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Asmare Z, Erkihun M, Abebe W, Tamrat E. Antimicrobial resistance and ESBL production in uropathogenic Escherichia coli: a systematic review and meta-analysis in Ethiopia. JAC Antimicrob Resist 2024; 6:dlae068. [PMID: 38716402 PMCID: PMC11073753 DOI: 10.1093/jacamr/dlae068] [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: 02/17/2024] [Accepted: 04/10/2024] [Indexed: 06/29/2024] Open
Abstract
Background Antimicrobial resistance (AMR) is a serious threat to global health systems. Escherichia coli is a major cause of urinary tract infections (UTIs). Understanding the AMR patterns of uropathogenic E. coli (UPEC) is crucial for effective public health interventions worldwide. Objectives This systematic review and meta-analysis aimed to consolidate existing research and provide a comprehensive information on AMR UPEC in Ethiopia. Methods We systematically searched databases such as PubMed, Web of Science, and Science Direct, along with including articles from Google Scholar. Data were extracted into Microsoft Excel and analysed using STATA 17.0. Cohen's kappa was computed to assess reviewer agreement, while the I2 statistic evaluated heterogeneity. Egger's tests were conducted to detect publication bias, and random-effects models were utilized to estimate the pooled resistance, with AMR rates for each antibiotic pooled separately. Results UPEC showed resistance rates, ranging from 3.64% (95% CI: -4.38% to 11.67%) for amikacin to 85.32% (95% CI: 78.6%-92.04%) for ampicillin. Highest resistance was to ampicillin (85.32%), followed by amoxicillin at 82.52% (95% CI: 74.3%-90.74%), tetracycline at 60.67% (95% CI: 51.53%-69.81%) and trimethoprim/sulfamethoxazole at 57.17% (95% CI: 49.93%-64.42%). Conversely, resistance rates were lower for amikacin at 3.64% and meropenem at 5.26% (95% CI: 2.64%-7.88%). UPEC demonstrated a pooled MDR rate of 79.17% (95% CI: 70.32%-88.01%) and a pooled ESBL production rate of 29.16% (95% CI: 22.36%-38.55%). Conclusions High levels of AMR were observed in UPEC strains, highlighting a critical public health issue requiring urgent action through robust antimicrobial stewardship and surveillance to preserve effective UTI treatment options.
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Affiliation(s)
- Zelalem Asmare
- Department of Medical Laboratory Science, College of Health Science, Woldia University, Amhara Region, PO Box: 400, Woldia, Ethiopia
| | - Mulat Erkihun
- Department of Medical Laboratory Science, College of Medicine and Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Wagaw Abebe
- Department of Medical Laboratory Science, College of Health Science, Woldia University, Amhara Region, PO Box: 400, Woldia, Ethiopia
| | - Ephrem Tamrat
- Department of Medical Laboratory Science, College of Health Science, Woldia University, Amhara Region, PO Box: 400, Woldia, Ethiopia
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Samarawickrama SS, Illangakoon HU, Uthuman A, Saranga V, Janaka C. The Clinical Profile of Patients With Culture-Positive Urinary Tract Infections Admitting to a Tertiary Hospital in Sri Lanka. Cureus 2024; 16:e58666. [PMID: 38774169 PMCID: PMC11106549 DOI: 10.7759/cureus.58666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2024] [Indexed: 05/24/2024] Open
Abstract
Introduction Urinary tract infections (UTIs) are globally prevalent. This study explores the clinical and pathological profile of culture-positive UTI patients at Sri Jayewardenepura General Hospital. Method In this descriptive cross-sectional study conducted at Sri Jayewardenepura General Hospital from December 2020 to May 2021, we evaluated patients over 14 years with positive urine culture reports. Excluding those with HIV, undergoing chemotherapy, or pregnant, we used consecutive sampling. Data were collected via interviewer-administered questionnaires and analyzed using SPSS version 21.0 (IBM Inc., Armonk, New York), employing descriptive statistics and Fisher's exact tests to identify factors associated with urinary tract infections. Results The study involved approximately 278 participants. The mean age remained 60 ± 20.279 years, with over half of the participants being female. Common symptoms like fever and lower abdominal pain were observed in 22.30% of cases. The incidence of acute kidney injury was 30.58%. Escherichia coli (36%) and Klebsiella pneumoniae (26%) were the predominant organisms found. Indwelling catheters and other urinary tract conditions were considered risk factors. Patients with at least one risk factor were more likely to receive antibiotics before the urine culture. Similarly, males exhibited a higher prevalence of at least a risk factor than females. Conclusion UTIs are a significant clinical issue in older populations, with females being more susceptible. Fever and abdominal pain were common symptoms. Escherichia coli and Klebsiella pneumoniae were the most frequent causative agents. Further research is necessary to identify risk factors and predictors of antimicrobial resistance in UTI patients.
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Affiliation(s)
- Sincy S Samarawickrama
- Department of Medicine, Goulburn Valley Health, Shepparton, AUS
- Department of Medicine, University of Colombo, Colombo, LKA
| | | | - Ali Uthuman
- Department of Rural Health, University of Melbourne, Shepparton, AUS
- Department of General Medicine, Goulburn Valley Health, Sehpparton, AUS
| | - Vinod Saranga
- Department of Surgery, Sri Jayewardenepura General Hospital, Sri Jayewardenepura Kotte, LKA
| | - Chaminda Janaka
- Department of Medicine, Sri Jayawardenepuera Genral Hospital, Nugegoda, LKA
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Wilson SN, Maffe P, Pant J, Grommersch BM, Handa H. S-Nitroso-N-acetylpenicillamine impregnated latex: A new class of barrier contraception for the prevention of intercourse-associated UTIs. J Biomed Mater Res B Appl Biomater 2024; 112:e35371. [PMID: 38359176 PMCID: PMC10919893 DOI: 10.1002/jbm.b.35371] [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: 08/08/2023] [Revised: 10/31/2023] [Accepted: 01/02/2024] [Indexed: 02/17/2024]
Abstract
Urinary tract infections (UTIs) are some of the most common infections seen in humans, affecting over half of the female population. Though easily and quickly treatable, if gone untreated for too long, UTIs can lead to narrowing of the urethra as well as bladder and kidney infections. Due to the disease potential, it is crucial to mitigate the development of UTIs throughout healthcare. Unfortunately, sexual activity and the use of condoms have been identified as common risk factors for the development of sexually acquired UTIs. Therefore, this study outlines a potential alteration to existing condom technology to decrease the risk of developing sexually acquired UTIs using S-nitroso-N-acetylpenicillamine (SNAP), a nitric oxide (NO) donor. Herein, varying concentrations of SNAP are integrated into commercialized condoms through a facile solvent swelling method. Physical characterization studies showed that 72%-100% of the ultimate tensile strength was maintained with lower SNAP concentrations, validating the modified condom's mechanical integrity. Additionally, the evaluation of room-temperature storage stability via NO release analysis outlined a lack of special storage conditions needed compared to commercial products. Moreover, these samples exhibited >90% relative cell viability and >96% bacterial killing, proving biocompatibility and antimicrobial properties. SNAP-Latex maintains the desired condom durability while demonstrating excellent potential as an effective new contraceptive technology to mitigate the occurrence of sexually acquired UTIs.
