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Abu Aleinein I, Salem Sokhn E. Knowledge and prevalence of urinary tract infection among pregnant women in Lebanon. Heliyon 2024; 10:e37277. [PMID: 39296194 PMCID: PMC11408011 DOI: 10.1016/j.heliyon.2024.e37277] [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: 03/26/2024] [Revised: 06/26/2024] [Accepted: 08/30/2024] [Indexed: 09/21/2024] Open
Abstract
Urinary tract infections (UTIs) rank among the most prevalent medical complications during pregnancy, affecting a significant number of women of reproductive age. We aimed to determine the prevalence of urinary tract infections among pregnant women and assess their knowledge of developing UTIs in Lebanon. A cross-sectional descriptive study was conducted among 215 pregnant women in Lebanon recruited via convenience sampling from various gynecologists and midwives between March 2023 and May 2023. A structured questionnaire was utilized to evaluate UTI prevalence and participants' knowledge levels. Data analysis was performed using SPSS Statistics version 27. A significance level of P < 0.05 was considered statistically significant for all analyses. This analysis revealed a UTI prevalence of 42.79% (95% CI: 38.21%-47.37%), The mean age of participants was 28.57 years. Knowledge assessment revealed that 66.51% (143/215) had average knowledge about UTIs, 20.47% (44/215) demonstrated good knowledge, and 12.79% (28/215) showed poor knowledge. Significant correlations were found between UTI prevalence and socioeconomic factors (P = 0.03), indicating higher incidence among women from lower economic backgrounds. Abnormal vaginal discharge was strongly associated with UTI prevalence (P < 0.001), suggesting it as a prominent symptom or risk factor. Additionally, a history of abortion correlated significantly with increased UTI incidence (P = 0.02), highlighting its relevance in pregnancy-related UTI risk. The study underscores the need for education programs tailored to raise awareness about UTI risks during pregnancy and promote preventive measures. Implementing these programs could significantly enhance maternal health outcomes in Lebanon.
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Affiliation(s)
- Iman Abu Aleinein
- Department of Nursing, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Elie Salem Sokhn
- Molecular Testing Laboratory, Department of Medical Laboratory Technology, Faculty of Health Sciences, Beirut Arab University, Beirut, P.O. Box 11-5020, Lebanon
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Iddrisu AK, Owusu G, Doe SK, Yeboah AA, Agyapong J, Yankey N. Uropathogens and their antibiotic susceptibility patterns among diabetic patients at st. john of god hospital, duayaw nkwanta, Ghana: a cross-sectional study. Health Sci Rep 2024; 7:e70072. [PMID: 39296635 PMCID: PMC11409053 DOI: 10.1002/hsr2.70072] [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] [Received: 03/21/2024] [Revised: 08/31/2024] [Accepted: 09/04/2024] [Indexed: 09/21/2024] Open
Abstract
Background Uropathogens are microorganisms that cause urinary tract infections (UTIs). Owing to higher blood glucose levels and compromised immune functions, treatment of uropathogens in diabetic patients is a challenge. Aim This study aims to assess the prevalence of uropathogens and their antibiotic susceptibility among diabetic patients at St. John of God Hospital at Duayaw Nkwanta (SJGHDN) in the Ahafo region of Ghana. Methods The cross-sectional study recruited 175 diabetic patients at SJGHDN between August and September 2023. Questionnaires were used to collect patients' background information. Fasting Blood Sugar (FBS) was assessed by using a glucometer. Urine samples were examined for the presence of uropathogens. A sterile inoculating loop with a calibrated volume of 2 µl was used for plating. Each colony equals 500 CFU/mL. Significant uropathogen was determined by multiplying the counted colonies by 500 to obtain CFU/mL. Positive uropathogen was defined as CFU ≥ 105/mL. Significant uropathogen was defined as ≥200 colonies per sample. The disc diffusion method was used to determine antibiotic susceptibility. Results Out of the 175 patients, 19.4% expressed various uropathogens with Escherichia coli being the predominant. Suboptimal glucose level was the most significant risk factor (p = 0.038). Glucosuria (p = 0.036), hazy urine (p = 0.028), positive leukocyte esterase (p = 0.001), and pus cells in urine sediment (p = 0.020) were significant indicators of uropathogen occurrence. Klebsiella pneumonia and Proteus mirabilis were resistant to ≥4 antibiotics. Amikacin, nitrofurantoin, levofloxacin, ciprofloxacin, and ceftriaxone demonstrated efficacy against the isolates. Conclusion This study underscores the notable prevalence of uropathogens in diabetic patients and the alarming levels of antibiotic resistance observed. The results highlight the critical need for vigilant monitoring and customized treatment approaches, particularly for diabetic patients exhibiting risk factors such as elevated urine glucose levels, cloudy urine, and presence of leukocyte esterase and pus cells in urine sediment. The significant resistance to frequently used antibiotics like co-trimoxazole and tetracycline points to the necessity of routine susceptibility testing and the use of alternative antibiotics for effective treatment. These findings can assist healthcare providers in more effectively managing and preventing UTIs in diabetic populations.
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Affiliation(s)
- Abdul-Karim Iddrisu
- Department of Mathematics and Statistics University of Energy and Natural Resources Sunyani Ghana
| | - George Owusu
- Department of Medical Laboratory Science University of Energy and Natural Resources Sunyani Ghana
| | - Samuel Kofi Doe
- Department of Medical Laboratory Science University of Energy and Natural Resources Sunyani Ghana
| | - Augustine Apraku Yeboah
- Department of Medical Laboratory Science University of Energy and Natural Resources Sunyani Ghana
| | - Joseph Agyapong
- Department of Medical Laboratory Science University of Energy and Natural Resources Sunyani Ghana
| | - Nicholas Yankey
- Department of Medical Laboratory Science University of Energy and Natural Resources Sunyani Ghana
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Ilangage JIMK, Ilangakoon IACS, Fernando KMK, Dissanayake DMMK, Rajapaksha NPD, Walpola LH, Hettiarachchi D. In vitro-antibacterial properties of ten medicinal plants against common uropathogenic organisms and toxicity determination using brine shrimp lethality assay. BMC Complement Med Ther 2024; 24:301. [PMID: 39143605 PMCID: PMC11323449 DOI: 10.1186/s12906-024-04595-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 07/18/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND In recent years, antibiotic resistance has emerged as a global health concern in bacterial infections such as urinary tract infections (UTIs). Uropathogenic Escherichia coli is the most frequent organism responsible for both simple and complex UTIs. Staphylococcus aureus and Pseudomonas aeruginosa are frequently associated with complicated UTIs. Sri Lanka has significant resources of medicinal plants used to cure UTIs in Ayurvedic and traditional medicine. METHODS Agar well diffusion and broth microdilution methods were used to determine the antibacterial activity of the methanolic extract of ten medicinal plants against P. aeruginosa ATCC27853, S.aureus ATCC25923, E.coli ATCC25922 and their UTI positive strains extracted from positive culture plates. As a preliminary toxicity assay, the Brine Shrimp Lethality Assay (BSLA) was used to determine its cytotoxicity. RESULTS The methanolic fruits extract of P. emblica demonstrated the highest antibacterial activity against both E. coli ATCC25922 and E. coli UTI-positive strains. B. diffusa roots extract exhibited the highest activity against S. aureus ATCC25923, while T. chebula fruits extract showed the highest activity against the S. aureus UTI-positive strain. T. involucrata roots extract displayed the highest activity against P. aeruginosa ATCC27853, and Z. officinale rhizomes extract showed the highest activity against the P. aeruginosa UTI-positive strain. Moreover, the plant mixture showed the most substantial antibacterial effect against P. aeruginosa ATCC27853. However, the methanolic seed extract of C. melo did not exhibit any antimicrobial effects against the selected organisms. All plant material, including the plant mixture, showed cytotoxicity according to the BSLA. CONCLUSION All the methanolic extracts including P. emblica fruits, O. tenuiflorum whole plant, T. chebula fruits, Z. officinale rhizome, T. terrestris roots, T. involucrata roots, A. lanata whole plant. B. diffusa roots and A. falcatus roots showed antimicrobial effects against selected strains except C. melo seed extract. The results of the present study evidently supports the traditional and ayurvedic use of these plants for the treatment of UTIs. This paves the way for another praise for new plant-based therapeutic product development for the treatment of UTIs. However, further toxicity studies are needed for medicinal dose determination.
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Affiliation(s)
| | | | | | | | | | - Lakmini Hasanthika Walpola
- Department of Biomedical Science, Faculty of Health Science, Kaatsu International University (KIU), Colombo, Sri Lanka
| | - Dineshani Hettiarachchi
- Department of Anatomy, Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
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Hambali KU, Eilu E, Kumar S, Afolabi AO, Tijani NA, Faseun YO, Odoki M, Gechemba Mokaya C, Makeri D, Jakheng SPE, Sankarapandian V, Adeyemo RO, Adegboyega TT, Adebayo IA, Ntulume I, Akinola SA. Monitoring Multi-Drug Resistant Klebsiella pneumoniae in Kitagata Hot Spring, Southwestern Uganda: A Public Health Implication. Infect Drug Resist 2024; 17:3325-3341. [PMID: 39131514 PMCID: PMC11315647 DOI: 10.2147/idr.s472998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 07/31/2024] [Indexed: 08/13/2024] Open
Abstract
Background The concerning frequency of K. pneumoniae in various recreational settings, is noteworthy, especially regarding multi-drug resistant (MDR) strains. This superbug is linked to the rapid spread of plasmids carrying these resistance genes. The objective of this study was to evaluate the spatiotemporal prevalence of MDR-K. pneumoniae in the Kitagata hot spring, Southwestern Uganda. Methods A laboratory-based descriptive longitudinal study was conducted between May and July 2023. During rainy and dry seasons, we collected eighty water samples in the morning and evening from the hot spring. The temperature at each point was measured prior to sample collection, and two samples were obtained at varying depths. 5 mL of each homogenized sample were pre-enriched in brain heart infusion broth, and subsequently in both blood and violet red bile agar. The Kirby-Bauer disk diffusion method was performed, followed by the detection of carbapenemase (CR) and extended-spectrum β-lactamase (ESBL) production. Polymerase chain reaction showed resistance genes viz. bla TEM, bla CTX-M and bla KPC. Data were analyzed using SPSS-20 to obtain chi-square tests and regression analysis. Results K. pneumoniae accounted for 30.0% of isolates obtained from Kitagata hot springs, with all isolates classified as multi-drug resistant. All isolates were resistant to ampicillin, rifampicin, ceftazidime, and azithromycin (79.2%). Additionally, 95.8% of isolates harbored bla TEM gene alone and both bla TEM and bla CTX genes, followed by bla KPC alone (33.3%), with 25% harboring all three resistance genes. During the dry season, K. pneumoniae had a higher prevalence (35.0%) compared to the wet season (25.0%). The prevalence of MDR-K. pneumoniae significantly increased over the course of the study. The presence of the three studied resistance genes in the isolates showed a positive correlation with the second phase of sample collection and the dry season but exhibited a negative correlation with temperature, except for isolates harboring either bla TEM alone or bla TEM+KPC+CTX genes. Conclusion Kitagata hot spring serves as a hotspot for continuous dissemination and acquisition of MDR-K. pneumoniae harboring resistance genes that encode for ESBL and CR production. The healthcare sector ought to implement an ongoing monitoring and surveillance system as well as robust antimicrobial resistance stewardship programs aimed at delivering health education to the community.
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Affiliation(s)
- Kaltume Umar Hambali
- Department of Medical Microbiology and Immunology, Kampala International University-Western Campus, Ishaka-Bushenyi, Uganda
| | - Emmanuel Eilu
- Department of Medical Microbiology and Immunology, Kampala International University-Western Campus, Ishaka-Bushenyi, Uganda
| | - Sunil Kumar
- Department of Medical Microbiology and Immunology, Kampala International University-Western Campus, Ishaka-Bushenyi, Uganda
| | - Abdullateef Opeyemi Afolabi
- Department of Medical Microbiology and Immunology, Kampala International University-Western Campus, Ishaka-Bushenyi, Uganda
| | - Naheem Adekilekun Tijani
- Department of Medical Microbiology and Immunology, Kampala International University-Western Campus, Ishaka-Bushenyi, Uganda
| | - Yusuf Olusola Faseun
- Department of Medical Microbiology and Immunology, Kampala International University-Western Campus, Ishaka-Bushenyi, Uganda
| | - Martin Odoki
- Department of Medical Microbiology and Immunology, Kampala International University-Western Campus, Ishaka-Bushenyi, Uganda
| | - Christine Gechemba Mokaya
- Department of Medical Microbiology and Immunology, Kampala International University-Western Campus, Ishaka-Bushenyi, Uganda
| | - Danladi Makeri
- Department of Medical Microbiology and Immunology, Kampala International University-Western Campus, Ishaka-Bushenyi, Uganda
| | | | - Vidya Sankarapandian
- Department of Medical Microbiology and Immunology, Kampala International University-Western Campus, Ishaka-Bushenyi, Uganda
| | - Rasheed Omotayo Adeyemo
- Department of Microbiology and Parasitology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda
| | - Taofeek Tope Adegboyega
- Department of Microbiology and Parasitology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda
| | - Ismail Abiola Adebayo
- Department of Medical Biochemistry, Molecular Biology and Genetics, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda
| | - Ibrahim Ntulume
- School of Biosecurity Biotechnical and Laboratory Sciences, College of Medicine and Veterinary Medicine, Makerere University, Kampala, Uganda
| | - Saheed Adekunle Akinola
- Department of Microbiology and Parasitology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda
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Giliazeva A, Akosah Y, Noack J, Mardanova A. Adhesion of Klebsiella oxytoca to bladder or lung epithelial cells is promoted by the presence of other opportunistic pathogens. Microb Pathog 2024; 190:106642. [PMID: 38599551 DOI: 10.1016/j.micpath.2024.106642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 04/02/2024] [Accepted: 04/07/2024] [Indexed: 04/12/2024]
Abstract
The intestinal and respiratory tracts of healthy individuals serve as habitats for a diverse array of microorganisms, among which Klebsiella oxytoca holds significance as a causative agent in numerous community- and hospital-acquired infections, often manifesting in polymicrobial contexts. In specific circumstances, K. oxytoca, alongside other constituents of the gut microbiota, undergoes translocation to distinct physiological niches. In these new environments, it engages in close interactions with other microbial community members. As this interaction may progress to co-infection where the virulence of involved pathogens may be promoted and enhance disease severity, we investigated how K. oxytoca affects the adhesion of commonly co-isolated bacteria and vice versa during co-incubation of different biotic and abiotic surfaces. Co-incubation was beneficial for the adhesion of at least one of the two co-cultured strains. K. oxytoca enhanced the adhesion of other enterobacteria strains to polystyrene and adhered more efficiently to bladder or lung epithelial cell lines in the presence of most enterobacteria strains and S. aureus. This effect was accompanied by bacterial coaggregation mediated by carbohydrate-protein interactions occurring between bacteria. These interactions occur only in sessile, but not planktonic populations, and depend on the features of the surface. The data are of particular importance for the risk assessment of the urinary and respiratory tract infections caused by K. oxytoca, including those device-associated. In this paper, we present the first report on K. oxytoca ability to acquire increased adhesive capacities on epithelial cells through interactions with common causal agents of urinary and respiratory tract infections.
