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Al-Haifi AY, Al-Shami AS, Al-Mehdar AA, Al-Thamarani SM, Saleh MA. Isolation and identification of Candida species from catheter-associated urinary tract infection in Thamar city hospitals, Yemen. Int Microbiol 2024:10.1007/s10123-024-00578-8. [PMID: 39158667 DOI: 10.1007/s10123-024-00578-8] [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: 05/03/2024] [Revised: 08/03/2024] [Accepted: 08/07/2024] [Indexed: 08/20/2024]
Abstract
BACKGROUND The incidence of urinary tract infections associated with Candida is increasing in Yemeni public hospitals. OBJECTIVES The primary objective of this research was to isolate specific Candida species responsible for catheter-associated urinary tract infections (UTIs) and to examine the antifungal sensitivity of these Candida isolates. PATIENTS AND METHODS A total of 200 samples were collected from patients with catheters admitted to multiple hospitals of Thamar city (Yemen). There were 50 positive samples with Candida out of 200 samples. We conducted the primary identification process using the established protocols. Before isolation and identification, all yeast isolates underwent sub-culturing on Sabouraud dextrose agar. We employed the standard microbiological procedures such as Gram staining, colonial morphology analysis, lactophenol cotton blue assay, germ tube formation assessment, colony staining on chrom agar Candida medium, and incubation at 37 °C for 48 h. The assessment of cultures was conducted by evaluating their predominant species. All Candida isolates were tested for antifungal susceptibility using the disk diffusion technique, as indicated by the Clinical and Laboratory Standards Institute (CLSI) M44-A document recommendations. RESULTS In this study, the prevalence of Candida species obtained from catheter-associated UTIs was shown to be the highest among individuals aged 51-60 years (28.0%) and the lowest was among those aged 10-20 years (8.0%). Males exhibit higher rates than females, with males accounting for 56.0 and females for 44.0%, respectively. The predominant strain from catheters linked to urinary tract infections was Candida albicans. The Candida isolates had the highest susceptibility to itraconazole, with fluconazole and nystatin at sensitivity rates of 64, 60, and 50%, respectively. Amphotericin B and ketoconazole exhibited the most elevated concentrations. The p value of duration of catheterization < 5 was significant (p = 0.01), as well as significant in anti-fungal susceptibility testing of itraconazole, ketoconazole, and nystatin which are (p = 0.03), (p = 0.04), and (p = 0.03) respectively. CONCLUSION Urinary tract infection due to candiduria was more common in patients with indwelling urinary catheter. The catheter-associated urinary tract infection caused by Candida species occurred mainly in old male patients. Candia albicans was the predominant Candida species isolated from urinary tract infection associated with urinary catheter at Thamar city hospitals. This study determined that diabetes and antibiotic use are significant predisposing factors associated with isolation of Candida in specimens submitted by patients at Thamar city hospitals.
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Affiliation(s)
- Abdulrahman Y Al-Haifi
- Department of Microbiology, Medical School in Thamar University, Thamar City, Republic of Yemen
| | - Ali Salman Al-Shami
- Department of Pharmacy, Medical School in Thamar University, Thamar City, Republic of Yemen.
- Department of Biomedical Sciences, School of Pharmacy, Lebanese International University, Sanaa City, Republic of Yemen.
| | - Ali A Al-Mehdar
- College of Medicine, Thamar University, Thamar City, Republic of Yemen
| | - Samar M Al-Thamarani
- Department of Microbiology, Medical School in Thamar University, Thamar City, Republic of Yemen
| | - Mohammed A Saleh
- Department of Biochemistry, Faculty of Medicine and Health Science, Sanaa University, Sanaa City, Republic of Yemen
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Mendonça A, Santos H, Franco-Duarte R, Sampaio P. Fungal infections diagnosis - Past, present and future. Res Microbiol 2022; 173:103915. [PMID: 34863883 PMCID: PMC8634697 DOI: 10.1016/j.resmic.2021.103915] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/19/2021] [Accepted: 11/26/2021] [Indexed: 01/07/2023]
Abstract
Despite the scientific advances observed in the recent decades and the emergence of new methodologies, the diagnosis of systemic fungal infections persists as a problematic issue. Fungal cultivation, the standard method that allows a proven diagnosis, has numerous disadvantages, as low sensitivity (only 50% of the patients present positive fungal cultures), and long growth time. These are factors that delay the patient's treatment and, consequently, lead to higher hospital costs. To improve the accuracy and quickness of fungal infections diagnosis, several new methodologies attempt to be implemented in clinical microbiology laboratories. Most of these innovative methods are independent of pathogen isolation, which means that the diagnosis goes from being considered proven to probable. In spite of the advantage of being culture-independent, the majority of the methods lack standardization. PCR-based methods are becoming more and more commonly used, which has earned them an important place in hospital laboratories. This can be perceived now, as PCR-based methodologies have proved to be an essential tool fighting against the COVID-19 pandemic. This review aims to go through the main steps of the diagnosis for systemic fungal infection, from diagnostic classifications, through methodologies considered as "gold standard", to the molecular methods currently used, and finally mentioning some of the more futuristic approaches.
