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Gautron JMC, Tu Thanh G, Barasa V, Voltolina G. Using intersectionality to study gender and antimicrobial resistance in low- and middle-income countries. Health Policy Plan 2023; 38:1017-1032. [PMID: 37599460 PMCID: PMC10566319 DOI: 10.1093/heapol/czad054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 06/29/2023] [Accepted: 07/25/2023] [Indexed: 08/22/2023] Open
Abstract
Different sexes and genders experience differentiated risks of acquiring infections, including drug-resistant infections, and of becoming ill. Different genders also have different health-seeking behaviours that shape their likelihood of having access to and appropriately using and administering antimicrobials. Consequently, they are distinctly affected by antimicrobial resistance (AMR). As such, it is crucial to incorporate perspectives on sex and gender in the study of both AMR and antimicrobial use in order to present a full picture of AMR's drivers and impact. An intersectional approach to understanding gender and AMR can display how gender and other components 'intersect' to shape the experiences of individuals and groups affected by AMR. However, there are insufficient data on the burden of AMR disaggregated by gender and other socio-economic characteristics, and where available, it is fragmented. For example, to date, the best estimate of the global burden of bacterial AMR published in The Lancet does not consider gender or other social stratifiers in its analysis. To address this evidence gap, we undertook a scoping review to examine how sex and gender compounded by other axes of marginalization influence one's vulnerability and exposure to AMR as well as one's access to and use of antimicrobials. We undertook a gendered analysis of AMR, using intersectionality as a concept to help us understand the multiple and overlapping ways in which different people experience exposure vulnerability to AMR. This approach is crucial in informing a more nuanced view of the burden and drivers of AMR. The intersectional gender lens should be taken into account in AMR surveillance, antimicrobial stewardship, infection prevention and control and public and professional awareness efforts, both donor and government funded, as well as national and international policies and programmes tackling AMR such as through national action plans.
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Affiliation(s)
- Juliette M C Gautron
- Department of Social Anthropology, University of Cambridge, Free School Lane, Cambridge, CB2 3RF, United Kingdom
| | - Giada Tu Thanh
- Independent Consultant, Gran de Gracia, Barcelona 08012, Spain
| | - Violet Barasa
- Institute of Development Studies, University of Sussex, Library Road, Brighton & Hove, BN1 9RE, United Kingdom
| | - Giovanna Voltolina
- Itad, Preece House, Davigdor Road, Brighton & Hove, BN3 1RE, United Kingdom
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Fonseca-Martínez SA, Martínez-Vega RA, Farfán-García AE, González Rugeles CI, Criado-Guerrero LY. Association Between Uropathogenic Escherichia coli Virulence Genes and Severity of Infection and Resistance to Antibiotics. Infect Drug Resist 2023; 16:3707-3718. [PMID: 37333681 PMCID: PMC10275372 DOI: 10.2147/idr.s391378] [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: 10/17/2022] [Accepted: 01/26/2023] [Indexed: 06/20/2023] Open
Abstract
Purpose Urinary tract infection (UTI) is the most frequent bacterial infection. Some uropathogenic Escherichia coli (UPEC) genes have been associated with disease severity and antibiotic resistance. The aim was to determine the association of nine UPEC virulence genes with UTI severity and antibiotic resistance of strains collected from adults with community-acquired UTI. Patients and Methods A case-control study (1:3) (38 urosepsis/pyelonephritis and 114 cystitis/urethritis) was conducted. The fimH, sfa/foc, cvaC, hlyA, iroN, fyuA, ireA, iutA, and aer (the last five are siderophore genes) virulence genes were determined by PCR. The information of antibiotic susceptibility pattern of the strains was collected from medical records. This pattern was determined using an automated system for antimicrobial susceptibility testing. Multidrug-resistant (MDR) was defined as resistance to three or more antibiotic families. Results fimH was the most frequently detected virulence gene (94.7%), and sfa/foc was the least frequently detected (9.2%); 55.3% (83/150) of the strains were MDR. The evaluated genes were not associated with UTI severity. Associations were found between the presence of hlyA and carbapenem resistance (Odds ratio [OR] = 7.58, 95% confidence interval [CI], 1.50-35.42), iutA and fluoroquinolone resistance (OR = 2.35, 95% CI, 1.15-4.84, and aer (OR = 2.8, 95% CI, 1.20-6.48) and iutA (OR = 2.95, 95% CI, 1.33-6.69) with penicillin resistance. In addition, iutA was the only gene associated with MDR (OR = 2.09, 95% CI,1.03-4.26). Conclusion There was no association among virulence genes and UTI severity. Three of the five iron uptake genes were associated with resistance to at least one antibiotic family. Regarding the other four non-siderophore genes, only hlyA was associated with antibiotic resistance to carbapenems. It is essential to continue studying bacterial genetic characteristics that cause the generation of pathogenic and multidrug-resistant phenotypes of UPEC strains.
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Affiliation(s)
| | | | - Ana Elvira Farfán-García
- Programa de Bacteriología y Laboratorio Clínico, Universidad de Santander, Bucaramanga, Santander, Colombia
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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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Multidrug-Resistant Uropathogens Causing Community Acquired Urinary Tract Infections among Patients Attending Health Facilities in Mwanza and Dar es Salaam, Tanzania. Antibiotics (Basel) 2022; 11:antibiotics11121718. [PMID: 36551375 PMCID: PMC9774515 DOI: 10.3390/antibiotics11121718] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/15/2022] [Accepted: 11/19/2022] [Indexed: 12/05/2022] Open
Abstract
In low-income countries, the empirical treatment of urinary tract infections (UTIs) without laboratory confirmation is very common, especially in primary health facilities. This scenario often leads to unnecessary and ineffective antibiotic prescriptions, prompting the emergence and spread of antimicrobial resistance. We conducted this study to examine the antibiogram of uropathogens causing community-acquired urinary tract infections among outpatients attending selected health facilities in Tanzania. METHOD This was a cross-sectional health centre-based survey conducted for a period of five months, from July to November 2021, in the Mwanza and Dar es Salaam regions in Tanzania. We enrolled consecutively a total of 1327 patients aged between 2 and 96 years with a median [IQR] age of 28 [22-39] from Dar es Salaam (n = 649) and Mwanza (n = 678). RESULTS Significant bacteriuria was observed in 364 (27.4% [95%CI: 25.0-29.9]) patients, from whom 412 urinary pathogens were isolated. Gram-negative bacteria contributed to 57.8% (238) of the 412 uropathogens isolated, of which 221 were Enterobacterales, and Escherichia coli was the most frequent. Staphylococcus aureus and Staphylococcus haemolyticus were the most frequently isolated among Gram-positive uropathogens (n = 156). Generally, resistance among Escherichia coli ranged from 0.7% (meropenem) to 86.0% (ampicillin) and from 0.0% (meropenem) to 75.6% (ampicillin) in other Enterobacterales. Moreover, about 45.4% (108) of Enterobacterales and 22.4% (35) of Gram-positive bacteria were multidrug resistant (MDR), p = 0.008. We observed 33 MDR patterns among Gram-negative bacteria, predominantly AMP-CIP-TCY (23/108; 21.3%), and 10 MDR patterns among Gram-positive bacteria, most commonly CIP-GEN-TCY (22/35; 62.9%). CONCLUSION the presence of a high number of wide-ranging uropathogens that are multidrug resistant to a variety of antibiotics points to the need to strengthen the laboratory diagnostic systems for the regular surveillance of the antimicrobial resistance of uropathogens to guide and update empirical treatment guidelines.
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Abalkhail A, AlYami AS, Alrashedi SF, Almushayqih KM, Alslamah T, Alsalamah YA, Elbehiry A. The Prevalence of Multidrug-Resistant Escherichia coli Producing ESBL among Male and Female Patients with Urinary Tract Infections in Riyadh Region, Saudi Arabia. Healthcare (Basel) 2022; 10:1778. [PMID: 36141390 PMCID: PMC9498880 DOI: 10.3390/healthcare10091778] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/09/2022] [Accepted: 09/12/2022] [Indexed: 11/16/2022] Open
Abstract
The Escherichia coli that produces extended-spectrum lactamases (ESBL-E. coli) can develop resistance to many antibiotics. The control of ESBL-E. coli disorders is challenging due to their restricted therapeutic approaches, so this study aims to determine the prevalence and pattern of the antibiotic resistance of ESBL-E. coli among male and female patients with urinary tract infections in Riyadh, Saudi Arabia. During the period of 2019 to 2020 at King Fahd Medical City, Riyadh, 2250 urine samples from patients with urinary tract infections (UTIs) were collected, and microbial species were cultured and identified using standard biochemical techniques. A double-disc synergy test was used to identify ESBL-producing strains of E. coli, and an in vitro method and the clinical laboratory standard institute (CLSI) criteria were employed to determine the resistance of these strains to antimicrobial drugs. ESBL-E. coli was detected in 510 (33.49%) of the 1523 E. coli isolates, 67.27% of which were recovered from women and 33.7% of which were recovered from men. A total of 284 (55.69%) ESBL-E. coli isolates were found in patients under 50 years of age, and 226 (44.31%) were found in patients over 50 years of age. Nearly all the isolates of ESBL-E. coli were resistant to cephalosporins (ceftriaxone, cefotaxime, cefepime, cefuroxime, and cephalothin) and penicillin (ampicillin), whereas the majority of the isolates were sensitive to several carbapenems (imipenem, meropenem, and ertapenem), aminoglycosides (amikacin), and nitrofurantoins. The development of antibiotic resistance by ESBL-E. coli, the most frequent pathogen linked to urinary tract infections, plays a crucial role in determining which antibiotic therapy is appropriate.
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Affiliation(s)
- Adil Abalkhail
- Department of Public Health, College of Public Health and Health Informatics, Qassim University, Al Bukayriyah 52741, Saudi Arabia
| | - Ahmad S. AlYami
- King Fahad Medical City, P.O. Box 59046, Riyadh 11525, Saudi Arabia
| | | | | | - Thamer Alslamah
- Department of Public Health, College of Public Health and Health Informatics, Qassim University, Al Bukayriyah 52741, Saudi Arabia
| | - Yasir Ahmed Alsalamah
- General Surgery Department, Unaizah College of Medicine, Qassim University, Unayzah 56453, Saudi Arabia
| | - Ayman Elbehiry
- Department of Public Health, College of Public Health and Health Informatics, Qassim University, Al Bukayriyah 52741, Saudi Arabia
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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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Ngong IN, Fru-Cho J, Yung MA, Akoachere JFKT. Prevalence, antimicrobial susceptibility pattern and associated risk factors for urinary tract infections in pregnant women attending ANC in some integrated health centers in the Buea Health District. BMC Pregnancy Childbirth 2021; 21:673. [PMID: 34607572 PMCID: PMC8489089 DOI: 10.1186/s12884-021-04142-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 09/23/2021] [Indexed: 11/17/2022] Open
Abstract
Background Urinary tract infections (UTIs) are the second most frequent infections after respiratory tract infections that affect humans, with over 150 million cases per year. The anatomy of the female urinary tract predisposes them to UTIs than men. More so, physiological and hormonal changes during pregnancy put pregnant woman at risk of UTIs. Untreated UTI(s) in pregnancy can be detrimental to both the mother and child causing preterm labour, low birth weight and pyelonephritis. The situation is worrisome because the infection can be asymptomatic. This study investigated the prevalence and risk factors for UTIs, diagnostic potential of dipstick analyses and antimicrobial susceptibility of uropathogens from pregnant women attending ANC in some Integrated Health Centers (IHCs) in Buea Health District (BHD). Methods A structured questionnaire was administered to consenting pregnant women at participating IHCs to collect data on demographic characteristics, risk factors and symptoms of UTI. Urine samples were collected for dipstick analysis and culture. Antibiograms were performed on the isolates by the disc diffusion method. A bivariate analysis was performed to investigate the association of the risk factors to UTI. Chi square (χ2) test, odds ratios with corresponding 95% confidence intervals were used to compare statistics and test for associations at a significant level of p ≤ 0.05. Results Of the 287 participants recruited, 89(31%) were positive for UTI. There were 150 women with no symptoms of which 43(28.7%) were positive for UTI. E. coli was the most frequent (43.2%) of the organisms implicated in bacteriuria. There was no significant association between the risk factors studied and UTI. Isolates were most sensitive to ciprofloxacin (73.5%) and gentamycin (73.5%) and resistant to ceftriaxone (70.6%) and tetracycline (64.7%). Nitrite test was highly specific (100%) for the diagnosis of UTI while leucocyte esterase was more sensitive (48.3%) than specific (44.9%). Conclusions The prevalence of UTI in BHD was high. In conformity with previous findings in same area, there were no risk factors associated with UTI. We recommended a longitudinal study with a larger sample size to follow up the women to term in order to determine the gravity of this infection on pregnancy outcomes.