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Affiliation(s)
- Adeliia Giliazeva
- Institute of Biotechnology, Faculty of Environment and Natural Sciences, Brandenburg University of Technology Cottbus-Senftenberg, Universitätsplatz 1, Building 15, 01968, Senftenberg, Germany.
| | - Yaw Akosah
- Department of Molecular Pathobiology, College of Dentistry, New York University, 345 E. 24th St., 10010, New York, USA
| | - Jonas Noack
- Medipan GmbH, Computer Science, Ludwig-Erhard-Ring 3, 15827, Dahlewitz, Germany
| | - Ayslu Mardanova
- Department of Microbiology, Institute of Fundamental Medicine and Biology, Kazan (Volga region) Federal University, Kremlyovskaya 18, 420008, Kazan, Russia
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Sisay A, Seid A, Tadesse S, Abebe W, Shibabaw A. Assessment of bacterial profile, antimicrobial susceptibility status, and associated factors of isolates among hospitalized patients at Dessie Comprehensive Specialized Hospital, Northeast Ethiopia. BMC Microbiol 2024; 24:116. [PMID: 38575901 PMCID: PMC10993541 DOI: 10.1186/s12866-024-03224-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 02/13/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Antimicrobial resistant bacteria among hospitalized patients are becoming a major public health threat worldwide, mainly in developing countries. Infections by these multidrug resistant pathogens cause high rate of mortality, prolong hospital stays, and affect individual and country economies in greater amounts. Thus, this study aimed to assess the bacterial profile, antimicrobial susceptibility status, and associated factors of isolates from hospitalized patients at the Dessie Comprehensive Specialized Hospital. METHODOLOGY This hospital-based cross-sectional study was conducted between February and April 2021. Consecutive sampling was used to select the study participants. All bacterial isolates were identified using standard bacteriological techniques. Antibiotic susceptibility testing was performed using disk diffusion technique. The data was analyzed using SPSS version 25. Descriptive statistics and logistic regression were used. A P-value of less than 0.05 was considered statistically significant. RESULTS Of 384 clinical samples (blood, urine, stool, wound, vaginal discharge, and ear discharge) processed 180 (46.9%) were culture positive. Overall, Escherichia coli was the predominant isolate (41; 22.8%), followed by Staphylococcus aureus (36; 20%). Most of the isolates were from blood (70; 38.9%). The level of overall drug resistance of the gram-negative bacteria isolates for ampicillin, tetracycline, and cotrimoxazole was (104; 88.1%), (79; 75.9%), and (78; 75.0%), respectively. The overall multidrug rate of isolates was 143 (79.4%). Variables such as history of invasive procedures, chronic underlying diseases, history of hospitalization, and habit of eating raw animal products were statistically significant for the acquisition of bacterial infection. CONCLUSIONS AND RECOMMENDATION E. Coli and S. aureus were the most common isolates. Most of the isolates were resistant to commonly prescribed antibiotics. And also, consumption of raw animal products, chronic underlying disease, previous hospitalization, history of invasive procedures, and educational status were associated with the acquisition of bacterial infections. Therefore, routine antimicrobial susceptibility testing, proper patient management, wise use of antibiotics in clinical settings and health education are recommended.
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Affiliation(s)
- Assefa Sisay
- Department of Medical Laboratory Science, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Abdurahaman Seid
- Department of Medical Laboratory Science, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Selamyhun Tadesse
- Department of Medical Laboratory Science, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Wagaw Abebe
- Department of Medical Laboratory Science, College of Health Science, Woldia University, Woldia, Ethiopia.
| | - Agumas Shibabaw
- Department of Medical Laboratory Science, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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Samarawickrama SS, Illangakoon HU, Uthuman A, Saranga V, Janaka C. The Clinical Profile of Patients With Culture-Positive Urinary Tract Infections Admitting to a Tertiary Hospital in Sri Lanka. Cureus 2024; 16:e58666. [PMID: 38774169 PMCID: PMC11106549 DOI: 10.7759/cureus.58666] [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: 04/20/2024] [Indexed: 05/24/2024] Open
Abstract
Introduction Urinary tract infections (UTIs) are globally prevalent. This study explores the clinical and pathological profile of culture-positive UTI patients at Sri Jayewardenepura General Hospital. Method In this descriptive cross-sectional study conducted at Sri Jayewardenepura General Hospital from December 2020 to May 2021, we evaluated patients over 14 years with positive urine culture reports. Excluding those with HIV, undergoing chemotherapy, or pregnant, we used consecutive sampling. Data were collected via interviewer-administered questionnaires and analyzed using SPSS version 21.0 (IBM Inc., Armonk, New York), employing descriptive statistics and Fisher's exact tests to identify factors associated with urinary tract infections. Results The study involved approximately 278 participants. The mean age remained 60 ± 20.279 years, with over half of the participants being female. Common symptoms like fever and lower abdominal pain were observed in 22.30% of cases. The incidence of acute kidney injury was 30.58%. Escherichia coli (36%) and Klebsiella pneumoniae (26%) were the predominant organisms found. Indwelling catheters and other urinary tract conditions were considered risk factors. Patients with at least one risk factor were more likely to receive antibiotics before the urine culture. Similarly, males exhibited a higher prevalence of at least a risk factor than females. Conclusion UTIs are a significant clinical issue in older populations, with females being more susceptible. Fever and abdominal pain were common symptoms. Escherichia coli and Klebsiella pneumoniae were the most frequent causative agents. Further research is necessary to identify risk factors and predictors of antimicrobial resistance in UTI patients.
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Affiliation(s)
- Sincy S Samarawickrama
- Department of Medicine, Goulburn Valley Health, Shepparton, AUS
- Department of Medicine, University of Colombo, Colombo, LKA
| | | | - Ali Uthuman
- Department of Rural Health, University of Melbourne, Shepparton, AUS
- Department of General Medicine, Goulburn Valley Health, Sehpparton, AUS
| | - Vinod Saranga
- Department of Surgery, Sri Jayewardenepura General Hospital, Sri Jayewardenepura Kotte, LKA
| | - Chaminda Janaka
- Department of Medicine, Sri Jayawardenepuera Genral Hospital, Nugegoda, LKA
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Hossain MJ, Azad AK, Shahid MSB, Shahjahan M, Ferdous J. Prevalence, antibiotic resistance pattern for bacteriuria from patients with urinary tract infections. Health Sci Rep 2024; 7:e2039. [PMID: 38617042 PMCID: PMC11009458 DOI: 10.1002/hsr2.2039] [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: 10/26/2023] [Revised: 03/09/2024] [Accepted: 03/26/2024] [Indexed: 04/16/2024] Open
Abstract
Background and Aims Antibiotic resistance presents a significant global public health challenge, particularly for urinary tract infections (UTIs), and is notably severe in developing countries. Surveillance of the antimicrobial susceptibility patterns of UTI-causing bacteria is crucial for effective treatment selection. This study aimed to analyze these patterns in bacteria isolated from the urine samples of patients at Mughda Medical College Hospital, Dhaka, Bangladesh. Methods A retrospective study (January 2019 to December 2020) at Mugdha Medical College and Hospital, Dhaka, examined clinical and laboratory data from patients with positive urine cultures (≥105 CFU/mL). The study classified patients into four age groups: children (1-<18 years), young adults (18-<33 years), middle-aged adults (33-50 years), and old adults (>50 years). The standard Kirby-Bauer method was used to assess antibiotic sensitivity to 28 common antibiotics. Results Among 243 positive urine cultures in both community- and hospital-acquired UTIs, Escherichia coli was the most common uropathogen (65.84%), followed by Klebsiella spp. (12.34%), Enterococcus spp. (8.23%), and other types of bacteria. Conclusion Old adults are particularly vulnerable to UTIs, with E. coli being the predominant causative agent in the study region. The observed antimicrobial resistance patterns underscore the necessity of judicious antibiotic selection to effectively treat UTIs across different age groups.
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Affiliation(s)
- Md. Jubayer Hossain
- Population Health Studies Division, Center for Health Innovation, ResearchAction, and Learning – Bangladesh (CHIRAL Bangladesh)DhakaBangladesh
| | - Abul Kalam Azad
- Department of MicrobiologyJagannath UniversityDhakaBangladesh
| | - Md. Shahadat Bin Shahid
- Population Health Studies Division, Center for Health Innovation, ResearchAction, and Learning – Bangladesh (CHIRAL Bangladesh)DhakaBangladesh
- Department of MicrobiologyJagannath UniversityDhakaBangladesh
| | - Muhibullah Shahjahan
- Population Health Studies Division, Center for Health Innovation, ResearchAction, and Learning – Bangladesh (CHIRAL Bangladesh)DhakaBangladesh
- Department of MicrobiologyJagannath UniversityDhakaBangladesh
| | - Jannatul Ferdous
- Department of Transfusion MedicineMugdha Medical College and HospitalDhakaBangladesh
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Mbuvi CM, Musila BN, Nyamache AK. Urogenital Infections Among Women Attending Mwingi Hospital, Kitui County, Kenya: Safeguarding Antibiotics Through Microbiological Diagnosis. East Afr Health Res J 2024; 8:99-105. [PMID: 39234350 PMCID: PMC11371010 DOI: 10.24248/eahrj.v8i1.754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 02/02/2024] [Indexed: 09/06/2024] Open
Abstract
Background Urogenital infections pose a considerable public health threat, as almost half of women will experience urinary and reproductive system infections at some point in their lives. However, the urogenital infection burden is often not clear in some regions. Nevertheless, the misuse of antimicrobial agents, including self-prescription, has increased widespread antimicrobial resistance, limiting treatment benefits. Therefore, this study aimed to identify the various urogenital infections, associated risk factors, and profile the bacterial isolates, and assess their antibiotic resistance among women attending Mwingi Hospital. Methods A cross-sectional study was conducted on 322 women aged between the ages of 15 to 44 years. Urine and high vaginal swabs were collected from all participants and analyzed within 6 hours. Microscopic examination on wet mounts was done, bacterial isolation was done and those with significant growth were confirmed and subjected to antimicrobial susceptibility testing using specific media. Descriptive statistics were used in expressing the infection frequencies and antimicrobial resistance. Odds ratios were used to determine the risk of urogenital infection. The level of significance was considered at a P value of less than 0.05. Results Among the 322 women, 45.3% (146) had a urogenital infection, with bacteria being the primary cause (26.4%). The infections included UTI (22.7%), Candidiasis (15.2%), Trichomoniasis (3.7%), Gonorrhea (2.5%), and Bacterial vaginitis (1.2%). Antibiotic use was 32.9%, with only 2.8% receiving a microbiological diagnosis before antibiotic use. The overall antibiotic resistance was 53%, with the lowest resistance observed against penicillin and combinations (31.4%) and 3rd Cephalosporins (39.4%). The highest resistance was observed against nalidixic acid (74.8%) and cotrimoxazole (62.6%). Conclusion Women attending Mwingi Hospital are commonly affected by various urogenital infections. Antibiotic use without microbiological diagnosis was observed. Among the antibiotics tested, 3rd generation cephalosporins and penicillin combination agents were noted as the most effective in treating bacterial urogenital infections, while nalidixic acid and cotrimoxazole were ineffective. Improved diagnosis and targeted treatments are necessary to prevent further development of antibiotic resistance.
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Affiliation(s)
- Christine Musungi Mbuvi
- Dept of Population, Reproductive Health & Community Resource Management, Kenyatta University
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Mareș C, Petca RC, Popescu RI, Petca A, Mulțescu R, Bulai CA, Ene CV, Geavlete PA, Geavlete BF, Jinga V. Update on Urinary Tract Infection Antibiotic Resistance-A Retrospective Study in Females in Conjunction with Clinical Data. Life (Basel) 2024; 14:106. [PMID: 38255721 PMCID: PMC10820678 DOI: 10.3390/life14010106] [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: 11/29/2023] [Revised: 01/06/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
Urinary tract infections (UTIs) represent a frequent pathology among the female population that has become more and more difficult to treat in the past decade, considering the increase in antibiotic resistance-a serious global public health problem. A cross-sectional retrospective study was conducted for six months to report an update regarding the rates of resistance and susceptibility of uropathogens necessary for optimal treatment. A total of 5487 patients were screened, of which 524 (9.54%) were female patients who met the criteria for inclusion in the study. Escherichia coli was the most common pathogen, representing 290 cases (55.34%), followed by Enterococcus spp. 82 (15.64%). Escherichia coli presented the highest resistance to amoxicillin-clavulanic acid (R = 33.1%), followed by trimethoprim-sulfamethoxazole (R = 32.41%) and levofloxacin (R = 32.06%). The highest sensitivity rates were observed for fosfomycin (S = 96.55%), followed by imipenem (S = 93.1%). Enterococcus spp. showed the highest resistance to levofloxacin (R = 50.0%), followed by penicillin (R = 39.02%). The highest sensitivity was observed for fosfomycin (S = 90.24%), linezolid (S = 89.02%), and nitrofurantoin (S = 86.58%). The second most frequent Gram-negative uropathogen was represented by Klebsiella spp., which had the highest resistance to amoxicillin-clavulanic acid (R = 35.89%), followed by levofloxacin (R = 25.64) and trimethoprim-suflamethoxazole (R = 24.35%). The most frequently associated pathology was an episode of UTI in the previous year, followed by diabetes and chronic kidney disease. Antibiotic resistance is a serious problem for all clinicians who treat UTIs. An up-to-date knowledge of antibiotic resistance rates is a major necessity to stop its evolution. Overall, the highest resistance rates were observed for aminopenicillins, fluoroquinolones, and trimethoprim-sulfamethoxazole. The best susceptibility rates were observed for fosfomycin, nitrofurantoin, and carbapenems. Our report aims to guide clinicians whenever they are forced to prescribe antibiotics empirically.
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Affiliation(s)
- Cristian Mareș
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti Str., 042122 Bucharest, Romania;
| | - Răzvan-Cosmin Petca
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Prof. Dr. Th. Burghele” Clinical Hospital, 20 Panduri Str., 050659 Bucharest, Romania
| | - Răzvan-Ionuț Popescu
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Prof. Dr. Th. Burghele” Clinical Hospital, 20 Panduri Str., 050659 Bucharest, Romania
| | - Aida Petca
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania;
- Department of Obstetrics and Gynecology, Elias University Emergency Hospital, 17 Mărăști Blvd., 050474 Bucharest, Romania
| | - Răzvan Mulțescu
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti Str., 042122 Bucharest, Romania;
| | - Cătălin Andrei Bulai
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti Str., 042122 Bucharest, Romania;
| | - Cosmin Victor Ene
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti Str., 042122 Bucharest, Romania;
| | - Petrișor Aurelian Geavlete
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti Str., 042122 Bucharest, Romania;
| | - Bogdan Florin Geavlete
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti Str., 042122 Bucharest, Romania;
| | - Viorel Jinga
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Prof. Dr. Th. Burghele” Clinical Hospital, 20 Panduri Str., 050659 Bucharest, Romania
- Medical Sciences Section, Academy of Romanian Scientists, 050085 Bucharest, Romania
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Sah RK, Dahal P, Parajuli R, Giri GR, Tuladhar E. Prevalence of blaCTX-M and blaTEM Genes in Cefotaxime-Resistant Escherichia coli Recovered from Tertiary Care at Central Nepal: A Descriptive Cross-Sectional Study. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2024; 2024:5517662. [PMID: 38226321 PMCID: PMC10789516 DOI: 10.1155/2024/5517662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/17/2024]
Abstract
Urinary tract infections (UTIs) are highly prevalent globally, and various antibiotics are employed for their treatment. However, the emergence of drug-resistant uropathogens towards these antibiotics causes a high rate of morbidity and mortality. This study was conducted at the Microbiology Laboratory of Grande International Hospital from November 2021 to May 2022 and aimed to assess the prevalence of UTI caused by Escherichia coli and their antibiotic susceptibility pattern with a focus on extended-spectrum beta-lactamases (ESBLs) and the prevalence of two genes (blaCTX-M and blaTEM) in cephalosporin-resistant E. coli. Altogether, 1050 urine samples were processed to obtain 165 isolates of E. coli. The isolates were identified by colony morphology and biochemical characteristics. Antimicrobial susceptibility tests (ASTs) were determined by the Kirby-Bauer disk diffusion method, and their ESBL enzymes were estimated by the combined disk method (CDM). Two ESBL genes (blaCTX-M and blaTEM) were investigated by polymerase chain reaction (PCR) in cefotaxime-resistant E. coli. Among the 1050 urine samples that were processed, 335 (31.9%) were culture-positive with 165 (49.2%) identified as E. coli. The age group ≥60 years (30.3%) had greater susceptibility to bacterial infections. AST revealed that meropenem was highly effective (95.7% susceptibility), while ampicillin showed the least sensitivity (42.4%). Among the E. coli isolates, 86 were multidrug resistant (MDR) and 10 were extensively drug resistant (XDR). Of these, 46 MDR (96%) and 2 XDR (4%) were ESBL producers. The prevalence of ESBL genes (blaCTX-M and blaTEM) was 49.3% and 54.8%, respectively. The overall accuracy of CDM as compared to PCR for the detection of the blaCTX-M gene was 55.26%. The prevalence of MDR E. coli harboring the blaCTX-M and blaTEM genes underscores the imperative role of ESBL testing in accurately identifying both beta-lactamase producers and nonproducers.
