Cause Of Urinary Tract Infections Research Articles

Genomic analysis of the zoonotic ST73 lineage containing avian and human extraintestinal pathogenic Escherichia coli (ExPEC)

Extraintestinal pathogenic Escherichia coli (ExPEC) is a globally distributed pathogen, with uropathogenic E. coli (UPEC) and sepsis-associated E. coli (SEPEC) pathotypes particularly involved in human and companion animal disease, while avian pathogenic pathotype (APEC) severely impact poultry health and production. Similarities between APEC from poultry/meat and human ExPEC suggest that some APEC lineages may have zoonotic potential. ExPEC sequence type 73 (ST73) and its clonal complex (CC) are increasing causes of urinary tract infections and sepsis, but its role in zoonotic disease is less well understood. Here, we analyzed the genome sequences of 25 E. coli isolates from Brazil (11 APEC and 14 UPEC) from two time periods, from poultry producing areas and hospitals in the same geographical regions. Isolates were compared to 558 publicly available ST73/CC73 global sequences. Brazilian APEC harbored virulence factors associated with UPEC/SEPEC such as sfa, cnf1, vat, usp, hlyA, iron acquisition and protectins/serum resistance systems, while lacking some common APEC markers and widespread multidrug resistance. Analysis of core genome MLST and SNP phylogenetic trees indicated evolutionary relationships between subgroups of the Brazilian APEC to two contemporary Brazilian UPEC isolates from the same region, and one Brazilian UPEC available from another study. Phylogenies showed a non-host, geographical, or pathotype specificity, with APEC isolates clustering closely with international human UPEC, SEPEC. The remaining Brazilian UPEC grouped within human clusters. Collectively, this suggests a zoonotic potential for subgroups of Brazilian APEC from the ST73 lineage that could contaminate poultry products and subsequently cause human infection.

Efficacy of Noncarbapenem β-Lactams Compared to Carbapenems for Extended-Spectrum β-Lactamase-Producing Enterobacterales Urinary Tract Infections.

BackgroundExtended-spectrum β-lactamase (ESBL)–producing Enterobacterales are frequent causes of urinary tract infections (UTIs). Severe infections caused by ESBL Enterobacterales are often treated with carbapenems, but optimal treatment for less severe infections such as UTIs is unclear.MethodsThis retrospective cohort study included patients admitted to 4 hospitals in an academic healthcare system with an ESBL UTI treated with either a noncarbapenem β-lactam (NCBL) or a carbapenem for at least 48 hours from 1 April 2014 to 30 April 2018. Those who received an NCBL were compared to those receiving a carbapenem, with a primary outcome of hospital length of stay (LOS) and secondary outcomes of clinical and microbiological response, days until transition to oral therapy, rate of relapsed infection, and rate of secondary infections with a multidrug-resistant organism.ResultsCharacteristics were similar among patients who received carbapenems (n = 321) and NCBLs (n = 171). There was no difference in LOS for the NCBL group compared to the carbapenem group (13 days vs 15 days, P = .66). The NCBL group had higher rates of microbiologic eradication (98% vs 92%, P = .002), shorter time to transition to oral therapy (5 days vs 9 days, P < .001), shorter overall durations of therapy (7 days vs 10 days, P < .001), and lower rates of relapsed infections (5% vs 42%, P = .0003).ConclusionsPatients treated with NCBLs had similar LOS, higher rates of culture clearance, and shorter durations of antibiotic therapy compared to patients treated with carbapenems, suggesting that treatment for ESBL UTIs should not be selected solely based on phenotypic resistance.

