Etiology Of Urinary Tract Infections Research Articles

Lactobacillus rhamnosus PL1 and Lactobacillus plantarum PM1 versus Placebo as Prophylaxis for Recurrence of Urinary Tract Infections in Children.

Urinary tract infections (UTIs) rank among the most prevalent bacterial infections in children. Probiotics appear to reduce the risk of recurrence of UTIs. This study aimed to evaluate whether probiotics containing Lactobacillus rhamnosus PL1 and Lactobacillus plantarum PM1 therapy prevent UTIs in the pediatric population compared to a placebo. A superiority, double-blind, randomized, controlled trial was conducted. In total, 54 children aged 3-18 years with recurrent UTIs or ≥one acute pyelonephritis and ≥one risk factor of recurrence of UTIs were randomly assigned (27 patients in each arm) to a 90-day probiotic or placebo arm. The age, sex, diagnosis, renal function, risk factors, and etiology of UTIs did not vary between the groups. During the intervention, 26% of children taking the probiotic had episodes of UTI, and it was not significantly less than in the placebo group. The number of UTI episodes during the intervention and the follow-up period decreased significantly in both groups, but the difference between them was insignificant. We observed a decrease in UTIs during the study of almost 50% in the probiotic group compared to the placebo group. Probiotics can be used as natural, safe prophylaxis for children with risk factors for UTIs in whom antibiotic prevention is not indicated.

Prevalence and Antibiotic Susceptibility of Urinary Tract Infections in Diabetic and Non Diabetic Individuals: A Prospective Study

Background & Objectives: Diabetes mellitus is increasingly recognized as a major health concern worldwide, particularly in developing countries like India. Diabetic individuals are known to have a higher susceptibility to urinary tract infections (UTIs), compounded by the emergence of drug-resistant uropathogens. This study aims to determine the prevalence and etiology of UTIs in diabetic patients. Materials and Methods: A cross-sectional prospective study involving 220 individuals was conducted from March to April 2023 to assess the spectrum of pathogens causing UTIs and their antibiotic susceptibility. Primary cultures were performed on McConkey agar and sheep blood agar, followed by identification and antimicrobial susceptibility testing (AST) using the Vitek2 system and Kirby Bauer's disc diffusion method on Mueller-Hinton agar. Results: Of the 220 samples tested, 150 exhibited significant bacteriuria, with 36 (75%) of 48 diabetic individuals testing positive for UTIs. Gram-negative bacilli (GNB) accounted for 135 (61.4%) isolates, with Escherichia coli (E. coli) being the most prevalent pathogen (52.7%), followed by Klebsiella spp. (25.3%). Among gram-positive organisms, Enterococcus spp. (5.3%) were predominant, with Candida isolates detected in 3 cases (2%). Meropenem (87.6%) exhibited the highest susceptibility against GNB, followed by Netilmycin (87.6%) and Imipenem (82.5%). For gram-positive organisms, Imipenem and Nitrofurantoin demonstrated high susceptibility. Conclusion: E. coli emerged as the predominant pathogen in both diabetic and non-diabetic populations. High sensitivity to meropenem, imipenem, amikacin, and fosfomycin was observed in both groups, suggesting their potential for empirical treatment. Regular surveillance of drug resistance patterns is crucial for identifying evolving resistance trends and optimizing treatment strategies.

Prescription pattern of antibiotics in urinary tract infection based on antimicrobial susceptibility test at a tertiary care hospital

