bacterial aetiology, and outcome of urinary tract infection in children hospitalized with diarrhoea in Bangladesh. Epidemiol Infect 2016; 145:1018-1024. [PMID: 28029092 DOI: 10.1017/s0950268816002971] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Urinary tract infection (UTI) is common in children aged <5 years with diarrhoea, but little is known about risk factors, aetiology and outcome of such children. We aimed to evaluate these knowledge gaps of UTI in children aged <5 years with diarrhoea. We enrolled all children aged <5 years with diarrhoea admitted to Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh, between May 2011 and April 2013, who had history of fever (⩾38 °C) and obtained a urine sample for culture. Diarrhoea with UTI (confirmed by culture) constituted cases (n = 26) and those without UTI constituted controls (n = 78). Threefold controls were randomly selected. The case-fatality rate was comparable in cases and controls (4% vs. 1%, P = 0·439). Escherichia coli (69%) and Klebsiella (15%) were the most commonly isolated pathogens. Persistent diarrhoea, pneumonia and prior antibiotics use were identified as risk factors for UTI in logistic regression analysis (P < 0·05 for all). Thus, children with diarrhoea presenting with persistent diarrhoea, pneumonia, and prior antibiotic use should be investigated for UTI for their prompt management that may reduce morbidity.
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Wani KA, Ashraf M, Bhat JA, Parry NA, Shaheen L, Bhat SA. Paediatric Urinary Tract Infection: A Hospital Based Experience. J Clin Diagn Res 2016; 10:SC04-SC07. [PMID: 27891414 DOI: 10.7860/jcdr/2016/20174.8746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 08/01/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Paediatric Urinary Tract Infection (UTI) is one of the commonly encountered entities by paediatricians. Studies have shown easy vulnerability of paediatric urinary tract in any acute febrile illness and a miss in diagnosis could have long term consequences like renal scaring with its adverse effects. Bearing these evidence based preludes in view we designed our study to know the prevalence of UTI in Kashmir province. AIM Aim of the present study was to know the prevalence of UTI in febrile children and to know the sensitivity of different imaging modalities like Renal and Urinary Bladder Ultrasonography (RUS), Voiding Cystourethrography (VCUG) and Dimercaptosuccinic Acid (DMSA) scan in diagnosing UTI. MATERIALS AND METHODS A total of 304 patients, between 2 months to 10 years, with axillary temperature of ≥ 100.4oF (38oC), who did not have a definite source for their fever and who were not on antibiotics were included in the study. Detailed history and through clinical examination was done to rule out any potential or definite focus of infection as per the predesigned proforma. Routine urine examination with culture and sensitivity, followed by RUS and VCUG was done in all patients where routine urine examination was suggestive of UTI. DMSA was done in only culture proven cases after 6 months to document the renal scarring. RESULTS Out of 304 children, 140 were males and 164 were females, UTI was present in 40 patients who had fever without any apparent cause giving a prevalence of 13.2%. Escherichia coli (E. coli) were the commonest isolated organism, followed by Klebsiella and Citrobacter species. Renal and Urinary Bladder Ultrasonography (RUS) detected Vesicoureteral Reflux (VUR) in 25% (10/40) while VCUG showed VUR in 55% (22/40) giving a RUS sensitivity of 45% for detecting VUR. DMSA done only after 6 months in UTI diagnosed patients showed a renal scarring in 25% (10/40) patients. CONCLUSION Missing a febrile paediatric UTI, can prove a future catastrophe if not timely diagnosed and treated.