Facklamia hominis pyelonephritis in a pediatric patient: first case report and review of the literature

BackgroundPyelonephritis is one of the most serious bacterial illnesses during childhood. Gram-negative organisms account for up to 90% of the cases. Gram-positive bacteria are uncommon causes of urinary tract infections, and only a few cases caused by Facklamia hominis have been reported in the literature.Case presentationA five-year-old girl with tracheostomy and gastrostomy and past medical history of congenital lymphangioma presented with a two-week history of with intermittent fever, frequent urination, and vesical tenesmus. Diagnosis of pyelonephritis was made. Urine culture reported colonies with alpha-hemolysis in blood agar at 48-h of incubation and Facklamia hominis was identified by MALDI-TOF. The patient was successfully treated with gentamicin.ConclusionsThis is the first reported case of pyelonephritis by Facklamia hominis in a child, and the second involving infection in a pediatric patient. Although this pathogen is uncommon, current treatment of F. hominis is a challenge for physicians. This case illustrates the requirement to standardize identification and treatment of care to avoid treatment failure and antimicrobial resistance.

Anti-Proteus Activity, Anti-Struvite Crystal, and Phytochemical Analysis of Sida acuta Burm. F. Ethanolic Leaf Extract.

Proteus mirabilis is a significant cause of urinary tract infection that may contribute to struvite stones. Anti-infection of this bacterium and anti-struvite formation must be considered. Sida acuta Burm. F. (SA) has been used for the treatment of diseases related to kidneys. Therefore, we investigated the effects of the SA leaf ethanolic extract (SAEE) on growth and on virulent factors (swarming motility and urease activity) of Proteus mirabilis isolated from kidney stone formers. We also evaluated anti-struvite crystal formation and phytochemical constituents of SAEE. The minimum inhibitory concentrations (MICs) of SAEE against three clinical P. mirabilis isolates were 8 mg/mL. Intriguingly, the 1/2MIC of SAEE had significant inhibitory effects on the swarming motility and urease activity of clinical P. mirabilis isolates when compared with the condition without SAEE. The SAEE at the various concentrations significantly inhibited the average weights of struvite crystals in a dose-dependent manner, compared with the control. The phytochemical analysis revealed that SAEE contained catechin, chlorogenic acid, rutin, and ferulic acid. This study indicated that SAEE has anti-P. mirabilis and anti-struvite crystal activities via its bioactive compounds. For this reason, SAEE may be developed as a new agent for the treatment of struvite stone induced by P. mirabilis.

Evaluation of mechanisms of colistin resistance in Klebsiella pneumoniae strains isolated from patients with urinary tract infection in ICU.

Background and Objectives:One of the major causes of urinary tract infections is Klebsiella pneumoniae. Currently, few studies investigated the mechanisms of resistance to colistin in Iran. The current study aimed to determine the prevalence of plasmid and chromosome-mediated resistance to colistin in K. pneumoniae isolates.Materials and Methods:177 urine samples were collected from patients with urinary tract infections hospitalized in the intensive care unit (ICU) of hospitals in the city of Qazvin. K. pneumoniae isolates were identified by standard biochemical methods, resistance to colistin among K. pneumoniae isolates were tested by disk diffusion and microbroth dilution methods. The chromosomal mutation and presence of the mcr genes in colistin-resistant K. pneumoniae were evaluated by PCR.Results:Out of 177 samples, 65 K. pneumoniae were obtained from patients in the ICU. Six colistin-resistant isolates were isolated with MIC values ≥4 μg/mL, none of them was positive for mcr1-5. In 4 isolates, missense mutation in mgrB gene resulted in amino acid substitutions and in one isolate of mgrB gene was found intact mgrB gene.Conclusion:The results suggest that mgrB mutation was the main mutation among colistin-resistant isolates and plasmid-borne colistin resistance was not expanded among strains.

A Rare Pathogen Comamonas Testosteroni: A Case Report and Review of the Literature

Comamonas testosteroni is a Gram- negative, aerobic, motile, non-spore-forming bacillus. It has not been recognized as a component of the endogenous human microflora. Due to its ability to survive in liquid environments, it can survive for a long time in a hospital environment and cause opportunistic infections. Although rare, C. testosteroni has been reported as a cause of cellulitis, peritonitis, endocarditis, meningitis, endophthalmitis, tenosynovitis, pneumonia and bacteremia. Here, we present a case of a 4-year-old girl who was operated on for persistent cloaca with C. testosteroni isolated in her urine culture. Identification studies were performed by MALDI-TOF MS (bioMerieux, France) mass spectrophotometer method. Antibiotic susceptibility tests were performed with the automatic device VITEK-2 Compact (bioMérieux, France). Microorganism was found susceptible to ceftazidime and ciprofloxacin; intermediate susceptible to meropenem and piperacillin / tazobactam and resistant to gentamicin, amikacin, imipenem and trimethoprim-sulfamethoxazole. With this case report, C. testosteroni was reported as the first cause of urinary tract infection in our country and the third in the world.