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Affiliation(s)
- Innocentia Nji Ngong
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, South West Region, Buea, Cameroon
| | - Jerome Fru-Cho
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, South West Region, Buea, Cameroon
| | - Melduine Akom Yung
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, South West Region, Buea, Cameroon
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Trends of Antibacterial Resistance at the National Reference Laboratory in Cameroon: Comparison of the Situation between 2010 and 2017. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9957112. [PMID: 34124266 PMCID: PMC8166466 DOI: 10.1155/2021/9957112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/28/2021] [Accepted: 05/11/2021] [Indexed: 11/29/2022]
Abstract
Introduction Antimicrobial resistance represents a growing public health threat. One of the World Health Organization's strategic objectives is “strengthening knowledge through surveillance and research.” Sub-Saharan African countries are still far from achieving this objective. We aimed to estimate and compare the prevalence of antibacterial resistance in 2010 and 2017 in Cameroon. Methods We conducted a retrospective study on all clinical specimens cultured in Centre Pasteur du Cameroun (CPC) in 2010 and 2017. Data were extracted from the CPC's laboratory data information system software and then managed and analyzed using R. Bacterial resistance rates were calculated in each year and compared using chi-square or Fisher's tests, and relative changes were calculated. Outcomes included acquired resistance (AR), WHO priority resistant pathogens, some specific resistances of clinical interest, and resistance patterns (multi, extensively, and pan drug resistances) for five selected pathogens. Results A total of 10,218 isolates were analyzed. The overall AR rate was 96.0% (95% CI: 95.4–96.6). Most of WHO priority bacterial resistance rates increased from 2010 to 2017. The most marked increases expressed as relative changes concerned imipenem-resistant Acinetobacter (6.2% vs. 21.6%, +248.4%, p = 0.02), imipenem-resistant Pseudomonas aeruginosa (13.5% vs. 23.5%, +74.1%, p < 0.01), 3rd generation-resistant Enterobacteriaceae (23.8% vs. 40.4%, +65.8%, p < 10−15), methicillin-resistant Staphylococcus aureus (27.3% vs. 46.0%, +68.6%, p < 0.002), fluoroquinolone-resistant Salmonella (3.9% vs. 9.5%, +142.9%, p = 0.03), and fluoroquinolone-resistant Enterobacteriaceae (32.6% vs. 54.0%, +65.8%, p < 10−15). For selected pathogens, global multidrug resistance was high in 2010 and 2017 (74.9% vs. 78.0% +4.1%, p = 0.01), intensively drug resistance rate was 5.8% (7.0% vs. 4.7%; p = 0.07), and no pan drug resistance has been identified. Conclusion Bacterial resistance to antibiotics of clinical relevance in Cameroon was high and appeared to increase between 2010 and 2017. There is a need for regular surveillance of antibacterial resistance to inform public health strategies and empirically inform prescription practices.
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Sun B, Wang W, Ma P, Gu B. Accuracy of matrix-assisted laser desorption ionization time-of-flight mass spectrometry for direct bacterial identification from culture-positive urine samples. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:647. [PMID: 33987345 PMCID: PMC8106043 DOI: 10.21037/atm-20-7310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Urinary tract infection (UTI) is one of the most frequent reasons for antimicrobial therapy. In typical clinical setting, 18–48 h is needed to identify pathogens by urine culture. A rapid method for pathogenic UTI diagnosis by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) has been developed in recent years. Methods This meta-analysis systematically evaluated the accuracy of MALDI-TOF MS for direct identification of bacteria from culture-positive urine samples. We queried the electronic database of Medline and Web of Science to obtain relevant articles. Results Nineteen articles involving 4,579 isolates were included after final selection in the meta-analysis. The random-effects pooled identification accuracy of MALDI-TOF MS was 0.82 with 95% confidence interval of 0.79 to 0.86 at the species level. For Gram-negative isolates, the correct identification performance of the species ranged from 0.54 to 0.98, with a cumulative rate of 0.87 (95% CI: 0.83 to 0.91). For Gram-positive isolates, the correct identification rate ranged from 0.32 to 0.80, with a cumulative rate of 0.59 (95% CI: 0.49 to 0.68). Conclusions MALDI-TOF MS provides a reliable direct identification of bacteria, particularly in cases of Gram-negative isolates, from clinical urine specimens. Nevertheless, the identification accuracy of this method is moderate for Gram-positive bacteria.
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Affiliation(s)
- Bin Sun
- Department of Laboratory Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Wei Wang
- Medical Technology School of Xuzhou Medical University, Xuzhou, China
| | - Ping Ma
- Department of Laboratory Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.,Medical Technology School of Xuzhou Medical University, Xuzhou, China
| | - Bing Gu
- Department of Laboratory Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.,Medical Technology School of Xuzhou Medical University, Xuzhou Key Laboratory of Laboratory Diagnostics, Xuzhou, China
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Meena M, Kishoria N, Meena DS, Sonwal VS. Bacteriological Profile and Antibiotic Resistance in Patients with Urinary Tract Infection in Tertiary Care Teaching Hospital in Western Rajasthan India. Infect Disord Drug Targets 2021; 21:257-261. [PMID: 32188395 DOI: 10.2174/1871526520666200318110447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 11/11/2019] [Accepted: 03/03/2020] [Indexed: 06/10/2023]
Abstract
Urinary tract infection (UTI) is one of the most common bacterial infection with a significant economic burden on the health care system in developing countries like India. Rising antibiotic resistance is a matter of great concern. ; Aims: The aim of this study was to determine the bacteriological profile and antibiotic resistance pattern in patients with UTI in Tertiary Care Hospital in western Rajasthan India. ; Settings and Design: A cross-sectional, descriptive study was conducted from December 2017 to November 2018 at MDM hospital S.N. medical college, Jodhpur in Western Rajasthan. ; Materials and Methods: All the patients with symptoms of urinary tract infection presented in the outpatient unit or developed symptoms within 48 hr of hospitalisation were included in the study. Only those patients with significant bacteriuria (105 colony-forming units /ml) were included. ; Results: A total of 119 (55.34%) positive urine cultures were identified. The most common bacteria isolated in the urine sample was E. coli (37.2%) followed by Klebsiella pneumonia (10.2%), Enterococci spp. (3.3%), and Pseudomonas spp. (1.9%). Gram-negative bacteria represented 92.44% of the isolates. E. coli showed maximum resistance towards co-trimoxazole (78.75%) followed by cefuroxime (77.5%) and ciprofloxacin (72.5%). Klebsiella pneumoniae showed the highest resistance against co-trimoxazole (23.75%) and ciprofloxacin (23.75%). ; Conclusion: The present study gives an idea about the common trend of antibiotic resistance of uropathogens in this region. The findings in our study will help in the formulation of antibiotic policy and the determination of empirical treatment of UTI in this region.
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LEI DERU, CHEN PEIYING, CHEN XUETING, ZONG YUJIE, LI XIANGYANG. Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry for Identification of Microorganisms in Clinical Urine Specimens after Two Pretreatments. Pol J Microbiol 2021; 70:1-7. [PMID: 34131429 PMCID: PMC8196241 DOI: 10.33073/pjm-2021-018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/29/2021] [Accepted: 04/06/2021] [Indexed: 02/06/2023] Open
Abstract
Rapid identification of microorganisms in urine is essential for patients with urinary tract infections (UTIs). Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) has been proposed as a method for the direct identification of urinary pathogens. Our purpose was to compare centrifugation-based MALDI-TOF MS and short-term culture combined with MALDI-TOF MS for the direct identification of pathogens in urine specimens. We collected 965 urine specimens from patients with suspected UTIs, 211/965 isolates were identified as positive by conventional urine culture. Compared with the conventional method, the results of centrifugation-based MALDI-TOF MS were consistent in 159/211 cases (75.4%), of which 135/159 (84.9%) had scores ≥ 2.00; 182/211 cases (86.3%) were detected using short-term culture combined with MALDI-TOF MS, of which 153/182 (84.1%) had scores ≥ 2.00. There were no apparent differences among the three methods (p = 0.135). MALDI-TOF MS appears to accelerate the microbial identification speed in urine and saves at least 24 to 48 hours compared with the routine urine culture. Centrifugation-based MALDI-TOF MS is characterized by faster identification speed; however, it is substantially affected by the number of bacterial colonies. In contrast, short-term culture combined with MALDI-TOF MS has a higher detection rate but a relatively slow identification speed. Combining these characteristics, the two methods may be effective and reliable alternatives to traditional urine culture.
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Affiliation(s)
- DERU LEI
- The Center of Laboratory Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
| | - PEIYING CHEN
- The Center of Laboratory Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
| | - XUETING CHEN
- The Center of Laboratory Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
| | - YUJIE ZONG
- The Center of Laboratory Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
| | - XIANGYANG LI
- The Center of Laboratory Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
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Kubone PZ, Mlisana KP, Govinden U, Abia ALK, Essack SY. Antibiotic Susceptibility and Molecular Characterization of Uropathogenic Escherichia coli Associated with Community-Acquired Urinary Tract Infections in Urban and Rural Settings in South Africa. Trop Med Infect Dis 2020; 5:tropicalmed5040176. [PMID: 33260860 PMCID: PMC7709581 DOI: 10.3390/tropicalmed5040176] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/05/2020] [Accepted: 11/10/2020] [Indexed: 02/03/2023] Open
Abstract
We investigated the phenotypic and genotypic antibiotic resistance, and clonality of uropathogenic Escherichia coli (UPEC) implicated in community-acquired urinary tract infections (CA-UTIs) in KwaZulu-Natal, South Africa. Mid-stream urine samples (n = 143) were cultured on selective media. Isolates were identified using the API 20E kit and their susceptibility to 17 antibiotics tested using the disk diffusion method. Extended-spectrum β-lactamases (ESBLs) were detected using ROSCO kits. Polymerase chain reaction (PCR) was used to detect uropathogenic E. coli (targeting the papC gene), and β-lactam (blaTEM/blaSHV-like and blaCTX-M) and fluoroquinolone (qnrA, qnrB, qnrS, gyrA, parC, aac(6')-Ib-cr, and qepA) resistance genes. Clonality was ascertained using ERIC-PCR. The prevalence of UTIs of Gram-negative etiology among adults 18-60 years of age in the uMgungundlovu District was 19.6%. Twenty-six E. coli isolates were obtained from 28 positive UTI samples. All E. coli isolates were papC-positive. The highest resistance was to ampicillin (76.9%) and the lowest (7.7%) to amoxicillin/clavulanic acid and gentamycin. Four isolates were multidrug-resistant and three were ESBL-positive, all being CTX-M-positive but SHV-negative. The aac(6')-Ib-cr and gyrA were the most detected fluoroquinolone resistance genes (75%). Isolates were clonally distinct, suggesting the spread of genetically diverse UPEC clones within the three communities. This study highlights the spread of genetically diverse antibiotic-resistant CA-UTI aetiologic agents, including multidrug-resistant ones, and suggests a revision of current treatment options for CA-UTIs in rural and urban settings.
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Affiliation(s)
- Purity Z. Kubone
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa; (P.Z.K.); (U.G.); (S.Y.E.)
| | - Koleka P. Mlisana
- Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban 4000, South Africa;
| | - Usha Govinden
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa; (P.Z.K.); (U.G.); (S.Y.E.)
| | - Akebe Luther King Abia
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa; (P.Z.K.); (U.G.); (S.Y.E.)
- Correspondence: ; Tel.: +27-73-440-3343
| | - Sabiha Y. Essack
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa; (P.Z.K.); (U.G.); (S.Y.E.)
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Nji CP, Assob JCN, Akoachere JFTK. Predictors of Urinary Tract Infections in Children and Antibiotic Susceptibility Pattern in the Buea Health District, South West Region, Cameroon. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2176569. [PMID: 33490237 PMCID: PMC7803141 DOI: 10.1155/2020/2176569] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 10/03/2020] [Accepted: 10/16/2020] [Indexed: 11/17/2022]
Abstract
Urinary tract infections (UTI) are among the most common pediatric infections and if not promptly diagnosed and treated, it could cause long term complications. Worldwide and in Cameroon, little attention has been paid to this growing problem in the pediatric population. Identification of risk factors will contribute significantly to prevention. A cross-sectional case-control study was carried out in children ≤ 15 years to identify the risk factors of UTI, etiologic agents, and their antibiotic susceptibility. Samples (urine) were collected from in and outpatients with symptoms of UTI attending two health facilities in Buea. Controls were age- and sex-matched children in the community and those visiting these health facilities for unrelated reasons. Samples were analyzed by microscopy, culture, and antibiotic susceptibility of bacteria isolates tested by the disc diffusion technique. Questionnaires were administered to collect sociodemographic, clinical characteristics and data on risk factors. Odds ratios and bivariate and multivariate analyses were used to assess the relationship between predictors (symptoms and risk factors) and UTI. P < 0.05 was considered significant. A total of 405 participants (200 cases and 205 controls) were investigated. UTI prevalence was 12% in cases. From the UTI cases, bacteria was the major cause of infection, with E. coli (39.4%) predominating. Parasitic organisms, Trichomonas vaginalis (0.5%) and Schistosoma spp (0.5%), and yeast (6%) were also detected. Urinary urgency (F = 4.98, P = 0.027) and back pain (F = 12.37, P = 0.001) were associated to UTI following bivariate analysis. These parameters could be used to predict UTI in the pediatric population in the study area. Third generation cephalosporins: ceftriaxone (90.1%) and cefadroxil (85.4%) were the most effective and thus recommended for treatment.