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Safdar S, Shamim S, Khan M, Imran A, Khan MA, Ali Q, Han S. Probing Antibacterial and Anticancer Potential of Selenicereus undatus, Pistacia vera L. and Olea europaea L. against Uropathogens, MCF-7 and A2780 Cancer Cells. Molecules 2023; 28:8148. [PMID: 38138636 PMCID: PMC10746009 DOI: 10.3390/molecules28248148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/30/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
Urinary tract infection is an infectious disease that requires immediate treatment. It can occur in any age group and involves both genders equally. The present study was to check the resistance of some antibiotics and to assess the antibacterial potential of three extracts of three plants against notorious bacteria involved in urinary tract infections. Along with assessing the antibacterial activity of plant extracts, we checked for the anticancer potential of these extracts against the cancer cell lines MCF-7 and A2780. Cancer is the leading cause of mortality in developed countries. Determinations of total flavonoid content, total phenolic content, total alkaloid content, total tannin content, total carotenoid content, and total steroid content were performed. The disk diffusion method was used to analyze the antibacterial activity of plant extracts. Ethanolic extract of Selenicereus undatus showed sensitivity (25-28 mm) against bacteria, whereas chloroform and hexane extracts showed resistance against all bacteria except Staphylococcus (25 mm). Ethanolic extract of Pistacia vera L. showed sensitivity (22-25 mm) against bacteria, whereas chloroform and hexane extracts showed resistance. Ethanolic extract of Olea europaea L. showed sensitivity (8-16 mm) against all bacteria except Staphylococcus, whereas chloroform and hexane extracts showed resistance. Positive controls showed variable zones of inhibition (2-60 mm), and negative control showed 0-1 mm. The antibiotic resistance was much more prominent in the case of hexane and chloroform extracts of all plants, whereas ethanolic extract showed a sensitivity of bacteria against extracts. Both cell lines, MCF-7 and A2780, displayed decreased live cells when treated with plant extracts.
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Affiliation(s)
- Sahar Safdar
- School of Biological Sciences and Technology, Liupanshui Normal University, Liupanshui 553004, China;
- Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore 54000, Pakistan; (M.K.); (A.I.)
| | - Saba Shamim
- Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore 54000, Pakistan; (M.K.); (A.I.)
| | - Maryam Khan
- Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore 54000, Pakistan; (M.K.); (A.I.)
| | - Ali Imran
- Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore 54000, Pakistan; (M.K.); (A.I.)
| | - Mudassar Ali Khan
- Department of Physiology, Rashid Latif Medical College, Lahore 54000, Pakistan;
| | - Qurban Ali
- Department of Plant Breeding and Genetics, Faculty of Agricultural Sciences, University of the Punjab, Lahore 54590, Pakistan;
| | - Shiming Han
- School of Biological Sciences and Technology, Liupanshui Normal University, Liupanshui 553004, China;
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Jayathilaka N, Pathirana T, Kumari C, Navaratne V, Gunasekara S, Nakkawita D, Senaratne T. Fosfomycin: A potential oral option for treatment of urinary tract infections in Sri Lanka in the context of high antibiotic resistance. Germs 2023; 13:314-320. [PMID: 38361540 PMCID: PMC10866161 DOI: 10.18683/germs.2023.1400] [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: 08/02/2023] [Revised: 10/18/2023] [Accepted: 10/28/2023] [Indexed: 02/17/2024]
Abstract
Introduction Fosfomycin is an effective treatment for urinary tract infections (UTIs). It is not currently used in Sri Lanka to treat UTIs. Hence, this study was conducted to assess the fosfomycin susceptibility for E. coli in urinary isolates, with an aim to find the usability of fosfomycin in the context of high antibiotic resistance. Methods E. coli isolates were identified by the colony appearance and by performing biochemical tests for the urinary coliform isolates collected from two different hospitals in Western Province Sri Lanka, during the period of November 2021 to February 2022. Susceptibility to fosfomycin 200 μg disc was performed following the Clinical Laboratory Standard Institute (CLSI) disc diffusion method. Results A total of 101 E. coli isolates from both oncology patients (52.5%) and non-oncology patients (47.5%) were identified and included in the study. The study sample showed majority of females (63.3%). Ampicillin showed the highest resistance rate (72.2%) while fosfomycin was the only antibiotic that showed 100% in vitro susceptibility to all the tested clinical isolates. The overall presence of multidrug-resistant (MDR) and carbapenem-resistant (CR) E. coli were 47.5% and 9.9% respectively. Conclusions Fosfomycin is a potential antibiotic option especially for MDR and CR organisms, with 100% in vitro susceptibility. Further studies involving multiple centers, with larger sample size and clinical efficacy studies would be important to assess the potential use of fosfomycin especially for the treatment of UTI-causing MDR and CR organisms.
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Affiliation(s)
- Nishadi Jayathilaka
- BSc (Hons), Medical Laboratory Science, Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Rathmalana, 10390, Sri Lanka
| | - Tharushi Pathirana
- BSc (Hons), Medical Laboratory Science, Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Rathmalana, 10390, Sri Lanka
| | - Chathurika Kumari
- BSc (Hons) Medical Laboratory Science, Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Rathmalana, 10390, Sri Lanka
| | - Varuna Navaratne
- MBBS, PG. Dip (Medical Microbiology), MD (Medical Microbiology) BSc, Department of Paraclinical Sciences, Faculty of Medicine, General Sir John Kotelawala Defence University, Rathmalana, 10390, Sri Lanka
| | - Samanmalee Gunasekara
- MBBS, MD (Medical Microbiology and Bacteriology), Department of Microbiology, National Cancer Institute, Maharagama, 10280, Sri Lanka
| | - Dilini Nakkawita
- MBBS, PG. Dip (Medical Microbiology), MD (Medical Microbiology), Dip. RCPath (UK), Department of Paraclinical Sciences, Faculty of Medicine, General Sir John Kotelawala Defence University, Rathmalana, 10390, Sri Lanka
| | - Thamarasi Senaratne
- PhD (Medical Virology), MSc (Med Micro), BSc, Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Rathmalana, 10390, Sri Lanka
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Subramaniyan Y, Khan A, Fathima F, Rekha PD. Differential expression of urease genes and ureolytic activity of uropathogenic Escherichia coli and Pseudomonas aeruginosa isolates in different nutritional conditions. Arch Microbiol 2023; 205:383. [PMID: 37973630 DOI: 10.1007/s00203-023-03722-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/18/2023] [Accepted: 10/24/2023] [Indexed: 11/19/2023]
Abstract
Uropathogens have adaptation strategies to survive in the host urinary tract by efficiently utilizing and tolerating the urinary metabolites. Many uropathogens harbour the enzyme urease for the breakdown of urea and the enzymatic breakdown of urea increases the pH and facilitate the struvite crystallization. In this study, the differential urease activity of uropathogenic Escherichia coli and Pseudomonas aeruginosa strains was investigated under different nutritional conditions. The experiments included measurement of growth, pH, urease activity, NH4-N generation and urease gene (ureC) expression among the bacterial strains under different conditions. Further, the implications of urea breakdown on the struvite crystallization in vitro and biofilm formation were also assessed. The study included urease positive isolates and for comparison urease negative isolates were included. Compared to the urease negative strains the urease positive strains formed higher biofilms and motility. The urease positive P. aeruginosa showed significantly higher (p < 0.01) pH and urease activity (A557-A630) compared to E. coli under experimental conditions. Further, supplementation of glucose to the growth media significantly increased the urease activity in P. aeruginosa and in contrast, it was significantly lower in E. coli. The expression profile of urease gene (ureC) was significantly higher (p < 0.001) in P. aeruginosa compared to E. coli and was consistent with the biochemical results of the urease activity under the nutritional conditions. The differential urease activity under two nutritional conditions influenced the biogenic struvite crystallization. It correlated with the urease activity showing higher crystallization rate in P. aeruginosa compared to E. coli. The results highlight the differential urease activity in two common uropathogens under different nutritional conditions that may have significant role on the regulation of virulence, pathogenicity and in the kidney stone disease.
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Affiliation(s)
- Yuvarajan Subramaniyan
- Division of Microbiology and Biotechnology, Yenepoya Research Centre, Yenepoya (Deemed to Be University), University Road, Deralakatte, Mangalore, 575018, India
| | - Altaf Khan
- Department of Urology, Yenepoya Medical College and Hospital, Yenepoya (Deemed to Be University), University Road, Deralakatte, Mangalore, 575018, India
| | - Fida Fathima
- Division of Microbiology and Biotechnology, Yenepoya Research Centre, Yenepoya (Deemed to Be University), University Road, Deralakatte, Mangalore, 575018, India
| | - Punchappady Devasya Rekha
- Division of Microbiology and Biotechnology, Yenepoya Research Centre, Yenepoya (Deemed to Be University), University Road, Deralakatte, Mangalore, 575018, India.
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Kebbeh A, Dsane-Aidoo P, Sanyang K, Darboe SMK, Fofana N, Ameme D, Sanyang AM, Darboe KS, Darboe S, Sanneh B, Kenu E, Anto F. Antibiotics susceptibility patterns of uropathogenic bacteria: a cross-sectional analytic study at Kanifing General Hospital, The Gambia. BMC Infect Dis 2023; 23:723. [PMID: 37880663 PMCID: PMC10599079 DOI: 10.1186/s12879-023-08373-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 06/04/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Antimicrobial resistance poses a public health threat for the treatment of community-acquired urinary tract infections. This study determined the susceptibility patterns of uropathogens and associated risk factors among outpatients diagnosed with urinary tract infections at the Kanifing General Hospital in the Gambia. METHODS A cross-sectional analytic study was conducted among patients with suspected urinary tract infections at Kanifing General Hospital from March to May 2021. Data on socio-demographic and other risk factors were collected from the study participants using a structured pre-tested questionnaire. Mid-stream urine samples were collected, and bacteria identification and antimicrobial susceptibility testing done using standard microbiological methods. Descriptive and inferential statistical analysis were done to determine factors associated with urinary tract infection at 95% confidence level and a p -value < 0.05. RESULTS A total of 422 patients were enrolled with 82.5% (348/422) being females. The prevalence of community acquired urinary tract infection was 12.8% (54/422). Escherichia coli was the most prevalent isolate (74.1%, 40/54), followed by Klebsiella spp (8.5%, 10/54). Antimicrobial resistance was highest for Ampicillin (87.0%, 47/54), Trimethoprim/Sulfamethoxazole (77.8%, 42/54) and Tetracycline (75.9%, 41/54). Uropathogens sensitivity was 77.8% (42/54) for Nitrofurantoin and 75.9% (41/54) for Ceftazidime. Being female (aOR 5.90 95% CI = 1.48-23.67), previous history of urinary tract infection (aOR 2.34, 95% CI = 1.06-5.14), use of unprescribed antibiotics (aOR 2.0, 95% CI = 1.05-3.62) and having no formal education (aOR 8.02, 95% CI = 1.04-62.0) were significant factors associated for having uropathogenic bacterial infection. CONCLUSION E. coli was the most prevalent uropathogen isolated. Ciprofloxacin, Nitrofurantoin and Ceftazidime were the most sensitive antibiotics. Routine surveillance of susceptibility of uropathogenic bacteria would be helpful to update clinicians on the choice of antibiotics.
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Affiliation(s)
- Abou Kebbeh
- Ghana Field Epidemiology and Laboratory Training Program, Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana.
- National Public Health Laboratories, Ministry of Health, Banjul, The Gambia.
| | | | - Kawsu Sanyang
- Ghana Field Epidemiology and Laboratory Training Program, Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Sheriffo M K Darboe
- Ghana Field Epidemiology and Laboratory Training Program, Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Nuha Fofana
- Ghana Field Epidemiology and Laboratory Training Program, Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Donne Ameme
- Ghana Field Epidemiology and Laboratory Training Program, Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Abdoulie M Sanyang
- National Public Health Laboratories, Ministry of Health, Banjul, The Gambia
| | | | - Saffiatou Darboe
- Laboratory Management, Medical Research Council Unit at the LSTHM, Banjul, The Gambia
| | - Bakary Sanneh
- National Public Health Laboratories, Ministry of Health, Banjul, The Gambia
| | - Ernest Kenu
- Ghana Field Epidemiology and Laboratory Training Program, Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Francis Anto
- Ghana Field Epidemiology and Laboratory Training Program, Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
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Thapa TB, Pokhrel S, Lamichhane A, Singh VK, Shrestha O, Sapkota M, Khanal PR. Prevalence and antibiogram of bacteria causing urinary tract infection among patients with chronic kidney disease. Open Med (Wars) 2023; 18:20230824. [PMID: 37873539 PMCID: PMC10590610 DOI: 10.1515/med-2023-0824] [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] [Received: 06/16/2023] [Revised: 07/31/2023] [Accepted: 09/29/2023] [Indexed: 10/25/2023] Open
Abstract
Identifying and appropriately managing urinary tract infections (UTIs) among chronic kidney disease (CKD) patients are essential to reduce further disease complications and economic burden. Hence, this study aims to determine the prevalence of UTIs among CKD patients and study the antibiogram of the bacterial isolates. Four hundred eighty-two clean catch midstream urine samples were collected from CKD patients during the study period. The samples were cultured, and bacteria were isolated using standard microbiological techniques. Antibiotic susceptibility testing was performed by the Kirby-Bauer disc diffusion method following the Clinical and Laboratory Standards Institute guidelines. Of the 482 CKD patients, 15.8% were culture positive, and the majority was elderly aged group population. Most bacterial isolates were Escherichia coli 50%, followed by Pseudomonas aeruginosa 15.80%, Enterococcus species 15.80%, and Klebsiella pneumoniae 11.84%. The majority of bacteria were found to be resistant to beta-lactam antibiotics, ampicillin (94.67%), ceftriaxone (89.04%), cefotaxime (87.5%), and ceftazidime (84.0%), while polymyxin, colistin, vancomycin, meropenem, and imipenem were the most sensitive antibiotics. In our study, higher levels of antibiotic resistance were observed among urinary isolates. Therefore, our findings suggest clinicians to choose better antibiotic options to treat UTIs among CKD patients.
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Affiliation(s)
- Tika Bahadur Thapa
- Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Soalteemode, Kathmandu, Nepal
- Department of Pathology, Sumeru Hospital Pvt Ltd, Dhapakhel, Lalitpur, Nepal
| | - Sushant Pokhrel
- Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Soalteemode, Kathmandu, Nepal
| | - Anit Lamichhane
- Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Soalteemode, Kathmandu, Nepal
- Department of Pathology, Sumeru Hospital Pvt Ltd, Dhapakhel, Lalitpur, Nepal
| | - Vinay Kumar Singh
- Department of Pathology, Sumeru Hospital Pvt Ltd, Dhapakhel, Lalitpur, Nepal
| | - Ojaswee Shrestha
- Department of Pathology, Sumeru Hospital Pvt Ltd, Dhapakhel, Lalitpur, Nepal
| | - Manisha Sapkota
- Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Soalteemode, Kathmandu, Nepal
| | - Puspa Raj Khanal
- Department of Pathology, Sumeru Hospital Pvt Ltd, Dhapakhel, Lalitpur, Nepal
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Gebretensaie Y, Atnafu A, Alemu Y, Girma S, Desta K. Evaluation of the Diagnostic Performance of the LINEAR Cromatest and Laboquick URS 10-T Dipsticks Among Urinary Tract Infection Suspects in Addis Ababa, Ethiopia: A Cross-Sectional Study. Res Rep Urol 2023; 15:437-445. [PMID: 37818231 PMCID: PMC10560765 DOI: 10.2147/rru.s434128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 09/28/2023] [Indexed: 10/12/2023] Open
Abstract
Background Urinary tract infections (UTIs) bring a significant and serious health-related problem. Repeated infections may lead to the development of renal scarring and end-stage renal dysfunction. Therefore, balancing the choices of UTI diagnostic tools depending on the costs versus accuracy can minimize false results that may subject patients to wrong treatments. Objective The objective of the study was to evaluate the diagnostic performance of LINEAR cromatest and Laboquick URS 10-T dipsticks against conventional urine culture at Arsho Advanced Medical Laboratory (AAML), Addis Ababa, Ethiopia. Methods A similar cohort of UTI-suspected patients from our previous study, who were prospectively enrolled from Arsho Advanced Medical Laboratory, Addis Ababa, Ethiopia, were considered for this analysis. Data analysis was performed using SPSS version 26. The sensitivity, specificity, and predictive value of different dipsticks were calculated using culture as a gold standard. ROC curve analysis was also used to determine diagnostic performance. A test with a P-value of <0.05 was considered statistically significant. Results Out of 446 urine samples processed, bacterial growth was observed in 141 (31.6%). Of this figure, 105/141 (74.5%) and 36/141 (25.5%) were from female and male participants, respectively. The sensitivity and specificity of the LINEAR Cromatest dipstick were 83.7% and 67.9%, respectively (P-value <0.001). The Laboquick URS 10-T dipstick showed sensitivity and specificity of 87.9% and 68.5%, respectively (P-value <0.001). The ROC analysis showed an AUC of >0.7 for both dipsticks. Conclusion In a setting where there is no access to urine culture, the urine dipstick may be considered an alternative diagnostic tool in the diagnosis of UTIs.
