Causative Agent Of Urinary Tract Infections Research Articles

Comparison of Microbial Pattern Causing Urinary Tract Infection in Female Out and Hospitalized Patients in Jakarta

Urinary Tract Infection (UTI) is an infection in any part of the urinary system. Women are 3 times more likely to have UTI than men. The UTI accounts for 15% infection cases in outpatients and 24% cases in hospitalized patients. Although the most common cause of UTI is certain bacteria, but it was not easy to choose the appropriate antimicrobial therapy. Strategy for choosing empiric antimicrobial treatments for UTI in female out- and hospitalized patients should be based on the pattern of the causative organisms. The aim of this study was to understand the microbial pattern causing UTI in female out- and hospitalized patients in Jakarta. The UTI -1 causative microorganisms were obtained from urine culture containing 100,000 cfu/mL . Twenty nine microorganisms were found as the causative agents of UTI in 317 pregnant women who came to six Community Health Centres (Puskesmas) in Jakarta: Makassar; Pulogadung, Cakung, Pasar Rebo, Duren Sawit, and Kramat Jati for antenatal care. Twenty nine microorganisms were isolated from 114 urine samples of female hospitalized patients who were diagnosed of UTI. The samples were obtained from the Microbiology Laboratory Clinic of FKUI-RSCM. The most common microorganisms causing UTI in female out- and hospitalized patients were Gram negative bacteria. In female outpatients, Klebsiella sp was the most common causative bacteria (31%), followed by Escherichia coli (24.1%). In female hospitalized patients, Escherichia coli was the most common causative bacteria (30%), followed by Candida sp (24.1%) and Klebsiella pneumonia (6.8%). There was more variation in the pattern of UTI causative organisms in hospitalized female patients in comparison to that of the outpatients. Candida sp. was only found in hospitalized UTI patients but not in outpatients.

Prevalence of urinary tract infection, its causative agents and antibiotic sensitivity pattern : A study in Northern International Medical College Hospital, Dhaka

Background : Urinary tract infection (UTI) is one of the most important causes of morbidity and mortality in the developing countries like Bangladesh. Antimicrobial agents are the frequently used drug for its treatment. Periodic evaluation of antimicrobial activity of different antibiotics is essential as the pattern of antibiotic sensitivity may vary over periods. Increasing antibiotic resistance among urinary pathogens to commonly prescribed drugs has become a global reality today.Objective : To determine the prevalence and to find out the causative agents of UTI and their antibiotic sensitivity pattern among suspected UTI patients attending Northern International Medical College Hospital (NIMCH), Dhaka.Methods : A retrospective study was conducted at Northern International Medical College Hospital, Dhaka, Bangladesh by analyzing the records of urine samples collected for culture and sensitivity tests over a period of six months (January 2014 to June 2014). Of the total 878 clean catch mid-stream urine samples collected from suspected cases of UTI patients of all ages and both sexes. Urine specimens were cultured for isolation of microbial agents of urinary tract infection. The isolated bacteria were identified using biochemical test. The diffusion susceptibility test was used to determine susceptibility of bacterial agents to antibiotics. Computerized data was collected from Microbiology department of NIMCH and analyzed by Microsoft Excel Version 2013.Results : In this study, 182 (20.73%) out of 878 urine sample were positive for pathogenic organisms. Of the various pathogenic organisms isolated, Escherichia coli constituted for 85.16% followed by Pseudomonas sp, Acinatobactersp, Group D Streptococcus, Staphylococcus aureus, Klebsiellasp, Enterobactersp and others. E.coli was found to be most sensitive to Imipenem, Amikacin and Meropenem and resistant to most commonly used oral drugs like Azithromycin, Cefexime, cotrimoxazole and Ciprofloxacin and Levofloxacin.Conclusion : Mainly Gram negative bacilli is responsible for UTI and most frequent isolated bacteria was E-coli. The most effective antibiotics were Imipenem, Amikacin, Meropenem,all of them are parentral. Majority E-coli were resistant to commonly used oral drugs like Azithromycin, Cefexime, cotrimoxazole and Ciprofloxacin. Therefore the choice of antibiotic therapy in UTI should be depends on the local sensitivity pattern of the infecting organisms.Northern International Medical College Journal Vol.7(1) Jul 2015: 105-109