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Affiliation(s)
- Che Pantalius Nji
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, South West Region, Cameroon
| | - Jules Clément Nguedia Assob
- Department of Biomedical Sciences, Faculty of Health Sciences, University of Buea, P. O. Box, 63 Buea, South West Region, Cameroon
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Farahat EM, Hassuna NA, Hammad AM, Fattah MA, Khairalla AS. Distribution of integrons and phylogenetic groups among Escherichia coli causing community-acquired urinary tract infection in Upper Egypt. Can J Microbiol 2020; 67:451-463. [PMID: 33119995 DOI: 10.1139/cjm-2020-0292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Escherichia coli is a major cause of community-acquired urinary tract infections (CA-UTIs). In this study, we investigated the antimicrobial resistance patterns, the distribution of phylogenetic groups, and the prevalence and characteristics of integron-bearing E. coli isolates from outpatients with CA-UTIs in El-Minia governorate, in Upper Egypt. Out of the 583 urine samples collected, 134 were positive for E. coli, from which the most resistant isolates (n = 80) were selected for further analysis. The majority of these isolates (62.5%, 50/80) showed multidrug resistance profiles. Group B2 was the most predominant phylogenetic group (52.5%), followed by group F (21.25%), Clades I or II (12.5%), and finally isolates of unknown phylogroup (13.75%). Of the 80 isolates, 7 (8.75%) carried class 1 integrons, which contained 3 different types of integrated gene cassettes, including those conferring resistance to streptomycin/spectinomycin, trimethoprim, and some open reading frames of unknown function (gcuF). In conclusion, the types and combinations of the gene cassettes in our study may reflect the specific selective pressures to which the isolates were subjected within the study region, therefore, providing valuable data for future intervention strategies that are precisely tailored to prevent the dissemination of the uropathogenic E. coli strains circulating within Upper Egypt.
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Affiliation(s)
- Eman M Farahat
- Microbiology and Botany Department, Faculty of Science, Beni-Suef University, Beni-Suef, Egypt
| | - Noha A Hassuna
- Medical Microbiology and Immunology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Adel M Hammad
- Microbiology Department, Faculty of Agriculture, Minia University, Minia, Egypt
| | - Medhat Abdel Fattah
- Microbiology and Botany Department, Faculty of Science, Beni-Suef University, Beni-Suef, Egypt
| | - Ahmed S Khairalla
- Microbiology and Immunology Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt.,Department of Biology, University of Regina, Saskatchewan, Canada; Department of Biology, Coast Mountain College, British Columbia, Canada
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Mfoutou Mapanguy CC, Adedoja A, Kecka LGV, Vouvoungui JC, Nguimbi E, Velavan TP, Ntoumi F. High prevalence of antibiotic-resistant Escherichia coli in Congolese students. Int J Infect Dis 2020; 103:119-123. [PMID: 33002618 DOI: 10.1016/j.ijid.2020.09.1441] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/19/2020] [Accepted: 09/22/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) is of growing concern worldwide, and the AMR status in sub-Saharan Africa (SSA), including the Republic of the Congo, is largely undetermined due to a lack of real-time monitoring. As the incidence of multi-resistant Escherichia coli has been increasing in recent years, an investigation was performed to determine the antibiotic resistance of E. coli isolated from stool samples of Congolese students. Furthermore, factors associated with the carriage of resistant bacteria were investigated. METHODS A total of 339 stool samples from 339 high school students living in the Madibou area of Brazzaville, Republic of Congo, were tested for E. coli. Isolates obtained were tested for susceptibility to 10 antibiotics that are widely used in the region. RESULTS One hundred and seventy-three (51%) individuals were E. coli-positive in stool, with 61% being female students. Antimicrobial resistance was highest for ceftazidime (65%), followed by amoxicillin (57%), piperacillin-tazobactam (51%), ofloxacin (11%), azithromycin (8%), ciprofloxacin (4%), nalidixic acid (2%), and amoxicillin-clavulanic acid (1%). Antibiotic procurement from non-legalized local vendors had a significant impact on E. coli positivity and antibiotic resistance when compared to procurement from state-licensed pharmacies (p < 0.05). CONCLUSIONS The high prevalence of resistant commensal E. coli in the community justifies further investigation and urges the need for routine monitoring of antimicrobial susceptibility testing in the region.
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Affiliation(s)
- Claujens Chastel Mfoutou Mapanguy
- Fondation Congolaise pour la Recherche Médicale (FCRM), Brazzaville, Congo; Faculty of Sciences and Technology, University Marien Ngouabi, Brazzaville, Congo
| | - Ayodele Adedoja
- Fondation Congolaise pour la Recherche Médicale (FCRM), Brazzaville, Congo
| | | | | | - Etienne Nguimbi
- Faculty of Sciences and Technology, University Marien Ngouabi, Brazzaville, Congo
| | - Thirumalaisamy P Velavan
- Fondation Congolaise pour la Recherche Médicale (FCRM), Brazzaville, Congo; Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; Faculty of Medicine, Duy Tan University, Da Nang, Viet Nam
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale (FCRM), Brazzaville, Congo; Faculty of Sciences and Technology, University Marien Ngouabi, Brazzaville, Congo; Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.
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Samje M, Yongwa O, Mbi Enekegbe A, Njoya S. Prevalence and antibiotic susceptibility pattern of bacteriuria among HIV-seropositive patients attending the Bamenda Regional Hospital, Cameroon. Afr Health Sci 2020; 20:1045-1052. [PMID: 33402950 PMCID: PMC7751511 DOI: 10.4314/ahs.v20i3.7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background HIV causes a decrease in CD4+ lymphocyte cells count, exposing the individual to infections (urinary tract infections). This study was carried out to determine the prevalence of bacteriuria and antimicrobial susceptibility pattern of bacteria isolates among HIV patients. Methods Clean catch mid-stream urine samples were collected from 135 HIV- seropositive patients, cultured on Cystein lactose electrolyte deficient (CLED) agar and incubated at 370C for 24 hours. The modified Kirby-Bauer's disc diffusion method was used to assess susceptibility to antimicrobial agents. Results The prevalence of bacteriuria was 67.4% (91/135). Staphylococcus aureus was the most predominant (42.9%) isolate, followed by Escherichia. coli (24.2%), then Coagulase negative Staphylococci (10.9%). The highest proportion of bacteria was isolated from patients having a CD4+ T-cell count of less than 300 cells/mm3 (39.6%). There was an association between the level of CD4+cell count and bacterial urinary tract infection (P= 0.001). Most sensitive drugs were gentamycin, vancomycin and amoxicillin-clavulanic acid while the drug with the greatest resistance was sulphamethoxazole-trimethoprim, with Enterococcus and Proteus showing 100% resistance to this drug. Conclusion Bacteriuria and resistance to commonly used antibiotics is prevalent among HIV/AIDS patients attending the Bamenda Regional Hospital. Therapy based on antimicrobial susceptibility test is encouraged.
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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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Ghavidel M, Gholamhosseini-Moghadam T, Nourian K, Ghazvini K. Virulence factors analysis and antibiotic resistance of uropathogenic Escherichia coli isolated from patients in northeast of Iran. IRANIAN JOURNAL OF MICROBIOLOGY 2020; 12:223-230. [PMID: 32685119 PMCID: PMC7340601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND OBJECTIVES Escherichia coli is known to be the pathogen commonly isolated from those infected with urinary tract infections (UTIs). The aim of this study was to investigate the presence of E. coli virulence genes and antibiotics' resistance pattern among clinical isolates in the Northeast of Iran. Relationships between virulence genes and antimicrobial resistances were studied as well. MATERIALS AND METHODS Three hundred isolates of E. coli were isolated from patients with UTIs that referred to Ghaem and Imam Reza hospitals (Mashhad, Iran) during August 2016 to February 2017. A multiplex PCR was employed to amplify the genes encoding pyelonephritis associated pili (pap), S-family adhesions (sfa), type1fimbriae (fimH) and aerobactin (aer). Disk diffusion test was performed to test the susceptibility of isolates to β-lactams, aminoglycosides, cephalosporins, quinolone, fluoroquinolones, carbapenems and trimethoprim-sulfamethoxazole. RESULTS The PCR results identified the fimH in 78.4%, aer in 70.5%, sfa in 13.6% and the pap in 8.2% of isolates. The rates of antibiotic resistance of the isolates were as follows: 64.7% resistant to cephalosporins, 34% to trimethoprim-sulfamethoxazole, 31% to fluoroquinolones, 15.3% to aminoglycosides, 13.3% to β-lactams, 7.8% to quinolones and 4.4% to carbapenems. Significant relationships existed between pap and aer, pap and sfa, aer and fluoroquinolones also pap and cephalosporins. CONCLUSION fimH and aer were found in > 50% of isolates suggesting the importance of both genes in UPEC. The majority of isolates had fimH as adhesion factor for colonization. Determining antibiotic resistance patterns in specific geographical areas is necessary for appropriate treatment of urinary tract infection. The high rate of resistance to cephalosporins is most likely due to incorrect drug administration.
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Affiliation(s)
- Mahdis Ghavidel
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran,Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Kimiya Nourian
- Department of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Kiarash Ghazvini
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran,Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran,Corresponding author: Kiarash Ghazvini, MD, Ph.D, Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran AND Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Tel: +98-5138012589, Fax: +98-5118409612,
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Madaha EL, Gonsu HK, Bughe RN, Fonkoua MC, Ateba CN, Mbacham WF. Occurrence of blaTEM and blaCTXM Genes and Biofilm-Forming Ability among Clinical Isolates of Pseudomonas aeruginosa and Acinetobacter baumannii in Yaoundé, Cameroon. Microorganisms 2020; 8:microorganisms8050708. [PMID: 32403300 PMCID: PMC7285512 DOI: 10.3390/microorganisms8050708] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/15/2020] [Accepted: 04/26/2020] [Indexed: 01/25/2023] Open
Abstract
Background: Pseudomonas aeruginosa (PSA) and Acinetobacter baumannii (ACB) are non-fermentative bacteria mostly associated with nosocomial infections in humans. Objective: This study aimed to determine the antimicrobial resistance profiles and virulence gene of PSA and ACB previously isolated from humans in selected health facilities in Yaoundé, Cameroon. Methods: A total of 77 and 27 presumptive PSA and ACB isolates, respectively, were collected from the Yaoundé teaching hospital. These isolates were previously isolated from various samples including pus, blood and broncho-alveolar lavage. The identities of the isolates were determined through polymerase chain reaction (PCR) amplification of PSA and ACB specific sequences. Antimicrobial susceptibility testing (AST) was performed using the Kirby–Bauer disc diffusion method. Phenotypical expression of AmpC β-lactamases (AmpC), extended spectrum β-lactamases (ESBLs) and metallo β-Lactamases (MBLs) were determined using the combined disc method. Bacterial genomes were screened for the presence of β-lactamases blaTEM and blaCTXM genes using specific PCR. The pathogenicity of PSA and ACB was assessed through amplification of the lasB, exoA, pslA and exoS as well as OmpA and csuE virulence genes, respectively. Results: Of the 77 presumptive PSA isolates, a large proportion (75 to 97.4%) were positively identified. All (100%) of the presumptive 27 ACB harbored the ACB-specific ITS gene fragment by PCR. Twenty five percent of the PSA isolates produced ESBLs phenotypically while more than 90% of these isolates were positive for the lasB, exoA, pslA and exoS genes. A large proportion (88%) of the ACB isolates harboured the OmpA and csuE genes. blaTEM and blaCTXM were detected in 17 and 4% of PSA, respectively, while a much higher proportion (70 and 29%) of the ACB isolates possessed these resistance determinants respectively. Conclusion: Our findings reveal the occurrence of both virulence and drug-resistant determinants in clinical PSA and ACB isolates from patients in health care settings in Yaoundé, Cameroon, thus suggesting their role in the pathological conditions in patients.
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Affiliation(s)
- Estelle Longla Madaha
- Biotechnology Centre, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon; (E.L.M.); (R.N.B.)
- Laboratory of Bacteriology, Yaoundé University Teaching Hospital, Yaoundé, Cameroon;
- Department of Disease, Epidemics and Pandemics Control, Ministry of Public Health, Yaoundé, Cameroon
- Bacteriology Service, Centre Pasteur du Cameroun, Yaoundé, Cameroon;
- Antibiotic Resistance and Phage Biocontrol Research Group, Department of Microbiology, Faculty of Natural and Agricultural Sciences, North-West University, Mafikeng Campus, Private Bag X2046, Mmabatho 2735, South Africa
- Food Security and Safety Niche Area, Faculty of Natural and Agricultural Sciences, North-West University, Mafikeng Campus, Private Bag X2046, Mmabatho 2735, South Africa
| | - Hortense Kamga Gonsu
- Laboratory of Bacteriology, Yaoundé University Teaching Hospital, Yaoundé, Cameroon;
- Department of Disease, Epidemics and Pandemics Control, Ministry of Public Health, Yaoundé, Cameroon
| | - Rhoda Nsen Bughe
- Biotechnology Centre, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon; (E.L.M.); (R.N.B.)
| | | | - Collins Njie Ateba
- Antibiotic Resistance and Phage Biocontrol Research Group, Department of Microbiology, Faculty of Natural and Agricultural Sciences, North-West University, Mafikeng Campus, Private Bag X2046, Mmabatho 2735, South Africa
- Food Security and Safety Niche Area, Faculty of Natural and Agricultural Sciences, North-West University, Mafikeng Campus, Private Bag X2046, Mmabatho 2735, South Africa
- Correspondence: (C.N.A.); (W.F.M.); Tel.: +27-183-892-247/+27-783-344-878 (C.N.A.); +23-76-7757-9180 (W.F.M.); Fax: +27-183-862-686 (C.N.A.); 22-237-429 (W.F.M.)
| | - Wilfred Fon Mbacham
- Biotechnology Centre, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon; (E.L.M.); (R.N.B.)
- Correspondence: (C.N.A.); (W.F.M.); Tel.: +27-183-892-247/+27-783-344-878 (C.N.A.); +23-76-7757-9180 (W.F.M.); Fax: +27-183-862-686 (C.N.A.); 22-237-429 (W.F.M.)
