Antimicrobial Susceptibility Profile and Immune Response of Bacteria Isolated from Urinary Tract Infections

Vibrio parahaemolyticus and Vibrio vulnificus are naturally occurring estuarine bacteria and are the leading causes of seafood-associated infections and mortality in the United States. Though multiple-antibiotic-resistant V. parahaemolyticus and V. vulnificus strains have been reported, resistance patterns in vibrios are not as well documented as those of other foodborne bacterial pathogens. Salinity relaying (SR) is a postharvest processing (PHP) treatment to reduce the abundances of these pathogens in shellfish harvested during the warmer months. The purpose of this study was to evaluate the antimicrobial susceptibility (AMS), pathogenicity, and genetic profiles of V. parahaemolyticus and V. vulnificus recovered from oysters during an oyster relay study. Isolates (V. parahaemolyticus [n = 296] and V. vulnificus [n = 94]) were recovered from oysters before and during the 21-day relaying study to detect virulence genes (tdh and trh) and genes correlated with virulence (vcgC) using multiplex quantitative PCR (qPCR). AMS to 20 different antibiotics was investigated using microbroth dilution, and pulsed-field gel electrophoresis (PFGE) was used to study the genetic profiles of the isolates. Twenty percent of V. vulnificus isolates were vcgC+, while 1 and 2% of V. parahaemolyticus were tdh+ and trh+, respectively. More than 77% of the V. vulnificus isolates and 30% of the V. parahaemolyticus isolates were resistant to at least one antimicrobial. Forty-eight percent of V. vulnificus and 8% of V. parahaemolyticus isolates were resistant to two or more antimicrobials. All isolates demonstrated a high genetic diversity, even among those isolated from the same site and having a similar AMS profile. No significant effects of the relaying process on AMS, virulence genes, or PFGE profiles of V. vulnificus and V. parahaemolyticus were observed.IMPORTANCE Analysis of the antibiotic resistance profiles of V. vulnificus and V. parahaemolyticus isolated from oysters during this study indicated that more than 48% of V. vulnificus isolates were resistant to two or more antimicrobials, including those recommended by the CDC for treating Vibrio infections. Also, the V. parahaemolyticus isolates showed high MICs for some of the Vibrio infection treatment antibiotics. Monitoring of AMS profiles of this bacterium is important to ensure optimal treatment of infections and improve food safety. Our study showed no significant differences in the AMS profiles of V. vulnificus (P = 0.26) and V. parahaemolyticus (P = 0.23) isolated from the oysters collected before versus after relaying. This suggests that the salinity of the relaying sites did not affect the AMS profiles of the Vibrio isolates, although it did reduce the numbers of these bacteria in oysters (S. Parveen et al., J Food Sci 82:484-491, 2017, https://doi.org/10.1111/1750-3841.13584).

Background Urinary tract infections (UTIs) remain the most common infections diagnosed in in- and outpatients as well as hospitalized patients. Current knowledge on antimicrobial susceptibility pattern for uropathogens is essential to effectively manage UTIs. This study aimed at determining the prevalence of E. coli and its antimicrobial susceptibility profiles among patients presenting with signs and symptoms of UTI in Mulago Hospital in Uganda. Methods Midstream urine samples were collected from 100 patients presenting with signs and symptoms of UTI at the outpatient department of Mulago Hospital. The samples were cultured, and isolates of E. coli and its antimicrobial susceptibility profiles among patients presenting with signs and symptoms of UTI in Mulago Hospital in Uganda. Results Out of 100 patients studied, E. coli and its antimicrobial susceptibility profiles among patients presenting with signs and symptoms of UTI in Mulago Hospital in Uganda. Escherichia coli isolates were highly susceptible to cefotaxime/clavulanic acid (100%) and nitrofurantoin (70%) but showed high resistance to cefuroxime (100%), ceftazidime (100%), nalidixic acid (90%), and ciprofloxacin (90%). Conclusion Escherichia coli, the predominant uropathogen, showed significant multidrug resistance to antibiotics commonly prescribed for the management of UTIs. These findings should form a basis for preliminary decision making on the appropriate line of treatment for UTIs.Escherichia coli isolates were highly susceptible to cefotaxime/clavulanic acid (100%) and nitrofurantoin (70%) but showed high resistance to cefuroxime (100%), ceftazidime (100%), nalidixic acid (90%), and ciprofloxacin (90%).

