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Allami M, Mohammed EJ, Alnaji Z, A Jassim S. Antibiotic resistance and its correlation with biofilm formation and virulence genes in Klebsiella pneumoniae isolated from wounds. J Appl Genet 2024:10.1007/s13353-024-00893-w. [PMID: 39031267 DOI: 10.1007/s13353-024-00893-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 05/29/2024] [Accepted: 07/12/2024] [Indexed: 07/22/2024]
Abstract
Klebsiella pneumoniae is the most important species of the Klebsiella genus and often causes hospital infections. These bacteria have a high resistance to most of the available drugs, which has caused concern all over the world. In this study, we investigated the antibiotic resistance profile and the ability to produce extended-spectrum beta-lactamase (ESBL) among K. pneumoniae isolates, and then we investigated the relationship between these two factors with biofilm formation and the prevalence of different virulence genes. In this study, 130 isolates of K. pneumoniae isolated from wounds were investigated. The antibiotic resistance of the isolates was evaluated by the disk diffusion method. The microtiter plate method was used to measure biofilm formation. The prevalence of virulence genes was detected by multiplex PCR. Among the examined isolates, 85.3% showed multidrug resistance. 87.6% of the isolates were ESBL-positive. Imipenem, meropenem, and fosfomycin were the most effective drugs. The ability of the isolates to produce biofilm was strong (80%), moderate (12.3%), and weak (7.6%), respectively. fimH, mrKD, entB, and tolC virulence genes were observed in all isolates. High prevalence of antibiotic resistance (especially multidrug resistance), high prevalence of ESBL-producing isolates, the ability of all isolates to biofilm formation, and the presence of fimH, mrKD, entB, and tolC virulence genes in all isolates show the importance of these factors in the pathogenesis of K. pneumoniae isolates in Iraq.
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Affiliation(s)
- Mohammed Allami
- Department of Dentistry, Al-Manara College for Medical Sciences, Misan, Iraq.
- Department of Biology, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran.
- Microbiology Laboratory, Qal'at Saleh General Hospital, Misan Health Department, Misan, Iraq.
| | - Eman Jassim Mohammed
- Department of Microbiology, College of Science, Mustansiriyah University, Baghdad, Iraq
| | - Zainab Alnaji
- College of Pharmacy, University of Misan, Misan, Iraq
| | - Salsabil A Jassim
- Department of Biology, College of Science, Mustansiriyah University, Baghdad, Iraq
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ElTaweel M, Said HS, Barwa R. Emergence of extensive drug resistance and high prevalence of multidrug resistance among clinical Proteus mirabilis isolates in Egypt. Ann Clin Microbiol Antimicrob 2024; 23:46. [PMID: 38790053 PMCID: PMC11127457 DOI: 10.1186/s12941-024-00705-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Proteus mirabilis is an opportunistic pathogen that has been held responsible for numerous nosocomial and community-acquired infections which are difficult to be controlled because of its diverse antimicrobial resistance mechanisms. METHODS Antimicrobial susceptibility patterns of P. mirabilis isolates collected from different clinical sources in Mansoura University Hospitals, Egypt was determined. Moreover, the underlying resistance mechanisms and genetic relatedness between isolates were investigated. RESULTS Antimicrobial susceptibility testing indicated elevated levels of resistance to different classes of antimicrobials among the tested P. mirabilis clinical isolates (n = 66). ERIC-PCR showed great diversity among the tested isolates. Six isolates (9.1%) were XDR while all the remaining isolates were MDR. ESBLs and AmpCs were detected in 57.6% and 21.2% of the isolates, respectively, where blaTEM, blaSHV, blaCTX-M, blaCIT-M and blaAmpC were detected. Carbapenemases and MBLs were detected in 10.6 and 9.1% of the isolates, respectively, where blaOXA-48 and blaNDM-1 genes were detected. Quinolone resistant isolates (75.8%) harbored acc(6')-Ib-cr, qnrD, qnrA, and qnrS genes. Resistance to aminoglycosides, trimethoprim-sulfamethoxazole and chloramphenicol exceeded 80%. Fosfomycin was the most active drug against the tested isolates as only 22.7% were resistant. Class I or II integrons were detected in 86.4% of the isolates. Among class I integron positive isolates, four different gene cassette arrays (dfrA17- aadA5, aadB-aadA2, aadA2-lnuF, and dfrA14-arr-3-blaOXA-10-aadA15) and two gene cassettes (dfrA7 and aadA1) were detected. While class II integron positive isolates carried four different gene cassette arrays (dfrA1-sat1-aadA1, estXVr-sat2-aadA1, lnuF- dfrA1-aadA1, and dfrA1-sat2). CONCLUSION P. Mirabilis ability to acquire resistance determinants via integrons may be held responsible for the elevated rates of antimicrobial resistance and emergence of XDR or even PDR strains limiting the available therapeutic options for management of infections caused by those strains.
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Affiliation(s)
- Maggi ElTaweel
- Department of Microbiology and Immunology, Faculty of Pharmacy, Mansoura University, Mansoura, 35516, Egypt
| | - Heba Shehta Said
- Department of Microbiology and Immunology, Faculty of Pharmacy, Mansoura University, Mansoura, 35516, Egypt.