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Botelho TKR, Danielli LJ, Seide M, Borges PP, Cruz AB. Distribution and antifungal susceptibility of Candida species isolated from clinical samples in southern Brazil. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e20727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Singh DP, Kumar Verma R, Sarswat S, Saraswat S. Non- Candida albicans Candida species: virulence factors and species identification in India. Curr Med Mycol 2021; 7:8-13. [PMID: 35028479 PMCID: PMC8740851 DOI: 10.18502/cmm.7.2.7032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/14/2021] [Accepted: 05/10/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND AND PURPOSE The predominant cause of candidiasis was Candida albicans which has recently changed to non-Candida albicans Candida (NCAC) (i.e., Candida spp. other than the C. albicans). The NCAC spp., earlier considered non-pathogenic or minimally virulent, are now considered a primary cause of morbidity and mortality in immunocompromised individuals. Given the NCAC spp.has become more common in clinical cases, this study aimed to determine the prevalence of NCAC spp. in different clinical specimens and assess a few of their virulence factors. MATERIALS AND METHODS Routine samples for bacterial culture and sensitivity that showed colony characteristics, like Candida on Blood Agar and microscopic features resembling Candida spp., were processed further. Candida isolates underwent tests for chlamydospore formation and biochemical tests, including sugar fermentation and sugar assimilation tests. These were grown at 42oC, and their colony color was identified using HiCromeTM Candida Differential Agar (HiMedia Laboratories Pvt. Ltd., Mumbai, India), HiCandida TM Identification Kit (HiMedia Laboratories Pvt. Ltd., Mumbai, India), and VITEK-2® Compact (Biomérieux, France). Virulence factors, such as adherence to buccal epithelial cells (ABEC), biofilm formation, hemolytic activity, and production of coagulase enzyme were also tested. RESULTS Mean age of the patients was 38.46 years with a male-female ratio of 1.36:1. In total, 137 Candida isolates were recovered; 45.3%, 19.7%, and 13.9% of the isolates were isolated from urine, vaginal swabs, and oropharyngeal swabs, respectively. Moreover, 55 (40.1%) isolates were those of C. albicans and 82 (59.9%) isolates belonged to NCAC spp., with C. tropicalis (23.4%) contributing highest among NCAC species. Furthermore, C. albicans (3; 50%) was the most common spp. in cases of candidemia. Haemolysin production (85.5%) and ABEC (78.2%) were the major virulence factors in C. albicans. C. tropicalis (59.4%) and C. dubliniensis (50%) showed maximum ABEC. Biofilm forming capacity was higher in C. tropicalis (78.1%) than C. albicans (67%). CONCLUSION Results of this study suggest varied prevalence and virulence based on geographical locations, even within a subcontinent. It clearly indicates the emergence of the NCAC spp. and their predominance in different body fluids. Identification of Candida to the spp. level should become a routine in all laboratories.
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Affiliation(s)
| | - Rajesh Kumar Verma
- Department of Microbiology, Uttar Pradesh University of Medical Sciences, Saifai, India
| | - Swati Sarswat
- Department of Community Medicine, Gajra Raja Medical College, Gwalior, India
| | - Satender Saraswat
- Department of Microbiology, Uttar Pradesh University of Medical Sciences, Saifai, India
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A New Gold Rush: A Review of Current and Developing Diagnostic Tools for Urinary Tract Infections. Diagnostics (Basel) 2021; 11:diagnostics11030479. [PMID: 33803202 PMCID: PMC7998255 DOI: 10.3390/diagnostics11030479] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/03/2021] [Accepted: 03/05/2021] [Indexed: 11/16/2022] Open
Abstract
Urinary tract infections (UTIs) are one of the most common infections in the United States and consequently are responsible for significant healthcare expenditure. The standard urine culture is the current gold standard for diagnosing urinary tract infections, however there are limitations of the test that directly contribute to increased healthcare costs. As a result, new and innovative techniques have been developed to address the inefficiencies of the current standard-it remains to be seen whether these tests should be performed adjunctly to, or perhaps even replace the urine culture. This review aims to analyze the advantages and disadvantages of the newer and emerging diagnostic techniques such as PCR, expanded quantitative urine culture (EQUC), and next generation sequencing (NGS).
