Cause Of Urinary Tract Infections Research Articles

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

Background
 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.
 Methods
 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.
 Results 
 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%).
 Conclusion
 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%)

Fungal Urinary Tract Infection; A Study Conducted On Patients With Liver Cirrhosis

Objective: To determine frequency of fungal infection of urinary tract in patients with liver cirrhosis Design &amp; duration: This is a cross sectional study. This study was completed in duration of six months. Setting: Study was conducted in Margalla Hospital Gulshan Colony PMO, Taxila. Patients &amp; Methods: Patients admitted in study hospital with liver cirrhosis having child class A, B and C were evaluated for fungal urinary tract infection, belonging to any gender, having age above 40 years. All data was documented and analyzed using SPSS software version-20 and means, frequencies, standard deviation and p-value were calculated. Results presented in the form of tables and graphs. Results: Total 400 cases were evaluated for fungal urinary tract infection having liver cirrhosis admitted in study hospital in given duration of study. Fungal cause of UTI was found in 260 cases including 29.3% male and 70.7% female cases. While other causes were found in 140 cases. According to child classification out of 260 cases with fungal UTI, 11 cases were in class B and 249 cases were in class-C while no case belonged to class-A. Most of the cases (42%) with UTI were in age interval of 40-50 years. Duration of CLD was 2-4 years in most of the cases (30%). Conclusion: Fungal cause of urinary tract infection is very common among patients with liver cirrhosis and older age as these cases have week immunity Key words: Liver cirrhosis, chronic liver disease, urinary tract infection, fungal infection, immunocompromised

Antimicrobial Susceptibilities of Urinary Extended-spectrum β-lactamase Escherichia coli to Fosfomycin.

ObjectivesEscherichia coli (E. coli)-induced urinary tract infection (UTI) is a common infection associated with frequent use of antibiotics and the increase in global antibiotic resistances. We aimed to determine the susceptibility profile of extended-spectrum β-lactamase (ESBL) producing E. coli isolated from the urinary samples to fosfomycin and other antibiotics.MethodsWe retrospectively analyzed urine samples with ESBL-producing E. coli isolates obtained between January 2018 and December 2019 in the Microbiology Section, Salmaniya Medical Complex, Bahrain. We collected and analyzed all the E. coli urinary isolates’ data and their antibiotic susceptibility patterns.ResultsThe study included 3044 E. coli isolates with 50.6% obtained in 2018 and 49.4% in 2019; 38.1% (1161 isolates) were ESBL E. coli, and 0.7% (21 isolates) were carbapenem-resistant Enterobacteriaceae (CRE). There were 1161 (38.1%) isolates with ESBL-producing E. coli, with 37.3% isolated in 2018 and 39.0% isolated in 2019. The antibiotic susceptibility of ESBL-producing E. coli during the study period showed susceptibility to trimethoprim/sulfamethoxazole in 46.1% of isolates (50.2% in 2018 dropped to 41.9% in 2019), to ciprofloxacin in 49.0% of isolates (49.5% in 2018 dropped to 48.4% in 2019), to nitrofurantoin in 91.8% of isolates (94.3 in 2018 dropped to 89.3% in 2019), and to fosfomycin in 97.6% of isolates (98.8% in 2018 dropped to 96.3% in 2019).ConclusionsESBL-producing E. coli is an important cause of UTI in Bahrain. Fosfomycin is a very effective oral antimicrobial that retains high efficacy against ESBL-producing E. coli, which helps decrease the need for parenteral therapy and, consequently, hospitalization.

Coagulase-negative Staphylococci: a rare cause of urinary tract infections in children with consequences on clinical practice.

Isolation of coagulase-negative Staphylococci (CoNS) in urine cultures of children is usually considered a contamination of the sample, except for Staphylococcus saprophyticus in older children. The aim of this study was to describe the characteristics of children in whom CoNS was considered a true urinary pathogen. The medical records of all children aged 0 to 18years at Shaare Zedek Medical Center between 2013 and 2020 who were diagnosed with CoNS urinary tract infection (UTI) were reviewed for demographic, clinical, and laboratory data. CoNS were identified as the causative organism of UTIs in 30 children, none of whom was bacteremic. Male sex, younger age, and infection with non-S. saprophyticus CoNS were associated with higher risk of pyelonephritis in comparison to cystitis. Eleven (37%) children had previously known or newly diagnosed underlying urinary tract abnormalities. All patients recovered. CoNS were found to be an uncommon urinary pathogen among children but can cause pyelonephritis, especially in young children and in males.Conclusion: The finding of CoNS pyelonephritis requires thorough search for urinary abnormalities.