| | - Rasha Barwa
- Department of Microbiology and Immunology, Faculty of Pharmacy, Mansoura University, Mansoura, 35516, Egypt
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Ibrahim K, Tahsin M, Rahman A, Rahman SM, Rahman MM. Surveillance of Bacterial Load and Multidrug-Resistant Bacteria on Surfaces of Public Restrooms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:574. [PMID: 38791788 PMCID: PMC11120863 DOI: 10.3390/ijerph21050574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024]
Abstract
Public restrooms are often a hub of microbial contamination and the examination of bacterial contamination in these facilities can serve as an important indicator of the transmission of infectious diseases. This study was conducted to determine the prevalence of bacterial contamination in public restrooms based on the economic class of the building. Samples were collected from various spots in 32 restrooms found in 10 shopping malls, classifying them into two categories: upper-end restrooms and lower-end restrooms. The findings showed that the level of contamination was higher in the lower-end restrooms, with the seat being the most contaminated area. The most dominant Gram-positive bacteria were of the coagulase-negative staphylococci species, making up 86% of the identified Gram-positive isolates. The most dominant Gram-negative bacteria identified were Klebsiella pneumoniae (K. pneumoniae) and Pseudomonas aeruginosa (P. aeruginosa). The antibiotic sensitivity test results revealed the presence of multidrug-resistant bacteria among the Gram-positive and negative isolates, including Staphylococcus haemolyticus (S. haemolyticus), Staphylococcus kloosii (S. kloosii), Acinetobacter baumanii (A. baumanii), and P. aeruginosa. In conclusion, the study underscores the significance of monitoring bacterial contamination in public restrooms and the need for measures to reduce the spread of infectious diseases. Further research is crucial to gain a complete understanding of the bacterial contamination in public restrooms and their resistance patterns, to ensure the safety and health of the public. The implementation of improved cleaning practices and hands-free designs in addition to the installation of antimicrobial surfaces in restrooms can help reduce the risk of cross-contamination and prevent the spread of diseases.
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Affiliation(s)
- Khadega Ibrahim
- Flow Cytometry Core, Research Department, Sidra Medicine, Doha, Qatar;
| | | | - Aninda Rahman
- Communicable Disease Control, Directorate General of Health Services, Ministry of Health & Family Welfare, Dhaka 1212, Bangladesh;
| | | | - Md Mizanur Rahman
- Biological Science Program, Department of Biological and Environmental Sciences, Collage of Arts and Sciences, Qatar University, Doha 2713, Qatar
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Haley E, Luke N, Mathur M, Festa RA, Wang J, Jiang Y, Anderson LA, Baunoch D. The Prevalence and Association of Different Uropathogens Detected by M-PCR with Infection-Associated Urine Biomarkers in Urinary Tract Infections. Res Rep Urol 2024; 16:19-29. [PMID: 38221993 PMCID: PMC10787514 DOI: 10.2147/rru.s443361] [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: 10/06/2023] [Accepted: 12/16/2023] [Indexed: 01/16/2024] Open
Abstract
Background Many emerging uropathogens are currently identified by multiplex polymerase chain reaction (M-PCR) in suspected UTI cases. Standard urine culture (SUC) has significantly lower detection rates, raising questions about whether these organisms are associated with UTIs and truly cause inflammation. Objective To determine if microbes detected by M-PCR were likely causative of UTI by measuring inflammatory biomarkers in the urine of symptomatic patients. Design Setting and Participants Midstream voided urine was collected from subjects ≥60 years presenting to urology clinics with symptoms of UTI (n = 1132) between 01/2023 and 05/2023. Microbe detection was by M-PCR and inflammation-associated biomarker (neutrophil gelatinase-associated lipocalin, interleukin 8, and interleukin 1β) was by enzyme-linked immunosorbent assay. Biomarker positivity was measured against individual and groups of organisms, E. coli and non-E. coli cases, emerging uropathogens, monomicrobial and polymicrobial cases. Outcome Measurements and Statistical Analysis Distributions were compared using 2-sample Wilcoxon Rank Sum test with 2-tailed p-values < 0.05 considered statistically significant. Results and Limitations M-PCR was positive in 823 (72.7%) specimens with 28 of 30 (93%) microorganisms/groups detected. Twenty-six of twenty-eight detected microorganisms/groups (93%) had ≥2 biomarkers positive in >66% of cases. Both non-E. coli cases and E. coli cases had significant biomarker positivity (p < 0.05). Limitations were that a few organisms had low prevalence making inferences about their individual significance difficult. Conclusion The majority of microorganisms identified by M-PCR were associated with active inflammation measured by biomarker positivity, indicating they are likely causative of UTIs in symptomatic patients. This includes emerging uropathogens frequently not detected by standard urine culture.
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Affiliation(s)
- Emery Haley
- Department of Clinical Research, Pathnostics, Irvine, CA, USA
| | - Natalie Luke
- Department of Clinical Research, Pathnostics, Irvine, CA, USA
| | - Mohit Mathur
- Department of Medical Affairs, Pathnostics, Irvine, CA, USA
| | - Richard A Festa
- Department of Research and Development, Pathnostics, Irvine, CA, USA
| | - Jimin Wang
- Department of Statistical Analysis, Stat4Ward, Pittsburgh, PA, USA
| | - Yan Jiang
- Department of Statistical Analysis, Stat4Ward, Pittsburgh, PA, USA
| | - Lori A Anderson
- L.Anderson Diagnostic Market Access Consulting, San Diego, CA, USA
| | - David Baunoch
- Department of Research and Development, Pathnostics, Irvine, CA, USA
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Ramli SR, Abdul Hadi FS, Nor Amdan NA, Kamaradin IH, Zabari N, Maniam S, Sulaiman NS, Ghazali S, Seman Z, Hashim R, Ahmad N. Secondary and Co-Infections in Hospitalized COVID-19 Patients: A Multicenter Cross-Sectional Study in Malaysia. Antibiotics (Basel) 2023; 12:1547. [PMID: 37887248 PMCID: PMC10604684 DOI: 10.3390/antibiotics12101547] [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: 07/01/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 10/28/2023] Open
Abstract
Bacterial and fungal secondary and co-infections are commonly identified with viral respiratory infections. This study was undertaken to determine the incidence and factors associated with bacterial and fungal infections in patients with COVID-19 as well as antibiotics prescription patterns within the first and second waves of the outbreak in Malaysia. Clinical records of 3532 COVID-19 patients admitted to hospitals in Malaysia between 4 February and 4 August 2020 were analyzed. Co-morbidities, clinical features, investigations, treatment, and complications were captured using the REDCap database. Culture and sensitivity test results were retrieved from the WHONET database. Univariate and multivariate regression analyses were used to identify associated determinants. A total of 161 types of bacterial and fungal infections were found in 81 patients, i.e., 2.3%. The most common bacterial cultures were Gram-negative, i.e., Pseudomonas aeruginosa (15.3%) and Klebsiella pneumoniae (13.9%). The most common fungal isolate was Candida albicans (41.2%). Augmentin, ceftriaxone, tazocin, meropenem, and azithromycin were the five most frequently prescribed antibiotics. The latter four were classified under the "Watch" category in the WHO AwaRe list. Our data showed that bacterial and fungal secondary and co-infections were frequently found in severely ill COVID-19 patients and were associated with a higher mortality rate.