Introduction: Urinary tract infection is a common bacterial infection associated with significant morbidity, mortality, and financial burden. This study aimed to identify the causative bacteria, assess their antimicrobial susceptibility patterns and evaluate empirical and definitive antibiotic therapy for urinary tract infection. Methods: A hospital-based crosssectional study was conducted at the outpatient medicine department at a teaching hospital in Nepal from February 15 to July 14, 2022. Two hundred participants with positive urine cultures and antimicrobial susceptibility testing were included. The microorganism causing urinary tract infection and prescription pattern of antibiotics pre-and post-AST report were analyzed. Results: The majority of isolated pathogens were gram-negative bacteria (73%), with Escherichia coli being the most common (53.5%), followed by Staphylococcus aureus among gram-positive bacteria (14.5%). Female patients had a higher incidence of urinary tract infection (59.5%) than males (40.5%). The age group above 60 years had the highest occurrence (34%). Antibiotic susceptibility testing revealed that Escherechia coli exhibited higher sensitivity to nitrofurantoin, amikacin, and meropenem, while resistance was observed against ampicillin, cefixime, and norfloxacin. Empirical antibiotics were commonly prescribed, with levofloxacin and ceftriaxone being the most frequent choices. After antibiotic susceptibility testing, nitrofurantoin and levofloxacin were frequently prescribed. Conclusions: This study provides valuable insights into the etiology of urinary tract infection and antibiotic susceptibility patterns, aiding in selecting appropriate antimicrobial therapy based on local resistance patterns.

Pre- and Post-COVID-19 Appraisal of Antimicrobial Susceptibility for Urinary Tract Infections at an Outpatient Setting of a Tertiary Care Hospital in Delhi.

This study was conducted to understand the effect of the COVID-19 pandemic on urine culture and sensitivity results in an outpatient setting. There are plenty of data from inpatient and ICU settings but there is a paucity of data in outpatient or community settings. Thus, this study primarily targeted change in antibiotic resistance of urinary tract infection (UTI) agents in the pre- and post-COVID-19 period. In the study, urine samples received in the Department of Laboratory Medicine (microbiology laboratory) with a preliminary diagnosis of UTI between April 2019 and March 2021 were analyzed. Urine cultures and antibiotic susceptibility tests of the patients included in the study were examined in two periods (pre-pandemic and post-pandemic). A total of 22,372 urine samples were received in the pre-pandemic period (April 2019 to March 2020) and 4885 samples in the post-pandemic period (April 2020 to March 2021). The positivity rate obtained from urine cultures sent post-COVID-19 pandemic (16%) was significantly higher than those sent before the COVID-19 pandemic (8%). According to cultures and antibiogram results, resistance to ampicillin, amikacin, ceftazidime (p < 0.05), co-trimoxazole, levofloxacin, gentamicin (p < 0.05), nitrofurantoin, fosfomycin, and tetracycline decreased compared with the pre-COVID-19 period. In this study, we found that the frequency of significant bacteriuria increased significantly in the post-pandemic period. However, resistance to antibiotics decreased significantly in the post-COVID-19 period compared to the pre-COVID-19 period. There was no significant change in the etiology of UTI during the two time periods.

BACTERIOPHAGE COCKTAIL EXHIBITED SUPERB ANTIBACTERIAL AND ANTIBIOFILM ACTIVITY AGAINST SELECTED UROPATHOGENS

Urinary tract infections (UTIs) are most abundant bacterial infection worldwide. Approximately 150 million urinary tract infections occur every year globally. The predominant pathogens involved in etiology of UTI are Escherichia coli followed by Staphylococcus spp., Pseudomonas aeruginosa, Proteus spp., Klebsiella spp., Acinetobacter spp., Enterobacter spp., Citrobacter spp., and Enterococcus spp. It is estimated that uropathogenic E. coli (UPEC) cause 80% of UTIs cases. The over use of anti-microbial agents has extraordinarily amplified the rise of multidrug resistant (MDR) uropathogens. Biofilm formation by UPEC is also a major cause of antimicrobial resistance. To curb harmful ripple effects of antibiotic resistance we need to identify alternative treatment procedures. Bacteriophages are bacterial viruses that can invade and infect bacteria. Phage therapy is considered as best alternate to combat several antimicrobial resistant pathogens, including MDR uropathogens. The aim of this research was to isolate and characterize lytic bacteriophages from sewage water and to identify antibacterial and antibiofilm activity of isolated bacteriophage against UPEC. Hazara University Mansehra was the subject of the research. Bacterial samples of UPEC were collected from Ayub Teaching Hospital Abbottabad and Punjab University Lahore. Various biochemical tests including Gram staining, oxidase and catalase test were performed to identify UPEC. The isolated bacteriophages were confirmed by spot assay and plaque assay against the host bacterial strain. The phages were purified by serial dilution up to 5-6 times repeatedly. For morphological studies electron microscopy was performed. The specificity, lytic activity and efficient bacterial growth reduction ability of isolated phages in this study emphasize that these phages could be a suitable therapeutic agents for treatment of MDR infections.

