Catheterized Urine Samples Research Articles

Draft genomes of one Staphylococcus haemolyticus and five Staphylococcus lugdunensis strains isolated from catheterized urine samples of females.

Although Staphylococcus haemolyticus and Staphylococcus lugdunensis are members of the normal human flora, they also can cause infection. Here, we present the draft genomes of five strains of S. lugdunensis and one strain of S. haemolyticus isolated from transurethral catheterized urine samples from different females experiencing lower urinary tract symptoms.

Draft genome sequences of an Enterobacter hormaechei and Providencia rettgeri isolated from the urine of a male experiencing a catheter-associated urinary tract infection.

Catheter-associated urinary tract infections (CAUTIs) can be caused by a variety of microbes. Here, we describe the draft genome assemblies of two species-Enterobacter hormaechei and Providencia rettgeri-purified from the catheterized urine sample of a male diagnosed with a CAUTI.

Draft genomes of two Enterobacter hormaechei strains isolated from catheterized urine samples from females experiencing overactive bladder symptoms.

In this study, we present the draft genome of two Enterobacter hormaechei strains isolated from catheterized urine specimens from females with overactive bladder (OAB) symptoms. Through the sequencing of these E. hormaechei strains, we aim to better understand its presence and putative role in OAB in the female urinary tract.

Draft genome assemblies of three Klebsiella grimontii strains isolated from catheterized urine samples from the same male participant over the course of 6 months.

Klebsiella grimontii is a newly identified species within the Klebsiella oxytoca complex. Here, we present the draft genome sequence of three K. grimontii strains that were isolated from catheterized urine samples collected from a participant in a longitudinal study over ~6 months.

Automatic urine cultures from catheter-obtained samples—time to implement a practice change to improve value

Abstract Objectives Urine cultures are often automatically obtained after urinary catheterization in young children, even in the absence of pyuria, to test for urinary tract infections (UTIs). Although this practice conflicts with some newer guidelines, it is frequently followed in busy emergency departments (EDs) to minimize the need for a repeat invasive procedure. To assess the implications of this longstanding practice, we aimed to describe the frequency and characteristics of children with normal urinalysis (UA) and positive urine culture obtained via catheterization, and to describe their clinical course. Methods A single center, retrospective cohort study was performed for otherwise healthy children aged 6 to 24 months, presenting to a Pediatric ED between January and June 2019 who underwent UTI testing via a urine catheterization. The point-of-care (POC) UA and urine culture results along with any follow-up phone call documentation were reviewed and analyzed using descriptive statistics. Results Of the 818 urine cultures obtained via catheterization during the 6-month study period, 131 (16%) cultures were reported as positive. Of these positive cultures, 14 (10.7%) of the patients meeting inclusion criteria had a normal POC UA. In follow-up phone calls after the ED visit, the majority of these 14 patients were asymptomatic without any antibiotic treatment and 3 (2.3%) patients were still febrile and classified as a potentially missed UTI. Conclusions The routine practice of sending urine cultures from all catheterized urine samples in children 6 to 24 months, regardless of POC UA results, rarely detect missed UTIs. In alignment with more recent practice guidelines, this practice should be reconsidered in low-risk children seen in EDs to improve overall care quality and resource utilization.

Uropathogenic Infection Associated with Prostate Hypertrophy and Transurethral Resection of Prostate