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Affiliation(s)
- Siti Roszilawati Ramli
- Infectious Diseases Research Centre, Institute for Medical Research, National Institutes of Health, Setia Alam, Shah Alam 40170, Malaysia
| | - Fashihah Sherina Abdul Hadi
- Infectious Diseases Research Centre, Institute for Medical Research, National Institutes of Health, Setia Alam, Shah Alam 40170, Malaysia
| | - Nur Asyura Nor Amdan
- Infectious Diseases Research Centre, Institute for Medical Research, National Institutes of Health, Setia Alam, Shah Alam 40170, Malaysia
| | - Insyirah Husna Kamaradin
- Infectious Diseases Research Centre, Institute for Medical Research, National Institutes of Health, Setia Alam, Shah Alam 40170, Malaysia
| | - Noraliza Zabari
- Infectious Diseases Research Centre, Institute for Medical Research, National Institutes of Health, Setia Alam, Shah Alam 40170, Malaysia
| | - Saraswathiy Maniam
- Infectious Diseases Research Centre, Institute for Medical Research, National Institutes of Health, Setia Alam, Shah Alam 40170, Malaysia
| | - Nur Suffia Sulaiman
- Nutrition, Metabolism & Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Setia Alam, Shah Alam 40170, Malaysia
| | - Sumarni Ghazali
- Special Resource Centre, Institute for Medical Research, National Institutes of Health, Setia Alam, Shah Alam 40170, Malaysia
| | - Zamtira Seman
- Sector for Biostatistics & Data Repository, National Institutes of Health, Setia Alam, Shah Alam 40170, Malaysia
| | - Rohaidah Hashim
- Infectious Diseases Research Centre, Institute for Medical Research, National Institutes of Health, Setia Alam, Shah Alam 40170, Malaysia
| | - Norazah Ahmad
- Infectious Diseases Research Centre, Institute for Medical Research, National Institutes of Health, Setia Alam, Shah Alam 40170, Malaysia
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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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Niu X, Hou B, Yang L, Wang W, Yu Q, Mao M, Shen W. Patterns of Drug Resistance and Bacterial Pathogen Distribution in Patients with Urinary Tract Infections in the Jiaxing Region from 2020 to 2022. Infect Drug Resist 2023; 16:5911-5921. [PMID: 37700799 PMCID: PMC10493148 DOI: 10.2147/idr.s424158] [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: 07/09/2023] [Accepted: 08/31/2023] [Indexed: 09/14/2023] Open
Abstract
Background Urinary tract infections (UTIs) and the antibiotic resistance of pathogenic bacteria pose severe threats to public health in the current healthcare environment. Objective The purpose of this study was to assess the frequency distribution of bacterial pathogens causing UTIs as well as the characteristics of antibiotic susceptibility and resistance. Methods The retrospective study was conducted on 32,391 samples of midstream urine culture from January 1, 2020, to December 31, 2022, in Jiaxing. Bacteria were cultivated on blood agar and identified using MALDI-TOF, and their susceptibility to different antibiotics was assessed using the Kirby-Bauer disk diffusion method and drug sensitivity reaction cards. The SPSS 22 software was used for data analysis. Bivariate logistic regression was used to analyze the risk factors for multidrug resistance. Results The total number of positive growth samples was 5378 (16.6%), including 3206 females (59.6%) and 2172 males (40.4%). The four most common urinary pathogens were Escherichia coli (39.2%), Enterococcus faecalis (12.4%), Klebsiella pneumoniae (7.6%), and Enterococcus faecium (7.6%). As far as antibiotic resistance was concerned, Escherichia coli had a greater than 50% resistance rate to ampicillin (76.1%), ciprofloxacin (58.6%), and levofloxacin (51.2%). The multidrug resistance rate was high (41.8%). Low levels of resistance were seen to ertapenem (0.1%), imipenem (0.7%), meropenem (0.7%), piperacillin/tazobactam (0.7%), and nitrofurantoin (1.8%). Klebsiella pneumoniae was highly sensitive to ertapenem (100%). The resistance rates to nitrofurantoin, ceftriaxone, and ciprofloxacin were 37.4%, 37.1%, and 35.1%, respectively. Up to 41% of Escherichia coli strains and 26% of Klebsiella pneumoniae strains produced extended-spectrum lactamases (ESBL). Two species of enterococci were highly sensitive to tigecycline and linezolid (100%), and a small number of norvancomycin-resistant strains (0.2%/two strains) were found. Conclusion Escherichia coli and Enterococcus faecium were the most common urinary pathogens in this study. The isolated pathogens showed different sensitivity patterns. Antibiotics should be selected reasonably according to the sensitivity mode of pathogenic bacteria to effectively treat and prevent urinary tract infections.