Should Asymptomatic Bacteriuria Be Systematically Treated in Kidney Transplant Recipients? Results From a Randomized Controlled Trial.

Urinary tract infection (UTI) treatment in primary care is increasingly complicated by antimicrobial resistance (AMR), and antimicrobial susceptibility profiles are rarely available to prescribers at the point of prescription. Susceptibility profiles from previous urine culture results could inform prescribing, but little is known about associations between previous and current susceptibilities and the impact of time between infections (inter-infection time) on these associations. We analysed routinely collected healthcare records of women ≥16 years in Oxfordshire, UK, who had two or more culture-positive urine specimens consistent with a UTI between 2013 and 2019. We used generalized additive logistic models to estimate associations between resistance to each of eight commonly prescribed antibiotics at first UTI and at second UTI, and their interaction with inter-infection time, adjusted for age and calendar year. In 10 216 women, significant associations were observed between AMR at first and second UTIs. For all antibiotics, these were largest for short inter-infection times. Pivmecillinam resistance at first UTI (OR: 41.70; 95% CI: 27.70-62.80), followed by fosfomycin (OR: 19.90; CI: 13.66-28.92) and ciprofloxacin resistance (OR: 19.65; 95% CI: 16.30-23.75), were strongly associated with resistance to the same antibiotic at the second UTI for inter-infection times ≤3 months. Lower magnitude associations were observed for other antibiotics. For UTIs caused by Escherichia coli only, these associations were generally larger. In a cohort of women experiencing UTIs, AMR at the first UTI and inter-infection time were key determinants of AMR in the second UTI. This information could inform empirical antimicrobial treatment to limit treatment failure in women with recurrent UTI.

Urinary tract infections are among the most prevalent extra-intestinal infections, with high prevalence globally. This cross-sectional study established prevalence of bacterial aetiology causing urinary tract infection (UTI) and their antimicrobial susceptibility profiles. A questionnaire was used to capture socio-demographic data and possible UTI risk factors among the 206 consented adults seeking medicare at Kiambu Level 5 Hospital. The collected midstream urine samples were subjected to dipstick analysis, microscopy and culture for UTI diagnosis. Results: The overall prevalence rate of UTIs was 27.6%, with women’s prevalence rate being significantly higher at 80.7% compared to men 19.2%. Pregnant women had UTI prevalence at 34% which was higher than other sets of participants. Women who did not frequently change their underpants daily had a higher UTI cases at 34.8%. Escherichia coli, Staphylococcus aureus and Klebsiella pneumoniae were the most prevalent bacterial pathogens at 38.5%, 21% and 19.3%, respectively. Antimicrobial sensitivity analysis revealed high resistances towards Sulfamethoxazole and Ampicillin at range between 50% - 85%, suggesting that these drugs are no longer effective for UTI empirical treatment. The resistance patterns towards Cefotaxime, Cefepime and Ciprofloxacin were below 40%. However, more resistance patterns at a range between 14% - 40% revealed towards Amoxicillin-clavulanic and Nitrofurantoin imply that these are drugs remain potent but there is the need to revise the current UTI management guidelines. In addition, to elude treatment failure, innovation of prophylactic measures is key to halt UTI contraction and offer support to pharmaceutical industries that have fewer new antibiotics in the pipeline.