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Affiliation(s)
- Yosef Gebretensaie
- American Advanced Medical Laboratory, American Medical Center, Addis Ababa, Ethiopia
| | - Abay Atnafu
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Yonas Alemu
- Department of Microbiology, Immunology, and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Selfu Girma
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Kassu Desta
- Department of Medical Laboratory Science, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Almutawif YA, Eid HMA. Prevalence and antimicrobial susceptibility pattern of bacterial uropathogens among adult patients in Madinah, Saudi Arabia. BMC Infect Dis 2023; 23:582. [PMID: 37674127 PMCID: PMC10481549 DOI: 10.1186/s12879-023-08578-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/01/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Urinary tract infection (UTI) is considered one of the most prevalent infections that may lead to many renal complications. They account for almost 10% of all infections in Saudi Arabia, making them the second most common cause of emergency department admissions. Bacterial pathogens, primarily Escherichia coli, Klebsiella spp., Enterococcus spp., Proteus spp., and Staphylococcus spp. are the most causative agents of UTI. This study aims to evaluate the prevalence and antimicrobial susceptibility patterns of uropathogens in adult patients from Madinah, Saudi Arabia. METHODS A retrospective cross-sectional study was performed using data collected from patients who visited King Fahad General Hospital in Madinah, Saudi Arabia. Data included 16,803 urine bacterial cultures and their antimicrobial susceptibility profiles collected between January 2019 and October 2021. RESULTS Among the 16,803 tested samples, 3937 (23.4%) showed positive results for urine bacterial cultures. UTI prevalence was slightly higher in women (52.1%) than men (47.9%). Escherichia coli (29.8%) was the most prevalent, followed by Klebsiella spp. (23.2%) and Pseudomonas spp. (8.4%). As for Gram-positive bacteria, Enterococcus spp. (10.8%) were most common, followed by Streptococcus spp. (8%) and Staphylococcus spp. (3.3%). Gram-negative bacteria exhibited high resistance rates toward aztreonam (> 83.3%), ampicillin (78.8%), and cephalexin (68.5%). Enterococcus spp. displayed elevated resistance rates (> 62.3%) against ciprofloxacin, gentamicin, and tetracycline. Conversely, Streptococcus spp. showed substantial resistance rates (> 76.6%) toward colistin and trimethoprim/sulfamethoxazole. CONCLUSION To optimize therapy and minimize the risk of multidrug-resistant uropathogenic infections, physicians should consider the local epidemiological trends and antimicrobial resistance patterns of prevalent uropathogens prior to initiating any empirical antibacterial therapy.
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Affiliation(s)
- Yahya A Almutawif
- Department of Medical Laboratories Technology, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Hamza M A Eid
- Department of Medical Laboratories Technology, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia.
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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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Kiggundu R, Waswa JP, Nakambale HN, Kakooza F, Kassuja H, Murungi M, Akello H, Morries S, Joshi MP, Stergachis A, Konduri N. Development and evaluation of a continuous quality improvement programme for antimicrobial stewardship in six hospitals in Uganda. BMJ Open Qual 2023; 12:e002293. [PMID: 37336576 DOI: 10.1136/bmjoq-2023-002293] [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: 01/30/2023] [Accepted: 05/27/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Appropriate antimicrobial use is essential for antimicrobial stewardship (AMS). Ugandan hospitals are making efforts to improve antibiotic use, but improvements have not been sufficiently documented and evaluated. METHODS Six Ugandan hospitals implemented AMS interventions between June 2019 and July 2022. We used the WHO AMS toolkit to set-up hospital AMS programmes and implemented interventions using continuous quality improvement (CQI) techniques and targeting conditions commonly associated with antibiotic misuse, that is, urinary tract infections (UTIs), upper respiratory tract infections (URTIs) and surgical antibiotic prophylaxis (SAP). The interventions included training, mentorship and provision of clinical guidelines to support clinical decision-making. Quarterly antibiotic use surveys were conducted. RESULTS Data were collected for 7037 patients diagnosed with UTIs. There was an increase in the proportion of patients receiving one antibiotic for the treatment of UTI from 48% during the pre-intervention to 73.2%, p<0.01. There was a 19.2% reduction in the number of antimicrobials per patient treated for UTI p<0.01. There was an increase in use of nitrofurantoin, the first-line drug for the management of UTI. There was an increase in the use of Access antibiotics for managing UTIs from 50.4% to 53.8%. The proportion of patients receiving no antimicrobials for URTI increased from 26.3% at pre-intervention compared with 53.4% at intervention phase, p<0.01. There was a 20.7% reduction in the mean number of antimicrobials per patient for URTI from the pre-intervention to the intervention phase, from 0.8 to 0.6, respectively, p<0.001 and reduction in the number of treatment days, p=0.0163. Among patients undergoing surgery, 49.5% (2212) received SAP during the pre-intervention versus 50.5% (2169) during the intervention. CONCLUSIONS Using CQI approaches to focus on specific causes of inappropriate antibiotic use led to desirable overall reductions in antibiotic use for URTI and UTI.
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Affiliation(s)
- Reuben Kiggundu
- USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Kampala, Uganda
| | - J P Waswa
- USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Kampala, Uganda
| | - Hilma N Nakambale
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Francis Kakooza
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Hassan Kassuja
- USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Kampala, Uganda
| | - Marion Murungi
- USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Kampala, Uganda
| | | | - Seru Morries
- Department of Pharmaceuticals and Natural Medicines, Ministry of Health, Kampala, Uganda
| | - Mohan P Joshi
- USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Arlington, Virginia, USA
| | - Andy Stergachis
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Pharmacy, University of Washington School of Pharmacy, Seattle, Washington, USA
| | - Niranjan Konduri
- USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Arlington, Virginia, USA
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Altamimi I, Almazyed A, Alshammary S, Altamimi A, Alhumimidi A, Alnutaifi R, Malhis M, Altamimi A. Bacterial Pathogens and Antimicrobial Susceptibility Patterns of Urinary Tract Infections in Children during COVID-19 2019-2020: A Large Tertiary Care Center in Saudi Arabia. CHILDREN (BASEL, SWITZERLAND) 2023; 10:971. [PMID: 37371203 DOI: 10.3390/children10060971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/24/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND One of the most prevalent bacterial infections in children is urinary tract infection (UTI), which has become a major concern with increasing resistance of the pathogens to the routinely used antimicrobial agents. The aim of the study is to determine the antimicrobial susceptibility patterns of pediatric UTI-causing pathogens, including ESBL-producing bacteria, in Saudi Arabia. METHODS This cross-sectional retrospective study was conducted to ascertain the frequency of isolation and the antimicrobial resistance pattern of uropathogens among children aged 0-15 years. The data from the urine cultures was collected during 2019-2020 at the King Fahad Medical City, a major tertiary hospital in Riyadh, Saudi Arabia. A total of 1022 urine samples from patients diagnosed with urinary tract infections (UTIs) were collected for this study. Microbial species present in the samples were cultured and identified using standard biochemical techniques. To assess the resistance of these strains to antimicrobial drugs, an in vitro method was employed, and the criteria set by the Clinical Laboratory Standard Institute (CLSI) were followed. In addition, a double-disc synergy test was conducted to identify strains of E. coli that produce extended-spectrum beta-lactamase (ESBL). RESULTS The predominant pathogens were E. coli (58.6%), followed by Klebsiella sp. (23.9%). E. coli isolates were more sensitive to meropenem and ertapenem in 99.2% of cases, followed by amikacin (99%). Klebsiella sp. were sensitive to amikacin in 97.1% of cases, followed by meropenem and ertapenem (92.2% in both). The highest sensitivities of antimicrobials toward ESBL were for meropenem and ertapenem (100% in both), followed by amikacin (99%). CONCLUSIONS Our study recommends using local antibiotic sensitivity data for empirical UTI treatment. Amikacin, ertapenem, and meropenem are effective intravenous options. Cephalosporin, cefuroxime, amoxicillin/clavulanic acid, and nitrofurantoin are suitable oral choices. No significant changes in antimicrobial susceptibility were observed during the COVID-19 pandemic. Further research is needed to assess potential pandemic-related alterations.
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Affiliation(s)
- Ibraheem Altamimi
- College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
| | - Abeer Almazyed
- Microbiology Department, King Fahad Medical City, Riyadh 11525, Saudi Arabia
| | - Sami Alshammary
- Palliative Care, King Fahad Medical City, Riyadh 11525, Saudi Arabia
| | - Abdulaziz Altamimi
- College of Medicine, King Saud Bin Abdulaziz University for Health and Sciences, Riyadh 11481, Saudi Arabia
| | | | - Raed Alnutaifi
- College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
| | - Mohammed Malhis
- College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
| | - Abdullah Altamimi
- Pediatric Emergency and Medical Toxicology, King Fahad Medical City, Riyadh 11525, Saudi Arabia
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Gebretensaie Y, Atnafu A, Girma S, Alemu Y, Desta K. Prevalence of Bacterial Urinary Tract Infection, Associated Risk Factors, and Antimicrobial Resistance Pattern in Addis Ababa, Ethiopia: A Cross-Sectional Study. Infect Drug Resist 2023; 16:3041-3050. [PMID: 37215305 PMCID: PMC10199700 DOI: 10.2147/idr.s402279] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 05/09/2023] [Indexed: 05/24/2023] Open
Abstract
Background Urinary tract infections (UTIs) brought a significant and serious health-related problem that may lead to the subsequent development of serious indications with the challenge of the emergence of antibiotic resistance. Therefore, the choice of antibiotics depends on the accuracy of the diagnostic tool of UTIs to minimize false results that may subject patients to wrong treatments. This study aimed to determine the prevalence of bacteriuria, associated factors, and AMR pattern of UTI-suspected patients. Methods A cross-sectional study was conducted from March to May 2022, at Arsho Advanced Medical Laboratory (AAML), Addis Ababa, Ethiopia. Species identification and isolation from bacterial colonies were characterized by gram stain and biochemical properties followed by antibiotic susceptibility testing using the Kirby-Bauer method on Muller-Hinton agar. Logistic regression analysis was carried out to determine the association between the independent variables and significant bacterial growth to identify factors that affect the prevalence of UTI. A test is considered statistically significant that has a P value less than 0.05. Results Out of 141 (31.6%) which yielded significant bacteriuria, 16 different species of bacterial uropathogens were identified. A total of 105/446 (91 Gram-negative and 14 Gram-positive) of bacterial growth in the female gender and 36/446 (33 Gram-negative and 3 Gram positive) in male were observed with a P value of 0.03. The most predominant bacteria were E. coli followed by Klebsiella pneumoniae. Amoxicillin had shown the highest resistance rate (100%) followed by Ampicillin (98.9%). Females and participants with previous infections were shown to be associated with significant bacterial growth. Conclusion Based on our study finding, the ordinarily used antibiotics seem to face emerging resistant strains, which needs considerable and due attention to the impact of UTI in developing countries including Ethiopia. History of previous UTIs and female gender were shown to be possible risk factors associated with UTIs.
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Affiliation(s)
- Yosef Gebretensaie
- Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abay Atnafu
- Mycobacterial Disease Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Selfu Girma
- Mycobacterial Disease Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Yonas Alemu
- Department of Microbiology, Immunology, and Parasitology, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Kassu Desta
- Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
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Maione A, Galdiero E, Cirillo L, Gambino E, Gallo MA, Sasso FP, Petrillo A, Guida M, Galdiero M. Prevalence, Resistance Patterns and Biofilm Production Ability of Bacterial Uropathogens from Cases of Community-Acquired Urinary Tract Infections in South Italy. Pathogens 2023; 12:pathogens12040537. [PMID: 37111423 PMCID: PMC10145297 DOI: 10.3390/pathogens12040537] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/23/2023] [Accepted: 03/28/2023] [Indexed: 04/29/2023] Open
Abstract
Community-acquired urinary tract infections represent the most common infectious diseases in the community setting. Knowing the antibiotic resistance patterns of uropathogens is crucial for establishing empirical treatment. The aim of the current study is to determine the incidence of the causative agents of UTIs and their resistance profiles. Patients of all ages and both sexes were enrolled in the study, and admitted to San Ciro Diagnostic Center in Naples between January 2019 and Jun 2020. Bacterial identification and antibiotic susceptibility testing were carried out using Vitek 2 system. Among the 2741 urine samples, 1702 (62.1%) and 1309 (37.9%) were negative and positive for bacterial growth, respectively. Of 1309 patients with infection, 760 (73.1%) were females and 279 (26.9%) were males. The greatest number of positive cases were found in the in the elderly (>61 years). Regarding uropathogens, 1000 (96.2%) were Gram-negative while 39 (3.8%) were Gram-positive strains. The three most isolated pathogenic strains were Escherichia coli (72.2%), Klebsiella pneumoniae (12.4%), and Proteus mirabilis (9.0%). Strong biofilm formation ability was observed in about 30% of the tested isolates. The low resistance rates recorded against nitrofurantoin, fosfomycin, piperacillin-tazobactam, and gentamicin could suggest them as the most appropriate therapies for CA-UTIs.
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Affiliation(s)
- Angela Maione
- Department of Biology, University of Naples 'Federico II', Via Cinthia, 80126 Naples, Italy
| | - Emilia Galdiero
- Department of Biology, University of Naples 'Federico II', Via Cinthia, 80126 Naples, Italy
| | - Luigi Cirillo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | - Edvige Gambino
- Department of Biology, University of Naples 'Federico II', Via Cinthia, 80126 Naples, Italy
| | | | - Francesca Paola Sasso
- Department of Dermatology and Venereology, University of Rome "La Sapienza", 00161 Rome, Italy
| | | | - Marco Guida
- Department of Biology, University of Naples 'Federico II', Via Cinthia, 80126 Naples, Italy
| | - Marilena Galdiero
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", 81100 Naples, Italy
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Katawa G, Tchalon A, Tchopba CN, Amessoudji MO, Ataba E, Tchadié PE, Ameyapoh AH, Sadji A, Halatoko W, Karou SD, Ameyapoh Y. On-site verification of the CBEU method using UriSelect4 chromogenic medium at the National Institute of Hygiene (INH) of Lomé. Indian J Med Microbiol 2023; 42:1-6. [PMID: 36967207 DOI: 10.1016/j.ijmmb.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 09/10/2022] [Accepted: 01/01/2023] [Indexed: 01/18/2023]
Abstract
PURPOSE The Cytobacteriological Examination of Urine (CBEU) is one of the most requested microbiological analyses in the medical bacteriology laboratory. According to the ISO 15189 standard, Medical Biology Laboratory (MBL) must validate the techniques before their use. It is in this perspective that, within the Medical Bacteriology Laboratory of the INH of Lome, we have carried out the on-site verification of the CBEU method using UriSelect4 chromogenic medium at the INH of Lomé. MATERIAL AND METHODS The biological material was composed of reference bacterial strains and clinical bacterial strains isolated at INH. Failure Modes Effects and Criticality Analysis (FMECA) with 5 M model was used to perform risk analysis and performances as repeatability, intermediate fidelity/reproducibility, sensitivity and inter-operator variability were evaluated using references strains and different operators. "Comité Français d'Accréditation" (COFRAC) SH GTA 04 was used as reference. Single-factor ANOVA was used to analyze the data. RESULTS Operating procedures, Patients preparation, Samples and Preparation of culture media were identified as main critical points with a criticality index of 8, 9, 9 and 12 respectively. The use of uriselect4 to perform ECBU was shown to be repeatable and reproducible. The sensibility of Uriselect4 to detect urinary infection was 100% with negligible inter-operator variability. CONCLUSION This study performed on-site verification of Uriselect4 at the bacteriology lab of INH of Lome and identified some critical points to master. The overall performance criteria from COFRAC SH GTA 04 were conform.
