Bacteria In Urinary Tract Infections Research Articles

The biological function of the type II toxin-antitoxin system ccdAB in recurrent urinary tract infections.

Urinary tract infections (UTIs) represent a significant challenge in clinical practice, with recurrent forms (rUTIs) posing a continual threat to patient health. Escherichia coli (E. coli) is the primary culprit in a vast majority of UTIs, both community-acquired and hospital-acquired, underscoring its clinical importance. Among different mediators of pathogenesis, toxin-antitoxin (TA) systems are emerging as the most prominent. The type II TA system, prevalent in prokaryotes, emerges as a critical player in stress response, biofilm formation, and cell dormancy. ccdAB, the first identified type II TA module, is renowned for maintaining plasmid stability. This paper aims to unravel the physiological role of the ccdAB in rUTIs caused by E. coli, delving into bacterial characteristics crucial for understanding and managing this disease. We investigated UPEC-induced rUTIs, examining changes in type II TA distribution and number, phylogenetic distribution, and Multi-Locus Sequence Typing (MLST) using polymerase chain reaction (PCR). Furthermore, our findings revealed that the induction of ccdB expression in E. coli BL21 (DE3) inhibited bacterial growth, observed that the expression of both ccdAB and ccdB in E. coli BL21 (DE3) led to an increase in biofilm formation, and confirmed that ccdAB plays a role in the development of persistent bacteria in urinary tract infections. Our findings could pave the way for novel therapeutic approaches targeting these systems, potentially reducing the prevalence of rUTIs. Through this investigation, we hope to contribute significantly to the global effort to combat the persistent challenge of rUTIs.

The Effect of Honey on Bacteria Isolated from Urinary Tract Infections among Patients Attending Ruhengeri Referral Hospital

Background: Urinary tract infections (UTIs) occur when bacteria enter the urethra from the skin or rectum and infect the bladder, causing symptoms. UTIs are becoming increasingly multidrug-resistant, with some drugs no longer effective in treatment. According to the National Center for Biotechnology Information (NCBI), honey has been shown to have high osmotic pressure and high acidity that prevent the multiplication of bacteria. This study aimed to evaluate the effect of honey on bacteria isolated from urine samples collected from patients with UTI’s attending Ruhengeri Referral Hospital.
 Methodology: Urine samples were collected in sterile containers at Ruhengeri Referral Hospital and transported to the microbiology laboratory at the Ruhengeri Institute of Higher Education (INES Ruhengeri). Two types of honey, raw and processed were used as antimicrobial agents on bacteria isolated from UTIs. Various methods were used to isolate and identify bacterial isolates, including culture on solid medium, gram staining, and biochemical tests.
 Results: The most commonly isolated bacterium was S. aureus (33.3%) which is in the second group of bacteria susceptible to honey, followed by P. aeruginosa (13.8%) and CoNS (13.8%). E. coli, K. pneumonia, and Streptococcus spp. each accounted for 11.2%. The former and the latter were the most susceptible bacteria to natural honey honey (mIZ = 36 ±2.83; ±4.24 mm, respectively), while E. aerogenes was the least isolated bacterium at 5.5% and the least susceptible to honey.
 Conclusion: Honey was showed to exhibit an antimicrobial effect against all bacteria isolated from the UTI, suggesting natural honey as a remedy in controlling urinary tract bacterial infection. Further studies are needed to evaluate its capacity compared to classical antibiotics currently used to treat bacteria in UTIs. The practical way to use honey to get targeted area is also an interested point that need to be investigated.
 Keywords: Urinary tract infection; honey; bacteria.

High Incidence of Antibiotic Resistance in the Uropathogenic Bacteria Associated with Different Urological Diseases and Metabolic Complications: A Single Center Cross-Sectional Study.

