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Sujith S, Solomon AP, Rayappan JBB. Comprehensive insights into UTIs: from pathophysiology to precision diagnosis and management. Front Cell Infect Microbiol 2024; 14:1402941. [PMID: 39380727 PMCID: PMC11458535 DOI: 10.3389/fcimb.2024.1402941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 09/02/2024] [Indexed: 10/10/2024] Open
Abstract
Urinary tract infections (UTIs) are the second most common infectious disease, predominantly impacting women with 150 million individuals affected globally. It increases the socio-economic burden of society and is mainly caused by Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae, Enterobacter spp., and Staphylococcus spp. The severity of the infection correlates with the host factors varying from acute to chronic infections. Even with a high incidence rate, the diagnosis is mainly based on the symptoms, dipstick analysis, and culture analysis, which are time-consuming, labour-intensive, and lacking sensitivity and specificity. During this period, medical professionals prescribe empirical antibiotics, which may increase the antimicrobial resistance rate. Timely and precise UTI diagnosis is essential for addressing antibiotic resistance and improving overall quality of life. In response to these challenges, new techniques are emerging. The review provides a comprehensive overview of the global burden of UTIs, associated risk factors, implicated organisms, traditional and innovative diagnostic methods, and approaches to UTI treatment and prevention.
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Affiliation(s)
- Swathi Sujith
- Quorum Sensing Laboratory, Centre for Research in Infectious Diseases (CRID), School of Chemical and Biotechnology, SASTRA Deemed to be University, Thanjavur, India
| | - Adline Princy Solomon
- Quorum Sensing Laboratory, Centre for Research in Infectious Diseases (CRID), School of Chemical and Biotechnology, SASTRA Deemed to be University, Thanjavur, India
| | - John Bosco Balaguru Rayappan
- Nanosensors Laboratory, School of Electrical & Electronics Engineering, Centre for Nanotechnology & Advanced Biomaterials (CeNTAB), SASTRA Deemed to be University, Thanjavur, India
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Kim Y, Kim H, Kim J, Han JH, Chung EJ, Nam SW, Shin M, Kwak W. The Description and Analysis of the Complete Genome of Dermacoccus barathri FBCC-B549 Strain. Microorganisms 2024; 12:1227. [PMID: 38930609 PMCID: PMC11206071 DOI: 10.3390/microorganisms12061227] [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: 06/03/2024] [Revised: 06/14/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024] Open
Abstract
Dermacoccus barathri is the first reported pathogen within the Dermacoccus genus to cause a catheter-related bloodstream infection, which occurred in 2015. In this study, the complete genome assembly of Dermacoccus barathri was constructed, and the complete genome of Dermacoccus barathri FBCC-B549 consists of a single chromosome (3,137,745 bp) without plasmids. The constructed genome of D. barathri was compared with those of two closely related species within the Dermacoccus genus. D. barathri exhibited a pattern similar to Dermacoccus abyssi in terms of gene clusters and synteny analysis. Contrary to previous studies, biosynthetic gene cluster (BGC) analysis for predicting secondary metabolites revealed the presence of the LAP biosynthesis pathway in the complete genome of D. barathri, predicting the potential synthesis of the secondary metabolite plantazolicin. Furthermore, an analysis to investigate the potential pathogenicity of D. barathri did not reveal any antibiotic resistance genes; however, nine virulence factors were identified in the Virulence Factor Database (VFDB). According to these matching results in the VFDB, despite identifying a few factors involved in biofilm formation, further research is required to determine the actual impact of D. barathri on pathogenicity. The complete genome of D. barathri is expected to serve as a valuable resource for future studies on D. barathri, which currently lack sufficient genomic sequence information.
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Affiliation(s)
- Yeha Kim
- Department of Medical and Biological Sciences, The Catholic University of Korea, Bucheon 14662, Republic of Korea
- Department of Biotechnology, The Catholic University of Korea, Bucheon 14662, Republic of Korea
| | - Hyaekang Kim
- Bio-Resources Bank Division, Nakdonggang National Institute of Biological Resources, Sangju 37242, Republic of Korea
| | - Jina Kim
- Department of Medical and Biological Sciences, The Catholic University of Korea, Bucheon 14662, Republic of Korea
- Department of Biotechnology, The Catholic University of Korea, Bucheon 14662, Republic of Korea
| | - Ji-Hye Han
- Performance Innovation Division, Nakdonggang National Institute of Biological Resources, Sangju 37242, Republic of Korea
| | - Eu Jin Chung
- Bio-Resources Bank Division, Nakdonggang National Institute of Biological Resources, Sangju 37242, Republic of Korea
| | - Seung Won Nam
- Bio-Resources Bank Division, Nakdonggang National Institute of Biological Resources, Sangju 37242, Republic of Korea
| | - Miyoung Shin
- Department of Pathology, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Woori Kwak
- Department of Medical and Biological Sciences, The Catholic University of Korea, Bucheon 14662, Republic of Korea
- Department of Biotechnology, The Catholic University of Korea, Bucheon 14662, Republic of Korea
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Kahsay T, Gebrehiwot GT, Gebreyohannes G, Tilahun M, Gessese A, Kahsay A. Antimicrobial susceptibility patterns of urinary tract infections causing bacterial isolates and associated risk factors among HIV patients in Tigray, Northern Ethiopia. BMC Microbiol 2024; 24:148. [PMID: 38678188 PMCID: PMC11055276 DOI: 10.1186/s12866-024-03297-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/07/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Urinary tract infections, a prevalent global infectious disease, are clinical issues not well studied in HIV-positive individuals. UTIs have become a global drug resistance issue, but the prevalence and antibiotic susceptibility patterns of UTI-causing bacteria among HIV patients in Tigray, Ethiopia, are poorly understood. This study aims to identify the prevalence of UTI-causing bacteria, their antibiotic susceptibility patterns, and associated risk factors in HIV patients attending ART clinics at Mekelle General Hospital and Ayder Comprehensive Specialized Hospital in Tigray, Northern Ethiopia. METHOD Clean-catch midstream urine samples (10-15 mL) were collected from HIV patients who are attending ART clinics at Mekelle General Hospital and Ayder Comprehensive Specialized Hospital. Samples were analyzed based on standard microbiological protocols using cysteine-lactose electrolyte deficient (CLED) agar. Pure colonies of bacterial isolates were obtained by sub-culturing into Mac-Conkey, Manitol Salt agar and blood agar plates. The bacterial isolates were then identified using macroscopic, microscopic, biochemical, and Gram staining methods. Gram-negative bacteria were identified using biochemical tests like triple sugar iron agar, Simon's citrate agar, lysine iron agar, urea, motility test, and indol test, whereas Gram-positive isolates were identified using catalase and coagulase tests. The Kirby-Bauer disk diffusion technique was used to analyze the antimicrobial susceptibility pattern of bacterial isolates. Data was analyzed using SPSS version 25.0. RESULTS Among the 224 patients, 28 (12.5%) of them had been infected by UTIs-causing bacteria. E. coli was the dominant bacterium (16 (57%)) followed by K. pneumoniae (4 (14%)), and S. aureus (3 (11%)). Of the total bacterial isolates, 22 (78.6%) of them developed multi-drug resistance. All Gram-positive (100%) and 75% of Gram-negative bacterial isolates were found to be resistant to two or more drugs. Patients with a history of UTIs, and with CD4 count < 200 cells/ mm3, were more likely to have significant bacteriuria. Compared to male patients, female patients were more affected by the UTIs-causing bacteria. More than 93% of the UTIs-causing bacterial isolates were susceptible to nitrofurantoin, ceftriaxone, ciprofloxacin, and gentamycin; whereas they are highly resistant to ampicillin (96%), cotrimoxazole (82%) and tetracycline (71%). CONCLUSIONS Most of the bacterial isolates were highly resistant to ampicillin, cotrimoxazole, and tetracycline. Female patients were more affected by the UTIs causing bacteria. The highest prevalence (12.5%) of UTIs in HIV patients needs special attention for better management and monitoring. Previous UTI history and immune suppression are predictors of UTIs, highlighting the need for intervention measures involving molecular studies to identify resistant bacteria genes and promote patient immune reconstitution.
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Affiliation(s)
- Tsgabu Kahsay
- Department of Microbiology and Immunology, Dr. Tewelde Legesse College of Health Sciences, Mekelle, Tigray, Ethiopia
| | - Gebrecherkos Teame Gebrehiwot
- Department of Biomedical Research and Technology Transfer, Tigray Health Research Institute, Mekelle, Tigray, Ethiopia.
| | - Gebreselema Gebreyohannes
- Department of Biomedical Research and Technology Transfer, Tigray Health Research Institute, Mekelle, Tigray, Ethiopia
- Department of Biological and Chemical Engineering, Mekelle Institute Technology, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Mulugeta Tilahun
- Department of Biomedical Research and Technology Transfer, Tigray Health Research Institute, Mekelle, Tigray, Ethiopia
| | - Ataklti Gessese
- Department of Biomedical Research and Technology Transfer, Tigray Health Research Institute, Mekelle, Tigray, Ethiopia
| | - Amlisha Kahsay
- Department of Medical Microbiology and Immunology, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
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Jwarchan B, Sapkota S, Dhungana D, Dhakal A. Positive Bacterial Culture among Adults with Suspected Urinary Tract Infections Presenting to the Department of Medicine of a Tertiary Care Centre. JNMA J Nepal Med Assoc 2024; 62:89-91. [PMID: 38409980 PMCID: PMC10924528 DOI: 10.31729/jnma.8438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Indexed: 02/28/2024] Open
Abstract
Introduction Urinary tract infections are the most common infections encountered in clinical practice. Treatment needs to take into account the likely organism, comorbidities and local antibiotic sensitivity pattern. This study aimed to find the prevalence of positive bacterial culture among adults with suspected urinary tract infections presenting to the department of medicine of a tertiary care centre. Methods A descriptive cross-sectional study was conducted among adults with suspected urinary tract infections. Data was collected between 1 July 2022 to 31 December 2022 after obtaining ethical approval from the Institutional Review Committee. Individuals with symptomatic urinary tract infections were included in the study. The antibiotic susceptibility tests of the isolates were done. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results Among 355 patients, positive cultures were obtained in 148 (41.69%) (36.56-46.82, 95% Confidence Interval). Escherichia coli 120 (81.08%) was the predominant organism cultured among the positive bacterial culture cases. Conclusions The prevalence of positive bacterial culture was found to be higher than other studies done in similar settings. Keywords aminoglycosides; Escherichia coli; prevalence; urinary tract infections.
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Affiliation(s)
- Bishnu Jwarchan
- Department of Medicine, Manipal College of Medical Sciences, Pokhara, Kaski, Nepal
| | - Subash Sapkota
- Department of Medicine, Manipal College of Medical Sciences, Pokhara, Kaski, Nepal
| | - Durga Dhungana
- Department of Medicine, Manipal College of Medical Sciences, Pokhara, Kaski, Nepal
| | - Anil Dhakal
- Department of Medicine, Manipal College of Medical Sciences, Pokhara, Kaski, Nepal
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Mareș C, Petca RC, Popescu RI, Petca A, Mulțescu R, Bulai CA, Ene CV, Geavlete PA, Geavlete BF, Jinga V. Update on Urinary Tract Infection Antibiotic Resistance-A Retrospective Study in Females in Conjunction with Clinical Data. Life (Basel) 2024; 14:106. [PMID: 38255721 PMCID: PMC10820678 DOI: 10.3390/life14010106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/06/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
Urinary tract infections (UTIs) represent a frequent pathology among the female population that has become more and more difficult to treat in the past decade, considering the increase in antibiotic resistance-a serious global public health problem. A cross-sectional retrospective study was conducted for six months to report an update regarding the rates of resistance and susceptibility of uropathogens necessary for optimal treatment. A total of 5487 patients were screened, of which 524 (9.54%) were female patients who met the criteria for inclusion in the study. Escherichia coli was the most common pathogen, representing 290 cases (55.34%), followed by Enterococcus spp. 82 (15.64%). Escherichia coli presented the highest resistance to amoxicillin-clavulanic acid (R = 33.1%), followed by trimethoprim-sulfamethoxazole (R = 32.41%) and levofloxacin (R = 32.06%). The highest sensitivity rates were observed for fosfomycin (S = 96.55%), followed by imipenem (S = 93.1%). Enterococcus spp. showed the highest resistance to levofloxacin (R = 50.0%), followed by penicillin (R = 39.02%). The highest sensitivity was observed for fosfomycin (S = 90.24%), linezolid (S = 89.02%), and nitrofurantoin (S = 86.58%). The second most frequent Gram-negative uropathogen was represented by Klebsiella spp., which had the highest resistance to amoxicillin-clavulanic acid (R = 35.89%), followed by levofloxacin (R = 25.64) and trimethoprim-suflamethoxazole (R = 24.35%). The most frequently associated pathology was an episode of UTI in the previous year, followed by diabetes and chronic kidney disease. Antibiotic resistance is a serious problem for all clinicians who treat UTIs. An up-to-date knowledge of antibiotic resistance rates is a major necessity to stop its evolution. Overall, the highest resistance rates were observed for aminopenicillins, fluoroquinolones, and trimethoprim-sulfamethoxazole. The best susceptibility rates were observed for fosfomycin, nitrofurantoin, and carbapenems. Our report aims to guide clinicians whenever they are forced to prescribe antibiotics empirically.
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Affiliation(s)
- Cristian Mareș
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti Str., 042122 Bucharest, Romania;
| | - Răzvan-Cosmin Petca
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Prof. Dr. Th. Burghele” Clinical Hospital, 20 Panduri Str., 050659 Bucharest, Romania
| | - Răzvan-Ionuț Popescu
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Prof. Dr. Th. Burghele” Clinical Hospital, 20 Panduri Str., 050659 Bucharest, Romania
| | - Aida Petca
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania;
- Department of Obstetrics and Gynecology, Elias University Emergency Hospital, 17 Mărăști Blvd., 050474 Bucharest, Romania
| | - Răzvan Mulțescu
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti Str., 042122 Bucharest, Romania;
| | - Cătălin Andrei Bulai
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti Str., 042122 Bucharest, Romania;
| | - Cosmin Victor Ene
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti Str., 042122 Bucharest, Romania;
| | - Petrișor Aurelian Geavlete
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti Str., 042122 Bucharest, Romania;
| | - Bogdan Florin Geavlete
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti Str., 042122 Bucharest, Romania;
| | - Viorel Jinga
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.M.); (R.-I.P.); (C.A.B.); (C.V.E.); (P.A.G.); (B.F.G.); (V.J.)