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Affiliation(s)
- Gnatoulma Katawa
- Higher School of Biological and Food Technology (ESTBA)/Laboratory of Microbiology and Quality Control of Foodstuffs (LAMICODA)/Research Unit in Immunology and Immunomodulation (UR2IM), University of Lome, Togo.
| | - Akpanto Tchalon
- Higher School of Biological and Food Technology (ESTBA)/Laboratory of Microbiology and Quality Control of Foodstuffs (LAMICODA)/Research Unit in Immunology and Immunomodulation (UR2IM), University of Lome, Togo.
| | - Christèle Nguepou Tchopba
- Higher School of Biological and Food Technology (ESTBA)/Laboratory of Microbiology and Quality Control of Foodstuffs (LAMICODA)/Research Unit in Immunology and Immunomodulation (UR2IM), University of Lome, Togo.
| | - Marthe Oukoé Amessoudji
- Higher School of Biological and Food Technology (ESTBA)/Laboratory of Microbiology and Quality Control of Foodstuffs (LAMICODA)/Research Unit in Immunology and Immunomodulation (UR2IM), University of Lome, Togo.
| | - Essoham Ataba
- Higher School of Biological and Food Technology (ESTBA)/Laboratory of Microbiology and Quality Control of Foodstuffs (LAMICODA)/Research Unit in Immunology and Immunomodulation (UR2IM), University of Lome, Togo.
| | - Pélagie Edlom Tchadié
- Higher School of Biological and Food Technology (ESTBA)/Laboratory of Microbiology and Quality Control of Foodstuffs (LAMICODA)/Research Unit in Immunology and Immunomodulation (UR2IM), University of Lome, Togo.
| | - Adjoa Holali Ameyapoh
- Higher School of Biological and Food Technology (ESTBA)/Laboratory of Microbiology and Quality Control of Foodstuffs (LAMICODA)/Research Unit in Immunology and Immunomodulation (UR2IM), University of Lome, Togo.
| | - Adodo Sadji
- National Institute of Hygiene (INH) of Lome, Togo.
| | | | - Simplice Damintoti Karou
- Higher School of Biological and Food Technology (ESTBA)/Laboratory of Microbiology and Quality Control of Foodstuffs (LAMICODA)/Research Unit in Immunology and Immunomodulation (UR2IM), University of Lome, Togo.
| | - Yaovi Ameyapoh
- Higher School of Biological and Food Technology (ESTBA)/Laboratory of Microbiology and Quality Control of Foodstuffs (LAMICODA)/Research Unit in Immunology and Immunomodulation (UR2IM), University of Lome, Togo.
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Zegeye AF, Kassahun CW, Temachu YZ. Work experience was associated with the knowledge and practice of catheter-associated urinary tract infection prevention among nurses at University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia, 2021. BMC Womens Health 2023; 23:40. [PMID: 36717910 PMCID: PMC9885554 DOI: 10.1186/s12905-023-02176-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 01/16/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Catheter-associated urinary tract infection is the source of about 20% of episodes of health-care acquired infections in acute care facilities and it is over 50% in long-term care facilities. In Ethiopia, there is no published scientific research regarding knowledge and practice of nurses on catheter-associated urinary tract infections prevention. Therefore, this study aimed to assess knowledge, practice and associated factors of CAUTI prevention among nurses working at university of Gondar comprehensive specialized hospital, northwest Ethiopia, 2021. METHODS Institutional based cross sectional study was conducted at University of Gondar Comprehensive Specialized Referral Hospital from April 01 to May 01, 2021 among 423 nurses. Simple random sampling technique was used. Data were collected by using self-administered questionnaire then coded and entered into EPI- Data version 4.6 and then exported to SPSS version 23. Descriptive statistics was computed, and the result was summarized by texts, tables, and charts. All variables with P-value < 0.25 in the univariate analysis were included in the multivariable regression analysis. The degree of association was interpreted by using the adjusted odds ratio with 95% confidence intervals. RESULTS Good knowledge and practice of nurses towards CAUTI prevention was 37.7% and 51.8% respectively. Good knowledge was associated with sex [AOR = 1.84, 95% CI (1.09, 3.11)], work experience [AOR = 2.36, 95% CI (1.09, 5.10)], working unit [AOR = 6.9, 95% CI (2.11, 22.52)], training [AOR = 2.33, 95% CI (1.17, 4.65)] and had guideline [AOR = 2.78, 95% CI (1.59, 4.88)]. Good practice was associated with sex, work experience, attitude and knowledge towards CAUTI prevention [AOR = 2.19, 95% CI (1.23, 3.88)], [AOR = 5.44, 95% CI (1.66, 17.84)], [AOR = 3.06, 95% CI (1.65, 5.67)], and [AOR = 5.28, 95% CI (2.86, 9.76)] respectively. CONCLUSIONS Nearly one-third of nurses had good knowledge and more than half of nurses had good practice towards CAUTI prevention. Sex, work experience, work unit, presence of guideline, and training were significantly associated with knowledge. Sex, work experience, good attitude and, knowledge were associated with practice of nurses towards CAUTI prevention. The knowledge and practice towards catheter associated urinary tract infection prevention among nurses should be increased, so that the patients could enjoy and maintain the healthy lifestyle.
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Affiliation(s)
| | | | - Yemataw Zewdu Temachu
- Department of Emergency and Critical Care, School of Nursing, University of Gondar, Gondar, Ethiopia
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Simeneh E, Gezimu T, Woldemariam M, Alelign D. Magnitude of Multidrug-resistant Bacterial Uropathogens and Associated Factors in Urinary Tract Infection Suspected Adult HIV-Positive Patients in Southern Ethiopia. Open Microbiol J 2022. [DOI: 10.2174/18742858-v16-e2208180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Due to the reduction of their immunity, people living with the human immunodeficiency virus (HIV) are more susceptible to acquiring urinary tract infections (UTI). Moreover, the emergence of drug-resistant bacterial uropathogens has grown widely and now constitutes a severe clinical problem among HIV-positive patients.
Methods:
An institution-based cross-sectional study was conducted at the ART clinic of Arba Minch General Hospital from 1st January to 30th May, 2021. A total of 251 adult HIV-positive patients clinically suspected of having UTIs were systematically recruited. Socio-demographic and other factors were collected by a pre-tested structured questionnaire. A clean-catch mid-stream urine sample was collected and inoculated onto blood agar, MacConkey agar, and cysteine lactose electrolyte deficient agar (CLED). The inoculated culture media were incubated aerobically at 37°C for 24 hrs. After overnight incubation, significant bacteriuria, 105 CFU/ml, was considered. Bacterial identification was made by standard protocols. Antimicrobial susceptibility testing was done by Kirby Bauer’s disk diffusion method. The data was analyzed using SPSS version 25. A P-value less than 0.05 was used as statistical significance.
Results:
The overall magnitude of multidrug-resistant (MDR) uropathogens was found to be 14.3%, with a 95% CI (10-19.1). Gram-negative bacteria (83.3%) were the predominant MDR isolates, with E. coli (41.7%) followed by K. pneumoniae (22.2%). All isolates of S. aureus and two-thirds of the isolated CoNS were MDR. A total of 30% and 16.7% of Gram-negative isolates were ESBL and carbapenemase producers, respectively, whereas 50% and 33.3% of isolated S. aureus and CoNS were methicillin-resistant, respectively. Antibiotic use in the previous 6 months [AOR = 6.7, 95% CI: (2.53-17.6)], presence of chronic underlying disease [AOR = 7.03, 95% CI: (1.72-28.73)], antibiotic use without a prescription [AOR = 9.7, 95% CI: (3.53-26.675)], CD4+ counts less than 250 cells/mm3 [AOR = 8.05, 95% CI: (2.078–31.154)], and CD4+ count in between 250-500 cells/mm3 [AOR = 2.49, 95% CI: (1.05-5.923)] were found to be statistically significant associated with MDR uropathogens.
Conclusion:
This study found a significant number of multidrug-resistant uropathogens, indicating that healthcare providers should be aware of this and take urgent action to minimize resistance spread, as well as consider current empirical antibiotic therapy for UTI in HIV-positive patients.
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Isolation and Identification of Multi-Drug Resistant (MDR) Pathogens from Patients with Urinary Tract Infection (UTI) in Dhaka City, Bangladesh. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2022. [DOI: 10.22207/jpam.16.3.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Urinary tract infection (UTI) is the leading cause of death among patients and majority of people visiting the hospital worldwide. In the current quantitative study, urine samples were obtained using sterile method and 100 isolates, including 60 Escherichia coli, 28 Klebsiella sp., and 12 Proteus sp., were investigated in a laboratory. Current study showed that E. coli 60/100 (60%) was the most common cause of UTI followed by Klebsiella sp. 28/100 (28%) and Proteus sp. 12/100 (12%). Cefotaxime (86.67% sensitive) was found to be the best drug for treating infections with E. coli, ceftazidime (100% sensitive) for infections with Klebsiella sp., and imipenem and levofloxacin (100% sensitive) for infections with Proteus sp. Overall, 51% of the isolated strains showed high multidrug resistance (MDR). Because of the alarming increase in extensively drug-resistant and MDR uropathogens, which is a concern in public health, the rational use of antimicrobial therapy should be implemented.
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Bhargava K, Nath G, Bhargava A, Kumari R, Aseri GK, Jain N. Bacterial profile and antibiotic susceptibility pattern of uropathogens causing urinary tract infection in the eastern part of Northern India. Front Microbiol 2022; 13:965053. [PMID: 36016776 PMCID: PMC9396120 DOI: 10.3389/fmicb.2022.965053] [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: 06/09/2022] [Accepted: 07/15/2022] [Indexed: 11/27/2022] Open
Abstract
Urinary tract infection (UTI) is a common infectious disease that affects men and women. It is a significant health concern due to multidrug-resistant (MDR) organisms. Therefore, it is necessary to have a current understanding of the antibiotic susceptibility (AS) pattern of uropathogens to manage UTI effectively. Since the bacterial pathogen causing UTI and its AS vary with time and place, the prevailing AS pattern of the causative agents are essential for empirical antibiotic therapy. This study aims to determine the prevalence and AS of uropathogens isolated from UTI patients in the eastern part of Northern India. The study was carried out between November 2018 and December 2019. Clean catch midstream urine samples were collected and processed using standard guidelines for microbiological procedures. Positive microbiological cultures were found in 333 of the 427 patients, where 287 were gram-negative bacteria (GNB), and 46 were gram-positive bacteria (GPB). Females had a higher prevalence of UTI (60.7%) than males (39.3%) (p = 0.00024). The most susceptible age group in females was 18–50 years as compared to males, whereas at the age of 51–80 years and >80 years males were more susceptible than females (p = 0.053). The most prevalent pathogen identified were Escherichia coli (55.0%), followed by Proteus sp. (6.9%), Klebsiella pneumoniae (6.6%), Pseudomonas aeruginosa (6.3%), of which 96.0% were MDR bacteria. The susceptibility pattern of our study also revealed that amikacin, gentamycin and imipenem were the most effective drugs against GNB. In contrast, nitrofurantoin, vancomycin, and chloramphenicol were the most effective drugs against GPB. According tothe findings, MDR pathogens are very much prevalent. Since UTI is one of the most frequent bacterial diseases, proper management necessitates extensive investigation and implementation of antibiotic policy based on AS patterns for a particular region.
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Affiliation(s)
- Kanika Bhargava
- Amity Institute of Microbial Technology, Amity University Rajasthan, Jaipur, India
- Department of Microbiology, Institute of Medical Sciences (IMS), Banaras Hindu University, Varanasi, India
| | - Gopal Nath
- Department of Microbiology, Institute of Medical Sciences (IMS), Banaras Hindu University, Varanasi, India
- Gopal Nath,
| | - Amit Bhargava
- Department of Medicine, Hayes Memorial Hospital, Sam Higginbottom University of Agriculture, Technology and Sciences (SHUATS), Allahabad, India
| | - Ritu Kumari
- Department of Microbiology, Institute of Medical Sciences (IMS), Banaras Hindu University, Varanasi, India
| | - G. K. Aseri
- Amity Institute of Microbial Technology, Amity University Rajasthan, Jaipur, India
| | - Neelam Jain
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, India
- *Correspondence: Neelam Jain,
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Prasada Rao CMM, Vennila T, Kosanam S, Ponsudha P, Suriyakrishnaan K, Alarfaj AA, Hirad AH, Sundaram SR, Surendhar PA, Selvam N. Assessment of Bacterial Isolates from the Urine Specimens of Urinary Tract Infected Patient. BIOMED RESEARCH INTERNATIONAL 2022; 2022:4088187. [PMID: 35937407 PMCID: PMC9348933 DOI: 10.1155/2022/4088187] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 11/17/2022]
Abstract
Urinary tract infections (UTIs) maintained a serious public health concern, as did the growth in antibiotic resistance both between uropathogenic microorganisms. A regular assessment of the microbiological agents that cause UTIs, as well as their antimicrobial resistance, is essential for a tailored empirical antibiotic response. Knowing the variables that cause UTIs can help you intervene quickly and simply to get the condition under control. The most common infecting species in acute infection is Escherichia coli (E. coli). To strengthen infection control strategies, it is necessary to know the prevalence and location of UTI. The goal of this research is to measure the frequency of microorganisms isolated from patients with UTIs as well as the antimicrobial sensitivity characteristics of Gram-negative bacteria. The purpose of this research has been to evaluate the frequency of UTIs by extracting and characterizing the various bacterial etiological organisms, as well as to assess the factors linked to UTIs. The goal of this research is to identify, characterize, and establish the antibiotic susceptibility patterns of bacteria linked to urinary tract infections. Fresh collected urine specimen was taken from inpatients or outpatients in UTI cases and bacteriologically tested using conventional microbiological methods. The Kirby-Bauer disc diffusion method was used to create the antibiogram. Staphylococcus saprophyticus, Staphylococcus aureus (28%), and Escherichia coli (24.6%) were the most common isolates (20%). The evaluated agents' antibacterial activity was all in the following order: cefixime, ciprofloxacin, augmentin, gentamicin, ceftazidime, nitrofurantoin, ofloxacin, and cefuroxime. It was discovered that each and every one of the microbes exhibited varied degrees of resistance to the antibiotics nitrofurantoin, ciprofloxacin, and ofloxacin. Every type of bacteria, with the exception of those belonging to the genus Streptococcus, has a Multiple Antibiotic Resistance Index (MARI) that is more than 0.2. The first-line therapies for urinary tract infections (UTIs) in the region would consist of ciprofloxacin, ofloxacin, and nitrofurantoin. Lower urinary tract infections almost never result in problems if they are diagnosed and treated as soon as possible and in the correct manner. However, if treatment is not sought, a urinary tract infection can lead to serious complications.
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Affiliation(s)
- Chennu M. M. Prasada Rao
- Department of Pharmaceutical Chemistry, School of Pharmacy, Raffles University, Neemrana, Rajasthan 301020, India
| | - T. Vennila
- Department of Chemistry, Sri Sairam Engineering College, Chennai, Tamil Nadu 602109, India
| | - Sreya Kosanam
- Department of Pharmacology and Pharmacy Practice, Nirmala College of Pharmacy, Atmakur, Andhra Pradesh 522503, India
| | - P. Ponsudha
- Department of Electronics and Communication Engineering, Velammal Engineering College, Chennai, Tamil Nadu 600066, India
| | - K. Suriyakrishnaan
- Department of Electronics and Communication Engineering, Sona College of Technology, Salem, Tamil Nadu 636005, India
| | - Abdullah A. Alarfaj
- Department of Botany and Microbiology, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia
| | - Abdurahman Hajinur Hirad
- Department of Botany and Microbiology, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia
| | - S. R. Sundaram
- Department of Sciences, University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - P. A. Surendhar
- Department of Biomedical Engineering, Vels Institute of Science, Technology and Advanced Studies (VISTAS), Chennai, Tamil Nadu, India
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Karikari AB, Saba CK, Yamik DY. Reported Cases of Urinary Tract Infections and the Susceptibility of Uropathogens from Hospitals in Northern Ghana. Microbiol Insights 2022; 15:11786361221106109. [PMID: 35769634 PMCID: PMC9234931 DOI: 10.1177/11786361221106109] [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: 10/05/2021] [Accepted: 05/22/2022] [Indexed: 11/25/2022] Open
Abstract
As global studies report varying trends in antibiotic susceptibility of
uropathogens, it is necessary to have current and constant information on the
prevalence of urinary tract infections, the causative pathogens, and their
susceptibility profiles, for effective management in specific geographical
settings. This prospective cross-sectional study focused on the prevalence of
urinary tract infections, etiological agents, and their antibiogram in a
secondary and tertiary care hospital in Northern Ghana. Urine samples collected
from 219 patients of all age groups were cultured on cysteine lactose
electrolyte deficient agar. Pathogens were identified following standard
microbiological methods, and their susceptibility to antibiotics was determined
by the Kirby-Bauer disk diffusion method. Approximately 34% of the patients had
significant bacteria, but the prevalence was slightly higher
(P = .763) in the Tertiary care hospital (37.3%) than in the
Secondary hospital (30.3%). Patients who were 60 years and above (27.0%) were
commonly found with UTIs followed by the year group 20 to 29 years (20.3%).