Frequency and Antimicrobial Susceptibility Pattern of Gram-Negative Bacilli Isolated From Urine Specimens at a Tertiary Care Setting

OBJECTIVES: To find out the frequency and pattern of conventional antibiotic susceptibility of gram-negative bacilli cultured from urine specimens of patients at a tertiary care setting. METHODOLOGY: This study was conducted at the Microbiology Department of Combined Military Hospital Multan from June 2016 to May 2017. The data in this retrospective descriptive study was collected from urine culture records of the Microbiology Department, CMH Multan. Only those urine specimens who revealed positive gram-negative bacilli cultures were included in the study. Drug susceptibility patterns of these isolates were recorded against routinely used antibiotics (e.g. Nitrofurantoin, Imipenem, Sulbactum-cefoperazone, Gentamicin and Ciprofloxacin) and evaluated accordingly. RESULTS: A total of 1703 urine specimens were submitted for culture and antibiotics susceptibility testing during the period of study. A total of 128 specimens showed growth of gram-negative rods. Imipenem (95% sensitivity), Sulbactam- Cefoperazone (88% sensitivity) and Nitrofurantoin (87% sensitivity) were highly effective antibiotics against the cultured gram-negative bacilli in the study. CONCLUSION: This study showed that E. coli is the commonest cause of urinary tract infection (UTIs), followed by Klebsiella and Enterobacter species among gram-negative bacilli in our set up. In-vitro efficacy of Imipenem, Sulbactam- Cefoperazone and Nitrofurantoin was found to be the highest against these gram-negative bacilli as compared to other antimicrobials. On the contrary, in-vitro efficacy of ciprofloxacin and gentamycin was found to be extremely low.

Antibiotic susceptibility of escherichia coli strains isolates determined as a cause of urinary tract infection in pediatric patients

Antibiotic susceptibility of escherichia coli strains isolates determined as a cause of urinary tract infection in pediatric patients

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.

Evaluation of the Relationship of the Time of Vesicoureteral Reflux Between Renal Scar Development and Endoscopic Treatment Success in Early Childhood

INTRODUCTION: Vesicoureteral reflux (VUR) is an important cause of urinary tract infection and chronic renal disease. Voiding cystourethrography (VCUG) is the gold standard diagnostic test in the diagnosis of VUR. In recent years, new parameters related to VCUG have been more objectively studied to evaluate the clinical prognosis. It is aimed to evaluate the effect of reflux time in primary VUR in terms of predicting endoscopic treatment success and treatment timing in VUR management. METHOD: In our study, the records and imaging findings of children with primary VUR who underwent VCUG examination between 2012 and 2019, who were treated with endoscopic injections, were retrospectively reviewed. Forty one children (67 renal units) were included in our study. Patients with preoperative VCUG, urinary ultrasonography, dimercaptosuccinic acid (DMSA) renal scan, and post-operative control VCUG were included in this study. RESULTS: Patients with preoperative VUR grade 1-2 were divided into two groups as “low grade” and patients with stage 3-4-5 as “high grade”. In the general patient population, endoscopic success rates in terms of renal unit deficit were found to be 46.3% (31/67). When the subgroup was analyzed, the endoscopic treatment success rate was 72.2% (13/18) in the low-grade group, versus 36.7% (18/49) in the high-grade group (p = 0.010). In the multivariate logistic regression analysis performed to identify independent predictors of scarring, reflux degree and reflux time were found to be independent predictors of scarring. CONCLUSION: In our study, we found that in VCUG evaluated preoperatively, VUR time as well as VUR grade were effective on endoscopic success rate and scar development. Based on these results, it could be thought that VUR time may be effective in selecting the best candidates for surgery and in the management and timing of treatment of VUR patients.