Bacterial Etiology of Urinary Tract Infection and Antibiogram Profile in Children Attending Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia.

Bacterial urinary tract infections are important public health problems in children. This study was conducted to identify the bacterial agents of urinary tract infections and antibiogram patterns in children. A hospital-based cross-sectional study including 220 children was carried out between November 15, 2021, and March 10, 2022. Simple random sampling was used to enroll participants. The sociodemographic and clinically pertinent information was gathered using a semi-structured questionnaire. Every participant in the study who was ≤15 years old gave clean-catch midstream urine. Urine samples were inoculated onto a cystine lactose electrolyte-deficient agar using a calibrated inoculating loop with a 0.001 ml capacity and then incubated aerobically for 24 hours at 37°C. Subculturing for significant bacteriuria was done on MacConkey and blood agar. Gram staining, biochemical assays, and colony characteristics were used for bacterial identification. The disc diffusion method developed by Kirby and Bauer was used for antimicrobial susceptibility testing. SPSS software version 25 was used for data entry and analysis. To find the risk factors, bivariate and multivariate logistic regression analyses were performed. An association was deemed statistically significant if the p value at the 95 percent confidence interval was less than 0.05. In this study, the majority (50.5%) of the study participants were males. The mean age of the study participants was 6 ± 0.91 years. It was found that 31.8% of children had urinary tract infections. The most prevalent urinary pathogens among the isolates were E. coli (27.1%) and S. aureus (18.6%). Approximately 56% of the participants were infected with multidrug-resistant pathogens. Additionally, compared to children who have never had a urinary tract infection, children with a history of infection had 1.04 (95 percent confidence interval (CI): 0.39, 2.75) times higher risk of infection. This study has shown an alarming increase in the prevalence of pediatric urinary tract infections which warrants further investigation into multidrug-resistant bacterial infection.