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Affiliation(s)
- Sarah N. Wilson
- School of Chemical, Materials and Biological Engineering, College of Engineering, University of Georgia, Athens, GA 30602, US
| | - Patrick Maffe
- School of Chemical, Materials and Biological Engineering, College of Engineering, University of Georgia, Athens, GA 30602, US
| | - Jitendra Pant
- School of Chemical, Materials and Biological Engineering, College of Engineering, University of Georgia, Athens, GA 30602, US
| | - Bryan M. Grommersch
- School of Chemical, Materials and Biological Engineering, College of Engineering, University of Georgia, Athens, GA 30602, US
| | - Hitesh Handa
- School of Chemical, Materials and Biological Engineering, College of Engineering, University of Georgia, Athens, GA 30602, US
- Department of Pharmaceutical and Biomedical Sciences, College of Pharmacy, University of Georgia, Athens, GA 30602, US
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Hassan SA, Ahmed YMA, Hassan GD. Antimicrobial susceptibility of Escherichia coli isolated from diabetic patients in Mogadishu, Somalia. Front Microbiol 2023; 14:1204052. [PMID: 37692408 PMCID: PMC10484611 DOI: 10.3389/fmicb.2023.1204052] [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: 04/11/2023] [Accepted: 08/09/2023] [Indexed: 09/12/2023] Open
Abstract
Background Urinary tract infections (UTIs) are a major concern for diabetic patients due to the impact of diabetes on the urinary tract and immune system. Escherichia coli is the most common pathogen causing UTIs in diabetic patients and is known for its resistance. This study aimed to assess the antimicrobial susceptibility of Escherichia coli strains isolated from diabetic patients in Mogadishu, Somalia. Methods This descriptive cross-sectional study was conducted at Ummah Hospital in Mogadishu, Somalia, from November 2021 to April 2022. Clean catch mid-stream urine specimens were collected from each participant and uropathogens were identified using standard techniques. The samples were cultured on CLED agar and antibiotic susceptibility patterns were determined using the Kirby-Bauer disk diffusion method. Data analysis was performed using SPSS version 20. Results The overall prevalence of uropathogens among diabetic patients was 236/350 (67.5%) with Escherichia coli being the most common organism. According to multivariate logistic regression, the results showed that Female diabetic patients had a significantly higher likelihood of developing UTIs compared to males (AOR = 2.5, 95% CI: 1.357-4.522, p = 0.003). The duration of diabetes, history of previous UTIs, and previous antibiotic use were also significantly associated with UTIs. All isolates were found to be resistant to Cefotaxime (100%). In addition, high resistance rates were observed with ofloxacin (91%), ciprofloxacin (77.8%), amikacin (60.9%), ceftriaxone (58.3%), and cefepime (51.8%). The most sensitive antibiotics were colistin and imipenem (99.6 and 88.6%, respectively), followed by gentamycin (70%). Conclusion This study found a high prevalence of uropathogens and increased multi-drug resistance. Continuous surveillance is needed to monitor uropathogen prevalence and resistance rates, guiding treatment recommendations, rational prescription programs, and policy decisions.
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Affiliation(s)
- Shafie Abdulkadir Hassan
- Department of Medical Laboratory Sciences, Faculty of Medicine and Health Sciences, Jamhuriya University of Science and Technology, Mogadishu, Somalia
- Department of Microbiology, Faculty of Medical Laboratory Sciences, University of El Imam El Mahdi, Kosti, Sudan
| | - Yousif Mousa Alobaid Ahmed
- Department of Microbiology, Faculty of Medical Laboratory Sciences, University of El Imam El Mahdi, Kosti, Sudan
| | - Gallad Dahir Hassan
- Department of Public Health, Faculty of Medicine and Health Sciences, Jamhuriya University of Science and Technology, Mogadishu, Somalia
- School of Public Health and Research, Somali National University, Mogadishu, Somalia
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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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Diriba K, Awulachew E, Bizuneh B. Identification of Bacterial Uropathogen and Antimicrobial Resistance Patterns Among Patients with Diabetic and Hypertension Attending Dilla University General Hospital, Dilla, Ethiopia. Infect Drug Resist 2023; 16:4621-4633. [PMID: 37484906 PMCID: PMC10361459 DOI: 10.2147/idr.s417033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023] Open
Abstract
Background Having a urinary tract infection (UTI) is a serious health issue which is caused by microbial colonization and proliferation in the urinary system. Patients with diabetes and blood pressure are more vulnerable to bacterial urinary tract infections because their host defense is compromised and their urine has a high glucose content. A proper and quick investigation of uropathogen and their antibiogram is key to patient treatment and infection control. Objective Aimed to assess the identification of bacterial uropathogen and antimicrobial resistance patterns among diabetic and hypertension patients attending DUGH, Ethiopia. Methods A Facility-based cross-sectional study was conducted from February to December 2022 among 158 diabetic and hypertensive patients using a clean catch mid-stream urine sample. Pretested structured questionnaires were used to collect data from study participants. Urine samples were taken and cultured on Blood agar, MacConkey agar and CLED Agar for the identification of uropathogen. An antimicrobial susceptibility test was done according to CLSI. Binary and multiple logistic regression were used to assess the association. A P-value less than 0.05 was considered statistically significant. Results The overall prevalence of bacterial uropathogenic among diabetes mellitus and hypertension patients was 15.2%. E. coli (29.2%), coagulase negative Staphylococci (CoNS) (20.8%), K. pneumoniae 3 (12.5%) and S. aureus 2 (12.5%) were the leading isolated uropathogens. In our study, illiterates (AOR =8.1, 95% CI: (5.1-12.4)), participants with high blood glucose levels (AOR=1.81, 95% CI: (1.01-2.21)) and comorbid patients (AOR = 4.2, 95% CI: (4.1-17.2)) were significantly associated with UTI. Both gram-negative and gram-positive isolated bacteria showed higher resistance to most of the commonly used antibiotics. Multidrug resistance was reported in 62.5% of the total isolates. Conclusion This study revealed a high prevalence of bacterial isolate and multidrug resistance. Therefore, continuous monitoring of microbiological and antimicrobial surveillance of UTI among DM patients is crucial for appropriate treatment and infection control.