Epidemiological Profile of Urinary Tract Infections Observed at the Institut Pasteur in Bangui, Central African Republic

The urinary tract is the second most common site of bacterial infection after the respiratory tract. Enterobacteria remain the first cause of urinary tract infections (UTIs), followed by staphylococci and non-fermenter bacteria. Furthermore, bacteria producing extended spectrum beta-lactamases (ESBL) have become more frequent, exposing African patients to therapeutic dead ends. The aim of this study was to determine the epidemiological profile of UTIs diagnosed at the Institut Pasteur in Bangui (IPB), Central African Republic (CAR), a research center that carries out antibiotic sensitivity testing according to international standards. For that, the collected demographic, clinical and biological data come from patients calling at the IPB for a urinalysis and who gave their consent for their data to be included and analyzed in this six-month cross-sectional study (January-June 2019). A total of 412 patients were enrolled in this study. The mean age was 35.2 years [1-80], females made up 55.8% of the study population and the sex ratio was 0.79:1 (M: F). Overall, 117 UTIs were detected, giving a prevalence rate of 28.4%. Of the bacterial isolates, 89.8% (105/117) were enterobacteria, of which 52.4% (55/105) were ESBL-producers. <i>Escherichia coli</i> accounted for more than half of the isolates 55.5% (65/117) and the ESBL-producers 58.2% (32/55). The 0–15-year age group showed the highest incidence of UTIs, but this rate was not significantly different from the other age groups (P = 0.665). Antecedent UTI was not a significant factor in the observed infections. However, female gender, fever, painful urination, acquisition in a healthcare setting and samples collected outside the laboratory were all significantly associated with UTI cases (P<0.005). The high proportion of ESBL-producing bacteria found during this study poses a real potential threat for public health in the CAR. Controlling antibiotic use should thus be a priority for the Ministry of Health.

Awareness of Saudi women about causes of urinary tract infection and its complications in pregnant women in asir region

Background: Urinary tract infection (UTI) is one of the most common infections that occur during pregnancy. It can be symptomatic or asymptomatic and if left untreated, it could lead to maternal and perinatal morbidity and mortality complications. The highest prevalence of UTI in pregnant women is thought to be a result from significant physiological changes occur in the urogenital tract that lead to increasing the potential for pathogenic colonisation. Bladder volume increases and detrusor tone decreases and this will lead to stasis of urine and ascending of infection. In addition, pregnant women develop ureteric dilatation as the result of a combination of progestogenic relaxation of ureteric smooth muscle and pressure from the expanding uterus. Furthermore, this can lead to failure of treatment, recurrent infections, or significant morbidity and mortality with a poor outcome. The bacteria causing urinary infection in pregnancy are many, such as Escherichia coli, Gram-negative bacilli like Proteus mirabilis and Klebsiella pneumoniae. Staphylococcus saprophyticus is the second most frequently cultured uropathogen, 12 while other Gram-positive cocci, such as group B hemolytic streptococci, are less frequently isolated but remain clinically important. Other less common uropathogens include Staphylococcus aureus and Mycobacterium tuberculosis, which can arise through hematological inoculation rather than ascending infection. Nonbacterial causes include Chlamydia species and fungal infections, such as Candida albicans. Aim: The current study aimed to assess the awareness of Saudi women about the causes of UTI and its complications in pregnant women in Asir region, Southern of Saudi Arabia. Methodology: A cross-sectional study enrolled women at Asir region during the study period from Monday Feb 22, 2021–Jul 29, 2021 Data were collected using prestructured online questionnaire using social media platforms. Questionnaire included women bio-demographic data, children number, history of UTI, and awareness regarding UTI and its complications during pregnancy. Results: The study included 1662 Saudi females from Asir region with their ages ranged from 18 to 59 years with a mean age of 27.8 ± 12.4 years old. Majority of study participants (46%; 765) were single. Exact of 66.5% of the study females reported that pregnancy increases the chance of getting UTI. Regarding factors increases the risk of UTI in pregnant women, the most reported by the study females were prolonged retention of urine (72.4%). Also, 53.5% of the females know that the highest risk of getting UTI is at the 3rd trimester. As for complications for a pregnant woman with UTI, nephritis was known among 76.7% of the females. Conclusion: In conclusion, the current study revealed that females' awareness regarding UTI and its related causes and complications is poor in Asir region. Not all females know all risk factors, clinical presentation, or complications of UTI.