Urological diseases affect all age groups and are associated with different urinary complications. Presence of pathogenic bacteria complicates the urological diseases such as chronic kidney disease (CKD), kidney stone disease (KSD), emphysematous pyelonephritis (EPN), and urological cancers (UCs) coinciding with urinary metabolic complications. The One Health concept for preventing the spread of antibiotic resistant opportunistic pathogens necessitates detailed investigation on the virulence and the antibiotic sensitivity patterns of the pathogens from the urinary tract infections (UTIs). This cross-sectional study was aimed to profile the pathogenic bacteria associated with different urological diseases that included urine samples from the patients from a tertiary care hospital. The study included 258 patients representing CKD (15.1%), KSD (28.7%), EPN (15.5%), UC (12.0%), and UTI patients without any urological diseases (28.7%) with overall 70.5% patients showing positive urine culture. Furthermore, other than UTI in patients without any urological diseases (100%), higher culture positive cases were seen in KSD (64.9%), followed by CKD (61.5%), EPN (52.5%), and UC (48.4%). Escherichia coli was the most predominant bacteria in UTI (35.1%) and EPN (66.7%). In KSD, Pseudomonas aeruginosa (41.7%), Staphylococcus aureus (18.8%), and Proteus mirabilis (14.6%) were more common. S. aureus (86.7%) was the most isolated bacteria from the UC cases. Overall rate of multidrug resistance (MDR) was 77.8%. All (100%) E. coli, K. pneumoniae, P. mirabilis, and S. aureus strains were MDR. Among the strains, strong biofilm formation was observed in 73.6%, and 66.7% strains were urease positive. Biofilm was positively correlated with MDR and urease activity. The abundance and distribution of bacteria differed among the urological diseases suggesting their association with the urine metabolite profile. Colonization of MDR pathogens in patients with urological diseases is a serious concern requiring steps to control the emergence of drug resistance and their further spread into the ecosystem.

Risk Factors Analysis and Pathogen Distribution of Urinary Tract Infection in Patients Undergoing Cutaneous Ureterostomy After Radical Cystectomy for Bladder Cancer.

Postoperative urinary tract infection is a common complication that not only significantly prolongs the hospital stay and amplifies the economic burden on patients, but also affects their quality of life and prognosis. This study aimed to investigate risk factors and distribution of pathogenic bacteria in urinary tract infections among bladder cancer patients who underwent cutaneous ureterostomy following radical cystectomy. A total of 137 bladder cancer patients, who underwent cutaneous ureterostomy after radical cystectomy at our hospital from November 2018 to October 2022, were enrolled in this retrospective study. Univariate and multivariate logistic regression analyses were employed to investigate the risk factors associated with postoperative urinary tract infection and the distribution of pathogenic bacteria among the infected patients. The results of both univariate and multivariate analyses confirmed that age, proficiency in ostomy knowledge, frequency of ureteral stent tube replacement, ureteral stent tube dislodgement, urine immersion at the outer end of the ureteral stent tube, and the interval of ostomy bag replacement were independent risk factors for urinary tract infection after radical cystectomy and cutaneous ureterostomy in bladder cancer patients. A total of 55 pathogenic bacteria were isolated from 52 patients with infections. Predominantly, these were gram-negative bacteria (34 strains, 61.8%), with Proteus mirabilis having the highest proportion. Urinary tract infections after radical cystectomy and cutaneous ureterostomy predominantly involve gram-negative bacteria. This is correlated with factors such as the age of bladder cancer patients, the level of nursing education, the duration of ureteral stent tubes and ostomy bag usage, as well as issues related to impaired urine drainage.