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Affiliation(s)
- Kuma Diriba
- Department of Medical Laboratory Sciences, Health Science and Medical CollegeDilla University, Dilla, Ethiopia
| | - Ephrem Awulachew
- Department of Medical Laboratory Sciences, Health Science and Medical CollegeDilla University, Dilla, Ethiopia
| | - Bereket Bizuneh
- School of Medicine, Health Science and Medical College, Dilla University, Dilla, Ethiopia
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Tegegne KD, Wagaw GB, Gebeyehu NA, Yirdaw LT, Shewangashaw NE, Kassaw MW. Prevalence of urinary tract infections and risk factors among diabetic patients in Ethiopia, a systematic review and meta-analysis. PLoS One 2023; 18:e0278028. [PMID: 36649227 PMCID: PMC9844928 DOI: 10.1371/journal.pone.0278028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/08/2022] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Urinary tract infection (UTI) is a common clinical problem that comprises 1-6% of medical referrals and includes urinary tract, bladder, and kidney infections. UTI is the most commonly occurring infectious disease in diabetic patients. Therefore, this systematic review and meta-analysis aimed to estimate the prevalence of urinary tract infection and its associated factors in Ethiopia. METHODS The online libraries of PubMed, Google Scholar, Scopus, and Science Direct, were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 16). Forest plots, Begg's rank test, and Egger's regression test were all used to check for publication bias. To look for heterogeneity, I2 was computed, and an overall estimated analysis was carried out. Subgroup analysis was done by region, and publication year. Meta-regression analysis using study-level covariates as predictors of study-level estimates to explore the determinants of potential heterogeneity in our pooled estimates. The pooled odds ratio for related covariates was also calculated. RESULTS Out of 1128 studies assessed, 14 met our criteria and were included in the study. A total of 3773 people were included in the study. The prevalence of urinary tract infection was estimated to be 15.97% (95% CI: 12.72-19.23). According to subgroup analysis, the highest prevalence was observed in the SNNP region (19.21%) and studies conducted in and after 2018 (17.98%). Being female (AOR = 3.77; 95% CI: 1.88, 5.65), being illiterate (AOR = 5.29; 95% CI: 1.98, 8.61), prior urinary tract infection history (AOR = 3.04; 95% CI: 2.16-3.92) were the predictor of urinary tract infection. CONCLUSION The prevalence of urinary tract infections was high in Ethiopia. Female gender, illiteracy, and prior UTI history were associated with urinary tract infections. Since UTIs in diabetic patients has serious medical and public health consequence, screening of UTIs in diabetic patients and early initiation of treatment should become a public health priority.
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Affiliation(s)
- Kirubel Dagnaw Tegegne
- Department of Comprehensive Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
- * E-mail:
| | - Gebeyaw Biset Wagaw
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Natnael Atnafu Gebeyehu
- Department of Midwifery, College of Medicine and Health Science, Wolita Sodo University, Wolita Sodo, Ethiopia
| | - Lehulu Tilahun Yirdaw
- Department of Emergency Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | | | - Mesfin Wudu Kassaw
- School of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
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Ramya SR, Rajendran J, Anandhalakshmi S, Kanungo R. Clinical profile, predisposing risk factors for urinary tract infections and its outcome in diabetics and nondiabetics: The significant variants. JOURNAL OF CURRENT RESEARCH IN SCIENTIFIC MEDICINE 2023. [DOI: 10.4103/jcrsm.jcrsm_57_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
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Magnitude and antimicrobial susceptibility profiles of Gram-Negative bacterial isolates among patients suspected of urinary tract infections in Arba Minch General Hospital, southern Ethiopia. PLoS One 2022; 17:e0279887. [PMID: 36584225 PMCID: PMC9803306 DOI: 10.1371/journal.pone.0279887] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 12/15/2022] [Indexed: 12/31/2022] Open
Abstract
The emergence of drug-resistant Gram-negative bacterial uropathogens poses a grave threat worldwide, howbeit studies on their magnitude are limited in most African countries, including Ethiopia. Therefore, measuring the extent of their drug resistance is essential for developing strategies to confine the spread. A cross-sectional study was conducted at title hospital from 01 June to 31 August 2020. Midstream urine specimens were collected and inoculated onto MacConkey agar. Positive urine cultures showing significant bacteriuria as per the Kass count (>105 CFU/mL) were further subjected to biochemical tests to identify the type of uropathogens. Antimicrobial susceptibility testing was performed by the Kirby-Bauer disk diffusion technique, and potential carbapenemase producers were phenotypically determined by the modified carbapenem inactivation method as per the CLSI guidelines. Data were analyzed using SPSS version 26; P-value <0.05 was considered statistically significant. Totally, 422 patients were included, and the majority were females (54.7%). The prevalence of carbapenem-resistant Gram-negative uropathogens was 12.9%, and 64.7% of them were carbapenemase producers. Klebsiella pneumoniae (n = 5) was the predominant carbapenemase producer, followed by Pseudomonas aeruginosa (n = 4). Consumption of antibiotics prior to six months of commencement of the study, the presence of chronic diseases and hospitalizations were statistically associated with UTI caused by carbapenem-resistant Gram-negative uropathogens. Carbapenemase producers were resistant to most of the antibiotics tested. Our findings highlight the need for periodic regional bacteriological surveillance programs to guide empirical antibiotic therapy of UTI.