Urinary tract infection, antimicrobial susceptibility pattern of isolates, and associated factors among women with a post-fistula at public health facilities, Harar, eastern Ethiopia: A cross-sectional study.

Introduction:Urinary tract infection remains one of the major public health problems among post-fistula patients worldwide, particularly in sub-Saharan Africa. Besides, antimicrobial resistance impedes the effective infection prevention and treatment of ever-increasing bacteria. There was a paucity of data on urinary tract infections and the antimicrobial susceptibility profile of bacteria among post-fistula patients.Objective:To determine the prevalence, antimicrobial susceptibility pattern, and associated factors of urinary tract infections among women with post-fistula attending public health facilities, Harar, eastern Ethiopia.Methods:An institutional-based cross-sectional study was conducted among 146 consecutively enrolled women with post-fistula from February 2017 to December 2018. Risk factors were collected using a structured questionnaire. The midstream urine was collected, cultured and bacteria species were identified by using standard culture methods. Antimicrobial susceptibility testing was done by the disk diffusion technique. The association between independent and outcome variables was computed by using logistic regression analysis. A p-value < 0.05 was considered statistically significant.Results:The prevalence of urinary tract infections was 28.8% (95% confidence interval: 23.4, 33.6). Escherichia coli (19.1%), Pseudomonas aeruginosa (14.3%), and Proteus species (11.9%) were the commonest isolates. E. coli showed (75%) resistance to trimethoprim–sulfamethoxazole, amoxicillin (62.5%), and ciprofloxacin (62.5%). Staphylococcus aureus was shown 80% resistance to amoxicillin and erythromycin. Giving birth to a single baby (adjusted odds ratio: 0.3, 95% confidence interval: 0.1, 0.8), illness by a fistula for less than 3 years (adjusted odds ratio: 0.2, 95% confidence interval: 0.1, 0.6), and lack of a previous history of catheterization (adjusted odds ratio: 0.3, 95% confidence interval: 0.1, 0.9) decrease the odds of having urinary tract infections.Conclusion:Gram-negative organisms were the commonest cause of urinary tract infections in women with post-fistula. E. coli and P. aeruginosa showed higher resistance to most antimicrobials in the panels. Fistula patients need to be screened for urinary tract infections before antimicrobial treatment is indicated.

Prevalence of Quinolone Resistance Genes gyrA and gyrB in Bacteria Isolated from Urinary Tract Infections