- Department of Urology, “Prof. Dr. Th. Burghele” Clinical Hospital, 20 Panduri Str., 050659 Bucharest, Romania
- Medical Sciences Section, Academy of Romanian Scientists, 050085 Bucharest, Romania
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Sah RK, Dahal P, Parajuli R, Giri GR, Tuladhar E. Prevalence of blaCTX-M and blaTEM Genes in Cefotaxime-Resistant Escherichia coli Recovered from Tertiary Care at Central Nepal: A Descriptive Cross-Sectional Study. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2024; 2024:5517662. [PMID: 38226321 PMCID: PMC10789516 DOI: 10.1155/2024/5517662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/17/2024]
Abstract
Urinary tract infections (UTIs) are highly prevalent globally, and various antibiotics are employed for their treatment. However, the emergence of drug-resistant uropathogens towards these antibiotics causes a high rate of morbidity and mortality. This study was conducted at the Microbiology Laboratory of Grande International Hospital from November 2021 to May 2022 and aimed to assess the prevalence of UTI caused by Escherichia coli and their antibiotic susceptibility pattern with a focus on extended-spectrum beta-lactamases (ESBLs) and the prevalence of two genes (blaCTX-M and blaTEM) in cephalosporin-resistant E. coli. Altogether, 1050 urine samples were processed to obtain 165 isolates of E. coli. The isolates were identified by colony morphology and biochemical characteristics. Antimicrobial susceptibility tests (ASTs) were determined by the Kirby-Bauer disk diffusion method, and their ESBL enzymes were estimated by the combined disk method (CDM). Two ESBL genes (blaCTX-M and blaTEM) were investigated by polymerase chain reaction (PCR) in cefotaxime-resistant E. coli. Among the 1050 urine samples that were processed, 335 (31.9%) were culture-positive with 165 (49.2%) identified as E. coli. The age group ≥60 years (30.3%) had greater susceptibility to bacterial infections. AST revealed that meropenem was highly effective (95.7% susceptibility), while ampicillin showed the least sensitivity (42.4%). Among the E. coli isolates, 86 were multidrug resistant (MDR) and 10 were extensively drug resistant (XDR). Of these, 46 MDR (96%) and 2 XDR (4%) were ESBL producers. The prevalence of ESBL genes (blaCTX-M and blaTEM) was 49.3% and 54.8%, respectively. The overall accuracy of CDM as compared to PCR for the detection of the blaCTX-M gene was 55.26%. The prevalence of MDR E. coli harboring the blaCTX-M and blaTEM genes underscores the imperative role of ESBL testing in accurately identifying both beta-lactamase producers and nonproducers.
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Perdana MA, Wahyuni DD, Yunita R. Characteristics and susceptibility pattern of catheter-associated urinary tract infections (CAUTI) bacteria in Indonesia: A study in a national reference hospital of Sumatra region 2020-2021. NARRA J 2023; 3:e436. [PMID: 38450331 PMCID: PMC10914051 DOI: 10.52225/narra.v3i3.436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 12/19/2023] [Indexed: 03/08/2024]
Abstract
Catheter-associated urinary tract infection (CAUTI) is defined as a urinary tract infection associated with catheter placement for more than two consecutive days. Hence, antibiotic resistance in the context of CAUTIs represents a substantial challenge. The aim of this study was to present the characteristics of patients with CAUTI and the susceptibility pattern of CAUTI bacteria in the national reference hospital of the Sumatra region of Indonesia. A cross-sectional study was conducted at H. Adam Malik General Hospital, Medan, Indonesia, from 2020 to 2021, using a total sampling. All CAUTI patients included were on catheterization and diagnosed based on the Centers for Disease Control and Prevention (CDC) guidelines. The patient's urine culture and antibiotic susceptibility test were carried out on the patient's admitted urine sample for further assessment. Identification of bacteria, antibiotic susceptibility test, and the extended-spectrum beta-lactamase (ESBL) test for Escherichia coli and Klebsiella pneumoniae were conducted using the VITEK-2 Compact. A total of 74 CAUTI patients were included in the study, 59.5% were female, 54.1% were 46-65 years old, and a third had cardiovascular disease comorbidities (33.8%). A total of 83 CAUTI-associated bacteria were isolated. The majority were Gram-negative bacteria (74.7%), and the most bacteria isolated was E. coli (31.3%), followed by K. pneumoniae, Enterococcus faecalis, Acinetobacter baumannii, and Enterococcus faecium. The ESBL test was positive mostly in K. pneumoniae (100%) and E. coli (76.9%). CAUTI-associated E. coli was susceptible to tigecycline, meropenem, ertapenem, nitrofurantoin, and gentamicin. The isolated K. pneumoniae was susceptible to tigecycline, meropenem, ertapenem, and amikacin. While E. faecalis showed susceptibility to tigecycline, nitrofurantoin, vancomycin, imipenem, linezolid, ampicillin, piperacillin/tazobactam, amoxicillin/clavulanic acid, ampicillin/sulbactam, and piperacillin.
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Affiliation(s)
| | - Dian D Wahyuni
- Department of Microbiology, Universitas Sumatera Utara, Medan, Indonesia
- Department of Clinical Microbiology, H. Adam Malik General Hospital, Medan, Indonesia
| | - Rina Yunita
- Department of Microbiology, Universitas Sumatera Utara, Medan, Indonesia
- Department of Clinical Microbiology, H. Adam Malik General Hospital, Medan, Indonesia
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Gebretensaie Y, Atnafu A, Alemu Y, Girma S, Desta K. Evaluation of the Diagnostic Performance of the LINEAR Cromatest and Laboquick URS 10-T Dipsticks Among Urinary Tract Infection Suspects in Addis Ababa, Ethiopia: A Cross-Sectional Study. Res Rep Urol 2023; 15:437-445. [PMID: 37818231 PMCID: PMC10560765 DOI: 10.2147/rru.s434128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 09/28/2023] [Indexed: 10/12/2023] Open
Abstract
Background Urinary tract infections (UTIs) bring a significant and serious health-related problem. Repeated infections may lead to the development of renal scarring and end-stage renal dysfunction. Therefore, balancing the choices of UTI diagnostic tools depending on the costs versus accuracy can minimize false results that may subject patients to wrong treatments. Objective The objective of the study was to evaluate the diagnostic performance of LINEAR cromatest and Laboquick URS 10-T dipsticks against conventional urine culture at Arsho Advanced Medical Laboratory (AAML), Addis Ababa, Ethiopia. Methods A similar cohort of UTI-suspected patients from our previous study, who were prospectively enrolled from Arsho Advanced Medical Laboratory, Addis Ababa, Ethiopia, were considered for this analysis. Data analysis was performed using SPSS version 26. The sensitivity, specificity, and predictive value of different dipsticks were calculated using culture as a gold standard. ROC curve analysis was also used to determine diagnostic performance. A test with a P-value of <0.05 was considered statistically significant. Results Out of 446 urine samples processed, bacterial growth was observed in 141 (31.6%). Of this figure, 105/141 (74.5%) and 36/141 (25.5%) were from female and male participants, respectively. The sensitivity and specificity of the LINEAR Cromatest dipstick were 83.7% and 67.9%, respectively (P-value <0.001). The Laboquick URS 10-T dipstick showed sensitivity and specificity of 87.9% and 68.5%, respectively (P-value <0.001). The ROC analysis showed an AUC of >0.7 for both dipsticks. Conclusion In a setting where there is no access to urine culture, the urine dipstick may be considered an alternative diagnostic tool in the diagnosis of UTIs.
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Affiliation(s)
- Yosef Gebretensaie
- American Advanced Medical Laboratory, American Medical Center, Addis Ababa, Ethiopia
| | - Abay Atnafu
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Yonas Alemu
- Department of Microbiology, Immunology, and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Selfu Girma
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Kassu Desta
- Department of Medical Laboratory Science, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Almutawif YA, Eid HMA. Prevalence and antimicrobial susceptibility pattern of bacterial uropathogens among adult patients in Madinah, Saudi Arabia. BMC Infect Dis 2023; 23:582. [PMID: 37674127 PMCID: PMC10481549 DOI: 10.1186/s12879-023-08578-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/01/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Urinary tract infection (UTI) is considered one of the most prevalent infections that may lead to many renal complications. They account for almost 10% of all infections in Saudi Arabia, making them the second most common cause of emergency department admissions. Bacterial pathogens, primarily Escherichia coli, Klebsiella spp., Enterococcus spp., Proteus spp., and Staphylococcus spp. are the most causative agents of UTI. This study aims to evaluate the prevalence and antimicrobial susceptibility patterns of uropathogens in adult patients from Madinah, Saudi Arabia. METHODS A retrospective cross-sectional study was performed using data collected from patients who visited King Fahad General Hospital in Madinah, Saudi Arabia. Data included 16,803 urine bacterial cultures and their antimicrobial susceptibility profiles collected between January 2019 and October 2021. RESULTS Among the 16,803 tested samples, 3937 (23.4%) showed positive results for urine bacterial cultures. UTI prevalence was slightly higher in women (52.1%) than men (47.9%). Escherichia coli (29.8%) was the most prevalent, followed by Klebsiella spp. (23.2%) and Pseudomonas spp. (8.4%). As for Gram-positive bacteria, Enterococcus spp. (10.8%) were most common, followed by Streptococcus spp. (8%) and Staphylococcus spp. (3.3%). Gram-negative bacteria exhibited high resistance rates toward aztreonam (> 83.3%), ampicillin (78.8%), and cephalexin (68.5%). Enterococcus spp. displayed elevated resistance rates (> 62.3%) against ciprofloxacin, gentamicin, and tetracycline. Conversely, Streptococcus spp. showed substantial resistance rates (> 76.6%) toward colistin and trimethoprim/sulfamethoxazole. CONCLUSION To optimize therapy and minimize the risk of multidrug-resistant uropathogenic infections, physicians should consider the local epidemiological trends and antimicrobial resistance patterns of prevalent uropathogens prior to initiating any empirical antibacterial therapy.
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Affiliation(s)
- Yahya A Almutawif
- Department of Medical Laboratories Technology, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Hamza M A Eid
- Department of Medical Laboratories Technology, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia.
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Khatoon I, Khanam S, Azam A, Qadeer S, Naz S, Hassan NU. Incidence Pattern, Antibiotic Susceptibility Pattern and Associated Risk Factors of Bacterial Uropathogens Among General Population of Pakistan. Infect Drug Resist 2023; 16:4995-5005. [PMID: 37551281 PMCID: PMC10404436 DOI: 10.2147/idr.s418045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/21/2023] [Indexed: 08/09/2023] Open
Abstract
Purpose Urinary tract infections (UTIs) are of the most common bacterial infections in Pakistan. Rapid increase in antibiotic resistance has resulted in a limited number of treatment options available. This study aimed to determine the incidence patterns of uropathogens, their antimicrobial susceptibility pattern and risk factors for UTI among the general population. Methods This laboratory-based cross-sectional study was conducted between November 2020 and March 2021. Urine samples were collected, cultured and bacterial isolates were identified. Bacterial isolates were tested for antimicrobial susceptibility. Data regarding socio-demographic characteristics, clinical features and risk factors were collected using structured questionnaire. Results Of 459 urine samples, 299 (65.1%) showed positive urine cultures (105 CFU/mL). Both gram-negative and gram-positive isolates were obtained, with a prevalence of 230 (76.9%) and 69 (23%), respectively. Escherichia coli was the predominant bacteria isolated 146 (48.8%), and it showed most susceptibility to cefoperazone and imipenem. Most of the gram-negative isolates were resistant towards ampicillin. Most risk factors were not significantly associated with UTI, except for age, income, and previous history of hospitalization. Conclusion UTI is an important problem in the study area, with a prevalence rate of 65%. All bacterial isolates developed resistance towards most antibiotics available on the market. Therefore, there is a need to develop management strategies based on susceptibility pattern of uropathogens. Additionally, proper public education regarding causes of disease transmission and control strategies is required.
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Affiliation(s)
- Iram Khatoon
- Department of Zoology, Women University Swabi, Swabi, Khyber Pakhtunkhwa, Pakistan
| | - Surrya Khanam
- Department of Zoology, Women University Swabi, Swabi, Khyber Pakhtunkhwa, Pakistan
| | - Asima Azam
- Department of Zoology, Shaheed Benazir Bhutto Women University, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Saima Qadeer
- Department of Zoology, Division of Science & Technology, University of Education Lahore, Lahore, Punjab, 54000, Pakistan
| | - Shumaila Naz
- Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Punjab, Pakistan
| | - Najm Ul Hassan
- Department of Microbiology, Abdul Wali Khan University, Mardan, Khyber Pakhtunkhwa, Pakistan
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Girma A, Aemiro A, Workineh D, Tamir D. Magnitude, Associated Risk Factors, and Trend Comparisons of Urinary Tract Infection among Pregnant Women and Diabetic Patients: A Systematic Review and Meta-Analysis. J Pregnancy 2023; 2023:8365867. [PMID: 37545868 PMCID: PMC10403334 DOI: 10.1155/2023/8365867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 01/12/2023] [Accepted: 05/19/2023] [Indexed: 08/08/2023] Open
Abstract
Urinary tract infection (UTI) remains the most common bacterial infection that affects millions of people around the world, especially pregnant women (PW) and people with diabetes mellitus (DM). This systematic review and meta-analysis was aimed at finding the pooled prevalence of UTI and its associated risk factors among PW and DM patients. Scientific articles written in English were recovered from PubMed, ScienceDirect, Web of Science, Google Scholar, Cochrane Library, Google Engine, and University Library Databases. "Prevalence," "urinary tract infection," "associated factors," "pregnant women," "diabetic patients," and "Ethiopia" were search terms used for this study. For critical appraisal, PRISMA-2009 was applied. Heterogeneity and publication bias were evaluated using Cochran's Q, inverse variance (I2), and funnel plot asymmetry tests. A random effect model was used to calculate the pooled prevalence of UTI and its associated factors among both patients, along with the parallel odds ratio (OR) and 95% confidence interval (CI). For this meta-analysis, a total of 7271 participants were included in the 25 eligible studies. The pooled prevalence of UTI in Ethiopia among both patients was 14.50% (95% CI: 13.02, 15.97), of which 14.21% (95% CI: 12.18, 16.25) and 14.75% (95% CI: 12.58, 16.92) were cases of DM and PW, respectively. According to the subgroup analysis, the highest prevalence was observed in the Oromia region (19.84%) and in studies conducted from 2018 to 2022 (14.68%). Being female (AOR: 0.88, and 95% CI: 0.11, 1.65, P = 0.01) and having an income level ≤ 500ETB (AOR: 4.46, and 95% CI: -1.19, 10.12, P = 0.03) were risk factors significantly associated with UTI among patients with DM and PW, respectively. Furthermore, a history of catheterization (AOR = 5.58 and 95% CI: 1.35, 9.81, P < 0.01), urinary tract infection (AOR: 3.52, and 95% CI: 1.96, 5.08, P < 0.01), and symptomatic patients (AOR: 2.32, and 95% CI: 0.57, 4.06, P < 0.01) were significantly associated with UTI in both patients. Early diagnosis and appropriate medication are necessary for the treatment of UTI in patients with DM and PW.