A Review of Urinary Tract Infections in Pediatric Patients

Urinary tract infections (UTIs) are a common and significant health concern in children. The etiology of UTIs in children can vary depending on various factors, including age, gender, and underlying conditions. This comprehensive review aims to explore the etiology, pathogens involved, etiological evaluation by age group, diagnosis, differential diagnosis, follow-up, treatment, and prognosis of UTIs in children. Introduction: Urinary tract infections (UTIs) are bacterial infections that affect the urinary system, comprising the kidneys, ureters, bladder, and urethra. In children, UTIs can cause substantial morbidity if not promptly diagnosed and treated. Understanding the etiology and appropriate management strategies is crucial for healthcare providers involved in the care of pediatric patients. Etiology of UTIs in Children: UTIs in children can have various etiological factors, with the most common cause being bacterial invasion of the urinary tract. The majority of UTIs are caused by Gram-negative bacteria, with Escherichia coli being the predominant pathogen. Other potential pathogens include Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis, and Staphylococcus saprophyticus. Viral and fungal infections can also contribute to UTIs in certain cases. Pathogens Involved in the Etiology of UTIs: A detailed examination of the pathogens involved in UTIs is essential for appropriate diagnosis and treatment. E. coli, which colonizes the gastrointestinal tract, is responsible for the majority of UTIs in children. Understanding the antibiotic resistance patterns of these pathogens is crucial in selecting appropriate antimicrobial therapy. Etiological Evaluation by Age Group: The etiological evaluation of UTIs in children varies according to age group. Infants, young children, and older children may exhibit different risk factors and underlying conditions that contribute to UTIs. An age-specific approach is necessary to identify the potential causes, such as urinary tract abnormalities, voiding dysfunction, or anatomical abnormalities. Diagnosis of UTIs in Children: Accurate and timely diagnosis of UTIs is crucial to prevent complications and recurrent infections. Various diagnostic tools, including urinalysis, urine culture, and imaging studies, aid in identifying UTIs and determining the severity of infection. Clinical symptoms, such as fever, dysuria, and urinary frequency, must also be considered in the diagnostic process. Differential Diagnosis: UTIs can present with symptoms similar to other conditions, leading to diagnostic challenges. Differential diagnoses may include conditions such as pyelonephritis, urinary tract stones, urethritis, and sexually transmitted Open Access Journal of Urology &amp; Nephrology 2 Parlak ME and Kucukkelepce O. A Review of Urinary Tract Infections in Pediatric Patients. J Urol Nephrol 2023, 8(3): 000238. Copyright© Parlak ME and Kucukkelepce O. infections. An understanding of these potential differentials is essential to avoid misdiagnosis and provide appropriate treatment. Follow-up and Monitoring: After initiating treatment for UTIs, regular follow-up and monitoring are necessary to ensure the resolution of infection, assess treatment response, and prevent complications. Monitoring urine culture results, renal function, and imaging studies play a vital role in evaluating the effectiveness of treatment and detecting any underlying conditions that require further management. Treatment of UTIs in Children: Treatment of UTIs in children involves antimicrobial therapy targeted at the identified pathogen. The choice of antibiotics should consider local resistance patterns, age of the child, and severity of infection. Adequate hydration, symptomatic relief, and addressing predisposing factors are also important in the overall management of UTIs. Prognosis: With timely diagnosis and appropriate treatment, the prognosis for UTIs in children is generally favorable. However, the presence of underlying conditions, delayed diagnosis, or recurrent infections can influence the long-term outcome. Identifying and managing risk factors and promoting good urinary hygiene can help prevent future UTIs and potential complications. Conclusion: Urinary tract infections in children present unique challenges in terms of etiology, diagnosis, and management. Understanding the etiological factors, pathogens involved, appropriate diagnostic approaches, and treatment strategies is crucial for healthcare providers. By implementing a comprehensive approach that considers age-specific evaluations, accurate diagnosis, and effective treatment, healthcare professionals can ensure optimal outcomes and reduce the burden of UTIs in children.

Bacterial etiology of urinary tract infections in patients treated at Kenyan health facilities and their resistance towards commonly used antibiotics.

Evidence-based empirical antibiotic prescribing requires knowledge of local antimicrobial resistance patterns. The spectrum of pathogens and their susceptibility strongly influences guidelines for empirical therapies for urinary tract infections (UTI) management. This study aimed to determine the prevalence of UTI causative bacteria and their corresponding antibiotic resistance profiles in three counties of Kenya. Such data could be used to determine the optimal empirical therapy. In this cross-sectional study, urine samples were collected from patients who presented with symptoms suggestive of UTI in the following healthcare facilities; Kenyatta National Hospital, Kiambu Hospital, Mbagathi, Makueni, Nanyuki, Centre for Microbiology Research, and Mukuru Health Centres. Urine cultures were done on Cystine Lactose Electrolyte Deficient (CLED) to isolate UTI bacterial etiologies, while antibiotic sensitivity testing was done using the Kirby-Bauer disk diffusion using CLSI guidelines and interpretive criteria. A total of 1,027(54%) uropathogens were isolated from the urine samples of 1898 participants. Staphylococcus spp. and Escherichia coli were the main uropathogens at 37.6% and 30.9%, respectively. The percentage resistance to commonly used drugs for the treatment of UTI were as follows: trimethoprim (64%), sulfamethoxazole (57%), nalidixic acid(57%), ciprofloxacin (27%), amoxicillin-clavulanic acid (5%), and nitrofurantoin (9%) and cefixime (9%). Resistance rates to broad-spectrum antimicrobials, such as ceftazidime, gentamicin, and ceftriaxone, were 15%, 14%, and 11%, respectively. Additionally, the proportion of Multidrug-resistant (MDR) bacteria was 66%. High resistance rates toward fluoroquinolones, sulfamethoxazole, and trimethoprim were reported. These antibiotics are commonly used drugs as they are inexpensive and readily available. Based on these findings, more robust standardised surveillance is needed to confirm the patterns observed while recognising the potential impact of sampling biases on observed resistance rates.