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Affiliation(s)
- Khursheed Ahmed Wani
- Professor, Department of Pediatrics, Government Medical College , Srinagar, Jammu & Kashmir, India
| | - Mohd Ashraf
- Lecturer Pediatric Nephrology, Department of Pediatrics, Government Medical College , Srinagar, Jammu & Kashmir, India
| | - Javaid Ahmed Bhat
- Registrar, Department of Pediatrics, Government Medical College , Srinagar, Jammu & Kashmir, India
| | - Nazir Ahmed Parry
- Consultant Pediatrics, Jammu & Kashmir Health Services , Jammu & Kashmir, India
| | - Lubna Shaheen
- Aastha Multispecialty Hospital , Chakkar, Mandi Himachal Pradesh, India
| | - Sartaj Ali Bhat
- Registrar, Department of Pediatrics, Government Medical College , Srinagar, Jammu & Kashmir, India
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Yilmaz Y, Tekkanat Tazegun Z, Aydin E, Dulger M. Bacterial Uropathogens Causing Urinary Tract Infection and Their Resistance Patterns Among Children in Turkey. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016; 18:e26610. [PMID: 27621929 PMCID: PMC5003060 DOI: 10.5812/ircmj.26610] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Revised: 04/06/2015] [Accepted: 04/14/2015] [Indexed: 11/16/2022]
Abstract
Background Urinary tract infection (UTI) is a common problem in infants and children, as well as adults. Objectives The aim of this study was to assess the most common bacterial uropathogens, their susceptibility, and resistance to antibiotics in children with UTI. Materials and Methods This study included 7,365 urine samples sent from various departments to the Kars state hospital microbiology laboratory between January 2012 and May 2014. Bacterial isolation from clinical samples was made using standard microbiological methods. Antibiotic susceptibilities were determined by disk diffusion, according to CLSI recommendations. Results Bacterial growth was obtained in 1,373 samples (18.5%). The percentage distributions of the isolates were as follows: Escherichia coli, 940 (68.5%); Proteus spp, 183 (13.3%); Staphylococcus spp, 85 (6.2%); Enterococcus spp, 65 (4.7%); Klebsiella, 62 (4.5%); Pseudomonas aeruginosa, 21 (1.5%); and other Gram-negative bacteria and Gram-positive bacteria, 17 (1.2%). UTIs were more prevalent, after two years of age, among females than males (P < 0.001). Conclusions The identification of the most common microorganisms causing infectious diseases and regional resistance patterns is important in order to determine the antimicrobial policies and infection control guidelines of hospitals.
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Affiliation(s)
- Yunus Yilmaz
- Department of Pediatrics, Kafkas University Training and Research Hospital, Kars, Turkey
- Corresponding Author: Yunus Yilmaz, Department of Pediatrics, Kafkas University Training and Research Hospital, Kars, Turkey. Tel: +90-5069090995, Fax: +90-4742251430, E-mail:
| | | | - Emsal Aydin
- Department of Infectious Diseases and Clinical Microbiology, Kafkas University Training and Research Hospital, Kars, Turkey
| | - Mahmut Dulger
- Department of Infectious Diseases and Clinical Microbiology, Kars Government Hospital, Kars, Turkey
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Bacterial Etiologies and Antibiotic Susceptibility Pattern of Urinary Tract Infections at the Pediatric Ward of Dastgheib Hospital, Shiraz, Iran: A Three-Year Study (2009 - 2011). ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2016. [DOI: 10.5812/archcid.28973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sharma N, Gupta AK, Walia G, Bakhshi R. A retrospective study of the changing trends of antimicrobial resistance of Klebsiella pneumoniae isolated from urine samples over last 3 years (2012-2014). J Nat Sci Biol Med 2016; 7:39-42. [PMID: 27003967 PMCID: PMC4780164 DOI: 10.4103/0976-9668.175060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: In our country, the problem of antibiotic resistance is compounding because of overuse and misuse of antibiotics. There is no systematic national surveillance of antibiotic resistance and insufficient data are available to quantify the problem. Objectives: To study the changing pattern of antimicrobial resistance of Klebsiella pneumoniae isolates from patients of urinary tract infections over last 3 years. Materials and Methods: A retrospective, record-based study carried out based on the records culture sensitivity reports of indoor patients, during past 3 years (2012-2014). The type of organisms most common in urine sample was noted, and the drugs still effective for the particular organism were noted. Results: Klebsiella was the second most frequent isolate throughout the 3 years (14%) of the total isolates). Analysis of the results year wise indicated that the lowest percentage of resistance was manifested against imipenem between 11.94% (2012) and 13.75% (2014). Over the successive years, resistance to ceftriaxone tends to increase from 74.95 % (2012) to 81% (2014). Klebsiella showed very high resistance 90.78% (2012) and 95.63% (2012) to co-trimoxazole and tetracycline, respectively with increasing trend to absolute resistance to both groups over the 3 years period. On an average over the 3 years Klebsiella showed a high amount of resistances to fluoroquinolones (72.71%) and aminoglycosides (76.22%). While multi-drug resistant Klebsiella range between 65% (2012) and 67% (2014). Conclusion: The antimicrobial resistance patterns are constantly evolving and vary from region to region it has become a necessity to do constant antimicrobial sensitivity surveillance. This will help clinicians to provide safe and effective empirical therapies.