Frequency of bla CTX-M and bla TEM Virulence Genes and Antibiotic Resistance Profiles among Klebsiella pneumoniae Isolates in Urinary Tract Infection (UTI) Samples from Hashtgerd, Iran.

Klebsiella pneumoniae (K. pneumoniae) is an opportunistic microorganism and one of the most important causes of urinary tract infection. This study aimed to evaluate the frequency of K. pneumoniae producing broad-spectrum beta-lactamase in urinary tract infection and to determine the pattern of drug resistance. This study was performed on 50 samples of K. pneumoniae isolated from patients with urinary tract infection referred to the Medical Diagnostic Laboratory in Hashtgerd city. The isolates were first evaluated for antibiotic susceptibility by disk diffusion method according to the method proposed by the Clinical and Laboratory Standards Institute (CLSI). Then phenotypic detection of ESBLS was carried out by the DDST method. The frequency of gene bla TEM and bla CTX-M was determined by PCR. The highest resistance was observed to ampicillin (94%) and the highest sensitivity was observed to gentamicin (84%). 22 isolates (44%) were positive for ESBLs production. Of the 50 isolates studied, 34% had bla CTX-M and 28% had bla TEM and 11 (22%) had both genes simultaneously. Also, more than 77% of positive ESBLs isolates had the bla CTX-M gene and approximately 63.64% of positive ESBLs isolates had the bla TEM gene. Given the high prevalence of antibiotic-resistant and ESBL-producing isolates, early identification of these resistant isolates and their follow-up is essential to prevent further outbreaks. It is also important to use appropriate therapeutic strategies and proper and rational administration of antibiotics by physicians.

Urinary Tract Infection – A Review on Its Prevalence and Recent Advances

The Urinary Tract Infection (UTI) is a seasonal infection prevalent in coastal areas whose intensity varies among various age groups. Escherichia coli is one of the major causative organisms. The current study is to the frequency of UTI in the Coastal region; understand the recent advances in alternative treatment &amp; their efficacy. The known medication for the UTI is quinolones and cephalosporin. Cranberry extract is the only medicine used from a plant source that is expensive and not native to India. The main cause of UTI to spread is a lack of hygiene, sexual intercourse, and inadequate consumption of water. Change in the pH of the urethra during puberty &amp; menopause in women facilitates the growth of opportunistic Uropathogens. Innate immunity can also contribute to the resistance of the body but a recent study says that infection rate varies among individuals considering their age, immunity, and lifestyle. The pathogens causing UTI are developing resistance against multiple drugs. From this study, we understand that Cranberry is the only plant source for the treatment of UTI in combination with antibiotics. There is a need to understand the importance of improving innate immunity and to know the best treatment regime to treat UTI.

Capture and Electrochemical Detection of Pathogenic E. coli

Pathogenic E. coli are a significant threat both as a foodborne pathogen and a leading cause of urinary tract infections. Conventional methods to detect these microbes require centralized laboratory facilities and specialized equipment, as well as hours to days to complete. We have developed a sensitive electrochemical sensor to covalently capture, detect, and quantify viable pathogenic E. coli from complex matrices with a detection limit of 12 CFU/mL and a linear range of detection up to 107 CFU/mL. The technology enables quantification within two hours on disposable electrodes, even from milk and artificial urine. Endogenous E. coli were successfully detected from commonly-contaminated samples, including eggs, raw chicken, spinach, and romaine lettuce, in addition to an infected urine sample. The E. coli quantification tracked well with the current gold-standard of colony counting. This platform represents a major step in the development of field-deployable sensors to detect these dangerous microbes.