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Affiliation(s)
- Abayeneh Girma
- Department of Biology, College of Natural and Computational Science, Mekdela Amba University, P.O. Box 32, Tulu Awlia, Ethiopia
| | - Aleka Aemiro
- Department of Biology, College of Natural and Computational Science, Mekdela Amba University, P.O. Box 32, Tulu Awlia, Ethiopia
| | - Dereba Workineh
- Department of Biology, College of Natural and Computational Science, Mizan-Tepi University, P.O. Box 121, Tepi, Ethiopia
| | - Dessalew Tamir
- Department of Veterinary Science, College of Agriculture and Environmental Sciences, Debre Tabor University, P.O. Box 272, Debre Tabor, Ethiopia
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Helmy AK, Sidkey NM, El-Badawy RE, Hegazi AG. Emergence of microbial infections in some hospitals of Cairo, Egypt: studying their corresponding antimicrobial resistance profiles. BMC Infect Dis 2023; 23:424. [PMID: 37349674 DOI: 10.1186/s12879-023-08397-4] [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: 04/01/2023] [Accepted: 06/12/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Antimicrobial resistance is one of the ten major public health threats facing humanity, especially in developing countries. Identification of the pathogens responsible for different microbial infections and antimicrobial resistance patterns are important to help clinicians to choose the correct empirical drugs and provide optimal patient care. METHODS During the period from November 2020 to January 2021, one hundred microbial isolates were collected randomly from different specimens from some hospitals in Cairo, Egypt. Sputum and chest specimens were from COVID-19 patients. Antimicrobial susceptibility testing was performed according to CLSI guidelines. RESULTS Most microbial infections were more common in males and in elderly people over 45 years of age. They were caused by Gram-negative, Gram-positive bacteria, and yeast isolates that represented 69%, 15%, and 16%, respectively. Uropathogenic Escherichia coli (35%) were the most prevalent microbial isolates and showed high resistance rates towards penicillin, ampicillin, and cefixime, followed by Klebsiella spp. (13%) and Candida spp. (16%). Of all microbial isolates, Acinetobacter spp., Serratia spp., Hafnia alvei, and Klebsiella ozaenae were extremely multidrug-resistant (MDR) and have resisted all antibiotic classes used, except for glycylcycline, in varying degrees. Acinetobacter spp., Serratia spp., and Candida spp. were secondary microbial infections in COVID-19 patients, while H. alvei was a bloodstream infection isolate and K. ozaenae was recorded in most infections. Moreover, about half of Staphylococcus aureus strains were MRSA isolates and reported low rates of resistance to glycylcycline and linezolid. In comparison, Candida spp. showed high resistance rates between 77 and 100% to azole drugs and terbinafine, while no resistance rate towards nystatin was reported. Indeed, glycylcycline, linezolid, and nystatin were considered the drugs of choice for the treatment of MDR infections. CONCLUSION The prevalence of antimicrobial resistance in some Egyptian hospitals was high among Gram-negative, Gram-positive bacteria, and candida spp. The high resistance pattern -especially in secondary microbial infections in COVID-19 patients- to most antibiotics used is a matter of great concern, portends an inevitable catastrophe, and requires continuous monitoring to avoid the evolution of new generations.
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Affiliation(s)
- Asmaa K Helmy
- Botany and Microbiology Department, Faculty of Science for Girls, Al-Azhar University, Cairo, Egypt.
| | - Nagwa M Sidkey
- Botany and Microbiology Department, Faculty of Science for Girls, Al-Azhar University, Cairo, Egypt
| | | | - Ahmed G Hegazi
- Zoonotic Diseases Department, National Research Centre, Dokki, Giza, Egypt
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Gebretensaie Y, Atnafu A, Girma S, Alemu Y, Desta K. Prevalence of Bacterial Urinary Tract Infection, Associated Risk Factors, and Antimicrobial Resistance Pattern in Addis Ababa, Ethiopia: A Cross-Sectional Study. Infect Drug Resist 2023; 16:3041-3050. [PMID: 37215305 PMCID: PMC10199700 DOI: 10.2147/idr.s402279] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 05/09/2023] [Indexed: 05/24/2023] Open
Abstract
Background Urinary tract infections (UTIs) brought a significant and serious health-related problem that may lead to the subsequent development of serious indications with the challenge of the emergence of antibiotic resistance. Therefore, the choice of antibiotics depends on the accuracy of the diagnostic tool of UTIs to minimize false results that may subject patients to wrong treatments. This study aimed to determine the prevalence of bacteriuria, associated factors, and AMR pattern of UTI-suspected patients. Methods A cross-sectional study was conducted from March to May 2022, at Arsho Advanced Medical Laboratory (AAML), Addis Ababa, Ethiopia. Species identification and isolation from bacterial colonies were characterized by gram stain and biochemical properties followed by antibiotic susceptibility testing using the Kirby-Bauer method on Muller-Hinton agar. Logistic regression analysis was carried out to determine the association between the independent variables and significant bacterial growth to identify factors that affect the prevalence of UTI. A test is considered statistically significant that has a P value less than 0.05. Results Out of 141 (31.6%) which yielded significant bacteriuria, 16 different species of bacterial uropathogens were identified. A total of 105/446 (91 Gram-negative and 14 Gram-positive) of bacterial growth in the female gender and 36/446 (33 Gram-negative and 3 Gram positive) in male were observed with a P value of 0.03. The most predominant bacteria were E. coli followed by Klebsiella pneumoniae. Amoxicillin had shown the highest resistance rate (100%) followed by Ampicillin (98.9%). Females and participants with previous infections were shown to be associated with significant bacterial growth. Conclusion Based on our study finding, the ordinarily used antibiotics seem to face emerging resistant strains, which needs considerable and due attention to the impact of UTI in developing countries including Ethiopia. History of previous UTIs and female gender were shown to be possible risk factors associated with UTIs.
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Affiliation(s)
- Yosef Gebretensaie
- Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abay Atnafu
- Mycobacterial Disease Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Selfu Girma
- Mycobacterial Disease Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Yonas Alemu
- Department of Microbiology, Immunology, and Parasitology, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Kassu Desta
- Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
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Resistance to Some New Drugs and Prevalence of ESBL- and MBL-Producing Enterobacteriaceae Uropathogens Isolated from Diabetic Patients. Life (Basel) 2022; 12:life12122125. [PMID: 36556490 PMCID: PMC9788504 DOI: 10.3390/life12122125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/09/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Diabetes is a leading non-communicable disease and a risk factor for relapsing infections. The current study was aimed at investigating the prevalence and antibiotic susceptibility of carbapenem-resistant (CR) uropathogens of the family Enterobacteriaceae in diabetic patients. The data of 910 bacterial isolates was collected from diagnostic laboratories during January 2018 to December 2018. The bacterial isolates were identified using traditional methods including colonial characteristics, biochemical tests, and API (20E). Antimicrobial susceptibility and phenotypic characterization of ESBL, MBLs, and KPC was determined by utilizing CLSI recommended methods. The phenotypically positive isolates were further analyzed for resistance-encoding genes by manual PCR and Check-MDR CT103XL microarray. Susceptibility to colistin and cefiderocol was tested in accordance with CLSI guidelines. The data revealed that most of the patients were suffering from type 2 diabetes for a duration of more than a year and with uncontrolled blood sugar levels. Escherichia coli and Klebsiella pneumoniae were the most frequently encountered pathogens, followed by Enterobacter cloacae and Proteus mirabilis. More than 50% of the isolates showed resistance to 22 antibiotics, with the highest resistance (>80%) against tetracycline, ampicillin, and cefazolin. The uropathogens showed less resistance to non-β-lactam antibiotics, including amikacin, fosfomycin, and nitrofurantoin. In the phenotypic assays, 495 (54.3%) isolates were found to be ESBL producers, while ESBL-TEM and -PER were the most prevalent ESBL types. The resistance to carbapenems was slightly less (250; 27.5%) than ESBL producers, yet more common amongst E. coli isolates. MBL production was a common feature in carbapenem-resistant isolates (71.2%); genotypic characterization also validated this trend. The isolates were found to be sensitive against the new drugs, cefiderocol and eravacycline. with 7−28% resistance, except for P. mirabilis which had 100% resistance against eravacycline. This study concludes that a few types of ESBL and carbapenemases are common in the uropathogens isolated from the diabetic patients, and antibiotic stewardship programs need to be revisited, particularly to cure UTIs in diabetic patients.
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Tornimbene B, Eremin S, Abednego R, Abualas EO, Boutiba I, Egwuenu A, Fuller W, Gahimbare L, Githii S, Kasambara W, Lukwesa-Musyani C, Miamina FA, Mtapuri-Zinyowera S, Najjuka G, Perovic O, Zayed B, Ahmed YA, Ismail MT, Pessoa da Silva CL. Global Antimicrobial Resistance and Use Surveillance System on the African continent: Early implementation 2017–2019. Afr J Lab Med 2022; 11:1594. [PMID: 36091353 PMCID: PMC9453120 DOI: 10.4102/ajlm.v11i1.1594] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 04/20/2022] [Indexed: 11/06/2022] Open
Abstract
Background Antimicrobial resistance (AMR) is becoming a critical public health issue globally. The World Health Organization launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) to support the strengthening of the AMR evidence base. Objective The article describes the evolution of national AMR surveillance systems and AMR data reporting of countries in the African continent between 2017 and 2019, and the constraints, perceived impact and value of the participation in GLASS. Methods Data on implementation of national surveillance systems and AMR rates were submitted to GLASS between 2017 and 2019 and summarised though descriptive statistics. The information on constraints and perceived impact and value in GLASS participation was collected though a set of questionnaires. Results Between 2017 and 2019, Egypt, Ethiopia, Madagascar, Malawi, Mali, Mozambique, Nigeria, South Africa, Sudan, Tunisia, Uganda and Zambia submitted data to GLASS. The main constraints listed are linked to scarce laboratory capacity and capability, limited staffing, budget issues, and data management. Moreover, while the data are not yet nationally representative, high resistance rates were reported to commonly-used antibiotics, as the emerging resistance to last treatment options. Conclusion Despite the limitations, more and more countries in the African continent are working towards reaching a status that will enable them to report AMR data in a complete and systematic manner. Future improvements involve the expansion of routine surveillance capacity for several countries and the implementation of surveys that allow to effectively define the magnitude of AMR in the continent.
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Affiliation(s)
- Barbara Tornimbene
- AMR Division, Surveillance, Prevention and Control Department, World Health Organization, Geneva, Switzerland
| | - Sergey Eremin
- AMR Division, Surveillance, Prevention and Control Department, World Health Organization, Geneva, Switzerland
| | - Reuben Abednego
- National Health Laboratory Quality Assurance and Training Centre (NHLQATC), Tanzania, Dar es Salaam, United Republic of Tanzania
| | - Elamin O. Abualas
- National Public Health Laboratory, Federal Ministry of Health, Khartoum, Sudan
| | - Ilhem Boutiba
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | | | - Walter Fuller
- Antimicrobial Resistance (AMR) World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Laetitia Gahimbare
- Antimicrobial Resistance (AMR) World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Susan Githii
- National Microbiology Reference Lab, National Public Health Laboratories, Nairobi, Kenya
| | | | | | - Fidy A. Miamina
- Department of Health Watch, Epidemiological Surveillance and Response (DVSSER), Antananarivo, Madagascar
| | | | - Grace Najjuka
- Department of Microbiology, Joint Clinical Research Centre (JCRC), Kampala, Uganda
| | - Olga Perovic
- Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses (CHARM), Johannesburg, South Africa
| | - Bassem Zayed
- World Health Organization, Regional Office for East Mediterranean, Cairo, Egypt
| | - Yahaya A. Ahmed
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Maha T. Ismail
- World Health Organization, Regional Office for East Mediterranean, Cairo, Egypt
| | - Carmem L. Pessoa da Silva
- AMR Division, Surveillance, Prevention and Control Department, World Health Organization, Geneva, Switzerland
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Antimicrobial susceptibility of bacteria isolated from urine cultures in Southern Turkey. Curr Urol 2022; 16:180-184. [PMID: 36204355 PMCID: PMC9527924 DOI: 10.1097/cu9.0000000000000144] [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: 01/27/2022] [Accepted: 04/01/2022] [Indexed: 11/25/2022] Open
Abstract
Background Pathogen spectrum and antibiotic susceptibility patterns vary in different regions and should consider the empirical treatment of urinary tract infections (UTIs). Information on susceptibility is the basis for providing reliable treatment. This study aimed to determine the antibiotic susceptibility of bacteria isolated from urine cultures at Çukurova State Hospital, which is located south of Turkey and east of the Mediterranean region. Materials and methods Urine culture results were retrospectively evaluated between April 2018 and January 2021. Variables, such as age, sex, and medical department, were also recorded. Inclusion criteria were patients aged at least 18 years with pathogenic bacterial growth in their urine cultures. Antibiotic susceptibility testing and bacterial identification were performed using the VITEK 2 automated system. Results Of 12,288 urine samples, 2033 (16.5%) had pathogenic growth. The rates of bacterial and yeast growth were 93.3% and 6.7%, respectively. Gram-negative pathogens constituted 91.6% of the cohort. The most prevalent bacteria were Escherichia coli with a 66% rate, followed by Klebsiella (14.2%). According to our results, ciprofloxacin, trimethoprim-sulfamethoxazole, and ampicillin are not suitable for empirical treatment of UTIs, whereas nitrofurantoin and fosfomycin are rational options. Conclusions Uropathogens exhibit an increased resistance rate against ampicillin, trimethoprim-sulfamethoxazole, and ciprofloxacin. Nitrofurantoin, fosfomycin, and ceftazidime have better efficacy than other investigated antibiotics in urine culture against common uropathogens and are suitable for empirical treatment of UTI.