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Duque CM, Sanchez DM, Gaviria A, Vallejo Acosta A, Gómez B, Gómez OM, Rua Giraldo A, Hernandez O. Caracterización de Candida spp. aisladas a partir de urocultivos en la ciudad de Medellín. INFECTIO 2020. [DOI: 10.22354/in.v24i4.879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Candida spp. es un agente etiológico importante en infecciones del tracto urinario, principalmente en población con terapia antimicótica de amplio espectro y con catéteres urinarios. Candida albicans es la especie más frecuente, pero otras especies han surgido como patógenos emergentes. En este trabajo se recolectaron aislamientos de Candida spp. de urocultivos de pacientes que consultaron en Dinamica IPS entre enero 2016 y noviembre 2017. Para estimar la frecuencia de las especies y observar los patrones de sensibilidad, se realizó la identificación fenotípica y su perfil de sensibilidad con el sistema comercial Vitek 2® (BioMérieux, Inc.), adicionalmente se evaluaron mediante análisis de las secuencia y filogenética ITS1-5.8S-ITS2. En el estudio se incluyeron 78 aislamientos de Candida spp. Las frecuencias de especies de Candida identificadas empleando las herramientas moleculares fueron: C. albicans (38,5%), C. tropicalis (23,1%), C. glabrata (21,8%), C. parapsilosis (10,3%), C. metapsilosis y C. krusei (2,5%) y C. guillermondi (1,3%). La identificación por métodos moleculares y por el sistema Vitek 2 fue: C. albicans (93,3%), C. glabrata (94,1 %), C. tropicalis (83,3%), C. parapsilosis (75%) C. guilliermondii y C. krusei (100%). La sensibilidad de todos los aislamientos al fluconazol fue 93,6%.
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Edward EA, Mohamed NM, Zakaria AS. Resensitization of Fluconazole-Resistant Urinary Candida spp. Isolates by Amikacin through Downregulation of Efflux Pump Genes. Pol J Microbiol 2020; 69:73-84. [PMID: 32189482 PMCID: PMC7256858 DOI: 10.33073/pjm-2020-010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/11/2020] [Accepted: 02/06/2020] [Indexed: 10/26/2022] Open
Abstract
The contribution of fluconazole-resistant Candida spp. isolates to urinary tract infections in Egypt has become a nationwide problem. A recent approach to overcome such disaster is combining conventional antifungals with non-antifungals. This study investigated the interaction of amikacin with fluconazole against resistant Candida strains isolated from the urine culture of patients admitted to Alexandria Main University Hospital. Among the collected Candida spp. isolates, 42.9% were resistant to fluconazole with MICs ranging between 128 and 1,024 μg/ml. The resistance-modifying activity of amikacin (4,000 μg/ml) was studied against fluconazole-resistant isolates where amikacin sensitized 91.7 % of resistant Candida spp. isolates to fluconazole with a modulation factor ranging between 32 and 256. The rhodamine efflux assay was performed to examine the impact of amikacin on efflux pump activity. After 120 minutes of treatment, amikacin affected the efflux pump activity of the isolates tested with a percentage of reduction in the fluorescence intensity of 8.9%. Quantitative real-time PCR was applied to assess the amikacin effect on the expression of the efflux pump genes MDR1, CDR1, and CDR2. The downregulatory effect of amikacin on the expression of the studied genes caused a percentage of reduction in the expression level ranging between 42.1 and 94%. In conclusion, amikacin resensitized resistant Candida spp. isolates to fluconazole and could be used in combination in the management of candiduria with a higher efficiency or at lower administration doses. To the best of our knowledge, this is the first study evaluating the enhancement of fluconazole activity in combination with amikacin against Candida spp. The contribution of fluconazole-resistant Candida spp. isolates to urinary tract infections in Egypt has become a nationwide problem. A recent approach to overcome such disaster is combining conventional antifungals with non-antifungals. This study investigated the interaction of amikacin with fluconazole against resistant Candida strains isolated from the urine culture of patients admitted to Alexandria Main University Hospital. Among the collected Candida spp. isolates, 42.9% were resistant to fluconazole with MICs ranging between 128 and 1,024 μg/ml. The resistance-modifying activity of amikacin (4,000 μg/ml) was studied against fluconazole-resistant isolates where amikacin sensitized 91.7 % of resistant Candida spp. isolates to fluconazole with a modulation factor ranging between 32 and 256. The rhodamine efflux assay was performed to examine the impact of amikacin on efflux pump activity. After 120 minutes of treatment, amikacin affected the efflux pump activity of the isolates tested with a percentage of reduction in the fluorescence intensity of 8.9%. Quantitative real-time PCR was applied to assess the amikacin effect on the expression of the efflux pump genes MDR1, CDR1, and CDR2. The downregulatory effect of amikacin on the expression of the studied genes caused a percentage of reduction in the expression level ranging between 42.1 and 94%. In conclusion, amikacin resensitized resistant Candida spp. isolates to fluconazole and could be used in combination in the management of candiduria with a higher efficiency or at lower administration doses. To the best of our knowledge, this is the first study evaluating the enhancement of fluconazole activity in combination with amikacin against Candida spp.