Molecular Detection of Ampicillin Resistant Genes in E. coli Isolates from ‎Dogs in India

The most common cause of urinary tract infection in dogs is uropathogenic Escherichia coli (UPEC). This condition often presents with vaginal discharge, dribbling of urine, straining or vocalization while urinating due to pain. Furthermore, the following signs are also noticeable: hematuria, lethargy, proteinuria, dysuria, cystitis, and oliguria. The aim of this research was to investigate the genes of ampicillin resistance in E. coli isolates from dogs with urinary tract infections. Out of 103 urine samples cultured (Blood agar, MacConkey’s lactose agar and Eosin methylene blue agar), 24.3% were positive for uropathogenic Escherichia coli. The positive isolates were further subjected to antimicrobial sensitivity test and PCR analysis. All the uropathogenic Escherichia coli isolates were resistant to ampicillin while 96% were resistant to Cloxacillin and Oxytetracycline. Susceptibility to Meropenem, Gentamicin and Amikacin were 64 %, 44 % and 40% respectively. All the 25 strains of the E. coli were identified to be resistant to two or more antibiotics. The PCR result showed the presence of blaAMPC in all the samples and 60 % had blaTEM genes responsible for ampicillin resistance. However, none of the isolates were positive for the blaSHV gene.The presence of the blaAMPC and blaTEM genes in the dogs studied resulted in ampicillin resistance, with blaAMPC being the most commonly detected ampicillin gene in Escherichia coli in the study area. Meropenem was also found to be a good choice for treating uropathogenic E. coli infection in dogs.

Virulence and Resistance Characterization of Staphylococci-associated Urinary Tract Infection in Pregnant Women in Lagos, Nigeria

Background: Urinary Tract Infection (UTI) is the most prevalent bacterial infection in developing countries. UTI is sometimes asymptomatic. The occurrence of UTI in pregnancy can result in complications such as premature or low-birth-weight babies. Escherichia coli is the most common cause of UTI followed by Staphylococci species. However, E.coli associated UTI has been well studied while there is paucity of data on the virulence and resistance of Staphylococci-associated UTIs in women. This study aimed to characterize the virulence and resistance genes in Staphylococci species isolated from the urine of pregnant women. Methods: This was a cross-sectional study involving pregnant women attending ante-natal clinic in Lagos State, Nigeria. Clean catch midstream urine specimens were collected from the women and cultured on appropriate agar. Bacteria were identified using both biochemical and molecular methods and evaluated for resistance to antibiotics. Polymerase chain reaction was used to detect the mecA and blaZ resistance genes and the PVL and TSST virulence genes. Results: Staphylococci species were isolated from 21 (26.25%) of the 80 urine samples of which 7 (29%) were Staphylococcus aureus and 17 (71%) coagulase-negative staphylococcus (CoNS). S. epidermidis and S. saprophyticus were the most commonly isolated CoNS. All the isolates tested were resistant to cotrimoxazole, cloxacillin, erythromycin, ampicillin, amoxicillin-clavulanate, and tetracycline. Both blaZ and the mecA genes were detected in the isolates that were phenotypically susceptible to methicillin and cefoxitin. There was an occurrence of the mecA, blaZ and PVL genes in S. saprophyticus in patients who were co-infected with S. aureus. Conclusion: UTI caused by Staphylococci is common among pregnant women. There is a need to consider staphylococcal associated UTI screening in both symptomatic and asymptomatic cases of UTI in pregnant women.