Background: Diabetes mellitus has some damaging effects on the genitourinary system and has been found to have adverse effects on the host immune system, resulting in higher risk of infections including urinary tract infections (UTI). Incidences of UTI caused by bacteria have been increasingly reported globally and the abuse of antibiotics leading to evolving resistant strains of antibiotics is a public health challenge for the management of this condition. Information on the difference in types of bacterial agents causing UTI in diabetic patients and non-diabetic individuals, and their susceptibility profiles, will facilitate effective management among these groups of patients. Therefore, this study aimed at determining the difference in prevalence of UTI, the causative bacteria, and their antimicrobial susceptibility profiles in diabetic patients and non-diabetic individuals at a diabetes management center. Methods: This was a prospective cross-sectional study conducted amongst 100 diagnosed diabetic patients and 100 non-diabetic individuals. Urine sample was collected aseptically and analyzed microbiologically for the presence of urinary tract bacterial pathogens. Drug susceptibility testing was conducted on the isolates by the Kirby Bauer method to ascertain the antibiotic susceptibility patterns. Results: Among the diabetic and non-diabetic individuals, urinary tract bacterial pathogens were observed in 28.0% and 26.0% of samples, respectively. The organisms were in the following proportions for diabetic and non-diabetic individuals, respectively: E. coli (14/28, 50% and 8/26, 30.7%), S. aureus (2/28, 7.1% and 4/26, 15.4%), K. pneumoniae (4/28, 14.3% and 8/26, 30.7%), K. ozoenae (2/28, 7.14% and 0/26, 0%), K. oxytoca (0/28, 0% and 4/26, 15.4%) and C. urealyticum (6/28, 21.4% and 2/26, 7.69%). The difference between the proportions of bacteria isolated was, however, not statistically significant (p-value = 0.894). Bacteria isolated from both diabetic and non-diabetic individuals were highly susceptible to most of the antibiotics tested, especially nitrofurantoin, cefuroxime, ceftriaxone, and cefotaxime. Conclusion: This study has shown that similarities exist in prevalence of UTI, the causative bacteria, and their antimicrobial susceptibility patterns amongst diabetic patients and non-diabetic individuals at a diabetes management center. These data will help in the management of UTI among these individuals.

Purpose: Urinary tract infection (UTI) is a common bacterial infection affecting millions worldwide. Escherichia coli (E. coli) is the most prevalent causative agent of UTIs. This study aimed to determine the prevalence, antimicrobial susceptibility profiles and carriage of ESβL resistance genes among uropathogenic E. coli recovered from adults at Mama Lucy Hospital. Methodology: A cross-sectional study was conducted. A purposive method was used to obtain 347 urine samples from patients who presented with symptoms suggestive of UTI and were cultured for E. coli using cysteine lactose electrolyte-deficient agar and eosin methylene blue agar. The collected urine samples were also subjected to dipstick analysis and microscopy. Questionnaires were used to collect sociodemographic data and possible risk factors for urinary tract infections. The recovered isolates were identified using conventional biochemical tests. Antimicrobial susceptibility profiles were determined using the Kirby diffusion disc method. The occurrence of ESβLs, including TEM, OXA, SHV, and CTX-M, was determined by polymerase chain reaction (PCR). Findings: The overall prevalence rate of UTIs was 23.7%, whereas the E. coli prevalence rate was 13.3%. The isolates presented high levels of resistance to trimethoprim-sulfamethoxazole (81.3%), amoxicillin-clavulanic acid (66.7%), ciprofloxacin (62.5%), tetracycline (60.4%), ceftriaxone (54.2%), and cefoxitin (54.2%), whereas they were more susceptible to meropenem (14.6%), chloramphenicol (12.5%), and nitrofurantoin (8.3%). A total of 25 of the 46 E. coli isolates were screened for ESβL genes. TEM was the most common gene21/25 (84%), SHV12/25 (48%), OXA 7/25 (28%), and CTX-M 18/25 (66.1%), which indicates a high frequency of β-lactamase gene production among UTIs causing E. coli. Unique Contribution to Theory, Practice and Policy: Based on these findings, current treatment guidelines should be revised to prevent increasing antimicrobial resistance through continuous surveillance, screening for extended-spectrum beta-lactamase genes, routine culture and antibiotic sensitivity testing. Additionally, the prevalence of UTIs should be continuously monitored to monitor trends that form a basis for preventive and treatment guidelines, such as policy development and prudent use of antibiotics, to reduce the increasing UTI burden in the population.