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Sun C, Zhang X, Wang J, Cheng C, Kang H, Gu B, Ma P. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry combined with UF-5000i urine flow cytometry to directly identify pathogens in clinical urine specimens within 1 hour. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:602. [PMID: 32566628 PMCID: PMC7290531 DOI: 10.21037/atm.2019.10.73] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Urinary tract infection (UTI) is one of the most common hospital-associated infectious. The traditional laboratory diagnosis method for UTI requires at least 24 hours, and it cannot provide the etiology basis for the clinic in time. The aim of our study is to develop a new method for pathogenic diagnosis of UTI by combining matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) and UF-5000i from urine samples directly within 1 hour. Methods A total of 1,503 urine samples were collected from patients suggesting symptoms of UTI from August 2018 to January 2019. Each of these samples was divided into three aliquots. The first aliquot was used for conventional cleaning mid-stream urine culture; the second one for UF-5000i analysis to screen out the bacterial counts, which were more than 1×105 bacteria/mL. The third one was processed to bacterial purification and directly identified by the MALDI-TOF MS. Results In our study, 296 of 1,503 urine specimens were screened out by UF-5000i (bacterial pellets counts ≥105/mL). Compared the conventional culture-dependent method, the results of our methods were consistent in 249 of 263 (94.7%) cases, and they were both single-microorganism. Among 249 credible results, species-level identification (score ≥2.0) was contained 233 (233/249. 93.6%), 16 (16/249, 6.4%) samples scored between 1.7 and 1.99, and 14 (14/249, 5.6%) samples scored <1.7 or no peaks found. When there were 2 different kinds of bacteria in the urine, the result of MALDI-TOF MS was unreliable. Conclusions MALDI-TOF MS combined with UF-5000i to identify the pathogenic bacteria in urine directly is a novel and reliable method and saves at least 23 hours relative to the current routine conventional method. Thus its rapid and accurate detection may provide the basis of etiology for clinical diagnosis of UTIs efficiently.
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Affiliation(s)
- Chuang Sun
- Medical Technology School of Xuzhou Medical University, Xuzhou 221004, China
| | - Xiao Zhang
- Department of Laboratory Medicine, Suzhou Ninth People's Hospital, Suzhou 215200, China
| | - Jingqiao Wang
- Medical Technology School of Xuzhou Medical University, Xuzhou 221004, China
| | - Chen Cheng
- Medical Technology School of Xuzhou Medical University, Xuzhou 221004, China
| | - Haiquan Kang
- Department of Laboratory Medicine, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, China
| | - Bing Gu
- Medical Technology School of Xuzhou Medical University, Xuzhou 221004, China.,Department of Laboratory Medicine, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, China
| | - Ping Ma
- Medical Technology School of Xuzhou Medical University, Xuzhou 221004, China.,Department of Laboratory Medicine, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, China
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Belete Y, Asrat D, Woldeamanuel Y, Yihenew G, Gize A. Bacterial Profile And Antibiotic Susceptibility Pattern Of Urinary Tract Infection Among Children Attending Felege Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia. Infect Drug Resist 2019; 12:3575-3583. [PMID: 31819542 PMCID: PMC6874112 DOI: 10.2147/idr.s217574] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 10/28/2019] [Indexed: 11/28/2022] Open
Abstract
Background Urinary tract infection (UTI) is a common and important clinical problem in pediatrics. Recurrent UTIs may lead to renal scarring, hypertension, and end-stage renal dysfunction later in life. The objective of the study was to determine bacterial profile and antimicrobial susceptibility pattern of urinary tract infections (UTIs) among children attending Felege Hiwot Referral Hospital (FHRH). Methods A cross-sectional study was conducted from February 2013 to May 2013 among children 5–15 years of age with symptoms of UTI. Samples were processed for culture and identification. Antimicrobial susceptibility was done for positive urine cultures by the Kirby-Bauer’s disk diffusion method based on standards of the Clinical Laboratory Standard Institute (CLSI). Data were entered into Epi-data version 3.2.1 and exported to the Statistical Package for the Social Science (SPSS) version 20 statistical software. Fisher’s exact test and binary logistic regression test results were used. Results A total of 259 urine samples were collected from children with UTI. The result revealed 41 (15.8%) samples had significant bacteriuria, among which the most prevalent pathogen was E. coli 14 (34.1%) followed by Pseudomonas species. Gram-negative bacteria showed high level of sensitivity to ciprofloxacin (70), norfloxacin (63.4%) and ceftriaxone (60%), whereas the level of resistance was high to ampicillin (80%) and nitrofurantoin (70%). Gram-positive isolates showed high sensitivity to ciprofloxacin (77.8%), penicillin (72.8%) and erythromycin (72.7%). Multiple drug resistance (MDR) for Gram-positive and Gram-negative bacteria was 100% and 83.1%, respectively. Conclusion E. coli is the predominant bacteria isolated in the present study. The results showed that the prevalence of resistance to at least one antibiotic to commonly prescribed antimicrobials was high. Hence, the guidelines for empiric treatment of UTI should be re-evaluated periodically based on local studies.
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Affiliation(s)
- Yerega Belete
- Department of Microbiology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Daniel Asrat
- Department of Microbiology, Immunology And Parasitology, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yimtubezinash Woldeamanuel
- Department of Microbiology, Immunology And Parasitology, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gebeyehu Yihenew
- Department of Microbiology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Addisu Gize
- Department of Microbiology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Mouiche MMM, Moffo F, Akoachere JFTK, Okah-Nnane NH, Mapiefou NP, Ndze VN, Wade A, Djuikwo-Teukeng FF, Toghoua DGT, Zambou HR, Feussom JMK, LeBreton M, Awah-Ndukum J. Antimicrobial resistance from a one health perspective in Cameroon: a systematic review and meta-analysis. BMC Public Health 2019; 19:1135. [PMID: 31426792 PMCID: PMC6700798 DOI: 10.1186/s12889-019-7450-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 08/06/2019] [Indexed: 11/10/2022] Open
Abstract
Background Antimicrobial resistance (AMR) is widely acknowledged as a global health problem, yet in many parts of the world its magnitude is not well elucidated. A baseline assessment of the AMR prevalence is a priority for implementation of laboratory-based AMR surveillance This review, focused on a One health approach, aimed at describing the current status of AMR in Cameroon. Methods PubMed, Google Scholar and African Journals Online databases were searched for articles published in English and French in accordance with the PRISMA guidelines. Retrieval and screening of article was done using a structured search string with strict inclusion/exclusion criteria. Free-text and grey literature were obtained by contacting the authors directly. The pooled prevalence and 95% confidence intervals were calculated for each pathogen–antibiotic pairs using random-effects models. Result Amongst 97 full-text articles reviewed, 66 met the eligibility criteria. The studies originated from the Centre (24; 36.4%), South-West (16; 24.2%), West (13; 19.7%), Littoral (9; 13.6%) and other (4; 6.1%) regions of Cameroon. These studies reported AMR in human (45; 68.2%), animals (9; 13.6%) and the environment (12; 18.2%). Overall, 19 species of bacteria were tested against 48 antibiotics. These organisms were resistant to all classes of antibiotics and showed high levels of multidrug resistance. Escherichia coli, Klebsiella pneumoniae and Staphylococcus spp were reported in 23, 19 and 18 of the human studies and revealed multidrug resistance (MDR) rates of 47.1% [95% CI (37.3–57.2%)], 51.0% [95% CI (42.0–59.9)] and 45.2% [95% CI (38.0–54.7)], respectively. Salmonella spp was reported in 6 of the animal studies and showed a MDR rate of 46.2% [95% CI (39.2–53.5%)] while Staphylococcus spp in 8 of environment studies showed MDR rate of 67.1% [95% CI (55.2–77.2%)]. Conclusion This review shows that resistance to commonly prescribed antibiotics in Cameroon is high. The findings emphasize the urgent need to address gaps in the standardization of AMR diagnostics, reporting and use of available information to optimize treatment guidelines for the arsenal of antibiotics. Effective AMR surveillance through continued data sharing, large-scale collaboration, and coordination of all stakeholders is essential to understand and manage the AMR national burden.
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Affiliation(s)
- Mohamed Moctar Mouliom Mouiche
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon. .,MOSAIC, Yaoundé, Cameroon.
| | - Frédéric Moffo
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon.,Laboratory of Animal Physiology and Health, Department of Zootechnics, Faculty of Agronomy and Agricultural Sciences, University of Dschang, Dschang, Cameroon
| | | | - Ndode Herman Okah-Nnane
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon.,Institute of Agricultural Research for Development, Veterinary Research Laboratory, Wakwa Regional Center, Ngaoundéré, Cameroon
| | - Nabilah Pemi Mapiefou
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | | | - Abel Wade
- National Veterinary Laboratory (LANAVET), Yaounde, Cameroon
| | | | | | - Henri René Zambou
- Epidemiology-Public Health-Veterinary Association (ESPV), Yaounde, Cameroon
| | - Jean Marc Kameni Feussom
- Epidemiology-Public Health-Veterinary Association (ESPV), Yaounde, Cameroon.,Cameroon Epidemiological Network for Animal Diseases (RESCAM), Ministry of Livestock, Fisheries and Animal Industries (MINEPIA), Yaoundé, Cameroon
| | | | - Julius Awah-Ndukum
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon.,Laboratory of Animal Physiology and Health, Department of Zootechnics, Faculty of Agronomy and Agricultural Sciences, University of Dschang, Dschang, Cameroon.,College of Technology, University of Bamenda, Bambili, Cameroon
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Donkor ES, Horlortu PZ, Dayie NTKD, Obeng-Nkrumah N, Labi AK. Community acquired urinary tract infections among adults in Accra, Ghana. Infect Drug Resist 2019; 12:2059-2067. [PMID: 31372013 PMCID: PMC6628945 DOI: 10.2147/idr.s204880] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 04/23/2019] [Indexed: 11/23/2022] Open
Abstract
Background: Urinary tract infection (UTI) is one of the most common bacterial infectious diseases encountered in clinical practice, and accounts for significant morbidity and high medical costs. To reduce its public health burden, there is the need for local research data to address aspects of prevention and management of UTI. The aim of this study was to investigate community-acquired UTI among adults in Accra, Ghana, including the risk factors, etiological agents, and antibiotic resistance. Methods: This was a cross-sectional study involving 307 patients clinically diagnosed with UTI at the Korle Bu and Mamprobi polyclinics in Accra. Urine specimens were collected from the study participants and analyzed by culture, microscopy, and dipstick. The bacterial isolates were identified using standard microbiological methods and tested against a spectrum of antibiotics by the Kirby Bauer method. Multidrug resistant Enterobacteriaceae isolates were screened for Extended Spectrum β-lactamase (ESBL) production by the double disc method, and isolates that tested positive were analyzed by Polymerase Chain Reaction for ESBL genes. Demographic information and clinical history of study participants were collected. Results: Based on the criteria for laboratory confirmed UTI, 31 (10.1%) of the 307 specimens were positive and the main risk factor of UTI among the study participants was pregnancy (P=0.02, OR=2.43). The most common uropathogen isolated was Escherichia coli (48.9%), followed by Klebseilla sp. (16.1%). Prevalence of resistance was highest for Piperacillin (87.1%) and Amoxicillin+Clavulanic Acid (87.1%) and lowest for Amikacin (12.9%). Prevalence of multidrug resistance among the uropathogens was 80.1% (25) and the most common ESBL gene detected was CTX-M-15. Conclusion: Pregnant women constitute the key risk population of UTI in Accra, while Amikacin remains a suitable drug for the treatment of febrile UTI. The high prevalence of multidrug resistance among the uropathogens highlights the need for surveillance of antimicrobial resistance among these pathogens.
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Affiliation(s)
- Eric S Donkor
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Prince Z Horlortu
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Nicholas TKD Dayie
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Noah Obeng-Nkrumah
- Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
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Ngemenya MN, Djeukem GGR, Nyongbela KD, Bate PNN, Babiaka SB, Monya E, Kanso RK. Microbial, phytochemical, toxicity analyses and antibacterial activity against multidrug resistant bacteria of some traditional remedies sold in Buea Southwest Cameroon. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 19:150. [PMID: 31242939 PMCID: PMC6595550 DOI: 10.1186/s12906-019-2563-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 06/13/2019] [Indexed: 11/17/2022]
Abstract
Background Traditional medicine remedies are commonly used for treatment of diverse ailments including bacterial infections. The activity against resistant bacteria and safety of some remedies sold as anti-infective treatments in market places in Buea, Southwest Cameroon were investigated as potential alternative treatment to counter increasing antibiotic resistance. Methods Ten remedies were purchased, their components documented and microbial load estimated. Methanol extracts of the remedies were tested for antibacterial activity by disc diffusion and microdilution. Cytotoxicity was evaluated on monkey kidney epithelial cells (LLC-MK2) while acute oral toxicity was done in BALB/c mice for the bactericidal extract. Extracts were further analysed using phytochemical tests. Results All the remedies had microbial loads above the acceptable limit of 105 CFU/g. The highest activity was produced by extracts of four remedies (TP 1, 2, 4, 6a, 6b) against all clinical isolates among which three were active against four control strains. Zones of inhibition ranged from 8 to 27 mm. Two of the four extracts produced zones ≥20 mm against multidrug resistant clinical isolates of Citrobacter freundii and Escherichia coli but were less active compared to Gentamycin positive control (P < 0.0001–0.0014). The most active extracts also recorded minimum inhibitory concentrations of 1 to 4 mg/mL. One of them (TP2) was bactericidal against a clinical isolate of methicillin–resistant Staphylococcus aureus with a minimum bactericidal concentration of 8 mg/mL. Extracts of six remedies did not show cytotoxicity and no mortality or adverse effect was recorded in the acute oral toxicity test. Phytochemical screening showed the most active extracts contained relatively high amounts of alkaloids and flavonoids. Conclusion Only four of the eight remedies tested showed activity against multidrug resistant bacteria suggesting some of these remedies may not be effective against bacterial infections. Production and handling methods should be improved and the product quality controlled to ensure biosecurity. The remedies which were both active and non-toxic should be further investigated including in vivo experiments to assess their efficacy.