The Etiology of Urinary Tract Infections among Pregnant Women in a Tertiary Care Hospital- A Prospective Observational Study

Introduction: Urinary tract infections (UTIs) are a common health issue among pregnant women, leading to adverse maternal and neonatal outcomes. Despite this, the etiology of UTIs among pregnant women, particularly in resource-limited settings like Bangladesh, is poorly understood. Methods: This prospective observational study was conducted at the Department of Obstetrics and Gynecology, Holy Family Red Crescent Medical College Hospital, Dhaka, Bangladesh. A total of 120 pregnant women with UTIs, admitted between January 2021 and June 2022, were included in the study following specific inclusion and exclusion criteria. Result: The majority of the women was aged 18-24 years (35.83%) and had secondary education (32.50%). Anemia and proteinuria were present in 31.67% and 20.00% of the women, respectively. The primary obstetric characteristic was being primigravida (60.00%). Key risk factors of UTIs included a history of UTI (25.00%), diabetes mellitus (12.50%), frequent sexual activity (33.33%), history of urinary tract abnormalities (8.33%), use of urinary catheters (4.17%), and recent antibiotic use (20.83%). The primary etiological agent was Escherichia coli (60.00%). Conclusion: The findings underscore the need for comprehensive antenatal care, including routine screening for UTIs, anemia, and proteinuria among pregnant women in Bangladesh. Targeted interventions, such as health education and improved sanitation, are recommended to mitigate the identified risk factors. Further research on antimicrobial resistance patterns among the identified etiological agents is warranted to guide appropriate antimicrobial therapy.

Inhibitive Properties of Anredera Cordifolia Extract on Escherichia Coli Swimming Motility

Background Escherichia coli, a Gram-negative bacterium, is one of the main etiology of urinary tract infection (UTI). An important pathogenicity factor influencing biofilm production is its motility, swimming, or swarming. Anredera cordifolia (AC) leaves have been proven to have an antibacterial effect on various Gram-positive and Gram-negative bacteria, including E. coli.Objective To determine the effect of AC leaves extract on swimming motility property of E. coli derived from UTI patients. Methods AC leaves were extracted with the maceration method. E. coli was identified and isolated from UTI patients. There are4 diluting concentrations of AC leaves extract (from 875 mg per ml to 7000 mg per ml) and one negative control. The preparation underwent incubation, inoculation, and re-incubation. Swimming motility was measured manually, and the result was tested for significant difference between each dose with one-way ANOVA (limit of significance is 0.05)Results On AC leaves extract concentration of 1750 mg per ml, the swimming motility has been inhibited significantly compared to negative control and lower concentration of 875 mg per ml (0.543 cm vs 1.673 cm and 1.358 cm, respectively; p &lt; 0.001). Increasing concentration (3500 mg per ml and 7000 mg per ml) did not show a significant difference in inhibition compared to 1750 mg per ml (0.539 cm and 0.530 vs 0.543).Conclusion AC leaves extract with a concentration of at least 1750 mg per ml would inhibit the swimming motility of E. Coli derived from UTI patients.

Bacterial and Fungal Profile, Antibiotic Susceptibility Patterns of Bacterial Pathogens and Associated Risk Factors of Urinary Tract Infection Among Symptomatic Pediatrics Patients Attending St. Paul's Hospital Millennium Medical College: A Cross-Sectional Study.