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Affiliation(s)
- Xiaoqin Niu
- Department of Clinical Laboratory, The First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, 314000, People’s Republic of China
| | - Bolong Hou
- Department of Clinical Laboratory, The First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, 314000, People’s Republic of China
| | - Lunyun Yang
- Department of Clinical Laboratory, The First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, 314000, People’s Republic of China
| | - Wei Wang
- Department of Clinical Laboratory, The First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, 314000, People’s Republic of China
| | - Qinlong Yu
- Department of Clinical Laboratory, The First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, 314000, People’s Republic of China
| | - Minjie Mao
- Department of Clinical Laboratory, The First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, 314000, People’s Republic of China
| | - Weifeng Shen
- Department of Clinical Laboratory, The First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, 314000, People’s Republic of China
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Meng H, Zhao Y, An Q, Zhu B, Cao Z, Lu J. Use of Ceftazidime-Avibactam for Suspected or Confirmed Carbapenem-Resistant Organisms in Children: A Retrospective Study. Infect Drug Resist 2023; 16:5815-5824. [PMID: 37692471 PMCID: PMC10492574 DOI: 10.2147/idr.s426326] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 08/29/2023] [Indexed: 09/12/2023] Open
Abstract
Background The incidence of carbapenem-resistant organism (CRO) infections is increasing in children. However, pediatric-specific treatment strategies present unique challenges. Ceftazidime/avibactam is a β-lactam/β-lactamase inhibitor combination, showing adequate efficiency against CRO isolates. However, clinical data on the efficacy of ceftazidime/avibactam in children are still lacking. Methods This was a retrospective study of children (aged <18 years) infected with confirmed or suspected carbapenem-resistant pathogens and treated with ceftazidime-avibactam at the First Affiliated Hospital of Zhengzhou University between 2020 and 2022. Results We identified 38 children aged 14 (5.0-16.3) years; 20 (52.6%) had hematologic malignancies. 25 children with confirmed CRO infections were administered ceftazidime-avibactam as targeted therapy. The median treatment was 10 (6.0-16.5) days. Among them, 24 had infections caused by carbapenem-resistant Enterobacterales (CRE) (18 carbapenem-resistant Klebsiella pneumoniae and six carbapenem-resistant Escherichia coli species) and one with carbapenem-resistant Pseudomonas aeruginosa strains. The source of infection was the bloodstream in 60.0% of the cases (15/25). The clinical response rate was 84.0% (21/25), and 30-day mortality rate was 20% (5/25). 13 children were administered ceftazidime-avibactam as empiric therapy for suspected infections. The median treatment was 8 (6.0-13.0) days. No deaths occurred and clinical response was achieved in 12 of the 13 patients (92.3%) who empirically treated with ceftazidime-avibactam. Conclusion Ceftazidime-avibactam is important for improving survival, and clinical response in children with infections caused by CRO.
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Affiliation(s)
- Haiyang Meng
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
- Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Yongmei Zhao
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
- Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Qi An
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
- Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Baoling Zhu
- Department of pharmacy, Xiangcheng Hospital of Chinese Medicine, Xiangcheng, People’s Republic of China
| | - Zhe Cao
- Department of pharmacy, Zhenping People’s Hospital, Zhenping, People’s Republic of China
| | - Jingli Lu
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
- Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, People’s Republic of China
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Zhang B, Zhou J, Xie G, Zhang L, Zhang Y, Xu K, Feng T, Yang S. A Case of Urinary Tract Infection Caused by Multidrug Resistant Streptococcus mitis/oralis. Infect Drug Resist 2023; 16:4285-4288. [PMID: 37424671 PMCID: PMC10327669 DOI: 10.2147/idr.s416387] [Citation(s) in RCA: 1] [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: 04/28/2023] [Accepted: 06/22/2023] [Indexed: 07/11/2023] Open
Abstract
S. mitis/oralis has been previously reported in isolated cases of bacterial endocarditis and liver abscesses. Its presence in urine is generally considered a contaminant. A 66-year-old male patient was admitted to the hospital due to recurrent chest tightness and four-year history of exertional dyspnea. On the second day of admission, the patient presented with urgent and frequent urination, as well as dysuria. Both initial and subsequent urine cultures showed S. mitis/oralis infection, with polymorphonuclear leukocyte phagocytosis observed in the second sample. MALDI-TOF results confirmed the isolated strain as S. mitis/oralis. Drug susceptibility testing revealed multidrug resistance to penicillin, ceftriaxone, cefepime, levofloxacin, ofloxacin, and tetracycline, but sensitivity to quinupristin/dalfopristin, vancomycin, and linezolid. The clinician then prescribed vancomycin for anti-infective treatment, which proved effective. Keywords: S. mitis/oralis, UTI, MDR, phagocytosis.