English

This retrospective study was conducted at Specialist Hospital Sokoto, Sokoto State to outline the causative agents associated with urinary tract infections (UTIs) and to compare the prevalence of UTI among sexes and age groups. The cases seen between November, 2013 and October, 2014 were included in the study. Total number of patients in the study was 1,120 (589 male and 631 female). Total number of patients with positive urine culture was 525, while 638 were culture negative and 57 were neither decided (positive or negative). The rate for positive culture was 52.4% for male patients and 47.6% for female patients. Age range indicated 11.1% are ≤ 18 years of age, while 88.9% accounts for patients >18 years. The study revealed that Escherichia coli (26.9%) and Staphylococcus spp. (26.9%) were the common causative organisms, followed by Klebsiella spp. (16.4%), Proteus spp. (13.1%), Citrobacter spp. (6.5%) and others accounting for 10.3% (Streptococcus spp., 3.8%, Enterobacter spp., 3.4% and Pseudomonas spp., 3.1%). Most commonly preferred antibiotics in the study were Ciprofloxacin, Ofloxacin, Norfloxacin, Cefotaxime, Cotrimoxazole, Nalidixic acid, Nitrofurantoin, Ceftazidime, Ampicillin, Erythromycin, Tetracycline, Amoxicillin/ Clavulanic acid and Gentamicin. Cotrimoxazole displayed a high resistant rate of 84.2%, while Amoxicillin/Clavulanic acid showed a high susceptibility rate of 88.8% to all isolates. The study creates awareness on the causative agents of UTIs as well as the prevalence of UTI among sexes and age group in Sokoto Metropolis. The study also creates awareness on the susceptibility pattern of the causative agents. Key words: Retrospective studies, prevalence, uropathogens.

Application of quantitative multiplex real-time polymerase chain reaction for identification of causative agents of urinary tract infections in pregnancy

Urinary tract infections (UTIs) represent the most common bacterial infections and often complicate pregnancy. UTIs in pregnancy are classified by site of bacterial proliferation as follows: asymptomatic bacteriuria, cystitis, pyelonephritis. Screening for asymptomatic bacteriuria is a standard of obstetrical care and is included in most international guidelines. The urine microbiologic culture is considered the gold standard for laboratory diagnosis of UTIs. Molecular methods enable to rapidly detect, identify and quantitate causative agents of UTIs in urine and are effective alternative to traditional bacteriological methods.

Bacteriological Study of Urinary Tract Infections with Antibiotics Susceptibility to Bacterial Isolates among Honeymoon Women in Al Qassim Hospital, Babylon Province, Iraq

Urinary Tract Infections (UTIs) is an infection caused by the presence and growth of microorganism anywhere in the urinary tract. This study aims at determining the most common microorganism that causes UTI in honeymoon women, detection the most effective antimicrobial agents that causative agents of UTI and select the best antibiotics for treated UTI. One hundred and thirty specimens were collected from women suspected with UTI {honeymoon (95) and other women (35)} in al-Qassim hospital; during the period (January 2012 to 30

Self-Transmissibility of the Integrative and Conjugative Element ICEPm1between Clinical Isolates Requires a Functional Integrase, Relaxase, and Type IV Secretion System

Integrative and conjugative elements (ICEs), which are chromosomal mobile elements, can conjugatively transfer between bacteria. Recently, we identified a genomic island of Proteus mirabilis, a common agent of catheter-associated urinary tract infection (UTI), that possesses all the properties consistent with an ICE. This element, designated ICEPm1, is highly conserved in other causative agents of UTI, suggesting its mobility. We demonstrate that ICEPm1 can actively excise from the chromosome in a clonal population of bacteria and that this excision is integrase dependent. Although in P. mirabilis HI4320, ICEPm1 is annotated as integrated into the phenylalanine tRNA gene pheV, we show that ICEPm1 can integrate into either pheV or pheU. We determined that ICEPm1 transfers at a frequency of 1.35 × 10(-5) transconjugants/donor to ICEPm1-deficient P. mirabilis using plate mating assays with clinical isolates. Insertional inactivation of a putative integrase gene on ICEPm1 decreased transfer frequencies of ICEPm1 to below the limit of detection. Mutation of the relaxase of ICEPm1 also eliminates transfer and demonstrates that this element is indeed self-transmissible and not transferred in trans, as are some mobilizable genomic islands. Together, these findings clearly demonstrate that ICEPm1 can actively excise from the chromosome in an integrase-dependent manner, dynamically integrate into both phenylalanine tRNA genes, and transfer into clinical strains using its own conjugation machinery.