Urinary Tract Infection Bacteria Classification: Artificial Intelligence-based Medical Application

Urinary tract infection (UTI) is a type of health disorder, an infection in the urinary glands mainly caused by bacteria. Currently, conventional early detection methods that have been established involve rapid dipstick strip test and urine culture analysis, which have suboptimal accuracy and effectiveness. Several retrospective studies regarding UTI bacteria classification have shown promising results, but still have limitations regarding prediction accuracy and technical simplicity. This study aims to implement a method based on artificial intelligence (AI) in classifying images of bacteria that causes UTIs. Eight artificial intelligence methods based on deep neural networks were used in the study; the models were evaluated and compared based on the prediction's effectiveness and accuracy. This study also seeks to create the easiest method of classifying bacteria causing UTIs using a computer-based application with the best obtained AI-based model. The best training results using an intelligent approach placed DenseNet201 as the method with the highest accuracy (83.99%). Then, the output model was used as a knowledge reference for the designed computer-based application. Real-time prediction results will appear in the application window.

Extended Spectrum B-Lactamase (ESBL) and Metallo B-Lactamase (MBL) Production in Gram-Negative Bacteria isolated from Urinary Tract Infection Patients.

Background: The rate of infections caused by Morganella species is reported to be affected by difficulties in their isolation. Enterobacter, species, Citrobacter freundii, Serratia marcescens, and Morganella morganii are the major pathogens involved in hospital acquired infections. All of them are extensively reported in the infections of urinary tract, respiratory tract, cutaneous disorders, catheter associated infections and infections of the central nervous system.Objective: To investigate the frequency of ESBL producing bacteria in Urinary Tract Infection. Material and Methods: A cross-sectional study of 200 urine samples was collected from the outdoor patient departments of Khyber Teaching Hospital Peshawar through consecutive sampling technique during April, 2019 to June 2019. The urine samples were collected and then cultured on selective media i.e., Cysteine Lactose Electrolyte Deficient Agar (CLED) and on MacConkey agar plates. Isolates were identified by conventional morphological and biochemical tests while antibiotic susceptibility was analyzed by “Agar disc diffusion method” using different antibiotics and their zone of inhibition was measured. Results: Total 200 samples processed, 125 (62.5%) isolates, including 67 (53.6%) females, tested positive for the growth of Gram-negative bacteria. Among the identified species, 76 (60.8%) isolates produced ESBLs, with Escherichia coli accounting for 32.6%, Enterobacter for 23.2%, and Morganella species for 12.0%. Moreover, 77 (61.6%) of the isolates were found to be MBL positive, with 30 (24.0%) of them being E. coli, 28 (22.4%) being Enterobacter, and 19 (15.2%) being Morganella spp. The isolates formed a zone of inhibition like a clover leaf and demonstrated a sensitivity of 85 (68%) to antibiotics in the carbapenem class, such as imipenem and meropenem. Cefoparazone/Sulbactam 80 (64.0%), Ofloxacin 79 (63.2%), and Amikacin 78 (62.4%) were the next three antibiotics with high sensitivity. Ampicillin 106 (84.8%) showed the highest resistance, followed by Nitrofurantoin 84 (67.2%) and Ceftriaxone 79 (63.2%), in that order. Conclusion: The study indicated that ESBL-producing bacteria were present frequently among UTI patients. Most of the isolates exhibited strong carbapenem class antibiotic sensitivity. The findings of this study may contribute to the formulation of tactics to lower the incidence of ESBL-producing UTI.Keywords: Antibiotics resistance, Gram Negative bacteria, Plasmid-mediated enzymes, UTI.

A review on prevalence of bacteria in urinary tract infection

Worldwide, Urinary tract infections are the most common infections. Which can involve the urethra, bladder and kidney and are caused by Gram-negative bacteria, followed by Gram-positive bacteria or fungi. Most commonly by Escherichia coli, Klebsiella pneumonia, Proteus mirabilis, Enterococcus faecalis and Staphylococcus saprophyticus.Women are at greater risk of developing a UTI than men are. Antibiotics are the typical treatment for a UTI. But you can take steps to reduce your chance of getting a UTI in the first place. Antibacterial agents are a major part of the treatment for UTI. Antimicrobial resistance patterns vary from time-to-time and across different regions. In this Review, we discuss how basic science studies are elucidating the molecular details of the crosstalk that occurs at the host–pathogen interface, as well as the consequences of these interactions for the pathophysiology of UTIs. We also describe current efforts to translate this knowledge into new clinical treatments for UTIs. A recent study says that infection rate varies among individuals considering their age, immunity, and lifestyle. The pathogens causing UTI are developing resistance against multiple drugs. From this study, we understand that Cranberry is the only plant source for the treatment of UTI in combination with antibiotics. There is a need to understand the importance of improving innate immunity and to know the best treatment regime to treat UTI.