Urinary Tract Infections in Solid Organ Transplant Recipients

Background: Urinary tract infection (UTI) is a frequent condition encountered in primary care. Treatment is usually empirical without urine culture and susceptibility testing because the causative uropathogens and their antimicrobial susceptibility profiles are considered to be predictable. However, there is increasing evidence of antimicrobial resistance in community- acquired uropathogens. This study aimed to assess the prevalence and antimicrobial susceptibility pattern of uropathogens causing UTI. Methods: A prospective study was conducted over a period of six months in a tertiary care hospital in Kerala, India. A total of 100 patient case records satisfying the inclusion criteria were analysed to determine the prevalence of uropathogens causing UTI and also to determine antibiotic sensitivity pattern of uropathogens to various antibiotics. All the relevant and necessary data of the patient were collected from patient’s case record and microbiology department to study the rational prescribing of antibiotics before and after culture sensitivity test. Data analysis was conducted using Chi-squared test and descriptive statistics. Result: In this study, we observed a higher incidence of UTIs in females, particularly among individuals aged over 70 years. The primary microorganisms isolated from these cases were Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Upon conducting culture sensitivity tests, approximately half of the initially prescribed antibiotics were altered. Penicillin class of antibiotic was frequently substituted, predominantly with drugs from the carbapenem class. Our analysis of antibiotic sensitivity revealed that Imipenem exhibited the highest sensitivity, followed by meropenem and colistin within our study cohort. Furthermore, a chi-square test was conducted, yielding a chi-square value of 12.25 with a p-value less than 0.001, implies that there is a significant difference between drugs given before and after C/S was done. These findings underscore the importance of tailored antibiotic selection based on microbial sensitivity profiles, especially in elderly female patients, to ensure effective treatment outcomes for UTIs. Conclusions: According to the research, UTIs are the most common public health issue, primarily affecting women. Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosawere the most common isolated organisms in our study that caused UTIs in IndiaMost isolates exhibited resistance to widely used antibiotics.Thus, regular surveillance and monitoring are essential for improved patient care.

Objective: The aim of this study was to investigate cases of Urinary tract infection (UTI) and Asymptomatic bacteriuria (ASB) in pregnant women in a Brazilian city, as well as identify the pathogens causing these diseases and its antimicrobial susceptibility profile. Also, we investigated the antibiotic therapy used in pregnant women to treat UTI and ASB, and the comorbidities which can be related to increased risk of these type of infection. Methods: This study was prospective research, descriptive and exploratory, with a qualitative approach, conducted among 35 pregnant women from October 2019 at Basic Health Unit (BHU) in Diadema, São Paulo, Brazil. Patient’s data were obtained using specific terms in the search filters from data base of BHU, as well the results of identification of bacterial species isolated from urine culture and the Antimicrobial Susceptibility Testing (AST). Results: From 35 study participants, 34.3% had a presumptive diagnosis of ASB and 65.7% had a diagnosis of symptomatic UTI. The predominant bacteria isolated were Escherichia coli (n=11) and Staphylococcus saprophyticus (n=2). The AST revealed a low rate of resistance to antimicrobials used for the treatment of UTI. The antimicrobial agents most prescribed was cephalexin. Further, 13 pregnant women presented comorbidities. Also, 20% presented premature delivery and 11,4% babies presented neonatal diseases. Conclusion: In this study, it was possible to know which bacterial species are commonly isolated from pregnant women urine cultures and evaluate the isolates susceptibility profile, as well as analyze the common antimicrobial therapy prescribed to these women.