Introduction: Antibioticshave significant importance in medicinal drugs but unfortunately bacteria can adapt various resistance mechanisms against those due to their abuse. A frequent way through which nitrate-reducing uropathogens acquire resistance mechanism against fluoroquinolones group of antibiotics is by continuously occurring mutation either in gyrA or gyrB genes through altering enzyme DNA gyrase that help in DNA replication. Microorganisms causing Urinary Tract Infection (UTI) vary in their susceptibility to antimicrobials from place to place and from time to time. Aim: The current study was performed to find the prevalence of nitrate-reducing bacteria in district Kohat and Hangu, their antimicrobial sensitivity pattern to various fluoroquinolones group of antibiotics and detection of mutation in gyrA and gyrB genes in the resistant bacterial isolates. Nitrate-reducing bacteria i.e E.coli, Klebsiella and Proteus are considered to be the frequent cause of UTI that reduce nitrate to nitrite by releasing enzyme nitrate reductase. Methodology: A Total of 252 urine specimens of suspected UTI patients were collected from Districts Head Quarter Hospitals (DHQ) and Combined Military Hospital (CMH) hospitals of districts Kohat and Hangu, Pakistan. Specimens reactive to nitrate strip reduction test were inoculated on (Cysteine Lactose Electrolyte Deficient) CLED media, and incubated at 37°C for 24 hours. Ciprofloxacin, levofloxacin, norfloxacin, ofloxacin and moxifloxacin fluoroquinolones group of antibiotics were used for to check their sensitivity patterns. Result: One hundred and seventy-five (69.44%) urine specimens were positive for nitrate reduction test, including 135 (77.14%) E. coli, 33 (18.85%) Klebsiella and 7 (4.0%) Proteus, verified through biochemical tests. Conclusion: Among the nitrate-reducing bacteria, fifty-one (37.22%) out of 135 E. coli, 9 (27.27 %) out of 33 Klebsiella and 2 (28.57%) out of 7 Proteus were resistant to most of fluoroquinolones group of antibiotics with moxifloxacin being the least resistant while ofloxacin being the most resistant antibiotic Malformed DNA gyrase producing mutated gyrA and gyrB genes were further detected in nitrate-reducing bacteria showing resistant to fluoroquinolones.

Antibiotic Resistance, Biofilm Formation and Sub-Inhibitory Hydrogen Peroxide Stimulation in Uropathogenic Escherichia coli.

Uropathogenic Escherichia coli (UPEC) is the most prevalent cause of urinary tract infections (UTIs). Biofilm formation and antibiotic resistance could be high among the causative agent. The purpose of this study was to determine antibiotic resistance, biofilm production, and biofilm-associated genes, bcsA and csgD, and sub-inhibitory hydrogen peroxide (H2O2) stimulation in UPEC for biofilm formation. A total of 71 UPEC were collected from a tertiary care hospital in Kathmandu and subjected to identify antibiotic susceptibility using Kirby-Bauer disk diffusion. The biofilm formation was assessed using microtiter culture plate method while pellicle formation was tested by a tube method. In representative 15 isolates based on biofilm-forming ability, bcsA and csgD were screened by conventional polymerase chain reaction, and treated with sub-lethal H2O2. The UPEC were found the most susceptible to meropenem (90.2%), and the least to ampicillin (11.3%) in vitro and 90.1% of them were multi-drug resistant (MDR). Most UPEC harbored biofilm-producing ability (97.2%), and could form pellicle at 37°C. Among representative 15 isolates, csgD was detected only among 10 isolates (66.67%) while bcsA gene was present in 13 isolates (86.67%). This study revealed that level of biofilm production elevated after sub-lethal H2O2 treatment (P = .041). These findings suggested that the pathogens are emerging as MDR. The biofilm production is high and the majority of selected strains contained bcsA and csgD genes. Pellicle formation test was suggestive to be an alternative qualitative method to screen biofilm production in UPEC. The sub-inhibitory concentration of H2O2 may contribute in increasing biofilm formation in UPEC.

Cathetar Related Antimicrobial Resistance Pattern in Intensive Care Unit Patients: A Single Centre Study

Background&#x0D; Urinary catheter is the most common cause of urinary tract infection (UTI) which has been associated with three fold increase risk in mortality. A high level of resistance was noted among the admitted patients for cephalosporin. The primary aim of the study is to known the strain of pathogens; its drugs sensitivity and resistance in intensive care unit (ICU) patients which help the physician in proper management and reduces the mortality and morbidity in urinary catheter related complication.&#x0D; Methods&#x0D; This study was conducted in Intensive care unit patients of Hayatabad medical complex Peshawar Pakistan over a period of 1 year from 1st January to 31st December 2019. Medical charts were reviewed and 100 patients were selected based on inclusion criteria and their urine culture and sensitivity reports were noted to know about the most common pathogens, its drugs sensitivity and resistance in these patients. Clinical and Laboratory Standards Institute (CLSI) used for uropathogen by culture and Disc diffusion method to determined antimicrobial susceptibility pattern. The data were shifted from excel sheet to SPPS 21 IBMS version.&#x0D; Results &#x0D; The mean age (standard deviation) of patients was 51.60+26.59 years (Median age 58.50 years). Of the total, 64 were female and the remaining were male patients. It was found that most common pathogens in urine sample was E. coli. Maximum pathogens were sensitive to intra venous meropenem (65%), and fosfomycin (55%).&#x0D; Conclusion&#x0D; It is concluded that resistance patterns of uropathogens changes which results in treatment failure. Further, based on clinical practice, meropenem, fosfomycin, and cefepime had high sensitivity profile against catheter related infection in ICU.