A review on prevalence of bacteria in urinary tract infection

A review on prevalence of bacteria in urinary tract infection

Cultureless enumeration of live bacteria in urinary tract infection by single-cell Raman spectroscopy.

Urinary tract infections (UTIs) are the most common outpatient infections. Obtaining the concentration of live pathogens in the sample is crucial for the treatment. Still, the enumeration depends on urine culture and plate counting, which requires days of turn-around time (TAT). Single-cell Raman spectra combined with deuterium isotope probing (Raman-DIP) has been proven to identify the metabolic-active bacteria with high accuracy but is not able to reveal the number of live pathogens due to bacteria replication during the Raman-DIP process. In this study, we established a new approach of using sodium acetate to inhibit the replication of the pathogen and applying Raman-DIP to identify the active single cells. By combining microscopic image stitching and recognition, we could further improve the efficiency of the new method. Validation of the new method on nine artificial urine samples indicated that the exact number of live pathogens obtained with Raman-DIP is consistent with plate-counting while shortening the TAT from 18 h to within 3 h, and the potential of applying Raman-DIP for pathogen enumeration in clinics is promising.

Flavonoic content and antibacterial evaluation of Moringa oleifera Lam. leaves grow in Algeria.

The objective of this study is to fight against antibiotic resistance, especially in urinary tract infection. To limit the spread of this scourge, we have proposed the use of flavonoid extract of the medicinal plant Moringa oleifera Lam against pathogenic bacteria of urinary tract infections. M. oleifera, was introduced in the arid regions of the Algerian Sahara for sustainable rural development in Algeria. The phytochemical study, revealed the presence of a multitude of metabolites. The yield of aqueous extract is 27.35% ± 1.95 and flavonoid concentration is 38.59 ± 0.002 mg EQ/gE. The high-performance liquid chromatography revealed the presence of 47 compounds, the most important of which are ascorbic acid (16.82%) and luteolin-7-Glycoside (26.8%). The aqueous extract has very significant antibacterial activity with an inhibition zone varying between 26.2 ± 0.25 (mm) for Bacillus anthracis and 12.66 ± 1.15 for Salmonella enteritidis.

Antibacterial Resistance Patterns Among Common Infections in a Tertiary Care Hospital in Saudi Arabia.

Background The rapid emergence of antibiotic-resistant bacteria threatens the control of infectious diseases by reducing treatment effectiveness, prolonging illness duration, and increasing healthcare costs. This study aimed to identify the common rate of bacterial resistance against antibacterial agents in tertiary healthcare providers in Saudi Arabia. Methodology This retrospective cross-sectional observational study was conducted from May 2016 to December 2019 on 1,151 urinary tract infection (UTI) and respiratory tract infection (RTI) positive cultures collected from participants aged 15 years or older who received antibiotic treatment. The obtained variables included age, gender, diagnosis, antibiotic type, specimen source, culture results, and sensitivity test results. Results The most common bacteria in UTI were Escherichia coli (46.7%), followed by Klebsiella pneumoniae (30.5%). Moreover, E. coli was most resistant to ampicillin (56.4%), followed by ceftriaxone (33.8%). Among the respiratory cultures, the most frequently isolated pathogen was Pseudomonas aeruginosa (28.5%), followed by K. pneumoniae (17.6%). The 162 respiratory P. aeruginosa isolates were most resistant to piperacillin/tazobactam (51.9%), followed by ciprofloxacin (25%) and ampicillin (10.6%). Conclusion High levels of antibiotic resistance were observed in both Gram-negative and Gram-positive bacteria. This indicates a need for better implementation of antibacterial stewardship and increased awareness of appropriate antibiotic use to limit the rapid spread of antibacterial resistance.