BackgroundUrinary tract infection is a common infection in pediatrics. Understanding the common etiology of urinary tract infections, their antimicrobial susceptibility pattern, and associated risk factors in a particular setting can provide evidence for the appropriate treatment of the cases.PurposeThe current study is aimed to determine the common etiology and prevalence of uropathogens associated with urinary tract infection, as well as the antibiotic susceptibility profile of bacterial isolates, and to identify risk factors associated with urinary tract infection among pediatric patients.Materials and MethodsThe study was conducted at St. Paul Hospital Millennium Medical College between October 2019 and July 2020. Urine was collected aseptically from patients, inoculated onto culture media, and incubated at 37 °C for 18–48 hours. Bacteria and yeast were identified following standard procedures. Antibiotic susceptibility testing of bacterial pathogens was carried out by the Kirby Bauer disc diffusion method. Descriptive statistics and logistical regressions were used to estimate the crude ratio with a 95% confidence interval. P-value < 0.05 was considered significant.ResultsSignificant bacterial/fungal growth was observed in 65 samples giving a prevalence of 28.6% of which 75.4% (49/65) and 24.6% (16/65) were bacterial and fungal pathogens, respectively. About 79.6% of bacterial etiology were Escherichia coli and Klebsiella pneumoniae. The highest resistance was observed against ampicillin (100%), cefazolin (92.1%), and trimethoprim-sulfamethoxazole (84.1%), both of which are commonly used for empirical treatment in Ethiopia. Length of hospital stay (P=0.01) and catheterization (P=0.04) were statistically associated with urinary tract infection.ConclusionThe high prevalence of urinary tract infection was observed in our study. Enterobacteriaceae were the major cause of urinary tract infection. Length of hospital stay and catheterization were significantly associated with urinary tract infection. Both Gram-negative and Gram-positive bacteria were extremely resistant to ampicillin and trimethoprim-sulfamethoxazole.

Incidence, risk factors and microbiological aetiology of urinary tract infections in admitted stroke patients at a teaching hospital in Zimbabwe: A prospective cohort study

SummaryBackground and purposeThe occurrence of urinary tract infections (UTIs) after stroke is a well recognised complication. The aim of this study was to determine the incidence of UTIs in stroke patients admitted at a teaching hospital in Zimbabwe.MethodsA prospective cohort study was conducted in stroke patients admitted within 7 days from onset of stroke. Patients were followed up throughout the admission period and those with symptomatic UTI were identified. Urine samples for analysis were collected and causative bacterial organisms were identified with their antibiotic susceptibility patterns analysed.ResultsA total of 145 stroke patients were followed up during their in-patient care. 28 patients (19.3%) developed a urinary tract infection, 45 patients (31%) had asymptomatic bacteriuria and 72 patients (49.7%) had no bacteriuria. The median time from admission to UTI occurrence post stroke was 5 (IQR 4–7) days. Severe stroke (NIHSS score 16–42) was an independent risk factor for UTI development with an odds ratio (OR) 5.15 (1.68–15.75) p<0.001.The commonest bacterial causative organisms cultured were Escherichia coli (27.6%) ; Klebsiella species (21.1%) and Enterococcus faecalis (19.7%). Twenty nine percent of the cultured Gram negative bacteria were extended-spectrum beta-lactamase (ESBL) producers.ConclusionsUTIs are common in admitted stroke patients and a significant percentage of causative organisms are multi-drug resistant. UTI occurrence is more common in patients with severe stroke and is associated with increased hospital stay. These observations highlight the need for robust infection prevention and control strategies to curb this common post-stroke complication.

An Overview: Antibiotic Sensitive Pattern in Urinary Tract Infection

Urinary tract infections (UTIs) are the inflammatory disorders of the urinary tract caused by the abnormal growth of pathogens. Urinary tract infections can be community acquired or nosocomial. Symptoms of UTIs such as fever, burning sensations while urinating, LAP, itching, formation of blisters and ulcers in the genital area, genital and supra pubic pain, and pyuria generally depend on the age of the person infected the location of the urinary tract infected. E.coli is the major etiologic agent in causing UTI, which accounts for up to 75%-90% of cases whereas Staphylococcus saprophyticus causes an estimated 5 - 1 5% of UTIs frequently in younger women. P. mirabilis, Klebsiella species, P. aeruginosa and Enterobacter species are less frequent offenders. Less commonly, Enterococci, G. vaginalis and U. urealyticum are also known agents in UTIs. Due to the rapidly evolving adaptive strategies of bacteria, the etiology of UTI and antibiotic resistance profile of bacterial uropathogens have changed considerably over the past years, both in community and nosocomial infections. Treatment of UTIs cases is often started empirically and therapy is based on information determined from the antimicrobial resistance pattern of the urinary pathogens.

Fast antibiotic susceptibility testing of urine microflora using a microbiological analyzer based on coherent fluctuation nephelometry.

