MP8-05 SEVEN HOURS TO DEFINITIVE ANTIMICROBIAL THERAPY IN URINARY TRACT INFECTION USING ISOTHERMAL MICROCALORIMETRY

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder1 Apr 2014MP8-05 SEVEN HOURS TO DEFINITIVE ANTIMICROBIAL THERAPY IN URINARY TRACT INFECTION USING ISOTHERMAL MICROCALORIMETRY Gernot Bonkat, Georg Mueller, Adrian Egli, Andreas Widmer, Reno Frei, Malte Rieken, Armin Halla, Stephen Wyler, Thomas Gasser, Alexander Bachmann, and Olivier Braissant Gernot BonkatGernot Bonkat More articles by this author , Georg MuellerGeorg Mueller More articles by this author , Adrian EgliAdrian Egli More articles by this author , Andreas WidmerAndreas Widmer More articles by this author , Reno FreiReno Frei More articles by this author , Malte RiekenMalte Rieken More articles by this author , Armin HallaArmin Halla More articles by this author , Stephen WylerStephen Wyler More articles by this author , Thomas GasserThomas Gasser More articles by this author , Alexander BachmannAlexander Bachmann More articles by this author , and Olivier BraissantOlivier Braissant More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.348AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Drug resistance is more and more commonly encountered in the setting of urinary tract infection (UTI) and threaten the life of many patients. In most cases empirical antibiotic therapy needs to be initiated as drug susceptibility results can take up to 72 hours before being available. In this context we aim to use isothermal microcalorimetry (IMC) to assess drug resistance pattern of UTI causative pathogens within 6 to 7 hours. METHODS For this proof of concept study we used 8 strains of E. coli isolated at our institution and presenting different antibiotic resistance patterns (ciprofloxacin resistant strains and extended beta-lactamase spectrum strains (ESBL)). The strains were diluted to a final concentration of 5x10e4 CFU/mL. Artificial urine was added with 6 different antibiotics (ciprofloxacin, cotrimoxazole, ceftriaxone, amoxicillin, piperacillin and ertapenem) at breakpoint concentrations. A microcalorimetry instrument (TAM48, TA Instruments, New Castle, DE) equipped with 48 channels was used to follow bacterial growth (or its absence). Results were quantified with respect to growth parameters and an inhibition index was calculated for each antibiotic. The inhibition indexes were compared to the resistance pattern obtained by conventional cultures. RESULTS Inhibition indexes for each antibiotic corresponded well to the strain resistance pattern obtained by conventional culture. Ciprofloxacin resistant and ESBL strains were detected correctly. The time until an accurate assessment of the drug susceptibility patterns could be delivered using IMC was about 6 hours. An additional hour for sample handling needs to be added to this value. CONCLUSIONS The results obtained here strongly suggest that urine from UTI patients can be directly analyzed using IMC. Time to results is expected to be very close to the one obtained here. Even shorter delivery time can be expected as our inoculum seize was rather low. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e76 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Gernot Bonkat More articles by this author Georg Mueller More articles by this author Adrian Egli More articles by this author Andreas Widmer More articles by this author Reno Frei More articles by this author Malte Rieken More articles by this author Armin Halla More articles by this author Stephen Wyler More articles by this author Thomas Gasser More articles by this author Alexander Bachmann More articles by this author Olivier Braissant More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...