Detection of E. Coli Bacteria in Urinary Tract Infection in Emergency Department at Alimmam Al-Sadiq Hospital: Hilla \ Iraq

Background: Urinary tract infection (UTIS) is a common microbial infection in community and in all age groups. are alarming worldwide. Therefore, this study aims to detection antibiotics resistance of Escherichia coli (E. coli) bacteria responsible for UTIS Methods: Retrospective chart review for patients admitted to emergency department and diagnosed with UTIS at Al-immam Al-SAdiq Hospital between February to April 2021 was performed. Antimicrobial susceptibility to ampicillin, augmentin (amoxicillin/clavulanate), cefazolin, co-trimoxazole (sulfamethoxazole/trimethoprim), ciprofloxacin, and nitrofurantoin, and cefpodoxime was determined for 101 E. coli urinary isolates. Results: Escherichia coli was the most bacteria causing UTIS representing 93.55, 60.24, and 45.83% of all bacteria isolated from urine culture of pediatric, adult, and elderly, respectively. High rates of resistance to ampicillin (82.76, 58, and 63.64%) and co-trimoxazole (51.72, 42, and 59.09%), among E. coli isolated from pediatric, adult and elderly respectively. Nitrofurantoin was the most active agent, followed by ciprofloxacin, augmentin and cefazolin. 22.77% of E. coli isolates exhibited multiple drug resistance (MDR). Among 66 and 49 isolates resistant to ampicillin and co-trimoxazole, respectively, 34.84 and 42.85% were MDR. In contrast, all isolates resistant to augmentin and nitrofurantoin were MRD, while 72.7 and 82.4% of isolates resistant to ciprofloxacin and cefazolin were MDR. Conclusions: High resistance was observed to ampicillin and co-trimoxazole which commonly used as empirical treatments for UTIS, limiting their clinical use. This necessitates continuous surveillance for resistance pattern of uropathogens against antibiotics. Keywords: Antibiotics sensitivity , E. coli bacteria , UTIS.

Assessment of Antibacterial Efficacy of Callistemon viminalis (Sol. ex Gaertn.) G. Don against Some Isolates Obtained from Urinary Tract Infections.

This study aimed to examine the antibacterial effects of constituents obtained from Callistemon viminalis leaves. This goal was achieved by using three organic solvents, namely Ethanol, Ethyl acetate, and Hexane to prevent the growth of the causative urinary tract infections isolates, such as Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumonia, and Proteus sp. in Iraq. The C. viminalis fresh leaves collected from different regions of Hillah City, during March 2020, were classified according to the taxonomic features of Iraqi Flora. Extractions were completed by a method of digestion and then the stock solution of 200 mg/mL was prepared in 10% of Dimethylsulfoxide. A Millipore filter (0.22 µm) was used for the sterilization of all the extracts used in this study. Agar well diffusion method was utilized to test the antibacterial effects of the constituents separated from the dried leaves of C. viminalis against the urinary tract infection bacteria at three concentrations of 50, 100, and 200 mg/mL for each extracted constitute by the three different solvents. Dimethylsulfoxide 10% and the meropenem were utilized as the negative and positive controls. Constituents separated by ethanol solvent at 200 mg/mL exhibited significant supremacy (P≤0.05) over the meropenem against Proteus sp. isolate, and exhibited the same significant difference (P≤0.05), compared to the meropenem drug against E. coli. Constituents extracted by Ethyl acetate organic solvent at a concentration of 200 mg/mL exhibited a similarly significant effect (P≤0.05), compared to the meropenem against Proteus sp. isolate. However, the hexane extract was the least effective among the other solvents utilized in this study. The results of the current study revealed that constituents in the leaves of C. viminalis could be considered a valuable herbal remedy for controlling urinary tract infections pathogenic bacteria.