Benign prostatic hyperplasia (BPH) is a prevalent condition among elderly and middle-aged men characterized by symptoms such as dysuria, urinary incontinence, and frequent micturition. The gold standard procedure for relieving BPH symptoms is transurethral resection of the prostate (TURP). However, some patients undergoing TURP are at risk of developing urinary tract infections (UTIs) due to uropathogenic bacteria. This prospective study aimed to investigate post TURP bacteruria alongside with multifactoria risk factors that implicated postoperatively compared to preoperative and intraoperative periods. Ninety patients undergoing TURP and 30 control subjects were included in the study. Urine specimen for urine analysis from pateints were conducted on three occasions: (60 mid-stream urine and 30 catheterized urine samples) were taken preoperatively, (90 samples via cystoscopy) were taken intraoperastively, and (90 mid-stream urine samples after catheter removal) were taken at the third day post-TURP procedure. The study findings were analyzed in correlation with various pre-, intra-, and postoperative potential risk factors to underscores the vulnerability of BPH patients to UTIs, particularly during the postoperative recovery phase. The Escherichia coli was the most commonly isolated uropathogen preoperatively, while Pseudomonas aeruginosa emerged as the primary pathogen intra- and post-operatively. Several risk factors were identified as significantly associated with post-TURP bacteriuria. These include preoperatively, positive pre-operative culture analysis, diabetic patients, and preoperative catheterization. Additionally, intraoperative factors such as prolonged operation duration were also implicated. Postoperatively, persistent bacteriuria was significantly linked with the duration of catheterization. In conclusion, the findings highlight the complex interplay of factors contributing to post-TURP UTIs and stresses the significance of thorough risk evaluation and customized preventative measures to reduce infection risks among BPH patients undergoing TURP.

Catheter-associated urinary tract infection and biofilms: Dreaded duo in health settings

Abstract Background: Urinary tract infections (UTIs) alone account for 30% of hospital infections, 80% of these are catheter-associated UTIs (CAUTI). Microbial film in indwelling medical devices worsens the existing medical condition and leads to multidrug resistance (MDR) and prolonged hospital stay. This cross-sectional study was done to find out the organisms causing CAUTI, their sensitivity pattern, the proportion of biofilm formation, and the sensitivity, specificity of different procedures in the demonstration of biofilm. Materials and Methods: Urine sample was collected from 307 patients with indwelling catheters. Direct Gram stain was performed from well-mixed uncentrifuged urine. Specimens were processed, organisms were isolated by standard microbiological procedures, and antimicrobial sensitivity testing was performed. Various methods such as Congo red agar, tube adherence, and microtiter plate methods were used to identify biofilm formation for all the isolates. Results: Out of 307 catheterized urine samples, a direct Gram stain was positive in 137 (44.62%) samples and culture positive in 148 (48.2%) samples. Out of 134 bacterial isolates, biofilm was observed by Congo red agar in 36 (27%), tube adherence in 59 (44%), and microtiter plate in 80 (60%) isolates. Escherichia coli (50.74%) was the predominant isolate followed by Klebsiella spp (26.11%). MDR was observed in 53 (66%) biofilm-forming isolates. Conclusions: Catheterized patients are prone to develop a microbial biofilm that is multidrug resistant and burdensome. Of the 80 biofilm-producing isolates, MDR was observed in 53 (66%). The effective ways to prevent CAUTI are strict adherence to indications for catheterization and, a bundle care approach with a preinsertion checklist.

The bladder microbiota is not significantly altered by intravesical BCG therapy

IntroductionBladder microbiota dysbiosis has been associated with several urological disorders. However, dysbiosis markers in bladder cancer have not been identified and little is known about the effect of Bacillus Calmette-Guérin (BCG) intravesical therapy on the bladder microbiota. In this study, we compared the bladder microbiota of patients with non-muscle-invasive bladder cancer (NMIBC) undergoing BCG therapy to nononcological controls. We also longitudinally analyzed the impact of BCG therapy on the bladder microbiota of NMIBC patients and addressed whether bladder microbiota is associated with BCG efficacy. MethodsWe collected catheterized urine samples from males with intermediate/high-risk NMIBC (cancer group, n = 32) or benign prostatic hyperplasia (control group, n = 41). The cancer group also provided urine samples during and after BCG induction. We used 16S rRNA gene sequencing to characterize the bladder microbiota. Bladder microbiota parameters, such as diversity and taxonomic composition, were compared between groups and associated with clinicopathological data and BCG efficacy. ResultsWe observed no significant differences between the bladder microbiota of NMIBC patients and controls. BCG intravesical instillations did not significantly alter the bladder microbiota of NMIBC patients, and BCG was rarely detected in the bladder during and after BCG therapy. Microbiota diversity and overall composition before BCG induction did not influence disease persistence at 3 months. However, higher abundance of Lactobacillus, Streptococcus, and Cutibacterium in the pre-BCG bladder microbiota was associated with BCG effectiveness. ConclusionWe were unable to identify markers of bladder microbiota dysbiosis among male NMIBC patients. Moreover, we demonstrated for the first time using longitudinally collected samples that BCG cannot persist in the bladder microbiota nor significantly alter its diversity and composition. The associations found between bladder microbes and BCG efficacy highlight the potential of microbial-based therapeutic and risk-stratification strategies in the intermediate/high-risk NMIBC setting.