Although all the diagnoses had a positive relationship with urinary tract
infection except Pyelonephritis, none of the underlying conditions was a
significant (P > .05) predictor of urinary tract infection,
with the odds ratio indicating that patients with hyperparathyroidism and
dysuria had 2.606 times more likely increased risk or predictor of urinary tract
infection. Ten different pathogens were identified, but
Escherichia coli and Staphylococcus
saprophyticus were frequently encountered. Gram-negative isolates
generally showed more resistance. High resistance against ampicillin (100%),
trimethoprim-sulfamethoxazole (88.5%), chloramphenicol (84.6%), augmentin
(69.2%), ceftriaxone (69.2%), and ciprofloxacin (61.5%) were recorded. Amikacin
was relatively effective against isolated pathogens. The high records of
resistance among uropathogens and the occurrence of multidrug resistance (92%)
reiterate the urgent call for rigorous surveillance of antimicrobial resistance
among infectious pathogens in Ghana.
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Affiliation(s)
- Akosua B Karikari
- Department of Clinical Microbiology, School of Medicine, University for Development Studies, Tamale, Ghana
| | - Courage Ks Saba
- Department of Microbiology, Faculty of Biosciences, University for Development Studies, Tamale, Ghana
| | - David Y Yamik
- Department of Microbiology, Faculty of Biosciences, University for Development Studies, Tamale, Ghana
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Narayan Swamy SN, Jakanur RK, Sangeetha SR. Significance of C-reactive Protein Levels in Categorizing Upper and Lower Urinary Tract Infection in Adult Patients. Cureus 2022; 14:e26432. [PMID: 35915684 PMCID: PMC9337713 DOI: 10.7759/cureus.26432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 06/29/2022] [Indexed: 01/08/2023] Open
Abstract
Background: Urinary tract infections (UTIs) are one of the most commonly encountered infections in outpatients. The distinction between upper UTI and lower UTI is significant as it has therapeutic and prognostic importance. The accurate diagnosis of UTI, especially its anatomical location, is essential for administering anti-microbial therapy successfully. Plasma levels of C-reactive protein (CRP) increase 1,000-fold during bacterial infections. Elevated CRP levels are often seen in acute pyelonephritis and rarely in cystitis. Therefore, this study aimed to evaluate the diagnostic role of serum CRP in upper and lower UTI in adult patients along with correlating its role in UTI patients. Materials and methods: The study included 81 patients who were >18 years old, diagnosed with UTI by microbiological culture and ultrasonography of the pelvis. Demographic data along with findings of the systemic examination, complete blood count, random blood sugar, urine analysis, and CRP levels of all patients were recorded. Data were analyzed using R Studio.3.5.3 software, and a p-value ≤ 0.05 was considered significant. Results: The prevalence of UTI was higher among females (60.49%). About 53.09% of patients exhibited upper and 46.91% exhibited lower UTI. The prevalence of Escherichia coli was higher among cases of both upper (88.37%) and lower (65.79%) UTI. The most common final diagnosis in upper UTI patients was acute pyelonephritis (90.7%) and that in lower UTI was cystitis (65.79%). The difference in the CRP levels between the upper and lower UTI patients was significant (p=0.02). Thirty-four patients had CRP levels >100 mg/L, all exhibiting upper UTI. Conclusion: About 53.09% of patients exhibited upper UTI and were diagnosed with acute pyelonephritis. A significant increase in the CRP levels in upper UTI can help determine the anatomical location and can help in targeting effective management of the infection by anti-microbial therapy.
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Occurrence of Extended-spectrum Beta-lactamases and the Antibiogram Pattern of Escherichia coli Isolates from Pus and Urine Samples. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2022. [DOI: 10.22207/jpam.16.2.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Escherichia coli (E. coli) is a significant species and a common dweller in the guts of humans and animals causing urinary tract infections, wound infection, otitis media, bloodstream infections, and other complications in humans. Worldwide resistance to antimicrobials is a serious public health problem. β-lactamases production by E. coli is responsible for resistance to frequently used beta-lactam antibiotics. 1) To determine antibiotic susceptibility pattern of Escherichia coli isolated from pus and urine samples 2) To determine ESBL producing Escherichia coli and its antibiotic susceptibility pattern. Retrospective study of E. coli isolates from urine and pus samples was performed by collecting data from bacteriology registers. Gender, age details of patients, number of E. coli isolates, and their antimicrobial susceptibility profiles were collected from the records. Out of 747 samples 102 E. coli were isolated and among them 60 (59%) were ESBL producers. Male preponderance was seen i.e. 59 (57.84%) and majority 68 (66.66%) were isolated from the age group of <18 years. E. coli showed maximum sensitivity to imipenem 88 (86.27%), followed by piperacillin-tazobactam 84 (82.35%), aminoglycoside group 76 (74.5%) and maximum resistance was seen to penicillin groups 92 (90.19%), followed by cephalosporins 71 (69.6%). Urinary isolates showed maximum sensitivity to nitrofurantoin (93.67%). ESBL producers showed resistance to ciprofloxacin 47 (78%). This study helps in the periodic formulation of regional antimicrobial policies and also giving continuous information to the clinicians with respect to the sensitivity pattern along with ESBL production which can help to avert further drug resistance.
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Campbell JSO, van Henten S, Koroma Z, Kamara IF, Kamara GN, Shewade HD, Harries AD. Culture Requests and Multi-Drug Resistance among Suspected Urinary Tract Infections in Two Tertiary Hospitals in Freetown, Sierra Leone (2017-21): A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4865. [PMID: 35457729 PMCID: PMC9024669 DOI: 10.3390/ijerph19084865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/04/2022] [Accepted: 04/13/2022] [Indexed: 11/16/2022]
Abstract
In sub-Saharan Africa, there is limited information about the use of microbiology laboratory services in patients with suspected urinary tract infections (UTIs). This cross-sectional study assessed the requests for urine culture in patients with suspected UTI in two tertiary (maternal and paediatric) hospitals-Freetown and Sierra Leone, during May 2017-May 2021-and determined antimicrobial resistance (AMR) patterns among bacterial isolates. One laboratory served the two hospitals, with its electronic database used to extract information. Overall, there were 980 patients, of whom 168 (17%) had cultures requested and performed. Of these, 75 (45%) were culture positive. During 2017-2019, there were 930 patients, of whom 156 (17%) had cultures performed. During 2020-2021, when services were disrupted by the COVID-19 pandemic, there were 50 patients, of whom 12 (24%) had cultures performed. The four commonest isolates were Escherichia coli (36), Klebsiella pneumoniae (10), Staphylococcus aureus (9), and Pseudomonas spp. (6). There were high levels of AMR, especially for trimethoprim-sulfamethoxazole (47%), nalidixic acid (44%), nitrofurantoin (32%) and cefotaxime (36%). Overall, 41 (55%) bacterial isolates showed multidrug resistance, especially E. coli (58%), Pseudomonas spp. (50%), and S. aureus (44%). These findings support the need for better utilization of clinical microbiology services to guide antibiotic stewardship and monitoring of trends in resistance patterns.
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Affiliation(s)
- Julian S. O. Campbell
- Ola During Children’s Hospital (ODCH) and Princess Christian Maternity Hospital (PCMH) Laboratory, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone
| | - Saskia van Henten
- Department of Clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium;
| | - Zikan Koroma
- Directorate of Laboratory, Diagnostics and Blood Services, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone;
| | - Ibrahim Franklyn Kamara
- Infection Prevention and Control Unit-Health Security and Emergency Cluster, World Health Organization Country Office, Freetown 00232, Sierra Leone;
| | - Gladys N. Kamara
- Joint Medical Unit, Ministry of Defense, Republic of Sierra Leone Armed Forces, Freetown 00232, Sierra Leone;
| | - Hemant Deepak Shewade
- Division of Health System Research, ICMR-National Institute of Epidemiology (ICMR-NIE), Chennai 600077, India;
| | - Anthony D. Harries
- Centre for Operational Research, International Union Against Tuberculosis and Lung Disease (The Union), 2 Rue Jean Lantier, 75001 Paris, France;
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
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Study of Antibacterial Chemical Substances and Molecular Investigation among Sulfamethoxazole-trimethoprim (SXT)-Resistant Escherichia coli Isolates. Rep Biochem Mol Biol 2022; 11:166-175. [PMID: 35765533 PMCID: PMC9208570 DOI: 10.52547/rbmb.11.1.166] [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: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 01/11/2023]
Abstract
Background Escherichia coli (E. coli) remains one of the leading agents of urinary tract infection (UTIs), it has become resistant to many drugs. Current work aimed to evaluate some chemical substances as antibacterial agents and molecular study of virulence factors associated with UTIs. Methods This work involved 133 urine specimens obtained from females' patients suffering from UTIs, Methods of well diffusion and disk diffusion were achieved to assay the effect of some chemical substances and antibiogram profiles toward Sulfamethoxazole-trimethoprim (SXT)-resistant E. coli respectively. Virulence genes were done based on the technique of Polymerase Chain Reaction (PCR). Results The results recorded 49/133 (36.84%) E. coli among women suffering UTIs, 28/49 (57.14%) were resistant to SXT drug. imipenem, meropenem, and nitrofurantoin were recorded more effectively. Chemicals substances at the concentration 0.3 (g/ml) recorded percentages of inhibition, reaching 9.143±1.442, 15.36±0.5914, and 21.82±0.8699 for NaHCO3, Ch4c, and Viroxide Super™ respectively. PCR demonstrated that 28/28 (100%) of SXT-resistant E. coli isolates were harbored Sul-2, FeoB and PapC genes, while 14/28 (50%), 15/28 (53.57%), 19/28 (67.85%) and 26/28 (92.85%) in U250 (pet), FumC, Sul-1 and IutA genes, respectively. Sul-3 gene was not observed. Conclusion Observed a high percentage of E. coli that were resistant to SXT drug, and having several virulence genes, poses a real threat, it requires a real pause to create substitutions to limit the spreading of this threat.
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Antimicrobial Resistance Patterns, Extended-Spectrum Beta-Lactamase Production, and Associated Risk Factors of Klebsiella Species among UTI-Suspected Patients at Bahir Dar City, Northwest Ethiopia. Int J Microbiol 2022; 2022:8216545. [PMID: 35355926 PMCID: PMC8960036 DOI: 10.1155/2022/8216545] [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: 05/29/2021] [Accepted: 02/28/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Klebsiella species cause pneumonia, UTI, and septicemia in human beings. Beta-lactam drugs are used extensively to treat patients infected with Klebsiella, but most of the Klebsiella species are resistant to third- and fourth-generation cephalosporins and monobactams to which data are scarce in the study area. Objective To determine the prevalence, antimicrobial resistance, ESBL production, and associated risk factors of Klebsiella species among UTI-suspected patients in Bahir Dar City, Northwest Ethiopia. Methods A multi-institution-based prospective cross-sectional study was conducted from January to May 2019. Midstream urines were collected from 385 patients and inoculated onto CLED and MacConkey agars. Identification of growth was done by a battery of biochemical tests. Antimicrobial resistance and ESBL production patterns were determined by using the disc-diffusion method on Mueller–Hinton agar. Quality of data was maintained by following SOPs and using Klebsiella pneumoniae (ACTT700603). Logistic regression statistical analysis was done using the SPSS, version 25, statistical package. A pvalue ≤ 0.05 was considered statistically significant. Results The median age of the study participants was 32 years. Majority of them were female, urban residents, and unable to read and/or write. The total Klebsiella species detected were 38 (9.9%). Of which, 25 (65.8%) were Klebsiella pneumoniae, followed by 6 (15.8%) Klebsiella ozaenae. 20 (80%), 19 (76%), and 19 (76%) Klebsiella pneumoniae showed resistance to amoxicillin/clavulanic acid, ampicillin, and cotrimoxazole, respectively. All K. oxytoca were resistant to ampicillin, and all K. rhinoscleromatis were resistant to cefoxitin and cefotaxime. Klebsiella species that showed resistance to ≥3 antimicrobials were 26 (68%). ESBL-producing Klebsiella species were 10 (26.3%). Patients who had history of antibiotic use, hospitalization, and tight dressing habit had more risk of getting UTI (p < 0.05) than their counterparts. Conclusions Overall UTI prevalence in our study was lower than that of previous Ethiopian studies. High MDR and ESBL-producing Klebsiella species were detected. Patients' history of antibiotic use, hospitalization, and tight dressing habit were risk factors for UTI. It calls up for improving prevention/control systems of Klebsiella species.
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Mukapa N, Mataruse A, Ngwende GW, Robertson V. Incidence, risk factors and microbiological aetiology of urinary tract infections in admitted stroke patients at a teaching hospital in Zimbabwe: A prospective cohort study. Infect Prev Pract 2022; 4:100210. [PMID: 35308560 PMCID: PMC8924623 DOI: 10.1016/j.infpip.2022.100210] [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: 11/01/2021] [Accepted: 02/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background and purpose The occurrence of urinary tract infections (UTIs) after stroke is a well recognised complication. The aim of this study was to determine the incidence of UTIs in stroke patients admitted at a teaching hospital in Zimbabwe. Methods A prospective cohort study was conducted in stroke patients admitted within 7 days from onset of stroke. Patients were followed up throughout the admission period and those with symptomatic UTI were identified. Urine samples for analysis were collected and causative bacterial organisms were identified with their antibiotic susceptibility patterns analysed. Results A total of 145 stroke patients were followed up during their in-patient care. 28 patients (19.3%) developed a urinary tract infection, 45 patients (31%) had asymptomatic bacteriuria and 72 patients (49.7%) had no bacteriuria. The median time from admission to UTI occurrence post stroke was 5 (IQR 4–7) days. Severe stroke (NIHSS score 16–42) was an independent risk factor for UTI development with an odds ratio (OR) 5.15 (1.68–15.75) p<0.001.The commonest bacterial causative organisms cultured were Escherichia coli (27.6%) ; Klebsiella species (21.1%) and Enterococcus faecalis (19.7%). Twenty nine percent of the cultured Gram negative bacteria were extended-spectrum beta-lactamase (ESBL) producers. Conclusions UTIs are common in admitted stroke patients and a significant percentage of causative organisms are multi-drug resistant. UTI occurrence is more common in patients with severe stroke and is associated with increased hospital stay. These observations highlight the need for robust infection prevention and control strategies to curb this common post-stroke complication.
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Affiliation(s)
- Nickson Mukapa
- Department of Primary Health Care Sciences, Internal Medicine Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Zimbabwe
- Corresponding author. Address: Department of Primary Health Care Sciences, Internal Medicine Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, P.O. Box A178, Avondale, Harare, Zimbabwe.
| | - Andrew Mataruse
- Department of Primary Health Care Sciences, Internal Medicine Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Zimbabwe
| | - Gift Wilson Ngwende
- Department of Primary Health Care Sciences, Internal Medicine Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Zimbabwe
| | - Valerie Robertson
- Department of Laboratory Diagnostic and Investigative Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Zimbabwe
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Giliazeva AG, Misheeva PS, Sharipova MR, Mardanova AM. Bioinformatic Analysis of a Grimelysin-like Protease in the Klebsiella oxytoca Strain NK-1. BIONANOSCIENCE 2022. [DOI: 10.1007/s12668-021-00924-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Klebsiella oxytoca Complex: Update on Taxonomy, Antimicrobial Resistance, and Virulence. Clin Microbiol Rev 2021; 35:e0000621. [PMID: 34851134 DOI: 10.1128/cmr.00006-21] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Klebsiella oxytoca is actually a complex of nine species-Klebsiella grimontii, Klebsiella huaxiensis, Klebsiella michiganensis, K. oxytoca, Klebsiella pasteurii, Klebsiella spallanzanii, and three unnamed novel species. Phenotypic tests can assign isolates to the complex, but precise species identification requires genome-based analysis. The K. oxytoca complex is a human commensal but also an opportunistic pathogen causing various infections, such as antibiotic-associated hemorrhagic colitis (AAHC), urinary tract infection, and bacteremia, and has caused outbreaks. Production of the cytotoxins tilivalline and tilimycin lead to AAHC, while many virulence factors seen in Klebsiella pneumoniae, such as capsular polysaccharides and fimbriae, have been found in the complex; however, their association with pathogenicity remains unclear. Among the 5,724 K. oxytoca clinical isolates in the SENTRY surveillance system, the rates of nonsusceptibility to carbapenems, ceftriaxone, ciprofloxacin, colistin, and tigecycline were 1.8%, 12.5%, 7.1%, 0.8%, and 0.1%, respectively. Resistance to carbapenems is increasing alarmingly. In addition to the intrinsic blaOXY, many genes encoding β-lactamases with varying spectra of hydrolysis, including extended-spectrum β-lactamases, such as a few CTX-M variants and several TEM and SHV variants, have been found. blaKPC-2 is the most common carbapenemase gene found in the complex and is mainly seen on IncN or IncF plasmids. Due to the ability to acquire antimicrobial resistance and the carriage of multiple virulence genes, the K. oxytoca complex has the potential to become a major threat to human health.