Comparison of different urine culture methods in urinary tract infection.

BackgroundMidstream urine specimen cultures play an important role in assisting clinicians to choose antibiotics to remove urinary tract pathogens. At present, there are many culture methods for obtaining midstream urine specimens. In this article, different urine culture methods were compared to improve the detection rate of pathogenic bacteria in patients with urinary tract infections (UTIs).MethodsUrina sanguinis specimens were collected from 90 outpatients and inpatients who had UTI symptoms, had been clinically diagnosed with UTI between February and March 2021, and had been tested within 2 h using the conventional 1-µL culture method, the modified 100-µL culture method, and the centrifugal urine sediment culture method. After incubation at 35 °C with 5% carbon dioxide (CO2) for 48 h, the detection rates of pathogenic bacteria in UTIs were compared among the three methods.ResultsA total of 75 strains of pathogenic bacteria were detected in the 90 specimens. The positive detection rates of pathogenic microorganisms were 23.33%, 73.33%, and 75.56% for the conventional 1-µL culture method, the modified 100-µL culture method, and the centrifugal urine sediment culture method, respectively. Among the patients who used antibiotics before the collection of the urine specimens, the positive detection rates of pathogenic microorganism were 16.00%, 66.00% and 66.00% for the conventional 1-µL culture method, the modified 100-µL culture method, and the centrifugal urine sediment culture method, respectively. In the specimens grown aseptically using the conventional 1-µL culture method, a similar average number of colonies was found using the modified 100-µL culture method and the centrifugal urine sediment culture method. Among the specimens with bacterial growth in the conventional 1-µL culture method, the average colony numbers of the three methods were similar.ConclusionsThe modified 100-µL culture method and the centrifugal urine sediment culture method greatly improved the positive detection rates of pathogenic bacteria in patients with UTIs.

Effectiveness of Methanol Extract of Moringa oleifera Lam. Leaf as Antibacterial Drug to Bacterial Triggers of Urinary Tract Infections In vitro

Background: Urinary tract infections (UTIs) are a severe public health problem and are caused by a range of pathogens, but most commonly by Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis and Staphylococcus saprophyticus. High recurrence rates and increasing antimicrobial resistance among uropathogens threaten to greatly increase the economic burden of these infections. This study aimed to measure the lowest concentration of Moringa oleifera Lam. Leaf that did not show any growth of the tested microorganisms.
 Methods: The antibacterial activity test was adapted from the CLSI broth microdilution assay, with minor modifications, were used for the evaluation of the antibacterial activity of M. oleifera extracts against tested bacteria. Three concentrations higher than the MIC standard were cultured on the MHA. The lowest concentration on agar which was not found any growth of the bacterial colonies was determined as the MBC.
 Results: The antibacterial activity test results showed that Moringa leaf extract could inhibit bacterial growth. Inhibition of bacterial growth based on extract concentration. For E. coli bacteria, the results showed the highest absorbance value at 100mg/ml concentration (2.86±0.02); even when diluted to 3,13 mg/ml (1.08±0.01), the moringa leaf extracts could inhibit the E. coli growth, although the value did not differ greatly from that of the negative control (0.13±0.06). The same as E. coli, the antibacterial activity test results showed that moringa leaf extract could inhibit others bacteria growth of UTIs.
 Conclusions: Methanol extract of Moringa oleifera leaf can inhibit and bactericide the growth of urinary tract infections bacteria.

Urinary tract infection caused by bacterial pathogens of the respiratory tract in children.