Urinary microbiome community types associated with urinary incontinence severity in women

BackgroundUrinary microbiome (urobiome) studies have previously reported on specific taxa and community differences in women with mixed urinary incontinence compared to controls. Therefore, we hypothesized that higher urinary and vaginal microbiome diversity would be associated with increased urinary incontinence severity. ObjectivesTo test if specific urinary or vaginal microbiome community-types are associated with urinary incontinence severity in a population of women with mixed urinary incontinence. Study DesignThis planned secondary, cross-sectional analysis evaluated associations between the urinary/vaginal microbiomes and urinary incontinence severity in a subset of ESTEEM trial participants with urinary incontinence. Incontinence severity was measured using bladder diaries and Urinary Distress Inventory (UDI) questionnaires collected at baseline. Catheterized urine samples and vaginal swabs were concurrently collected prior to treatment at baseline to assess the urinary and vaginal microbiomes.16S rRNA V4-V6 variable regions were sequenced, characterizing bacterial taxa to the genus level using the DADA2 pipeline and SILVA database. Using Dirichlet multinomial mixture methods, samples were clustered into community-types based on core taxa. Associations between community-types and severity measures (UDI total, UDI subscale scores, and the number of urinary incontinence episodes (total, urgency, and stress) from bladder diary) were evaluated using linear regression models adjusted for age and body mass index. Alpha diversity measures for richness (total taxa numbers) and evenness (proportional distribution of taxa abundance) were also analyzed for associations with urinary incontinence episodes and community-type. ResultsSix urinary microbiome community-types were identified, characterized by varying levels of common genera (Lactobacillus, Gardnerella, Prevotella, Tepidomonas, Acidovorax, Escherichia, and others). Analysis of urinary incontinence severity in 126 participants with MUI identified a Lactobacillus-dominated reference group with the highest abundance of Lactobacillus (76% mean relative abundance). A community characterized by fewer Lactobacilli (19% mean relative abundance) and greater alpha diversity, was associated with higher total urinary incontinence episodes (2.67 daily leaks, 95% CI: 0.76 - 4.59, p=0.007) and urgency urinary incontinence episodes (1.75 daily leaks, 95% CI: 0.24 - 3.27, p=0.02) compared to the reference group. No significant association was observed between community-type and stress urinary incontinence episodes or UDI total or subscores. The composition of vaginal community-types and urinary community-types were similar but comprised of slightly different bacterial taxa. Vaginal community-types were not associated with urinary incontinence severity, as measured by bladder diary or UDI total and subscale scores. Alpha diversity indicated that greater sample richness was associated with more incontinence episodes (observed genera p=0.01) in urine. Measures of evenness (Shannon/Pielou) were not associated with incontinence severity in the urinary or vaginal microbiomes. ConclusionsIn the urobiome of women with mixed urinary incontinence, a community-type with fewer Lactobacilli and more diverse bacteria was associated with more severe urinary incontinence episodes (total and urgency) compared to a community-type with high predominance of a single genus, Lactobacillus. Whether mixed urinary incontinence severity is due to lesser predominance of Lactobacillus, greater presence of other non-Lactobacillus genera, or the complement of bacteria comprising urobiome community-types, remains to be determined.

Impact of microbiota and host immunologic response on the efficacy of anticholinergic treatment for urgency urinary incontinence.