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Affiliation(s)
- Neetu Sharma
- Department of Pharmacology, Government Medical College, Patiala, Punjab, India
| | - Anita K Gupta
- Department of Pharmacology, Government Medical College, Patiala, Punjab, India
| | - Geeta Walia
- Department of Microbiology, Government Medical College, Patiala, Punjab, India
| | - Rupinder Bakhshi
- Department of Microbiology, Government Medical College, Patiala, Punjab, India
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Adeep M, Nima T, Kezang W, Tshokey T. A retrospective analysis of the etiologic agents and antibiotic susceptibility pattern of uropathogens isolated in the Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan. BMC Res Notes 2016; 9:54. [PMID: 26825932 PMCID: PMC4733272 DOI: 10.1186/s13104-015-1728-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 11/20/2015] [Indexed: 11/17/2022] Open
Abstract
Background Urinary tract infection is one of the major public health problems. Specific population studies to understand the common etiologic agents and antibiotic susceptibility patterns are important to determine the empirical treatment of urinary tract infections. This is the first study in Bhutan to analyze the etiologic agents and antibiotic susceptibility pattern of uropathogens isolated from patients visiting Jigme Dorji Wangchuck National Referral Hospital with the ultimate goal of guiding empirical treatment. Methods Hospital based (inpatients/outpatients) retrospective cross sectional study of 6030 clinically suspected patients with urinary tract infections who have submitted urine samples for culture in a 6 months period was done. Urine samples were collected and processed as per standard microbiological procedures and antibiotic susceptibility testing performed by CLSI guidelines. Results Significant bacteriuria were detected in 14.9 % of the total patients. The most common uropathogens isolated were Escherichia coli (79.3 %) followed by Klebsiella pneumoniae. Females around the age group of 18–26 have the highest prevalence of urinary tract infection. The highest rate of antibiotic resistance was seen in amoxicillin (71.4 %) and nalidixic acid (80.3 %), and resistance were lower in nitrofuration (3.4 %) and gentamycin (17.5 %). The third generation cephalosporin resistance (which is a surrogate marker of ESBL) was 16.1 % in outpatient and 16.7 % approximately in inpatient setting. Conclusion Escherichia coli was the predominant uropathogen making up 79.3 % (outpatient 81.1 % and inpatient 69.5 %) of the total and its antibiotic susceptibility pattern needs to be considered for treating community-acquired UTIs empirically. The third generation cephalosporin resistance (which is a surrogate marker of ESBL) is alarmingly high among the isolates and there is need for further studies.
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Affiliation(s)
- M Adeep
- Microbiology unit, Department of Laboratory Services, JDWNRH, Thimphu, Bhutan.
| | - T Nima
- Microbiology unit, Department of Laboratory Services, JDWNRH, Thimphu, Bhutan.
| | - W Kezang
- Microbiology unit, Department of Laboratory Services, JDWNRH, Thimphu, Bhutan.
| | - T Tshokey
- Microbiology unit, Department of Laboratory Services, JDWNRH, Thimphu, Bhutan.