Urinary tract infections (UTIs) caused by bacterial pathogens of the respiratory tract such as Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are rare and little is known about their clinical features and potential host risk factors. The aim of this study is to reveal their clinical characteristics. We conducted a retrospective descriptive study on pediatric UTI due to S.pneumoniae, Haemophilus spp., or M.catarrhalis at a tertiary-care pediatric hospital. Pediatric patients diagnosed with UTI between 2002 and 2020 were included. Patient demographics, laboratory data, and microbiological findings were extracted from their electronic medical records and the infectious disease surveillance system. Among 46,332 urine samples, 76 bacteriuria (0.16%) and 22 UTI (0.05%) events due to the targeted species were identified (S.pneumoniae, n=7, and Haemophilus spp., n=15). Of the patients, 17 (85%) had underlying urinary tract abnormalities and 13 (60%) had vesicocutaneous fistula. All the UTI episodes caused by S.pneumoniae and Haemophilus spp. occurred after cystostomy. All the patients had satisfactory clinical outcomes. Although S.pneumoniae and Haemophilus spp. are rare causes of UTIs in children, they could be the true causative bacteria of UTI, particularly in the patients with urinary tract abnormalities and vesicocutaneous fistulas. Thus, clinicians should not ignore these pathogens as contaminations in special populations.

Bacterial Profile of Urinary Tract Infections and Antimicrobial Susceptibility Patterns among Pregnant Women at the Benghazi Medical Centre, Benghazi/Libya

Urinary tract infection (UTI) is one of the most common diseases caused by bacteria during pregnancy, and it can create serious consequences for both the fetus and the mother, necessitating early detection and prevention of problems. The study aimed to isolate and identify urinary tract infections bacteria among pregnant women at the Benghazi Medical Centre. Initially, a sectional descriptive design was used on 200 pregnant women who attended the Obstetrics and Gynecology Clinic at the Benghazi Medical Centre from June 2018 to October 2018. A purposive sample was employed to collect data utilizing a structured interviewing questionnaire and laboratory test records. Bacterial infection during pregnancy was more frequent within the age range of 25 to 35 years with 25 out of 44 patients (56.8%). The second trimester of pregnancy was the time period most related to the infection with 23 patients (52.3%). The results also showed that housewives were more susceptible to the infection (28 patients; 63.6%). Several varieties of bacteria were related to UTIs during pregnancy including Escherichia coli (56.8%), which was the most frequently isolated pathogen followed by S. aureus (25%), Enterococcus (9.1%), Klebsiella (6.8%) and Staphylococcus saprophyticus (2.3%). Antibiotic sensitivity revealed that the response to antibiotics was variable; most of the isolated pathogens were sensitive to the tested antibiotics specifically to ciprofloxacin and levofloxacin. The isolated bacteria that were sensitive to all the used antibiotics included Escherichia coli and S. saprophyticus. Antibiotic resistance was increasingly seen in amoxicillin, azithromycin, and erythromycin. To avoid UTIs during pregnancy and the complications of infection, which could lead to fetal loss, all pregnant women should be routinely screened for UTIs with urine culture and treated with the appropriate antibiotics as needed as well as reducing the risk of developing a urinary tract infection by increasing the level of cultural awareness. Women confront double dangers with UTIs; the danger of the disease and the risk of anti-microbial treatment. Pre-natal connection to the baby is highlight when preparing to make this choice, weighing both the shorter-term risks from UTIs and the longer-term dangers from anti-microbial use, particularly the chance of AMR.

Clinical impact of multidrug-resistant bacteria in older hospitalized patients with community-acquired urinary tract infection