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Affiliation(s)
- Eva A Edward
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University , Egypt
| | - Nelly M Mohamed
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University , Egypt
| | - Azza S Zakaria
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University , Egypt
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Barati M, Mirkalantari S, Ansari S, Salari S, Fattahi A. Determination of antimicotic susceptibility pattern of Candida species isolated from patients with symptomatic candiduria. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2019; 24:35. [PMID: 31143236 PMCID: PMC6521611 DOI: 10.4103/jrms.jrms_880_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 01/01/2019] [Accepted: 01/16/2019] [Indexed: 12/20/2022]
Abstract
Background The present study was conducted to determine antimicotic susceptibility of Candida species (sp.) from patients with symptomatic candiduria. Materials and Methods Identification of Candida sp. and determination of efficacy of most routine antifungals were done using polymerase chain reaction-restriction fragment length polymorphism method and E-test, respectively. Results The results from susceptibility test reveal that caspofungin and amphotericin B have high antifungal activity against both albicans (100% and 96%, respectively) and nonalbicans (95.11% and 72.72%, respectively) isolates. Conclusion The present study suggests that caspofungin and amphotericin B have the excellent ability to eradicate both Candida groups that showed decreased susceptibility to other compounds.
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Affiliation(s)
- Mitra Barati
- Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran.,Department of Infectious Disease, Rasul-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Shiva Mirkalantari
- Department of Microbiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Microbiol Biotechnology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saham Ansari
- Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Scienses, Tehran, Iran
| | - Samira Salari
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran.,Department of Medical Mycology and Parasitology, School of Medicine, Medical University of Kerman, Kerman, Iran
| | - Azam Fattahi
- Center for Research and Training in Skin Disease and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
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Zhengxin H, Haipu Z, Yan C, Xiangyang R, Jing C, Xiaosai H, Fukun W. Performance of yeast-like cell counting (YLCC) using the Sysmex UF-1000i for clinical candiduria screening. Eur J Clin Microbiol Infect Dis 2019; 38:891-894. [PMID: 30767096 DOI: 10.1007/s10096-019-03491-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 01/17/2019] [Indexed: 11/29/2022]
Abstract
Candiduria is common in clinical practice. However, an effective and convenient assay to screen for candiduria is still needed. This study aimed to evaluate the performance of the Sysmex UF-1000i urine analyzer for yeast-like cell counting (YLCC) to screen for candiduria prior to urine culture. We retrospectively analyzed data from 5233 urine samples from 1813 patients, including 837 males and 976 females. Urine culture and urinalysis-obtained YLCC data were used to estimate the performance of YLCC in diagnosing candiduria. Different cutoff values were used to calculate sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The YLCC-positive rates differed according to the Candida colony-forming units (CFU) counts in the urine samples. A sharp drop in YLCC-positive rate (from 64.3 to 22.0%) was observed between the urine groups with 104 CFUs and 103 CFUs. A cutoff value of 0 YLCs/μL results in the highest Youden index (0.71) with 77.04% sensitivity and 93.68% specificity. In a group of 34 hospitalized candiduria patients with serial urinalysis data, 25 were YLCC-positive before urine culture. In conclusion, YLCC with the Sysmax UF-1000i could serve as an auxiliary technique to exclude culture-negative specimens prior to urine culture. Positive YLCC results could imply candiduria, especially when persistent YLCC-positive results were observed.