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Oumer O, Metaferia Y, Gebretsadik D. Bacterial uropathogens, their associated factors, and antimicrobial susceptibility pattern among adult diabetic patients in two health centers at Kombolcha town, Northeastern Ethiopia. SAGE Open Med 2022; 10:20503121221139149. [PMID: 36457843 PMCID: PMC9706039 DOI: 10.1177/20503121221139149] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 10/28/2022] [Indexed: 08/08/2023] Open
Abstract
OBJECTIVE Urinary tract infection has catastrophic health outcome among diabetes mellitus patients. This study was conducted to investigate prevalence of bacterial uropathogens, their antibiogram, and associated factors among diabetes mellitus patients in Kombolcha town. METHOD Cross-sectional study was done from February to April 2020. A total of 282 study participants were involved and simple random technique was applied for enrollment of subjects. Well-constructed and pre-tested questionnaire was utilized to collect the data. Five to ten milliliters of mid-stream urine specimen was collected for microbiological data. Each sample was inoculated into cystine lactose electrolyte deficient medium, incubated overnight in aerobic atmosphere at 37°C for 24 h and finally biochemical tests were carried out. According to Kirby-Bauer disk diffusion method, the antimicrobial susceptibilities pattern of the bacteria was performed on Mueller-Hinton Agar. The data were analyzed with Statistical Package for Social Sciences version 23. Descriptive statistics, bi-variable, and multivariable logistic regression analyses were performed. For statistical significance association, p value ⩽ 0.05 with a 95% confidence interval was considered. RESULTS The general prevalence of urinary tract infection among study participants was 20.2% (57/282). Being female and having merchant occupation had a statistically significant association. Gram-negative bacteria accounted for 70.2% (40/57) and the leading isolate was Escherichia coli, followed by Klebsiella pneumoniae and Coagulase negative Staphylococcus. About 57.5% gram-negative and 35.3% gram-positive bacteria showed multidrug resistance. CONCLUSION The general prevalence of significant bacteriuria was found to be consistent with similar studies conducted in different areas. The higher multidrug resistance rate was observed for the isolated bacteria. Health-care professionals should give due attention and follow rational antibiotic prescription practices to treat these infections.
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Affiliation(s)
- Ousman Oumer
- Department of Medical Laboratory
Science, Gambela Teacher’s Education and Health Science College, Gambela,
Ethiopia
| | - Yeshi Metaferia
- Department of Medical Laboratory
Science, College of Medicine and Health Sciences, Wollo University, Dessie,
Ethiopia
| | - Daniel Gebretsadik
- Department of Medical Laboratory
Science, College of Medicine and Health Sciences, Wollo University, Dessie,
Ethiopia
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Li L, Li Y, Yang J, Xie X, Chen H. The immune responses to different Uropathogens call individual interventions for bladder infection. Front Immunol 2022; 13:953354. [PMID: 36081496 PMCID: PMC9445553 DOI: 10.3389/fimmu.2022.953354] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/05/2022] [Indexed: 11/13/2022] Open
Abstract
Urinary tract infection (UTI) caused by uropathogens is the most common infectious disease and significantly affects all aspects of the quality of life of the patients. However, uropathogens are increasingly becoming antibiotic-resistant, which threatens the only effective treatment option available-antibiotic, resulting in higher medical costs, prolonged hospital stays, and increased mortality. Currently, people are turning their attention to the immune responses, hoping to find effective immunotherapeutic interventions which can be alternatives to the overuse of antibiotic drugs. Bladder infections are caused by the main nine uropathogens and the bladder executes different immune responses depending on the type of uropathogens. It is essential to understand the immune responses to diverse uropathogens in bladder infection for guiding the design and development of immunotherapeutic interventions. This review firstly sorts out and comparatively analyzes the immune responses to the main nine uropathogens in bladder infection, and summarizes their similarities and differences. Based on these immune responses, we innovatively propose that different microbial bladder infections should adopt corresponding immunomodulatory interventions, and the same immunomodulatory intervention can also be applied to diverse microbial infections if they share the same effective therapeutic targets.
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Affiliation(s)
- Linlong Li
- The School of Basic Medical Sciences, Southwest Medical University, Luzhou, China
| | - Yangyang Li
- The School of Basic Medical Sciences, Southwest Medical University, Luzhou, China
| | - Jiali Yang
- The School of Basic Medical Sciences, Southwest Medical University, Luzhou, China
| | - Xiang Xie
- The School of Basic Medical Sciences, Southwest Medical University, Luzhou, China
- Public Center of Experimental Technology, Model Animal and Human Disease Research of Luzhou Key Laboratory, Southwest Medical University, Luzhou, China
- *Correspondence: Xiang Xie, ; Huan Chen,
| | - Huan Chen
- The School of Basic Medical Sciences, Southwest Medical University, Luzhou, China
- Nucleic Acid Medicine of Luzhou Key Laboratory, Southwest Medical University, Luzhou, China
- *Correspondence: Xiang Xie, ; Huan Chen,
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Antimicrobial Resistance Patterns, Extended-Spectrum Beta-Lactamase Production, and Associated Risk Factors of Klebsiella Species among UTI-Suspected Patients at Bahir Dar City, Northwest Ethiopia. Int J Microbiol 2022; 2022:8216545. [PMID: 35355926 PMCID: PMC8960036 DOI: 10.1155/2022/8216545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 02/28/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Klebsiella species cause pneumonia, UTI, and septicemia in human beings. Beta-lactam drugs are used extensively to treat patients infected with Klebsiella, but most of the Klebsiella species are resistant to third- and fourth-generation cephalosporins and monobactams to which data are scarce in the study area. Objective To determine the prevalence, antimicrobial resistance, ESBL production, and associated risk factors of Klebsiella species among UTI-suspected patients in Bahir Dar City, Northwest Ethiopia. Methods A multi-institution-based prospective cross-sectional study was conducted from January to May 2019. Midstream urines were collected from 385 patients and inoculated onto CLED and MacConkey agars. Identification of growth was done by a battery of biochemical tests. Antimicrobial resistance and ESBL production patterns were determined by using the disc-diffusion method on Mueller–Hinton agar. Quality of data was maintained by following SOPs and using Klebsiella pneumoniae (ACTT700603). Logistic regression statistical analysis was done using the SPSS, version 25, statistical package. A pvalue ≤ 0.05 was considered statistically significant. Results The median age of the study participants was 32 years. Majority of them were female, urban residents, and unable to read and/or write. The total Klebsiella species detected were 38 (9.9%). Of which, 25 (65.8%) were Klebsiella pneumoniae, followed by 6 (15.8%) Klebsiella ozaenae. 20 (80%), 19 (76%), and 19 (76%) Klebsiella pneumoniae showed resistance to amoxicillin/clavulanic acid, ampicillin, and cotrimoxazole, respectively. All K. oxytoca were resistant to ampicillin, and all K. rhinoscleromatis were resistant to cefoxitin and cefotaxime. Klebsiella species that showed resistance to ≥3 antimicrobials were 26 (68%). ESBL-producing Klebsiella species were 10 (26.3%). Patients who had history of antibiotic use, hospitalization, and tight dressing habit had more risk of getting UTI (p < 0.05) than their counterparts. Conclusions Overall UTI prevalence in our study was lower than that of previous Ethiopian studies. High MDR and ESBL-producing Klebsiella species were detected. Patients' history of antibiotic use, hospitalization, and tight dressing habit were risk factors for UTI. It calls up for improving prevention/control systems of Klebsiella species.