Traditional culture-based microbiological methods remain the most used for defining the etiology of urinary tract infections and antibiotic susceptibility testing (AST) of isolated uropathogens. They are time-consuming and lead to delays of several days when obtaining the final results of microbiological tests. In this study, we validate the possibility of using a microbiological CFN analyzer combined with MALDI-TOF mass spectrometry (MS) for fast conclusive urine testing (1day) without obtaining pure cultures. The study included three stages: detection of urine microflora growth using the CFN analyzer to separate positive and negative samples within 2-4h; fast MS identification of positive samples without isolating uropathogens; fast AST using CFN analyzer within 3-6h. In parallel, all urine samples were tested by traditional culture-based microbiological methods. In total, 194 urine samples were tested, and 22 urine cultures were identified by MS, among them, 20 monocultures with bacterial counts ≥ 105 and 2 mixed cultures. The AST of these 22 urine cultures and additional 88 pure clinical cultures was performed using eight antibiotics. Overall, 276 tests were performed. The results of AST obtained using the CFN analyzer and traditional methods were in good agreement (98.2%). Although two mixed cultures were falsely identified as monocultures, their susceptibility determined by the CFN analyzer was correct. The CFN analyzer is promising and effective for fast AST. Combined with MS identification, it allows to perform full urine analysis in 1day without the lengthy isolation of pure cultures.

An Overview on Urinary tract infection Diagnostic and Management Approach in Primary Health Care

The urinary tract infection (UTI) counts for many visits to the primary health clinic. It occurs across different age groups and genders with variable rates, nevertheless it spares no one. Knowing this condition from its presentation to management is the key factor for a competent family physician. We aim to review literature searching for the etiology of urinary tract infection, risk factors, diagnosis, clinical presentation, and management regarding this disease. PubMed database was used for a

Clinical documentation requirements for the accurate coding of hospital-acquired urinary tract infections in Australia.

Aims We evaluated the accuracy of medical coders in distinguishing the aetiology of urinary tract infection according to clinical documentation. Methods The clinical documentation of patients coded as having had a hospital-acquired urinary tract infection from January to June 2020 at two Melbourne hospitals were assessed for community or hospital acquisition. Results We found that 48.89% of cases were inaccurately categorised as hospital-acquired, due to insufficient detail in clinical documentation. Risk factors for hospital-acquired urinary tract infection were present in at least 30% of correctly categorised cases. Conclusions Clinical documentation is not filled out with sufficient detail or in a timely enough manner for clinical coders to distinguish between hospital or community origin.

Antimicrobial susceptibility pattern in Escherichia coli causing urinary tract infection among children

BACKGROUND: The etiology of urinary tract infection (UTI) and their antibiotic sensitivity pattern vary from time to time and across different areas in India. This study is designed to analyse the antimicrobial resistance pattern in Escherichia coli causing urinary tract infection among children. AIM: The aim of the study is to detect the antimicrobial resistance pattern in Escherichia coli causing urinary tract infection among children in MATERIALS AND METHODS : It is a prospective study done in our department with culture positive for Escherichia coli in urine samples collected over a period of 3 months from paediatric group of patients. RESULTS: Among the 52 isolated uropathogenic E.coli, showed sensitivity to ampicillin n=1(2%),ciprofloxacin n=8(15%) norfloxacin n=10(19%), ceftriazone n=3(6%) ,cefipime n=2(4%), gentamicin n=8(15%) , Imipenem n=32(62%) .Nitrofurantoin showed highest sensitivity of about 47( 90%).12 were ESBL producing and 3 were MBL producing.