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Affiliation(s)
- Baohu Zhang
- Department of Clinical Laboratory, Pingshan General Hospital, Southern Medical University (Pingshan District People’s Hospital of Shenzhen), Shenzhen, Guangdong, People’s Republic of China
| | - Jie Zhou
- Department of Clinical Laboratory, Pingshan General Hospital, Southern Medical University (Pingshan District People’s Hospital of Shenzhen), Shenzhen, Guangdong, People’s Republic of China
| | - Guancong Xie
- Department of Cardiovascular Medicine, Pingshan General Hospital, Southern Medical University (Pingshan District People’s Hospital of Shenzhen), Shenzhen, Guangdong, People’s Republic of China
| | - Li Zhang
- Department of Clinical Laboratory, Pingshan General Hospital, Southern Medical University (Pingshan District People’s Hospital of Shenzhen), Shenzhen, Guangdong, People’s Republic of China
| | - Yang Zhang
- Department of Clinical Laboratory, Pingshan General Hospital, Southern Medical University (Pingshan District People’s Hospital of Shenzhen), Shenzhen, Guangdong, People’s Republic of China
| | - Kangli Xu
- Department of Clinical Laboratory, Pingshan General Hospital, Southern Medical University (Pingshan District People’s Hospital of Shenzhen), Shenzhen, Guangdong, People’s Republic of China
| | - Tianyuan Feng
- Department of Clinical Laboratory, Pingshan General Hospital, Southern Medical University (Pingshan District People’s Hospital of Shenzhen), Shenzhen, Guangdong, People’s Republic of China
| | - Shucai Yang
- Department of Clinical Laboratory, Pingshan General Hospital, Southern Medical University (Pingshan District People’s Hospital of Shenzhen), Shenzhen, Guangdong, People’s Republic of China
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Korman HJ, Baunoch D, Luke N, Wang D, Zhao X, Levin M, Wenzler DL, Mathur M. A Diagnostic Test Combining Molecular Testing with Phenotypic Pooled Antibiotic Susceptibility Improved the Clinical Outcomes of Patients with Non- E. coli or Polymicrobial Complicated Urinary Tract Infections. Res Rep Urol 2023; 15:141-147. [PMID: 37151752 PMCID: PMC10162393 DOI: 10.2147/rru.s404260] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/13/2023] [Indexed: 05/09/2023] Open
Abstract
Purpose Complicated UTIs (cUTIs) cause significant morbidity and healthcare resource utilization and cost. Standard urine culture has limitations in detecting polymicrobial and non-E. coli infections, resulting in the under-diagnosis and under-treatment of cUTIs. In this study, patient-reported outcomes were compared between treated and untreated patients when an advanced diagnostic test combining multiplex-polymerase chain reaction (M-PCR) with a pooled antibiotic susceptibility method (P-AST) was incorporated into the patients' clinical management. Methods Patients who had symptoms typical of cUTI and positive M-PCR/P-AST test results were recruited from urology clinics. Symptom reduction and clinical cure rates were measured from day 0 through day 14 using the American English Acute Cystitis Symptom Score (ACSS) Questionnaire. Clinical cure was defined based on the sum of the scores of four US Food and Drug Administration (FDA) symptoms and the absence of visible blood in the urine. Results Of 264 patients with suspected cUTI, 146 (55.4%) had exclusively non-E. coli infections (115 treated and 31 untreated) and 190 (72%) had polymicrobial infections (162 treated and 28 untreated). Treated patients exhibited greater symptom reduction compared to untreated ones on day 14 for those with exclusively non-E. coli organisms (3.18 vs 1.64, p = 0.006) and polymicrobial infections (3.52 vs 1.41, p = 0.002), respectively. A higher percentage of treated patients than of untreated patients achieved clinical cure for polymicrobial infections on day 14 (58.7% vs 36.4%, p = 0.049). Conclusion Patients with cUTIs treated based on the M-PCR/P-AST diagnostic test had significantly improved symptom reduction and clinical cure rates compared to untreated patients among those with non-E. coli or polymicrobial infections.
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Affiliation(s)
- Howard J Korman
- Comprehensive Urology Division, Michigan Healthcare Professionals, Royal Oak, MI, USA
| | - David Baunoch
- Department of Research and Development, Pathnostics, Irvine, CA, USA
| | - Natalie Luke
- Department of Research and Development, Pathnostics, Irvine, CA, USA
| | - Dakun Wang
- Department of Writing, Stat4Ward, Pittsburgh, PA, USA
| | - Xihua Zhao
- Department of Statistical Analysis, Stat4Ward, Pittsburgh, PA, USA
| | - Michael Levin
- Comprehensive Urology Division, Michigan Healthcare Professionals, Royal Oak, MI, USA
| | - David L Wenzler
- Comprehensive Urology Division, Michigan Healthcare Professionals, Royal Oak, MI, USA
| | - Mohit Mathur
- Department of Medical Affairs, Pathnostics, Irvine, CA, USA
- Correspondence: Mohit Mathur, Pathnostics, 15545 Sand Canyon Suite 100, Irvine, CA, 92618, USA, Email
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11
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Prevalence of Mutated Colistin-Resistant Klebsiella pneumoniae: A Systematic Review and Meta-Analysis. Trop Med Infect Dis 2022; 7:tropicalmed7120414. [PMID: 36548669 PMCID: PMC9782491 DOI: 10.3390/tropicalmed7120414] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/21/2022] [Accepted: 11/28/2022] [Indexed: 12/04/2022] Open
Abstract
The emergence of genetic mutations in chromosomal genes and the transmissible plasmid-mediated colistin resistance gene may have helped in the spread of colistin resistance among various Klebsiella pneumoniae (K. pneumoniae) isolates and other different bacteria. In this study, the prevalence of mutated colistin-resistant K. pneumoniae isolates was studied globally using a systematic review and meta-analysis approach. A systematic search was conducted in databases including PubMed, ScienceDirect, Scopus and Google Scholar. The pooled prevalence of mutated colistin resistance in K. pneumoniae isolates was analyzed using Comprehensive Meta-Analysis Software (CMA). A total of 50 articles were included in this study. The pooled prevalence of mutated colistin resistance in K. pneumoniae was estimated at 75.4% (95% CI = 67.2−82.1) at high heterogeneity (I2 = 81.742%, p-value < 0.001). Meanwhile, the results of the subgroup analysis demonstrated the highest prevalence in Saudi Arabia with 97.9% (95% CI = 74.1−99.9%) and Egypt, with 4.5% (95% CI = 0.6−26.1%), had the lowest. The majority of mutations could be observed in the mgrB gene (88%), pmrB gene (54%) and phoQ gene (44%). The current study showed a high prevalence of the mutation of colistin resistance genes in K. pneumoniae. Therefore, it is recommended that regular monitoring be performed to control the spread of colistin resistance.