Studies within the past decade have suggested associations among composition of the urinary microbiota, local immune responses, and urinary incontinence symptoms. To investigate these relationships, we evaluated the structure of the urinary microbiome, local inflammatory markers, and patient responses prior to and at 6-weeks after treatment with anticholinergic medication for urgency urinary incontinence (UUI). Using a prospective pilot study, we enrolled women who presented with UUI symptoms and were prescribed treatment with anticholinergics. Catheterized urine samples were collected from participants at their baseline and 6-week follow-up visits for microbiological (standard and 16S rRNA gene phylotyping analyses) and cytokine analysis along with the UDI-6 questionnaire and 2-day bladder diary. Patients were Caucasian, post- menopausal, with a median age of 64 and median BMI of 30.1kg/m2. Among the patients, 75% had UUI symptoms for less than 2years, but with a frequency of at least a few times a week or every day. Most women were prescribed 10mg oxybutynin ER daily at enrollment. Patients had varied urinary microbiota by culture and 16S phylotyping, with species of Lactobacillus being the most common, in six samples, in addition to taxa associated with Enterococcus, Staphylococcus, and mixed flora. Cytokine levels showed no differences before and after treatment with anticholinergics, nor correlation with urinary bacteria or microbiome composition. Our pilot study suggests factors in addition to the urinary microbiome and local immune responses may be involved in patients' response to anticholinergics for UUI.

A correlation study between virulence factors and multidrug resistance among clinical isolates of Proteus mirabilis

Treatment of Proteus mirabilis infections is a challenge due to the high abundance of virulence factors and the high intrinsic resistance to antimicrobials. Multidrug resistance (MDR) and extensive drug resistance (XDR) further challenge the control of P. mirabilis infection. This study aimed to investigate the correlation between virulence determinants and multidrug resistance in 100 clinical isolates of P. mirabilis collected in Alexandria from December 2019 to June 2021. Susceptibility to antimicrobials was tested by the Kirby Bauer method. Detection of swarming, urease, protease, hemolysin, and biofilm formation was performed phenotypically and by PCR amplification of zapA, flaA, ureC, mrpA, atfA, ucaA, hpmA, and luxS. MDR and XDR were detected in 34% and 5%, respectively. All isolates were positive for motility, swarming, urease, and protease production. Ninety percent were positive for hemolysin production, while 73% formed biofilm. All isolates possessed the ureC and zapA genes. The luxS, flaA, ucaA, hpmA, mrpA, and atfA genes were detected in 99%, 98%, 96% 90%, 89%, and 84%, respectively. The presence of a single biofilm-related gene was statistically correlated with non-biofilm production (P= 0.018). It was concluded that P. mirabilis isolates from catheterized-urine samples were significantly associated with biofilm formation. MDR and virulence were not statistically correlated. A significant positive correlation was detected between some virulence genes in P. mirabilis. Non-MDR isolates of P. mirabilis had a high abundance of virulence factors with no statistically significant difference from MDR. Most of the MDR and all XDR isolates could produce biofilm.

MP70-11 DEFINING THE URINARY MICROBIOME OF THE HEALTHY INFANT BLADDER.