Prevalence and Resistance Patterns of Pediatric Urinary Tract Infections in Bahrain.

BackgroundUrinary tract infections (UTI) are a commonly encountered infection in the pediatric age group. Knowledge of the causative pathogens and their antimicrobial resistance patterns in specific geographical locations is important to provide optimum care. The aim of this study is to describe the prevalence and the antimicrobial resistance patterns of the pathogens causing UTI in the pediatric age group in one tertiary inpatient Pediatric unit in Bahrain.MethodsThis is a retrospective cross-sectional study, conducted at King Hamad University Hospital (KHUH), Bahrain. The inclusion criteria consisted of patients ≤ 14 years of age admitted to the Pediatrics department at KHUH with bacteriologically proven UTI between the months of January 2018 and May 2021. Patients who were identified to have chronic urinary tract conditions or neurodevelopmental problems involving the urinary tract were excluded from the study. Electronic medical records were used to collect data regarding the isolated pathogens and sensitivity testing results.ResultsA total of 242 cases with positive culture were included. The most common bacteria causing UTI in this sample were successively Escherichia coli (68.60%), Klebsiella pneumoniae (10.30%), Proteus mirabilis (4.69%) and Pseudomonas aeruginosa (3.31%) (p<0.01). E. coli was most resistant to cefazolin (94%), followed by ampicillin (62.68%), whilst it was most sensitive to nitrofurantoin (98.96%) followed by amikacin (98.43%) (p<0.01). K. pneumoniae showed the highest rate of resistance to ampicillin (95.24%) followed by cefazolin (83.33%), meanwhile having the highest sensitivity rate to amikacin (95.24%), followed by ciprofloxacin (90.48%). P. mirabilis had the highest resistance to cefazolin (100%) followed by nitrofurantoin (87.50%), while having the highest sensitivity to piperacillin/tazobactam (100%).ConclusionE. coli is the most common cause of UTI in the pediatric population and it was found to be most sensitive to nitrofurantoin and amikacin whilst being relatively resistant to cefazolin and ampicillin. Similarities between our study and previous studies around the world were found when comparing the antibiotics resistance patterns. Nevertheless, it is our recommendation that empirical antibiotic selection should be tailored to the local data collected from the region.

Prevalence and Antibiotic Resistance Pattern of Pathogenic Bacteria Isolated From Urinary Tract Infections in Qal’at Saleh Hospital, Iraq

Background: Antibiotic resistance emerged in the pathogens causing urinary tract infections (UTIs) and became widespread. Moreover, increasing drug resistance has highlighted the need to evaluate the antibiotic resistance pattern to improve experimental treatment. The purpose of this study was to evaluate the bacteria causing UTIs and their susceptibility patterns based on the geographical area. Methods: The present study was conducted on outpatients referred to Qal’at Saleh Hospital in Iraq from January 2018 to January 2019. The pathogenic bacteria were detected using API 20E kit. The antimicrobial susceptibility testing was conducted using the disk diffusion method according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI). Results: Of 216 isolates, 87.9% contained gram-negative bacteria and 12.03% contained gram-positive bacteria. In this study, Escherichia coli was identified as the main cause of UTIs. Of all the isolates, 73.61% were resistant to three or more classes of antibiotics. The antibiotic susceptibility and resistance patterns of all isolates showed that amikacin and ciprofloxacin had the highest activity against gram-negative bacteria and vancomycin, amikacin, and levofloxacin had the highest activity against gram-positive bacteria. Conclusions: Due to the widespread resistance to drugs used in the treatment of UTIs, it is difficult to select the appropriate drugs for treating UTIs. UTI affects different age groups; therefore, sufficient knowledge should be transferred to the community to prevent these infections. If urine culture is unavailable, or it is impossible to wait for antibiotic susceptibility testing, Amikacin and Vancomycin might be the best candidates for UTI treatment.