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H. Barahim O, AL-Kadassy AM, Pyar H, Bin Dahman LS. Prevalence of Bacterial Urinary Tract Infections Amongst Diabetes Mellitus Patients Attending Ibn-sina General Hospital in Mukalla, Yemen. JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.3923/jms.2022.107.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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H. Barahim O, AL-Kadassy AM, Pyar H, Bin Dahman LS. Prevalence of Bacterial Urinary Tract Infections Amongst Diabetes Mellitus Patients Attending Ibn-sina General Hospital in Mukalla, Yemen. JOURNAL OF MEDICAL SCIENCES 2022; 22:107-112. [DOI: https:/doi.org/10.3923/jms.2022.107.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023] Open
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Khan S, Hashmi MS, Rana MA, Zafar GM, Asif S, Farooq MT, Zahoor S. Frequency of Urinary Tract Infections in Type 2 Diabetic Patients Taking Dapagliflozin. Cureus 2022; 14:e21720. [PMID: 35251794 PMCID: PMC8887691 DOI: 10.7759/cureus.21720] [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] [Accepted: 01/29/2022] [Indexed: 11/08/2022] Open
Abstract
Background Urinary tract infections (UTIs) are common in patients with diabetes. The use of sodium-glucose cotransporter-2 inhibitors (SGLT2i) to achieve good glycemic control increases glucose levels in urine. This glycosuria further enhances the risk of UTIs. This study aimed to evaluate the frequency of UTIs in patients with type 2 diabetes receiving the SGLT2i dapagliflozin as an add-on therapy. Methods We conducted this cross-sectional study at the Endocrinology Department of Hayatabad Medical Complex in Peshawar from April 2020 to September 2020. A total of 400 patients with diabetes receiving either 5 mg or 10 mg of dapagliflozin as an add-on therapy for the treatment of type 2 diabetes were included in this study. We collected blood and urine samples from participants and measured glycosylated hemoglobin levels. Urine samples were cultured on cysteine lactose electrolyte deficient agar. We used IBM SPSS Statistics for Windows, version 25.0 (IBM Corp., Armonk, NY) to analyze our data. Results The prevalence of UTIs in diabetic patients receiving 5 mg or 10 mg of dapagliflozin was 5.3%. Women were more affected (76.2%) than men (p < 0.05). UTIs were more prevalent in patients older than 50 years (85.7%) than in any other age group. The dose strength of dapagliflozin was not associated with UTIs (p > 0.05). Conclusion This study examined UTIs in patients taking dapagliflozin for the treatment of type 2 diabetes. These infections were mild to moderate and were treated easily. None of these infections caused the patient to discontinue the treatment. Dapagliflozin is well-tolerated in patients with diabetes but should be used with appropriate caution and monitoring.
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Goswami T, Krishnamurthy M, Varghese S. A study on the pathogenic microbes and antibiotic-sensitivity patterns in urinary tract infection among diabetes patients at a tertiary care hospital in Central Kerala. JOURNAL OF CURRENT RESEARCH IN SCIENTIFIC MEDICINE 2022. [DOI: 10.4103/jcrsm.jcrsm_15_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Paudel S, John PP, Poorbaghi SL, Randis TM, Kulkarni R. Systematic Review of Literature Examining Bacterial Urinary Tract Infections in Diabetes. J Diabetes Res 2022; 2022:3588297. [PMID: 35620571 PMCID: PMC9130015 DOI: 10.1155/2022/3588297] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 04/11/2022] [Indexed: 11/18/2022] Open
Abstract
This systematic review addresses the central research question, "what is known from the published, peer-reviewed literature about the impact of diabetes on the risk of bacterial urinary tract infections (UTI)?" We examine the results from laboratory studies where researchers have successfully adapted mouse models of diabetes to study the pathophysiology of ascending UTI. These studies have identified molecular and cellular effectors shaping immune defenses against infection of the diabetic urinary tract. In addition, we present evidence from clinical studies that in addition to diabetes, female gender, increased age, and diabetes-associated hyperglycemia, glycosuria, and immune impairment are important risk factors which further increase the risk of UTI in diabetic individuals. Clinical studies also show that the uropathogenic genera causing UTI are largely similar between diabetic and nondiabetic individuals, although diabetes significantly increases risk of UTI by drug-resistant uropathogenic bacteria.