You have accessJournal of UrologyCME1 Apr 2023MP70-11 DEFINING THE URINARY MICROBIOME OF THE HEALTHY INFANT BLADDER. Viktor Flores, Seth Reasoner, Leslie Peard, Benjamin Abelson, Carmila Manuel, Gerald Van Horn, Abby Taylor, Cyrus Adams, Mark Adams, John Thomas, John Pope, John Brock, Grace Morales, Jonathan Schmitz, Douglass Clayton, and Maria Hadjifrangiskou Viktor FloresViktor Flores More articles by this author , Seth ReasonerSeth Reasoner More articles by this author , Leslie PeardLeslie Peard More articles by this author , Benjamin AbelsonBenjamin Abelson More articles by this author , Carmila ManuelCarmila Manuel More articles by this author , Gerald Van HornGerald Van Horn More articles by this author , Abby TaylorAbby Taylor More articles by this author , Cyrus AdamsCyrus Adams More articles by this author , Mark AdamsMark Adams More articles by this author , John ThomasJohn Thomas More articles by this author , John PopeJohn Pope More articles by this author , John BrockJohn Brock More articles by this author , Grace MoralesGrace Morales More articles by this author , Jonathan SchmitzJonathan Schmitz More articles by this author , Douglass ClaytonDouglass Clayton More articles by this author , and Maria HadjifrangiskouMaria Hadjifrangiskou More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003338.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A decade ago, the ”healthy” bladder was presumed to be a sterile organ. The advent of expanded quantitative urine culture (EQUC) and incorporation of 16S rRNA sequencing in studying the urinary microbiome have now disproven this long-held dogma. To date, the pediatric urinary microbiome of healthy infants has not been characterized using EQUC and 16S rRNA. The aim of this study is to identify the cultivatable urobiome of male infants and characterize a representation of the core microbiome using 16S rRNA sequencing. METHODS: IRB approval was obtained to collect catheterized urine samples from healthy infants less than 12 months of age undergoing an elective circumcision. Exclusion criteria included prior history of UTI, genitourinary anomaly, or urethral catheterization. Urine aliquots were plated in 5% Sheep’s Blood and Brucella agar plates and incubated anaerobically and aerobically for up to 5 days. Speciation of bacterial isolates were verified by Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF). Environmental control samples were collected from the operating room also analyzed. Urine samples were shipped to University of California at San Diego Microbiome Center for DNA extraction and sequencing. Following DNA extraction, the V4 hypervariable 16S rRNA region was amplified using standardized primers from the Earth Microbiome Project and reads were processed using R programming. RESULTS: Fifty patients were enrolled. Sixty-four percent of patients grew organisms using EQUC, ranging from 1 to 5 unique species. Infants born full term were more likely to grow an organism using EQUC (p=0.03), but there was no difference in microbiome diversity with 16S rRNA sequencing based on method of infant delivery, birth term status, or prior antibiotic exposure. Forty different cultivatable species were identified, with the highest representation in the Actinomycetaceae (18%), Enterobacteriaceae and Staphylococcaceae families (13%). The most common species was Actinotignum schaalii seen in 18% of infants. 16S sequencing demonstrated that the core microbiome of infants is composed of bacteria from the phyla Actinobacteria, Bacteroides, Firmicutes, and Proteobacteria. CONCLUSIONS: Using EQUC we identified uncommon bacterial isolates in 64% of healthy infant samples, with 40 distinct organisms. A core microbiome representation of the infant bladder was identified with 16S rRNA sequencing. Our results demonstrate that a urinary microbiome can be detected in healthy infants using culturing and sequencing methods. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1008 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Viktor Flores More articles by this author Seth Reasoner More articles by this author Leslie Peard More articles by this author Benjamin Abelson More articles by this author Carmila Manuel More articles by this author Gerald Van Horn More articles by this author Abby Taylor More articles by this author Cyrus Adams More articles by this author Mark Adams More articles by this author John Thomas More articles by this author John Pope More articles by this author John Brock More articles by this author Grace Morales More articles by this author Jonathan Schmitz More articles by this author Douglass Clayton More articles by this author Maria Hadjifrangiskou More articles by this author Expand All Advertisement PDF downloadLoading ...

Urinary shedding of common DNA viruses and their possible association with bladder cancer: a qPCR-based study.

After a decade of human urinary microbiota research, little is known about the composition of the urinary virome and its association with health and disease. This study aimed to investigate the presence of 10 common DNA viruses in human urine and their putative association with bladder cancer (BC). Catheterized urine samples were collected from patients undergoing endoscopic urological procedures under anesthesia. After DNA extraction from the samples, viral DNA sequences were detected using real-time PCR. Viruria rates were compared between BC patients and controls. A total of 106 patients (89 males and 17 females) were included in the study. Fifty-seven (53.8%) were BC patients and 49 (46.2%) had upper urinary tract stones or bladder outlet obstruction. The viruses detected in the urine were human cytomegalovirus (2.0%), Epstein-Barr virus (6.0%), human herpesvirus-6 (12.5%), human papillomavirus (15.2%), BK polyomavirus (15.5%), torque teno virus (44.2%), and JC polyomavirus (47.6%), while no adenoviruses, herpes simplex virus 1 and 2, or parvoviruses were found. There were statistically significant differences in HPV viruria rates between cancer patients and controls (24.5% vs. 4.3%, p=0.032 after adjustment for age and gender). Viruria rates increased from benign to non-muscle-invasive and muscle-invasive tumors. Patients with a history of BC have higher HPV viruria rates than controls. Whether this relationship is a causal one remains to be established by further research.

Uromycobiome in infants and toddlers with and without urinary tract infections.