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12
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Arafa SH, Alshehri WA, Organji SR, Elbanna K, Obaid NA, Aldosari MS, Asiri FH, Ahmad I, Abulreesh HH. Antimicrobial Resistance, Virulence Factor-Encoding Genes, and Biofilm-Forming Ability of Community-Associated Uropathogenic Escherichia coli in Western Saudi Arabia. Pol J Microbiol 2022; 71:325-339. [PMID: 36048880 DOI: 10.33073/pjm-2022-029] [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: 04/27/2022] [Accepted: 07/01/2022] [Indexed: 11/05/2022] Open
Abstract
To explore the prevalence of multidrug-resistant community-associated uropathogenic Escherichia coli (UPEC) and their virulence factors in Western Saudi Arabia. A total of 1,000 urine samples were examined for the presence of E. coli by selective plating on MacConkey, CLED, and sheep blood agar. Antimicrobial susceptibility patterns were determined using Vitek® 2 Compact (MIC) and the disc diffusion method with Mueller-Hinton agar. Genes encoding virulence factors (kpsMTII, traT, sat, csgA, vat, and iutA) were detected by PCR. The overall prevalence of UTI-associated E. coli was low, and a higher prevalence was detected in samples of female origin. Many of the isolates exhibited resistance to norfloxacin, and 60% of the isolates showed resistance to ampicillin. No resistance to imipenem, meropenem, or ertapenem was detected. In general, half of the isolates showed multiple resistance patterns. UPEC exhibited a weak ability to form biofilms, where no correlation was observed between multidrug resistance and biofilm-forming ability. All uropathogenic E. coli isolates carried the kpsMTII, iutA, traT, and csgA genes, whereas the low number of the isolates harbored the sat and vat genes. The diversity of virulence factors harbored by community-associated UPEC may render them more virulent and further explain the recurrence/relapse cases among community-associated UITs. To the best of our knowledge, this study constitutes the first exploration of virulence, biofilm-forming ability, and its association with multidrug resistance among UPEC isolates in Saudi Arabia. Further investigations are needed to elucidate the epidemiology of community-associated UPEC in Saudi Arabia.
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Affiliation(s)
- Sara H Arafa
- Department of Biology, Faculty of Applied Science, Umm Al-Qura University, Makkah, Saudi Arabia.,Research Laboratories Unit, Faculty of Applied Science, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Wafa A Alshehri
- Department of Biology, College of Science, University of Jeddah, Jeddah, Saudi Arabia
| | - Sameer R Organji
- Department of Biology, Faculty of Applied Science, Umm Al-Qura University, Makkah, Saudi Arabia.,Research Laboratories Unit, Faculty of Applied Science, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Khaled Elbanna
- Department of Biology, Faculty of Applied Science, Umm Al-Qura University, Makkah, Saudi Arabia.,Research Laboratories Unit, Faculty of Applied Science, Umm Al-Qura University, Makkah, Saudi Arabia.,Department of Agricultural Microbiology, Faculty of Agriculture, Fayoum University, Fayoum, Egypt
| | - Najla A Obaid
- College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | - Fatimah H Asiri
- King Abdulaziz Hospital, Ministry of Health, Makkah, Saudi Arabia
| | - Iqbal Ahmad
- Department of Agricultural Microbiology, Faculty of Agricultural Sciences, Aligarh Muslim University, Aligarh, India
| | - Hussein H Abulreesh
- Department of Biology, Faculty of Applied Science, Umm Al-Qura University, Makkah, Saudi Arabia.,Research Laboratories Unit, Faculty of Applied Science, Umm Al-Qura University, Makkah, Saudi Arabia
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13
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Miftode IL, Pasare MA, Miftode RS, Nastase E, Plesca CE, Lunca C, Miftode EG, Timpau AS, Iancu LS, Dorneanu OS. What Doesn’t Kill Them Makes Them Stronger: The Impact of the Resistance Patterns of Urinary Enterobacterales Isolates in Patients from a Tertiary Hospital in Eastern Europe. Antibiotics (Basel) 2022; 11:antibiotics11050548. [PMID: 35625192 PMCID: PMC9137815 DOI: 10.3390/antibiotics11050548] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/16/2022] [Accepted: 04/19/2022] [Indexed: 02/06/2023] Open
Abstract
(1) Background: The evolution of bacterial resistance to antibiotics is one of the factors that make infectious pathology an extremely dynamic field, also inducing a significant burden on public health systems; therefore, continuous updates on the bacterial resistance to antibiotics and their particular regional patterns is crucial for the adequate approach of various infectious diseases. (2) Methods: We retrospectively analyzed 354 patients with Enterobacterales urinary tract infections (UTIs), determined their antibiotic resistance pattern, thus aiming to correlate them with the outcome and other specific markers of poor prognosis. (3) Results: The most frequent causative agent was Escherichia coli, representing 64.6% of all UTIs. We identified 154 patients resistant to multiple antibiotic classes, of which 126 were multidrug-resistant (MDR), 17 were extensive drug-resistant (XDR) and 11 were pandrug-resistant (PDR). Moreover, 25 isolates were resistant to carbapenems (CRE), 25 were difficult-to-treat (DTR), and 84 were extended-spectrum cephalosporin-resistant (ESC), with only 95 isolates susceptible to all tested antibiotics. Mortality ranged from 1% for UTIs caused by isolates susceptible to all tested antibiotics, to 24% for the ones caused by DTR or CRE isolates. Other significant risk factors associated with mortality were: prolonged hospital stay (p = 0.0001), Charlson comorbidity index ≥ 3 (p = 0.02), urinary catheterization (p = 0.001), associated respiratory pathologies (p = 0.004), obesity (p = 0.047), a history of previous hospitalizations (p = 0.007), inappropriate empiric antibiotic regimen (p = 0.001), or hyper inflammatory status (p = 0.006). Basically, we observed that a multiple regression model comprising urinary catheterization, inappropriate empiric anti-biotherapy, obesity, and respiratory comorbidities exhibits the best correlation with mortality rate in patients with UTI (R = 0.347, R2 = 0.12). (4) Conclusions: By focusing on the novel resistance patterns, our study provides complementary evidence concerning the resistance profiles found in an Eastern European region, as well as their prognostic implications in patients with UTI.
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Affiliation(s)
- Ionela-Larisa Miftode
- Department of Infectious Diseases, Faculty of Medicine, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iasi, Romania; (I.-L.M.); (E.N.); (C.E.P.)