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DEĞİRMENCİ H, VURAL S, YALÇIN S. Determination of Bacterial Species and their Antibiotic Susceptibility Profiles Isolated from Patients with Urinary Tract Infection in a Private Hospital in Istanbul. İSTANBUL GELIŞIM ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2022. [DOI: 10.38079/igusabder.1123454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: One of the most common bacterial infections in humans in the community and hospital settings is urinary tract infections. It is seen in the second frequency, with a rate of 25% among all infectious diseases. Urinary tract infections are caused by microorganisms that cause an inflammatory response in the urinary tract epithelium, more than 95% of which are bacterial agents. The aim of this study is to retrospectively examine and evaluate the bacteria isolated and their resistance/sensitivity to antibiotics as a result of microbiological analyzes of urine samples taken from patients who came to different services and polyclinics and inpatients with signs of urinary tract infection of a private hospital in Istanbul between 2017-2021 with the complaint of urinary tract infection.Method: In the study, 772 urine samples sent to the microbiology laboratory of the hospital between 2017-2021 were analyzed retrospectively in terms of isolated bacteria and their resistance/sensitivity to antibiotics. Data analysis was performed with SPSS Statistics version 26. Categorical variables were calculated as numbers and percentages. The difference between categorical variables was analyzed using the chi-square test.Results: In the study, microbiological culture/antibiogram results of urine samples of 772 patients, 572 of whom were female (74%) and 200 were male (26%), were examined. When the age distributions of the patients are examined; 6% are 0-15 years old, 5.9% are 15-24 years old, 33.9% are 25-49 years old and 54.2% are 49 years old and over. A total of 32 different bacterial species were isolated from urine samples, and the most isolated bacterial species were respectively; Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis. Among the antibiotics to which Escherichia coli isolates are most sensitive; amikacin (97.2%), meropenem (95.3%), imipenem (95.1%), colistin (94.7%), ertapenem (92%), tazobactam-piperacillin (88.6%), nitrofurantoin (87.7%), gentamicin (84.3%), ticarcillin-clavulanate (83.1%), and cefoxitin (82.9%). The antibiotics with the highest resistance development are respectively; ampicillin (71.3%), ampicillin-sulbactam (69.9%) and amoxicillin-clavulonic acid (49.4%). The antibiotics with the highest sensitivity in Klebsiella pneumoniae isolates are, respectively; colistin (70.4%) and amikacin (69.8%) were most resistant to ampicillin (94.9%), ampicillin - sulbactam (93.5%) and cefazolin (69.6%). In isolated Proteus mirabilis, the highest sensitivity was found to tazobactam-piperacillin (78.8%), aztreonam (78.6%) and meropenem (75%), while the antibiotics with the highest resistance development were nitrofurantoin (72.7%) and colistin (81.5%).Conclusion: Widespread use of antibiotics against UTI pathogens has led to the emergence of antibiotic-resistant strains. The most important reason for the formation of antibacterial resistance is the use of antibiotics for a long time and in insufficient doses. In addition, the wrong choice of antibiotics leads to the development of resistance. This situation affects the treatment process and reveals the need to determine the right chemotherapeutic options for an effective treatment. The antimicrobial resistance distributions of bacteria causing urinary tract infections show differences according to time and region. Because the antibiogram test results take time, patients who apply to clinics and hospitals with the complaint of UTI are usually treated with empirical antibiotics. In the selection of empirical preparations, first of all, the most frequently isolated agent and the antimicrobial agent with the lowest resistance rate should be taken into consideration, and if possible, urine samples should be delivered to the laboratory for agent isolation and antibiogram evaluation before starting antibiotic therapy.
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Bhargava K, Nath G, Bhargava A, Kumari R, Aseri GK, Jain N. Bacterial profile and antibiotic susceptibility pattern of uropathogens causing urinary tract infection in the eastern part of Northern India. Front Microbiol 2022; 13:965053. [PMID: 36016776 PMCID: PMC9396120 DOI: 10.3389/fmicb.2022.965053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/15/2022] [Indexed: 11/27/2022] Open
Abstract
Urinary tract infection (UTI) is a common infectious disease that affects men and women. It is a significant health concern due to multidrug-resistant (MDR) organisms. Therefore, it is necessary to have a current understanding of the antibiotic susceptibility (AS) pattern of uropathogens to manage UTI effectively. Since the bacterial pathogen causing UTI and its AS vary with time and place, the prevailing AS pattern of the causative agents are essential for empirical antibiotic therapy. This study aims to determine the prevalence and AS of uropathogens isolated from UTI patients in the eastern part of Northern India. The study was carried out between November 2018 and December 2019. Clean catch midstream urine samples were collected and processed using standard guidelines for microbiological procedures. Positive microbiological cultures were found in 333 of the 427 patients, where 287 were gram-negative bacteria (GNB), and 46 were gram-positive bacteria (GPB). Females had a higher prevalence of UTI (60.7%) than males (39.3%) (p = 0.00024). The most susceptible age group in females was 18–50 years as compared to males, whereas at the age of 51–80 years and >80 years males were more susceptible than females (p = 0.053). The most prevalent pathogen identified were Escherichia coli (55.0%), followed by Proteus sp. (6.9%), Klebsiella pneumoniae (6.6%), Pseudomonas aeruginosa (6.3%), of which 96.0% were MDR bacteria. The susceptibility pattern of our study also revealed that amikacin, gentamycin and imipenem were the most effective drugs against GNB. In contrast, nitrofurantoin, vancomycin, and chloramphenicol were the most effective drugs against GPB. According tothe findings, MDR pathogens are very much prevalent. Since UTI is one of the most frequent bacterial diseases, proper management necessitates extensive investigation and implementation of antibiotic policy based on AS patterns for a particular region.
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Affiliation(s)
- Kanika Bhargava
- Amity Institute of Microbial Technology, Amity University Rajasthan, Jaipur, India
- Department of Microbiology, Institute of Medical Sciences (IMS), Banaras Hindu University, Varanasi, India
| | - Gopal Nath
- Department of Microbiology, Institute of Medical Sciences (IMS), Banaras Hindu University, Varanasi, India
- Gopal Nath,
| | - Amit Bhargava
- Department of Medicine, Hayes Memorial Hospital, Sam Higginbottom University of Agriculture, Technology and Sciences (SHUATS), Allahabad, India
| | - Ritu Kumari
- Department of Microbiology, Institute of Medical Sciences (IMS), Banaras Hindu University, Varanasi, India
| | - G. K. Aseri
- Amity Institute of Microbial Technology, Amity University Rajasthan, Jaipur, India
| | - Neelam Jain
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, India
- *Correspondence: Neelam Jain,
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Joya M, Aalemi AK, Baryali AT. Prevalence and Antibiotic Susceptibility of the Common Bacterial Uropathogen Among UTI Patients in French Medical Institute for Children. Infect Drug Resist 2022; 15:4291-4297. [PMID: 35965851 PMCID: PMC9365322 DOI: 10.2147/idr.s353818] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 08/02/2022] [Indexed: 12/27/2022] Open
Affiliation(s)
- Mahdawi Joya
- Department of Medical Laboratory Technology, Kabul University of Medical Sciences, Kabul, Afghanistan
| | - Ahmad Khalid Aalemi
- Department of Oral Medicine, Kabul University of Medical Sciences, Kabul, Afghanistan
- Correspondence: Ahmad Khalid Aalemi, Department of Oral Medicine, Kabul University of Medical Sciences, Kabul, 1001, Afghanistan, Tel +93 704923443, Email
| | - Abdul Tawab Baryali
- Department of Quality Assurance, French Medical Institute for Children, Kabul, Afghanistan
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Karikari AB, Saba CK, Yamik DY. Reported Cases of Urinary Tract Infections and the Susceptibility of Uropathogens from Hospitals in Northern Ghana. Microbiol Insights 2022; 15:11786361221106109. [PMID: 35769634 PMCID: PMC9234931 DOI: 10.1177/11786361221106109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 05/22/2022] [Indexed: 11/25/2022] Open
Abstract
As global studies report varying trends in antibiotic susceptibility of
uropathogens, it is necessary to have current and constant information on the
prevalence of urinary tract infections, the causative pathogens, and their
susceptibility profiles, for effective management in specific geographical
settings. This prospective cross-sectional study focused on the prevalence of
urinary tract infections, etiological agents, and their antibiogram in a
secondary and tertiary care hospital in Northern Ghana. Urine samples collected
from 219 patients of all age groups were cultured on cysteine lactose
electrolyte deficient agar. Pathogens were identified following standard
microbiological methods, and their susceptibility to antibiotics was determined
by the Kirby-Bauer disk diffusion method. Approximately 34% of the patients had
significant bacteria, but the prevalence was slightly higher
(P = .763) in the Tertiary care hospital (37.3%) than in the
Secondary hospital (30.3%). Patients who were 60 years and above (27.0%) were
commonly found with UTIs followed by the year group 20 to 29 years (20.3%).
Although all the diagnoses had a positive relationship with urinary tract
infection except Pyelonephritis, none of the underlying conditions was a
significant (P > .05) predictor of urinary tract infection,
with the odds ratio indicating that patients with hyperparathyroidism and
dysuria had 2.606 times more likely increased risk or predictor of urinary tract
infection. Ten different pathogens were identified, but
Escherichia coli and Staphylococcus
saprophyticus were frequently encountered. Gram-negative isolates
generally showed more resistance. High resistance against ampicillin (100%),
trimethoprim-sulfamethoxazole (88.5%), chloramphenicol (84.6%), augmentin
(69.2%), ceftriaxone (69.2%), and ciprofloxacin (61.5%) were recorded. Amikacin
was relatively effective against isolated pathogens. The high records of
resistance among uropathogens and the occurrence of multidrug resistance (92%)
reiterate the urgent call for rigorous surveillance of antimicrobial resistance
among infectious pathogens in Ghana.
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Affiliation(s)
- Akosua B Karikari
- Department of Clinical Microbiology, School of Medicine, University for Development Studies, Tamale, Ghana
| | - Courage Ks Saba
- Department of Microbiology, Faculty of Biosciences, University for Development Studies, Tamale, Ghana
| | - David Y Yamik
- Department of Microbiology, Faculty of Biosciences, University for Development Studies, Tamale, Ghana
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Adekanmbi AO, Akinlabi OC, Usidamen S, Olaposi AV, Olaniyan AB. High burden of ESBL- producing Klebsiella spp., Proteus mirabilis, Enterobacter cloacae and Pseudomonas aeruginosa in diagnosed cases of urinary tract infection in a Nigerian Teaching Hospital. Acta Microbiol Immunol Hung 2022; 69:127-134. [DOI: 10.1556/030.2022.01747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/02/2022] [Indexed: 11/19/2022]
Abstract
Abstract
Infections of the urinary tract have been on the rise globally and these are also worsened by the increasing rate of antibiotic resistance in uropathogens. This study aimed to determine the susceptibility profile of extended spectrum β-lactamase (ESBL)- producing uropathogens to selected antibiotics and their carriage of ESBL genes. Bacterial uropathogens were obtained from the urine bench of a Microbiology laboratory in a Teaching Hospital in South-West Nigeria. Susceptibility to antibiotics was tested using the disc diffusion method, while detection of ESBL production was done using the double disc synergy test (DDST). Detection of ESBL genes was performed by PCR. A total of 21 ESBL- producing uropathogens were obtained namely: Klebsiella pneumoniae (11), Klebsiella oxytoca (6), Proteus mirabilis (2), Enterobacter cloacae (1) and Pseudomonas aeruginosa (1). The resistance to antibiotics in the uropathogens was: imipenem (0%), gentamicin (38.1%), sulfamethoxazole-trimethoprim (52.4%), amoxicillin-clavulanate (61.9%), aztreonam (66.7%), ceftazidime (66.7%), tetracycline (90.5%), cefpodoxime (100%) and cefotaxime (100%). Altogether, 90.5% (19/21) of the isolates were multidrug resistant (MDR). Of the 21 uropathogens, 61.9% (13/21) carried bla
CTX-M, 52.4% (11/21) carried bla
TEM while bla
SHV was detected in 47.6% (10/21) of the isolates. There was co-carriage of ESBL genes in 12 uropathogens. This study showed a high prevalence of multidrug resistance and a high carriage of ESBL genes in the ESBL- producing isolates obtained over the study period. There is a need for a review of antibiotic options in the treatment of UTI to clamp down on the ever-increasing tide of antibiotic resistance in uropathogens.
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Affiliation(s)
- Abimbola Olumide Adekanmbi
- Environmental Microbiology and Biotechnology Laboratory, Department of Microbiology, University of Ibadan, Ibadan, Nigeria
- Molecular Biology and Biotechnology Laboratory, Department of Microbiology, University of Ibadan, Ibadan, Nigeria
| | - Olabisi Comfort Akinlabi
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
| | - Sandra Usidamen
- Molecular Biology and Biotechnology Laboratory, Department of Microbiology, University of Ibadan, Ibadan, Nigeria
- Pathogenic Microbiology Laboratory, Department of Microbiology, University of Ibadan, Ibadan, Nigeria
| | - Adedolapo Victoria Olaposi
- Environmental Microbiology and Biotechnology Laboratory, Department of Microbiology, University of Ibadan, Ibadan, Nigeria
- Molecular Biology and Biotechnology Laboratory, Department of Microbiology, University of Ibadan, Ibadan, Nigeria
| | - Adeola Boluwatife Olaniyan
- Environmental Microbiology and Biotechnology Laboratory, Department of Microbiology, University of Ibadan, Ibadan, Nigeria
- Molecular Biology and Biotechnology Laboratory, Department of Microbiology, University of Ibadan, Ibadan, Nigeria
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Perween N, Rai S, Nandwani S, Kumar SK. Retrospective Analysis of Urinary Tract Infection in the Pediatric Population at a Tertiary Care Centre. Cureus 2022; 14:e24796. [PMID: 35677001 PMCID: PMC9169234 DOI: 10.7759/cureus.24796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2022] [Indexed: 11/08/2022] Open
Abstract
Background: Urinary tract infection (UTI) is among the most common infections occurring during childhood. It is caused by both gram-negative and gram-positive bacteria and Escherichia coli is the most common causative agent. Methods: Data of all pediatric patients in the age group of 6 months to 18 years with urinary tract infection were taken for analysis. Urine samples were collected and cultured on the cystine lactose electrolyte-deficient medium. The presence of bacteria was identified using biochemicals, and the antimicrobial test was performed using the Kirby-Bauer test or the VITEK 2 compact system (bioMérieux, Inc., France). Results: The prevalence of UTI was 23.5%. In total, 614 specimens tested positive with significant bacteriuria. The male-to-female ratio was 1:2.3. Approximately 54% patients presented with urinary symptoms alone. Culture positivity was significantly associated with pyuria (p < 0.0001). E. coli (334/614) was the most common isolate, followed by Enterococcus spp. (92/614). Colistin, polymyxin B, fosfomycin, nitrofurantoin, netilmicin, and amikacin were extremely good acting antimicrobials. Meanwhile, ampicillin, cefotaxime, ceftriaxone, and norfloxacin were highly resistant to gram-negative bacteria. Multidrug-resistant bacteria and extended-spectrum beta-lactamase-producing bacteria were found in 47% and 44.1% of cases, respectively. Vancomycin, linezolid, teicoplanin, and nitrofurantoin were highly effective against gram-positive bacteria. Furthermore, norfloxacin, trimethoprim/sulfamethoxazole, ciprofloxacin, and tetracycline were highly resistant to gram-positive bacteria. Of the 92, 42 Enterococcus spp. were resistant to high-dose gentamicin. Conclusion: Nitrofurantoin and amikacin can be used as empirical therapy for gram-negative and gram-positive bacteria. Because resistance to various commonly used antibiotics is found to be increasing, treatment must be guided by antibiotic susceptibility reports.