CHILDHOOD URINARY TRACT INFECTION: CLINICAL SIGNS, BACTERIAL CAUSES AND ANTIBIOTIC SUSCEPTIBILITY

Background and objective: Urinary tract infections (UTIs) are the neglected infection in children from the side of study its clinical symptoms, causative organisms and their antibiotic sensitivity. This investigation searches for determine clinical symptoms frequency, prevalence rate, bacterial features, and antibiotic sensitivity of bacterial urinary tract infection in children attending private children’s health center in Sana’a city. Methods: In a prospective study carried out over a 24-month period, 1925 samples from children patients suspected of having a UTI were investigated, of which 175 were culture-positive. Clinical and demographic data were collected. Isolated bacteria were identified by standard tests, and antibiotic susceptibility was performed by the disk diffusion method. Results: Fever was the most frequent symptom that occurred (88%) while other UTI symptoms were less frequent than that reported in adult patients for UTI. The most common etiological agent was Escherichia coli (89.7%), followed Staphylococcus aureus (3.4%), Klebsiella spp (2.9%), Proteus spp (2.3%), and beta haemolytic streptococci (1.7%). Results of antimicrobial resistant for E. coli, as the most prevalent cause of UTI, to commonly used antibiotics are ranged from less than 3% for levofloxacin, gentamicin, amikacin and cefoxitin to more than 75% for tetracycline, nalidixic acid, doxycycline, co-trimoxazol and amoxicillin . Conclusions: The results show the most common symptom of UTI are fever and lack of more obvious symptoms of UTI in adult patients. The antimicrobial resistance patterns of the causes of UTI are highly changeable and constant surveillance of trends in resistance patterns of uropathogens among children is essential. Peer Review History: Received: 11 July 2021; Revised: 13 August; Accepted: 5 September, Available online: 15 September 2021 Academic Editor: Ahmad Najib, Universitas Muslim Indonesia, Makassar, Indonesia, ahmad.najib@umi.ac.id UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. Nuray Arı, Ankara University, Turkiye, ari@ankara.edu.tr Dr. Salfarina Ramli, Department of Pharmacology and Pharmaceutical Chemistry, Faculty of Pharmacy, Universiti Teknologi MARA, 42300 Puncak Alam, Selangor, Malaysia. salfarina2892@uitm.edu.my Dr. Wadhah Hassan Ali Edrees, Hajja University, Yemen, edress2020@gmail.com Dr. Asia Selman Abdullah, University of Basrah, Iraq, asia_abdullah65@yahoo.com Similar Articles: URINARY TRACT INFECTIONS IN POST OPERATIVE PATIENTS: PREVALENCE RATE, BACTERIAL PROFILE, ANTIBIOTIC SENSITIVITY AND SPECIFIC RISK FACTORS BIOFILM FORMATION AND ANTIBIOTIC SUSCEPTIBILITY OF UROPATHOGENS IN PATIENTS WITH CATHETER ASSOCIATED URINARY TRACT INFECTIONS IN IBB CITY -YEMEN

Detection of extended-spectrum beta-lactamase genes among Escherichia coli isolates from urinary tract infection in Mashhad

Urinary tract infections (UTIs) are known as one of the most important infections around the world, and Escherichia coli is the most important cause of UTI. Also, the empiric treatment and misusing of antimicrobial agents has led to increasing multi-drug resistance around the world which is a worldwide concern. Extended-spectrum beta-lactamase (ESBLs) is an enzyme group that is produced by the Enterobacteriaceae family. The three main ESBLs enzyme are as follow: bla CTX-M , bla TEM , and bla SHV , additionally, there are several types of each of them by the same mechanism. This study was conducted to evaluate the prevalence of ESBL genes among E. coli isolated from UTI patients. A total of 105 isolates were collected from UTI patients at two hospitals in Mashhad from 2017 to 2019. Bacterial identification was performed by standard microbiologic methods. The assessment of antimicrobial susceptibility was accomplished by the disk diffusion method. The presence of ESBL genes was investigated by multiplex-PCR. The prevalence of UTI, among females, was identified more than males. Furthermore, the bla TEM and bla CTX-M genes were detected in all isolates, but only six isolates (5.7%) were harboring bla SHV . The considerable role of E. coli in UTI infection, as well as the presence of ESBL genes in E. coli strains, emphasize the need for surveillance of antimicrobial therapy to prevent the extension of resistance among clinical strains.

Incidence And Characteristics Of Urinary Tract Infections Among Febrile Children In Early Childhood

Introduction: Fever is the most common cause for concern for parents and a reason to seek help from a GP or emergency centers. The high temperature in children in most cases is short-lived and is a protective reaction that stops or slows down the development of many microorganisms, stimulates the immune response, and provides rest to the sick child. Negative effects are dehydration, hypovolemia, hyperthermic seizures in childhood, hypotension to collapse. Urinary tract infections (UTIs) can occur only with fever or with fever and non-specific symptoms such as malaise, vomiting, abdominal pain, and jaundice. Antibiotic treatment for fever without a proven cause may mask an existing urinary tract infection. Aim : The aim of this article is to review the scientific literature for a period of 40 years on the incidence of UTIs in infancy and early childhood in children with fever. Methods: Analysis of Bulgarian and foreign literature sources according to the PubMed and Google Scholar databases for a period of 40 years has been conducted. Results: The analysis of the data from the scientific literature showed that the frequency of UTI varies depending on gender and age. In most studies, the incidence of UTI in febrile children under 24 months of age, both sexes, with or without additional symptoms of UTI, was between 5% and 15%. In boys, the prevalence is highest in the first 3 months of life and then shows a declining trend, while in girls the prevalence is highest in the first 12 months of life. There is evidence in the literature that fever (rectal temperature ≥ 39°C) and uncircumcised status are more likely to be linked to UTI in boys. E. coli is the most common bacterial infection in early childhood and is the leading cause of UTI in this age group. Conclusion : The GP needs to make efforts to educate parents on the diagnosis, consequences and appropriate treatment of obscure febrile conditions, and UTI should be excluded. It is necessary to pay attention to the method of measuring the temperature, the differences in the values in the different measuring points. In this aspect, the GP should perform an in-depth analysis for early diagnosis of UTI in all boys under 12 months of age and girls under 24 months of age with unexplained fever, temperature above ≥ 38°C measured rectally for 3 minutes.