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Affiliation(s)
- Santosh Paudel
- Department of Biology, University of Louisiana at Lafayette, Lafayette, LA, USA 70504
| | - Preeti P. John
- Department of Biology, University of Louisiana at Lafayette, Lafayette, LA, USA 70504
| | | | - Tara M. Randis
- Department of Pediatrics, University of South Florida, Tampa, FL, USA 33620
| | - Ritwij Kulkarni
- Department of Biology, University of Louisiana at Lafayette, Lafayette, LA, USA 70504
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Walelgn B, Abdu M, Kumar P. The occurrence of urinary tract infection and determinant factors among diabetic patients at Dessie Referral Hospital, South Wollo, Northeast Ethiopia. SAGE Open Med 2021; 9:20503121211060614. [PMID: 34868594 PMCID: PMC8640288 DOI: 10.1177/20503121211060614] [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: 08/09/2021] [Accepted: 10/29/2021] [Indexed: 11/15/2022] Open
Abstract
Introduction: Diabetic patients have a higher tendency of developing all infections, especially infections of the genitourinary tract. Urinary tract infections cause considerable disorders in diabetic patients, and if complicated, can cause renal failure. In Ethiopia, the magnitude of diabetes mellitus-associated urinary tract infections increased from 7.1% in 2005 to 33.9% in 2019. The successful management of patients suffering from urinary tract infections in diabetic patients depends upon the identification of risk factors. This study aimed to determine the magnitude and factors affecting the urinary tract infections among diabetic patients which enable professionals to prevent infections and manage them effectively. Methods: Hospital-based cross-sectional study was conducted with 365 diabetic patients selected by systematic sampling technique from March to April 2020. Data were collected by trained BSc nurses via face-to-face interview and patient chart review. Urine microscopy was done to diagnose urinary tract infections. Data were coded and entered using Epi data version 3.1 and exported to Statistical Package of Social Sciences version 26 for analysis. Variables with p-value < 0.25 in bivariable logistic regression were included multivariable logistic regression and variables with a p-value < 0.05 were considered statistically significant. Results: The magnitude of urinary tract infections was 22.3% (95% confidence interval: 18–27). The odds of being infected by urinary tract infections were significantly higher in diabetic females (adjusted odds ratio: 2.46; 95% confidence interval: 1.40–4.32), duration of diabetes mellitus diagnosis of ⩾5 years (adjusted odds ratio: 1.98; 95% confidence interval: 1.05–3.72), with comorbidity (adjusted odds ratio: 4.87; 95% confidence interval: 2.76–8.59) and khat chewer (adjusted odds ratio: 1.84; 95% confidence interval: 1.04–3.24) compared with their counter. Conclusion and recommendation: Urinary tract infections were high among diabetic patients. Predictors like sex, duration of diagnosis, comorbidity, and khat chewer were found to be associated with urinary tract infections. Improvement of the regular screening of patients with diabetes mellitus for urinary tract infections will provide more effective measures in prevention and management.
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Affiliation(s)
- Betelhem Walelgn
- Department of Comprehensive Nursing, School of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Mehd Abdu
- Department of Nursing, College of Medicine and Health Science, Mizan-Tepi University, Mizan Teferi, Ethiopia
| | - Prem Kumar
- Department of Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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Yenehun Worku G, Belete Alamneh Y, Erku Abegaz W. Prevalence of Bacterial Urinary Tract Infection and Antimicrobial Susceptibility Patterns Among Diabetes Mellitus Patients Attending Zewditu Memorial Hospital, Addis Ababa, Ethiopia. Infect Drug Resist 2021; 14:1441-1454. [PMID: 33883912 PMCID: PMC8055279 DOI: 10.2147/idr.s298176] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/25/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Urinary tract infection (UTI) is caused by colonization and growth of microorganisms within the urinary system. Diabetic patients are more prone to bacterial UTI due to impaired host defense and high glucose concentration in urine. Surveillance of uropathogens and their antibiogram is a key to patient management. METHODS A hospital-based cross-sectional study was conducted from May to July, 2018. Urine samples were collected for culture and identification based on the standard protocol. An antimicrobial susceptibility test (AST) was done for all isolates using the Kirby-Bauer disk diffusion method. Data were entered into Epi-data version 3.2.1 and exported to the Statistical Package for the Social Science (SPSS) version 20. RESULTS Out of 225 participants, significant bacteriuria was reported in 9.8% of the cultures. Five species of bacteria were isolated and E. coli (63.6%) was the leading uropathogen, followed by K. pneumoniae (13.6%). Duration of diabetes, previous history of UTIs and symptomatic UTI were found to be strongly associated with significant bacteriuria. Gram-negative bacterial isolates showed high sensitivity to nitrofurantoin and meropenem (100%). In contrast, a high level of resistance to ampicillin, doxycycline and cefuroxime (100%) and to amoxicillin-clavulanate (94.4%) was observed. Gram-positive bacteria showed high level of resistance to penicillin (100%). Multiple-drug resistance (MDR) was high for Gram-negative bacteria (100%). CONCLUSION Previous history of UTIs and duration of diabetes were found to be important factors that increase the prevalence of UTI among diabetes patients. This study also showed a high prevalence of drug resistance to doxycycline, amoxicillin-clavulanate, cefuroxime and penicillin for both Gram-negative and Gram-positive bacteria. Since therapeutic selection for empirical treatment and management should be based on knowledge of the local bacterial profile and antimicrobial response, we suggest physicians take this high resistance profile in to consideration when prescribing antimicrobials against the pathogens in question.
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Affiliation(s)
- Gebremdhin Yenehun Worku
- Department of Microbiology, Addis Ababa Public Health Research and Emergency Management Directorate, Addis Ababa, Ethiopia
| | - Yerega Belete Alamneh
- Department of Microbiology, Immunology and Parasitology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Woldaregay Erku Abegaz
- Department of Microbiology, Immunology and Parasitology, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
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Seo SH, Jeong IS, Lee EJ. Impact of Obesity on Urinary Tract Infections in Korean Adults: Secondary Data Analysis Using Community-Based Cohort Study. J Korean Acad Nurs 2021; 51:150-161. [PMID: 33993122 DOI: 10.4040/jkan.20228] [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: 09/21/2020] [Revised: 01/19/2021] [Accepted: 02/10/2021] [Indexed: 11/09/2022]
Abstract
PURPOSE This study investigated the incidence of urinary tract infection (UTI) in community-dwelling adults and identified the association between obesity and UTI. METHODS The participants were 4,926 adults aged over 40 years who had no UTIs at the baseline survey of the Korean Genome Epidemiology Study. Obesity was defined according to the cirtieria of Korean Society for the Study of Obesity using body mass index (BMI) data. UTI was defined as those who had self-reported UTI or had either nitrite, or both leukocytes and blood in the urine dipstick test. Hazard ratio (HR) and 95% confidence interval (CI) were calculated using a multivariate Cox proportional hazards regression analysis to identify the association between the obesity and UTI. RESULTS The incidence proportion of UTI was 5.1%, and the incidence density per 1,000 person-years was 25.5. After controlling general characteristics, people with BMI ≥30.0 kg/m² remained 1.66 times (HR = 1.66, 95% CI = 1.06~2.60; p < .05) more likely to have UTI than those with normal weight. This trend was also present in men or people aged ≥ 60 years. Among women aged ≥ 60 years, people with BMI ≥ 30.0 kg/m² were 1.98 times (HR = 1.98, 95% CI = 1.01~3.86; p < .05) more likely to have UTI than those with normal weight. CONCLUSION The BMI ≥ 30.0 kg/m² is a risk factor of UTIs in Korean adult men over 40 years and women aged ≥ 60 years. It is necessary to emphasize the importance of obesity management to men or women aged ≥ 60 years, specifically.