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Affiliation(s)
- He Zhengxin
- Department of Clinical Laboratory, Bethune International Peace Hospital of PLA, 398 Zhongshan Road, Shijiazhuang, 050082, Hebei, People's Republic of China.
| | - Zhang Haipu
- Department of Clinical Laboratory, Bethune International Peace Hospital of PLA, 398 Zhongshan Road, Shijiazhuang, 050082, Hebei, People's Republic of China
| | - Cheng Yan
- Department of Clinical Laboratory, Bethune International Peace Hospital of PLA, 398 Zhongshan Road, Shijiazhuang, 050082, Hebei, People's Republic of China
| | - Ran Xiangyang
- Department of Clinical Laboratory, Bethune International Peace Hospital of PLA, 398 Zhongshan Road, Shijiazhuang, 050082, Hebei, People's Republic of China
| | - Chen Jing
- Department of Clinical Laboratory, Bethune International Peace Hospital of PLA, 398 Zhongshan Road, Shijiazhuang, 050082, Hebei, People's Republic of China
| | - Huo Xiaosai
- Department of Clinical Laboratory, Bethune International Peace Hospital of PLA, 398 Zhongshan Road, Shijiazhuang, 050082, Hebei, People's Republic of China
| | - Wang Fukun
- Department of Clinical Laboratory, Bethune International Peace Hospital of PLA, 398 Zhongshan Road, Shijiazhuang, 050082, Hebei, People's Republic of China.
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Toner L, Papa N, Aliyu SH, Dev H, Lawrentschuk N, Al-Hayek S. Vancomycin resistant enterococci in urine cultures: Antibiotic susceptibility trends over a decade at a tertiary hospital in the United Kingdom. Investig Clin Urol 2016; 57:129-34. [PMID: 26981595 PMCID: PMC4791667 DOI: 10.4111/icu.2016.57.2.129] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 02/23/2016] [Indexed: 11/23/2022] Open
Abstract
Purpose Enterococci are a common cause of urinary tract infection and vancomycin-resistant strains are more difficult to treat. The purpose of this surveillance program was to assess the prevalence of and determine the risk factors for vancomycin resistance in adults among urinary isolates of Enterococcus sp. and to detail the antibiotic susceptibility profile, which can be used to guide empirical treatment. Materials and Methods From 2005 to 2014 we retrospectively reviewed 5,528 positive Enterococcus sp. urine cultures recorded in a computerized laboratory results database at a tertiary teaching hospital in Cambridge, United Kingdom. Results Of these cultures, 542 (9.8%) were vancomycin resistant. No longitudinal trend was observed in the proportion of vancomycin-resistant strains over the course of the study. We observed emerging resistance to nitrofurantoin with rates climbing from near zero to 40%. Ampicillin resistance fluctuated between 50% and 90%. Low resistance was observed for linezolid and quinupristin/dalfopristin. Female sex and inpatient status were identified as risk factors for vancomycin resistance. Conclusions The incidence of vancomycin resistance among urinary isolates was stable over the last decade. Although resistance to nitrofurantoin has increased, it still serves as an appropriate first choice in uncomplicated urinary tract infection caused by vancomycin-resistant Enterococcus sp.
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Affiliation(s)
- Liam Toner
- Department of Surgery, Urology Unit, University of Melbourne, Melbourne, Australia
| | - Nathan Papa
- Department of Surgery, Urology Unit, University of Melbourne, Melbourne, Australia
| | - Sani H Aliyu
- Department of Microbiology, Addenbrookes' Hospital, Cambridge University, Cambridge, UK
| | - Harveer Dev
- Department of Urology, Addenbrookes' Hospital, Cambridge University, Cambridge, UK
| | - Nathan Lawrentschuk
- Department of Surgery, Urology Unit, University of Melbourne, Melbourne, Australia.; Olivia Newton-John Cancer Research Institute, Austin Health, Melbourne, Australia.; Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Samih Al-Hayek
- Department of Urology, Addenbrookes' Hospital, Cambridge University, Cambridge, UK
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