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Kito Y, Kuwabara K, Ono K, Kato K, Yokoi T, Horiguchi K, Kato K, Hirose M, Ohara T, Goto K, Nakamura Y, Koike Y, Horiguchi T. Seasonal variation in the prevalence of Gram-negative bacilli in sputum and urine specimens from outpatients and inpatients. FUJITA MEDICAL JOURNAL 2022; 8:46-51. [PMID: 35520292 PMCID: PMC9069267 DOI: 10.20407/fmj.2021-003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 04/14/2021] [Indexed: 11/04/2022]
Abstract
Objectives To determine whether the prevalence of gram-negative bacilli (GNB; Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli) in sputum and urine specimens from outpatients and inpatients differed by season and according to temperature and humidity changes. Methods In this retrospective study, microbiologic data for adult patients from 2008 to 2019 were retrieved from the electronic database of a hospital in Japan. Data were categorized by specimen type (sputum and urine) and specimen collection (outpatient and inpatient). Associations between variables were assessed using Spearman's rank correlation coefficients. Differences between groups were assessed using Pearson's chi-square test and analysis of discrete variance. Results Among inpatients, the frequencies of P. aeruginosa and K. pneumoniae isolation from sputum specimens were higher in summer and autumn. The frequency of P. aeruginosa isolation from urine specimens was higher in autumn. These seasonal trends were observed in specimens from both outpatients and inpatients. No seasonal trend was observed in the frequency of E. coli isolation. Mean monthly temperature was positively correlated with the frequency of isolating P. aeruginosa (r=0.2198, p=0.0081) and K. pneumoniae (r=0.3443, p=0.00002) from sputum as well as with the frequency of isolating K. pneumoniae (r=0.1905, p=0.0222) from urine. Mean monthly humidity was positively correlated with the frequency of isolating K. pneumoniae (r=0.2602, p=0.0016) from sputum. Conclusions GNB were isolated more frequently in summer and autumn than in other seasons. These seasonal trends were observed for both outpatient and inpatient specimens. Seasonality should be considered for optimal infection control of GNB in hospitals.
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Affiliation(s)
- Yusuke Kito
- Department of Respiratory Medicine II, Fujita Health University, School of Medicine, Nagoya, Aichi, Japan
| | - Kazunobu Kuwabara
- Department of Respiratory Medicine II, Fujita Health University, School of Medicine, Nagoya, Aichi, Japan
| | - Kiyotaka Ono
- Department of Respiratory Medicine II, Fujita Health University, School of Medicine, Nagoya, Aichi, Japan
| | - Kenichi Kato
- Department of Respiratory Medicine II, Fujita Health University, School of Medicine, Nagoya, Aichi, Japan
| | - Tatsuyoshi Yokoi
- Department of Respiratory Medicine II, Fujita Health University, School of Medicine, Nagoya, Aichi, Japan
| | - Kohki Horiguchi
- Department of Respiratory Medicine II, Fujita Health University, School of Medicine, Nagoya, Aichi, Japan
| | - Keisuke Kato
- Department of Respiratory Medicine II, Fujita Health University, School of Medicine, Nagoya, Aichi, Japan
| | - Masahiro Hirose
- Department of Respiratory Medicine II, Fujita Health University, School of Medicine, Nagoya, Aichi, Japan
| | - Tomomi Ohara
- Department of Clinical Laboratory, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Kenta Goto
- Department of Clinical Laboratory, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Yumi Nakamura
- Department of Clinical Laboratory, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Yoshikatsu Koike
- Pharmaceutical Department, Fujita Health University Okazaki Medical Center, Okazaki, Aichi, Japan
| | - Takahiko Horiguchi
- Department of Respiratory Medicine II, Fujita Health University, School of Medicine, Nagoya, Aichi, Japan
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Ali HA, Gemeel Abd F. Bacteriological and systemic immunity study of patients with urinary tract infection in Babylon province. Int J Health Sci (Qassim) 2022:1574-1582. [DOI: 10.53730/ijhs.v6ns4.6286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Abstract
One hundred mid stream urine specimens and blood sample and fifty healthy specimen[urine and blood ]as control for detection TLR-2 in serum have been collected From October to March 2021, urine specimen from urinary tract infection patients in Hospital Hilla were cultivated for isolation and identification in Uropathogenic bacteria can be found in a variety of places. The automated VITEK-2 compact system was used to perform the final identification, which was based on colony positive identification. morphology, microscopic examination, and biochemical tests, while final identification was done with the automated VITEK-2 compact system using Gram positive-identification morphology, microscopic examination, and biochemical tests [GP-ID]and Gram negative-identification [GP-ID] [GN-ID]. The current study's findings revealed that samples grew bacteria, which were classified into Gram negative bacteria [51.48%] and Gram positive bacteria [51.48%]. [48.52 percent ]. E. coli was the culprit. 80 [21.5%] followed by Klebsiella pneumoniae40 [10.75%], and then Staphylococcus aureus 36[9.6%], 35[9.4%] for each Staphylococcus epidermidis, and Staphylococcus saprophytics 16[4.3%] while Enterococcus faecalis50[13.44%], while Enterococcus facium 40[10.75%] Streptococcus agalactiae 2[0.5%]and Enterobacter cloacae at a rate of 2[0.5%] and finally each of Morganella morganii 10[2.68%], Pseudomonas aeruginosa 40[10.75], Proteus mirabilis 20[5.3%].Candida albicans 46 .
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Selim S, Faried OA, Almuhayawi MS, Saleh FM, Sharaf M, El Nahhas N, Warrad M. Incidence of Vancomycin-Resistant Staphylococcus aureus Strains among Patients with Urinary Tract Infections. Antibiotics (Basel) 2022; 11:antibiotics11030408. [PMID: 35326871 PMCID: PMC8944512 DOI: 10.3390/antibiotics11030408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 12/29/2022] Open
Abstract
There has been a substantial rise in the number of vancomycin-resistant Staphylococcus aureus (VRSA) strains during the last several years. The proportion of vancomycin-resistant strains among isolated S. aureus has risen steadily in recent years, with the first spike occurring in critical care units and thereafter in general hospital wards. S. aureus isolates from urinary tract infection patients were studied for their prevalence and antibiotic resistance. From 292 urine samples, 103 bacterial strains (35.3%) were identified as S. aureus. Various antibiotics were used to test the isolates’ antibacterial resistance profiles. Antibiotic resistance to erythromycin was found in most bacterial isolates, whereas tobramycin antibiotic sensitivity was found in most of them. Vancomycin resistance was found in 23 of all S. aureus isolates in this study. Analysis for β-lactamase found that 71% of S. aureus isolates were positive in all isolates. There was a single plasmid with a molecular weight of 39.306 Kbp in five selected VRSA isolates that was subjected to plasmid analysis. There was evidence of vancomycin resistance among the S. aureus isolates collected from UTI patients in this investigation. This vancomycin resistance pretenses a challenge in the treatment of S. aureus infections and the need to precisely recognize persons who require last-resort medication such as tobramycin.
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Affiliation(s)
- Samy Selim
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka 72341, Saudi Arabia
- Correspondence:
| | - Osama Ahmed Faried
- Medical Microbiology and Immunology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef 62513, Egypt;
| | - Mohammed S. Almuhayawi
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Fayez M. Saleh
- Department of Medical Microbiology, Faculty of Medicine, University of Tabuk, Tabuk 71491, Saudi Arabia;
| | - Mohamed Sharaf
- Department of Biochemistry, Faculty of Agriculture, AL-Azhar University, Cairo 11651, Egypt;
- Department of Biochemistry and Molecular Biology, College of Marine Life Sciences, Ocean University of China, Qingdao 266003, China
| | - Nihal El Nahhas
- Department of Botany and Microbiology, Faculty of Science, Alexandria University, Alexandria 21526, Egypt;
| | - Mona Warrad
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences at Al-Quriat, Jouf University, Al-Quriat 77454, Saudi Arabia;
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Hasan RN, Jasim SA, Ali YH. Detection of fimH, kpsMTII, hlyA, and traT genes in Escherichia coli isolated from Iraqi patients with cystitis. GENE REPORTS 2022. [DOI: 10.1016/j.genrep.2021.101468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Girma A, Aemiro A. The Bacterial Profile and Antimicrobial Susceptibility Patterns of Urinary Tract Infection Patients at Pawe General Hospital, Northwest Ethiopia. SCIENTIFICA 2022; 2022:3085950. [PMID: 35509515 PMCID: PMC9061053 DOI: 10.1155/2022/3085950] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/24/2022] [Accepted: 04/02/2022] [Indexed: 05/19/2023]
Abstract
Urinary tract infection remains the most common infection widespread worldwide in both community and hospital settings. Rapidly increasing antibiotic resistance of uropathogens is resulting in limited treatment options. Thus, understanding the current uropathogens and their antimicrobial susceptibilities is essential for effective urinary tract infection treatment. The purpose of this study was to isolate, characterize, and determine the antimicrobial susceptibility patterns of bacterial pathogens associated with urinary tract infection at Pawe General Hospital in Northwest Ethiopia. A hospital-based cross-sectional study design was conducted from January to April, 2020, at Pawe General Hospital. Midstream urine specimens were collected from 141 individuals with suspected urinary tract infection for bacteriological identification and antimicrobial susceptibility testing. Among the 141 study participants, twenty-nine (20.6%) showed significant bacteriuria. Escherichia coli (42.6%) had the highest proportion of isolated uropathogen followed by Klebsiella spp. and Pseudomonas spp. each (10.7%); Proteus spp. (9.3%); coagulase negative staphylococci, Staphylococcus aureus, and Enterobacter spp. each (6.7%); Citrobacter spp. (4%); and Enterococcus faecalis and Streptococcus spp. each (1.3%). Outpatient isolates showed a resistance of 64% and 78.6% to amoxicillin-clavulanic acid and tetracycline, respectively. Inpatients showed 63.9% and 87.2% of resistance to cephalexin and tetracycline. It was also observed that all the isolates have a multiple antimicrobial resistance index greater than 0.20 except Citrobacter spp. (0.142) in inpatients. Even though in this locality, most isolates were sensitive to ceftriaxone, gentamicin, ciprofloxacin, nitrofurantoin, and norfloxacin, they are considered appropriate antimicrobials for empirical treatment of urinary tract bacterial infections. Periodic monitoring of etiology and drug susceptibility is highly recommended, along with health education on the transmission and causes of urinary tract infection.
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Affiliation(s)
- Abayeneh Girma
- Department of Biology, College of Natural and Computational Science, Mekdela Amba University, P.O. Box 32, Tuluawlia, Ethiopia
| | - Aleka Aemiro
- Department of Biology, College of Natural and Computational Science, Mekdela Amba University, P.O. Box 32, Tuluawlia, Ethiopia
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Addis T, Mekonnen Y, Ayenew Z, Fentaw S, Biazin H. Bacterial uropathogens and burden of antimicrobial resistance pattern in urine specimens referred to Ethiopian Public Health Institute. PLoS One 2021; 16:e0259602. [PMID: 34767605 PMCID: PMC8589166 DOI: 10.1371/journal.pone.0259602] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/21/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Urinary tract infections (UTIs) are the leading causes of morbidity in the general population, and is the second most common infectious disease after respiratory infections. Appropriate antibiotic therapy is essential to achieving good therapeutic results. Therefore, the purpose of this study was to investigate the profile of pathogens cultured from urinary tract infections and to determine their resistance profiles to commonly prescribed antibiotics. METHOD A cross-sectional study was carried out at the National Referral Laboratory of the Ethiopian Institute of Public Health from January 2017 to December 2018. All positive cultures were characterized by colony morphology, Gram stain, and standard biochemical tests. The antimicrobial susceptibility test of the isolate was performed using the Kirby- Bauer disk diffusion test on Muller-Hinton agar. In addition, bacterial identification, antimicrobial susceptibility testing and phenotypic detection of MDR were performed with VITEK 2 Compact according to the manufacturer's instructions. RESULT Out of 1012 cultured urine specimens, 325 (32.1%) was showed significant bacteriuria. The overall prevalence of UTIs was 325(32.1%) and the highest prevalence rate was obtained from 21-30 years age group 73(22.5%). Among UTIs patients, 583(57.6%) were females and 429(42.4%) were males. The UTIs of 179 (55%) women is relatively higher than that of men 146 (45%). Among 325 isolates, Gram-negative bacteria (GNB) appeared more frequently 252 (51.7%) than Gram-positive bacteria 63 (19.4%). In GNB, E. coli 168(66.7%), Klebsiella species 32(12.7%), and Enterobacter species 13 (5.2%) were dominated isolates whereas in GPB accounted for coagulase-negative staphylococcus (CoNS) 33(52.4%), Enterococcus species 16(25.4%), and Staphylococcus aureus 10(15.9%). Major of the isolates showed high levels of antibiotic resistance to commonly prescribed antimicrobials. Imipenem, Amikacin, and Nitrofurantoin were the most sensitive antibiotics for Gram-negative isolates while Nitrofurantoin, clindamycin, and Gentamycin were effective against gram-positive uropathogens. Overall, 156/256(60.9%), 56/256(22.4%), 10/256(4%) of gram-negative isolates were MDR, XDR, and PDR respectively while among the GPB isolates, 34/63(53.1%), 10/63(15.8%), and 1/63(1.6%) were MDR, XDR, and PDR isolates respectively. Among the tested bacterial strains, 190/319 (59.5%) were MDR, 66/319 (20.7%) strains were XDR, and 11/319 (3.45%) were PDR isolated. CONCLUSION The prevalence of urinary tract infection was high, and Gram-negative organisms were the most common causes of UTIs in this study. It was found that the resistance to commonly used antibiotics is very high. Early detection and close monitoring of MDR, XDR, or even PDR bacterial strains must be started by all clinical microbiology laboratories to reduce the menace of antimicrobial resistance that is now a global problem.
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Affiliation(s)
- Tesfa Addis
- Department of Clinical bacteriology and Mycology, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Yonas Mekonnen
- Department of Clinical bacteriology and Mycology, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Zeleke Ayenew
- Department of Clinical bacteriology and Mycology, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Surafel Fentaw
- Department of Clinical bacteriology and Mycology, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Habtamu Biazin
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Hailemariam M, Alemayehu T, Tadesse B, Nigussie N, Agegnehu A, Habtemariam T, Ali M, Mitiku E, Azerefegne E. Major bacterial isolate and antibiotic resistance from routine clinical samples in Southern Ethiopia. Sci Rep 2021; 11:19710. [PMID: 34611232 PMCID: PMC8492677 DOI: 10.1038/s41598-021-99272-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 08/13/2021] [Indexed: 02/08/2023] Open
Abstract
Currently, antibiotic-resistant bacterial infections are a challenge for the health care system. Although physicians demand timely drug resistance data to guide empirical treatment, local data is rather scarce. Hence, this study performed a retrospective analysis of microbiological findings at the Hawassa public hospital. Secondary data were retrieved to assess the prevalence and level of drug resistance for the most common bacterial isolates from clinical samples processed at Hawassa University Comprehensive Specialized Hospital. Out of 1085 clinical samples processed in the microbiology laboratory, the prevalence of bacterial infection was 32.6%. Bacterial bloodstream infection was higher in children than in adults (OR, 4; 95% CI 1.8-14.6; p = 0.005). E. coli and K. pneumoniae were the commonest bacterial isolate both in children (36.8%, 26.3%) and in adults (33.3%, 26.7%) from the urine sample while, the leading bacteria identified from the CSF sample was P. aeruginosa, 37% in children and 43% in adult. In this study, all identified bacterial isolates were multi-drug resistant (MDR) ranging from 50 to 91%. The highest proportion of MDR was S. aureus 91.1 followed by K. pneumoniae 87.6%. Since the nationwide investigation of bacterial isolate, and drug resistance is rare in Ethiopia, a report from such type of local surveillance is highly useful to guide empirical therapy by providing awareness on the level resistance of isolates.