MANAGEMENT OF URINARY TRACT INFECTIONS: HISTORICAL PERSPECTIVE AND CURRENT STRATEGIES: PART 2— MODERN MANAGEMENT

Background:Urinary tract infections (UTIs) are amongst the most common infections described in outpatients setting.Objectives:A study was conducted to evaluate the uropathogenic bacterial flora and its antimicrobial susceptibility profile among patients presenting to the out-patient clinics of a tertiary care hospital at Jaipur, Rajasthan.Materials and Methods:2012 consecutive urine specimens from symptomatic UTI cases attending to the outpatient clinics were processed in the Microbiology lab. Bacterial isolates obtained were identified using biochemical reactions. Antimicrobial susceptibility testing was performed by the Kirby-Bauer disc diffusion method. Extended spectrum beta lactamase (ESBL) production was determined by the double disk approximation test and the Clinical and Laboratory Standards Institute (formerly NCCLS) confirmatory method.Results:Pathogens were isolated from 346 (17.16%) of the 2012 patients who submitted a urine sample. Escherichia coli was the most frequently isolated community acquired uropathogen accounting for 61.84% of the total isolates. ESBL production was observed in 23.83% of E. coli strains and 8.69% of Klebsiella strains. With the exception of Nitrofurantoin, resistance to agents commonly used as empiric oral treatments for UTI was quite high.Conclusion:The study revealed E. coli as the predominant bacterial pathogen for the community acquired UTIs in Jaipur, Rajasthan. An increasing trend in the production ESBLs among UTI pathogens in the community was noted. Nitrofurantoin should be used as empirical therapy for primary, uncomplicated UTIs.

Urinary tract infections (UTIs) are a public health concern worldwide, with Escherichia coli (E. coli) being the primary cause. Biofilm-forming E. coli increases bacterial resistance to antibiotics, leading to significant morbidity and mortality among patients with UTIs. This study was conducted to determine biofilm formation potential and assess antimicrobial susceptibility patterns of E. coli isolated from adults with suspected UTIs attending Ruhengeri Level Two Teaching Hospital (RLTTH), Rwanda. A cross-sectional laboratory-based study was conducted between April and June 2025 on 151 adults with suspected UTIs. A questionnaire was used to record sociodemographic characteristics and risk factors contributing to UTIs among the participants. Midstream urine samples were collected, cultured, and biochemically analyzed to identify E. coli in urine samples. Antimicrobial susceptibility profiles were determined using the disc diffusion method. Biofilm production in E. coli isolates was detected using Congo Red Agar (CRA) method. Of 151 adults, 64.2% were female and 35.8% male, and the majority of participants were in the age group of 29-39 years (34.4%). E. coli accounted for 37/151 (24.5%) isolates, of which 16 (43.2%) were confirmed biofilm producers. High resistance was observed for amoxicillin (100%), trimethoprim-sulfamethoxazole (93.8%), nitrofurantoin (87.5%), ampicillin (87.5%), cefixime (56.2%), gentamycin (50%), and ceftazidime (37.5%). Ciprofloxacin and meropenem were effective. Age was the only risk factor associated with biofilm production by E. coli in the study population (p = 0.000). This study highlights the critical role of E. coli in biofilm production in adults with UTI at RLTTH. A high prevalence of drug resistance was observed among biofilm-producing strains. Intervention strategies, such as frequent biofilm screening, continuous surveillance, and enhanced antimicrobial stewardship programs, are needed.

Introduction: Urinary tract infections (UTIs) affect people worldwide. Escherichia coli is the main agent of UTI, however the etiology may vary according to the age and sex of the patient. Regional variations in the prevalence and antimicrobial resistance should be considered for therapy choice. Objectives: This study aimed to conduct a survey on the main agents of UTI, and assess the resistance of these microorganisms, during the period of March 2010 to June 2012 in the city of Jatai-GO. Method: A retrospective cross-sectional study were performed, collecting data on the prevalence of uropathogens and their sensitivity profiles which were evaluated by disk diffusion method. Results: During this period, 2,181 urine cultures were evaluated, of which 510 (23.4%) were positive, predominantly female (81.4%) and aged between 21 and 64 years old (59.7%). The most frequently isolated microorganism was E. coli (61%), followed by Staphylococcus saprophyticus (9.4%), and Proteus (9.4%). The prevalence of these bacteria according to the patient sex has suffered a statistically significant change (p < 0.05). It was possible to detect high resistance rate of E. coli to some antibiotics of choice for UTI treatment, such as ampicillin (57.9 %), pipemidic acid (50.5 %), nalidixic acid (48.6 %), and trimethoprim-sulfamethoxazole (44.8%). Conclusion: These data demonstrate the need to know the reality of each region in order to establish an appropriate empirical therapy, when it is not possible to perform culture and antimicrobial susceptibility testing.

Prevalence of gram-negative bacterial causes of urinary tract infection and their antimicrobial susceptibility profile at the university teaching hospitals in Lusaka, Zambia