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Afnabi RB, Sambo JJN, Mouiche MMM, Namegni RSP. Hazard assessment of Staphylococcus with positive coagulase in meat produced and distributed in the Northern regions of Cameroon. Vet World 2019; 12:466-471. [PMID: 31089319 PMCID: PMC6487253 DOI: 10.14202/vetworld.2019.466-471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 03/26/2018] [Indexed: 11/21/2022] Open
Abstract
Aim: Staphylococcus with positive coagulase (SPC) is a major problem for beef consumers in the northern part of Cameroon. For this purpose, the SPC concentrations in beef produced and supplied in the northern regions were determined, as well as the resistance profile of these bacteria to antibiotics. Materials and Methods: A total of 125 samples were obtained by the wet and dry swabbing method in traditional slaughterhouses and butcheries to evaluate the SPC concentration in meat, and then, 102 SPC isolations were collected to determine the antibiotic resistance profile. Results: The distribution of concentration of the SPC indicated no significant differences of bacterial evidence in almost all the slaughterhouses except the one in Manwi (with 2.66 log CFU/cm²) and the density in SPC is higher than that one in Guider (1.99 log CFU/cm²). The assessment of density in SPC among the selected slaughterhouse highlighted a superiority of the SPC concentrations in the Ngaoundere butcheries (3.83 log CFU/cm²) in comparison with those of other towns. At the level of the slaughterhouses, a higher proportion of resistance to Penicillin G was recorded than Gentamicin. Some butcheries recorded that all SPC reacted to Kanamycin, whereas they were more resistant to Penicillin G. Conclusion: These results reveal that the SPC found in meat poses a threat to meat consumers in the northern part of Cameroon.
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Affiliation(s)
- Raoul Bakari Afnabi
- Department of Microbiology and Infectious Diseases, Ngaoundere University, School of Veterinary Medicine and Sciences, P.O. Box: 454, Ngaoundere, Cameroon
| | - Jean Jacques Nenba Sambo
- Division of Microbiology, Institute of Agricultural Research for Development, P.O. Box: 65, Wakwa, Cameroon
| | - Moctar Mohamed Mouliom Mouiche
- Department of Pharmacy-Pharmacology and Toxicology, Ngaoundere University, School of Veterinary Medicine and Sciences, P.O. Box: 454, Ngaoundere Cameroon
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Paralikar P, Ingle AP, Tiwari V, Golinska P, Dahm H, Rai M. Evaluation of antibacterial efficacy of sulfur nanoparticles alone and in combination with antibiotics against multidrug-resistant uropathogenic bacteria. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART A, TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING 2019; 54:381-390. [PMID: 30912480 DOI: 10.1080/10934529.2018.1558892] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 11/29/2018] [Accepted: 12/01/2018] [Indexed: 06/09/2023]
Abstract
Urinary tract infections (UTIs) have been frequently reported from different parts of the world. The current knowledge on distribution of causative agents of urinary infections and antibiotics susceptibility pattern is essentially required. In the present study, total 351 uropathogenic bacteria were isolated; among them most prevalent were Escherichia coli (75%), followed by Pseudomonas aeruginosa (8%), Proteus mirabilis (6%), Klebsiella pneumoniae (4%), Staphylococcus aureus (4%) and Enterococcus faecalis (3%). Most isolates of uropathogenic bacteria showed resistance to amoxicillin and trimethoprim, followed by chloramphenicol and kanamycin. Biosynthesis of sulfur nanoparticles (SNPs) was performed by co-precipitation method using sodium thiosulfate in presence of Catharanthus roseus leaf extract. The characterization data showed that SNPs were polydispersed, spherical in shape with size range of 20-86 nm and having negative zeta potential of -9.24 mV. The potential antibacterial activity was observed for SNPs alone and in combination with antibiotics particularly amoxicillin and trimethoprim against majority of the uropathogens. The synergistic effect yielded increase in fold area with high activity index against tested uropathogens. Based on overall results, it can be recommended to use SNPs for the management of UTI alone and also in combination with antibiotics.
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Affiliation(s)
- Priti Paralikar
- a Nanobiotechnology Lab., Department of Biotechnology , SGB Amravati University , Amravati , India
| | - Avinash P Ingle
- a Nanobiotechnology Lab., Department of Biotechnology , SGB Amravati University , Amravati , India
- b Department of Biotechnology, Lorena School of Engineering , University of Sao Paulo , Lorena , Brazil
| | - Vaibhav Tiwari
- a Nanobiotechnology Lab., Department of Biotechnology , SGB Amravati University , Amravati , India
| | - Patrycja Golinska
- c Department of Microbiology , Nicolaus Copernicus University , Torun , Poland
| | - Hanna Dahm
- c Department of Microbiology , Nicolaus Copernicus University , Torun , Poland
| | - Mahendra Rai
- a Nanobiotechnology Lab., Department of Biotechnology , SGB Amravati University , Amravati , India
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Ndamason LM, Marbou WJ, Kuete V. Urinary tract infections, bacterial resistance and immunological status: a cross sectional study in pregnant and non-pregnant women at Mbouda Ad-Lucem Hospital. Afr Health Sci 2019; 19:1525-1535. [PMID: 31148980 PMCID: PMC6531958 DOI: 10.4314/ahs.v19i1.26] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Urinary tract infections (UTI) are frequently encountered medical complications of pregnancy. Objective This study was aimed at analyzing the bacterial resistance in urogenital tract as well as the immunological profile amongst pregnant and non-pregnant women at Mbouda Ad-Lucem Hospital, Western Region of Cameroon. Methods A cross-sectional study was carried out from December 2015 to May 2016 at Mbouda Ad-Lucem hospital on 104 pregnant women and 24 non-pregnant women. The midstream urine from participants was analysed for the presence, isolation and identification of the uro-pathogens, using selective and specific bacterial culture media. An antibiotic susceptibility tests was carried out using disk diffusion method. Blood samples were collected for C-reactive protein (CRP) dosage, CD4 and CD8 lymphocytes count. Results Out of 128 participants in this study, a high prevalence of uro-pathogens and resistance strains was observed. The most prevalent urinary tract pathogens were Staphylococcus sp. with 45% and 38.89% respectively in pregnant and non-pregnant women. Staphylococcus sp. showed resistance to Amoxicillin (AMO; 55.56%) and Chloramphenicol (CHL; 100%) respectively in pregnant and non-pregnant women. Pregnant women had a significantly high average of granulocytes (p=0.009), monocytes (P=0.001), high ratio of CD4/CD8 (p< 0.0001) and significantly low CD8 lymphocytes (p< 0.0001) average compared to non-pregnant women. Conclusion This study outlines high prevalence of Staphylococcus sp as the main urinary tract infectious pathogen in women at Mbouda Ad-Lucem hospital. It prevalence was accompanied with resistance to the routine antibiotics treatment, and a pronounced lymphocytosis and monocytosis.
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Affiliation(s)
- Loveline M Ndamason
- Department of Biochemistry, Faculty of Science, University of Dschang, Cameroon
| | - Wiliane Jt Marbou
- Department of Biochemistry, Faculty of Science, University of Dschang, Cameroon
| | - Victor Kuete
- Department of Biochemistry, Faculty of Science, University of Dschang, Cameroon
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Foroughi A, Ramezan-Ghanbari S. Prevalence and Pattern of Antibiotic Resistance of Escherichia Coli Causing Urinary Tract Infections in Patients Referring to a Laboratory in Kermanshah. JOURNAL OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASES 2018. [DOI: 10.29252/jommid.6.4.99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Prevalence of Cotrimoxazole Resistance Uropathogenic Bacteria in Iran: A Systematic Review and Meta-Analysis. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2018. [DOI: 10.5812/archcid.63256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Amin ET, Njumkeng C, Kika BT, Fualefac A, Njukeng P. Pattern of Antimicrobial Resistance among Bacterial Isolates from Urogenital Clinical Specimens: A Descriptive Study from the Buea Health District, Cameroon. Drugs Real World Outcomes 2018; 5:101-108. [PMID: 29651691 PMCID: PMC5984608 DOI: 10.1007/s40801-018-0132-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Antimicrobial resistance has become a global concern and is particularly affecting developing countries where infectious diseases and poverty are endemic. The effectiveness of currently available antimicrobials is decreasing as a result of increasing resistant strains among clinical isolates. OBJECTIVES The aim of this study was to determine the resistance pattern of bacterial isolates from different clinical urogenital specimens at different hospitals in the Buea Health District, Cameroon. METHODS A retrospective study was conducted in three hospital laboratories in the Buea Health District, Cameroon, from June to August 2017. All culture and antimicrobial susceptibility test results of patients who presented at each of the laboratories for urine, vaginal swab or urethral swab cultures from January 2012 to December 2016 were included in the study. Data were analysed using SPSS Windows version 20.0. The comparisons between different isolates' resistance to antimicrobials were performed using the chi-square test. The difference in the resistance of urogenital isolates to various antimicrobials within different years was also compared by the chi-square test. RESULTS A total of 423 bacterial isolates were obtained from clinical urogenital specimens such as: urine 93 (21.9%), vaginal swab 175 (41.4%) and urethral swab cultures 155 (36.6%). The predominant bacterial isolates were Staphylococcus spp. 320 (75.5%), Escherichia coli 37 (8.7%) and Enterococcus spp. 24 (5.7%). All the isolates showed significantly high resistance rates to amoxicillin/clavulanic acid (67.6% resistant rate, p = 0.025), but most isolates, except those of Staphylococcus, were relatively more susceptible to nitrofurantoin (82.6% susceptibility rate, p = 0.045). However, Staphylococcus spp. was more susceptible to ceftriaxone (91.0% susceptibility rate, p < 0.0001) and cefotaxime (74.4% susceptibility rate, p = 0.034). Generally, most of the isolates showed significantly rising rates of resistance to the majority of the antimicrobials tested from 2012 to 2017. CONCLUSION Our findings showed a progressively rising rate of antimicrobial resistance in urogenital bacterial isolates over the last 5 years in the Buea Health District. Thus, uncontrolled and irrational use or prescription of these drugs should be avoided to maintain low resistance of highly susceptible antimicrobials.
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Affiliation(s)
- Elvis Tajoache Amin
- St. Albert The Great Reference Medical Diagnostic Center, Buea, Cameroon
- Global Research Education and Health Foundation, Buea, Cameroon
- Ministry of Public Health, Yaounde, Cameroon
| | - Charles Njumkeng
- St. Albert The Great Reference Medical Diagnostic Center, Buea, Cameroon
- Global Research Education and Health Foundation, Buea, Cameroon
- Ministry of Public Health, Yaounde, Cameroon
| | - Belmond T. Kika
- Ministry of Public Health, Yaounde, Cameroon
- Atlantic Medical Foundation Hospital, Mutengene, Cameroon
- Clinical Research Education, Networking and Consultancy, Douala, Cameroon
| | | | - Patrick Njukeng
- Global Health Systems Solutions, SONARA Road, Limbe, Cameroon
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Mirzaii M, Jamshidi S, Zamanzadeh M, Marashifard M, Malek Hosseini SAA, Haeili M, Jahanbin F, Mansouri F, Darban-Sarokhalil D, Khoramrooz SS. Determination of gyrA and parC mutations and prevalence of plasmid-mediated quinolone resistance genes in Escherichia coli and Klebsiella pneumoniae isolated from patients with urinary tract infection in Iran. J Glob Antimicrob Resist 2018; 13:197-200. [PMID: 29747008 DOI: 10.1016/j.jgar.2018.04.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 04/26/2018] [Accepted: 04/27/2018] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES Fluoroquinolones (FQs) are recommended as the drugs of choice for the empirical treatment of urinary tract infections (UTIs). This study investigated the molecular determinants of FQ resistance in Escherichia coli and Klebsiella pneumoniae isolates in Iran. METHODS A total of 364 clinical isolates of E. coli (n=144) and K. pneumoniae (n=220) were collected from patients with UTI. Susceptibility of the isolates to ciprofloxacin, levofloxacin, gatifloxacin and nalidixic acid was evaluated by disk diffusion. The presence of qnrA, qnrB and qnrS genes was assessed by PCR. Nucleotide sequences of the gyrA and parC genes were determined. RESULTS Eighty-seven (60.4%) and 15 (6.8%) E. coli and K. pneumoniae isolates, respectively, were resistant to at least one of the tested FQs. Plasmid-mediated quinolone resistance (PMQR) genes were detected in 12.6% and 60.0% of FQ-resistant E. coli and K. pneumoniae, respectively. Whilst qnrB predominated in K. pneumoniae, qnrS was the most prevalent PMQR gene in E. coli. S83L (98.9%) and D87N (59.8%) were the most frequent mutations identified in GyrA of E. coli, and 55.2% (n=48) of FQ-resistant E. coli isolates had mutation in ParC harbouring S80I and E84V substitutions. The GyrAS83L substitution was found in only one FQ-resistant K. pneumoniae isolate. CONCLUSIONS FQ resistance was much more common in E. coli isolates than in K. pneumoniae. Whilst mutations in the drug target-encoding genes gyrA and parC were the major mechanisms involved in FQ resistance in E. coli, PMQR determinants commonly mediated FQ resistance in K. pneumoniae.