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Affiliation(s)
- Mengistu Hailemariam
- grid.192268.60000 0000 8953 2273School of Medical Laboratory Science, Hawassa University College of Medicine and Health Sciences, P.O. Box 1560, Hawassa, Ethiopia
| | - Tsegaye Alemayehu
- grid.192268.60000 0000 8953 2273School of Medical Laboratory Science, Hawassa University College of Medicine and Health Sciences, P.O. Box 1560, Hawassa, Ethiopia
| | - Bereket Tadesse
- grid.192268.60000 0000 8953 2273Hawassa University Comprehensive and Specialized Hospital, Hawassa, Ethiopia
| | - Netsanete Nigussie
- grid.192268.60000 0000 8953 2273Hawassa University Comprehensive and Specialized Hospital, Hawassa, Ethiopia
| | - Asnakech Agegnehu
- grid.192268.60000 0000 8953 2273Hawassa University Comprehensive and Specialized Hospital, Hawassa, Ethiopia
| | - Techilo Habtemariam
- grid.192268.60000 0000 8953 2273Hawassa University Comprehensive and Specialized Hospital, Hawassa, Ethiopia
| | - Mulubrhan Ali
- grid.192268.60000 0000 8953 2273School of Medical Laboratory Science, Hawassa University College of Medicine and Health Sciences, P.O. Box 1560, Hawassa, Ethiopia
| | - Enkosilassie Mitiku
- grid.192268.60000 0000 8953 2273Hawassa University Comprehensive and Specialized Hospital, Hawassa, Ethiopia
| | - Elshaday Azerefegne
- grid.192268.60000 0000 8953 2273Hawassa University Comprehensive and Specialized Hospital, Hawassa, Ethiopia
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30
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Bacterial Profile, Antimicrobial Susceptibility Pattern, and Associated Factors of Community- and Hospital-Acquired Urinary Tract Infection at Dessie Referral Hospital, Dessie, Northeast Ethiopia. Int J Microbiol 2021; 2021:5553356. [PMID: 34589128 PMCID: PMC8476241 DOI: 10.1155/2021/5553356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 08/27/2021] [Accepted: 09/04/2021] [Indexed: 11/18/2022] Open
Abstract
Background Bacterial urinary tract infection is among the most common community and hospital-acquired infections. Therefore, to know the status of the community and hospital-acquired urinary tract infection, antimicrobial susceptibility patterns, and associated factors among urinary tract infection profiles are essential to physicians and health workers to implement appropriate intervention. Methods An institution-based cross-sectional study was conducted among 422 urinary tract infection suspected patients. All isolates were identified by standard microbiological techniques, and their antibiotic susceptibility was done by the Kirby-Bauer disc diffusion method. Data were entered using EpiData version 3.1 and analyzed by SPSS software version 20. P value < 0.05 at 95% CI was considered statistically significant. Result Of 422 urine samples processed, 100 (23.7%) yielded bacterial isolates. About 50(30.7%) and 50(19.3%) were bacterial isolates from the community and hospitalized patients, respectively. E. coli 44/103(42.7%) predominated across the two groups, followed by S. aureus 25/103(24.3%), CONs, 14/103(13.5%), Klebsiella spp. 7/103(6.78), Proteus spp. 3/103(2.91), and Enterococcus spp. 3/103 (2.91%). Pseudomonas spp. 3/103 (2.91), Citrobacter spp. 2/103(1.94%), and Acinetobacter spp. 1/103(0.999), which were isolated from only the hospitalized patients. Meropenem susceptibly was 100% in both study groups and Ampicillin resistance was documented as 83.3% to 100% and 76.9% to 100% in hospitalized and community-acquired samples, respectively. Conclusion This study found a high prevalence of bacterial urinary tract infection in the study area and a high rate of bacterial resistance was observed to most antimicrobial drugs tested. Meropenem and nitrofurantoin were the most active drugs for urinary tract infections. Therefore, expanding routine bacterial culture and identification with antimicrobial susceptibility testing and strengthening regular surveillance systems are essential for appropriate patient care.
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Thapa S, Adhikari N, Shah AK, Lamichhane I, Dhungel B, Shrestha UT, Adhikari B, Banjara MR, Ghimire P, Rijal KR. Detection of NDM-1 and VIM Genes in Carbapenem-Resistant Klebsiella pneumoniae Isolates from a Tertiary Health-Care Center in Kathmandu, Nepal. Chemotherapy 2021; 66:199-209. [PMID: 34515078 DOI: 10.1159/000518256] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 07/04/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Klebsiella pneumoniae is one of the leading causes of nosocomial infections. Carbapenems are used as the last resort for the treatment of multidrug resistant Gram-negative bacterial infections. In recent years, resistance to these lifesaving drugs has been increasingly reported due to the production of carbapenemase. The main objective of this study was to detect the carbapenem-resistant genes blaNDM-1 and blaVIM in K. pneumoniae isolated from different clinical specimens. METHODS A total of 585 clinical specimens (urine, pus, sputum, blood, catheter tips, and others) from human subjects attended at Annapurna Neurological Institute and Allied Sciences, Kathmandu were obtained in the period between July 2018 and January 2019. The specimens were isolated and identified for K. pneumoniae. All K. pneumoniae isolates were processed for antimicrobial susceptibility testing (AST) using the disk diffusion method. The isolates were further phenotypically confirmed for carbapenemase production by the modified Hodge test (MHT) using imipenem (10 μg) and meropenem (10 μg) discs. Thus, confirmed carbapenemase-producing isolates were further screened for the production of blaNDM-1 and blaVIM using conventional polymerase chain reaction (PCR). RESULTS Among the clinical isolates tested, culture positivity was 38.29% (224/585), and the prevalence of K. pneumoniae was 25.89% (58/224). On AST, K. pneumoniae exhibited resistance toward carbapenems including ertapenem, meropenem, and imipenem, while it showed the highest susceptibility rate against to tigecycline (93.1%; 54/58). Overall, AST detected 60.34% (35/58) carbapenem-resistant isolates, while the MHT phenotypically confirmed 51.72% (30/58) isolates as carbapenemase-producers and 48.28% (28/58) as carbapenemase nonproducers. On subsequent screening for resistant genes among carbapenemase-producers by PCR assay, 80% (24/30) and 3.33% (1/30) isolates were found to be positive for blaNDM-1 and blaVIM, respectively. In the same assay among 28 carbapenem nonproducing isolates, 9 (32.14%) isolates were positive for blaNDM-1 gene while none of them were tested positive for blaVIM gene. CONCLUSIONS Molecular detection of resistant genes provides greater specificity and sensitivity than those with conventional techniques, thus aiding in accurate identification of antimicrobial resistance and clinical management of the disease.
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Affiliation(s)
- Sabita Thapa
- Kantipur College of Medical Sciences, Kathmandu, Nepal
| | - Nabaraj Adhikari
- Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal
| | - Anil Kumar Shah
- Annapurna Neurological Institute and Allied Sciences, Kathmandu, Nepal
| | | | - Binod Dhungel
- Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal
| | | | - Bipin Adhikari
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
| | - Megha Raj Banjara
- Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal
| | - Prakash Ghimire
- Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal
| | - Komal Raj Rijal
- Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal
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Extensive drug-resistance in strains of Escherichia coli and Klebsiella pneumoniae isolated from paediatric urinary tract infections. J Taibah Univ Med Sci 2021; 16:565-574. [PMID: 34408614 PMCID: PMC8348552 DOI: 10.1016/j.jtumed.2021.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/06/2021] [Accepted: 03/10/2021] [Indexed: 01/29/2023] Open
Abstract
Objectives Urinary tract infections (UTIs) in children are rapidly increasing worldwide and are commonly caused by extensively drug-resistant bacteria. This study determines the prevalence of UTIs in paediatric patients and evaluates the pattern of extensively drug-resistance in Escherichia coli and Klebsiellapneumoniae strains isolated from paediatric UTI patients. Methods Uropathogenic bacterial strains were isolated from paediatric patients with UTIs admitted to the Institute of Child Health, Lahore, Pakistan. Strains of both E. coli and K. pneumoniae were identified using biochemical characterisation and subjected to antibiotic susceptibility assays for 21 common antimicrobial drugs in order to determine their extensively drug-resistant profile. Results We isolated 63 E. coli and 37 K. pneumoniae strains from 130 paediatric patients with UTIs over a period of six months. The antibiotic susceptibility assays showed that both the E. coli and K. pneumoniae strains exhibited a high degree of resistance against co-amoxiclav, cefuroxime, cefixime, cefotaxime, ceftazidime, ceftriaxone, ciprofloxacin, nalidixic acid, norfloxacin, pepedemic acid, and co-trimoxazole. However, several of the antimicrobial agents, including polymyxin B, colistin sulphate, chloramphenicol, nitrofurantoin, and fosfomycin, were found to retain their antimicrobial activities against both pathogens. The five highest antibiotic resistant strains were identified as E. coli strains ZK9, ZK40, and ZK60 and K. pneumoniae ZK32 and ZK89 using 16S rRNA gene sequencing. Conclusion Our study demonstrates that E. coli and K. pneumonia are the dominant extensively drug-resistant uropathogenic bacteria in community-acquired UTIs in our cohort. These uropathogens were found to be resistant to the majority of the routinely-used classes of β-lactams, pyridopyrimidines, quinolones, and fluoroquinolone antibiotics, and these findings may be useful for clinicians in their treatment of paediatric UTIs.
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Appel TM, Quijano-Martínez N, De La Cadena E, Mojica MF, Villegas MV. Microbiological and Clinical Aspects of Raoultella spp. Front Public Health 2021; 9:686789. [PMID: 34409007 PMCID: PMC8365188 DOI: 10.3389/fpubh.2021.686789] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 07/09/2021] [Indexed: 11/13/2022] Open
Abstract
The genus Raoultella was established in 2001. Species of Raoultella and Klebsiella share many ecological, biochemical, clinical, and microbiological features. Given the shortcomings of available technology for species identification in the clinical microbiology laboratory, are practically indistinguishable. Since the late 2000s there has been an increase in case reports of human Raoultella infections. Therefore, several authors are postulating that Raoultella spp. are rare and/or emerging pathogens. Conclusions:Raoultella spp. are very similar to Klebsiella spp. The epidemiology and the clinical relevance of the human Raoultella spp. infections is uncertain and further studies are required. The previous difficulties in the identification of Raoultella spp. and the introduction of more precise identification techniques may explain the recent increase in the number of case reports. Raoultella spp. might be rather underdiagnosed than rare or emerging pathogens.
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Affiliation(s)
- Tobias M Appel
- Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany.,Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Bogotá, Colombia
| | | | - Elsa De La Cadena
- Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Bogotá, Colombia
| | - María F Mojica
- Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Bogotá, Colombia
| | - María Virginia Villegas
- Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Bogotá, Colombia
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Gerasimova NA, Evstigneeva NP, Grekova YN, Zilberberg NV. [Gonococcal pharyngitis]. Vestn Otorinolaringol 2021; 86:85-89. [PMID: 33929158 DOI: 10.17116/otorino20218602185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A description of a clinical case of oligosymptomatic pharyngitis associated with Neisseria gonorrhoeae is presented. On the example of oligosymptomatic localized gonococcal pharyngitis in a sexually active young man, included in the risk group for extragenital forms of sexually transmitted infections, an advantage has been shown molecular biological diagnostic method. Study of the spectrum of microflora of the oropharynx and urethra with assessment sensitivity to antibacterial drugs of representatives of the genus Neisseria isolated during mixed infection oropharynx, demonstrated that non-pathogenic Neisseria species are resistant to cephalosporins III-IV generations. Unrecognized forms of oropharyngeal gonococcal infection, as a consequence of the complications of clinical and diagnostic identification when patients refer to an otolaryngologist or dermatovenerologist, can serve a reservoir of resistant N. gonorrhoeae and a source of intractable gonococcal infection.
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Affiliation(s)
- N A Gerasimova
- Ural Research Institute of Dermatovenerology and Immunopathology, Ekaterinburg, Russia
| | - N P Evstigneeva
- Ural Research Institute of Dermatovenerology and Immunopathology, Ekaterinburg, Russia
| | - Yu N Grekova
- Ural Research Institute of Dermatovenerology and Immunopathology, Ekaterinburg, Russia
| | - N V Zilberberg
- Ural Research Institute of Dermatovenerology and Immunopathology, Ekaterinburg, Russia
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Lekhniuk N, Fesenko U, Pidhirnyi Y, Sękowska A, Korniychuk O, Konechnyi Y. Raoultella terrigena: Current state of knowledge, after two recently identified clinical cases in Eastern Europe. Clin Case Rep 2021; 9:e04089. [PMID: 34026135 PMCID: PMC8123537 DOI: 10.1002/ccr3.4089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 03/10/2021] [Accepted: 03/14/2021] [Indexed: 11/06/2022] Open
Abstract
Raoultella terrigena is a rarely found opportunistic pathogen that can cause healthcare-associated infections with high mortality. It is important to differentiate it from Klebsiella species.
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Affiliation(s)
- Nadiia Lekhniuk
- Department of Genetics and BiotechnologyIvan Franko National University of LvivLvivUkraine
| | - Ulbolgan Fesenko
- Department of Anesthesiology and Intensive CareDanylo Halytsky Lviv National Medical UniversityLvivUkraine
| | - Yaroslav Pidhirnyi
- Department of Anesthesiology and Intensive CareDanylo Halytsky Lviv National Medical UniversityLvivUkraine
| | - Alicja Sękowska
- Department of MicrobiologyLudwik Rydygier Collegium MedicumNicolaus Copernicus UniversityBydgoszczPoland
| | - Olena Korniychuk
- Department of MicrobiologyDanylo Halytsky Lviv National Medical UniversityLvivUkraine
| | - Yulian Konechnyi
- Department of MicrobiologyDanylo Halytsky Lviv National Medical UniversityLvivUkraine
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Tesfa T, Baye Y, Sisay M, Amare F, Gashaw T. Bacterial uropathogens and susceptibility testing among patients diagnosed with urinary tract infections at Hiwot Fana Specialized University Hospital, Eastern Ethiopia. SAGE Open Med 2021; 9:20503121211001162. [PMID: 33796299 PMCID: PMC7970184 DOI: 10.1177/20503121211001162] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 02/15/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Urinary tract infection is a common infection posing a significant healthcare
burden globally. Currently, it is becoming hard to manage due to the drug
resistance of uropathogens. This study aimed to evaluate the rate of culture
positivity and the susceptibility pattern of isolates among clinically
diagnosed patients with urinary tract infection. Methods: An institution-based cross-sectional study was conducted on patients
clinically diagnosed with urinary tract infections and received a drug
prescription at Hiwot Fana Specialized University Hospital from August 2018
to June 2019. A clean-catch mid-stream urine specimen was collected and
bacterial identification and susceptibility test were performed using
standard microbiological methods. Data were entered into EpiInfo 7 and
exported to STATA 15 for analysis. Data were analyzed using descriptive
analysis and bi-variate and multivariate regression analyses and presented
with graphs, frequency, and tables. Results: A total of 687 urine samples were collected from patients with clinically
diagnosed urinary tract infections. The mean age was 31 years and 56.62%
were female. 28.38% of the participants had a culture-positive result, of
which 86.15% had monomicrobial infections. Inpatients (AOR = 3.8, 95% CI =
(1.8–7.9)) and hypertensive patients (AOR = 2.1, 95% CI = (1.1–4.4)) had
higher odds of culture-positive results. Staphylococcus
species (35.3%), E. coli (25.34%),
Pseudomonas species (6.8%), and other Enterobacterales
are isolated. Most isolates showed resistance to more than one drug, and
amikacin, gentamicin, and nitrofurantoin showed relatively higher activity
against isolates. Conclusion: About one-third of the clinically diagnosed patients with urinary tract
infection were culture-positive with many types of bacterial uropathogens.