- St. Parascheva Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania; (M.-A.P.); (O.S.D.)
| | - Maria-Antoanela Pasare
- St. Parascheva Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania; (M.-A.P.); (O.S.D.)
| | - Radu-Stefan Miftode
- Department of Internal Medicine I (Cardiology), Faculty of Medicine, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iasi, Romania;
- Correspondence: (R.-S.M.); (E.-G.M.); Tel.: +40-742067839 (R.-S.M.); +40-744118866 (E.-G.M.)
| | - Eduard Nastase
- Department of Infectious Diseases, Faculty of Medicine, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iasi, Romania; (I.-L.M.); (E.N.); (C.E.P.)
- St. Parascheva Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania; (M.-A.P.); (O.S.D.)
| | - Claudia Elena Plesca
- Department of Infectious Diseases, Faculty of Medicine, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iasi, Romania; (I.-L.M.); (E.N.); (C.E.P.)
- St. Parascheva Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania; (M.-A.P.); (O.S.D.)
| | - Catalina Lunca
- Department of Preventive Medicine and Interdisciplinarity, Faculty of Medicine, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iasi, Romania; (C.L.); (L.S.I.)
| | - Egidia-Gabriela Miftode
- Department of Infectious Diseases, Faculty of Medicine, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iasi, Romania; (I.-L.M.); (E.N.); (C.E.P.)
- St. Parascheva Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania; (M.-A.P.); (O.S.D.)
- Correspondence: (R.-S.M.); (E.-G.M.); Tel.: +40-742067839 (R.-S.M.); +40-744118866 (E.-G.M.)
| | - Amalia-Stefana Timpau
- Department of Internal Medicine I (Cardiology), Faculty of Medicine, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iasi, Romania;
| | - Luminita Smaranda Iancu
- Department of Preventive Medicine and Interdisciplinarity, Faculty of Medicine, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iasi, Romania; (C.L.); (L.S.I.)
| | - Olivia Simona Dorneanu
- St. Parascheva Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania; (M.-A.P.); (O.S.D.)
- Department of Preventive Medicine and Interdisciplinarity, Faculty of Medicine, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iasi, Romania; (C.L.); (L.S.I.)
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14
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Baral R, Shrestha LB, Ortuño-Gutiérrez N, Pyakure P, Rai B, Rimal SP, Singh S, Sharma SK, Khanal B, Selvaraj K, Kumar AMV. Low yield but high levels of multidrug resistance in urinary tract infections in a tertiary hospital, Nepal. Public Health Action 2021; 11:70-76. [PMID: 34778019 DOI: 10.5588/pha.21.0044] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/21/2021] [Indexed: 11/10/2022] Open
Abstract
SETTING There are concerns about the occurrence of multidrug resistance (MDR) in patients with urine tract infections (UTI) in Nepal. OBJECTIVE To determine culture positivity, trends in MDR among Escherichia coli and Klebsiella pneumoniae infections and seasonal changes in culture-positive UTI specimens isolated from 2014 to 2018 at the B P Koirala Institute of Health Sciences, Dharan, Eastern Nepal. DESIGN This was a cross-sectional study using secondary laboratory data. RESULTS Among 116,417 urine samples tested, 19,671 (16.9%) were culture-positive, with an increasing trend in the number of samples tested and culture positivity. E. coli was the most common bacteria (54.3%), followed by K. pneumoniae (8.8%). Among E. coli and K. pneumoniae isolates, MDR was found in respectively 42.5% and 36.0%. MDR was higher in males and people aged >55 years, but showed a decreasing trend over the years. The numbers of isolates increased over the years, with a peak always observed from July to August. CONCLUSION Low culture positivity is worrying and requires further work into improving diagnostic protocols. Decreasing trends in MDR are a welcome sign. Information on seasonal changes that peak in July-August can help laboratories better prepare for this time with adequate buffer stocks to ensure culture and antibiotic susceptibility testing.
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Affiliation(s)
- R Baral
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - L B Shrestha
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | | | - P Pyakure
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal.,School of Public Health and Community Medicine, BPKIHS, Dharan, Nepal
| | - B Rai
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - S P Rimal
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - S Singh
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - S K Sharma
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - B Khanal
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - K Selvaraj
- All India Institute of Medical Sciences, Nagpur, India
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France.,The Union South-East Asia Office, New Delhi, India.,Yenepoya Medical College, Yenepoya (deemed University), Mangaluru, India
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15
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Ding Y, Wang H, Pu S, Huang S, Niu S. Resistance Trends of Klebsiella pneumoniae Causing Urinary Tract Infections in Chongqing, 2011-2019. Infect Drug Resist 2021; 14:475-481. [PMID: 33603411 PMCID: PMC7881772 DOI: 10.2147/idr.s295870] [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: 12/05/2020] [Accepted: 01/22/2021] [Indexed: 12/20/2022] Open
Abstract
Purpose To analyze the characteristics and trends of drug resistance for Klebsiella pneumoniae (K. pneumoniae), isolated from urinary tract infections (UTIs), to common antibiotics used in clinics. Methods This retrospective study was conducted in a teaching hospital in Chongqing from 2011 to 2019. Laboratory data of isolated bacteria were collected and analyzed. Results Among the 17,966 non-repetitive strains isolated from the urine sample, a total of 1543 K. pneumoniae isolates were identified, with an isolation frequency secondary only to Escherichia coli (E. coli) and there was a peak in the K. pneumoniae isolates in the year 2013. During the period, the rate of extended-spectrum β-lactamase (ESBL)-producing K. pneumoniae fell from 48.4% in 2011 to 32.9% in 2019, and a marked jump of resistance was seen in carbapenems from 2.2% to 18.0%. The peak of carbapenem resistance rate (22.6%) to K. pneumoniae was observed in 2017 along with a low ESBL-producing rate (30.9%). Piperacillin/tazobactam and cefepime resistance levels went up from 4.4% to 25.7% and from 18.2% to 30.5%, respectively. Moreover, the K. pneumoniae isolates resistance rate to carbapenems and amikacin gradually grew up, showing their peaks in 2017, and then dropped year by year. However, ceftazidime and aztreonam resistance levels were relatively stable, fluctuating between 21.8% and 35.6%, 32.2% and 39.4%, respectively. Conclusion There is a significant upward tendency in carbapenem resistance rate and a downward tendency in ESBL-production rate in K. pneumoniae isolates from UTIs, and continuous surveillance is necessary in the future.