OXA-48 Carbapenemase-Encoding Transferable Plasmids of Klebsiella pneumoniae Recovered from Egyptian Patients Suffering from Complicated Urinary Tract Infections.

Simple SummaryGram-negative bacteria are common causes of urinary tract infections (UTIs), some of which can resist treatment by antibiotics, including carbapenems, which are last resort treatment options. This study aimed to report the resistance of some Gram-negative bacteria causing complicated UTIs to carbapenems at two important hospitals in Cairo, Egypt, and to determine the possible transfer of this resistance to other bacterial species. The collected bacteria were tested for antibiotic resistance and detection of the genes responsible for this resistance. A total of 256 Gram-negative bacterial clinical isolates were collected, 65 (25.4%) of which showed carbapenem resistance. The detected carbapenem resistance genes were blaOXA-48, blaVIM, blaKPC, and blaNDM genes. The blaOXA-48, among other genes, was successfully transferred to a previously susceptible bacteria, making it resistant. The study concluded that the rate of carbapenem resistance among Gram-negative bacteria causing UTIs in Cairo, Egypt is relatively high and can be transferred among bacterial hosts.Gram-negative bacteria are common causes of urinary tract infections (UTIs). Such pathogens can acquire genes encoding multiple mechanisms of antimicrobial resistance, including carbapenem resistance. The aim of this study was to detect the carbapenemase-producing ability of some Gram-negative bacterial isolates from urine specimens of patients suffering from complicated UTIs at two vital tertiary care hospitals in Cairo, Egypt; to determine the prevalence of carbapenemase genes among plasmid-bearing isolates; and explore the possibility of horizontal gene transfer to other bacterial species. The collected isolates were subjected to antimicrobial susceptibility testing, phenotypic analysis of carbapenemase production, and molecular detection of plasmid-borne carbapenemase genes, then the extracted plasmids were transformed into competent E. coli DH5α. A total of 256 Gram-negative bacterial clinical isolates were collected, 65 (25.4%) isolates showed carbapenem resistance of which 36 (55.4%) were carbapenemase-producers, and of these 31 (47.7%) harbored plasmids. The extracted plasmids were used as templates for PCR amplification of blaKPC, blaNDM, blaVIM, blaOXA-48, and blaIMP carbapenemase genes. The blaOXA-48 gene was detected in 24 (77.4%) of the tested isolates while blaVIM gene was detected in 8 (25.8%), both blaKPC and blaNDM genes were co-present in 1 (3.2%) isolate. Plasmids carrying the blaOXA-48 gene from 4 K. pneumoniae clinical isolates were successfully transformed into competent E. coli DH5α. The transformants were carbapenemase-producers and acquired resistance to some of the tested antimicrobial agents as compared to untransformed E. coli DH5α. The study concluded that the rate of carbapenem resistance among Gram-negative bacterial uropathogens in Cairo, Egypt is relatively high and can be transferred horizontally to other bacterial host(s).

Characteristics of Women with Urinary Tract Infection in Pregnancy.