IntroductionPrevious studies have described some risk factors for multidrug-resistant (MDR) bacteria in urinary tract infection (UTI). However, the clinical impact of MDR bacteria on older hospitalized patients with community-acquired UTI has not been broadly analyzed. We conducted a study in older adults with community-acquired UTI in order to identify risk factors for MDR bacteria and to know their clinical impact.MethodsCohort prospective observational study of patients of 65 years or older, consecutively admitted to a university hospital, diagnosed with community-acquired UTI. We compared epidemiological and clinical variables and outcomes, from UTI due to MDR and non-MDR bacteria. Independent risk factors for MDR bacteria were analyzed using logistic regression.Results348 patients were included, 41.4% of them with UTI due to MDR bacteria. Median age was 81 years. Hospital mortality was 8.6%, with no difference between the MDR and non-MDR bacteria groups. Median length of stay was 5 [4–8] days, with a longer stay in the MDR group (6 [4–8] vs. 5 [4–7] days, p = 0.029). Inadequate empirical antimicrobial therapy (IEAT) was 23.3%, with statistically significant differences between groups (33.3% vs. 16.2%, p < 0.001). Healthcare-associated UTI variables, in particular previous antimicrobial therapy and residence in a nursing home, were found to be independent risk factors for MDR bacteria.ConclusionsThe clinical impact of MDR bacteria was moderate. MDR bacteria cases had higher IEAT and longer hospital stay, although mortality was not higher. Previous antimicrobial therapy and residence in a nursing home were independent risk factors for MDR bacteria.

Estimateof Biological Activity of Parsleyextract on the Isolated Pathogenic Bacteria in Baghdad City

This research investigates the most common urinary tract infection bacteria and their susceptibility to antibiotic disc and parsley (Aquas and methanol) extracts. The urinary tract microbial were isolated from patients of urinary tract infection (UTI) pregnant women patients from Baghdad Hospital. The pathogenic organisms were collected, cultured and identified. 50 microbial isolate wasset as, E. coli 56 (46.66%), Staphylococcus aureus19 (15.8%). Proteus mirabilis 6 (5%) and Klebsiella pneumonia3 (2.5%). The pathogenic bacterial showed various zone of sensitivity to different antibiotics. Within the parsley Antimicrobial activity ranged from 3 to 20 mm. Antibacterial activity of parsley extract (5-22) mm on UTI isolated pregnant women and methanol extracts was between (3-15) mm. Therefore, Parsley extract had a pharmacological to treat all of 50 isolates that were identify from patients. In conclusion, the findings suggested that different extractsmay content as a broad-spectrum bactericidal factor, to control the emergent pathogens any way of their drug resistance mechanismsto treat urinary tract infections

Biofilm Production by Uropathogens in Postmenopausal Women with Recurrent and Isolated Urinary Tract Infection.

The aims of this study were to assess the in vitro biofilm-producing capabilities of uropathogens grown from a postmenopausal urogynecologic population with isolated and recurrent urinary tract infection (UTI) and to determine whether the biofilm-producing bacterial phenotype was associated with recurrent infection. This was an institutional review board-approved cross-sectional analysis within a large academic referral center. Uropathogens were cultured from postmenopausal women with either isolated or recurrent acute UTI and then screened for in vitro biofilm formation using crystal violet microtiter assays. Demographic and clinical variables, including pelvic floor symptoms and surgical history were collected and analyzed. A multivariate model was developed to determine whether recurrent UTI was independently associated with biofilm production. Eighty-nine women were included: 67.4% White, 25.8% Black, 3.4% Asian, and 1.1% Hispanic with a mean age of 72 ± 10.5 years. Ninety-five uropathogen strains were isolated. Most uropathogens produced biofilm (n = 53, 55.8%). Uropathogens from women with recurrent UTI were significantly more likely to produce biofilm (70%) than uropathogens collected from women with isolated UTI (38.6%, P = 0.0033). Adjusting for age, prior pelvic reconstructive surgery, and body mass index, recurrent UTI bacteria were more likely to produce biofilm, compared with isolated UTI (odds ratio, 5.37; 95% confidence interval, 2.0-14.4; P = 0.001). In this cohort of postmenopausal urogynecology patients, in vitro biofilm formation was more frequently observed in uropathogens isolated from women with recurrent UTI compared with women with isolated UTI. Further study is needed to assess the role of biofilms in recurrent UTIs in postmenopausal women.