Bacterial drug-resistance patterns and genetic diversity of bacteria-associated bacteriuria in diabetic patients in Ghana

Our study aimed to determine the etiology of urinary tract infections (UTIs), resistance profiles of isolated bacteria, and virulence factors of Escherichia coli associated with bacteriuria in diabetic patients in Ghana. Midstream urine samples from 982 diabetic patients were tested for uropathogens at the National Diabetes Management and Research Centre in Ghana, using standard bacteriological methods, with antibiogram testing of the isolates using the Kirby-Bauer disk diffusion, as per CLSI guidelines. Polymerase chain reaction (PCR) was used to investigate the phylogenetic groupings and virulence factor (VF) genes of isolated E. coli. The overall prevalence of UTIs was 9.2%, and the main uropathogens were Klebsiella spp. (55.6%) and Escherichia coli (31.3%). Age, duration of diabetes, and a previous history of UTIs were risk factors associated with UTI (p-value < 0.05). High levels of antibacterial resistance to cefuroxime (84%), ampicillin (80%), and gentamicin (70.7%) were observed. The distribution of VFs in each phylogenetic group revealed that sfa-iutA-KpsTMII-KpsTMIII genes were associated with group B2, and iutA-ibe were associated with group D. The isolated uropathogens were highly resistant, and the E. coli isolates possessed varying VFs. Continuous monitoring of bacteria associated with UTI in diabetics is highly recommended.

A Study on Antibiotic Sensitivity Pattern in Children Hospitalized for Urinary Tract Infection in a Tertiary Care Hospital in South India

Abstract: Background: The etiology of urinary tract infection (UTI) and their antibiotic sensitivity pattern vary from time to time and across different areas in India. This study is designed to analyse the resistance of uropathogens to commonly used antibiotics. Aim: To study antibiotic resistance trends of uropathogens and assess the antimicrobial utilization pattern according to the antimicrobial susceptibility test in the paediatric department of a tertiary care hospital. Materials and Methods: It was an ambispective observational cohort study conducted in 144 patients admitted with UTI for a period of one year and observed for recurrent UTI for the next one year. Results: E. coli (50%) was found to be the most common cause of UTI followed by Klebsiella (22.22%). E. coli and other isolates were more sensitive to Meropenem and Amikacin compared to other antibiotics tested. These isolates show increasing resistance to commonly used antibiotics. Most (74.31%) children were given single antimicrobial agent. Majority of the children were prescribed with Cephalosporins (60.41%), followed by Penicillin derivatives (29.17%) and Carbapenems (11.11%). Out of 144 children, antibiotics were prescribed according to culture sensitivity report in only 31.94%. Among children whose antibiotics were not selected based on the culture report, 40 had recurrent UTI in the following year. Conclusion: Recurrent UTI can occur if adequate antimicrobial therapy based on antimicrobial susceptibility test is not administered during the initial UTI episode. Close cooperation between physicians, microbiologists and pharmacists is essential to ensure that UTI patients receive antimicrobial therapy, if required based on local susceptibility data. Key words: UTI, Uropathogens, Antimicrobials, Pediatrics, Antibiotic resistance.

Prevalence and antimicrobial sensitivity profile of uropathogens in a tertiary care hospital of Dhaka city

Urinary tract infection (UTI) is one of the most frequently occurring infections worldwide seeking medical attentions. The etiology of UTI and the antimicrobial sensitivity pattern of uropathogens vary in regions and change through time. This study aims to evaluate the pathogens responsible for causing UTI and analyze the antimicrobial sensitivity pattern of the isolated uropathogens. This cross sectional study was carried out in the Department of Microbiology, Bangladesh Medical College, Dhaka over a period of January 2018 to December 2019. Out of 11,274 urine samples, 1452 (12.88%) were positive for uropathogens by culture. Among these 1452 isolates, majority of them 936 (64.46%) were isolated from females. Escherichia coli 899 (61.91%) was the predominant organism followed by Enterococccus species 168 (11.57%), Klebsiella species 140 (9.64%), Enterobacter species 137 (9.44%). Escherichia coli showed high rate of sensitivity to nitrofurantoin 79.76%, gentamicin 75.31%, amikacin 88.65%, imipenem 97.89% and meropenem 80.87%. Pseudomonas species showed high rate of sensitivity to imipenem 70.45%. Enterococcus species showed high rate of sensitivity to vancomycin 94.05%, imipenem 70.83% and linezolid 79.76%. UTI is a very common problem and rate of antimicrobial resistance is increasing day by day. Therefore, each institution should have an antibiotic policy based on the local antibiogram which is to be renewed regularly.&#x0D; Bangladesh J Med Microbiol 2020; 14 (2): 3-11