Clinical and Laboratory Characteristics of Acute Community-Acquired Urinary Tract Infections in Adult Hospitalised Patients

Urinary tract infections (UTI) cause a great number of morbidity and mortality. These infections are serious complications in pregnancy, patients with diabetes, polycystic kidneys disease, sickle cell anaemia, kidney transplant and in patients with functional or structural anomalies of the urinary tract. The aim of this investigation was to determine a dominant causative agents of UTI and some of the clinical and laboratory characteristics of acute community-acquired UTI in adult hospitalised patients. We studied 200 adult patients with acute community-acquired UTI hospitalised in the Clinic for Infectious Diseases Tuzla from January 2006 to December 2007. The patients were divided into two groups: a group of patients with E. coli UTI (147) and a group of patients with non-E. coli UTI (53). In these two groups, the symptoms and signs of illness, blood test and urine analysis results were analysed. Our results have shown that the patients with E. coli UTI frequently had fever higher than 38,5 degrees C (p<0,0001), chills (p=0,0349), headache (p=0,0499), cloudy urine (p<0,0001), proteinuria (p=0,0011) and positive nitrite-test (p=0,0002). The patients with non-E. coli UTI frequently had fever lower than 38,5 degrees C (p<0,0001) and urine specific gravity <1015 (p=0,0012). There was no significant difference in blood test results between patients with E. coli and non-E. coli UTI. These clinical and laboratory findings can lead us to early etiological diagnosis of these UTI before urine culture detection of causative agents, which takes several days. Early etiological diagnosis of the E. coli and non-E. coli UTI is necessary for an urgent administration of appropriate empirical antibiotic treatment. This is very important in prevention of irreversible kidney damage, prolonged treatment, complications, as well as recidives and chronicity of the illness.

Urinary tract infections in patients with malignant neoplasms of the genitourinary system

Summary Aim To diagnose the etiological factors involved in urinary tract infections (UTI) and to examine antibiotic sensitivities in bacteria – causative agents of UTI in female patients with genitourinary malignancies. Materials/Methods Nineteen patients aged between 35 and 75 years treated for genitourinary malignancies and with a diagnosis of UTI were examined. The majority of these patients (17) were treated with X rays to the pelvic region (tele – and brachytherapy). Six patients were treated for endometrial carcinoma. One patient was treated for ovarian cancer, and one for vaginal cancer. Significant bacteriuria was defined as 10 4 or more CFUs/ml in quantitative urine examination. Microorganisms were identified according to standard bacteriological methods using bio-Merieux tests. The isolated bacteria were tested for antibiotic sensitivity using the ATB Expression system. Results E. coli was the most frequently observed causative factor in cases of UTI. E. faecalis strains were the next most commonly observed species. One of 11 isolated E. coli strains was resistant to 5 antibiotics, a second was resistant to 3 antibiotics and three strains were resistant to 2 antibiotics. E. coli strains were classified into 9, and E. faecalis into 4, sensitivity patterns. UTI was diagnosed in four patients with stage I B, in four with stage III B and in one patient with stage IV cervical cancer. Conclusions E. coli and E. faecalis were the most frequently isolated species from the urine of female patients with genitourinary malignancies. These bacteria are among the main causative agents of UTI. The results of these investigations may be used for epidemiological purposes: to find the causes and sources of nosocomial infections and in the prophylaxis of these infections.

Response from Emmanuel Lemichez: A new turn in Rho GTPase activation by Escherichia coli cytotoxic necrotizing factors