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Affiliation(s)
- Yanhui Ding
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Huijuan Wang
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Shuli Pu
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Shifeng Huang
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Siqiang Niu
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
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16
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Ravishankar U, P S, Thayanidhi P. Antimicrobial Resistance Among Uropathogens: Surveillance Report From South India. Cureus 2021; 13:e12913. [PMID: 33520560 PMCID: PMC7837632 DOI: 10.7759/cureus.12913] [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] [Indexed: 11/05/2022] Open
Abstract
Background Urinary Tract Infection (UTI) is one of the most common infections encountered in clinical practice. Evidence supports that empirical treatment guidelines based on local bacterial spectrum and antimicrobial resistance (AMR) surveillance provide the best clinical results and also prevent the emergence of resistant strains. Antimicrobial resistance has been increasing at an alarming rate throughout the world. This warrants continuous reporting and surveillance of the emergence of AMR among the uropathogens across regions and nations. Materials and methods A retrospective cross-sectional study using antibiograms of adult patients with culture-proven UTI during January 2011 and January 2017 was done. Comparative analysis was performed between the two study periods for the prevalence, changing trends of antimicrobial resistance, and usage of antimicrobials for testing. Results The commonest organism cultured during each study period was Escherichia coli (56.6% and 51.6%). The most frequently tested antibiotics were ampicillin (97%, 88%), amikacin (85%, 85%), nitrofurantoin (95%, 95%), cephalexin (84%, 93%), and norfloxacin (83%, 83%). There was a significant increase in resistance proportion noted for imipenem (by 29.8%), meropenem (by 18.3%), ertapenem (by 24.9%), ciprofloxacin (by 26.5%), nitrofurantoin (by 11.2%), amikacin (by 8.7%), and cefotaxime (by 7.4%) in 2017 as compared to 2011. A significant increase in susceptibility was seen for tobramycin (by 32.5%), cefepime (by 14.4%), and polymyxin (by 12.6%) in 2017 when compared to 2011. Conclusion Our analysis has shown that there is an alarmingly increasing trend for AMR among uropathogens in this region as compared to developed countries. Data on changing trends of antimicrobial testing and reporting might help in strengthening antimicrobial surveillance.
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Affiliation(s)
- Uma Ravishankar
- Internal Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Sathyamurthy P
- Internal Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
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17
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Aćimović M, Zorić M, Zheljazkov VD, Pezo L, Čabarkapa I, Stanković Jeremić J, Cvetković M. Chemical Characterization and Antibacterial Activity of Essential Oil of Medicinal Plants from Eastern Serbia. Molecules 2020; 25:molecules25225482. [PMID: 33238598 PMCID: PMC7700605 DOI: 10.3390/molecules25225482] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 12/14/2022] Open
Abstract
The objective of this study was to evaluate wild growing Satureja kitaibelii, Thymus serpyllum, Origanum vulgare, Achillea millefolium and Achillea clypeolata with respect to their essential oil (EO) content, composition and antimicrobial activity. The five species were collected at Mt. Rtanj and the village of Sesalac, Eastern Serbia. The main EO constituents of Lamiaceae plants were p-cymene (24.4%), geraniol (63.4%) and germacrene D (21.5%) in Satureja kitaibelii, Thymus serpyllum and Origanum vulgare ssp. vulgare, respectively. A. millefolium EO had multiple constituents with major ones being camphor (9.8%), caryophyllene oxide (6.5%), terpinen-4-ol (6.3%) and 1,8-cineole (5.6%), while the main EO constituents of A. clypeolata were 1,8-cineole (45.1%) and camphor (18.2%). Antimicrobial testing of the EO showed that Staphylococcus aureus (Gram-positive) was more sensitive to all of the tested EOs than Escherichia coli (Gram-negative). S. kitaibelii EO showed the highest antimicrobial activity against both tested bacterial strains. This is the first study to characterize the EO composition and antimicrobial activity of these five medicinal species from Eastern Serbia in comparison with comprehensive literature data. The results can be utilized by the perfumery, cosmetics, food and pharmaceutical industries, but also for healing purposes in self-medication.
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Affiliation(s)
- Milica Aćimović
- Institute of Field and Vegetable Crops Novi Sad, Maksima Gorkog 30, 21000 Novi Sad, Serbia;
- Correspondence:
| | - Miroslav Zorić
- Institute of Field and Vegetable Crops Novi Sad, Maksima Gorkog 30, 21000 Novi Sad, Serbia;
| | - Valtcho D. Zheljazkov
- College of Agricultural Sciences, Oregon State University, Corvallis, OR 97331, USA;
| | - Lato Pezo
- Institute of General and Physical Chemistry, University of Belgrade, Studentskitrg 12-16, 11000 Belgrade, Serbia;
| | - Ivana Čabarkapa
- Institute of Food Technology, University of Novi Sad, Bulevar Cara Lazara 1, 21000 Novi Sad, Serbia;
| | - Jovana Stanković Jeremić
- Institute of Chemistry, Technology and Metallurgy, University of Belgrade, Njegoševa 12, 11000 Belgrade, Serbia; (J.S.J.); (M.C.)
| | - Mirjana Cvetković
- Institute of Chemistry, Technology and Metallurgy, University of Belgrade, Njegoševa 12, 11000 Belgrade, Serbia; (J.S.J.); (M.C.)
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