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Affiliation(s)
- Mehdi Mirzaii
- Faculty of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Sanaz Jamshidi
- Department of Basic Sciences, Islamic Azad University, Yasooj Branch, Yasooj, Iran
| | - Maryam Zamanzadeh
- Department of Basic Sciences, Islamic Azad University, Yasooj Branch, Yasooj, Iran
| | - Masoud Marashifard
- Student Research Committee, Yasuj University of Medical Sciences, Yasuj, Iran
| | | | - Mehri Haeili
- Department of Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | - Fariba Jahanbin
- Department of Basic Sciences, Islamic Azad University, Yasooj Branch, Yasooj, Iran
| | - Fariba Mansouri
- Department of Basic Sciences, Islamic Azad University, Yasooj Branch, Yasooj, Iran
| | - Davood Darban-Sarokhalil
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Sajjad Khoramrooz
- Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran; Department of Microbiology, School of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran.
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Chem ED, Anong DN, Akoachere JFKT. Prescribing patterns and associated factors of antibiotic prescription in primary health care facilities of Kumbo East and Kumbo West Health Districts, North West Cameroon. PLoS One 2018; 13:e0193353. [PMID: 29505584 PMCID: PMC5837085 DOI: 10.1371/journal.pone.0193353] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 01/31/2018] [Indexed: 11/18/2022] Open
Abstract
Background Inappropriate use of antibiotics is a global public health challenge and has been associated with antibiotic resistance. WHO reports show that efforts to promote rational antibiotic use in developing countries are poor. With the growing number of infections with antibiotic resistant bacteria, rational drug use becomes imperative and studies that promote rational drug use are highly necessary. Considering this, we investigated prescribing patterns and predictors of antibiotic prescription in primary health care facilities in Kumbo East (KE) and Kumbo West (KW) health districts in North West Cameroon, to contribute data which could influence policy on antibiotic use. Methods and findings A cross sectional retrospective study was conducted from April 2014 to April 2015 in 26 randomly selected primary care facilities. Questionnaires were administered to 59 antibiotic prescribers to determine factors that predict antibiotic prescribing. Data on antibiotic prescription were collected by review of consultation registers. Prescription rates and demographics, prescriber and institution factors were analyzed using ANOVA. The best predictor of prescription was determined using multiple linear regression analysis. Results A total of 30,096 prescriptions were reviewed. Overall antibiotic prescription rate was 36.71%, with a mean of 1.14 antibiotics prescribed per patient. Amoxicillin was the most prescribed (29.9%). The most prevalent indications for prescribing were respiratory tract infections (21.27%). All antibiotics prescribed were broad-spectrum. Antibiotics were prescribed for patients with malaria and also in situations where diagnosis was uncertain. Prescribing by generic name was 98.36% while 99.87% was from Essential Drug List. Use of laboratory results, patient turnout and Performance Based Financing (PBF) were significantly associated with antibiotic prescribing rates (p < 0.05). PBF moderated prescribing. Conclusion There was misuse of antibiotics in primary care facilities in study area. We recommend all primary care health facilities in study area to be included in the PBF scheme and that prescribing should only be done by physicians as the have adequate training.
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Affiliation(s)
- Elvis Dzelamonyuy Chem
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon
| | - Damian Nota Anong
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon
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Saeed A, Hamid SA, Bayoumi M, Shanan S, Alouffi S, Alharbi SA, Alshammari FD, Abd H. Elevated antibiotic resistance of Sudanese urinary tract infection bacteria. EXCLI JOURNAL 2017; 16:1073-1080. [PMID: 29285003 PMCID: PMC5735337 DOI: 10.17179/excli2017-424] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Accepted: 06/12/2017] [Indexed: 11/16/2022]
Abstract
This study determined the prevalence of urinary tract infections in the Sudanese state of Khartoum and antimicrobial susceptibility pattern of isolated bacterial species. 200 adult patient urine specimens were collected and cultivated to identify the growing bacteria and their susceptibility to antibiotics. 35 % of specimens had significant bacterial growth. The most frequent isolates in this study were E. coli, E. faecalis and S. aureus. Most of the isolates were resistant to many antibiotics; Gram-negative and Gram-positive isolates were resistant to 67 % and 44 % of the examined antibiotics, respectively. E. coli was the most frequent bacterium in the studied samples and it was highly resistant to first-line antibiotics. The most resistant bacteria isolated were Pseudomonas species and the lowest was for S. saprophyticus. The results highlighted the need for knowledge about antibiotic susceptibility profile of the bacteria causing UTI prior to antibiotic prescription in order to ensure optimal treatment.
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Affiliation(s)
- Amir Saeed
- University of Hail, College of Applied Medical Sciences, Department of Clinical Laboratory Science, Hail, Kingdom of Saudi Arabia
- University of Medical Sciences and Technology, Faculty of Medical Laboratory Sciences, Department of Microbiology, Khartoum 11111, Sudan
- Karolinska Institute, Department of Laboratory Medicine, Division of Medical Microbiology, Stockholm, Sweden
| | - Shadia A. Hamid
- University of Medical Sciences and Technology, Faculty of Medical Laboratory Sciences, Department of Microbiology, Khartoum 11111, Sudan
| | - Magdi Bayoumi
- University of Medical Sciences and Technology, Faculty of Medical Laboratory Sciences, Department of Microbiology, Khartoum 11111, Sudan
| | - Salah Shanan
- University of Medical Sciences and Technology, Faculty of Medical Laboratory Sciences, Department of Microbiology, Khartoum 11111, Sudan
| | - Sultan Alouffi
- University of Hail, College of Applied Medical Sciences, Department of Clinical Laboratory Science, Hail, Kingdom of Saudi Arabia
| | - Samir A. Alharbi
- Al-Quweayiyah, Shaqra University, College of Applied Medical Sciences, Department of Medical Laboratory Sciences, Kingdom of Saudi Arabia
| | - Fawaz D. Alshammari
- University of Hail, College of Applied Medical Sciences, Department of Clinical Laboratory Science, Hail, Kingdom of Saudi Arabia
| | - Hadi Abd
- University of Hail, College of Applied Medical Sciences, Department of Clinical Laboratory Science, Hail, Kingdom of Saudi Arabia
- Al-Quweayiyah, Shaqra University, College of Applied Medical Sciences, Department of Medical Laboratory Sciences, Kingdom of Saudi Arabia
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Barry M, Diallo B, Kanté D, Diallo I. Antimicrobial susceptibility profile of community-acquired urinary tract infection in adults: A seven months prospective cross-sectional study in Dakar Town, Senegal. AFRICAN JOURNAL OF UROLOGY 2017. [DOI: 10.1016/j.afju.2016.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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Ayoyi AO, Kikuvi G, Bii C, Kariuki S. Prevalence, aetiology and antibiotic sensitivity profile of asymptomatic bacteriuria isolates from pregnant women in selected antenatal clinic from Nairobi, Kenya. Pan Afr Med J 2017; 26:41. [PMID: 28451019 PMCID: PMC5398259 DOI: 10.11604/pamj.2017.26.41.10975] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Accepted: 01/18/2017] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Asymptomatic bacteriuria (ASB) is the presence of bacteria in urine without apparent symptoms of urinary tract infections. The importance of asymptomatic bacteriuria lies in the insight it provides into symptomatic infections. To determine prevalence, bacterial isolates and Antibiotic Sensitivity Profile of asymptomatic bacterial urinary tract infection in pregnant women in selected clinics in Nairobi. METHODS This was a cross-sectional study involving women attending antenatal clinic at selected clinics of Nairobi County. The women who met the inclusion criteria were included in the study. The midstream urine samples of these women were subjected to microscopy, culture and sensitivity. RESULTS A total of 1020 of women on their first antenatal clinic visit participated in the study; 219 of them had ASB, giving a prevalence of 21.5 % at 95% confidence level. Escherichia coli were the common organism isolated at 38.8%. The majority of the organisms were sensitive to imipenem and gentamycin. CONCLUSION There is a high prevalence of ASB among pregnant women included in the study from the Nairobi county clinics. Therefore, routine ASB screening of pregnant women is recommended among the women attending antennal clinics in Nairobi county clinics.
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Affiliation(s)
- Adelaide Ogutu Ayoyi
- College of Health Sciences Jomo Kenyatta University of Agriculture and Technology, Kenya
| | - Gideon Kikuvi
- College of Public Health Jomo Kenyatta University Agriculture and Technology, Centre for Microbiology Research Kenya Medical Research Institute, Kenya
| | - Christine Bii
- College of Public Health Jomo Kenyatta University Agriculture and Technology, Centre for Microbiology Research Kenya Medical Research Institute, Kenya
| | - Samuel Kariuki
- College of Public Health Jomo Kenyatta University Agriculture and Technology, Centre for Microbiology Research Kenya Medical Research Institute, Kenya
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Nyandwi J, Manirakiza S, Ndirahisha E, Ngomirakiza JB, Nisubire D, Nduwayo E, Bukuru H. Frequency of Uropathogens and Antimicrobial Susceptibility in Childhood Urinary Tract Infection at Kamenge University Hospital, Bujumbura, Burundi. East Afr Health Res J 2017; 1:47-52. [PMID: 34308158 PMCID: PMC8279265 DOI: 10.24248/eahrj-d-16-00331] [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: 10/24/2016] [Accepted: 02/05/2017] [Indexed: 11/20/2022] Open
Abstract
Background Increasing resistance to antimicrobials is a worldwide problem. The aim of our study was to determine the pathogens and antimicrobial susceptibility of bacteria causing urinary tract infection (UTI) in children. Methods This is a prospective cohort study conducted over a 10-month period with 101 children hospitalised at Kamenge University Hospital for acute UTI. The infections were confirmed by Kass urinalysis criteria, and culture and susceptibility antibiotic tests were performed for isolated microbial agents. Results Frequency of UTI in the overall population of children hospitalised at Kamange University Hospital was 8.4%. Of the 101 children with UTIs, 87 (86.1%) were under the age of 24 months. Diagnosis of pyelonephritis (82%) was the most common, followed by cystitis (18%). Escherichia coli (82%) was the most frequent pathogen causing UTI. We found E coli and Klebsiella pneumonia to be resistant to aminopenicillins (100%), cotrimoxazole (98.2%, 100%), Augmentin (amoxicillin/clavulanic acid) (70.5%, 80%), cefotaxime (45.8%, 28.6%), cefuroxime (36.8 to 45.5%, 50%), fluoroquinolones (33.3 to 53.6%, 28.6 to 50%), gentamicin (27.5%, 20%), and nitrofurantoin (9.3%, 50%). Conclusion E coli is the main causal agent of UTI in childhood with a high resistance to antibiotics. Appropriate antibiotics for empiric therapy should be based on local circulating bacterial strains and resistance profiles.
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Affiliation(s)
- Joseph Nyandwi
- Département de Médecine Interne, Le Centre Hospitalo-Universitaire de Kamenge, Bujumbura, Burundi.,Unité d'Hémodialyse, Burundi Kidney Care Clinic, Bujumbura, Burundi
| | - Sébastien Manirakiza
- Département d'Imagerie Médicale, Le Centre Hospitalo-Universitaire de Kamenge, Bujumbura, Burundi
| | - Eugàne Ndirahisha
- Département de Médecine Interne, Le Centre Hospitalo-Universitaire de Kamenge, Bujumbura, Burundi
| | | | - Désiré Nisubire
- Département des Laboratoires, Le Centre Hospitalo-Universitaire de Kamenge, Bujumbura, Burundi
| | - Emmanuel Nduwayo
- Département de Médecine Interne, Le Centre Hospitalo-Universitaire de Kamenge, Bujumbura, Burundi
| | - Hélàne Bukuru
- Département de Pédiatrie, Le Centre Hospitalo-Universitaire de Kamenge, Bujumbura, Burundi
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Bacterial Etiology and Antibiotic Resistance Profile of Community-Acquired Urinary Tract Infections in a Cameroonian City. Int J Microbiol 2016; 2016:3240268. [PMID: 27667998 PMCID: PMC5030431 DOI: 10.1155/2016/3240268] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 08/22/2016] [Indexed: 11/21/2022] Open
Abstract
Introduction. Community-acquired urinary tract infections (CAUTIs) are usually treated empirically. Geographical variations in etiologic agents and their antibiotic sensitivity patterns are common. Knowledge of antibiotic resistance trends is important for improving evidence-based recommendations for empirical treatment of UTIs. Our aim was to determine the major bacterial etiologies of CAUTIs and their antibiotic resistance patterns in a cosmopolitan area of Cameroon for comparison with prescription practices of local physicians. Methods. We performed a cross-sectional descriptive study at two main hospitals in Yaoundé, collecting a clean-catch mid-stream urine sample from 92 patients having a clinical diagnosis of UTI. The empirical antibiotherapy was noted, and identification of bacterial species was done on CLED agar; antibiotic susceptibility testing was performed using the Kirby-Bauer disc diffusion method. Results. A total of 55 patients had samples positive for a UTI. Ciprofloxacin and amoxicillin/clavulanic acid were the most empirically prescribed antibiotics (30.9% and 23.6%, resp.); bacterial isolates showed high prevalence of resistance to both compounds. Escherichia coli (50.9%) was the most common pathogen, followed by Klebsiella pneumoniae (16.4%). Prevalence of resistance for ciprofloxacin was higher compared to newer quinolones. Conclusions. E. coli and K. pneumoniae were the predominant bacterial etiologies; the prevalence of resistance to commonly prescribed antibiotics was high.