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Current strategies in inhibiting biofilm formation for combating urinary tract infections: Special focus on peptides, nano-particles and phytochemicals. BIOCATALYSIS AND AGRICULTURAL BIOTECHNOLOGY 2021. [DOI: 10.1016/j.bcab.2021.102209] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Vega-Hernández R, Ochoa SA, Valle-Rios R, Jaimes-Ortega GA, Arellano-Galindo J, Aparicio-Ozores G, Ibarra JA, Hernández-Castro R, Cruz-Córdova A, Xicohtencatl-Cortes J. Flagella, Type I Fimbriae and Curli of Uropathogenic Escherichia coli Promote the Release of Proinflammatory Cytokines in a Coculture System. Microorganisms 2021; 9:2233. [PMID: 34835359 PMCID: PMC8624364 DOI: 10.3390/microorganisms9112233] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 09/21/2021] [Accepted: 09/27/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Urinary tract infections (UTIs) are a public health problem in Mexico, and uropathogenic Escherichia coli (UPEC) is one of the main etiological agents. Flagella, type I fimbriae, and curli promote the ability of these bacteria to successfully colonize its host. AIM This study aimed to determine whether flagella-, type I fimbriae-, and curli-expressing UPEC induces the release of proinflammatory cytokines in an established coculture system. METHODS The fliC, fimH, and csgA genes by UPEC strain were disrupted by allelic replacement. Flagella, type I fimbriae, and curli were visualized by transmission electron microscopy (TEM). HTB-5 (upper chamber) and HMC-1 (lower chamber) cells cocultured in Transwell® plates were infected with these UPEC strains and purified proteins. There was adherence to HTB-5 cells treated with different UPEC strains and they were quantified as colony-forming units (CFU)/mL. RESULTS High concentrations of IL-6 and IL-8 were induced by the FimH and FliC proteins; however, these cytokines were detected in low concentrations in presence of CsgA. Compared with UPEC CFT073, CFT073ΔfimH, CFT073ΔfimHΔfliC, and CFT073ΔcsgAΔfimH strains significantly reduced the adherence to HTB-5 cells. CONCLUSION The FimH and FliC proteins are involved in IL-6 and IL-8 release in a coculture model of HTB-5 and HMC-1 cells.
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Affiliation(s)
- Rubí Vega-Hernández
- Laboratorio de Investigación en Bacteriología Intestinal, Unidad de Investigación en Enfermedades Infecciosas, Hospital Infantil de México Federico Gómez, 06720 Ciudad de México, Mexico; (R.V.-H.); (S.A.O.)
- Posgrado en Biomedicina y Biotecnología Molecular, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, 09340 Ciudad de México, Mexico
| | - Sara A. Ochoa
- Laboratorio de Investigación en Bacteriología Intestinal, Unidad de Investigación en Enfermedades Infecciosas, Hospital Infantil de México Federico Gómez, 06720 Ciudad de México, Mexico; (R.V.-H.); (S.A.O.)
| | - Ricardo Valle-Rios
- Unidad Universitaria de Investigación en Cáncer e Inmunología, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, 04510 Ciudad de México, Mexico; (R.V.-R.); (G.A.J.-O.)
- Unidadde Investigación en Inmunología y Proteómica, Hospital Infantil de México Federico Gómez, 06720 Ciudad de México, Mexico
| | - Gustavo A. Jaimes-Ortega
- Unidad Universitaria de Investigación en Cáncer e Inmunología, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, 04510 Ciudad de México, Mexico; (R.V.-R.); (G.A.J.-O.)
- Unidadde Investigación en Inmunología y Proteómica, Hospital Infantil de México Federico Gómez, 06720 Ciudad de México, Mexico
- Posgrado en Biología Experimental, Departamento de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, 09340 Ciudad de México, Mexico
| | - José Arellano-Galindo
- Laboratorio de Virología Clínica y Experimental, Unidad de Investigación en Enfermedades Infecciosas, Hospital Infantil de Mexico Federico Gómez, 06720 Ciudad de México, Mexico;
| | - Gerardo Aparicio-Ozores
- Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, 11340 Ciudad de México, Mexico; (G.A.-O.); (J.A.I.)
| | - José Antonio Ibarra
- Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, 11340 Ciudad de México, Mexico; (G.A.-O.); (J.A.I.)
| | - Rigoberto Hernández-Castro
- Departamento de Ecología de Agentes Patógenos, Hospital General Dr. Manuel Gea González, 4800 Ciudad de México, Mexico;
| | - Ariadnna Cruz-Córdova
- Laboratorio de Investigación en Bacteriología Intestinal, Unidad de Investigación en Enfermedades Infecciosas, Hospital Infantil de México Federico Gómez, 06720 Ciudad de México, Mexico; (R.V.-H.); (S.A.O.)
| | - Juan Xicohtencatl-Cortes
- Laboratorio de Investigación en Bacteriología Intestinal, Unidad de Investigación en Enfermedades Infecciosas, Hospital Infantil de México Federico Gómez, 06720 Ciudad de México, Mexico; (R.V.-H.); (S.A.O.)
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Bacterial Profile, Antimicrobial Susceptibility Pattern, and Associated Factors of Community- and Hospital-Acquired Urinary Tract Infection at Dessie Referral Hospital, Dessie, Northeast Ethiopia. Int J Microbiol 2021; 2021:5553356. [PMID: 34589128 PMCID: PMC8476241 DOI: 10.1155/2021/5553356] [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: 02/15/2021] [Revised: 08/27/2021] [Accepted: 09/04/2021] [Indexed: 11/18/2022] Open
Abstract
Background Bacterial urinary tract infection is among the most common community and hospital-acquired infections. Therefore, to know the status of the community and hospital-acquired urinary tract infection, antimicrobial susceptibility patterns, and associated factors among urinary tract infection profiles are essential to physicians and health workers to implement appropriate intervention. Methods An institution-based cross-sectional study was conducted among 422 urinary tract infection suspected patients. All isolates were identified by standard microbiological techniques, and their antibiotic susceptibility was done by the Kirby-Bauer disc diffusion method. Data were entered using EpiData version 3.1 and analyzed by SPSS software version 20. P value < 0.05 at 95% CI was considered statistically significant. Result Of 422 urine samples processed, 100 (23.7%) yielded bacterial isolates. About 50(30.7%) and 50(19.3%) were bacterial isolates from the community and hospitalized patients, respectively. E. coli 44/103(42.7%) predominated across the two groups, followed by S. aureus 25/103(24.3%), CONs, 14/103(13.5%), Klebsiella spp. 7/103(6.78), Proteus spp. 3/103(2.91), and Enterococcus spp. 3/103 (2.91%). Pseudomonas spp. 3/103 (2.91), Citrobacter spp. 2/103(1.94%), and Acinetobacter spp. 1/103(0.999), which were isolated from only the hospitalized patients. Meropenem susceptibly was 100% in both study groups and Ampicillin resistance was documented as 83.3% to 100% and 76.9% to 100% in hospitalized and community-acquired samples, respectively. Conclusion This study found a high prevalence of bacterial urinary tract infection in the study area and a high rate of bacterial resistance was observed to most antimicrobial drugs tested. Meropenem and nitrofurantoin were the most active drugs for urinary tract infections. Therefore, expanding routine bacterial culture and identification with antimicrobial susceptibility testing and strengthening regular surveillance systems are essential for appropriate patient care.
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Jain N, Jansone I, Obidenova T, Simanis R, Meisters J, Straupmane D, Reinis A. Antimicrobial Resistance in Nosocomial Isolates of Gram-Negative Bacteria: Public Health Implications in the Latvian Context. Antibiotics (Basel) 2021; 10:antibiotics10070791. [PMID: 34209766 PMCID: PMC8300747 DOI: 10.3390/antibiotics10070791] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/23/2021] [Accepted: 06/29/2021] [Indexed: 11/24/2022] Open
Abstract
Antimicrobial resistance (AMR) is one of the most serious threats in modern medicine which requires the constant monitoring of emerging trends amongst clinical isolates. However, very limited surveillance data is available in the Latvian context. In the present study, we conducted a retrospective analysis of microbiological data from one of the largest public multispecialty hospitals in Latvia from 2017 to 2020. AMR trends for 19 gram-negative bacterial (GNB) genera were investigated. During the study period, 11,437 isolates were analyzed with Escherichia spp. (34.71%), Klebsiella spp. (19.22%) and Acinetobacter spp. (10.05%) being the most isolated. Carbapenems like Meropenem and Ertapenem were the most effective against GNBs (3% and 5.4% resistance rates, respectively) while high resistance rates (>50%) were noted against both Ampicillin and Amoxicillin/Clavulanic acid. Enterobacter spp. and Klebsiella spp. showed a significant increase in resistance rate against Ertapenem (p = 0.000) and Trimethoprim-Sulfamethoxazole (p = 0.000), respectively. A decrease in the prevalence of Extended-Spectrum Beta-Lactamase positive (ESBL+) Enterobacterales was noted. Despite the lower prescription levels of the penicillin group antimicrobials than the European average (as reported in ESAC-Net Surveillance reports), GNBs showed high average resistant rates, indicating the role of ESBL+ isolates in driving the resistance rates. Constant and careful vigilance along with proper infection control measures are required to track the emerging trends in AMR in GNBs.
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Affiliation(s)
- Nityanand Jain
- Department of Biology and Microbiology, Faculty of Medicine, Riga Stradiņš University, LV-1007 Riga, Latvia;
- Correspondence: ; Tel.: +371-67061584
| | - Inese Jansone
- Joint Laboratory, Pauls Stradiņš Clinical University Hospital, LV-1002 Riga, Latvia; (I.J.); (T.O.); (J.M.); (D.S.)
| | - Tatjana Obidenova
- Joint Laboratory, Pauls Stradiņš Clinical University Hospital, LV-1002 Riga, Latvia; (I.J.); (T.O.); (J.M.); (D.S.)
| | - Raimonds Simanis
- Department of Infectology, Faculty of Medicine, Riga Stradiņš University, LV-1007 Riga, Latvia;
| | - Jānis Meisters
- Joint Laboratory, Pauls Stradiņš Clinical University Hospital, LV-1002 Riga, Latvia; (I.J.); (T.O.); (J.M.); (D.S.)
| | - Dagnija Straupmane
- Joint Laboratory, Pauls Stradiņš Clinical University Hospital, LV-1002 Riga, Latvia; (I.J.); (T.O.); (J.M.); (D.S.)
| | - Aigars Reinis
- Department of Biology and Microbiology, Faculty of Medicine, Riga Stradiņš University, LV-1007 Riga, Latvia;
- Joint Laboratory, Pauls Stradiņš Clinical University Hospital, LV-1002 Riga, Latvia; (I.J.); (T.O.); (J.M.); (D.S.)
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Ngowi BN, Sunguya B, Herman A, Chacha A, Maro E, Rugarabamu LF, Bartlett J, Balandya E, Mteta KA, Mmbaga BT. Prevalence of Multidrug Resistant UTI Among People Living with HIV in Northern Tanzania. Infect Drug Resist 2021; 14:1623-1633. [PMID: 33911886 PMCID: PMC8075732 DOI: 10.2147/idr.s299776] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 03/11/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Bacterial urinary tract infection (BUTI) is the commonest urinary tract infection among people living with human immunodeficiency virus (PLHIV). It causes significant morbidity in this vulnerable group. Immunosuppression due to HIV can mask the signs and symptoms of infection leading to asymptomatic disease. There is limited evidence in Tanzania regarding BUTI and PLHIV. This study aimed to determine the prevalence, etiology, risk factors and susceptibility pattern of isolates causing asymptomatic UTI in PLHIV at Kilimanjaro Christian Medical Centre (KCMC). PATIENTS AND METHODS This cross-sectional study was conducted from July to September 2020 at Kilimanjaro Christian Medical Centre (KCMC) hospital. A questionnaire was used to collect social demographic data from patients' files together with necessary information required by this study. Urine samples were obtained from participants for urinalysis and urine culture and sensitivity. Data from 300 adults aged ≥18 years were analyzed using Statistical Package for Social Science (SPSS) version 22. Mean or median with their measure of dispersion were calculated for continuous variables. Logistic regression was used to determine associations between variables, where P-value <0.05 was considered to be significant. RESULTS Bacteriuria was prevalent in 37 (12.3%) of PLHIV. Positive nitrite in urine was associated with bacteriuria (P = 0.01). Gram-positive bacteria were the most common 25 (67.6%) isolates with high sensitivity to nitrofurantoin (88.2%) followed by gentamycin (69.2%). However, resistance was high against ciprofloxacin (77.8%). Multidrug resistance (MDR) was noted in 17 (45.9%). CONCLUSION One in eight of PLHIV attending CTC at KCMC referral hospital in Northern zone of Tanzania have BUTI. Presence of nitrites in urine is an important biomarker associated with BUTI. About two third of the isolates were Gram-positive bacteria, and nearly half of all isolates showed MDR to commonly used antibiotics.
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Affiliation(s)
| | - Bruno Sunguya
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Upanga West, Dar es salaam, Tanzania
| | - Ayesiga Herman
- General Surgery Department, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Alfred Chacha
- Clinical Laboratory Department, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Eusebious Maro
- Obstetric and Gynecology Department, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | | | | | - Emmanuel Balandya
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Upanga West, Dar es salaam, Tanzania
| | - Kien Alfred Mteta
- Urology Department, Kilimanjaro Christian Medical University College, Moshi, Tanzania
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Trend of Bacterial Uropathogens and Their Susceptibility Pattern: Study of Single Academic High-Volume Center in Italy (2015-2019). Int J Microbiol 2021; 2021:5541706. [PMID: 34035817 PMCID: PMC8116166 DOI: 10.1155/2021/5541706] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/06/2021] [Indexed: 12/25/2022] Open
Abstract
Urinary tract infections (UTIs) are a very widespread infection that can occur in disparate age range, in both sexes and in pregnancy/menopause state. Treatment of UTIs is difficult due to the emergence of antibiotic-resistant bacterial strains. The present study shows five years of data collected on patients admitted at the University Hospital "San Giovann di Dio e Ruggi d'Aragona" in Salerno, Italy. The investigation exhibits the incidence of the infection, of the gender, and of the age group affected, identifying the most representative bacteria involved, drawing their profile of antimicrobial resistance. Bacterial identification and antibiotic susceptibility testing were performed using the VITEK 2 system. Among the 46382 studied patients, 9896 (21.34%) and 36486 (78.66%) were positive and negative for microorganism growth, respectively. Of 9896 positive patients, 6158 (62.23%) females and 3738 (37.77%) males were identified. The highest incidence of positive subjects (56.66%) was recorded in the elderly (>61 years). 8431 (85.20%) uropathogens were Gram-negative, 1367 (13.81%) were Gram-positive, and 98 (0.99%) were Candida species (Candida spp.). Escherichia coli (E. coli) and Enterococcus faecalis (E. faecalis) were the most representative Gram-negative and Gram-positive strains, respectively. The Gram-negative bacteria most representative were highly resistant to ampicillin, whereas among the Gram-positive bacteria, E. faecalis was highly resistant to gentamicin and streptomycin high level synergy, and Enterococcus faecium (E. faecium) to ampicillin, ampicillin/sulbactam, and imipenem. This retrospective work investigates the local epidemiological trend in our university hospital in order to induce an increasingly targeted empirical therapeutic approach for the treatment of UTIs.
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Evaluation of Urinary Tract Infection following Corticosteroid Therapy in Patients with Multiple Sclerosis Exacerbation. CANADIAN JOURNAL OF INFECTIOUS DISEASES AND MEDICAL MICROBIOLOGY 2021; 2021:6616763. [PMID: 33603936 PMCID: PMC7870309 DOI: 10.1155/2021/6616763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/17/2021] [Accepted: 01/21/2021] [Indexed: 11/18/2022]
Abstract
The first treatment for multiple sclerosis exacerbation is usually short-term intravenous methylprednisolone (IVMP), with or without a regimen of oral prednisone taper (OPT). This study aims to evaluate the effects of IVMP and OPT in comparison with IVMP alone in raising the risk of urinary tract infection (UTI) and posttreatment improvement of urinary tract symptoms in patients with relapsing-remitting multiple sclerosis. This double-blind randomized clinical trial was conducted on 56 people with multiple sclerosis relapse who had undergone methylprednisolone for 5 days. Patients were randomly split into two groups: oral prednisolone and placebo (tapering for 20 days). Demographic data, duration of multiple sclerosis, urinary tract symptoms, the Expanded Disability Status Scale (EDSS) score, and urine data were analyzed. The incidence of UTI in the intervention and control groups did not differ significantly (
). However, the improvement of urinary tract symptoms in the intervention group was significantly more favorable than in the control group (
). Furthermore, administering OPT after IVMP did not increase the risk of UTI occurrence in patients with multiple sclerosis exacerbation. The urine analysis results did not show any differences at baseline and after the corticosteroid tapering regimen. Due to the risk of infection by corticosteroids, it is no longer necessary to do further urinary screening in this group of patients.