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Motamedifar M, Sedigh Ebrahim-Saraie H, Mansury D, Khashei R, Hashemizadeh Z, Rajabi A. Antimicrobial Susceptibility Pattern and Age Dependent Etiology of Urinary Tract Infections in Nemazee Hospital, Shiraz, South-West of Iran. INTERNATIONAL JOURNAL OF ENTERIC PATHOGENS 2015. [DOI: 10.17795/ijep26931] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Tajbakhsh E, Tajbakhsh S, Khamesipour F. Isolation and Molecular Detection of Gram Negative Bacteria Causing Urinary Tract Infection in Patients Referred to Shahrekord Hospitals, Iran. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e24779. [PMID: 26082853 PMCID: PMC4464383 DOI: 10.5812/ircmj.17(5)2015.24779] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 02/21/2015] [Accepted: 03/06/2015] [Indexed: 02/05/2023]
Abstract
BACKGROUND Urinary Tract Infections (UTI), and their complications, cause serious health problems, which affect millions of people every year. Infections of the urinary tract are the second most common type of infection in the body and approximately 20% of women are especially prone to UTIs for reasons not yet well understood. Urinary Tract Infections in men are not as common as in women yet can be very serious when they do occur. Accurate identification of bacterial isolates is an essential task of the clinical microbiology laboratory. OBJECTIVES The purpose of this study was to determine the incidence and variety of the causative microbial agents of UTIs in patients who had referred to a medical laboratory of Kashani and Hajar hospital in Shahrekord, Iran. PATIENTS AND METHODS In this cross-sectional study 147 urine samples of patients (urine test results were positive for UTIs) were examined during April to September 2013. A total of 147 urine samples of patients with clinical symptoms of UTI who had been referred to a medical laboratory of Kashani and Hajar hospital in Shahrekord (Iran), were collected and processed immediately for laboratory analysis. RESULTS Escherichia coli was identified as the most common causative agent of UTIs (51.70% of total isolates in both sexes), followed by Klebsiella pneumoniae (K. Pneumoniae) (16.32%). Frequency of Proteus spp., Acinetobacter spp., Entrobacter spp., Citrobacter spp., Pseudomonas aeruginosa (P. aeruginosa) and Providencia spp. was 10.88%, 6.12%, 5.44%, 4.08%, 3.40% and 2.04%, respectively. Statistical analysis by Fisher exact test showed that there was no significant relationship between the type of bacteria and gender (P > 0.05). Chi square test showed that there was no significant relationship between the type of bacteria and the use of catheter and age group (P > 0.05). However, there was a significant relationship between the type of bacteria and the history of hospitalization (P > 0.05). CONCLUSIONS Our findings implied that a wide range of bacteria could be involved in creating urinary tract infection in patients referred to a medical laboratory of Kashani and Hajar hospital in Shahrekord, Iran. Regardless of age, sex and the use of catheter, a wide range of bacteria could be involved in urinary tract infections.
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Affiliation(s)
- Elahe Tajbakhsh
- Department of Microbiology, Faculty of Basic Sciences, Shahrekord Branch, Islamic Azad University, Shahrekord, IR Iran
- Corresponding Author: Elahe Tajbakhsh, Department of Microbiology, Faculty of Basic Sciences, Shahrekord Branch, Islamic Azad University, Shahrekord, IR Iran. Tel: +98-9131841012, Fax: +98-3833361060, E-mail:
| | - Sara Tajbakhsh
- School of Nursing, Shahrekord University of Medical Sciences, Shahrekord, IR Iran
| | - Faham Khamesipour
- Young Researchers and Elite Club, Shahrekord Branch, Islamic Azad University, Shahrekord, IR Iran
- Faculty of Veterinary Medicine, Shahrekord Branch, Islamic Azad University, Shahrekord, IR Iran
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