Inpatients and hypertensive patients had a higher risk of developing
bacterial infections. Bacterial isolates showed different percentages of
susceptibility to the tested antibiotics.
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Affiliation(s)
- Tewodros Tesfa
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yohannes Baye
- Department of Paediatrics & Child Health Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mekonnen Sisay
- Department of Pharmacology and Toxicology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Firehiwot Amare
- Department of Pharmaceutical Analysis, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tigist Gashaw
- Department of Pharmacology and Toxicology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Mechal T, Hussen S, Desta M. Bacterial Profile, Antibiotic Susceptibility Pattern and Associated Factors Among Patients Attending Adult OPD at Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia. Infect Drug Resist 2021; 14:99-110. [PMID: 33469325 PMCID: PMC7813457 DOI: 10.2147/idr.s287374] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 12/29/2020] [Indexed: 12/16/2022] Open
Abstract
Background Urinary tract infection (UTI) is a common health problem occurring when infectious agents colonize, invade, and propagate the urinary tract including the urethra, bladder, renal pelvis, or renal parenchyma. The study aimed to determine the prevalence of symptomatic UTI, drug resistance pattern, and its associated factors among patients attending adult outpatient department (OPD) at Hawassa University Comprehensive Specialized Hospital (HUCSH). Methods A cross-sectional study was conducted from October 2018 to February 2019 among adults ≥18 years old with symptoms of UTI. Processing of specimens for culture and identification was done. Antimicrobial susceptibility was done for positive urine cultures. Data entry and analysis were performed using SPSS version 23.0 software. Bivariate and multivariate logistic regression analysis test results were used. Results The overall prevalence of symptomatic urinary tract infection was 32.8% (95% CI: 28.3–37.6). The predominant isolated bacteria was E. coli 46 (36.2%) followed by S. aureus 21 (16.5%). Gram-negative bacteria were a high level of resistance to ampicillin (71.4%), and tetracycline (68.2%). Gram-positive bacteria were highly resistant to norfloxacin (77.7%). The overall prevalence of multi-drug resistant isolates was 102 (80.3%). Being female, no formal education, and self-medication history had more likely cause UTI. Conclusion Urinary tract infection (UTI) among adults was prevalent in the study area. Being female, educational status and self-medication history had a significant association with UTI. Resistance to ampicillin, tetracycline, and norfloxacin was high. Therefore, culture and antibiotic susceptibility testing should be routinely used for the proper management of patients with UTI.
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Affiliation(s)
- Tigist Mechal
- Department of Medical Laboratory Science, Hawassa College of Health Sciences, Hawassa, South Nations and Nationalities Peoples Region, Ethiopia
| | - Siraj Hussen
- School of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Moges Desta
- School of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Aryal SC, Upreti MK, Sah AK, Ansari M, Nepal K, Dhungel B, Adhikari N, Lekhak B, Rijal KR. Plasmid-Mediated AmpC β-Lactamase CITM and DHAM Genes Among Gram-Negative Clinical Isolates. Infect Drug Resist 2020; 13:4249-4261. [PMID: 33262619 PMCID: PMC7699442 DOI: 10.2147/idr.s284751] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/06/2020] [Indexed: 12/25/2022] Open
Abstract
Background Antibiotic resistance mediated by the production of extended-spectrum β-lactamases (ESBLs) and AmpC β-lactamases is posing a serious threat in the management of the infections caused by Gram-negative pathogens. The aim of this study was to determine the prevalence of two AmpC β-lactamases genes, blaCITM and blaDHAM, in Gram-negative bacterial isolates. Materials and Methods A total of 1151 clinical samples were obtained and processed at the microbiology laboratory of Annapurna Neurological Institute and Allied Science, Kathmandu between June 2017 and January 2018. Gram-negative isolates thus obtained were tested for antimicrobial susceptibility testing (AST) using Kirby–Bauer disk diffusion method. AmpC β-lactamase production was detected by disk approximation method using phenylboronic acid (PBA). Confirmed AmpC β-lactamase producers were further screened for blaCITM and blaDHAM genes by conventional polymerase chain reaction (PCR). Results Out of 1151 clinical specimens, 22% (253/1152) had bacterial growth. Of the total isolates, 89.3% (226/253) were Gram-negatives, with E. coli as the most predominant species (n=72) followed by Pseudomonas aeruginosa (n=41). In the AST, 46.9% (106/226) of the Gram-negative isolates were multidrug resistant (MDR). In disk diffusion test, 113 (50%) isolates showed resistance against cefoxitin, among which 91 isolates (83 by disk test and Boronic acid test, 8 by Boronic test only) were confirmed as AmpC β-lactamase-producers. In PCR assay, 90.1% (82/91) and 87.9% (80/91) of the isolates tested positive for production of blaCITM and blaDHAM genes, respectively. Conclusions High prevalence of AmpC β-lactamase-producers in our study is an alarming sign. This study recommends the use of modern diagnostic facilities in the clinical settings for early detection and management which can optimize the treatment therapies, curb the growth and spread of the drug-resistant pathogens.
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Affiliation(s)
| | | | - Anil Kumar Sah
- Annapurna Neurological Institute and Allied Sciences, Kathmandu, Nepal
| | - Meharaj Ansari
- Shi-Gan Int'l College of Science and Technology (SICOST), Kathmandu, Nepal
| | | | - Binod Dhungel
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | - Nabaraj Adhikari
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | - Binod Lekhak
- Golden Gate International College, Kathmandu, Nepal.,Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | - Komal Raj Rijal
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
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Rizvi ZA, Jamal AM, Malik AH, Zaidi SMJ, Abdul Rahim NU, Arshad D. Exploring Antimicrobial Resistance in Agents Causing Urinary Tract Infections at a Tertiary Care Hospital in a Developing Country. Cureus 2020; 12:e9735. [PMID: 32944453 PMCID: PMC7489772 DOI: 10.7759/cureus.9735] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background and objective Urinary tract infections (UTIs) are usually treated with empirical therapy by physicians based on previous knowledge of the predictability of causative agents and their antimicrobial susceptibilities. The objective of this study was to determine the frequency of various pathogens causing UTIs and their antimicrobial resistance profile in patients presenting to the outpatient department (OPD) of a tertiary care hospital. Materials and methods This descriptive cross-sectional study was conducted in the urology OPD of a tertiary care hospital in Pakistan. The study was conducted over a period of six months, and it included 1,000 patients (of ages 12 years or above) who were clinically suspected for UTIs. Patients with comorbidities and immunocompromised patients were excluded from the study. Recipients of corticosteroid therapy or those with a history of intake of broad-spectrum antibiotics in the previous 15 days were also excluded. The modified Kirby-Bauer disc diffusion method was used for determining antimicrobial resistance against various antimicrobials. Results Out of 1,000 tested specimens, 530 (53%) isolates were found to be culture-positive. E.coli was the most common species isolated from the cultures with a prevalence of 77.4%, followed by Klebsiella (6.4%), Enterobacter (6.0%), Pseudomonas (3.8%), Staphylococcus saprophyticus (3.4%), Citrobacter (1.1%), and Morganella (0.4%). Antimicrobial resistance against commonly used antimicrobials was found to be alarmingly high. Conclusion E.coli was the most commonly isolated microorganism from the urine samples of UTI patients. Antimicrobial resistance against UTI-causing organisms is of great concern. The Surveillance of trends of antimicrobial susceptibility pattern for organisms causing UTIs is highly important. Antibiotics should be prescribed according to proper guidelines to prevent increasing antimicrobial resistance.
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Gurung S, Kafle S, Dhungel B, Adhikari N, Thapa Shrestha U, Adhikari B, Banjara MR, Rijal KR, Ghimire P. Detection of OXA-48 Gene in Carbapenem-Resistant Escherichia coli and Klebsiella pneumoniae from Urine Samples. Infect Drug Resist 2020; 13:2311-2321. [PMID: 32765007 PMCID: PMC7369300 DOI: 10.2147/idr.s259967] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 06/24/2020] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Resistance to carbapenem in Gram-negative bacteria is attributable to their ability to produce carbapenemase enzymes. The main objective of this study was to detect the presence of blaOXA-48 genes in carbapenem-resistant uropathogenic Escherichia coli and Klebsiella pneumoniae isolated from urine samples from patients attending Alka Hospital, Jawalakhel, Lalitpur, Nepal. METHODS A total of 1013 mid-stream urine samples were collected from patients with suspected urinary tract infection (UTI) between April and September 2018. The identified isolates underwent antibiotic susceptibility testing using the modified Kirby-Bauer disc-diffusion method. Phenotypic carbapenemase production was confirmed by the modified Hodge test, and the blaOXA-48 gene was detected using conventional polymerase chain reaction. RESULTS Out of 1013 urine samples, 15.2% (154/1013) had bacterial growth. Among the isolates, 91.5% (141/154) were Gram-negative bacteria, and E. coli was the most common bacterial isolate (62.9%; 97/154), followed by K. pneumoniae 15.6% (24/154). Among 121 bacterial isolates (97 E. coli isolates and 24 K. pneumoniae isolates), 70.3% (52/121) were multidrug-resistant E. coli and 29.7% (22/121) were multidrug-resistant K. pneumoniae. In addition, 9.1% (11/121) were carbapenem resistant (both imipenem and meropenem resistant). Development of multidrug resistance and development of carbapenem resistance were significantly associated (p<0.05). Of the 11 carbapenem-resistant isolates, only seven were carbapenemase producers; of these, 28.6% (2/7) were E. coli, 72.4% (5/7) were K. pneumoniae and 42.8% (3/7) had the blaOXA-48 gene. Of the three bacterial isolates with the blaOXA-48 gene, 33.3% (1/3) were E. coli and 66.7% (2/3) were K. pneumoniae. CONCLUSION One in ten isolates of E. coli and K. pneumoniae were carbapenem resistant. Among carbapenem-resistant isolates, one-third of E. coli and two-thirds of K. pneumoniae had the blaOXA-48 gene. OXA-48 serves as a potential agent to map the distribution of resistance among clinical isolates.
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Affiliation(s)
- Sushma Gurung
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | | | - Binod Dhungel
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | - Nabaraj Adhikari
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | | | - Bipin Adhikari
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Megha Raj Banjara
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | - Komal Raj Rijal
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | - Prakash Ghimire
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
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Prevalence and antibiotic susceptibility pattern of uropathogens in outpatients at a tertiary care hospital. New Microbes New Infect 2020; 36:100716. [PMID: 32637123 PMCID: PMC7330609 DOI: 10.1016/j.nmni.2020.100716] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 06/05/2020] [Accepted: 06/09/2020] [Indexed: 11/23/2022] Open
Abstract
Globally, urinary tract infection (UTI) is considered a major public health concern and the second most common bacterial infection affecting individuals of different ages. Bacteria are responsible for about 95% of UTIs. The emergence of antimicrobial resistance in uropathogens may lead to poor treatment outcomes in individuals with UTIs. The knowledge of the microorganism involves and antibiograms are important for the empirical treatment of UTIs. A cross-sectional study was carried out over 7 months (January to July 2019) with a focus on the identification of bacterial pathogens causing UTI and the evaluation of their antibiogram. In total, 804 urine samples were collected from individuals with suspected UTIs and inoculated on recommended media. Isolation and identification of the bacterial strains were performed using standard microbiological protocols. Antibiotic susceptibility was carried out following CLSI recommended guidelines. Among the tested specimens, 290 (36.1%) had significant bacterial growth and 147 (50.7%) of the strains were isolated from female patients. The frequently identified isolates were Escherichia coli (68.9%), followed by Klebsiella pneumoniae (8.9%) and Staphylococcus aureus (6.7%). The highest percentages of resistance have been observed against tested antibiotics. The majority of the isolates were extended-spectrum β-lactamase producers (85.2%) and multidrug-resistant (98.3%). We observed that Gram-negative bacteria were the main cause of UTIs where the predominant microorganism was E. coli.
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42
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Folliero V, Caputo P, Della Rocca MT, Chianese A, Galdiero M, Iovene MR, Hay C, Franci G, Galdiero M. Prevalence and Antimicrobial Susceptibility Patterns of Bacterial Pathogens in Urinary Tract Infections in University Hospital of Campania "Luigi Vanvitelli" between 2017 and 2018. Antibiotics (Basel) 2020; 9:antibiotics9050215. [PMID: 32354050 PMCID: PMC7277346 DOI: 10.3390/antibiotics9050215] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 04/26/2020] [Accepted: 04/26/2020] [Indexed: 12/22/2022] Open
Abstract
Urinary tract infections (UTIs) are the most common and expensive health problem globally. The treatment of UTIs is difficult owing to the onset of antibiotic-resistant bacterial strains. The aim of this study was to define the incidence of infections, identify the bacteria responsible, and identify the antimicrobial resistance profile. Patients of all ages and both sexes were included in the study, all admitted to University Hospital of Campania “Luigi Vanvitelli”, between January 2017 and December 2018. Bacterial identification and antibiotic susceptibility testing were performed using matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and Phoenix BD. Among the 1745 studied patients, 541 (31%) and 1204 (69%) were positive and negative for bacterial growth, respectively. Of 541 positive patients, 325 (60%) were females, while 216 (39.9%) were males. The largest number of positive subjects was recorded in the elderly (>61 years). Among the pathogenic strains, 425 (78.5%) were Gram-negative, 107 (19.7%) were Gram-positive, and 9 (1.7%) were Candida species. The most isolated Gram-negative strain is Escherichia coli (E. coli) (53.5%). The most frequent Gram-positive strain was Enterococcus faecalis (E. faecalis) (12.9%). Gram-negative bacteria were highly resistant to ampicillin, whereas Gram-positive bacteria were highly resistant to erythromycin.
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Affiliation(s)
- Veronica Folliero
- Department of Experimental Medicine, University of Study of Campania“Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (A.C.); (M.G.); (M.R.I.); (C.H.)
| | - Pina Caputo
- Section of Microbiology and Virology, University Hospital Luigi Vanvitelli of Naples, 80138 Naples, Italy; (P.C.); (M.T.D.R.)
| | - Maria Teresa Della Rocca
- Section of Microbiology and Virology, University Hospital Luigi Vanvitelli of Naples, 80138 Naples, Italy; (P.C.); (M.T.D.R.)
| | - Annalisa Chianese
- Department of Experimental Medicine, University of Study of Campania“Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (A.C.); (M.G.); (M.R.I.); (C.H.)
| | - Marilena Galdiero
- Department of Experimental Medicine, University of Study of Campania“Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (A.C.); (M.G.); (M.R.I.); (C.H.)
| | - Maria R. Iovene
- Department of Experimental Medicine, University of Study of Campania“Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (A.C.); (M.G.); (M.R.I.); (C.H.)
| | - Cameron Hay
- Department of Experimental Medicine, University of Study of Campania“Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (A.C.); (M.G.); (M.R.I.); (C.H.)