The bacterial components of the urobiome have been described in children, both with and without urinary tract infections (UTI). However, less is known about the pediatric uromycobiome: the community of fungi in the urine. The objectives of this study were to describe the uromycobiome in children and determine whether the uromycobiome differs between children with and without UTI. This was a cross-sectional study of febrile children less than 3years of age who presented to the Emergency Department and had a catheterized urine sample sent as part of clinical care. We obtained residual urine for use in this study and identified components of the uromyobiome through amplification and sequencing of the fungal ITS2 region. We then compared the uromycobiome between those with and without UTI. We included 374 children in this study (UTI = 50, no UTI = 324). Fungi were isolated from urine samples of 310 (83%) children. Fungi were identified in a higher proportion of children with UTI, compared to those without UTI (96% vs. 81%, p = 0.01). Shannon diversity index was higher in children with UTI, compared to those without (p = 0.04). Although there were differences in the most abundant taxa between children with and without UTI, there was no significant difference in beta diversity between groups. Fungi were detected in the majority of catheterized urine samples from children. While a higher proportion of children with UTI had fungi in their urine, compared to children without UTI, there was no difference in the composition of these groups. A higher resolution version of the Graphical abstract is available as Supplementary information.

Comparative Evaluation ofBiofilm Detection Methods among Uropathogenic Gram-Positive and Gram Negative Bacteria Isolated from Catheterized Urine Sample and its antibiogram

Background: Biofilm formation is a potential virulence characteristic exhibited by bacteria resulting in the severity of many infections. It will give rise to multidrug resistant strains disturbing the effective management of many chronic infections. Objectives: The present study aims to focus on the biofilm detection of uropathogenic bacteria by three distinct techniques. The sensitivity and specificity for all the three methods is evaluated. The present study also demonstrates the antibiogram of biofilm producing bacteria.Materials and Method: The study includes 89bacterial isolates from catheterized patients with urinary tract infections admitted in ICUs, dialysis units and various wards. Formation of biofilm was detected by: tube method (TM), the tissue culture plate (TCP) method and Congo Red Agar (CRA) method. According to CLSI guidelines the antimicrobial susceptibility test was performed among the biofilm forming bacteria.Results: Out of 89 bacterial isolates, 33 were gram positive cocci and 56 were gram negative bacilli. Among the gram positive cocci, 28 (84.8%) andgram negative bacilli, 50(89.2%) formed biofilm. Sensitivity of TCM, TM, and CRM methods were 98.3%, 71.4% and 18.6% respectively. For biofilm forming gram positive bacteria, the maximum antibiotic resistance was achieved towards Penicillin (89%) followed by Amoxyclav (78%). In the case of gram negative bacteria gentamicin showed maximum resistance in 88% followed by Ciprofloxacin in 80% of the isolates. Conclusion: Biofilm and multi-drug resistance plays a vital role in the pathogenesis of catheterized urinary tract infection (CAUTI). Evaluation of Biofilm among uropathogenic bacteria helps to manage clinically resulting in better prognosis. Tissue culture plate techniqueis very effectivein detecting biofilm that can be suggested in diagnostic laboratories. Keywords: Biofilm, virulence factor, multidrug resistance,CAUTI.

Phenotypic and genotypic characterization of multi-drug resistance Pseudomonas aeruginosa isolated from urinary tract infections of non-catheterized and catheterized Chinese patients: A descriptive study over 3 years.