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Asfaw M, Wordofa B, Ayalew Y, Habte T. Knowledge, attitude and practice of nurses towards major immobility complications and its associated factors at governmental hospitals in Addis Ababa, Ethiopia: A cross-sectional study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2021. [DOI: 10.1016/j.ijans.2021.100353] [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] Open
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Chandra H, Singh C, Kumari P, Yadav S, Mishra AP, Laishevtcev A, Brisc C, Brisc MC, Munteanu MA, Bungau S. Promising Roles of Alternative Medicine and Plant-Based Nanotechnology as Remedies for Urinary Tract Infections. Molecules 2020; 25:E5593. [PMID: 33260701 PMCID: PMC7731396 DOI: 10.3390/molecules25235593] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 12/22/2022] Open
Abstract
Urinary tract infections (UTIs) are considered to be the most common infections worldwide, having an incidence rate of 40-60% in women. Moreover, the prevalence of this disorder in adult women is 30 times more than in men. UTIs are usually found in many hospitals and clinical practice; as disorders, they are complicated and uncomplicated; in uncomplicated cases, there is no structural or functional abnormality in the urogenital tract. However, obstruction, retention of urine flow and use of catheters increase the complexity. There are several bacteria (e.g., E. coli, Klebsiella pneumoniae, Proteus vulgaris, etc.) successfully residing in the tract. The diagnosis must not only be accurate but rapid, so early detection is an important step in the control of UTIs caused by uropathogens. The treatment of UTIs includes appropriate antimicrobial therapy to control the infection and kill the causal microbes inside the body. A long-time usage of antibiotics has resulted in multidrug resistance causing an impediment in treatment. Thus, alternative, combinatorial medication approaches have given some hope. Available treatments considered Homeopathic, Ayurvedic, Unani, and other herbal-based drugs. There are new upcoming roles of nanoparticles in combating UTIs which needs further validation. The role of medicinal plant-based nanotechnology approaches has shown promising results. Therefore, there must be active research in phyto-based therapies of UTIs, such as Ayurvedic Biology.
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Affiliation(s)
- Harish Chandra
- Department of Botany and Microbiology, Gurukula Kangri (Deemed to be University), Haridwar 249404, India;
| | - Chanchal Singh
- Department of Microbiology, Faculty of Science and Technology, Mewar University, Chittorgarh 312901, India;
| | - Pragati Kumari
- S-02, Scientist Hostel, Chauras Campus, Srinagar Garhwal, Uttarakhand 246174, India;
| | - Saurabh Yadav
- Department of Biotechnology, H.N.B. Garhwal University (A Central University), Srinagar (Garhwal) 246174, Uttarakhand, India
| | - Abhay P. Mishra
- Adarsh Vijendra Institute of Pharmaceutical Sciences, Shobhit University, Gangoh 247341, India
| | - Aleksey Laishevtcev
- Federal Research Center, Russian Scientific Research Institute of Experimental Veterinary Medicine Named after K. I. Skryabin and Y. R. Kovalenko of the Russian Academy of Sciences, 109428 Moscow, Russia;
- Laboratory of Biocontrol and Antimicrobial Resistance, Orel State University, Named after I. S. Turgenev, 302026 Orel, Russia
| | - Ciprian Brisc
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (C.B.); (M.C.B.); (M.A.M.)
| | - Mihaela Cristina Brisc
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (C.B.); (M.C.B.); (M.A.M.)
| | - Mihai Alexandru Munteanu
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (C.B.); (M.C.B.); (M.A.M.)
| | - Simona Bungau
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania;
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Tuan-Anh T, Tuyen HT, Minh Chau NN, Toan ND, Triet TH, Triet LM, Trang NHT, To NTN, Bartholdson Scott J, The HC, Thanh DP, Clapham H, Baker S. Pathogenic Escherichia coli Possess Elevated Growth Rates under Exposure to Sub-Inhibitory Concentrations of Azithromycin. Antibiotics (Basel) 2020; 9:antibiotics9110735. [PMID: 33114588 PMCID: PMC7693856 DOI: 10.3390/antibiotics9110735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/19/2020] [Accepted: 10/26/2020] [Indexed: 11/20/2022] Open
Abstract
Antimicrobial resistance (AMR) has been identified by the World Health Organization (WHO) as one of the ten major threats to global health. Advances in technology, including whole-genome sequencing, have provided new insights into the origin and mechanisms of AMR. However, our understanding of the short-term impact of antimicrobial pressure and resistance on the physiology of bacterial populations is limited. We aimed to investigate morphological and physiological responses of clinical isolates of E. coli under short-term exposure to key antimicrobials. We performed whole-genome sequencing on twenty-seven E. coli isolates isolated from children with sepsis to evaluate their AMR gene content. We assessed their antimicrobial susceptibility profile and measured their growth dynamics and morphological characteristics under exposure to varying concentrations of ciprofloxacin, ceftriaxone, tetracycline, gentamicin, and azithromycin. AMR was common, with all organisms resistant to at least one antimicrobial; a total of 81.5% were multi-drug-resistant (MDR). We observed an association between resistance profile and morphological characteristics of the E. coli over a three-hour exposure to antimicrobials. Growth dynamics experiments demonstrated that resistance to tetracycline promoted the growth of E. coli under antimicrobial-free conditions, while resistance to the other antimicrobials incurred a fitness cost. Notably, antimicrobial exposure heterogeneously suppressed bacterial growth, but sub-MIC concentrations of azithromycin increased the maximum growth rate of the clinical isolates. Our results outline complex interactions between organism and antimicrobials and raise clinical concerns regarding exposure of sub-MIC concentrations of specific antimicrobials.
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Affiliation(s)
- Tran Tuan-Anh
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City Q5, Vietnam; (T.T.-A.); (H.T.T.); (N.N.M.C.); (N.D.T.); (L.M.T.); (N.H.T.T.); (N.T.N.T.); (H.C.T.); (D.P.T.)
| | - Ha Thanh Tuyen
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City Q5, Vietnam; (T.T.-A.); (H.T.T.); (N.N.M.C.); (N.D.T.); (L.M.T.); (N.H.T.T.); (N.T.N.T.); (H.C.T.); (D.P.T.)
| | - Nguyen Ngoc Minh Chau
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City Q5, Vietnam; (T.T.-A.); (H.T.T.); (N.N.M.C.); (N.D.T.); (L.M.T.); (N.H.T.T.); (N.T.N.T.); (H.C.T.); (D.P.T.)
| | - Nguyen Duc Toan
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City Q5, Vietnam; (T.T.-A.); (H.T.T.); (N.N.M.C.); (N.D.T.); (L.M.T.); (N.H.T.T.); (N.T.N.T.); (H.C.T.); (D.P.T.)
| | - Tran Hanh Triet
- Division of Aquacultural Biotechnology, Biotechnology Center of Ho Chi Minh City, Ho Chi Minh City Q5, Vietnam;
| | - Le Minh Triet
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City Q5, Vietnam; (T.T.-A.); (H.T.T.); (N.N.M.C.); (N.D.T.); (L.M.T.); (N.H.T.T.); (N.T.N.T.); (H.C.T.); (D.P.T.)
| | - Nguyen Hoang Thu Trang
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City Q5, Vietnam; (T.T.-A.); (H.T.T.); (N.N.M.C.); (N.D.T.); (L.M.T.); (N.H.T.T.); (N.T.N.T.); (H.C.T.); (D.P.T.)
| | - Nguyen Thi Nguyen To
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City Q5, Vietnam; (T.T.-A.); (H.T.T.); (N.N.M.C.); (N.D.T.); (L.M.T.); (N.H.T.T.); (N.T.N.T.); (H.C.T.); (D.P.T.)
| | - Josefin Bartholdson Scott
- Department of Medicine, Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), University of Cambridge, Cambridge CB2 0AW, UK;
| | - Hao Chung The
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City Q5, Vietnam; (T.T.-A.); (H.T.T.); (N.N.M.C.); (N.D.T.); (L.M.T.); (N.H.T.T.); (N.T.N.T.); (H.C.T.); (D.P.T.)
| | - Duy Pham Thanh
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City Q5, Vietnam; (T.T.-A.); (H.T.T.); (N.N.M.C.); (N.D.T.); (L.M.T.); (N.H.T.T.); (N.T.N.T.); (H.C.T.); (D.P.T.)
| | - Hannah Clapham
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore;
| | - Stephen Baker
- Department of Medicine, Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), University of Cambridge, Cambridge CB2 0AW, UK;
- Correspondence:
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Dasgupta C, Rafi MA, Salam MA. High prevalence of multidrug resistant uropathogens: A recent audit of antimicrobial susceptibility testing from a tertiary care hospital in Bangladesh. Pak J Med Sci 2020; 36:1297-1302. [PMID: 32968397 PMCID: PMC7501044 DOI: 10.12669/pjms.36.6.2943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives: Urinary tract infections due to multi drug resistant bacteria have been on the rise globally with serious implications for public health. The objective of this study was to explore the prevalence of multi drug resistant uropathogens and to correlate the urinary tract infections with some demographic and clinical characteristics of patients admitted in a tertiary care hospital in Bangladesh. Methods: A cross sectional prospective study was conducted at Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh among clinically suspected urinary tract infection patients from January to December, 2018. Clean-catch midstream or catheter-catch urine samples were subjected to bacteriological culture using chromogenic agar media. Antimicrobial susceptibility testing of the isolates was done by Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines. Descriptive statistical methods were used for data analysis. Results: Culture yielded a total of 537 (42.8%) significant bacterial growths including 420 (78.2%) multi drug resistant uropathogens from 1255 urine samples. Escherichia coli was the most common isolate (61.6%) followed by Klebsiella spp. (22.5%), Pseudomonas spp. (7.8%), Staphylococcus aureus (5.4%) and Enterobacter spp. (2.6%) with multi drug resistance frequency of 77.6%, 71.9%, 90.5%, 86.2% and 92.9% respectively. There was female preponderance (M:F; 1:1.97; P=0.007) but insignificant differences between paediatric and adult population (43.65% vs. 42.57%) and also among different age groups. Diabetes, chronic renal failure, fever and supra-pubic pain had significant association as co-morbidities and presentations of urinary tract infections (P<0.05). Multi drug resistance ranged from 3.7 to 88.1% including moderate to high resistance found against commonly used antibiotics like ciprofloxacin, cephalosporin, azithromycin, aztreonam, cotrimoxazole and nalidixic acid (28.6 to 92.9%). Isolates showed 2.4 to 32.2% resistance to nitrofurantoin, amikacin, netilmicin and carbapenems except Pseudomonas spp. (66.7% resistance to nitrofurantoin) and Enterobacter spp. (28.6 to 42.9% resistance to carbapenems). Conclusion: There is very high prevalence of multi drug resistant uropathogens among hospitalized patients and emergence of carbapenem resistance is an alarming situation. Antibiotic stewardship program is highly recommended for hospitals to combat antimicrobial resistance.
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Affiliation(s)
- Chandrika Dasgupta
- Chandrika Dasgupta, MBBS. Intern Doctor, Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh. Shaheed Ziaur Rahman Medical College, Bogura, Bangladesh
| | - Md Abdur Rafi
- Md. Abdur Rafi, MBBS. Intern Doctor, Rajshahi Medical College Hospital, Rajshahi, Bangladesh
| | - Md Abdus Salam
- Md. Abdus Salam, PhD, FRCP (UK). Department of Microbiology, Present Address: Department of Basic Medical Sciences, Kulliyyah (Faculty) of Medicine, International Islamic University Malaysia, 25200 Kuantan, Pahang, Malaysia. Shaheed Ziaur Rahman Medical College, Bogura, Bangladesh
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50
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Urmi UL, Nahar S, Rana M, Sultana F, Jahan N, Hossain B, Alam MS, Mosaddek ASM, McKimm J, Rahman NAA, Islam S, Haque M. Genotypic to Phenotypic Resistance Discrepancies Identified Involving β-Lactamase Genes, blaKPC, blaIMP, blaNDM-1, and blaVIM in Uropathogenic Klebsiella pneumoniae. Infect Drug Resist 2020; 13:2863-2875. [PMID: 32903880 PMCID: PMC7445497 DOI: 10.2147/idr.s262493] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/16/2020] [Indexed: 12/13/2022] Open
Abstract
Introduction Klebsiella pneumoniae carbapenemase (KPC) belongs to the Group-A β-lactamases that incorporate serine at their active site and hydrolyze various penicillins, cephalosporins, and carbapenems. Metallo-beta-lactamases (MBLs) are group-B enzymes that contain one or two essential zinc ions in the active sites and hydrolyze almost all clinically available β-lactam antibiotics. Klebsiella pneumoniae remains the pathogen with the most antimicrobial resistance to KPC and MBLs. Methods This research investigated the blaKPC, and MBL genes, namely, blaIMP, blaVIM, and blaNDM-1 and their phenotypic resistance to K. pneumoniae isolated from urinary tract infections (UTI) in Bangladesh. Isolated UTI K. pneumoniae were identified by API-20E and 16s rDNA gene analysis. Their phenotypic antimicrobial resistance was examined by the Kirby-Bauer disc diffusion method, followed by minimal inhibitory concentration (MIC) determination. blaKPC, blaIMP, blaNDM-1, and blaVIM genes were evaluated by polymerase chain reactions (PCR) and confirmed by sequencing. Results Fifty-eight K. pneumoniae were identified from 142 acute UTI cases. Their phenotypic resistance to amoxycillin-clavulanic acid, cephalexin, cefuroxime, ceftriaxone, and imipenem were 98.3%, 100%, 96.5%, 91.4%, 75.1%, respectively. Over half (31/58) of the isolates contained either blaKPC or one of the MBL genes. Individual prevalence of blaKPC, blaIMP, blaNDM-1, and blaVIM were 15.5% (9), 10.3% (6), 22.4% (13), and 19% (11), respectively. Of these, eight isolates (25.8%, 8/31) were found to have two genes in four different combinations. The co-existence of the ESBL genes generated more resistance than each one individually. Some isolates appeared phenotypically susceptible to imipenem in the presence of blaKPC, blaIMP, blaVIM, and blaNDM-1 genes, singly or in combination. Conclusion The discrepancy of genotype and phenotype resistance has significant consequences for clinical bacteriology, precision in diagnosis, the prudent selection of antimicrobials, and rational prescribing. Heterogeneous phenotypes of antimicrobial susceptibility testing should be taken seriously to avoid inappropriate diagnostic and therapeutic decisions.
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Affiliation(s)
- Umme Laila Urmi
- Department of Microbiology, Jahangirnagar University, Dhaka 1342, Bangladesh
| | - Shamsun Nahar
- Department of Microbiology, Jahangirnagar University, Dhaka 1342, Bangladesh
| | - Masud Rana
- Department of Microbiology, Jahangirnagar University, Dhaka 1342, Bangladesh
| | - Fahmida Sultana
- Department of Microbiology, Jahangirnagar University, Dhaka 1342, Bangladesh
| | - Nusrat Jahan
- Department of Microbiology, Jahangirnagar University, Dhaka 1342, Bangladesh
| | - Billal Hossain
- Department of Microbiology, Jahangirnagar University, Dhaka 1342, Bangladesh
| | - Mohammed Shah Alam
- Department of Microbiology, Gono Bishwabidyalay, Savar, Dhaka 1342, Bangladesh
| | - Abu Syed Md Mosaddek
- Department of Pharmacology, Uttara Adhunik Medical College, Uttara, Dhaka, Bangladesh
| | - Judy McKimm
- Medical Education, Strategic Educational Development, Leadership for the Health Professions, Swansea University Medical School, Swansea University, Swansea, Wales SA2 8PP, UK
| | - Nor Azlina A Rahman
- Department of Physical Rehabilitation Sciences, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Kuantan 25200, Malaysia
| | - Salequl Islam
- Department of Microbiology, Jahangirnagar University, Dhaka 1342, Bangladesh
| | - Mainul Haque
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur 57000, Malaysia
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