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Affiliation(s)
- Seung Hee Seo
- Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ihn Sook Jeong
- College of Nursing, Pusan National University, Yangsan, Korea.
| | - Eun Joo Lee
- Department of Nursing, Dong-Eui University, Busan, Korea
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Norafika, Arbianti N, Prihatiningsih S, Indriani DW, Indriati DW. A retrospective cross-sectional study of urinary tract infections and prevalence of antibiotic resistant pathogens in patients with diabetes mellitus from a public hospital in Surabaya, Indonesia. Germs 2020; 10:157-166. [PMID: 33134193 DOI: 10.18683/germs.2020.1201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/14/2020] [Accepted: 07/15/2020] [Indexed: 12/24/2022]
Abstract
Introduction Diabetes mellitus (DM) is a metabolic disease that can cause many complications. The occurrence of urinary tract infection is also considered to be the cause of complications in patients with DM. This study aimed to evaluate the prevalence of urinary tract infection (UTI) and antibiotic-resistant bacteria found in urine culture from patients with DM in Surabaya, Indonesia. Methods This study was conducted with a retrospective cross-sectional study design, using a database of 1551 patients with DM admitted to Haji Hospital, Surabaya, Indonesia, from January 2017 to December 2018. Data regarding the bacteria isolated from urine and antimicrobial sensitivity were analyzed. Results The prevalence of UTI was 3.93% - 61 patients were confirmed with urine culture for UTI diagnosis. The predominant isolates found were Escherichia coli (24.5%) and Enterococcus faecalis (8%). This study also showed multidrug-resistant organisms (MDRO) found in UTI such as Escherichia coli MDRO (3.3 %), Klebsiella pneumoniae MDRO (3.3%), Acinetobacter baumannii MDRO (1.6%), extended-spectrum beta-lactamase (ESBL) Escherichia coli (3.3%). The E. coli were sensitive to fosfomycin (93%), meropenem (93%) and nitrofurantoin (67%). No significant difference in the prevalence of UTI was found among ages, sex, and duration of disease in all patients with DM. Conclusions The cases of UTI seen in patients with DM show the importance of monitoring UTI occurrence in this patient category to ensure better treatment for these patients.
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Affiliation(s)
- Norafika
- BSc, Team of Antimicrobial Resource Alternative Studies for Emerging and Re-emerging Infectious Disease Research Group, Department of Health, Faculty of Vocational Studies, Universitas Airlangga, Dharmawangsa Dalam Selatan no 28-30, Surabaya, 60286, East Java, Indonesia
| | - Novita Arbianti
- MD, Clinical Microbiologist, Team of Microbiology Laboratory, Haji General Hospital, Surabaya, 60116, East Java, Indonesia
| | - Septiyani Prihatiningsih
- M.OHS (Occupational Health and Safety), Team of Antimicrobial Resource Alternative Studies for Emerging and Re-emerging Infectious Disease Research Group, Department of Health, Faculty of Vocational Studies, Universitas Airlangga, Dharmawangsa Dalam Selatan no 28-30, Surabaya, 60286, East Java, Indonesia
| | - Dwi Wahyu Indriani
- PhD, Physiologist, Division of System Neurophysiology, National Institute for Physiological Science, Okazaki, 444-8585, Japan
| | - Dwi Wahyu Indriati
- Ph.D, Leader of Antimicrobial Resource Alternative Studies for Emerging and Re-emerging Infectious Disease Research Group, Department of Health, Division of Medical Laboratory Technologist, Faculty of Vocational Studies, Universitas Airlangga, Dharmawangsa Dalam Selatan no 28-30, Surabaya, 60286, East Java, Indonesia
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Warning of outbreak of important antibiotic resistance in strains of urology and nephrology wards. GENE REPORTS 2020. [DOI: 10.1016/j.genrep.2020.100684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Hailay A, Zereabruk K, Mebrahtom G, Aberhe W, Bahrey D. Magnitude and Its Associated Factors of Urinary Tract Infection among Adult Patients Attending Tigray Region Hospitals, Northern Ethiopia, 2019. Int J Microbiol 2020; 2020:8896990. [PMID: 32774382 PMCID: PMC7407062 DOI: 10.1155/2020/8896990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/14/2020] [Accepted: 06/17/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Urinary tract infection is a major public health problem in terms of morbidity and mortality worldwide. It ranks as the number one infection which leads to an antibiotic prescription after a physician's visit. However, there are limited studies done on UTI in Ethiopia. Hence, this study was aimed to assess the magnitude of urinary tract infection and its associated factors among adult patients attending hospitals of the Tigray region, Ethiopia. Methods and Material. A hospital-based cross-sectional study was conducted from April to May 2019. Systematic random sampling technique was used to select 472 participants from five randomly selected hospitals in Tigray region. A pretested structured questionnaire through face-to-face interview and patient chart review checklist was used to collect data. Data were analyzed by SPSS version 21. A binary logistic regression model was used to test the association between dependent and independent variables. RESULT The magnitude of urinary tract infection was 86 (18.2%) (95% CI: 14.6%-21.6%). After adjustment of the independent variables, the significant factors associated with urinary tract infection were being female (AOR = 3.50; 95% CI: 1.88-6.51), urine passing frequency < five times in a day (AOR = 2.32; 95% CI: 1.08-4.96), having diabetes mellitus (AOR = 4.03; 95% CI: 1.69-9.63), history of urinary tract infection (AOR = 4.40; 95% CI: 2.31-8.39), <7 glasses of water intake per day (AOR = 2.16; 95% CI: 1.02-4.58), and history of urinary obstructive diseases (AOR = 2.67; 95% CI: 1.03-6.90). Conclusion and Recommendation. The magnitude of urinary tract infection was considerably high. The factors associated with urinary tract infection were sex, less urine passing frequency, diabetes mellitus, low water intake, history of urinary tract infection, and urinary obstructive diseases. Therefore, patients having DM, previous history of UTI, and urinary obstructive diseases should be routinely screened for urinary tract infection and provided with education on voiding urine at least five times a day and on increasing daily water intake.