Urinary tract infections (UTI) are commonest infections, especially in catheterized patients. It is responsible of mortality and morbidity among hospitalized patients. The objectives of the study were to demonstrate the virulence factors and their genes of multi-drug resistance Pseudomonas aeruginosa causing UTI. A total of 366 non-catheterized and 171 catheterized patients' (in whom the catheter was in > 48 hours duration) urine samples (one sample/patient) from both sexes were collected and processed. >105 colony forming unit was considered as Pseudomonas aeruginosa culture-positive. Antimicrobial susceptibility testing was done by the Kirby Bauer disc diffusion method (The Clinical and laboratory standards institute guidelines 2019). The virulence factors were detected by in vitro assay method and polymerase chain reaction was done to detect the resistance genes present in Pseudomonas aeruginosa. Biofilm production was detected by the microtiter plate method. Out of 537 urine samples a total of 280 (52%) were females and 257 (48%) were male patients. Out of 366 non-catheterized urine samples 42 (23.6%) grew Pseudomonas aeruginosa and out of 171 catheterized urine 23 (25.84%) grew Pseudomonas aeruginosa. All were multi-drug resistance strains. A total of 10 (23.80%), 42 (100%), 8 (19.05%), 24 (57.14%), and 36 (85.71%) produced the Metallo-β-lactamases, AmpC-β-lactamase, carbapenemase, strong biofilm, and twitching motility positive, respectively in non-catheterized urine samples. A total of 11, 34, 9, 28, and 37 were oxacillinases-23, multidrug efflux protein resistance, New Delhi metallo-ß-lactamase-1, Verona Integron-encoded MBL, and Pseudomonas specific enzyme gene detected in non-catheterized urine samples. A total of 8 (34.8%), 6 (26.01%), 4 (17.39%), 15 (65.2%), and 18 (78.26%) were produced Metallo-β-lactamases, carbapenemase, AmpC-β-lactamase, strong biofilm, and twitching motility positive, respectively in catheterized urine samples. A total of 6, 18, 4, 16, and 15 were oxacillinases 23, multidrug efflux protein resistance, New Delhi metallo-ß-lactamase-1, Verona Integron-encoded MBL, and Pseudomonas specific enzyme, respectively genes detected in catheterized urine samples. Biofilm formation and twitching motility showed correlation among culture-positive Pseudomonas aeruginosa strains from catheterized patients (Correlation coefficients = 6.2, 95% confidence interval: 5.4-7.2). A better hospital infection control practice and detailed investigation of the microevolution of Pseudomonas aeruginosa in UTI are needed.

Draft Genome Sequence of Staphylococcus epidermidis UMB7543, Isolated from a Female Patient with Recurrent Urinary Tract Infections.

Staphylococcus epidermidis is a Gram-positive bacterium that is part of the normal human flora, found in multiple anatomical sites. Here, we present the 2.6-Mbp draft genome sequence of S. epidermidis UMB7543, isolated from a catheterized urine sample from a female patient with a documented diagnosis of recurrent urinary tract infection.

The detection of urinary viruses is associated with aggravated symptoms and altered bacteriome in female with overactive bladder.

Although it is known that changes in bacterial components of the urinary microbiome are associated with overactive bladder (OAB), the specific role of viruses is still insufficiently investigated. The aim of the present study is to evaluate the role of urinary viruses in woman with OAB, and analyze the potential relationship between viruses, bacteria and disease. Catheterized urine samples were collected from 55 women with OAB and 18 control individuals. OAB patients fulfilling the following criteria were considered eligible for this study: female, 18 years of age or older; presented with classic OAB symptoms defined by the International Continence Society; and OAB Symptom Score (OABSS) total score ≥ 3 points and question 3 (urgency) score ≥ 2 points. Based on results of metagenomic next-generation sequencing (mNGS), all participants were divided into virus-infected and virus-uninfected groups for analysis. The results of mNGS showed that the diversity of the OAB group was lower than that of the control group when focused on bacterial sequences, which was consistent with our previous study. According to the questionnaire filled out by the patients, OABSS and 8-item OAB questionnaire, female OAB patients who had viruses detected in their urine had more severe symptoms. In parallel, John Cunningham virus (mainly subtype 7 and subtype 2) was the most frequently detected virus in urine. Correlation analysis indicated that risk factors for virus infection in OAB patients include age, habit of holding urine and pelvic surgery history. Given our preliminary data, viral infection can aggravate OAB severity and affect the composition of bacterial. Further research is required to explain how viral infections can aggravate OAB patient symptoms and cause bacterial changes.