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Guyomard-Rabenirina S, Malespine J, Ducat C, Sadikalay S, Falord M, Harrois D, Richard V, Dozois C, Breurec S, Talarmin A. Temporal trends and risks factors for antimicrobial resistant Enterobacteriaceae urinary isolates from outpatients in Guadeloupe. BMC Microbiol 2016; 16:121. [PMID: 27342199 PMCID: PMC4919840 DOI: 10.1186/s12866-016-0749-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 06/15/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Urinary tract infections are bacterial infections most commonly encountered in the community. The resistance rate of uropathogens to commonly prescribed antibiotics has increased worldwide but there are no published data concerning the resistance of strains isolated from community-acquired UTI in Guadeloupe. To assess the susceptibility patterns of Enterobacteriaceae strains isolated from outpatients in Guadeloupe we conducted a prospective study from December 2012 to May 2014 among outpatients consulting at private and public laboratories for urine analysis. Risk factors for E. coli resistance to amoxicillin, third-generation cephalosporin, and ciprofloxacin were also determined. To study the trends of E. coli resistance rates over the past 10 years, data on the susceptibility patterns of E. coli from 2003 to 2014 were also collected from three major laboratories for a retrospective study. RESULTS During the prospective study, we isolated 1293 bacterial strains from the urine of outpatients presenting for urine analysis. The most commonly isolated bacteria were E. coli (57 %) and Klebsiella pneumoniae (15.5 %). Thirty seven per cent of the E. coli strains were resistant to amoxicillin. Resistance rates to third generation cephalosporin were low for E. coli and other Enterobacteriaceae (3.1 and 12.2 % respectively) and mostly due to the presence of an Extended Spectrum Beta-lactamase. Resistance to cotrimoxazole and ciprofloxacin was moderate (17.8 and 15.6 % respectively). However, the resistance rate of E. coli to ciprofloxacin has significantly increased during the last 10 years. Risk factors were consistent with previously reported data, especially for the increasing ciprofloxacin resistance with age. CONCLUSION General practitioners in Guadeloupe need to be better informed to favor the prescription of fosfomycin-trometamol to reduce the risk of resistance to fluoroquinolones.
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Affiliation(s)
| | - Joyce Malespine
- />Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe France
| | - Célia Ducat
- />Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe France
| | - Syndia Sadikalay
- />Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe France
| | - Mélanie Falord
- />Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe France
| | - Dorothée Harrois
- />Laboratoire de Biologie Clinique, Centre Hospitalier de Basse-Terre, Basse-Terre, Guadeloupe France
| | - Vincent Richard
- />Institut Pasteur de Nouvelle-Calédonie, Nouméa, Nouvelle-Calédonie France
| | | | - Sébastien Breurec
- />Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe France
- />Faculté de Médecine, Université des Antilles, Pointe-à-Pitre, Guadeloupe France
- />Laboratoire de Microbiologie Clinique et Environnementale, Centre Hospitalo-Universitaire de Pointe-à-Pitre/Abymes, Pointe-à-Pitre, Guadeloupe France
| | - Antoine Talarmin
- />Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe France
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Adeep M, Nima T, Kezang W, Tshokey T. A retrospective analysis of the etiologic agents and antibiotic susceptibility pattern of uropathogens isolated in the Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan. BMC Res Notes 2016; 9:54. [PMID: 26825932 PMCID: PMC4733272 DOI: 10.1186/s13104-015-1728-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 11/20/2015] [Indexed: 11/17/2022] Open
Abstract
Background Urinary tract infection is one of the major public health problems. Specific population studies to understand the common etiologic agents and antibiotic susceptibility patterns are important to determine the empirical treatment of urinary tract infections. This is the first study in Bhutan to analyze the etiologic agents and antibiotic susceptibility pattern of uropathogens isolated from patients visiting Jigme Dorji Wangchuck National Referral Hospital with the ultimate goal of guiding empirical treatment. Methods Hospital based (inpatients/outpatients) retrospective cross sectional study of 6030 clinically suspected patients with urinary tract infections who have submitted urine samples for culture in a 6 months period was done. Urine samples were collected and processed as per standard microbiological procedures and antibiotic susceptibility testing performed by CLSI guidelines. Results Significant bacteriuria were detected in 14.9 % of the total patients. The most common uropathogens isolated were Escherichia coli (79.3 %) followed by Klebsiella pneumoniae. Females around the age group of 18–26 have the highest prevalence of urinary tract infection. The highest rate of antibiotic resistance was seen in amoxicillin (71.4 %) and nalidixic acid (80.3 %), and resistance were lower in nitrofuration (3.4 %) and gentamycin (17.5 %). The third generation cephalosporin resistance (which is a surrogate marker of ESBL) was 16.1 % in outpatient and 16.7 % approximately in inpatient setting. Conclusion Escherichia coli was the predominant uropathogen making up 79.3 % (outpatient 81.1 % and inpatient 69.5 %) of the total and its antibiotic susceptibility pattern needs to be considered for treating community-acquired UTIs empirically. The third generation cephalosporin resistance (which is a surrogate marker of ESBL) is alarmingly high among the isolates and there is need for further studies.
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Affiliation(s)
- M Adeep
- Microbiology unit, Department of Laboratory Services, JDWNRH, Thimphu, Bhutan.
| | - T Nima
- Microbiology unit, Department of Laboratory Services, JDWNRH, Thimphu, Bhutan.
| | - W Kezang
- Microbiology unit, Department of Laboratory Services, JDWNRH, Thimphu, Bhutan.
| | - T Tshokey
- Microbiology unit, Department of Laboratory Services, JDWNRH, Thimphu, Bhutan.
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Fasugba O, Gardner A, Mitchell BG, Mnatzaganian G. Ciprofloxacin resistance in community- and hospital-acquired Escherichia coli urinary tract infections: a systematic review and meta-analysis of observational studies. BMC Infect Dis 2015; 15:545. [PMID: 26607324 PMCID: PMC4660780 DOI: 10.1186/s12879-015-1282-4] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 11/17/2015] [Indexed: 12/16/2022] Open
Abstract
Background During the last decade the resistance rate of urinary Escherichia coli (E. coli) to fluoroquinolones such as ciprofloxacin has increased. Systematic reviews of studies investigating ciprofloxacin resistance in community- and hospital-acquired E. coli urinary tract infections (UTI) are absent. This study systematically reviewed the literature and where appropriate, meta-analysed studies investigating ciprofloxacin resistance in community- and hospital-acquired E. coli UTIs. Methods Observational studies published between 2004 and 2014 were identified through Medline, PubMed, Embase, Cochrane, Scopus and Cinahl searches. Overall and sub-group pooled estimates of ciprofloxacin resistance were evaluated using DerSimonian-Laird random-effects models. The I2 statistic was calculated to demonstrate the degree of heterogeneity. Risk of bias among included studies was also investigated. Results Of the identified 1134 papers, 53 were eligible for inclusion, providing 54 studies for analysis with one paper presenting both community and hospital studies. Compared to the community setting, resistance to ciprofloxacin was significantly higher in the hospital setting (pooled resistance 0.38, 95 % CI 0.36-0.41 versus 0.27, 95 % CI 0.24-0.31 in community-acquired UTIs, P < 0.001). Resistance significantly varied by region and country with the highest resistance observed in developing countries. Similarly, a significant rise in resistance over time was seen in studies reporting on community-acquired E. coli UTI. Conclusions Ciprofloxacin resistance in E. coli UTI is increasing and the use of this antimicrobial agent as empirical therapy for UTI should be reconsidered. Policy restrictions on ciprofloxacin use should be enhanced especially in developing countries without current regulations. Electronic supplementary material The online version of this article (doi:10.1186/s12879-015-1282-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Oyebola Fasugba
- Faculty of Health Sciences, Australian Catholic University, 223 Antill Street, Watson, Australian Capital Territory, 2602, Australia.
| | - Anne Gardner
- Faculty of Health Sciences, Australian Catholic University, 223 Antill Street, Watson, Australian Capital Territory, 2602, Australia.
| | - Brett G Mitchell
- Faculty of Health Sciences, Australian Catholic University, 223 Antill Street, Watson, Australian Capital Territory, 2602, Australia. .,Faculty of Arts, Nursing and Theology, Avondale College of Higher Education, 185 Fox Valley Road, Wahroonga, New South Wales, 2076, Australia.
| | - George Mnatzaganian
- School of Allied Health, Faculty of Health Sciences, Australian Catholic University, 17 Young Street, Fitzroy, Victoria, 3065, Australia.
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Magale HI, Kassim IA, Odera SA, Omolo MJ, Jaoko WG, Jolly PE. ANTIBIOTIC SUSCEPTIBILITY OF ORGANISMS CAUSING URINARY TRACT INFECTION IN PATIENTS PRESENTING AT KENYATTA NATIONAL HOSPITAL, NAIROBI. EAST AFRICAN MEDICAL JOURNAL 2015; 92:333-337. [PMID: 27867208 PMCID: PMC5111625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Changes in susceptibility patterns of bacterial pathogens isolated from urinary tract infections emphasize the need for regional surveillance to generate information that can be used in management of patients. Knowledge on the current status of antimicrobial resistance in uropathogens, and the prevalence of expanding spectrum beta-lactamases (ESBLs) in the isolates will guide policy formulations and encourage prudent use of antimicrobials. OBJECTIVE Identify bacterial pathogens causing UTI and determine the association between the pathogens isolated from patients attending KNH. Determine antimicrobial susceptibility patterns of the UTI pathogens and the prevalence of ESBL in the isolated pathogens. DESIGN Laboratory-based study. SETTING Department of Medical Microbiology University of Nairobi and Kenyatta National Hospital microbiology laboratory, Nairobi, Kenya. SUBJECTS Nine hundred and forty eight patients presenting directly to the Kenyatta National Hospital's diagnostic lab. Patients were only classified as in-patients if at the time of specimen collection they were being admitted to one of KNH wards. RESULTS Out of the 948 urine samples processed, 189 in-patients and 37 out-patients samples had significant bacterial growth. The uropathogens identified from in-patient specimens were Escherichia coli (56), Klebsiellapneumoniae (33), Enterococcus spp. (34) and Entrobacter (16) making up 30%, 18%, 18% and 9% respectively. ESBL isolates were found to be resistant to the locally administered antibiotics; Augmentin (37%), Levofloxacin (37%), Cefoperazone (37%), Ampicillin (39%), Doxycyline (41%), Gentamicin (30%) and Nalidixic Acid (38%). CONCLUSION The increased prevalence of multidrug resistant ESBL pathogens poses challenges for health care providers at KNH and signifies the need for new approach to treat UTI. It would be prudent for laboratories to include specialized tests for detection of ESBL producing pathogens from isolates obtained from in-patients. Further studies on the mechanisms and pathways utilized by these bacteria to cause UTI will highlight other avenues in patient management.
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Affiliation(s)
- H I Magale
- The University of Arizona College of Medicine, 1501 N Campbell Ave, Tucson, Arizona, United States
| | - I A Kassim
- The Brody School of Medicine at East Carolina University, 600 Moye Boulevard, Greenville, North Carolina, United States
| | - S A Odera
- Department of Medical Microbiology, University of Nairobi, P. O. Box 19676-00202, Nairobi, Kenya
| | - M J Omolo
- Department of Medical Microbiology, University Of Nairobi, P. O. Box 19676-00202, Nairobi, Kenya
| | - W G Jaoko
- Department of Medical Microbiology, University of Nairobi, P. O. Box 19676-00202, Nairobi, Kenya, Kenya AIDS Vaccine Initiative (KAVI), School of Medicine, University of Nairobi, P.O. Box 19676-00202, Nairobi, Kenya
| | - P E Jolly
- Department of Epidemiology, University of Alabama in Birmingham School of Public Health, 1665 University Blvd, Birmingham, Alabama, United States
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Neamati F, Firoozeh F, Saffari M, Zibaei M. Virulence Genes and Antimicrobial Resistance Pattern in Uropathogenic Escherichia coli Isolated From Hospitalized Patients in Kashan, Iran. Jundishapur J Microbiol 2015; 8:e17514. [PMID: 25825647 PMCID: PMC4376973 DOI: 10.5812/jjm.17514] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 04/15/2014] [Accepted: 04/19/2014] [Indexed: 01/23/2023] Open
Abstract
Background: Urinary tract infection (UTI) is one of the most prevalent infectious diseases. Uropathogenic Escherichia coli (UPEC), as the most important cause of UTI, are associated with a number of virulence factors. Objectives: The current study aimed to investigate the virulence associated determinants as well as their patterns of antibiotic resistance in UPEC isolated from hospitalized patients with UTI. Materials and Methods: A total of 150 E. coli isolates were collected from patients with UTI from December 2012 to June 2013 in Kashan, Iran. Antimicrobial susceptibility screening of 12 antibiotics was determined using disk diffusion method. Polymerase Chain Reaction (PCR) assay was used to detect virulence-related genes in UPEC strains. The purified PCR products were sequenced. Results: Of the total 150 UPEC isolates, 111 (74%) were multidrug-resistant. High resistance was observed against ampicillin (81.3%), nalidixic acid (71.3%), cotrimoxazole (64.7%) and ciprofloxacin (61.3%), respectively. Eighty-four out of the 150 isolates showed resistance against the extended spectrum cephalosporins. Totally, virulence genes were detected in 126 (84%) UPEC isolates .The PCR results identified the traT gene in (74%), PAIs markers in (61.3%) and the pap gene in (16.6%) of the isolates. Conclusions: The traT gene and PAI markers were highly prevalent among UPEC strains isolated from patients in Kashan, Iran; therefore these determinants could be used as targets for prophylactic interventions. Also there was a high level of resistance against the antibiotics commonly used for urinary tract infection treatment. To reach better therapeutic outcomes, treatment regimens have to be modified.