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Affiliation(s)
- Abrha Hailay
- School of Nursing, Aksum University, Aksum, Ethiopia
| | | | | | - Woldu Aberhe
- School of Nursing, Aksum University, Aksum, Ethiopia
| | - Degena Bahrey
- School of Nursing, Aksum University, Aksum, Ethiopia
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Jankovic V, Jankovic SM, Folic M, Djordjevic Z. Predictors of antibiotic utilization among intensive care unit patients. J Chemother 2020; 32:156-159. [PMID: 32000618 DOI: 10.1080/1120009x.2020.1720342] [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: 10/25/2022]
Abstract
Increased antibiotic utilization in hospital is linked to higher total treatment costs, together with increased length of stay, surgery and emergency admission. The aim of our retrospective cohort study was to investigate predictors of antibiotic utilization per single patient from an intensive care unit (ICU) of a tertiary care, university hospital in Serbia. Average utilization of antibiotics per patient was 23.9 ± 20.4 defined daily doses (DDDs). Diagnosis of systemic infection increased antibiotics utilization per patient for 10.0 DDDs, positive blood culture for 5.4 DDDs, isolation of Pseudomonas spp. for 19.5 DDDs, isolation of Acinetobacter spp. for 6.3 DDDs and injury for 7.3 DDDs per patient. Each new day of hospitalization and each additional drug prescribed increased utilization for further 0.3 DDDs and 1.2 DDDs, respectively. Appropriate and limited use of antibiotics in ICU is of key importance for preserving their effectiveness and decrease of bacterial resistance.
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Affiliation(s)
- Vladimir Jankovic
- Faculty of Medical Science, University of Kragujevac, Kragujevac, Serbia
| | - Slobodan M Jankovic
- Faculty of Medical Science, University of Kragujevac, Kragujevac, Serbia.,Clinical Pharmacology Department, Clinical Centre Kragujevac, Kragujevac, Serbia
| | - Marko Folic
- Faculty of Medical Science, University of Kragujevac, Kragujevac, Serbia.,Clinical Pharmacology Department, Clinical Centre Kragujevac, Kragujevac, Serbia
| | - Zorana Djordjevic
- Department of Hospital Infections Control, Clinical Centre Kragujevac, Kragujevac, Serbia
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Alemu M, Belete MA, Gebreselassie S, Belay A, Gebretsadik D. Bacterial Profiles and Their Associated Factors of Urinary Tract Infection and Detection of Extended Spectrum Beta-Lactamase Producing Gram-Negative Uropathogens Among Patients with Diabetes Mellitus at Dessie Referral Hospital, Northeastern Ethiopia. Diabetes Metab Syndr Obes 2020; 13:2935-2948. [PMID: 32922054 PMCID: PMC7450280 DOI: 10.2147/dmso.s262760] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/29/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To determine the bacterial profile with its associated risk factors and to identify extended spectrum beta-lactamase producing Gram-negative bacterial uropathogens among diabetic patients at Dessie Referral Hospital, Northeastern Ethiopia. MATERIALS AND METHODS A hospital-based cross-sectional study was conducted from May to September 2018. A total of 336 diabetic patients were included using a simple random sampling technique. A structured questionnaire was used to collect socio-demographic and risk factor-related data. A 10-mL mid-stream urine specimen was collected and transported to the microbiology laboratory for culture, antimicrobial susceptibility testing, and detection of ESBL-producing bacteria. The data were entered into SPSS version 22, and descriptive statistics, bivariate and multivariate logistic regression analyses were performed. A p-value ≤0.05 with a 95% confidence interval was considered for statistical significance. RESULTS Among 336 diabetic patients, the overall prevalence of UTI was 11.6%. The predominant bacterial isolate was Escherichia coli 12/39 (30.8%), followed by Klebsiella pneumoniae 11/39 (28.2%) and coagulase-negative staphylococci 7/39 (17.9%). Gram-negative isolates showed 100% resistance to ampicillin, whereas Gram-positive isolates showed a high level of resistance to penicillin and tetracycline. Moreover, MDR was observed among 18 (46.2%) of the isolates and 2 of the isolated Gram-negative bacteria were ESBL producers. Being illiterate (AOR=7.226, 95% CI: (1.478, 35.340), p<0.015), having current symptoms of UTI (AOR = 2.702, 95% CI: (1.102, 6.624), p=0.030), and blood glucose level ≥126 mg/dl (AOR = 2.940, 95% CI: (1.080, 8.005), p=0.035) were significantly associated with the occurrence of bacterial UTI. CONCLUSION The overall prevalence of significant bacteriuria (11.6%) in this study was comparable with some studies in Ethiopia and relatively lower than others. A moderately higher rate of resistance to the commonly used antimicrobial agents was noticed for both Gram-negative and Gram-positive isolates. Health information dissemination should be given about UTI, glycemic control, and habit of drug use for diabetes mellitus patients.
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Affiliation(s)
- Mekuanent Alemu
- Department of Medical Laboratory Science, Dessie Health Science College, Dessie1212, Amhara, Ethiopia
| | - Melaku Ashagrie Belete
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie1145, Ethiopia
- Correspondence: Melaku Ashagrie Belete Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie1145, EthiopiaTel +251- 913867849Fax +251 333115250 Email
| | - Solomon Gebreselassie
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa1176, Ethiopia
| | - Assefa Belay
- Department of Medical Laboratory Science, Dessie Health Science College, Dessie1212, Amhara, Ethiopia
| | - Daniel Gebretsadik
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie1145, Ethiopia
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