The high frequency and high cost of urinary tract infections (UTIs) make these pathologies a major public health problem in developed countries. Uropathogenic Escherichia coli (UPEC), the major causative agent of UTIs, and its frequently associated cytotoxic necrotizing factor-1 (CNF1) toxin, have therefore attracted much attention. Investigations carried out in Aktories and Boquet's laboratories, together with Horiguchi's laboratory working on the CNF1-related dermonecrotic toxin of Bordetella, have clarified the molecular mechanism of action of this toxin family towards Rho GTPase proteins [1xBacterial toxins that modify the actin cytoskeleton. Barbieri, J.T. et al. Annu. Rev. Cell Dev. Biol. 2002; 18: 315–344Crossref | PubMed | Scopus (107)See all References, 2xSee all References].In vitro, these toxins cause permanent activation of Rho GTPases by modifying the glutamine residue responsible for GTP hydrolysis. Recent observations have revealed that in fact, CNF1 has a dual mechanism of action, comprising activation followed by the proteasome-dependent degradation of RhoA, Rac and Cdc42, thereby resulting in long-term, low-grade stimulation of the Rho GTPases [3xCNF1 exploits the ubiquitin-proteasome machinery to restrict Rho GTPase activation for bacterial host cell invasion. Doye, A. et al. Cell. 2002; 111: 553–564Abstract | Full Text | Full Text PDF | PubMed | Scopus (163)See all References, 4xProteasomal degradation of cytotoxic necrotizing factor 1-activated Rac. Lerm, M. et al. Infect. Immun. 2002; 70: 4053–4058Crossref | PubMed | Scopus (69)See all References]. This dual mechanism has been hidden until now owing to the lower capacity of some carcinoma cell lines used for CNF1 studies to efficiently carry out ubiquitination and proteasomal degradation of permanently activated Rho GTPases [3xCNF1 exploits the ubiquitin-proteasome machinery to restrict Rho GTPase activation for bacterial host cell invasion. Doye, A. et al. Cell. 2002; 111: 553–564Abstract | Full Text | Full Text PDF | PubMed | Scopus (163)See all References[3].Previous work has highlighted a role for CNF1 as an invasive factor [5xInduction of phagocytic behaviour in human epithelial cells by Escherichia coli cytotoxic necrotizing factor type 1. Falzano, L. et al. Mol. Microbiol. 1993; 9: 1247–1254Crossref | PubMedSee all References[5]. In addition, we could demonstrate that reaching a low level of Rac activation is required for efficient bacterial entry into non-professional phagocytic cells, together with associated cellular motility and cellular junction dynamic [3xCNF1 exploits the ubiquitin-proteasome machinery to restrict Rho GTPase activation for bacterial host cell invasion. Doye, A. et al. Cell. 2002; 111: 553–564Abstract | Full Text | Full Text PDF | PubMed | Scopus (163)See all References[3]. Both cellular motility and bacterial invasion thus appeared tightly coupled, requiring cell polarization [6xQuo vadis: polarized membrane recycling in motility and phagocytosis. Mellman, I. J. Cell Biol. 2000; 149: 529–530Crossref | PubMed | Scopus (24)See all References[6]. Our observations also raised an alternative hypothesis that pathogenic bacteria have developed antagonist virulence factors toward Rho GTPases to protect host cells from toxicity arising from massive activation of Rho GTPases. We suggest that instead, these virulence factors might cooperate for efficient bacterial invasion. Consistent with this model, different pathogenic bacteria appear to have developed different strategies to achieve a local polymerization of the actin cytoskeleton for cell penetration. For example, Salmonella injects both SopE/E2 and SptP virulence factors for the respective activation and inhibition of Rac and Cdc42 [7xStriking a balance: modulation of the actin cytoskeleton by Salmonella. Galan, J.E. and Zhou, D. Proc. Natl. Acad. Sci. U. S. A. 2000; 97: 8754–8761Crossref | PubMed | Scopus (179)See all References[7]. Likewise, Shigella injects IpaC for Rac and Cdc42 activation, and IpaA, which produces indirect disassembly of local actin filaments, both factors acting together to produce efficient bacterial entry into cells [8xBacterial signals and cell responses during Shigella entry into epithelial cells. Tran Van Nhieu, G. et al. Cell Microbiol. 2000; 2: 187–193Crossref | PubMed | Scopus (99)See all References[8].The crosstalk between bacterial virulence factors and the ubiquitin/proteasome machineries is a major point of interest for future research. Consistent with this, the YopJ/P virulence factor of Yersinia has been reported to cleave SUMO-1 ubiquitin-like polypeptide, and SigD/SopB inositol phosphatase of Salmonella appeared regulated by ubiquitylation [9xDisruption of signaling by Yersinia effector YopJ, a ubiquitin-like protein protease. Orth, K. et al. Science. 2000; 290: 1594–1597Crossref | PubMedSee all References, 10xSalmonella enterica serovar Typhimurium effector SigD/SopB is membrane-associated and ubiquitinated inside host cells. Marcus, S.L. et al. Cell Microbiol. 2002; 4: 435–446Crossref | PubMed | Scopus (70)See all References].Finally, in addition to the demonstration that CNF1 is a bona fide invasive factor, we have evidence that an oncogenic protein, exemplified by Rac, is rapidly withdrawn upon permanent activation by the ubiquitin-proteasome machinery, pointing out the proteasome to be a guardian of the cellular homeostasis.