GENETIC DIVERSITY OF ENTEROCOCCUS FAECALIS ISOLATES FROM CHILDREN WITH URINARY TRACT INFECTION IN PRIMORSKY KRAI OF RUSSIA

Background: Escherichia coli is the most common cause of urinary tract infections (UTI). However, Enterococcus faecalis has been shown to be the most common causative agent of UTI among children and newborns in Primorsky Krai of Russia warranting further research. Aim: To study the occurrence of pathogenicity factor genes in the E. faecalis isolates from children with UTI in the Primorsky Krai of the Russian Far East. Methods: Forty-two E. faecalis clinical isolates from children under the age of 16 with UTI identified in 2013-2017 were studied. Phylogenetic diversity of the strains was assessed by the ultilocus sequence typing. Six genes, namely, cylA, aggA, efaA, eep, gelE, esp were tested in the isolates by polymerase chain reaction . Results: CylA, aggA, efaA, eep, gelE and esp genes occurred in 50.0 %, 80.95 %, 100 %, 100 %, 76.2 % and 71.4 % of the isolates, respectively. Eleven different gene variants were detected for the combination of pathogenicity factor genes. The most common gene variants were (aggA, cylA, efaA, eep, gelE, esp) and (aggA, efaA, eep, gelE). Among the uropathogenic E. faecalis. Fourteen sequence-types were identified (ST6, ST16, ST21, ST25, ST40, ST41, ST64, ST116, ST133, ST151, ST179, ST480, ST537, ST774), with ST179, ST774, ST6 being the most common. Conclusions: The identified diversity of sequence-types indicates the genetic heterogeneity of uropathogenic enterococci isolated in the Primorsky Krai. The detection of a large amount of pathogenicity factors and their combinations causes the predominance of E. faecalis in the region as a clinically relevant etiological agent of UTI among children. The identification of highly virulent sequence types such as E. faecalis ST6, ST179 and ST774 warrants further research to determine the population structure of enterococci.

URINARY TRACT INFECTION IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA ADMITTED FOR PROSTATECTOMY

&nbsp; &nbsp;Urinary Tract Infection (UTI) in patients with Benign Prostatic Hyperplasia (BPH) causes UTI related complication before and after prostatectomy, reduction in their health-related quality of life and overall well-being, thus the knowledge of UTI may play a complementary role in management.The aim of this research was to study the prevalence of urinary tract infection (UTI), its causative organism and antibiotic susceptibility. All BPH patients who were admitted for prostatectomy were included to the study. Information on age, presence of an indwelling catheter, other factors related to UTI and antibiotic susceptibility results were obtained and analyzed using IBM SPSS version 26. Three hundred twenty six patients were studied. The age range of study participants was 51 to 89 years and displayed a median of 70 year (IQR=12). More than half of study participants 168 (51.5%) were between 61 to 70 years. Bacterial isolates were noted in 96 (29.4%) patients. Escherichia Coli noted in (25.3%) specimens was the most common organism isolated. The bacterial isolates were mostly sensitive to imipenem, meropenem, and fosfomycin, but showed greater resistance to cefotaxime, ceftazideme and cefazulin accordingly. The age of study participants was significantly greater for those who had bacteriuria (Mdn = 70) years than those who did not have bacteriuria (Mdn = 67), U = 9569, P = 0.048. The same it was significant for PSA level (P = 0.000) but were not significant for prostate size (P = 0.558). Less than one third of BPH patients had UTI (29.4%), E. Coli was the most common microbial cause of UTI in study participants it was the cause in one fourth of cases (25%), Imipenem group of antibiotic was the most sensitive antibiotics in study participants (93.9%), Cefotaxime was the most resistant antibiotics (66.7%)