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, SA 84081 Baronissi, Italy
- Correspondence: (G.F.); (M.G.); Tel.: +39-338-568-3762 (G.F.); +39-081-566-5834 (M.G.)
| | - Massimiliano Galdiero
- Department of Experimental Medicine, University of Study of Campania“Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (A.C.); (M.G.); (M.R.I.); (C.H.)
- Correspondence: (G.F.); (M.G.); Tel.: +39-338-568-3762 (G.F.); +39-081-566-5834 (M.G.)
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Prevalence of Asymptomatic Bacteriuria and Antibiotic Susceptibility Patterns of Bacterial Isolates among Cancer Patients and Healthy Blood Donors at the University of Gondar Specialized Hospital. Int J Microbiol 2020; 2020:3091564. [PMID: 32377201 PMCID: PMC7183528 DOI: 10.1155/2020/3091564] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 03/20/2020] [Indexed: 11/25/2022] Open
Abstract
Background Urinary tract infections are the common types of infections in the community and health care settings. Despite the widespread availability of antibiotics, urinary tract infection remains a worldwide therapeutic problem. It is a continuous and significant problem in cancer patients. Methods A hospital-based comparative cross-sectional study was conducted on 240 study participants from January to June 2019. Sociodemographic data were collected by a predesigned questionnaire and midstream urine samples collected using simple random sampling technique by using clean, sterile plastic cups and then inoculated onto CLED agar plates and incubated at 37°C for 24 hours. Urine culture was considered significant bacteriuria when colony forming units ≥105/mL of voided urine and a single pure colony suspended in nutrient broth and then subcultured onto a blood agar plate and MacConkey agar plate, incubated at 37°C for 24 hours for identification. Identification was done by using standard microbiological methods. Modified Kirby–Bauer disk diffusion technique was applied for antimicrobial susceptibility testing in accordance with CLSI 2018 criteria. Data were entered, cleared, and checked using Epi Info version 7 and exported to SPSS version 20 for analysis. The results were displayed using tables and figures. p value <0.05 at 95% CI was considered as statistically significant. Results The overall prevalence of asymptomatic bacteriuria in cancer patients was 23.3% while 6.7% in apparently healthy blood donors. E. coli (32.1%) was the commonest isolated uropathogenic bacteria followed by Klebsiella species (25.0%), S. aureus (21.4%), Enterococcus species (10.7%), Serratia species (7.1%), and Enterobacter aerogenes (3.6%) in cancer patients. In apparently healthy blood donors, E. coli, Klebsiella species, and S. aureus were isolated from 75%, 12.5%, and 12.5%, respectively. Most Gram-negative bacteria were more sensitive to ceftazidime, cefoxitin, nalidixic acid, nitrofurantoin, norfloxacin, ciprofloxacin, and tobramycin, whereas highly resistant to ampicillin, penicillin, tetracycline, and ceftazidime. S. aureus isolates were 100% susceptible to nitrofurantoin. Conclusions This study showed a high prevalence of asymptomatic bacteriuria among cancer patients (23.3%) compared to apparently healthy blood donors (6.7%). E. coli was isolated predominately. Nitrofurantoin and ciprofloxacin should be used to treat asymptomatic bacteriuria in the study area.
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Draft Genome Sequence of Dermacoccus nishinomiyaensis TSA37, Isolated from Wood Ash. Microbiol Resour Announc 2019; 8:8/50/e01370-19. [PMID: 31831617 PMCID: PMC6908802 DOI: 10.1128/mra.01370-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Dermacoccus nishinomiyaensis
is a common bacterial resident of the human skin microbiome, among other environments.
D. nishinomiyaensis
strain TSA37 was isolated from the ash pan of a residential wood pellet stove. A genome assembly of 3,130,592 bp was generated, with an
N
50
value of 197,547 bp and a calculated G+C content of 69.01%.
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Kapur S, Gehani M, Kammili N, Bhardwaj P, Nag V, Devara SM, Sharad S. Clinical Validation of Innovative Optical-Sensor-Based, Low-Cost, Rapid Diagnostic Test to Reduce Antimicrobial Resistance. J Clin Med 2019; 8:E2098. [PMID: 31805738 PMCID: PMC6947486 DOI: 10.3390/jcm8122098] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 11/20/2019] [Accepted: 11/27/2019] [Indexed: 12/17/2022] Open
Abstract
The antibiotic susceptibility test determines the most effective antibiotic treatment for bacterial infection. Antimicrobial stewardship is advocated for the rational use of antibiotics to preserve their efficacy in the long term and provide empirical therapy for disease management. Therefore, rapid diagnostic tests can play a pivotal role in efficient and timely treatment. Here, we developed a novel, rapid, affordable, and portable platform for detecting uropathogens and reporting antibiogram to clinicians in just 4 h. This technology replicates the basic tenets of clinical microbiology including bacterial growth in indigenously formulated medium, and measurement of inhibition of bacterial growth in presence of antibiotic/s. Detection is based on chromogenic endpoints using optical sensors and is analyzed by a lab-developed algorithm, which reports antibiotic sensitivity to the antibiotics panel tested. To assess its diagnostic accuracy, a prospective clinical validation study was conducted in two tertiary-care Indian hospitals. Urine samples from 1986 participants were processed by both novel/index test and conventional Kirby Bauer Disc Diffusion method. The sensitivity and specificity of this assay was 92.5% and 82%, respectively (p < 0.0005). This novel technology will promote evidence-based prescription of antibiotics and reduce the burden of increasing resistance by providing rapid and precise diagnosis in shortest possible time.
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Affiliation(s)
- Suman Kapur
- Department of Biological Sciences, Birla Institute of Technology and Science, Pilani, Hyderabad Campus, Hyderabad, Telangana 500078, India;
| | - Manish Gehani
- Department of Biological Sciences, Birla Institute of Technology and Science, Pilani, Hyderabad Campus, Hyderabad, Telangana 500078, India;
| | - Nagamani Kammili
- Department of Microbiology, Gandhi Medical College and Hospital, Hyderabad, Telangana 500003, India; (N.K.); (S.M.D.)
| | - Pankaj Bhardwaj
- All India Institute of Medical Sciences, Jodhpur, Rajasthan 342005, India; (P.B.); (V.N.)
| | - Vijayalakshmi Nag
- All India Institute of Medical Sciences, Jodhpur, Rajasthan 342005, India; (P.B.); (V.N.)
| | - Sudha M. Devara
- Department of Microbiology, Gandhi Medical College and Hospital, Hyderabad, Telangana 500003, India; (N.K.); (S.M.D.)
| | - Shashwat Sharad
- Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD 20817, USA
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The predictive value of procalcitonin for early detection of infection in elderly type 2 diabetes mellitus. J Infect Chemother 2019; 26:343-348. [PMID: 31735630 DOI: 10.1016/j.jiac.2019.10.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 09/06/2019] [Accepted: 10/16/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Aimed to investigate the predictive value of procalcitonin (PCT) in early detection of infections in elderly patients with type 2 diabetes, and to discover the optimum cut-off points of PCT. METHODS A retrospective study was conducted with type 2 diabetic patients (≥65 years) with lung infection (LI), urinary tract infection (UTI) or skin and soft tissue infection (SSTI). The receiver operating characteristic (ROC) curves of the 3 markers (PCT, WBC count, and CRP) were constructed and compared to assess their accuracies in diagnosing. RESULTS Among the three different groups with LI, UTI or SSTI, the area under the ROC curve (AUC) of PCT was 0.98 (95% confidence interval (CI): 0.96-0.99, p < 0.05) for the LI group, 0.98 (95% CI: 0.96-0.99, p < 0.05) for the UTI group, and 0.97 (95% CI: 0.94-1.00, p < 0.05) for the SSTI group. The optimum cut-off point of PCT level was 0.73 ng/mL (Sn 89.7%, Sp 97.7%) for the LI group, 1.48 ng/mL (Sn 88.9%, Sp 100%) for the UTI group, and 0.73 ng/mL (Sn 85.7%, Sp 97.7%) for the SSTI group. CONCLUSION PCT demonstrated the strongest correlation with each of the infection types, indicating significant diagnostic value. Optimum cut-off points of PCT levels in elderly diabetes were higher.
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Ivaska L, Alyazidi R, Hoang L, Goldfarb DM. Dermacoccus sp. isolated from a brain abscess in a 4-year-old child. J Infect Chemother 2019; 25:1070-1073. [PMID: 31253474 DOI: 10.1016/j.jiac.2019.05.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/27/2019] [Accepted: 05/29/2019] [Indexed: 11/25/2022]
Abstract
Dermacoccus spp. have rarely been reported as human pathogens. We describe a case of a 4-year-old boy with congenital heart disease who was diagnosed with a brain abscess. The abscess was drained and the sample grew Streptococcus intermedius, Aggregatibacter aphrophilus and Dermacoccus sp.. Dermacoccus grew after 5 days of incubation and the patient was treated with meropenem.
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Affiliation(s)
- Lauri Ivaska
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Kiinanmyllynkatu 4-8, 20521, Turku, Finland; University of British Columbia and BC Children's Hospital, 4480 Oak St, Vancouver, BC, V6H 3N1, Canada.
| | - Raidan Alyazidi
- University of British Columbia and BC Children's Hospital, 4480 Oak St, Vancouver, BC, V6H 3N1, Canada; Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Prince Majid Rd, Al Sulaymaniyah, Jeddah, 22252, Saudi Arabia.
| | - Linda Hoang
- BC Centre for Disease Control Public Health Microbiology, 655 W 12th Ave, Vancouver, BC, V5Z 4R4, Canada.
| | - David M Goldfarb
- University of British Columbia and BC Children's Hospital, 4480 Oak St, Vancouver, BC, V6H 3N1, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada.
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Sousa A, Makino H, Bruno V, Candido S, Nogueira B, Menezes I, Nakazato L, Dutra V. Perfil de resistência antimicrobiana de Klebsiella pneumoniae isoladas de animais domésticos e silvestres. ARQ BRAS MED VET ZOO 2019. [DOI: 10.1590/1678-4162-10599] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
RESUMO Klebsiella pneumoniae é um patógeno oportunista, responsável por diversos tipos de infecções nosocomiais, e é considerado um microrganismo multirresistente. Dados na literatura que forneçam informações a respeito da resistência desse microrganismo a antimicrobianos em amostras de animais são escassos. Dessa forma, o objetivo deste trabalho foi avaliar o perfil e o seu aumento das resistências a antimicrobianos dentro da medicina veterinária. Um total de 67 isolados de K. pneumoniae, provenientes de diferentes sítios de isolamento de animais domésticos (39/67) e silvestres (28/67), foi confirmado por sequenciamento do gene 16S rRNA. O maior percentual de isolamento de K. pneumoniae foi de amostras de urina, com 16% (11/67), fezes, com 15% (10/67), e pulmão, com 13,5% (09/67). No perfil de resistência, foram testadas 11 categorias de antibióticos, sendo a maior taxa de resistência ao metronidazol 97% (65/67), à ampicilina 94% (63/67), à amoxicilina 93% (62/67), às sulfonamidas 93% (62/67), à colistina 93% (62/67) e à nitrofurantoína 88% (59/67). Aqueles que apresentaram menor taxa de resistência foram: meropenem 3% (2/67), imipenem 6% (4/67) e amicacina 16% (11/67). Todos os isolados foram considerados bactérias multirresistentes (MRD), com o índice de resistência múltipla aos antibióticos (IRMA) variando de 0,15 a 0,85 e com 60 tipos de padrões de resistência. O resultado deste estudo reforça que os animais são reservatórios de K. pneumoniae multirresistentes.
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Affiliation(s)
| | - H. Makino
- Universidade Federal de Mato Grosso, Brazil
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Tanaka A, Watanabe Y, Ito C, Murata M, Shinjo H, Otsuka Y, Takeda A. Successful treatment of peritoneal dialysis-related peritonitis caused by Dermacoccus nishinomiyaensis. CEN Case Rep 2019; 8:183-187. [PMID: 30830670 DOI: 10.1007/s13730-019-00388-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 02/19/2019] [Indexed: 11/28/2022] Open
Abstract
A 53-year-old man receiving peritoneal dialysis (PD) for 4 months presented with PD-related peritonitis (abdominal pain, turbid peritoneal dialysate effluent, white blood cell in peritoneal dialysate effluent 5350/µL, C-reactive protein 25.56 mg/dL) caused by Dermacoccus (D.) nishinomiyaensis. He was first treated empirically with cefazolin and ceftazidime. After detection of D. nishinomiyaensis in the peritoneal effluent culture collected on the first day of hospitalization, the antibiotics were changed to amoxicillin and vancomycin. After confirming negative-conversion of peritoneal effluent culture, treatment was continued for more than 6 weeks. The peritonitis resolved; he continues peritoneal dialysis without withdrawal from PD or catheter removal. D. nishinomiyaensis is part of resident microbiota of the skin, and its pathogenicity is rarely reported. To date, there is no report of PD-related peritonitis caused by D. nishinomiyaensis. Because it is a slow grower, it may be missed and the peritonitis categorized as culture-negative. Long-term culture is important to detect it. It is difficult to determine the antibiotics that can be used because susceptibility to antibiotics is unknown due to the organism's rarity. Furthermore, the appropriate treatment period is also unknown. Long-term treatment may be useful in PD-related peritonitis caused by D. nishinomiyaensis because it is a slow grower.
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Affiliation(s)
- Akihito Tanaka
- Kidney Disease Center, Japanese Red Cross Nagoya Daini Hospital, 2-9, Myoken-cho, Showa- ku, Nagoya, 466-8650, Japan.
| | - Yu Watanabe
- Kidney Disease Center, Japanese Red Cross Nagoya Daini Hospital, 2-9, Myoken-cho, Showa- ku, Nagoya, 466-8650, Japan
| | - Chiharu Ito
- Kidney Disease Center, Japanese Red Cross Nagoya Daini Hospital, 2-9, Myoken-cho, Showa- ku, Nagoya, 466-8650, Japan
| | - Minako Murata
- Kidney Disease Center, Japanese Red Cross Nagoya Daini Hospital, 2-9, Myoken-cho, Showa- ku, Nagoya, 466-8650, Japan
| | - Hibiki Shinjo
- Kidney Disease Center, Japanese Red Cross Nagoya Daini Hospital, 2-9, Myoken-cho, Showa- ku, Nagoya, 466-8650, Japan
| | - Yasuhiro Otsuka
- Kidney Disease Center, Japanese Red Cross Nagoya Daini Hospital, 2-9, Myoken-cho, Showa- ku, Nagoya, 466-8650, Japan
| | - Asami Takeda
- Kidney Disease Center, Japanese Red Cross Nagoya Daini Hospital, 2-9, Myoken-cho, Showa- ku, Nagoya, 466-8650, Japan
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