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Affiliation(s)
- Foroogh Neamati
- Department of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Farzaneh Firoozeh
- Department of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, Kashan, IR Iran
- Corresponding author: Farzaneh Firoozeh, Department of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, Kashan, IR Iran. Tel/Fax: +98-3155540021, E-mail:
| | - Mahmood Saffari
- Department of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Mohammad Zibaei
- Department of Parasitology and Mycology, School of Medicine, Alborz University of Medical Sciences, Karaj, IR Iran
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Abejew AA, Denboba AA, Mekonnen AG. Prevalence and antibiotic resistance pattern of urinary tract bacterial infections in Dessie area, North-East Ethiopia. BMC Res Notes 2014; 7:687. [PMID: 25280498 PMCID: PMC4195856 DOI: 10.1186/1756-0500-7-687] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Accepted: 09/17/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Different studies have indicated that urinary tract infections frequently occur in both community and hospital environments and are of the most common bacterial infections in humans. the outcomes of urinary tract infections are increased hospitalization, increased direct patient costs and mortality. In Dessie, the prevalence of the commmon pathogens and antibiotic susceptibility pattern is not well studied sofar. Thus, the aim of this study is to address these gaps in the study area. METHODS Retrospective study was conducted in Dessie regional health reseacrh laboratory from January 1-March 31, 2012. All culture and antibiotic susceptibility test results of patients' diagnosed with UTI from September 2002 to September 2011 G.C were included in the study. Data were abstracted using structured questionnaires and finally, entered into SPSS Windows version 16.0, and descriptive statistics was generated to meet the study objective. RESULTS During the last ten years 680 (27.35%) bacteria were isolated in the regional laboratory. The most commonly isolated were E. coli 410 (60.29%), Pseudomonas species 59 (8.68%), Proteus species 53 (7.79%), S. aurous 50 (7.35%) and Klebsiella species 40 (5.88%). The E.coli were susceptible to Nitrofurantoin 43 (89.6%), furantoin 124 (87.3%), Nalidixic acid 91 (86.7%), kanamycin 116 (80%) & ciprofloxacin 66 (71.7%) but were almost resistant to Ampicillin, tetracycline, & trimethoprim-sulfamethoxazole. Similarly Pseudomonas and proteus species were resistant to almost all antibiotics except Gentamycin. CONCLUSION The E.coli, pseudomonas and proteus species were the commonly isolated bacteria in the regional health research laboratory. A majority of isolated bacterial microbes were resistant to antibiotics commonly used in clinical practices and generally available in the local economy without prescription. Culture results are necessary before initiating antibiotics.
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Affiliation(s)
- Asrat Agalu Abejew
- />Department of Pharmacy, College of Medicine and Health Sciences, P. O. Box: 1145, Dessie, Ethiopia
| | - Ayele A Denboba
- />Department of Experimental Medicine and Surgery, Microbiology, Immunology and Infectious Disease program, Faculty of Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
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Dibua UME, Onyemerela IS, Nweze EI. Frequency, urinalysis and susceptibility profile of pathogens causing urinary tract infections in Enugu State, southeast Nigeria. Rev Inst Med Trop Sao Paulo 2014; 56:55-9. [PMID: 24553609 PMCID: PMC4085832 DOI: 10.1590/s0036-46652014000100008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 04/18/2013] [Indexed: 11/22/2022] Open
Abstract
Objective: This study was designed to determine the frequency and
causative agent(s) of urinary tract infections (UTIs) in individuals with symptoms of
urinary tract infections in Enugu State of Southeast Nigeria, and to determine the
antibiotic susceptibility pattern of microbial agents isolated from urine
culture. Methods: The study involved 211 individuals (149 females and 62 males)
clinically suspected for UTI. Urine samples were collected by the mid-stream ‘clean
catch’ method and tested using standard procedures. Antibiotic susceptibility of the
isolated pathogens was tested using the Kirby-Bauer technique according to the
Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: Microscopy of centrifuged urine samples showed 16 patients had
pyuria while 54 had pus cells. Calcium oxalate crystals were found in 14 samples.
Urinalysis performed with urine samples showed 17 had protein; seven were nitrite
positive and three had moderate to high glucose concentration. Fifty-four urine
samples (36.2%) from females and 12 (19.4%) from males showed significant growth upon
culture. Gram stain and biochemical tests identified nine different organisms with
Escherichia coli as the most common isolated species. Forty three
randomly selected strains were further tested for their susceptibility against a
panel of antibiotics. Thirty isolates (81.08%) were resistant to four or more
antibiotics with the highest resistance shown by E. coli (76.67%).
All the Gram- negative isolates were resistant to Ampicilox, Cefuroxime and
Amoxicillin. Conclusion: Urinary tract infections were found more in females in the
area under study. As found in other studies, E. coli was the most
predominant isolate, although other organisms seem to be on the increase.
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Affiliation(s)
- Uju M E Dibua
- Department of Microbiology, University of Nigeria, Nsukka, Nigeria, Department of Microbiology, University of Nigeria, Nsukka, Nigeria
| | - Ifeoma S Onyemerela
- Department of Microbiology, University of Nigeria, Nsukka, Nigeria, Department of Microbiology, University of Nigeria, Nsukka, Nigeria
| | - Emeka I Nweze
- Department of Microbiology, University of Nigeria, Nsukka, Nigeria, Department of Microbiology, University of Nigeria, Nsukka, Nigeria
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Diversity and antibiotic resistance of uropathogenic bacteria from Abidjan. AFRICAN JOURNAL OF UROLOGY 2014. [DOI: 10.1016/j.afju.2013.11.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Bissong MEA, Fon PN, Tabe-Besong FO, Akenji TN. Asymptomatic bacteriuria in diabetes mellitus patients in Southwest Cameroon. Afr Health Sci 2013; 13:661-6. [PMID: 24250304 DOI: 10.4314/ahs.v13i3.20] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Asymptomatic bacteriuria (ASB) is common in diabetics and predisposes these patients to more severe urinary tract infections (UTIs). Reports on the prevalence and etiology of ASB especially in developing countries appear contradictory. OBJECTIVES To determine the prevalence and etiology of ASB and antimicrobial resistance of urinary isolates in diabetics and non-diabetics. METHODS The study involved a total of 265 participants including 154 diabetes mellitus patients and 111 non-diabetics in Southwest Cameroon. Mid-stream urine was collected from consented subjects and each sample tested using the dipstick, microscopy and culture techniques. Isolates were identified using standard biochemical tests. RESULTS ASB was detected in 33.2% of participants; 38.3% in diabetics and 26.1% in non-diabetics (P = 0.03). Coagulase-negative staphylococci (CNS) were the predominant organisms (36.3%) isolated from urine in both diabetics and nondiabetics. Other isolates included Klebsiella sp (15.9%), Candida sp (13.7%), E. coli (10.8%) and Serratia sp (10.8%). Candida sp was isolated more from diabetics than non-diabetics (P = 0.01). There was no significant difference in resistance between diabetics and non-diabetics (P > 0.05). Most isolates showed multiple resistance and ciprofloxacin was the most active ingredient against bacterial uropathogens. CONCLUSION The study revealed a high prevalence of ASB in diabetics than in non-diabetics. A change in the aetiologic spectrum was observed with Staphylococcus sp accounting for majority of ASB. Most isolates showed multiple resistance in both diabetics and non-diabetics; therefore the need to speed up sensitization against antibiotic abuse in Southwest Cameroon.
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Affiliation(s)
- Marie E A Bissong
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Cameroon
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Mokube MN, Atashili J, Halle-Ekane GE, Ikomey GM, Ndumbe PM. Bacteriuria amongst pregnant women in the Buea Health District, Cameroon: prevalence, predictors, antibiotic susceptibility patterns and diagnosis. PLoS One 2013; 8:e71086. [PMID: 23976983 PMCID: PMC3745459 DOI: 10.1371/journal.pone.0071086] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 06/30/2013] [Indexed: 11/23/2022] Open
Abstract
Background Bacteriuria is associated with significant maternal and foetal risks. However, its prevalence is not known in our community. Objectives This study was carried out to determine the prevalence and predictors of bacteriuria in pregnant women of the Buea Health District (BHD) as well as the antibiotic sensitivity patterns of bacterial isolates. It also sought to determine the diagnostic performance of the nitrite and leucocyte esterase tests in detecting bacteriuria in these women. Methods An observational analytic cross-sectional study was carried out amongst pregnant women attending selected antenatal care centres in Buea. We recruited 102 consenting pregnant women for the study. Demographic and clinical data were collected using structured questionnaires. Clean catch midstream urine was collected from each participant in sterile leak proof containers. Samples were examined biochemically, microscopically and by culture. Significant bacteriuria was defined as the presence of ≥108 bacteria/L of cultured urine. Identification and susceptibility of isolates was performed using API 20E and ATB UR EU (08) (BioMerieux, Marcy l'Etoile, France). Results Significant bacteriuria was found in the urine of 24 of the 102 women tested giving a bacteriuria prevalence of 23.5% in pregnant women of the BHD. Asymptomatic bacteriuria was detected in 8(7.8%) of the women. There was no statistically significant predictor of bacteriuria. Escherichia coli were the most isolated (33%) uropathogens and were 100% sensitive to cefixime, cefoxitin and cephalothin. The nitrite and leucocyte esterase tests for determining bacteriuria had sensitivities of 8%, 20.8% and specificities of 98.7% and 80.8% respectively. Conclusion Bacteriuria is frequent in pregnant women in the BHD suggesting the need for routine screening by urine culture. Empiric treatment with cefixime should be instituted until results of urine culture and sensitivity are available. Nitrite and leucocyte esterase tests were not sensitive enough to replace urine culture as screening tests.
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Affiliation(s)
- Morike Ngoe Mokube
- Faculty of Health Sciences, University of Buea, Buea, South-West Region, Cameroon
| | - Julius Atashili
- Faculty of Health Sciences, University of Buea, Buea, South-West Region, Cameroon
- * E-mail:
| | | | - George M. Ikomey
- Faculty of Health Sciences, University of Buea, Buea, South-West Region, Cameroon
| | - Peter M. Ndumbe
- Faculty of Health Sciences, University of Buea, Buea, South-West Region, Cameroon
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Akoachere JFTK, Omam LA, Massalla TN. Assessment of the relationship between bacteriological quality of dug-wells, hygiene behaviour and well characteristics in two cholera endemic localities in Douala, Cameroon. BMC Public Health 2013; 13:692. [PMID: 23895357 PMCID: PMC3734179 DOI: 10.1186/1471-2458-13-692] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 07/29/2013] [Indexed: 11/13/2022] Open
Abstract
Background Access to potable water is grossly inadequate in Douala-Cameroon. The situation is worse in slum areas, compelling inhabitants to obtain water from sources of doubtful quality. This has contributed to frequent outbreaks of water-borne diseases particularly cholera, which results in severe morbidity and mortality. Shallow wells are a major source of water in these areas. We analyzed the influence of some factors on the bacteriological quality of well water in Bepanda and New Bell, cholera endemic localities in Douala to generate data that would serve as basis for strengthening of water and health policies. Methods Questionnaires were administered to inhabitants of study sites to appraise their hygiene and sanitation practices, and level of awareness of waterborne diseases. The bacteriological quality of water was determined by investigating bacterial indicators of water quality. Relationship between well characteristics and bacteriological quality of water was determined using χ2 test. The Kendall tau_b nonparametric correlation was used to measure the strength of association between well characteristics and bacteriological parameters. Statistics were discussed at 95% confidence level. Antibiotic susceptibility of isolates was investigated by the Kirby-Bauer and broth dilution techniques. Multidrug resistant species were tested for extended β-lactamase production potential. Results Inhabitants demonstrated adequate knowledge of waterborne diseases but employed inappropriate method (table salt) for well disinfection. Well construction and location violated guidelines. Indicator bacterial counts greatly exceeded the WHO guidelines. Variation in bacteriologic parameters between sites was not significant (P > 0.05) since well characteristics and hygiene and sanitary practices were similar. Differences in bacteriologic quality with respect to state of well, and presence of molded casing and lid, and height of casing were not significant (P > 0.05). Well distance from sanitary structure negatively correlated with bacteriological characteristics indicating it could be a major contributory factor to poor water quality. Bacteria isolated were predominantly enteric organisms. Ciprofloxacin was the most active agent. Extended β-lactamase producers were detected among Salmonella species, Citrobacter fruendii and E. coli. Conclusion Poor well location, construction, and hygiene and sanitary practices were among the factors affecting water quality. There is an urgent need for education of inhabitants on effective water disinfection strategies and for regular monitoring of wells.
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