Background: Urinary tract infection (UTI) is the most common bacterial infection in pregnancy. Known risk factors for UTI in pregnancy include diabetes and certain urologic conditions. Other maternal characteristics might also be associated with risk and could provide clues to the etiology of UTI in pregnancy. Our objective was to identify maternal characteristics associated with UTI in pregnancy. Materials and Methods: We used data from pregnant women participating in the National Birth Defects Prevention Study, a population-based study of risk factors for major structural birth defects in 10 U.S. sites, from 1997 to 2011. In cross-sectional analyses, we used multivariable log-binomial regression to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for associations between self-reported maternal characteristics and UTI in pregnancy. Results: In our sample of 41,869 women, the overall prevalence of reported UTI in pregnancy was 18%, but ranged from 11% to 26% between study sites. In adjusted models, diabetes was moderately associated with higher UTI prevalence (PR 1.39, 95% CI: 1.24-1.57). Higher UTI prevalence was associated even more strongly with low educational attainment (PR 2.06, 95% CI: 1.77-2.40 for some high school vs. graduate school), low household income (PR 1.64, 95% CI: 1.46-1.84 for <$10,000 vs. ≥$50,000), and race/ethnicity (PR 1.45, 95% CI: 1.13-1.80 for American Indian or Alaska Native vs. White women). Conclusions: About one in six women reported UTI in pregnancy but the prevalence varied markedly by geography and maternal characteristics. This variability could provide clues to the causes of UTI in pregnancy.

Microbiological profile and antimicrobial susceptibility pattern among patients with urinary tract infection in northern Tanzania

Background: Urinary tract infection (UTI) is the most common bacterial infection, it causes morbidity as well as financial burden. There is a role of empirical treatment of UTI while awaiting urine culture and sensitivity result. The type of empirical antibiotics given varies from place to place depending on susceptibility pattern of the particular area. According to Tanzania standard treatment guidelines and essential medicine list of 2013, cystitis in adult is treated by ciprofloxacin while pregnant women and children are treated by amoxicillin/clavulanate. In case of pyelonephritis, women of reproductive age who does not require referral are treated by ciprofloxacin while all other cases that fulfill criteria for referral are given single dose of ceftriaxone before referral. However, most studies have shown increasing resistance to commonly used antibiotics as a result of misuse and overuse. The study aimed at describing the microbiological profile and susceptibility pattern among patients with UTI at KCMC. Methods: This was a seven-month hospital based descriptive, cross-sectional study conducted from June 2016 to December 2016 by using structured data extraction sheet. Data analysis was performed using SPSS after cleaning and checking for error(s). Results: A total of 270 samples that tested positive for UTI were analyzed. Majority 233(86.3%) of the sample were obtained from male subjects, age of study subjects ranged from 1-94 years with the median of 64 years. Majority 235 (87%) of the sample came from urology department with E. coli being most common cause of UTI (39.3%), followed by Klebsiella spp, 20%. E. coli demonstrated high sensitivity against amikacin, ceftazidime and Nitrofurantoin Conclusion: The commonest cause of UTI in our set up is E. coli that showed high resistance against most commonly used antibiotics in our setting.

Frequency of hlyA, hlyB, hlyC and hlyD genes in uropathogenic Escherichia coli isolated from UTI patients in Shiraz.

Background and objectives: One of the most important causes of urinary tract infections (UTI) is Escherichia coli. The infection is mainly due to the uropathogenic strain (UPEC), which has key virulence factors, including hemolysis. In this study, we evaluated the frequency of hlyA, hlyB, hlyC and hlyD genes in UPEC strains isolated from clinical samples from Shiraz city, Iran.Materials and methods: 130 urine samples with suspected UTI were collected from Shiraz medical centers and cultured on blood agar and EMB media. Colonies were then characterized by biochemical methods. The genomes were extracted and the presence of hemolysis genes was detected by polymerase chain reaction (PCR) using hly gene specific primers and 16S rRNA. Drug resistance was assessed by using 10 antibiotic disks in the disk diffusion method, according to CLSI criteria.Results: Out of the 130 collected UTI samples, 100 were identified as UPECs. Within isolates, the hlyD gene had the highest frequency – 95% – and hlyC had the lowest, with 23%. The frequencies of hlyA and hlyB genes were calculated as 50% and 43%, respectively. The rates of antibiotic resistance to Azithromycin, Ampicillin, Cefotaxime, Nalidixic Acid, Tetracycline, Trimethoprim-Sulfamethoxazole, Cefepime, Aztreonam, Gentamicin, and Nitrofurantoin were 95%, 86%, 68%, 66%, 65%, 64%, 51%, 46%, 44%, 14%, respectively. 98% of these isolates belonged to the MDR group.Conclusion: This study shows diversity of hemolysis virulence factor in UPECs and unique UPEC drug resistance that would indicate a high antibiotic use in the general population.