Detection of Biofilm Producing Uropathogenic Bacteria and Their Antibiotic Sensitivity Pattern

Background: Urinary tract infection is one the most common infection in clinical practice. Uropathogens have the ability to form biofilm in urinary tract, frequently within the indwelling catheter. Microorganism growing in a biofilm is associated with chronic and recurrent UTI and less sensitive to antimicrobial agent. So, the aim of the present study was to detect biofilm-producing uropathogenic bacteria by microtiter plate assay and antibiotic sensitivity pattern of biofilm- producing and biofilm non-producing organisms. Methods: This cross- sectional observational study was carried out in Microbiology Department, Chattogram Medical College, Bangladesh. Urine samples were collected from outpatient’s department and inpatients of different wards. Standard microbiological procedures and biochemical tests were carried out. Antibiotic susceptibility test was performed by using the Kirby-Bauer disk diffusion technique. Biofilm production was detected by Microtiter plate method (MPM). Results: Out of 252 tested samples, 73(55.3%) organisms were isolated from non-catheterized urine and 74(61.66%) from catheterized urine samples. The most frequently isolated organism was Escherichia coli (60.27%, 50%) in both non- catheterized and catheterized patients followed by Klebsiella spp. (21.91%, 27.02%); Pseudomonas spp. (9.58%, 12.21%); Acinetobacter spp. (1.36%, 4.05%); Staphylococcus aureus (4.1%, 2.7%) respectively and 2.7% CoNS from non-catheterized patients. In the non- catheterized patients, 19 (26.02%) out of 73 bacterial isolates were biofilm-forming and in the catheterized patients, 33 (44.59%) out of 74 bacterial isolates were biofilm forming. The maximum biofilm-producing organism was Escherichia coli in both isolates. Biofilm- producing organism found relatively high resistance against tested antibiotics. Imipenem, Amikacin, Nitrofurantoin, and Piperacillin-tazobactam are the few microbial agents that are effective against biofilm-producing gram-negative organisms ..

Cytological Evaluation of Urinary Samples among Vesicovaginal Fistula Patients in National Obstetrics Fistula Centre, Southeastern Nigeria

Vesicovaginal fistula (VVF) is a non-physiological epithelial fistulous tract between the bladder and the vagina, resulting in continuous urinary incontinence. VVF occurs most commonly after obstetrical and gynecological injury. This study is a descriptive cross-sectional study designed to carry out cytological evaluation of urine samples of vesicovaginal fistula patients in National Obstetrics Fistula Centre, Southeastern Nigeria. The voided and catheterized urine samples collected were stained using Papanicolaou and Diff-Quick staining techniques. A total number of 123 patients were involved in this study. The mean age of the patients was 36.66 (± 6.21) years. The patients were grouped according to age into 4 groups: 1 (0.8%) was ≤ 24 years, 59 (48.0%) were 25 to 34 years, 43 (35.0%) were 35 to 44 years and 20 (16.2%) were ≥ 45 years of age. The parity status of these cases was grand multipara 29 (23.6%), multipara 32 (37.4%), primipara 46 (37.4%) and nullipara 16 (13.0%). Majority of the patients 111 (90.2%) were from rural areas, 8 (6.5%) from urban areas and 4 (3.3%) were from semi-urban areas. According to marital status, 91 (74.0%) were married, 16 (13.0%) were widowed, 5 (4.1%) were single and 11 (8.9%) were divorced. According to the period the patients had lived with fistula, majority of the patients 94 (76.4%) had lived less than one year with this problem, while 29 (23.6%) had suffered from VVF for 1-5 years. Cytological evaluation of the urine smears showed that a total of 92 (74.8%) urine samples had normal findings. The rest of the 31 (25.2%) urine samples showed a variety of findings. Out of these 31 samples, 16 (51.6%) showed inflammatory aggregates suggestive of urinary tract inflammation, 3 (9.7%) showed decoy cells suggestive of Polyoma virus infection, 7 (22.6%) cases showed perinuclei halo suggestive of Trichomonas vaginalis infection, 3 (9.7%) showed oval fat bodies suggestive of possible nephrotic syndrome, 8(25.8%) cases showed koilocytes, indicative of Human papilloma virus infections. Cases that showed presence of haematuria were 7 (22.6%). There was no case of tumor cells detected in all the urine samples examined. From the outcome of this study, it is important to take special note of the presence of the viral carcinogens: Polyoma virus and Human papilloma virus, since in theory and as reported in few case reports, malignancy of the urinary tract can lead to formation of vesicovaginal fistula.